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The goals of the study were to (a) examine teacher-reported acceptability of a daily report card (DRC) intervention for a student in their classroom prior to and during implementation; (b) examine factors that predict acceptability; and (c) explore the relations between teacher-reported acceptability, student and teacher characteristics prior to implementation, implementation integrity (treatment dose, adherence, and teacher competence), and student outcomes. Participants were 39 elementary school teachers and 39 students with or at risk of attention-deficit hyperactivity disorder (ADHD). Teachers were asked to implement the DRC for up to 16 weeks with consultation support provided by research team staff every other week. Teachers completed acceptability ratings about the DRC prior to and after two months of implementation. This multi-method assessment using correlation and regression analyses revealed that although acceptability ratings prior to implementation were related to teacher knowledge of ADHD, they were was not related to acceptability ratings during implementation, integrity, or student outcomes. Student’s initial positive response to the intervention (i.e., the magnitude of improvement in DRC target behaviors) was associated with higher acceptability ratings during the intervention. Greater increases in acceptability over time were associated with greater DRC dose (i.e., teacher compliance to procedures and longer DRC duration). Greater duration of implementation and responding appropriately to rule violations were associated with greater student achievement of DRC goals. Implications for interpreting acceptability ratings and for understanding factors related to implementation and outcomes are discussed.

Objective: Social and academic functioning are linked in elementary school, and both are frequently impaired in children with elevated symptoms of attention-deficit/hyperactivity disorder (ADHD). This study evaluated the Making Socially Accepting Inclusive Classrooms (MOSAIC) program, a classroom intervention to support children's social and academic functioning, especially for children at risk for ADHD. Teachers delivered MOSAIC practices to the whole class and applied some strategies more frequently to target children selected for elevated ADHD symptoms and peer impairment.Method: Participants were 34 general education teachers (grades K-5) and 558 children in their classrooms, randomized to MOSAIC or to a typical practice control group for one academic year. In the fall and spring, we assessed (a) peers' sociometric judgments of children, (b) children's self-report of supportive relationships with teachers and peers, and (c) teachers' report of children's social and academic competencies and impairments.Results: Regarding whole class effects, relative to control group children, children in MOSAIC classrooms (target and non-target children) were rated by teachers in spring as having better competencies and lower impairment, after controlling for fall functioning. There were no main effects of MOSAIC on peer sociometrics or child perceptions of supportive relationships. Target status moderated some effects such that, in spring, target children in MOSAIC perceived greater support from their teachers but received poorer sociometrics than did target children in control classrooms.Conclusions: We discuss the difficulty in changing peers' perceptions of children with ADHD symptoms, even in the presence of improvements in other aspects of social and academic functioning.

Establishing a positive peer climate in the elementary school classroom is an important goal for educators. This pilot study examined if children’s liking and disliking of their classroom peers are predicted by teachers’ use of practices designed to address child disruptive behaviors that are off-putting to peers, and practices designed to enhance peer inclusivity. Whereas teacher practices to foster good peer relationships are useful for all students, they are particularly important for those with attention-deficit/hyperactivity disorder (ADHD) symptoms, as these children are often poorly regarded by classmates. Thus, we explored the moderating effect of child ADHD symptom status. Participants were 194 children (grades K-4) in the classrooms of 12 teachers. The teachers were helping our study team revise the Making Socially Accepting Inclusive Classrooms (MOSAIC) program for use in general education classrooms. The MOSAIC program contains a set of teacher strategies to encourage students’ increased liking and decreased disliking of one another, which was measured by sociometric ratings. Teachers’ use of MOSAIC strategies was observed and self-reported over a school year. Results indicated that teacher practices designed to improve children’s classroom behaviors, as well as practices that encouraged peers to be more inclusive, each predicted children receiving better sociometric ratings at the end of the year after accounting for ratings at the beginning of the year. Some practices appeared uniquely efficacious for children with elevated ADHD symptoms, whereas others were useful for all children but had accentuated benefits for typical children. Implications for practitioners are discussed.

The Academic Competence Evaluation Scales (ACES; DiPerna and Elliott in School Psychol Rev 31(3):293, 2002) is a 73-item teacher rating scale that assesses academic skills and enablers. The ACES Short Form (ASF) is a newly extracted 32-item short form of the ACES that has promising psychometric properties (Anthony and DiPerna in School Psychol Q 32(4):552, 2017; School Mental Health 10(3):314–321, 2018). The goals of this study were to examine the factor structure and extend the psychometric assessment of three subscales of the ASF (interpersonal skills, motivation, and engagement) with an independent sample. Participants were 193 students (63.2% White; 46.1% female) in grades K through 4, in the classrooms of 12 teachers. Teachers completed three subscales of the ACES and reported on student inattention, hyperactivity/impulsivity, social functioning, and academic functioning. We also obtained parent and peer assessments of student social functioning. Results corroborated the factor structure found by Anthony and DiPerna (School Mental Health 10(3):314–321, 2018) and the high internal consistency (α’s > .90; ω’s > .80) of the three subscales. In an extension of previous work, correlations with parent, peer, and teacher report on other measures provided evidence for convergent and divergent validity of the three ASF subscales. ASF scores also differed significantly for students with and without academic, behavioral, and social difficulties, in a manner similar to that of the ACES. These findings, along with those of Anthony and DiPerna (School Psychol Q 32(4):552, 2017; School Mental Health 10(3):314–321, 2018), provide evidence that the subscales of ASF, although substantially shorter than the respective subscales of the ACES, retain the strong psychometric properties and clinical utility of the full-length measure.

Importance Measurement-based care (MBC) is the systematic evaluation of patient symptoms before or during an encounter to inform behavioral health treatment. Despite MBC’s demonstrated ability to enhance usual care by expediting improvements and rapidly detecting patients whose health would otherwise deteriorate, it is underused, with typically less than 20% of behavioral health practitioners integrating it into their practice. This narrative review addresses definitional issues, offers a concrete and evaluable operationalization of MBC fidelity, and summarizes the evidence base and utility of MBC. It also synthesizes the extant literature’s characterization of barriers to and strategies for supporting MBC implementation, sustainment, and scale-up. Observations Barriers to implementing MBC occur at multiple levels: patient (eg, concerns about confidentiality breach), practitioner (eg, beliefs that measures are no better than clinical judgment), organization (eg, no resources for training), and system (eg, competing requirements). Implementation science—the study of methods to integrate evidence-based practices such as MBC into routine care—offers strategies to address barriers. These strategies include using measurement feedback systems, leveraging local champions, forming learning collaboratives, training leadership, improving expert consultation with clinical staff, and generating incentives. Conclusions and Relevance This narrative review, informed by implementation science, offers a 10-point research agenda to improve the integration of MBC into clinical practice: (1) harmonize terminology and specify MBC’s core components; (2) develop criterion standard methods for monitoring fidelity and reporting quality of implementation; (3) develop algorithms for MBC to guide psychotherapy; (4) test putative mechanisms of change, particularly for psychotherapy; (5) develop brief and psychometrically strong measures for use in combination; (6) assess the critical timing of administration needed to optimize patient outcomes; (7) streamline measurement feedback systems to include only key ingredients and enhance electronic health record interoperability; (8) identify discrete strategies to support implementation; (9) make evidence-based policy decisions; and (10) align reimbursement structures.

Objective Although tailored implementation methods are touted as superior to standardized, few researchers have directly compared the two and little guidance regarding the specific details of each method exist. Our study compares these methods in a dynamic cluster randomized trial seeking to optimize implementation of measurement based care (MBC) for depression in community behavioral health. This specific manuscript provides a detailed, replicable account of the components of each multi-faceted implementation method. Results The standardized best practice method includes training, consultation, a clinical guideline, and electronic health record enhancements with the goal to optimize the delivery of MBC with fidelity. Conversely, the tailored, customized and collaborative method is informed by recent implementation science advancements and begins with a needs assessment, followed by tailored training that feeds back barriers data to clinicians, the formation of an implementation team, a clinician-driven clinic-specific guideline, and the use of fidelity data to inform implementation team activities; the goal of the tailored condition is to ensure the intervention and implementation strategies address unique factors of the context. The description of these methods will inform others seeking to implement MBC, as well as those planning to use standardized or tailored implementation methods for interventions beyond behavioral health. Electronic supplementary material The online version of this article (10.1186/s13104-018-3193-0) contains supplementary material, which is available to authorized users.