This pilot feasibility trial is designed to evaluate an adapted Learning Collaborative (LC) as an implementation strategy to support delivery of the Supporting Transition Resilience of Newcomer Groups (STRONG) intervention in school settings serving newcomer youth. The LC will support bilingual school-based mental health providers delivering STRONG, a group-based, school-delivered behavioral intervention targeting stress, anxiety, depressive symptoms, and externalizing behaviors among newcomer middle school students. STRONG will be facilitated by bilingual providers with participating students and their caregivers completing pre- and post-intervention surveys assessing youth emotional and behavioral well-being. The primary aim is to assess the feasibility, acceptability, and appropriateness of the LC for supporting school-based implementation of STRONG, with feasibility measured by participation in LC activities and completion of implementation supports, and acceptability and appropriateness assessed through provider and leader feedback. Secondary aims include examining whether provider and school leader engagement in LC activities is associated with STRONG implementation fidelity and youth outcomes, and exploring potential mechanisms linking LC engagement to fidelity, including provider self-efficacy, leadership support, and team psychological safety. School-based providers and school leaders (e.g., principals and superintendents) will participate in LC activities focused on shared learning, collaboration, and implementation problem-solving, along with ongoing supports such as structured team support calls, Plan-Do-Study-Act (PDSA) cycles, and feedback forms during STRONG implementation cycles.
(a) over 18 years old;
(b) district-level or school-level staff who manage and oversee operations and may have some decision-making power; district examples are superintendents and directors, and school examples are principals, vice principals, and directors.
(a) over 18 years old;
(b) mental health clinicians or school staff who regularly interact with newcomer students;
None
Single group
STRONG
BehavioralSupporting Transition Resilience of Newcomer Groups (STRONG) is a school-based group intervention for anxiety, depression, and externalizing symptoms in newcomer youth. STRONG is an evidence-based treatment and has been translated in 6 languages. Newcomer youth will be receiving the STRONG intervention, which will be administered by school mental health providers. STRONG is a 10-week intervention, with one individual session with each newcomer student, a caregiver/parent session, and a teacher session if available. STRONG is strengths based, teaches newcomers coping skills, draws from cognitive behavioral therapy and because it is a group intervention, it helps facilitate social connectedness among newcomers.
Learning Collaborative
BehavioralA 12-month Learning Collaborative (LC) will be assigned to schools leaders/staff to help support the implementation of the STRONG intervention in schools. A LC helps systems implement effective interventions to improve the quality of care offered. Teams implementing STRONG and school leaders will meet often to learn about topics relevant to STRONG/newcomers and collaboratively solve challenges that arise when implementing STRONG. The LC consists of in person Peer Learning Workshop where participants will hear a presentation on a topic relevant to STRONG/newcomers and discuss their progress in implementing STRONG. The LC will also include Team Support Calls with all teams delivering STRONG on a regular basis. School leaders and school mental health providers will be participating in the LC.
Feasibility of LC - School Staff Ratings
To access feasibility of the LC, school mental health providers and school leaders will complete the Feasibility subscale from the Acceptability, Feasibility \& Appropriateness measure. The response scale is 1 = not at all, 3 = moderately, 5 = extremely.
Feasibility of LC - Attendance
Attendance records for LC learning sessions and consultation calls will be collected by the research team
Feasibility of LC - Completion of PDSA cycles
Using meeting minutes from LC consultation calls and session surveys completed by facilitators, the research team will track the use of plan-do-study-act cycles by each school team and their progress to testing improvement ideas.
Feasibility of LC - Barriers & Facilitators
Guided by the Consolidated Framework for Implementation Research, providers and leaders' semi-structured individual interviews will ask about barriers and facilitators to participating in LC activities and delivering STRONG
Youth Mental Health - SDQ
The Strengths \& Difficulties Questionnaire (SDQ) will be completed by youth and their caregivers to assess youth mental health symptoms. The SDQ has four subscales: motional symptoms, conduct problems, hyperactivity/inattention problems, and peer problems and a 3-point Likert scale (0 = "Not at All" to 2 = "Certainly True"). Total sum scores (range=0-40) or externalizing (range 0=20; conduct and hyperactivity/inattention problems) or internalizing scores (range 0-20; Emotional problems and peer problems) can be calculated to assess clinical levels of symptoms.
Youth Mental Health - YSR
The Youth Self Report (YSR) is a reliable and well-validated measure that contains a list of 118 behavior-problem items that the youth rates on a 3-point scale (not true = 0; sometime trues=1; very true=2). The YSR provides scores for internalizing and externalizing categories as well as DSM-oriented scales for anxious/depressed, depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior \& aggressive behavior.
Youth Mental Health - CBCL
The Child Behavior Checklist (CBCL) Parent Report Form is a reliable and well-validated measure contains a list of 118 behavior-problem items that the parent rates on a 3-point scale (not true = 0; sometime trues=1; very true=2). The CBCL provides scores for internalizing and externalizing categories as well as DSM-oriented scales for anxious/depressed, depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behaviour \& aggressive behaviour.
Connor Davidson Resilience Scale
The Connor-Davidson Resilience Scale measures youth adaptability and resilience using 25 items. Participants respond on a 5-point Likert scale (0= "Not True at All" to 4 = "True Nearly All of Time"). Total scores are calculated (range = 0 to 100), and higher scores indicate more resilience. This will only be collected from youth.
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