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. 2025 Jan 9;20(1):3.
doi: 10.1186/s13012-024-01414-3.

Study protocol for a hybrid type 3 effectiveness-implementation trial of a team-based implementation strategy to support educators' use of a social engagement intervention

Jill Locke  1   2 , Aksheya Sridhar  3 , Wendy Shih  4 , Stephanie Shire  5 , Andria B Eisman  6 , Emily Kim  3 , Adora Du  3 , Christine Espeland  3 , Connie Kasari  4
Affiliations

Study protocol for a hybrid type 3 effectiveness-implementation trial of a team-based implementation strategy to support educators' use of a social engagement intervention

Jill Locke et al. Implement Sci. .

Abstract

Background: Remaking Recess (RR) is a school-based evidence-based peer social engagement intervention for autistic students. RR involves direct training and coaching with educators; however, educators face several barriers to implementation at both the individual- and organizational-levels. This protocol paper describes a multi-site study that will test whether an educator-level implementation strategy, coaching, with or without a school-level implementation strategy, school-based teams, will maximize educators' use (fidelity and sustainment) of RR for autistic students and their peers who are socially-isolated, rejected, or peripheral and may need additional support during recess.

Methods: This study will employ a hybrid type-3 effectiveness-implementation trial. Fifty-five elementary schools will be recruited as well as 121 educators (e.g., classroom assistants, aides), 55 general and special educator teachers, and 83-138 other school personnel (e.g., administrators). Additionally, at least 118 autistic students and allistic or non-autistic classmates will be recruited as RR recipients. Participants will complete baseline assessments at the beginning of the year, and all schools will be provided RR training. Schools will be randomized to coaching with or without school-based teams. This study will measure RR fidelity (primary outcome), RR sustainment, as well as peer engagement, social network inclusion, and social skills (secondary outcomes). It is expected that coaching with school-based teams will improve both RR fidelity and social network inclusion, while coaching with and without school-based teams will result in improved peer engagement and social skills.

Discussion: Previous research has documented barriers to RR implementation at both the individual- (provider) and organization-level (school). Using multi-level implementation strategies such as coaching with school-based teams may address these barriers and support RR implementation in schools. Findings from this study may guide future efforts to scale up tailored implementation strategies for use in public school districts, with the ultimate goal of increasing intervention access and improving student outcomes.

Trial registration: Name of the Registry: clinicaltrials.gov.

Trial registration: Clinical Trials ID: NCT06559267 . Date of Registration: August 15, 2024. Prospectively registered.

Keywords: Autism; Implementation; Recess; Schools; Team.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All Institutional Review Boards (University of Washington, UCLA, University of Oregon, Wayne State University) approved this study; Study No. STUDY00020326. Informed consent will be obtained for each participant as follows: Recruitment for RR in schools will include an informational email and video about the study and intervention and school-based teams implementation strategy. If schools are interested, we will meet with school administrators via videoconference to inform them about the study, participation requirements, and answer any questions (approximately 30 min). Following approval by the school administrator, we will meet with educators to obtain their consent to participate in the study. Subsequently, we will ask educators to send recruitment materials home to parents/caregivers of autistic students. Recruitment materials explain what is expected of research participants and detail all research activities. If interested, parents/caregivers contact the research team to complete informed consent. Participants have not yet been recruited to the study. Adverse events will be reported as needed. Consent for publication: Not applicable. Competing interests: All Authors declare that there is no conflict of interest.

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Theorized mechanisms of change
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Study design
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Social network inclusion
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References

    1. Centers for Disease Control and Prevention. Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2018. MMWR Surveill Summ. 2021;70:1. - PMC - PubMed
    1. National Center for Education Statistics. Students With Disabilities. Condition of Education. U.S. Department of Education, Institute of Education Sciences; 2024. Retrieved [September 12, 2024], from https://nces.ed.gov/programs/coe/indicator/cgg.
    1. Cardinal DN, Griffiths AJ, Maupin ZD, Fraumeni-McBride J. An investigation of increased rates of autism in US public schools. Psychol Sch. 2021;58:124–40.
    1. Odom SL, Sam AM, Tomaszewski B. Factors associated with implementation of a school-based comprehensive program for students with autism. Autism. 2022;26:703–15. - PubMed
    1. Jones SM, Brown JL, Hoglund WL, Aber JL. A school-randomized clinical trial of an integrated social–emotional learning and literacy intervention: Impacts after 1 school year. J Consult Clin Psychol. 2010;78:829. - PubMed

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