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Cited by 58Health Policy Implementation ScienceSchool Health and Nursing EducationLGBTQ Health, Identity, and Policy

Implementing school nursing strategies to reduce LGBTQ adolescent suicide: a randomized cluster trial study protocol

Open access
Willging, Cathleen E., Green, Amy E., Ramos, Mary M.·2016·Implementation Science
DOI 10.1186/s13012-016-0507-2PMC PMC5075193
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Abstract

BACKGROUND: Reducing youth suicide in the United States (U.S.) is a national public health priority, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth are at elevated risk. The Centers for Disease Control and Prevention (CDC) endorses six evidence-based (EB) strategies that center on meeting the needs of LGBTQ youth in schools; however, fewer than 6 % of U.S. schools implement all of them. The proposed intervention model, "RLAS" (Implementing School Nursing Strategies to Reduce LGBTQ Adolescent Suicide), builds on the Exploration, Preparation, Implementation, and Sustainment (EPIS) conceptual framework and the Dynamic Adaptation Process (DAP) to implement EB strategies in U.S. high schools. The DAP accounts for the multilevel context of school settings and uses Implementation Resource Teams (IRTs) to facilitate appropriate expertise, advise on acceptable adaptations, and provide data feedback to make schools implementation ready and prepared to sustain changes. METHODS/DESIGN: Mixed methods will be used to examine individual, school, and community factors influencing both implementation process and youth outcomes. A cluster randomized controlled trial will assess whether LGBTQ students and their peers in RLAS intervention schools (n = 20) report reductions in suicidality, depression, substance use, bullying, and truancy related to safety concerns compared to those in usual care schools (n = 20). Implementation progress and fidelity for each EB strategy in RLAS intervention schools will be examined using a modified version of the Stages of Implementation Completion checklist. During the implementation and sustainment phases, annual focus groups will be conducted with the 20 IRTs to document their experiences identifying and advancing adaptation supports to facilitate use of EB strategies and their perceptions of the DAP. DISCUSSION: The DAP represents a data-informed, collaborative, multiple stakeholder approach to progress from exploration to sustainment and obtain fidelity during the implementation of EB strategies in school settings. This study is designed to address the real-world implications of enabling the use of EB strategies by school nurses with the goal of decreasing suicide and youth risk behaviors among LGBTQ youth. Through its participatory processes to refine and sustain EB strategies in high schools, the RLAS represents a novel contribution to implementation science. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02875535.

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  • In that study, EPIS and DAP were used to inform constructs and measurement of implementation outcomes in the sustainment phase.

    “(4) inform the constructs and measurement of the implementation outcomes in the sustainment phase.”

    From Ten recommendations for using implementation frameworks in research and practice (2020) · cites this paper as [68]

  • In that study, EPIS and DAP were used to guide tracking and integration of adaptations to the EBP strategy training and delivery during the implementation phase.

    “(3) guide the tracking and integration of adaptations to the EBP strategy training and delivery during the implementation phase”

    From Ten recommendations for using implementation frameworks in research and practice (2020) · cites this paper as [68]

  • In that study, EPIS and DAP were used to support identification of stakeholders and activities involved in the Implementation Resource Team developed in the preparation phase.

    “(2) support the identification of the stakeholders and activities involved in the Implementation Resource Team that was developed in the preparation phase”

    From Ten recommendations for using implementation frameworks in research and practice (2020) · cites this paper as [68]

  • The EPIS framework and the Dynamic Adaptation Process (DAP) were used in a cluster randomized trial to implement school nursing EBPs in US high schools to reduce LGBTQ adolescent suicide.

    “The EPIS framework and the Dynamic Adaptation Process (DAP) were used in a cluster randomized trial to implement school nursing EBPs in US high schools to reduce LGBTQ adolescent suicide [68].”

    From Ten recommendations for using implementation frameworks in research and practice (2020) · cites this paper as [68]

  • In that study, EPIS and DAP were used to inform constructs measured in the multi-level needs assessment during the exploration phase.

    “Within this study, the EPIS framework and the DAP were used to (1) inform the constructs measured in the multi-level needs assessment during the exploration phase”

    From Ten recommendations for using implementation frameworks in research and practice (2020) · cites this paper as [68]

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1 of the 87 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [45]Aarons GA Clinician personality and attitudes toward adoption of empirically supported treatment. Presented at the 15th International Conference on Mental Health Services Research: Evidence in Mental Health Services Research: What Types, How Much, and Then What? 2002 Washington, DC National Institute of Mental Health

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Authors
Willging, C. E., Green, A. E., & Ramos, M. M.
Affiliations
  • Pacific Institute For Research and Evaluation (US)
  • University of California San Diego (US)
  • University of New Mexico (US)
Corresponding author
Willging, Cathleen E.
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2016-10-22
Volume
11
Issue
1
Pages
145-145
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/s13012-016-0507-2
PMC
PMC5075193
OpenAlex
W2532583957
Cited by
58
References
87
Citations by year
2026: 2 · 2025: 4 · 2024: 10 · 2023: 3 · 2022: 10 · 2021: 10 · 2020: 8 · 2019: 2 · 2018: 6 · 2017: 1 · 2012: 2
FWCI
5.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UNM’s Digital Repository (University of New Mexico) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD083399)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Keywords
LGBTQ youth, adolescent suicide, school nursing, suicide prevention, EPIS framework, implementation fidelity, bullying, substance use, depression, truancy, high schools, youth risk behavior
MeSH terms
Sexual and Gender Minorities, Suicide Prevention, Adolescent, Adolescent Behavior, Bisexuality, Female, Homosexuality, Humans, Male, New Mexico, Research Design, School Nursing, Suicide, Transsexualism, Cluster Analysis, Sexuality, Bullying

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