Piloting a Learning Collaborative for School-Based Bilingual Providers Delivering Evidence-Based Interventions

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.

Bilingual providers play a critical role in increasing access to mental health care, yet there is a dearth of literature on bilingual provider training needs when delivering evidence-based interventions, especially to youth, and even less research on school-based interventions delivered in Spanish. One group with high mental health needs that relies on bilingual providers is newcomer youth, who have migrated to the U.S. within the past 5 years. Despite this high need, very few interventions have been developed for newcomers. One exception is Supporting Transition Resilience of Newcomer Groups (STRONG), a group-based, school-delivered behavioral intervention targeting stress, anxiety, depressive symptoms, and externalizing behaviors among newcomer youth. To date, however, interventions like STRONG remain underutilized in schools due to barriers like low leader support and poor provider fit. To maximize the public health impact of interventions delivered to Spanish-speaking youth, strategies that enhance bilingual provider training are needed. Learning Collaboratives (LC) are a promising implementation strategy that can strengthen intervention fit with schools and foster collective learning for bilingual providers. LCs involve recurring sessions with faculty experts, organization leaders, and providers who engage in Plan-Do-Study-Act (PDSA) cycles to overcome implementation challenges, and extant studies show LCs can positively influence provider fidelity and intervention sustainment. The LC in this study will aim to enhance the implementation of STRONG in schools for newcomer youth facilitated by bilingual providers. This study will be guided by the Exploration, Preparation, Implementation and Sustainment (EPIS) and Consolidated Framework for Implementation Research (CFIR) frameworks and builds upon a completed Exploration phase with school district partners, where STRONG was chosen as the intervention to be adopted. This study will recruit approximately 72 newcomer youth (ages 10-18) and their caregivers, 18 school mental health providers, and 9 school leaders, across four school districts and one county-level program. All youth will be receiving the STRONG intervention in their respective schools, delivered by school mental health providers and school staff familiar with the newcomer student experience, and all school provider/school leaders will take part in the LC. STRONG is a 10-week intervention, consisting of 10 small group sessions, one individual session, and teacher and parent education sessions. STRONG is strengths based, teaches newcomers coping skills, draws from cognitive behavioral therapy, and helps foster positive identity and facilitate social connectedness among newcomers. School providers will participate in a 2-day in-person STRONG training led by a national expert and will have access to up to 4 hours of consultation with a STRONG national expert during their first time implementing STRONG. Providers will implement STRONG trial.show_full_description

Inclusion Criteria: School Leader Eligibility: * (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. School Providers Eligibility: * (a) over 18 years old; * (b) mental health clinicians or school staff who regularly interact with newcomer students; * (c) bilingual in Spanish/English. It is important to note that at least one mental health clinician must facilitate STRONG but the co-facilitator can either be another clinician or a school staff who regularly interacts with newcomer students; example of such a school staff include English Language Development Teachers, interpreters, and equity coordinators Student Eligibility: * (a) newcomer status (students who have migrated to a new country) * (b) 6th-12th grade * c) speaks Spanish/English/Mam * (d) elevated levels of mental health symptoms and/or functional impairment Caregiver Eligibility: * (a) over 18 years old; * (b) primary caregiver (e.g., biological parent; older sibling) of a newcomer student aged 10-17 who is participating in STRONG; * (c) able to speak in English, Spanish or Mam. Exclusion Criteria: \- For Students: Born in mainland United States