title: Modeling the Mental Health Practice Change Preferences of Educators: A Discrete-Choice Conjoint Experiment.
abstract: Schools are sometimes slow to adopt evidence-based strategies for improving the mental health outcomes of students. This study used a discrete-choice conjoint experiment to model factors influencing the decision of educators to adopt strategies for improving children's mental health outcomes. A sample of 1,010 educators made choices between hypothetical mental health practice change strategies composed by systematically varying the four levels of 16 practice change attributes. Latent class analysis yielded two segments with different practice change preferences. Both segments preferred small-group workshops, conducted by engaging experts, teaching skills applicable to all students. Participants expressed little interest in Internet options. The support of colleagues, administrators, and unions exerted a strong influence on the practice change choices of both segments. TheChange Readysegment, 77.1 % of the sample, was more intent on adopting new strategies to improve the mental health of students. They preferred that schools, rather than the provincial ministry of education, make practice change decisions, coaching was provided to all participants, and participants received post-training follow-up sessions. TheDemand Sensitivesegment (22.9 %) was less intent on practice change. They preferred that individual teachers make practice change decisions, recommended discretionary coaching, and chose no post-training follow-up support. This study emphasizes the complex social, organizational, and policy context within which educators make practice change decisions. Efforts to disseminate strategies to improve the mental health outcomes of students need to be informed by the preferences of segments of educators who are sensitive to different dimensions of the practice change process. In the absence of a broad consensus of educators, administrators, and unions, potentially successful practice changes are unlikely to be adopted.
authors.affiliation: Hamilton Health Sciences, McMaster Children's Hospital, McMaster University, Hamilton, ON L9C 7N4 Canada ; Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, The Jack Laidlaw Chair in Patient-Centred Health Care, McMaster University, Hamilton, ON Canada.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Cunningham
authors.affiliation: Hospital for Sick Children, University of Toronto, Toronto, ON Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Barwick
authors.affiliation: Hamilton-Wentworth District School Board, Hamilton, ON Canada.
authors.forename: Kathy
authors.initials: K
authors.lastname: Short
authors.affiliation: McMaster University, Hamilton, ON Canada.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Chen
authors.affiliation: McMaster University, Hamilton, ON Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Rimas
authors.affiliation: McMaster University, Hamilton, ON Canada.
authors.forename: Jenna
authors.initials: J
authors.lastname: Ratcliffe
authors.affiliation: McMaster University, Hamilton, ON Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mielko
keywords: Conjoint analysis; Evidence-based practice; Implementation; Mental health; Schools