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Table 4 Measurement instruments presented by aim, timepoint, method and informant

From: A hybrid effectiveness-implementation cluster randomized trial of group CBT for anxiety in urban schools: rationale, design, and methods

Aim Construct Instrument Instrument characteristics Timepoints Method Informant
Competence Knowledge of CBT & treatment of anxiety Knowledge Test (KT) [55] 20-item questionnaire rated on a true/false or multiple choice format Initial training Self-report Therapist
Sample description Family characteristics Demographic information Age, grade, gender, race/ethnicity, and socioeconomic status Pre- diagnostic evaluation Self-report Parents
Screening Anxiety disorders Screen for Child Anxiety Related Disorders (SCARED) [43] 41-item, 3-point scale (0 = not true or hardly ever true to 2 = very true or often true) organized around five scales and a Total Score Pre- diagnostic evaluation Child behavior rating Parents & teachers
Aim 1-2 Effectiveness
Child psychopathology
Anxiety Disorders Interview Schedule for Children – DSM-5, Parent Version (ADIS-5-P) [44, 45] Semi-structured psychiatric interview. English & Spanish versions. DSM-V diagnoses, severity, and comorbidity. Clinical judgment is required to determine clinical diagnosis (Clinician Severity Rating; CSR ≥4) and identify those at risk (CSR=3) Pre- & post- treatment Child behavior report Parents
Aim 1 Clinical Global Impression Severity Clinical Global Impression - Severity CGI-S [71] Global score based on a 7-point scale (1 = normal, not at all ill to 7 = among the most extremely ill), with lower scores indicating less severity Pre- & post- treatment Functional impairment rating Diagnostician
Aim 1 Clinical Global Impression Improvement Clinical Global Impression - Improvement CGI-I [71] Global improvement score based on a 7-point scale (1 = very much improved to very much worse); assigned at post-treatment for the primary diagnosis Post- treatment Functional impairment rating Diagnostician
Aim 1 Global impairment Children’s Global Assessment Scale (CGAS) [72] Children ages 4–16 years. 1–100 scale reflecting level of child’s functioning during a specified time period Pre- & post- treatment Functional impairment rating Diagnostician
Aims 1-2 Anxiety symptoms Multidimensional Anxiety Scale for Children - 2nd Edition (MASC 2) [73] 50-item, 4-point rating scale (0 = never to 3 = often). Sensitive for measuring treatment effects [73] Pre- & post- treatment Child behavior rating &
Self-report
Parents & children
Aims 1-2 Academic competence Academic Competence Evaluation Scales (ACES) [74] Ratings for Reading/Language Arts and Math and academic enablers (i.e., engagement in academic activities and motivation to achieve). Sensitive for measuring intervention effects [7477] Pre- & post- treatment Child academic performance rating Teachers
Aim 2 Implementation
Content fidelity
Content Fidelity Checklist (CFC) Yes/no rating scale to indicate whether or not a therapist covered a particular component of the treatment Ongoing Video coding Independent coding of therapist behavior
Aim 2 Process fidelity Process Fidelity Checklist (PFC) [47] 12-item, 5-point scale (0 = not at all, to 4 = very often) Ongoing Video coding Independent coding of therapist behavior
Aim 2 Content & process fidelity Supervision Content & Fidelity Measure (SCFM) Supervision content and process as detailed in the training manual, e.g., prepared for next session; Demonstrated empathy and provided positive reinforcement Ongoing Self-report Supervisor
Aim 2 Content & process fidelity Consultation Content & Process Measure (SCPM) Consultation content and process as detailed in the training manual, e.g., prepared for next session; Demonstrated empathy and provided positive reinforcement Ongoing Self-report Consultant
Aim 2 Appropriateness & acceptability Qualitative interviews Interviewers will follow a script to ask questions of supervisors and therapists, e.g., “How acceptable is the level of support you received for the implementation of the FRIENDS protocol?”; “Was the supervision you received from your agency’s supervisor appropriate for running groups with children?”; “Was the consultation you received from the research team appropriate for preparing you to conduct supervision with STS therapists?” Post-treatment NVivo coding [78] of interview transcriptions Therapists & supervisors
Aim 1-2 Cost Modified DATCAP interview [79, 80] Therapist time, trainer time, expert supervision, time implementing the program, and cost of materials used in the implementation of the program Ongoing Multi-method Administrators
Aim 3 Moderators
Behavioral intentions
Behavioral Intentions (BI) [36, 35] Two items, 7-point scale (1 = very unlikely, to 7 = very likely), e.g., “How likely is that you will participate in supervision for the implementation of Friends for Life in the school setting? Pre- implementation Self-report Therapists
Aim 3 Mediators
Service interruptions
Service Interruption Coding (SIC) Therapist availability for treatment session and supervision: 1) Projected length of the session in minutes minus time spent on interruptions (e.g., answering a phone call, talking about unrelated topics); 2) Number of interruptions; 3) Total number of supervision / consultation and treatment sessions per group Treatment sessions & supervision Video coding Independent coders
Aim 3 Reflection on Process; Professional Flexibility; Newly Created Professional Activities; Role Interdependence Index of Inter-professional Team Collaboration for Expanded School Mental Health (IITC-ESMH) [81] 26-item, 5-point scale (1 = never, to 5 = always)   Self-report School team -
School & agency employees