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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