Understanding the Relation of Provider Characteristics, Implementation Factors and Participant Risk to Student Outcomes in the Coping Power Program

This study proposed and tested a conceptual model of evidence-based mental health intervention implementation in schools that considered the association between provider, participant, and implementation factors to participant outcomes in a group-based Tier II program targeting students’ externalizing behaviors (The Coping Power Program; CPP). It was hypothesized that implementation variables (CPP content and process fidelity) would mediate the association between provider characteristics (knowledge of evidence-based services and mental health experience) and student outcomes (teachers’ ratings of students externalizing behavior at post-intervention). It was also hypothesized that cohort risk would moderate the relation between provider characteristics and implementation variables. Data was leveraged from Project ACCESS, a five-year cluster randomized trial that examined the implementation of CPP in six urban schools. Individual students (N=186) participated in one of 44 CPP cohorts with 18 unique group providers. A three-level moderated mediation model was estimated to test the study hypotheses. Results indicated that the proposed mediating and moderating relations were not supported, and the only significant predictors of students’ post-intervention externalizing behavior scores were students’ grade level, race, and pre-intervention scores. However, when the student variables were excluded from model analyses, providers’ knowledge of evidence-based services positively predicted cohorts’ process fidelity scores and providers’ mental health experience negatively predicted cohorts’ content fidelity scores. The results of this study suggest that provider characteristics, implementation variables, and cohort risk may be less predictive of participant outcomes within the CPP than individual student characteristics. Additional implications, study limitations, and future directions are discussed.