ABSTRACT
Highly prevalent mental health needs among youth necessitate the use of evidence-based practices (EBPs). However, EBPs are inconsistently implemented in their primary service delivery setting, schools. Educators’ and School-based clinicians’ motivation and beliefs often hinder their EBP adoption. Beliefs and Attitudes for Successful Intervention in Schools (BASIS) is a theory-informed, group-based, pre-implementation strategy that blends Motivational Interviewing (MI), Strategic Education, and Social Influence techniques shown to improve individual behavior change mechanisms and evidence-based practice (EBP) adoption. MI techniques (e.g. elicit change talk, build an action plan) are integrated throughout BASIS sessions (n= 2; group 3–10), including facilitator-mediated technical aspects (e.g. elicit change talk with open-ended questions, reflect on participant experiences); and individually oriented and small group workbook activities (e.g. setting an intention, problem-solving, planning). As part of a large-scale cluster-randomized control trial simultaneously examining the effectiveness of BASIS and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), BASIS was delivered via the web by a community-based facilitator to 47 school-based mental healthcare (SBMH) practitioners serving 47 schools in six states. In this paper, we describe the BASIS fidelity elements of content adherence (Aim 1); comprehensiveness, facilitation supports, facilitator competence, and participant responsiveness (Aim 2); and explore the variability and associations between fidelity elements (Aim 3). Overall fidelity elements were high, and closer analysis revealed that adherence and responsiveness were associated. These exploratory findings point to a need for future research to describe and analyze fidelity elements of BASIS other group-based MI-embedded supports, particularly for complex or comprehensive web-based MI-delivery.
For the nearly one in five youth with emotional, behavioral, and mental health needs in the US (Child and Adolescent Health Measurement Initiative, Citation2023), there is a demand for evidence-based practices (EBPs) in accessible settings (Hoover & Bostic, Citation2021). While EBPs have demonstrated effectiveness addressing such needs, their implementation in schools – the most common context for children’s mental health services – remains limited (Duong et al., Citation2021). Educators’ individual factors, such as their self-efficacy and attitudes, strongly predict their EBP adoption (Cook et al., Citation2019; Miller & Moyers, Citation2017; Stahmer et al., Citation2015), making them critical targets for implementation strategies (Baffsky et al., Citation2023). To address these factors, Motivational Interviewing (MI; Miller & Rollnick, Citation2013), a well-established approach for enhancing the motivation and intentions that drive behavior change is being increasingly incorporated into training and coaching for educators (Frey et al., Citation2013; Reinke et al., Citation2011). The translation of MI to improve EBP use requires specification of how MI can be delivered to with high levels of fidelity (Akiba et al., Citation2022; Small et al., Citation2025). We provide an example of how core fidelity elements of MI were delivered in an efficacy trial of Beliefs and Attitudes for Successful Implementation Schools (BASIS), an effective, group-based, MI-driven implementation strategy (Carroll et al., Citation2007; Cook et al., Citation2019; Larson et al., Citation2021; Lyon, Cook, & Duong, Citation2019; Merle et al., Citation2023).
Hugh, M. L., Martinez Cueto, A. P., Bruzios, K. E., Corbin, C. M., Gaias, L. M., Landa, Y., … Lyon, A. R. (2025). Exploring Fidelity Elements of a Motivational Interviewing-Based Implementation Strategy to Improve Adoption of Evidence-Based Practices in Schools. Journal of Educational and Psychological Consultation, 1–26. https://doi.org/10.1080/10474412.2025.2595110