IMPACT (Integrated Management of Physician-Delivered Alcohol Care for Tuberculosis patients) is a randomized, controlled effectiveness trial based in Tomsk, Russia, that assesses the effect of oral naltrexone and brief behavioral counseling on tuberculosis outcomes and alcohol use in 200 patients. Tuberculosis physicians without addiction experience delivered interventions as part of routine care over a 6-month period, focusing on alcohol intake reduction to support successful tuberculosis treatment. We describe design, training, and fidelity monitoring using a Russian and American team of physicians, bilingual coders, and supervisors. Culturally appropriate adaptations, limitations, and implications for future trials are discussed. The clinical trial identification number is NCT00675961. Funding came from the National Institutes of Health and National Institute on Drug Abuse.

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This final column of the series is focused on how school and district teams can continue the forward motion toward positive student outcomes using data via continuous improvement cycles. We draw on the work of technical assistance providers and researchers from the National Implementation Research Network (NIRN; https://nirn.fpg.unc.edu) and the Center on Positive Behavioral Interventions and Supports (PBIS; https://www.pbis.org/). The key takeaway of this series is to describe how implementation of EBPs in schools can be enhanced when implementation teams “invest in the systems to support their implementation” (Kittelman et al., 2020, p. 96).

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Syftet med uppsatsen var att ta reda på vilka lärdomar Linköpings kommun och boende i området Hållbara kvarteren i Lambohov, Linköping hade kring projektet som innefattat kommunala beteendeinsatser i form av nudging och aktiviteter. Vi har även ämnat ta reda på hur boende ställer sig till beteendeförändringar. För att besvara våra frågeställningar har nio enskilda intervjuer genomförts, med slumpmässigt utvalda boende i Hållbara kvarteren och en projektledare vid Linköpings kommun. Flera boende har intervjuats oberoende på delaktighet i projektet för att få en bild av projektets effekter genom ett opåverkat urval av boende. Resultatet visade att många av de intervjuade boende inte hade uppfattat syftet med projektet eller varit aktiva i det. Resultatet visade även att majoriteten av intervjupersonerna hade en positiv syn på projekt som ämnar främja en mer hållbar livsstil även om det finns olika engagemang kring hållbarhetsfrågor hos de boende. Det finns skilda åsikter kring vilka tillvägagångssätt som de boende föredrar för att förändra sitt beteende i en mer klimatsmart riktning. Alla boende är dock överens om att smidighet är en nödvändig aspekt för att vilja ta del av en beteendeinsats. / The purpose of this paper was to investigate the experiences among the municipality of Linköping and the residents in the district of “the Sustainable quarters” of Lambohov, Linköping, regarding the project that included municipal behavioural interventions in terms of nudges and activities. We also aimed to investigate how the residents adjust to behavioural changes. Nine individual interviews have been conducted to answer our questions. The interviews have been done with randomly chosen residents of “the Sustainable quarters” as well as with a project leader at the municipality of Linköping. The residents have been interviewed regardless of the extent they have been participating, this was done to create a picture of the effects that the project has led to, by having an unaffected selection of residents. The result showed that many of the interviewees had not perceived the aim of the project or participated in it. The result also showed that most interviewees had a positive attitude towards projects that aims on promoting sustainable lifestyles, even though the extent of engagement differs regarding questions on sustainability. There are different opinions among the residents on what approach that is preferable for them to change their behaviour towards a more climate smart way of living. However, all the interviewees agree on it having to be easy to adjust to, to be interested in taking part of such a change.

This study evaluated the predictive and concurrent validity of the Tiered Fidelity Inventory (TFI). Structural equation modeling was applied to test the associations between the TFI and student outcomes. First, a total of 1,691 schools with TFI Tier 1 in 2016-17 and school-wide discipline outcomes in 2015-16 and 2016-17 were targeted, finding a negative association between TFI Tier 1 and differences between African American and non-African American students in major office discipline referrals (ODR) per 100 students per day in elementary schools. A sensitivity test with schools with TFI Tier 1, 2, and 3 was conducted, showing a negative association between TFI Tier 1 and the square root of major ODR rates in elementary schools. Second, TFI Tier 1 was positively related to the proportions of students meeting or exceeding state-wide standards in reading from 1,361 schools with TFI Tier 1 and academic outcomes in 2014-15 and 2015-16. Also, the association between TFI Tier 1 and academic outcomes was found to be stronger when schools implemented SWPBIS for 6 or more years. A sensitivity test with schools with TFI Tier 1, 2, and 3 indicated positive associations between TFI Tier 1 and the proportions of students meeting or exceeding state-wide standards in both subjects. Third, TFI Tier2 was positively associated with the logit of proportions of students with CICO daily points from 570 schools with TFI Tier 2 in 2016-17 and CICO outcomes in 2015-16 and 2016-17. Fourth, correlations between the Evaluation subscale of TFI Tier 1 or 2 and relevant measures in 2016-17 were tested from 2,379 schools. TFI Tier 1 Evaluation was positively correlated with counts of TFI administrations, number of fidelity measures, and counts of viewing SWIS Reports. These correlations were significant except for ODRs by staff. Also, TFI Tier 2 Evaluation was significantly positively correlated with years of SWPBIS implementation, years of CICO-SWIS implementation, and counts of viewing CICO Reports except student period, and negatively with counts of viewing student single period. These findings were discussed by comparing them with previous research findings, suggesting implications for future research and practice, and addressing research limitations.

This study assessed the Prevent-Teach-Reinforce (PTR) model to determine its impact on problem and replacement behaviors of three children who are typically developing with behavioral challenges in a high-need elementary school setting. Specifically, this study evaluated the use of the PTR model as an intensive individualized Tier 3 intervention within a multi-tiered intervention system. In addition, the study examined the validity and usability of the Individualized Behavior Rating Scale Tool (IBRST), which was developed as a feasible daily progress monitoring tool in conjunction with the PTR model. Social validity and fidelity of intervention implementation were also assessed. A multiple baseline across participants was employed to evaluate the impact of implementation of the model on the children's behaviors. The results of the study indicated that the PTR model was effective in reducing problem behaviors and increasing the use of replacement behaviors for all three participants. In addition, the IBRST completed by the teachers was found to have a substantial correlation to data collected during direct observations.