Background: Schools serve as an important context for the prevention of behavioral and mental health problems.
There is growing interest among educators in the application of a three-tiered public health prevention model to prevent
a range of behavioral and mental health concerns, and in turn, improve academic and social-emotional outcomes for
students. One such multi-tiered system of supports framework used by schools is called Positive Behavioral Interventions
and Supports (PBIS). This model has been widely disseminated in over 20,000 schools across the U.S., with the goal of
improving social, emotional, and behavioral outcomes among youth. Yet, most of the implementation efforts and research
on PBIS have focused on elementary schools.
Method: This paper describes a collaborative state-wide effort, called Maryland Safe and Supportive Schools, to disseminate
this model in high schools and conduct a randomized trial to determine the impact of PBIS on adolescents. The
model uses a collaborative, team-focused coaching framework and draws upon school climate data to implement a continuum
of evidence-based prevention programs. The goal of this effort is to reduce behavioral, academic, and mental health
problems among adolescents. This paper summarizes the design, implementation, and lessons learned through this unique
school/non-profit/university partnership-based approach to implementing a comprehensive three-tiered model of support
within the state of Maryland.
Results: A relatively large and diverse sample of 58 schools voluntarily participated in the school-level group randomized
controlled trial. Annual measures of school climate were collected via self-reports from over 25,000 students and through
observations across 25 classrooms per school. Fidelity of tier 1 and 2 supports was generally high among the intervention
schools. Preliminary findings from the randomized trial testing the impact of MDS3 suggest a positive impact on school
climate and other safety related concerns following the first year of implementation.
Conclusions: The MDS3 project promoted a framework for helping the school leadership teams develop data-based decision-
making skills, generate data reports to establish need, optimize evidence-based program implementation, and use
data to monitor progress toward goals and celebrate successes. Lessons learned include the importance of 1) obtaining
data at the student and school levels; and communicating and sharing data with the schools in a way that makes sense to
them and is consistent with the school’s mission.