Elaine Sarah Belansky

My research has been guided by principles of community-based participatory research (CBPR), an approach to conducting research in which community members and academic researchers are equitably involved throughout each research phase so that power-sharing and co-learning are a part of the process (Israel, et al., 1998). Israel et al identified eight CBPR principles. I particularly value the 6th one which states: CBPR balances research and action for the mutual benefit of all partners. I strive to ensure that my projects strike a balance between knowledge generation (research) and community improvement (action).

The goal of my research is to identify strategies that shorten the research-to-practice time delay so that rural communities facing the greatest physical and mental health disparities can implement evidence-based practices on a more aggressive timeline. My research falls under the umbrella of implementation science, defined by the National Institutes of Health as “the study of methods to promote the adoption and integration of evidence-based practices, interventions, and policies into routine health care and public health settings to improve the impact on population health." This field developed out of a recognition that while there is no shortage of evidence-based practices, it can take up to 17 years for them to be implemented (Greene et al., 2009).

In 2005, our team developed and tested a strategic planning process “Assess. Identify. Make it Happen” (AIM) in a pair randomized design. In that study, we demonstrated that AIM led to the implementation of 4.4 evidence-based practices (EBPs) per rural school with 90% of those practices still in place one year later compared to “usual care” schools which made an average of 0.6 effective changes with 66% in place a year later (Belansky et al, 2013). AIM was successful because it included external, trained facilitators; required principal involvement; focused on specific student behavior goals; identified effective environment and policy changes; prioritized potential changes based on importance and feasibility; and included action planning. Because of AIM’s success, we have continued to expand and improve it over the years to help rural schools learn about and implement EBPs. AIM has been highly effective in reducing the amount of time it takes to get the latest best practices into the hands of high-poverty, rural/frontier schools furthest from opportunity. As of today, AIM has led to the implementation of approximately 2,500 EBPs in rural schools.

I have been the PI or Co-PI of 18 CBPR grants totaling $20M. Funders have included the Centers for Disease Control and Prevention, National Institutes of Health, Robert Wood Johnson Foundation, The Colorado Health Foundation, and others. Almost all my grants have the goal of supporting rural, high-poverty schools in learning about, selecting, and implementing EBPs to support students’ health and education outcomes. I have been continuously working with 14 school districts in the San Luis Valley since 1999 and 17 school districts in Southeast Colorado since 2010. In the 2000s, my grants were focused on combatting the childhood obesity epidemic. However, in 2013, my rural school partners began sharing their growing concerns about youth mental health. Thus, I began to shift my focus to be responsive to community-identified priorities. In fact, the main reason I moved to the Morgridge College of Education was to be surrounded by faculty and graduate students with expertise in school psychology, school counseling, family-school-community partnerships, and educational leadership so that I could better serve my community partners.

Since coming to DU, our community improvement agenda has consisted of passing millions of dollars of grant funds directly to our rural school partners and providing them with tools, resources, and technical assistance to support their efforts in developing and implementing comprehensive health and wellness plans aligned with the Whole School, Whole Community, Whole Child model. Our team at the Center for Rural School Health & Education has developed several exciting products to support schools in selecting and implementing evidence-based practices including AIM-XL (the latest version of our strategic planning process which has been expanded to align with the Whole School, Whole Community, Whole Child framework), a Comprehensive Health and Wellness Plan template, a guide for schools to conduct listening sessions with community stakeholders, and a guide for selecting health education curricula. These grants resulted in rural schools implementing hundreds of EBPs. At the same time, our Center for Rural School Health & Education's research agenda has focused on understanding the contextual factors that facilitate or inhibit the implementation of EBPs in rural, high-poverty schools. In 2019, we developed a survey based on the Consolidated Framework for Implementation Research (CFIR) (Damshroder et al., 2009) to measure inner and outer contextual factors in rural schools. While we are in the early stages of this new line of research, we presented our work at the 2019 Society for Implementation Research Collaboration Conference and are preparing a manuscript for Implementation Science. Currently, we are conducting analyses to identify relationships between the presence of contextual factors and the types of EBPs rural school districts included in their comprehensive health and wellness plans.