Adapting a ‘screening-to-intervention’ pathway for child anxiety problems for delivery in routine practice

Abstract Objective An integrated screening-to-intervention pathway has been shown to reduce child anxiety problems in a large trial in primary schools in England. Mental Health Support Teams (MHSTs) provide a clear route to future implementation in England. We set-out to identify what adaptations need to be made to the pathway to maximise fit with a routine practice context where MHSTs work with schools to deliver the pathway. This paper summarises key findings from the adaptation process and shows how we used learnings from qualitative interviews with key actors (MHST staff, school staff, parents), follow-up discussions with a subset of interview participants and wider consultations to adapt pathway procedures and produce guidance and materials for future implementation. Results Adaptations are presented using the Model for Adaptation Design and Impact (MADI) domains and include: pre-implementation activities to raise the profile of MHSTs in schools, procedural adjustments to accommodate local variation in MHST communication channels and systems for collecting screening data, and removal of activities included in the research trial. Our adaptation process is applicable for other research that aims to transfer intervention delivery from research to routine practice contexts and the pathway could be expanded to other mental health problems and age groups.