Limited research exists about factors that influence the sustainability of preventive school mental health interventions when research support ends. This study assessed barriers and facilitators to sustaining RAP (Relax, be Aware, do a Personal rating) Club, a trauma-informed universal mental health intervention, in urban schools following efficacy trial implementation. Between 2016 and 2018, 13 Baltimore City schools implemented RAP Club. We evaluated RAP Club sustainability using semi-structured interviews with administrators (n = 10) and school staff trained to deliver the intervention (n = 11), as well as review of intervention fidelity logs (n = 137) and notes from supervision calls (n = 10) with school staff and research team members who implemented the program. Although most school staff described RAP Club as acceptable and beneficial, none of the 13 schools sustained the intervention. Barriers to sustainability included low self-efficacy among school staff trained to deliver the intervention, school staff turnover, logistical challenges with space and time in the regular school calendar to deliver the program, insufficient funding to sustain the program outside of the research context, and limited planning and ongoing communication between school personnel and researchers about sustainability. Recommendations for increasing post-trial program sustainability include developing sustainability plans with schools during the pre-implementation phase, enhancing ongoing support for school staff during the implementation phase, and using academic–community partnerships to facilitate sustainability and intervention scale-up during the post-implementation phase. Increasing sustainability of beneficial school-based mental health programs has the potential to reduce mental health disparities and promote health equity.

当研究支持结束时，关于影响预防性学校心理健康干预可持续性的因素的研究有限。本研究评估了在功效试验实施后，在城市学校中维持 RAP（放松、注意、进行个人评分）俱乐部的障碍和促进因素，这是一种创伤知情的普遍心理健康干预措施。2016 年至 2018 年间，巴尔的摩市 13 所学校实施了 RAP 俱乐部。我们通过对管理人员 ( n  = 10) 和接受过干预培训的学校工作人员 ( n = 11) 的半结构化访谈 以及对干预保真度日志 ( n  = 137) 和监督电话记录 (n = 137) 的审查来评估 RAP 俱乐部的可持续性n = 10) 与实施该计划的学校工作人员和研究团队成员一起。尽管大多数学校工作人员将 RAP 俱乐部描述为可以接受和有益的，但 13 所学校中没有一所支持干预。可持续性的障碍包括受过实施干预培训的学校工作人员的自我效能感低、学校工作人员更替、在正常学校日历中实施该计划的空间和时间方面的后勤挑战、在研究范围之外维持该计划的资金不足，以及学校人员和研究人员之间关于可持续性的规划和持续沟通有限。提高试验后计划可持续性的建议包括在实施前阶段与学校制定可持续性计划，在实施阶段加强对学校工作人员的持续支持，在实施后阶段利用学术界与社区的伙伴关系促进可持续性和干预规模扩大。提高以学校为基础的有益心理健康计划的可持续性有可能减少心理健康差异并促进健康公平。