Behavioral health practitioners recognize how critical the process of implementation is to the successful use of evidence-based practices. It is further recognized that implementation is a complex, time-consuming process and that successful implementation often occurs in stages. Capitalizing on a national evaluation examining the implementation of school-based behavioral health (SBBH) services, this project involved an analysis of qualitative interview data to assess the unique barriers and facilitators that arise across time and organizational levels in the implementation of SBBH services. Forty-eight semi-structured telephone interviews were analyzed across 3 years and two organizational levels in seven sites (n = 48). Qualitative analysis identified five major implementation facilitators including communication and collaboration, data utilization, leadership, planning, and training. Major barriers to implementation included systemic state/governmental barriers, workforce shortages, and funding issues. While there were small changes in the relative importance of these facilitators and barriers over time and by organizational level, the most salient barriers and facilitators remained important across all 3 years of the study. Differences across organizational levels included greater emphasis at local levels for facilitators such as training and leadership and a greater emphasis at state levels for state/governmental barriers. Results suggest that while the importance of given facilitators and barriers changes as implementation progresses, the major factors that contribute to implementation are likely to remain unchanged over time. Effective communication/collaboration among stakeholders remains a powerful facilitator across time, and systemic state/governmental barriers remain a potent barrier. Implications for increasing successful integration of behavioral health services in public school settings are discussed.

行为健康从业人员认识到实施过程对成功使用循证实践至关重要。进一步认识到，实施是一个复杂，耗时的过程，成功的实施通常分阶段进行。该项目利用一项国家评估来检查学校行为健康（SBBH）服务的实施情况，其中涉及对定性访谈数据的分析，以评估在实施SBBH服务时，跨时间和组织水平出现的独特障碍和促进因素。在3年中对七个站点的两个组织级别的48个半结构化电话采访进行了分析（n = 48）。定性分析确定了五个主要的实施促进者，包括沟通与协作，数据利用，领导力，计划和培训。实施的主要障碍包括系统性的州/政府障碍，劳动力短缺和资金问题。这些促进者和障碍的相对重要性随时间和组织水平的变化很小，但在整个研究的三年中，最显着的障碍和促进者仍然很重要。组织层面的差异包括培训和领导等对促进者的本地重视，以及对州/政府壁垒的重视。结果表明，尽管实施过程中给定的促进者和障碍的重要性发生了变化，促成实施的主要因素可能会随着时间的流逝而保持不变。利益相关者之间的有效沟通/合作仍然是跨时间的强大推动者，而系统性的州/政府障碍仍然是潜在的障碍。讨论了在公立学校环境中增加行为健康服务成功整合的意义。