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@ARTICLE{Schfer:302863,
      author       = {S. K. Schäfer and S. Streit and C. G. Schäfer and L. B.
                      Roembell and M. Corneli and L. M. Schaubruch and M.
                      Wessa$^*$ and K. Lieb and M. Equit and D. Fuhr},
      collaboration = {S.-C. Consortium},
      title        = {{B}arriers and facilitators for the implementation of
                      preventative mental health interventions among secondary
                      schools in high-income countries: a systematic review.},
      journal      = {European child $\&$ adolescent psychiatry},
      volume       = {nn},
      issn         = {1018-8827},
      address      = {Darmstadt},
      publisher    = {Steinkopff},
      reportid     = {DKFZ-2025-01403},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Recent societal crises have negatively impacted the mental
                      health of adolescents, emphasizing the need for effective
                      preventative mental health interventions. Schools as key
                      environments for young people offer opportunities to deliver
                      those interventions at low threshold. However, many
                      interventions are not sustained beyond initial funding
                      periods due to persistent implementation barriers,
                      contributing to a significant gap between intervention
                      development and long-term practice. This systematic review
                      synthesizes qualitative research on barriers and
                      facilitators affecting the implementation of school-based
                      interventions in secondary schools in high-income countries.
                      Seven databases were searched for qualitative and
                      mixed-methods studies on the implementation of preventative
                      school-based mental health interventions in regular
                      secondary schools. Implementation determinants were
                      synthesized using the updated version of the Consolidated
                      Framework for Implementation Research. Study quality was
                      assessed using modified checklists of the Critical Appraisal
                      Skills Programme. Twenty-six studies, involving 5 to 8,630
                      pupils, met the inclusion criteria. A total of 336
                      implementation factors were identified, with barriers (N =
                      207; $61.6\%)$ outweighing facilitators (N = 129; $38.4\%).$
                      Barriers included scheduling conflicts, low prioritization
                      of mental health, and logistical challenges. Key
                      facilitators were leadership support, age-appropriate
                      intervention design, and staff engagement. Sustained success
                      of preventative mental health interventions requires
                      integrating programs into school structures, aligning with
                      academic priorities, and addressing resource limitations.
                      Future research should focus on adapting interventions to
                      fit school contexts and strengthening leadership and
                      community support. Understanding multidimensional,
                      interacting implementation factors is essential for creating
                      sustainable interventions that positively impact adolescent
                      mental health.},
      subtyp        = {Review Article},
      keywords     = {Adolescents (Other) / Children (Other) / Implementation
                      (Other) / Mental health (Other) / Pupils (Other) /
                      Systematic review (Other)},
      cin          = {C160},
      ddc          = {610},
      cid          = {I:(DE-He78)C160-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40586958},
      doi          = {10.1007/s00787-025-02796-5},
      url          = {https://inrepo02.dkfz.de/record/302863},
}