Kognito
About Kognito Another great reason to participate in the RESPONSE program. These courses are made available for free to all educators and staff in the first 100 high schools in Oregon that sign up and have implemented the RESPONSE program. The courses are provided through the Oregon Public Health Division, with funding from the Substance Abuse and Mental Health Services Administration. In this 1-hour online training, users enter a virtual environment, assume the role of an educator, and engage in conversations with three emotionally responsive student avatars that exhibit signs of psychological distress, including thoughts of suicide. Step In, Speak Up! for supporting LGBTQ youth is a 30-minute online training to prepare educators and school staff to support students who may be struggling due to harassment or exclusion related to sexual identity, sexual orientation or other differences. Both trainings are listed in SPRC/AFSP
Best Practices Registry. Kognito
At-Risk for High School Educators The course begins by introducing the participant to a teacher who is concerned about three of his students. Assuming the role of the teacher and with the help of a virtual coach, the participant practices using evidence-based techniques to effectively broach the topic of psychological distress and motivate each student to accept appropriate support. The participant also learns to avoid common pitfalls in conducting referral conversations, such as attempting to diagnose the problem or giving unwarranted advice. By providing hands-on practice, the training increases participants' confidence and ability to handle similar challenging situations in real life. A local resources button within the course links participants to specific information about the availability of local mental health resources. Kognito provides At-Risk for High School Educators under licensing agreements to schools, districts, statewide agencies, and nonprofit organizations. A member of the client agency serves as the course administrator. Program setup requires 1 hour of the administrator's time and is conducted via an online meeting. Depending on the institution's infrastructure, goals, and overall suicide prevention strategy, administrators can expect to spend 2-8 hours per month disseminating and promoting the course to learners. Professional development credit is often available for those completing the course. Kognito At-Risk for High School Educators is part of a suite of online role-play training simulations offered by Kognito. Other courses are available for college students, military families, and medical professionals (see Adaptations section below). Descriptive Information Areas of Interest Mental health promotion Outcomes Review Date: May 2012 1. Preparedness to recognize, approach, and refer students exhibiting signs of psychological distress Outcome Categories: Mental health:
Suicide Rural and/or frontier Implementation History Since its release in 2010, Kognito At-Risk for High School Educators has been adopted by State-level agencies in Alaska, Arizona, Illinois, Maryland, New York, North Dakota, Ohio, Texas, and Washington for use by more than 500,000 teachers, administrators, and staff. It has been used in public, charter, vocational, and parochial schools and teacher training programs. The course was developed to be suitable for a wide variety of settings and appropriate for and acceptable to a broad range of racial and ethnic groups. NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No Evaluated in comparative effectiveness research studies: No Adaptations Kognito At-Risk for High
School Educators is part of a suite of online role-play
training simulations that support large-scale, universal
mental health promotion and suicide prevention, as well as
early intervention of suicidal ideation and mental illness
(see www.kognito.com/products/
Adverse Effects: No adverse effects, concerns, or unintended consequences were identified by the developer. IOM Prevention Categories
Universal Quality of
Research expanded arrow image The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted. Study 1 Albright, G., Eastgard, S., Goldman, R., & Shockley, K. (2011). At-Risk for High School Educators: On-line interactive gatekeeper training simulation for identification and referral of students exhibiting signs of psychological distress. Unpublished manuscript. Study 2 Albright, G., Eastgard, S., Goldman, R., & Shockley, K. (2011). At-Risk for High School Educators: On-line interactive gatekeeper training simulation for identification and referral of students exhibiting signs of psychological distress. Unpublished manuscript. Supplementary Materials At-Risk for High School Educators Supporting Document (document created for the NREPP review) Outcomes Outcome 1: Preparedness to recognize, approach, and refer students exhibiting signs of psychological distress Description of Measures Three items from a 12-item online questionnaire were used to assess this outcome. Teachers were asked to rate their perceived preparedness to (1) recognize when a student is exhibiting signs of psychological distress, (2) approach a student exhibiting signs of distress to discuss their concerns, and (3) refer a distressed student to a counseling center. An example of one of the items is "How would you rate your preparedness to recognize when a student's behavior is an indicator of psychological distress?" Responses were on a 4-point Likert scale ranging from "low" to "very high." Key Findings In one study, teachers in the intervention group completed pre- and posttest assessments immediately before and after the 1-hour intervention. The results of these assessments were compared with those of a single assessment completed by teachers in a no-treatment control group. The groups were equivalent on all measures at pretest. At posttest, compared with the control group, the intervention group had higher scores for preparedness to recognize, approach, and refer a distressed student (all p values < .001). The intervention group also showed pre- to posttest increases in preparedness to recognize, approach, and refer a distressed student (all p values < .001). In another study, teachers in the intervention group completed a posttest assessment immediately after the 1-hour intervention. The results of this assessment were compared with those of an assessment completed by teachers in a no-treatment control group. At posttest, compared with the control group, the intervention group reported greater preparedness to recognize (p = .02), approach (p < .001), and refer (p < .001) a distressed student. Studies Measuring Outcome Study 1, Study 2 Study Designs Quasi-experimental, Preexperimental Quality of Research Rating 2.8 (0.0-4.0 scale) Outcome 2: Likelihood of approaching and referring students exhibiting signs of psychological distress Description of Measures One item from a 12-item online questionnaire was used to assess this outcome. Teachers were asked, "How likely are you to approach and, if necessary, refer a student exhibiting signs of psychological distress?" Responses were on a 4-point Likert scale ranging from "not likely" to "very likely." Key Findings In one study, teachers in the intervention group completed pre- and posttest assessments immediately before and after the 1-hour intervention. The results of these assessments were compared with those of a single assessment completed by teachers in a no-treatment control group. The groups were equivalent on all measures at pretest. At posttest, compared with the control group, the intervention group reported a higher likelihood of approaching and referring a student exhibiting signs of psychological distress (p < .001). The intervention group also showed a pre- to posttest increase for this outcome (p < .001). In another study, teachers in the intervention group completed a posttest assessment immediately after the 1-hour intervention. The results of this assessment were compared with those of an assessment completed by teachers in a no-treatment control group. At posttest, compared with the control group, the intervention group reported a higher likelihood of approaching and referring a student exhibiting signs of psychological distress (p < .001). Studies Measuring Outcome Study 1, Study 2 Study Designs Quasi-experimental, Preexperimental Quality of Research Rating 2.8 (0.0-4.0 scale) Outcome 3: Confidence in one's ability to help students exhibiting signs of psychological distress Description of Measures One item from a 12-item online questionnaire was used to assess this outcome. Teachers were asked to rate their agreement with the following statement: "I feel confident in my ability to help a suicidal student seek help." Responses were on a 4-point Likert scale ranging from "strongly disagree" to "strongly agree." Key Findings In one study, teachers in the intervention group completed pre- and posttest assessments immediately before and after the 1-hour intervention. The results of these assessments were compared with those of a single assessment completed by teachers in a no-treatment control group. The groups were equivalent on all measures at pretest. At posttest, compared with control group participants, teachers in the intervention group showed higher confidence in their ability to help a suicidal student seek help (p < .001). The change in teachers' confidence from pre- to posttest was not signficant. In another study, teachers in the intervention group completed a posttest assessment immediately after the 1-hour intervention. The results of this assessment were compared with those of an assessment completed by teachers in a no-treatment control group. At posttest, compared with control group participants, teachers in the intervention group had higher confidence in their ability to help a suicidal student seek help (p < .001). Studies Measuring Outcome Study 1, Study 2 Study Designs Quasi-experimental, Preexperimental Quality of Research Rating 2.8 (0.0-4.0 scale) Study Populations The following populations were identified in the studies reviewed for Quality of Research. Study Study 1 Age: 8-25 (Young adult);
26-55 (Adult); 55+
(Older adult) Study 2 Quality of Research Ratings by Criteria (0.0-4.0 scale) External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria: 1. Reliability of measures Overall Rating 1: Preparedness to recognize,
approach, and refer students exhibiting signs of
psychological distress 2.2 2.5 3.0 4.0 2.0 3.0 2.8 Study Strengths Evidence of adequate test-retest reliability and face and content validity was presented for the measures used. The online delivery of the program provides some assurance of fidelity. Missing data and attrition were reported to be low, such that no adjustments were needed. Appropriate statistical methods were used. Study Weaknesses For some of the outcome measures, the
reliability coefficients were low, and reliability and
validity data were based on a different population than that
used in the study. A number of confounding variables were
not adequately addressed, including differences in the
timing of data collection for the intervention and control
groups and differences between the study groups in
recruitment source, teaching experience, and age. In one
study, pre- and posttest assessments for the intervention
group were compared with a single assessment for the control
group that was used as both pre- and posttest; this study
design does not control for the effects of pretesting and
lowers confidence in the analyses involving comparisons of
the two groups at posttest. The second study was limited by
the use of a posttest-only design. Program Web site, highschool.kognito.com
Teacher login, highschool.kognito.com/ohio/
Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale) External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria: 1. Availability of implementation materials For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination. Dissemination Strengths The online gatekeeper training is accessible 24 hours per day, 7 days per week, and is attractive, easy to navigate, and culturally sensitive. The course includes interactive role-play exercises with student avatars, videos, and information on making local and national referrals for students in distress. An online administrator account includes a variety of tools and resources to promote and manage the intervention. An account manager assigned to each implementing site provides an initial orientation by phone as well as ongoing support. An optional introductory Webinar can be hosted and recorded by the developer, with the recording made available for future use. User tracking reports and participant surveys support quality assurance. Email reminders are automatically sent to participants who have not finished the course to increase the rate of completion. The developer continually updates and refines the course processes and materials using input from implementers. Dissemination Weaknesses:
No weaknesses were noted by
reviewers. The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements. Program license (includes
access to training and administrator access to
downloadable implementaion manual, promotional
materials, usage reports and participant
surveys Institutional licenses for
individual schools and districts: starting at
$500 per school per year, depending on the number
and size of the schools Statewide and large-district
licenses: contact the developer Yes Consultation and technical
assistance by phone or email Included with
license Yes Additional Information Information on optional training
Webinars to support implementation of this intervention can
be found on the developer's Web site at www.kognito.com/webinars/
Consider these Questions
to Ask Web Site(s): • www.kognito.com/ While Supplies
Last The possibility of fulll funding for the RESPONSE program during this school year.
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