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Supporting Implementation of Expanded School Mental Health Services: Application of the Interactive Systems Framework in Ohio

In this article, we compare and contrast the Multilevel Implementation Quality Framework (Domitrovich et al, 2008, this issue) with other emerging frameworks, theories, and models emerging in health services literature. We describe application of the Interactive Systems Framework for Dissemination and Implementation (ISF) to support strengthening implementation of Expanded School Mental Health Services (ESMH) in Ohio. We argue that participatory framework development presents promise as a means to overcome disciplinary and structural impediments to promoting implementation of ESMH. We describe the process of engaging key stakeholders to explore, understand, and improve implementation of ESMH services, and provide examples of how the process led to improved understanding of dissemination and implementation, and fomented commitment and support for strategies to strengthen implementation of ESMH services across the state.