Understanding the behavioral determinants of intervention fidelity in school mental health: a COM-B model study of multi-tiered systems of support in Chile

Rodrigo Miguel Rojas-Andrade; Luiz Paulo Ribeiro

doi:10.30715/doxa.v27i00.20595

Authors

Rodrigo Miguel Rojas-Andrade Universidad de Santiago de Chile https://orcid.org/0000-0002-6459-6902
Luiz Paulo Ribeiro Universidade Federal de Minas Gerais https://orcid.org/0000-0002-4278-7871

DOI:

https://doi.org/10.30715/doxa.v27i00.20595

Keywords:

Multi-Tiered System of Support (MTSS), Intervention Fidelity, School Mental Health, COM-B Framework

Abstract

Mental disorders are a leading cause of morbidity among children and adolescents worldwide, with Chile showing particularly high levels of stress, anxiety, and depression in students. Multi-Tiered Systems of Support (MTSS) offer a structured framework for school-based mental health interventions, yet sustaining fidelity remains challenging. This cross-sectional study analyzed how the COM-B model dimensions (capability, opportunity, and motivation) relate to intervention fidelity in Chilean public schools. Data were collected via surveys from 359 education professionals across all 16 regions, using an adapted DIBQ-18 and a composite fidelity index. Partial least squares structural equation modeling revealed psychological capability and reflective motivation as direct predictors of fidelity, while physical and social opportunities and automatic motivation exerted indirect effects through psychological capability. The model explained 33.2% of fidelity variance. Findings highlight the central role of individual-level determinants, suggesting that capacity-building strategies should prioritize enhancing competencies to strengthen school-based mental health interventions.

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Author Biographies

Rodrigo Miguel Rojas-Andrade, Universidad de Santiago de Chile

School of Psychology, University of Santiago de Chile (Usach), Santiago de Chile – Chile. Psychologist, Ph.D. in Psychology. Professor at the School of Psychology, University of Santiago de Chile. Funded by Proyecto FONIDE n. 2400071.

Luiz Paulo Ribeiro, Universidade Federal de Minas Gerais

Federal University of Minas Gerais (UFMG), Belo Horizonte – Minas Gerais (MG) – Brazil. Professor in the Department of Applied Educational Sciences at the School of Education (UFMG).

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