Clinical trial NCT06270914: Inclusive Positive Behaviour Supports
Official title: Inclusive Positive Behavior Support in School - the Causal Mechanisms and Interactive Processes. A Study Protocol
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Behavior Problem
Social Skills
Keywords: behavior problem
positive behavior support
prevention
universal
Lead sponsor: Uppsala University
Sponsor class: OTHER
Collaborators: name: The Swedish Research Council
First posted: 2024-02-21
Enrollment: 5000
Sex: ALL
Minimum age (years): 9
Maximum age (years): 15
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: This study utilizes quasi-experimental non-randomized design, including two waves of participant recruitment. Two waves of recruitment are used. In the first wave of recruitment, intervention and active control group are used and outcomes will be measured at three time points. In addition to quantitative data, qualitative observations and interviews are conducted to get a deeper understanding of the process of implementation of SWPIS. In the second wave of data recruitment, intervention and wait-list control group are used and outcomes will be measured at two time points (pre- and post).
Primary purpose: PREVENTION

Brief summary: Background: While positive school climate is important for students' well-being and mental health, school personnel may experience challenges in creating a nurturing school climate. School-Wide Positive Behavioral Interventions and Supports (SW-PBIS) have shown positive effects on school climate, but fewer studies have been conducted in the European context. Aim: The present project aims to investigate the effectiveness of SW-PBIS programs for students' social-emotional skills and academic achievement as well as teachers' and students' perceptions of the learning environment. Furthermore, the study intends to evaluate how school-level factors mediate or moderate the effects of the intervention. In addition, the study includes a qualitative evaluation of the dynamic interaction processes that occur during program implementation in local school contexts. Methods: Data on school- and individual-level measures are collected in intervention and control schools. With regard to challenges in retaining control groups over extended time periods, two waves of recruitment are used. In the first wave, an active control group is used, and data are collected during three time points. In the second wave, a wait-list control group is used, and data are collected during two time points during one school year. Hierarchical regression analyses will be conducted to explore the effects of SW-PBIS on the outcomes of the study. An ethnomethodological approach will be applied to provide a detailed examination of the social interactional and meaning-making practices of different school implementation teams, and the negotiation of normative expectations and rules of conduct in peer-teacher-student interactions in different classrooms. Discussion: The study is expected to contribute knowledge on the effects of the SWPBIS program and how these effects may be mediated or moderated by school-level factors. Combining quantitative and qualitative methods to explore the significance of school contexts in the implementation of the SWPBIS program constitutes the strength of the study. The challenge in the study is the extended period of implementation of SWPBIS, which entails difficulties in retaining a control group over the required time period. Therefore, two waves of recruitment are used, encompassing different procedures of allocation to intervention or control groups.

Detailed description: Aim and Research Questions:

Firstly, the aim is to evaluate the effectiveness of the SWPBIS program for students' socio-emotional skills and academic achievement as well as teachers' and students' perceptions of the learning environment, and to explore how school-level factors may moderate or mediate the effect of SWPBIS on the outcomes. Secondly, the aim is to gain a deeper understanding of the social processes and local meanings that emerge and take form among the students, teachers, and other school professionals as they participate in the SW-PBIS program. The aims are specified in four research questions:

1. What are the effects of the SW-PBIS program on students' socio-emotional skills and academic achievement as well as teachers' and students' perceptions of the learning environment?
2. To what extent do school-level factors mediate and moderate the effects of the SW-PBIS program on the study outcomes over time?
3. How are the central contents of the SW-PBIS program made sense of and negotiated in school teams and classrooms at two schools during the course of program implementation?
4. How do specific instances of student-teacher interaction lead to changes in students' behavior and responses to the SW-PBIS program, and what forms of ethical dilemmas evolve in the management of behavior problems in classrooms?

Methods:

This study utilizes a quasi-experimental non-randomized design, including two waves of participant recruitment. In the first wave of recruitment, intervention and active control groups are used, and outcomes will be measured at three time points. In addition to quantitative data, qualitative observations and interviews are conducted to gain a deeper understanding of the process of implementing SWPIS. In the second wave of data recruitment, intervention and wait-list control groups are used, and outcomes will be measured at two time points (pre- and post).

The study will be conducted in compulsory schools and will include classes from grade four to grade nine. Each of the two waves of recruitment in the study will include 80 schools. Data will be collected on school-level measures and individual-level measures. School-level measures encompass: (a) Teacher collective self-efficacy; (b) Problem behavior in the classroom and school. Individual-level measures encompass: (a) Social-emotional skills; (b) Classroom environment; (c) Student achievement in national tests of mathematics and literacy.

The intervention is based on the Norwegian manualized program of SW-PBIS, N-PALS (Positiv Atferd, Støttende Læringsmiljø, og Samhandling). The Norwegian model shares its core components with the original SW-PBIS model. The program's core components constitute: (a) Positive behavior support strategies, including positive expectations and classroom rules, which are followed up with positive feedback and encouragement; (b) A system for monitoring student behavior, (c) School-wide corrections using consequences, (d) Instruction in classroom management skills for teachers, and (e) Strategies for collaboration with parents. These components are implemented through activities at the school level and at the classroom level. The implementation at the school level starts with establishing a leadership team, comprised of school leaders, team leaders, and members of the school welfare team. The leadership team assesses the needs and resources at the school and agrees on behavioral expectations and rules. The team monitors student behaviors and provides opportunities for teacher professional development with a focus on classroom management and relationship building. At the classroom level, the teachers incorporate school-wide expected behaviors into their classroom instruction through classroom activities and classroom rules. The teachers also integrate their training in classroom management and relationship building into their teaching practices. The duration of Tier 1 intervention is expected to be three years.

The control group in the first wave of data collection is selected in accordance with a quasi-experimental design with a nonequivalent control group. The teachers in the control group will, instead of a wait-list intervention, receive a shortened version of SW-PBIS containing only classroom leadership lectures. The schools that are part of the classroom management group also send staff for instructor training (ten training sessions, 25 hours in total, just as much as the SW-PBIS schools). Similar to the SW-PBIS group, the instructors in this group educate and supervise school staff, supported by a team at the school. Both groups have access to a manual and supporting materials. This design does not pose threats to the internal validity of the study, as classroom leadership is one of the principles of the PBIS framework. In this way, it will be possible to explore the specific contribution of schoolwide PBS in contrast to classroom leadership only. The control group in the second wave of data collection constitutes a wait-list control group and will not be engaged in any kind of intervention during the intervention period.

Hierarchical regression analyses with a three-level structure will be conducted to explore the effects of SW-PBIS on study outcomes. Hierarchical regression analyses allow for accounting for the nested structure of the data, in which teachers' and students' responses are nested within schools and grade levels. The outcomes at the school and individual levels will be studied as a function of time (three time points for wave 1 and two time points for wave 2) and group belonging (intervention or control group). To take into account the nestedness of the data, a three-level random effect model will be used, varying by school, grade, and the individuals' identification codes. Furthermore, the possible mediators (quality of implementation) and moderators (school characteristics, school-level variables) of the SWPBIS intervention will be analyzed. Missing data will be handled by imputation, provided that the assumption of data missing completely at random is met.

In the qualitative study, a longitudinal ethnographic approach will be used in order to obtain detailed contextualized knowledge on interactions in various contexts in two of the intervention schools, recruited in wave 1, over a longer period of time. Through purposeful sampling, three schools with different characteristics regarding size and catchment area will be selected.

Eligibility criteria: Inclusion Criteria:

* compulsory school, grades 4-9;
* the school have not been previously enrolled in an SWPBIS program by other providers;
* principal, teachers, students and their parents consent to participate in the study.

Exclusion Criteria:

* grades other than 4-9;
* the school has previously received or is enrolled in SWPBIS program or other PBS program;
* students or their parents have not consented to participation in the study.

Primary outcomes:
measure: Social emotional skills
timeFrame: 11 months
measure: Classroom environment
timeFrame: 11 months
measure: Students' achievement
timeFrame: 11 months
Secondary outcomes:
measure: Collective self-efficacy
timeFrame: 11 months
measure: Problem behavior in classroom and school
timeFrame: 11 months
Other outcomes:
measure: Implementation fidelity
timeFrame: 11 months
Locations:
city: Uppsala
country: Sweden
facility: Department of Education
state: Uppland
Study officials:
References: