SCALE-UP OF SAFE & CIVIL SCHOOLS’ MODEL FOR SCHOOL-WIDE POSITIVE BEHAVIORAL INTERVENTIONS AND SUPPORTS

Multi-tiered systems of support with focus on behavioral modification in elementary schools: A systematic review

Multi-tiered systems of support (MTSS) are effective in addressing challenges in schools through a tiered system of support and diagnostics. A broad field of research has developed over the past 50 years. This systematic literature review aims to provide an overview of MTSS quality, outcomes, and characteristics in elementary education research. The review includes international studies and focuses on MTSS approaches that integrate behavior modification. After searching several databases, 40 studies published between 2004 and 2020 met the criteria for closer examination. The review presents study characteristics and theoretical references of different MTSS, including location, time, sample, study design, outcome measures, groups involved, interventions, and effects. In summary, MTSS have been found to be effective in elementary schools internationally, particularly for behavior change. Future studies should investigate the interactions between interventions within the school setting and involve teachers, school staff, and stakeholders in MTSS development to improve the system's coherence and effectiveness. It's important to note that MTSS have a political dimension that affects implementation and sustainability and can impact society by improving school experiences and reducing negative behaviors.

Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT

Background

Poor mental health in childhood is common, persistent and associated with a range of adverse outcomes that include persistent psychopathology, as well as risk-taking behaviour, criminality and educational failure, all of which may also compromise health. There is a growing policy focus on children’s mental health and the role of schools in particular in addressing this.

Objectives

To evaluate whether or not the Incredible Years®(IY) Teacher Classroom Management (TCM) training improved children’s mental health, behaviour, educational attainment and enjoyment of school, improved teachers’ mental health and relationship with work, and was cost-effective in relation to potential improvements.

Design

A two-arm, pragmatic, parallel-group, superiority, cluster randomised controlled trial.

Setting

A total of 80 UK schools (clusters) were recruited in three distinct cohorts between 2012 and 2014 and randomised to TCM (intervention) or teaching as usual [(TAU) control] with follow-ups at 9, 18 and 30 months. Schools and teachers were not masked to allocation.

Participants

Eighty schools (n = 2075 children) were randomised: 40 (n = 1037 children) to TCM and 40 (n = 1038 children) to TAU.

Interventions

TCM was delivered to teachers in six whole-day sessions, spread over 6 months. The explicit goals of TCM are to enhance classroom management skills and improve teacher–student relationships.

Main outcome measures

The primary planned outcome was the teacher-reported Strengths and Difficulties Questionnaire Total Difficulties (SDQ-TD) score. Random-effects linear regression and marginal logistic regression models using generalized estimating equations were used to analyse outcomes.

Results

The intervention reduced the SDQ-TD score at 9 months [adjusted mean difference (AMD) –1.0, 95% confidence interval (CI) –1.9 to –0.1;p = 0.03] but there was little evidence of effects at 18 months (AMD –0.1, 95% CI –1.5 to 1.2;p = 0.85) and 30 months (AMD –0.7, 95% CI –1.9 to 0.4;p = 0.23). Planned subgroup analyses suggested that TCM is more effective than TAU for children with poor mental health. Cost-effectiveness analysis using the SDQ-TD suggested that the probability of TCM being cost-effective compared with TAU was associated with some uncertainty (range of 40% to 80% depending on the willingness to pay for a unit improvement in SDQ-TD score). In terms of quality-adjusted life-years (QALYs), there was evidence to suggest that TCM was cost-effective compared with TAU at the National Institute for Health and Care Excellence thresholds of £20,000–30,000 per QALY at 9- and 18-month follow-up, but not at 30-month follow-up. There was evidence of reduced disruptive behaviour (p = 0.04) and reductions in inattention and overactivity (p = 0.02) at the 30-month follow-up. Despite no main effect on educational attainment, subgroup analysis indicated that the intervention’s effect differed between those who did and those who did not have poor mental health for both literacy (interactionp = 0.04) and numeracy (interactionp = 0.03). Independent blind observations and qualitative feedback from teachers suggested that teachers’ behaviour in the classroom changed as a result of attending TCM training.

Limitations

Teachers were not masked to allocation and attrition was marked for parent-reported data.

Conclusions

Our findings provide tentative evidence that TCM may be an effective universal child mental health intervention in the short term, particularly for primary school children who are identified as struggling, and it may be a cost-effective intervention in the short term.

Future work

Further research should explore TCM as a whole-school approach by training all school staff and should evaluate the impact of TCM on academic progress in a more thorough and systematic manner.

Trial registration

Current Controlled Trials ISRCTN84130388.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 7, No. 6. See the NIHR Journals Library website for further project information. Funding was also provided by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (NIHR CLAHRC South West Peninsula).

Teacher Victimization in Authoritative School Environments

BACKGROUND

Victimization in schools is not limited to students. Teachers increasingly face threats and attacks from their students. An authoritative school environment, characterized by high structure and support, has been associated with lower rates of victimization. The purpose of this study was to explore the relationship between authoritative school environments and teacher victimization rates.

METHODS

Researchers examined public school teacher responses (N = 37,497) from the Schools and Staffing Survey regarding rules and issues facing the school community. Descriptive statistics were gathered, and a hierarchical regression technique was employed to assess the impact of a structured, supportive school environment on teacher victimization.

RESULTS

Results indicate an authoritative school environment helped reduce rates of teacher victimization. White, female teachers are among the teachers most likely to experience violence from students. Enforcing school rules, by both teachers and administrators, is the most effective way to diminish episodes of teacher victimization.

CONCLUSIONS

P-12 school personnel should emphasize the importance of enforcing school rules and reducing negative issues, such as student truancy and apathy within each school. As high levels of structure and support reduce instances of violence, these findings have important implications for school environments and teacher health.

Effectiveness evaluation of the Positive Family Support intervention: A three-tiered public health delivery model for middle schools

This article presents the results of an evaluation of Positive Family Support, an ecological family intervention and treatment approach to parent supports and family management training developed from a history of basic and translational research. This effectiveness trial, with 41 public middle schools randomly assigned to intervention or control, examined student-, teacher-, and parent-reported outcomes, as well as math and reading scores and school attendance. Multilevel analyses suggested that for students at risk for behavior problems, immediate-intervention schools outperformed control schools on parent-reported negative school contacts for students at risk for behavior problems. Implementation, however, was hampered by several challenges, including school funding cuts, lack of staff time to provide parenting supports, and staff turnover. Given that preventive interventions are generally cost effective, it is critical that researchers continue their efforts to refine these interventions and find ways to support schools' implementation of evidence-based programs that can reduce problem behavior. This article is part of a special issue "Parental Engagement in School-Based Interventions".