A randomized controlled trial of the impact of a teacher classroom management program on the classroom behavior of children with and without behavior problems

Strengthening the Resilience of Children and Adolescents during a Pandemic: A Scoping Review on Eligible Interventions

BACKGROUND

The COVID-19 pandemic dramatically affects children's and adolescents' mental health. The accumulation of stress factors and a lack of social support complicate a healthy development. Since the beginning of the pandemic, there has been almost a doubling of mental health problems in children and adolescents. Promoting resilience is a possible approach to reduce the incidence of mental health problems despite these adverse circumstances.

OBJECTIVES

This literature search aims at identifying and evaluating interventions to promote resilience mechanisms, with a special focus on feasibility in a crisis situation.

MATERIALS AND METHODS

This scoping review is based on a systematic literature search including the databases Cochrane Library, PubMed, Psyc-Info, Psyndex and Google Scholar (2006-2020). Of 1733 identified articles 75 were included.

RESULTS

Out of 72 identified intervention studies 28% were feasible under pandemic conditions. The most effective resilience trainings seem to be individualized interventions using cognitive behavioral therapy elements. However, many approaches primarily show short-term success.

DISCUSSION

Few evidence-based programs are feasible online or under pandemic restrictions. Most of them show short-term effects and focus on parents and individuals. Multiple programs are ready for use, but still lack proof of efficacy. The development and improvement of (digital) resilience interventions should be an essential part of preventive health care, especially for risk groups.

HINTERGRUND

Die COVID-19-Pandemie beeinflusst die mentale Gesundheit von Kindern und Jugendlichen auf dramatische Weise. Durch eine Akkumulation von Belastungsfaktoren und das Wegfallen sozialer Unterstützung ist eine regelrechte Entwicklung erschwert. Seit Beginn der Pandemie kam es nahezu zu einer Verdopplung der psychischen Auffälligkeiten. Die Förderung der Resilienz kann ein Ansatz sein, das Auftreten von psychischen Auffälligkeiten trotz dieser widrigen Umstände zu vermindern.

ZIEL DER ARBEIT

Ziel dieser Literaturrecherche ist die Identifikation und Bewertung von Interventionen zur Förderung von Resilienzmechanismen, mit Fokus auf die Durchführbarkeit unter Krisenbedingungen.

MATERIAL UND METHODEN

Dieses Scoping Review basiert auf einer systematischen Literaturrecherche der Datenbanken Cochrane Library, PubMed, Psyc-Info, Psyndex sowie Google Scholar (2006-2021). Von der insgesamt 1733 Artikel umfassenden Suche wurden 75 Artikel eingeschlossen.

ERGEBNISSE

Von 72 identifizierten Interventionsstudien sind 28% unter Pandemiebedingungen durchführbar. Die wirksamsten Resilienztrainings scheinen individualisierte Interventionen mit Elementen der kognitiven Verhaltenstherapie zu sein. Viele Ansätze zeigen jedoch in erster Linie kurzfristige Erfolge.

DISKUSSION

Nur wenige evidenzbasierte Programme sind online oder unter Pandemiebedingungen verfügbar. Die meisten von ihnen zeigen kurzfristige Effekte und konzentrieren sich auf Eltern und Einzelpersonen. Zahlreiche Programme sind nutzbar, allerdings fehlt häufig ein Evidenznachweis. Die Entwicklung und Verbesserung von (digitalen) Resilienzmaßnahmen sollte ein wesentlicher Bestandteil der präventiven Gesundheitsversorgung sein, insbesondere für Risikogruppen.

Internet and Video Games: Causes of Behavioral Disorders in Children and Teenagers

Even though video games have been present among children for many years, children are using them more continuously and in an abusive and indiscriminate way nowadays because of the "technological boom". It is affecting the behavior of children and adolescents. This is the reason why we are carrying out this systematic review. The main objective of this article is to investigate literature that directly connects the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people. The PRISMA statement was followed in the process of this article. We used SCOPUS, Web of Science and PubMed as databases, moreover, we searched studies with a scoping review. The results indisputably supported six out of seven of our hypotheses. We find that the excessive use of video games causes addiction to technology, aggressive behaviors, sleep disorders, and poor school performance. In addition, it hinders social relationships and the development of emotional intelligence. To conclude, it is necessary to correctly use video games in particular, and technologies in general, adapting their content to children's age, as well as the amount of time that they dedicate to use them.

Professional Development Targeting Classroom Management and Behavioral Support Skills in Early Childhood Settings: A Systematic Review

Early childhood educators are expected to provide the children in their centers high-quality care and preparation for later school success. At the same time, nearly a third of children enter early care and education settings displaying challenging behaviors, which in turn impacts educators' stress levels and wellbeing. It is then unsurprising that classroom management and providing behavioral supports are consistently identified as areas where educators require further training upon entering the workforce. The purpose of this study is to conduct a systematic review of the empirical literature on professional development (PD) approaches targeting these areas for early childhood professionals. Forty-two studies were identified as meeting inclusion criteria and were coded for strategies targeted, the context and characteristics of the PD series, and the research design and outcomes utilized. Findings revealed that studies were highly variable in terms of targeted strategies, format of administration, training dose, research design, educator and child samples, and reporting practices. The majority of studies were conducted with educators from Head Start and public preschools and utilized research staff in the administration of the PD approaches. This indicates a need for more high-quality empirical evidence on PD approaches that cater to the larger early childhood workforce and centers' needs. Implications for researchers and early childhood mental health professionals and administrators are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12310-022-09562-x.

Systematic Review and Meta-Analysis of the Effectiveness of Teacher Delivered Interventions for Externalizing Behaviors

This systematic review and meta-analysis explores the effectiveness of teacher interventions supporting children with externalizing behaviors based on teacher and child outcomes. A systematic search was conducted using 5 electronic databases. From 5714 papers, 31 papers that included interventions delivered directly to teachers and aimed to benefit either teachers and/or children with externalizing behaviors were included. The review focused on qualified teachers working with children aged 2-13. The results of the current meta-analysis revealed a positive effect of teacher intervention on teacher and child outcomes, including the increased use of teacher-appropriate strategies, as well as significant and moderate improvements in teacher-child closeness, and small reductions in teacher-child conflict. For child outcomes, the interventions reduced externalizing behavior problems and ADHD symptoms and enhanced prosocial behavior. Only one fully blinded analysis for conduct problems was possible and revealed a moderate but significant reduction in favor of intervention. These findings provide evidence to support the role of teacher interventions for both teachers and children with externalizing behaviors. Future research should include more PBLIND measurements so that MPROX findings can be confirmed. More research should be done to evaluate the influence of teacher interventions on teachers' well-being.

A Meta-Analysis of the Current State of Evidence of the Incredible Years Teacher-Classroom Management Program

This meta-analysis evaluated the current state of evidence and identified potential treatment moderators of the Incredible Years Teacher Classroom Management (IYTCM) program used to reduce externalizing and internalizing behaviors in school-aged children. Inclusion criteria involved published studies between 1984–2018 and examining the effects of IYTCM as a standalone program on teacher and/or child behavioral outcomes. We identified and narratively summarized potential moderators, which included the severity of child behavior, dosage, study design, and reporting methods. Overall, effect sizes revealed IYTCM had moderate positive effects on teachers and small positive effects on children. Narrative summaries indicated larger effect sizes in higher dosage studies and higher risk children. The results align with previous systematic reviews on the Incredible Years Parent Training (IYPT) program but this is the first study to look at the teacher training program. Overall, IYTCM seems to be an effective intervention; however, what components of this program work best, for whom, and under what conditions require further empirical investigation.

Improving emotion recognition is associated with subsequent mental health and well-being in children with severe behavioural problems

Impaired emotion recognition is a transdiagnostic risk factor for a range of psychiatric disorders. It has been argued that improving emotion recognition may lead to improvements in behaviour and mental health, but supportive evidence is limited. We assessed emotion recognition and mental health following a brief and targeted computerised emotion recognition training in children referred into an intervention program because of severe family adversity and behavioural problems (n = 62; aged 7-10). While all children continued to receive their usual interventions, only children impaired in emotion recognition (n = 40) received the emotion training. Teachers blind to whether or not children had received the training rated children's mental health problems before and 6 months after the training. Participants who received the emotion training significantly improved their recognition of negative and neutral facial expressions. Although both groups showed improved behaviour at follow-up, the reduction in behavioural problems was only significant in children who received the emotion training. Post-training emotion recognition scores predicted mental health problems 6 months later independently of initial emotion recognition ability and severity of behavioural problems. The results are consistent with the view that targeting emotion recognition can improve longer term functioning in individuals with disruptive behaviour, although further research using fully randomised designs is needed before causal conclusions can be drawn with confidence.

The Incredible Years Teacher Classroom Management Program: Outcomes from a Group Randomized Trial

This group randomized controlled trial (RCT) evaluated the efficacy of the Incredible Years Teacher Classroom Management Program (IY TCM) on student social behavioral and academic outcomes among a large diverse sample of students within an urban context. Participants included 105 teachers and 1817 students in kindergarten to third grade. Three-level hierarchical linear models (HLM) were conducted to examine the overall treatment effects on teacher-reported student behavior and academic outcomes. In addition, multi-level moderation analyses were conducted to examine whether the treatment effects on student outcomes differed by demographic variables and pretest measures of social emotional and disruptive behavior and academics. Findings indicate that IY TCM reduced student emotional dysregulation (d = - 0.14) and increased prosocial behavior (d = 0.13) and social competence (d = 0.13). In addition, students initially lower on measures of social and academic competence demonstrated significant improvements on the same measure at outcome in comparison to similar peers in control classrooms. Practical significance of the findings and implications for schools and policy makers are discussed.

Teachers' perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils

BACKGROUND

The Incredible Years^® (IY) Teacher Classroom Management (TCM) programme may be an effective way to reduce teacher stress levels, improve child behaviour, and promote positive socio-emotional development. However, few studies have considered what teachers think of the course and how it might work.

AIMS

In this paper, we examine teachers' perceptions of the impact of the TCM programme and how it might work in the classroom.

SAMPLE(S)

Forty-four UK primary school teachers who attended the TCM programme as part of the STARS trial (Ford et al., 2018, Psychol. Med., 49, 828).

METHODS

Focus groups and interviews were held with teachers two months after completing the TCM programme. Thematic analysis (Braun & Clarke, 2006, Qual. Res. Psychol., 3, 77) was employed to explore the subsequent data.

RESULTS

Three main themes were identified: impact on the teacher; on children; and on parent-teacher relationships. Impact on the teacher included a positive change in their ethos. Teachers reported being more able to see things from the child's perspective; placing a greater focus on building positive relationships; thinking before responding; feeling calmer, more confident, and in control; and employing strategies to create positive interactions with children. Teachers felt this had had a positive impact on their pupils' development and relationships with parents. Feedback on whether or not TCM was effective in tackling particularly challenging behaviour was more mixed.

CONCLUSIONS

Our findings suggest that teachers experience the TCM programme as beneficial. This is discussed alongside other qualitative and quantitative studies in this field.

The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial

BACKGROUND

We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools' important influence on child mental health.

METHODS

A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes.

TRIAL REGISTRATION

ISRCTN84130388.

RESULTS

Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = -1.0; 95% CI-1.9 to -0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health.

CONCLUSIONS

TCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.

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).

Investigating teacher and student effects of the Incredible Years Classroom Management Program in early elementary school

The present paper reports on the results of a cluster randomized trial of the Incredible Years® Teacher Classroom Management Program (IY-TCM) and its effects on early elementary teachers' management strategies, classroom climate, and students' emotion regulation, attention, and academic competence. IY-TCM was implemented in 11 rural and semi-rural schools with K-2 teachers and a diverse student sample. Outcomes were compared for 45 teachers who participated in five full day training workshops and brief classroom consultation and 46 control teachers; these 91 teachers had a total of 1192 students. A high level of teacher satisfaction was found and specific aspects of the training considered most valuable for early elementary teachers were identified. Hierarchical linear modeling indicated a statistically significant intervention effect on Positive Climate in the classroom (d=0.45) that did not sustain into the next school year. No main effects on student outcomes were observed, although a priori moderator analyses indicated that students with elevated social-behavioral difficulties benefitted with regard to prosocial behavior (d=0.54) and inattention (d=-0.34). Results highlight potential benefits and limitations of a universal teacher training program for elementary students, and suggest strategies for future delivery of the IY-TCM program and areas for future research.

Does the Incredible Years Teacher Classroom Management Training programme have positive effects for young children exhibiting severe externalizing problems in school?: a quasi-experimental pre-post study

BACKGROUND

Young children exhibiting severe externalizing problems in school are at risk of developing several poor outcomes. School-based intervention programs have been found to be effective for students with different problems, including those with behavioral problems, emotional distress, or social problems. The present study investigated whether the IY-TCM programme, as a universal stand-alone school intervention programme, reduced severe child externalizing problems as reported by the teacher, and evaluated if these children improved their social competence, internalizing problems, academic performances and student- teacher relationship as a result of the IY TCM training.

METHODS

A quasi-experimental pre-post study was conducted, including 21 intervention schools and 22 control schools. Children in 1^st - 3^rd grade (age 6-8 years) assessed by their teacher as having severe externalizing problems on the Sutter-Eyberg Student Behavior Inventory-Revised (SESBI-R) total Intensity score, were included in the study, N = 83 (65 boys and 18 girls). Treatment effects were evaluated using 3- level linear mixed models analysis.

RESULTS

In our study we found no differences in change between the two conditions from baseline to follow-up in externalizing problems, social skills, internalizing problems and closeness with teacher. The intervention condition did however show advantageous development in terms of student-teacher conflicts and increased academic performances.

CONCLUSION

The IY Teacher Classroom Management program is not sufficient being a stand-alone universal program in a Norwegian primary school setting, for students with severe externalizing problems. However; some important secondary findings were found. Still, young school children with severe externalizing problems are in need of more comprehensive and tailored interventions.

Protocol for a cluster randomised controlled trial of an intervention to improve the mental health support and training available to secondary school teachers - the WISE (Wellbeing in Secondary Education) study

BACKGROUND

Teachers are reported to be at increased risk of common mental health disorders compared to other occupations. Failure to support teachers adequately may lead to serious long-term mental disorders, poor performance at work (presenteeism), sickness absence and health-related exit from the profession. It also jeopardises student mental health, as distressed staff struggle to develop supportive relationships with students, and such relationships are protective against student depression. A number of school-based trials have attempted to improve student mental health, but these have mostly focused on classroom based approaches and have failed to establish effectiveness. Only a few studies have introduced training for teachers in supporting students, and none to date have included a focus on improving teacher mental health. This paper sets out the protocol (version 4.4 20/07/16) for a study aiming to address this gap.

METHODS

Cluster randomised controlled trial with secondary schools as the unit of randomisation. Intervention schools will receive: i) Mental Health First Aid (MHFA) training for a group of staff nominated by their colleagues, after which they will set up a confidential peer support service for colleagues ii) training in MHFA for schools and colleges for a further group of teachers, which will equip them to more effectively support student mental health iii) a short mental health awareness raising session and promotion of the peer support service for all teachers. Comparison schools will continue with usual practice. The primary outcome is teacher wellbeing measured using the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). Secondary outcomes are teacher depression, absence and presenteeism, and student wellbeing, mental health difficulties, attendance and attainment. Measures will be taken at baseline, one year follow up (teachers only) and two year follow up. Economic and process evaluations will be embedded within the study.

DISCUSSION

This study will establish the effectiveness and cost-effectiveness of an intervention that supports secondary school teachers' wellbeing and mental health, and improves their skills in supporting students. It will also provide information regarding intervention implementation and sustainability.

TRIAL REGISTRATION

International Standard Randomised Controlled Trial Number: ISRCTN95909211 registered 24/03/16.

A pilot cluster randomised controlled trial of a support and training intervention to improve the mental health of secondary school teachers and students - the WISE (Wellbeing in Secondary Education) study

BACKGROUND

Secondary school teachers are at heightened risk of psychological distress, which can lead to poor work performance, poor quality teacher-student relationships and mental illness. A pilot cluster randomised controlled trial (RCT) - the WISE study - evaluated the feasibility of a full-scale RCT of an intervention to support school staff's own mental health, and train them in supporting student mental health.

METHODS

Six schools were randomised to an intervention or control group. In the intervention schools i) 8-9 staff received Mental Health First Aid (MHFA) training and became staff peer supporters, and ii) youth MHFA training was offered to the wider staff body. Control schools continued with usual practice. We used thematic qualitative data analysis and regression modelling to ascertain the feasibility, acceptability and potential usefulness of the intervention.

RESULTS

Thirteen training observations, 14 staff focus groups and 6 staff interviews were completed, and 438 staff (43.5 %) and 1,862 (56.3 %) students (years 8 and 9) completed questionnaires at baseline and one year later. MHFA training was considered relevant for schools, and trainees gained in knowledge, confidence in helping others, and awareness regarding their own mental health. Suggestions for reducing the length of the training and focusing on helping strategies were made. A peer support service was established in all intervention schools and was perceived to be helpful in supporting individuals in difficulty - for example through listening, and signposting to other services - and raising the profile of mental health at a whole school level. Barriers to use included lack of knowledge about the service, concerns about confidentiality and a preference for accessing support from pre-existing networks.

CONCLUSIONS

The WISE intervention is feasible and acceptable to schools. Results support the development of a full-scale cluster RCT, if steps are taken to improve response rates and implement the suggested improvements to the intervention.

TRIAL REGISTRATION

International Standard Randomised Controlled Trial Number: ISRCTN13255300 retrospectively registered 28/09/16.

Teaching classroom management – a potential public health intervention?

Purpose

– The purpose of this paper is to explore the feasibility of a classroom management course as a public health intervention. Improved socio-emotional skills may boost children’s developmental and academic trajectory, while the costs of behaviour problems are enormous for schools with considerable impact on others’ well-being.

Design/methodology/approach

– In total, 40 teachers attended the Incredible Years (IY) Teacher Classroom Management (TCM) intervention in groups of ten. Afterwards teachers attended focus groups and semi-structured interviews were completed with headteachers to explore whether TCM was feasible, relevant and useful, research processes were acceptable and if it influenced teachers’ practice and pupils. Teachers completed standardised questionnaires about their professional self-efficacy, burnout and well-being before and after attendance.

Findings

– In all, 37/40 teachers completed the course. Teachers valued sharing experiences, the support of colleagues in the group and time out to reflect on practice and rehearse new techniques. Most teachers reported that they applied the strategies with good effect in their classrooms. Teachers’ questionnaires suggested an improvement in their self-efficacy in relation to classroom management (p=0.03); other scales changed in the predicted direction but did not reach statistical significance.

Research limitations/implications

– Although preliminary and small, these feasibility study findings suggest that it was worthwhile proceeding to a definitive randomised controlled trial (RCT).

Practical implications

– Should the RCT demonstrate effectiveness, then the intervention is an obvious candidate for implementation as a whole school approach.

Originality/value

– Successful intervention with one teacher potentially benefits every child that they subsequently teach and may increase the inclusion of socio-economically deprived children living in challenging circumstances in mainstream education.

Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial

Background

The ‘Supporting Teachers And childRen in Schools’ (STARS) study is a cluster randomised controlled trial evaluating the Incredible Years Teacher Classroom Management (TCM) programme as a public health intervention. TCM is a 6 day training course delivered to groups of 8–12 teachers. The STARS trial will investigate whether TCM can improve children’s behaviour, attainment and wellbeing, reduce teachers’ stress and improve their self-efficacy. This protocol describes the methodology of the process evaluation embedded within the main trial, which aims to examine the uptake and implementation of TCM strategies within the classroom plus the wider school environment and improve the understanding of outcomes.

Methods/design

The STARS trial will work with eighty teachers of children aged 4–9 years from eighty schools. Teachers will be randomised to attend the TCM course (intervention arm) or to “teach as normal” (control arm) and attend the course a year later. The process evaluation will use quantitative and qualitative approaches to assess fidelity to model, as well as explore headteachers’ and teachers’ experiences of TCM and investigate school factors that influence the translation of skills learnt to practice. Four of the eight groups of teachers (n = 40) will be invited to participate in focus groups within one month of completing the TCM course, and again a year later, while 45 of the 80 headteachers will be invited to take part in telephone interviews. Standardised checklists will be completed by group leaders and each training session will be videotaped to assess fidelity to model. Teachers will also complete standardised session evaluations.

Discussion

This study will provide important information about whether the Teacher Classroom Management course influences child and teacher mental health and well-being in both the short and long term. The process evaluation will provide valuable insights into factors that may facilitate or impede any impact.

Trial registration

The trial has been registered with ISCTRN (Controlled Trials Ltd) and assigned an ISRCTN number ISRCTN84130388. Date assigned: 15 May 2012.