The Irie Classroom Toolbox, a universal violence-prevention teacher-training programme, in Jamaican preschools: a single-blind, cluster-randomised controlled trial

The effectiveness of a contextually grounded social emotional learning program in Haiti: A pilot cluster randomized control trial

Social emotional learning (SEL) has a robust evidence basis, but there remains a large gap in literature on the effectiveness of programs across educational settings in low- and middle-income countries and conflict-affected settings. The present study was a pilot trial aimed at evaluating the effects of a classroom based SEL program on dimensions of classroom climate and individual student social emotional skills. In the present study, fourth through sixth grade classrooms in 10 schools (N = 39 teachers, 75.68% female; N = 1048 students, 62.3% female) were randomly allocated to the SEL or wait-list control condition. The SEL program was associated with significant improvements in teacher reports of student achievement orientation (dr = 1.21) and responsible decision-making (dr = 0.49). There were no significant differences between conditions on peer sensitivity, teacher-pupil interactions, student interpersonal skills, or overall social emotional skills. Findings suggest that this community-developed, contextually relevant SEL curriculum may hold promise even in the context of ongoing adversity, including the COVID-19 pandemic and heightened insecurity due to political violence.

A Systematic Review of the Prevalence and Correlates of Emotional Violence by Teachers

There is increasing evidence for the deleterious impact of emotional violence on children`s well-being and development. This systematic review focused on a) the prevalence and (b) correlates of emotional violence by teachers. A literature search of quantitative and peer-reviewed studies published in English between 1980 and April 2021 was conducted. Eighty-four studies met the inclusion criteria. Studies represented all geographical regions of the world, were predominantly cross-sectional and of moderate quality. Studies were heterogeneous in terms of their samples, conceptualization, and measurement of emotional violence. Results indicated that emotional violence by teachers is prevalent across cultural settings, although large variations within and between regions are noted. It is related to mental health, behavioral and academic problems of children above and beyond physical violence by teachers and victimization by peers and parents. Boys are at higher risk of experiencing emotional violence by teachers than girls. Family dysfunction, low socioeconomic status (of the family or the community), and violent school environments appear to increase risk as well. The observed patterns of co-occurrence of emotional violence with physical violence by teachers and victimization by peers as well as perpetration of violence against peers and teachers lend support to notions of poly-victimization and cycles of violence in the school settings. Future research should use representative surveys, examine antecedents, and consequences of emotional violence by teachers using longitudinal and experimental designs and evaluate interventions to prevent emotional violence by teachers.

Qualitative process evaluation of the EmpaTeach intervention to reduce teacher violence in schools in Nyarugusu Refugee Camp, Tanzania

OBJECTIVE

We explored the experiences and perceptions of school staff and students with the EmpaTeach intervention to prevent teachers' violence against school students.

DESIGN

This qualitative study involved in-depth interviews with 58 and 39 participants at midline and endline, respectively, with Burundian and Congolese intervention schools in Nyarugusu refugee camp. They comprised three education coordinators of primary and secondary schools, 29 EmpaTeach intervention coordinators, 14 stakeholders including headteachers and discipline teachers, 25 classroom teachers and 26 students. Thematic analysis was used to develop codes by examining the content of quotes to capture key themes in line with the key elements of the programme theory.

RESULTS

Coordinators and teachers widely reported positive experiences with the EmpaTeach programme. The intervention sessions enabled teachers to reflect on their own values and experiences of corporal punishment and equipped them with useful and acceptable classroom management and alternative discipline strategies. Teachers adopted the use of counselling, praise and reward, and joint discussions with students and parents. On the other hand, several teachers reported persistent use of corporal punishment which they attributed to children's (mis)behaviours and strong beliefs that beating was a positive approach to disciplining students.

CONCLUSION

The majority of coordinators and teachers widely accepted the EmpaTeach intervention as it offered useful and relevant knowledge and skills on alternative disciplinary methods. Students noticed some positive changes on the way they were being disciplined by teachers, where non-violent methods were used. Further research is needed to understand how violence prevention interventions can successfully lead to reductions in violence in fragile settings.

TRIAL REGISTRATION NUMBER

NCT03745573.

The association between violence victimization and subsequent unplanned pregnancy among adolescent girls in Uganda: Do primary schools make a difference?

Violence victimization is a risk factor for adolescent pregnancy in high-income, low violence prevalence countries, but longitudinal data are lacking from settings where violence and adolescent pregnancy are common, including sub-Saharan Africa. We also know little about contextual factors which modify this association. We analyzed data from the Contexts of Violence in Adolescence Cohort (CoVAC) study in Luwero District, Uganda. Primary students in 42 schools completed surveys in 2014 (Wave 1) and 2018 (Wave 2). Our outcome was unplanned pregnancy. Our exposure was violence victimization, including any violence, type of violence (physical, emotional, sexual), perpetrator group (teacher, peer, family member), and polyvictimization. We fit mixed-effects logistic regression models and examined school factors (e.g., connectedness, absenteeism) as effect modifiers, using data from students (n = 3,431) and staff (n = 591) at the 42 schools. 1,449 girls were included in analyses (78% follow-up). At Wave 1, 88% (n = 1,281/1,449) reported any violence (mean age = 12.73, SD = 1.44 years). At Wave 2, 13.9% (n = 201/1,449) reported an unplanned pregnancy. In adjusted models, compared to no violence, significant associations (p<0.05) were observed for any violence (OR = 1.99, 95%CI = 1.03-3.85), physical violence (OR = 1.96, 95%CI = 1.02-3.79), teacher violence (OR = 1.96, 95%CI = 1.01-3.79), peer violence (OR = 2.00, 95%CI = 1.00-4.03), family violence (OR = 2.23, 95%CI = 1.07-4.65), violence from one perpetrator group (OR = 2.04, 95%CI = 1.01-4.15), and violence from three perpetrator groups (OR = 2.21, 95%CI = 0.99-4.95). Sexual and emotional violence were associated in crude but not adjusted analyses. School and peer connectedness modified the association (p<0.05); girls who experienced violence had higher odds of unplanned pregnancy in schools with lower versus higher connectedness. Violence victimization in early adolescence is strongly associated with subsequent unplanned pregnancy among adolescent girls in Uganda but attending schools with more school or peer connectedness attenuated this link. Interventions should seek to reduce violence against girls to prevent unplanned pregnancy. Interventions promoting positive connections to school may be especially important for violence victims.

Reducing Violent Discipline by Teachers: a Matched Cluster-Randomized Controlled Trial in Tanzanian Public Primary Schools

Violent discipline in schools infringes on children's rights and is associated with harmful developmental consequences for students. This calls for effective intervention programs, particularly in countries with high prevalence of violent discipline in schools. This study tested the effectiveness of the preventative intervention Interaction Competencies with Children-for Teachers (ICC-T) in reducing violent discipline by teachers in a two-arm matched cluster-randomized controlled trial. The sample comprised teachers (n = 173, 53.7% female) and students (n = 914, 50.5% girls) from 12 public primary schools from six regions in Tanzania. Teacher physical and emotional violent discipline reported by teachers and students was assessed before and six to eight and a half months after the intervention. The schools were randomly allocated to either intervention (6; ICC-T) or control condition (6; no intervention). Teachers were not blinded. Students and research assistants conducting the follow-up assessment were blinded. A series of multivariate multilevel models revealed significant time*intervention effects on physical violent discipline reported by teachers and students and teachers' favorable attitudes towards physical violent discipline, FDRs < .05. In addition, we found a spill-over effect on peer-to-peer violence and students' externalizing, ps < .05. There were no significant time*intervention effects either on emotional violent discipline, FDRs > .05, teachers' favorable attitudes towards emotional violent discipline or on student's internalizing problems and academic performance, ps > .05. Our results provide further evidence that ICC-T may positively change teachers' violent disciplining behavior and their attitudes towards violent discipline. ClinicalTrials.gov, NCT03893851.

Understanding why EmpaTeach did not reduce teachers' use of violence in Nyarugusu Refugee Camp: A quantitative process evaluation of a school-based violence prevention intervention

EmpaTeach was the first intervention to address teacher violence to be tested in a humanitarian setting and the first to focus on reducing impulsive use of violence, but a cluster randomised trial found no evidence that the intervention was effective in reducing physical and emotional violence from teachers. We aimed to understand why. We conducted a quantitative process evaluation to describe the intervention implementation process (what was implemented and how); examine teachers' adoption of positive teaching practices (was the content of the intervention taken up by participants), and test mechanisms of impact underlying the program theory (how the intervention was supposed to produce change). Despite participation in the intervention activities and adoption of intervention-recommended strategies (classroom management and positive disciplinary methods), we show that teachers who used more positive discipline did not appear to use less violence; and teachers in intervention schools did not experience gains in intermediate outcomes such as empathy, growth mindset, self-efficacy or social support. Our findings suggest that the intervention did not work due to the failure of some key hypothesised mechanisms, rather than because of implementation challenges.

The Process of Scaling Early Childhood Violence Prevention Programs in Jamaica

BACKGROUND

Violence is a global public health problem, and early childhood interventions are a core component of violence prevention programming. Interventions to support parents and teachers of young children can prevent violence against children by caregivers and prevent the early development of antisocial behavior. However, there is limited guidance on how to scale up these programs in low- and middle-income countries.

METHODS

In this article, we describe how we applied implementation science principles in the design, implementation, evaluation, and initial scaling of 2 complementary early childhood, violence prevention, caregiver training programs in Jamaica: the Irie Classroom Toolbox (a teacher-training program) and the Irie Homes Toolbox (a parenting program).

RESULTS

We identified 7 implementation science principles most relevant to our work in scaling the Irie Toolbox programs and describe how these principles were operationalized in the Jamaican context. The principles are: (1) design programs for scale from the outset; (2) use learning cycles for quality improvement; (3) plan strategically for government agency adoption; (4) provide high-quality initial and ongoing training and regular supervision; (5) monitor implementation quality; (6) use flexible delivery modes; and (7) plan for program sustainment.

CONCLUSIONS

Through applying these principles to scale the Irie Toolbox programs, we aim to promote a consistent approach to reducing violence against children, reducing child behavior problems, and increasing caregiver and child competencies across both home and school contexts at the population level. The principles and processes described in this article are relevant to other behavior change interventions in early childhood development, education, and public health.

A qualitative evaluation of the mechanisms of action in an early childhood parenting programme to prevent violence against children in Jamaica

BACKGROUND

Violence against children (VAC) is a global public health problem, and parenting programmes are a key strategy to reduce VAC at home. We developed and evaluated a preschool-based, early childhood, violence prevention, parenting programme (the Irie Homes Toolbox) in Jamaica and reported significant reductions in parents' use of VAC [Effect size (ES) = -0.29] and increases in parents' positive practices (ES = 0.30). This study presents qualitative findings on the mechanisms of action of the programme.

METHODS

As part of a cluster randomized trial, 115 parents from nine preschools participated in the Irie Homes Toolbox parenting programme. The programme consisted of eight 90-min sessions with groups of six parents and focussed on strengthening parent-child relationships, understanding children's behaviour, using appropriate discipline strategies and understanding and managing emotions. We conducted in-depth, semi-structured interviews with a stratified random sample of 28 parents (two to four parents per school) and with nine preschool teachers (one teacher per preschool). Topic guides were developed to explore participants' perspectives of the mechanisms of action of the programme. All interviews were audio-recorded and transcribed, and data were analysed using the framework approach.

RESULTS

The most salient direct pathways to reduced VAC by both parent and teacher reports were through parents' use of alternative strategies to manage child misbehaviour and through improved parent well-being, especially parents' self-management skills. Other factors leading to reduced VAC by parents, reported by both parents and teachers, included self-identification as an 'Irie parent', use of proactive parenting strategies and improved child behaviour. Parents reported that the main factors leading to continued use of VAC were their inconsistency in using positive discipline strategies and poor emotional self-regulation.

CONCLUSION

Reports from participating parents and preschool teachers indicate that contents related to parental self-management and how to use positive discipline strategies to manage child misbehaviour were important factors on the pathway to reduced VAC.

'I went there in an effort to help the child, but you can see there is corruption in the world': Adults' conceptualisations and enactments of child protection in schools in a challenging context

Schools have the potential to be sites of support for vulnerable children, but can also be sites of violence perpetration. In this qualitative study we explore how adult school stakeholders in and around two public Catholic primary schools in Zimbabwe conceptualise and enact child protection. We analysed our findings in light of the protracted economic crisis in Zimbabwe; the current policy context for child protection; and the Covid-19 pandemic. We conducted semi-structured interviews with 18 adult education stakeholders in and around one rural and one urban school in the Harare Archdiocese, from October 2020 to January 2021. This comprised 12 school-level stakeholders, including teachers (N = 4), parents (N = 4), school priests (N = 2), and headteachers (N = 2), who were the main focus of this study, and a further 6 high-level education actors. We employed thematic analysis. Adults in this study placed considerable responsibility on children to protect themselves, with often unreasonably high expectations of children's capacity to prevent abuse. At times they also blamed and stigmatised children, which was gendered, and particularly emerged around adolescent sexuality. Our findings suggest that this was linked to social norms around discipline, protection and gender, but in particular, the way these emerged in relation to the challenges of the context. Policy and interventions to promote child protection in schools in Zimbabwe should incorporate both an attention to the challenges teachers face in contexts of adversity, as well as address a tendency for adult school stakeholders to hold children responsible for their own protection.

The Relationship between the Outdoor School Violence Distribution and the Outdoor Campus Environment: An Empirical Study from China

It is widely believed that outdoor environmental design contributes to outdoor violence prevention. To enhance the effectiveness of environmental design, the intrinsic link between the outdoor school violence distribution (OSVD) and the outdoor campus environment (OCE) should be fully considered. For this purpose, this study investigated boarding school L, located in southern Zhejiang Province of China, through a questionnaire and Spatial Syntax theory. Based on the questionnaire marker method (N = 338, 50.59% female), the OSVD was mapped using the kernel density estimation in ArcGIS, including four types of teacher-student conflict: verbal bullying, physical conflict, and external intrusion. The spatial analysis of the OCE (spatial configuration and spatial visibility) then was generated by the DepthmapX, involving four spatial attributes such as integration, mean depth, connectivity, and visibility connectivity. Statistical analysis results indicated the correlation between the OSVD and both the spatial configuration and spatial visibility of the OCE. For the different violence types, there were differences in the impact relationships, with integration being a significant predictor of teacher-student conflict and physical conflict (p < 0.01) and a general predictor of verbal bullying (p < 0.05), while mean depth was a significant predictor of physical conflict (p < 0.01), but not recommended as a predictor of external intrusion. This study explores and predicts the relationship between the OSVD and the OCE, providing guidance and evidence for school violence prevention environmental design. It is a novel attempt, but still challenging and requires more research to refine.

Preventing Violence by Teachers in Primary Schools: Study Protocol for a Cluster Randomized Controlled Trial in Haiti

Context

Although teacher violence at schools is a serious problem in Haiti, there is a lack of systematic evidence on the effectiveness of school-based interventions in reducing teacher violence in this low-income country.

Objective

To test the effectiveness of the preventative intervention Interaction Competencies with Children for Teachers (ICC-T) aiming to reduce teachers' use of violent disciplinary strategies and to improve their interaction competences with children in the Haitian context.

Design, Setting, Participants

The study is designed as a two-arm matched cluster randomized controlled trial. The sample consists of 468 teachers and 1,008 children from 36 (community and public) primary schools around Cap-Haïtien (Département du Nord) in Haiti. Data will be collected in three phases, before the intervention, and 6 and 18 months after.

Intervention

In the group of intervention schools, ICC-T will be delivered as a 5-day training workshop. Workshop sessions are divided into five modules: 1) improving teacher-student interactions, 2) maltreatment prevention, 3) effective discipline strategies, 4) identifying and supporting burdened students, and 5) implementation in everyday school life.

Main Outcome Measure

The main outcome measure is teacher violence assessed in two ways: (i) teachers' self-reported use of violence, and (ii) children's self-reported experiences of violence by teachers.

Conclusions

Prior evaluations of ICC-T had been conducted in sub-Saharan Africa with promising results. This study will test for the first time the effectiveness of this intervention outside the context of sub-Saharan Africa.

The Irie Classroom Toolbox: Mixed method assessment to inform future implementation and scale-up of an early childhood, teacher-training, violence-prevention programme

Introduction

Violence against children (VAC) is a violation of child rights, has high prevalence in low- and middle-income countries, is associated with long-term negative effects on child functioning, and with high economic and social costs. Ending VAC at home and at school is thus a global public health priority.

Methods

In Jamaica, we evaluated an early childhood, teacher-training, violence-prevention programme, (the Irie Classroom Toolbox), in a cluster-randomised trial in 76 preschools. The programme led to large reductions to teachers' use of VAC, although the majority of teachers continued to use VAC at times. In this paper, we describe a mixed-method evaluation of the Irie Classroom Toolbox in the 38 Jamaican preschools that were assigned to the wait-list control group of the trial. In a quantitative evaluation, 108 preschool teachers in 38 preschools were evaluated at pre-test and 91 teachers from 37 preschools were evaluated at post-test. One preschool teacher from each of these 37 preschools were randomly selected to participate in an in-depth interview as part of the qualitative evaluation.

Results

Preschool teachers were observed to use 83% fewer instances of VAC across one school day after participating in the programme, although 68% were observed to use VAC at least once across two days. The qualitative evaluation confirmed these findings with all teachers reporting reduced use of violence, but 70% reporting continued use of VAC at times. Teachers reported that the behaviour change techniques used to deliver the intervention increased their motivation, knowledge and skills which in turn led to improved child behaviour, improved relationships and improved professional well-being. Direct pathways to reduced use of VAC by teachers were through improved child behaviour and teacher well-being. The main reasons for continued use of VAC were due to barriers teachers faced using positive discipline techniques, teachers' negative affect, and child behaviours that teachers perceived to be severe.

Discussion

We describe how we used the results from the mixed-method evaluation to inform revisions to the programme to further reduce teachers' use of VAC and to inform the processes of training, supervision and ongoing monitoring as the programme is scaled-up through government services.

Can the 'Learn in peace, educate without violence' intervention in Cote d'Ivoire reduce teacher violence? Development of a theory of change and formative evaluation results

OBJECTIVES

To gather evidence on whether a brief intervention (Apprendre en paix et éduquer sans violence, developed by the Ivorian Ministry of Education and Graines de Paix) to promote peace in primary schools by reducing teacher violence perpetration and improving pedagogical techniques was acceptable to teachers and affected change in intermediate outcomes.

DESIGN

Mixed-methods formative research.

SETTING

Primary schools in Tonkpi region, Cote d'Ivoire.

PARTICIPANTS

160 teachers participating in the peace training, surveyed three times during implementation; qualitative in-depth interviews with 19 teachers and teacher-counsellors.

INTERVENTIONS

Learn in peace, educate without violence-a brief intervention with primary school teachers designed to promote peace in primary schools.

OUTCOMES

For survey data, we generated composite measures of intermediate outcomes (teachers' awareness of consequences of violence, self-efficacy in applying positive classroom management methods, acceptance of physical discipline practices in school) and used random intercept linear mixed-effects models to compare responses over time. Qualitative research included open-ended questions about acceptability and perceived need for such an intervention. A framework analysis was undertaken.

RESULTS

Four-months post-training (vs pretraining), teachers had higher self-efficacy in applying positive classroom management methods (pre-mean=26.1; post-mean=27.5; p<0.001) and borderline lower acceptance of physical discipline practices (premean=4.2; postmean=3.6; p=0.10). We found no change in teacher awareness of the consequences of violence. Qualitatively, teachers found the intervention acceptable and understandable, perceiving it as useful because it provided methods for non-violent discipline. Teachers had mixed views about whether the techniques improved classroom dynamics.

CONCLUSIONS

Data suggest that the intervention is acceptable and leads to change in intermediate outcomes for teachers. Further evaluation in a randomised controlled trial is warranted.

Reducing physical and emotional violence by teachers using the intervention Interaction Competencies with Children - for Teachers (ICC-T): study protocol of a multi-country cluster randomized controlled trial in Ghana, Tanzania, and Uganda

Background

Violence has severe and long-lasting negative consequences for children’s and adolescents’ well-being and psychosocial functioning, thereby also hampering communities’ and societies’ economic growth. Positive attitudes towards violence and the lack of access to alternative non-violent strategies are likely to contribute to the high levels of teachers’ ongoing use of violence against children in sub-Saharan African countries. Notwithstanding, there are currently very few school-level interventions to reduce violence by teachers that a) have been scientifically evaluated and b) that focus both on changing attitudes towards violence and on equipping teachers with non-violent discipline strategies. Thus, the present study tests the effectiveness of the preventative intervention Interaction Competencies with Children – for Teachers (ICC-T) in primary and secondary schools in Tanzania, Uganda, and Ghana.

Methods

The study is a multi-site cluster randomized controlled trial with schools (clusters) as level of randomization and three data assessment points: baseline assessment prior to the intervention, the first follow-up assessment 6 months after the intervention and the second follow-up assessment 18 months after the intervention. Multi-stage random sampling will be applied to select a total number of 72 schools (24 per country). Schools will be randomly allocated to the intervention and the control condition after baseline. At each school, 40 students (stratified by gender) in the third year of primary school or in the first year of secondary/junior high school and all teachers (expected average number: 20) will be recruited. Thus, the final sample will comprise 2880 students and at least 1440 teachers. Data will be collected using structured clinical interviews. Primary outcome measures are student- and teacher-reported physical and emotional violence by teachers in the past week. Secondary outcome measures include children’s emotional and behavioral problems, quality of life, cognitive functioning, academic performance, school attendance and social competence. Data will be analyzed using multilevel analyses.

Discussion

This study aims to provide further evidence for the effectiveness of ICC-T to reduce teacher violence and to improve children’s functioning (i.e., mental health, well-being, academic performance) across educational settings, societies and cultures.

Trial registration

The trial was registered at clinicaltrials.org under the ClinicalTrials.gov identifier NCT04948580 on July 2, 2021.

The EmpaTeach intervention for reducing physical violence from teachers to students in Nyarugusu Refugee Camp: A cluster-randomised controlled trial

BACKGROUND

School-based violence prevention interventions offer enormous potential to reduce children's experience of violence perpetrated by teachers, but few have been rigorously evaluated globally and, to the best of our knowledge, none in humanitarian settings. We tested whether the EmpaTeach intervention could reduce physical violence from teachers to students in Nyarugusu Refugee Camp, Tanzania.

METHODS AND FINDINGS

We conducted a 2-arm cluster-randomised controlled trial with parallel assignment. A complete sample of all 27 primary and secondary schools in Nyarugusu Refugee Camp were approached and agreed to participate in the study. Eligible students and teachers participated in cross-sectional baseline, midline, and endline surveys in November/December 2018, May/June 2019, and January/February 2020, respectively. Fourteen schools were randomly assigned to receive a violence prevention intervention targeted at teachers implemented in January-March 2019; 13 formed a wait-list control group. The EmpaTeach intervention used empathy-building exercises and group work to equip teachers with self-regulation, alternative discipline techniques, and classroom management strategies. Allocation was not concealed due to the nature of the intervention. The primary outcome was students' self-reported experience of physical violence from teachers, assessed at midline using a modified version of the ISPCAN Child Abuse Screening Tool-Child Institutional. Secondary outcomes included student reports of emotional violence, depressive symptoms, and school attendance. Analyses were by intention to treat, using generalised estimating equations adjusted for stratification factors. No schools left the study. In total, 1,493 of the 1,866 (80%) randomly sampled students approached for participation took part in the baseline survey; at baseline 54.1% of students reported past-week physical violence from school staff. In total, 1,619 of 1,978 students (81.9%) took part in the midline survey, and 1,617 of 2,032 students (79.6%) participated at endline. Prevalence of past-week violence at midline was not statistically different in intervention (408 of 839 students, 48.6%) and control schools (412 of 777 students, 53.0%; risk ratio = 0.91, 95% CI 0.80 to 1.02, p = 0.106). No effect was detected on secondary outcomes. A camp-wide educational policy change during intervention implementation resulted in 14.7% of teachers in the intervention arm receiving a compressed version of the intervention, but exploratory analyses showed no difference in our primary outcome by school-level adherence to the intervention. Main study limitations included the small number of schools in the camp, which limited statistical power to detect small differences between intervention and control groups. We also did not assess the test-retest reliability of our outcome measures, and interviewers were unmasked to intervention allocation.

CONCLUSIONS

There was no evidence that the EmpaTeach intervention effectively reduced physical violence from teachers towards primary or secondary school students in Nyarugusu Refugee Camp. Further research is needed to develop and test interventions to prevent teacher violence in humanitarian settings.

TRIAL REGISTRATION

clinicaltrials.gov (NCT03745573).

Effects of a Teacher-Training Violence Prevention Program in Jamaican Preschools on Child Behavior, Academic Achievement, and School Attendance in Grade One of Primary School: Follow up of a Cluster Randomized Trial

Objective: We evaluated the effect of a universal, teacher-training, violence-prevention program implemented in preschool, on high-risk children's behavior, achievement, and attendance in grade one of primary school. Methods: A cluster-randomized trial was conducted in 24 preschools in Kingston, Jamaica. Three children from each class with the highest level of teacher-reported conduct problems were recruited for evaluation of outcomes (n = 225 children). For this study, to increase power, we recruited an additional two children from each class with the next highest teacher-reported scores for conduct problems in preschool. In the final term of grade one of primary school, we assessed children's: (1) conduct problems and social skills at home and school, (2) academic achievement, language, and self-regulation skills, and (3) school attendance. Results: 214/225 (95.1%) of the children evaluated in preschool were assessed in grade one of primary school; an additional 150 children were recruited to give 364 children (181 intervention, 183 control). Significant benefits of intervention were found for child academic achievement (Effect size (ES) = 0.23, p = 0.02), oral language (ES = 0.28, p = 0.006), self-regulation (ES = 0.25, p = 0.007), and school attendance (ES = 0.30, p = 0.003). No significant benefits were found for observed conduct problems (ES = -0.13, p = 0.16), and parent-reported conduct problems (ES = 0.10, p = 0.31) and social skills (ES = -0.07, p = 0.52). Benefits to teacher-reported conduct problems and social skills were significant at p < 0.1 (ES = -0.16, p = 0.09, and ES = 0.19, p = 0.06, respectively). Conclusion: A scalable intervention involving training preschool teachers in classroom behavior management and how to promote child social-emotional competence led to positive outcomes in primary school across multiple child developmental domains for high-risk children.