Childhood Resiliency Effects for School-wide Treatment in Belize City (CREST)

University of North Texas, Denton, TX

Status: Completed

Conditions: Child Behavior

Treatments: Behavioral: Control; Behavioral: Positive Action

Study type: Interventional

Funder types: Other

Identifiers

NCT03026335

11403

Details and patient eligibility

About

The purpose of the study is to use existing school resources and improve identification, referral and local support for children that exhibit exposure to childhood trauma resulting from environmental violence in Belize City. The Ministry of Education has identified the goals of the project to reduce violent behaviors in primary school children and supporting those children that have been exposed to violence or other malicious behavior that would inhibit normal school functioning. In addition, the MOE is supporting additional resources and data collection for a comprehensive evaluation of student behavior and academic performance.

Full description

Belize is a country with a developing economy based primarily on agriculture and tourism. Crime and violence are emerging as a threat to the country's governance and business climate. The number of homicides in Belize have increased by more than 30% from 2003-2006. This notion of violence, in particular gang violence, is extremely concerning because the population of Belize is very young. Almost half of the population of Belize is under the age of 18. The youth of Belize are becoming engaged in criminal and delinquent behaviors at an early age that have both individual and societal consequences.

In addition to the violence rates among youth in Belize there is also an educational crisis that must be addressed. Education in Belize is compulsory between the ages of 5-14 and in 2001 93% of 5-14 year old children attended school. Although primary school is mandatory (up to age 14), only about 75% of youth complete primary school and only 25% graduate from secondary school. With few students completing high school it is likely that many may turn to gang related and other illegal activities if they are not prepared to undertake better job opportunities, have not been provided with environmental assets that protect from involvement in risky behavior, and if they are exposed to community/family values that condone gang activity. A number of studies have demonstrated that school-based interventions have moderate effects in reducing violence (average of d = .20 across studies). Combining a sound school-based intervention in Belize that is primarily targeted toward students and teachers, but combined with school-based community/family components designed to heighten awareness of the necessity of protective assets, implemented with local and international support teams, and that fosters positive norms may enhance the effects.

Enrollment: 6,296 patients

Sex: All

Ages: 4 to 12 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Enrolled in primary schools under the authority of the Belize Ministry of Education in the Belize District
• Enrolled in eight grades referred to as Infant 1 and 2 (generally aged 5 and 6 years), and 1st through 6th Standard (comprising ages 7 - 12 years)

Exclusion criteria

• None

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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6,296 participants in 2 patient groups

Positive Action Curriculum

Experimental group

Description:

A school-wide program was implemented in the experimental schools referred to as "Positive Action" and was integrated with the existing Health and Family Life Education curriculum.

Treatment:

Behavioral: Positive Action

Control/Comparison Group

Active Comparator group

Description:

Business as usual with students in non-intervened schools

Treatment:

Behavioral: Control