School Climate and Children's Behavioral Health (Project Access)

Children's Hospital of Philadelphia (CHOP)

Status: Completed

Conditions: Consultation and Coaching (HLS); Consultation (LLS)

Treatments: Behavioral: Coping Power Program; Behavioral: Friends for Life

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01941069

12-009477

5R01HD073430-02 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The overall purpose of this project is to determine whether school personnel implementing a two-tier School-wide Positive Behavior Support (SWPBS, an evidence based intervention) program for typically developing children as well as children with, or at risk for, externalizing or anxiety disorders can implement the components of the program with the same level of fidelity, integrity and clinical effectiveness when they receive a low level of support (consultation) from their coaches and supervisors as they can with a high level of support (consultation and coaching).

Full description

Demonstrating that school personnel can implement evidence based interventions (EBIs) for externalizing and anxiety problems with a high degree of fidelity, integrity and clinical effectiveness could spur more initiatives toward the adoption of EBIs in urban schools, thus further lowering health disparities in these settings. The overall purpose of this project is to determine whether school personnel implementing a two-tier School-wide Positive Behavior Support (SWPBS, an evidence based intervention) program for typically developing children as well as children with, or at risk for, externalizing or anxiety disorders can implement the components of the program with the same level of fidelity, integrity and clinical effectiveness when they receive a low level of support (consultation) from their coaches and supervisors as they can with a high level of support (consultation and coaching). This study will target six schools within the Philadelphia School District (PSD). Within those 6 schools, research participants will consist of students (grades 4-8) and school staff members. The investigators will evaluate 1) the effectiveness of SWPBS with consultation and coaching, as compared to the baseline and to SWPBS with consultation only; in reducing office discipline referrals (ODRs) and improving school climate, and children's grades, diagnostic status, symptom severity and impairment; 2) the effectiveness of the SWPBS with consultation and coaching, as compared to SWPBS with consultation only, in increasing program fidelity and integrity.

Enrollment: 437 patients

Sex: All

Ages: 8 to 15 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All 6 participating schools are included in Tier 1.
• The inclusion criteria for Tier 2 includes children in grades 3-8, who are referred by a school staff member because of behavioral or emotional difficulties or because they have received 3 or more Office Discipline Referrals. Children who consent to participate in the project.

Exclusion criteria

• There are no exclusion criteria for Tier 1.
• The exclusion criteria for Tier 2 include any child in grades 3-8 whose family chooses not to consent to screening or participate in the intervention, has Special Education classification of "Intellectual Disability", who is not able to communicate in English, or has a history of psychotic or autistic spectrum disorders.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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437 participants in 2 patient groups

Internalizing Disorders

Active Comparator group

Description:

Students identified as being at-risk for or meeting criteria for Internalizing Disorders will assigned to this intervention arm. They will receive the FRIENDS for Life intervention. FRIENDS is a group Cognitive Behavioral Therapy (CBT) intervention, based on a theoretical model, which addresses cognitive, physiological and behavioral processes that are seen to interact in the development and perpetuation of excessive anxiety.

Treatment:

Behavioral: Friends for Life

Externalizing Disorders

Active Comparator group

Description:

Students identified as being at-risk for or meeting criteria for Externalizing Disorders will be assigned to this intervention arm. They will receive the Coping Power Program (CPP) intervention. CPP is a cognitive-behavioral, multi-component group intervention for elementary and middle school students at risk for externalizing behavior disorders. In addition to anger management, the CPP includes units on goal setting, emotional awareness, relaxation training, social skills training, problem solving, and handling peer pressure.

Treatment:

Behavioral: Coping Power Program