Djamnezhad Dariush, Bergström Martin, Andrén Per, Hofvander Björn
Department of Clinical Sciences Lund, Lund Clinical Research on Externalizing and Developmental Psychopathology, Lund University, Lund, Sweden.
Administration of Compulsory Education Department, Malmö, Sweden.
Front Psychiatry. 2023 Oct 5;14:1256714. doi: 10.3389/fpsyt.2023.1256714. eCollection 2023.
Early conduct problems and school failure are prominent risk factors for several adverse outcomes in later life. With the potential of reaching many children at early stages of their life, school-based interventions constitute a valuable approach to universal prevention. Good behavior game (GBG) is a promising school-based behavior management program, having shown immediate reductions in conduct problems along with several long-term positive effects. Adapting interventions to new contexts may however affect their effectiveness. The current study aims to evaluate the effectiveness of a Swedish adaption of GBG under pragmatic conditions. The intervention is hypothesized to reduce conduct problems in the classroom (primary outcome). Secondary analyses will investigate changes in conduct problems in common school areas, classroom climate, teacher collective efficacy, on-task behavior, as well as investigating behavioral management practices, implementation, and barriers to implementation.
This is a cluster-randomized trial with two parallel groups. Schools will be randomized (1,1, stratified by their areas sociodemographic index score) to be provided training in GBG or perform business-as-usual. The intervention and data collection lasts for a school year. Data will be collected at three time points: at baseline in the beginning of the school year (prior to training in GBG), after three months, and after nine months (at the end of the school year; primary endpoint). Data consists of teacher-rated measures of conduct problems, classroom climate, teacher collective efficacy, behavior management practices, and implementation factors, along with demographic factors. In addition, data will be collected by independent and blinded observers using corresponding measures in a subset of randomly chosen classrooms. Procedural fidelity will be rated and collected by GBG-trainers during nine observations throughout the school year. Statistical analysis will include frequentist intention-to-treat analysis, and comparisons of estimates with a corresponding Bayesian model using weakly informative priors. The study has currently completed data collection.
This study will provide knowledge in universal prevention and school-based interventions with high reach, as well as specific knowledge concerning the effectiveness of an adapted version of GBG under real-world conditions, along with factors affecting its implementation and effects.
ClinicalTrials.gov, identifier NCT05794893.
早期行为问题和学业失败是日后出现多种不良后果的显著风险因素。鉴于有可能在儿童生命早期阶段接触到众多儿童，基于学校的干预措施是一种具有重要价值的普遍预防方法。良好行为游戏（GBG）是一项颇具前景的基于学校的行为管理项目，已显示出能立即减少行为问题，并产生若干长期积极影响。然而，使干预措施适应新环境可能会影响其效果。本研究旨在评估在实际条件下瑞典版GBG的有效性。假设该干预措施能减少课堂上的行为问题（主要结果）。二级分析将调查学校公共区域的行为问题变化、课堂氛围、教师集体效能感、专注行为，以及调查行为管理实践、实施情况和实施障碍。
这是一项有两个平行组的整群随机试验。学校将被随机分组（1:1，按社会人口学指数得分分层），一组接受GBG培训，另一组照常开展工作。干预和数据收集持续一学年。数据将在三个时间点收集：学年开始时的基线期（GBG培训前）、三个月后和九个月后（学年末；主要终点）。数据包括教师对行为问题、课堂氛围、教师集体效能感、行为管理实践和实施因素的评分，以及人口统计学因素。此外，将由独立且不知情的观察者在随机选择的部分教室中使用相应测量方法收集数据。GBG培训师将在整个学年的九次观察中对程序保真度进行评分和收集。统计分析将包括频率学派的意向性分析，以及使用弱信息先验的相应贝叶斯模型对估计值进行比较。该研究目前已完成数据收集。
本研究将提供有关具有广泛覆盖面的普遍预防和基于学校的干预措施的知识，以及关于在现实世界条件下GBG改编版有效性的具体知识，以及影响其实施和效果的因素。
ClinicalTrials.gov，标识符NCT05794893。
