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Clinical Trial Summary

The primary purpose of this project is to test a comprehensive, two-part intervention with ReACT and a recently adapted, Coping Power+ Program. ReACT and PBIS are school-wide universal interventions. Coping Power and Coping Power+ are targeted preventive interventions designed to assist at-risk 7th grade students to improve their coping with interpersonal stressors during middle school. This project will evaluate the effects of the program on teacher, student and parent perceptions of school climate, student behavior, social-emotional competence, disciplinary infractions, and identity for 7th grade students in Coping Power or Coping Power+

Clinical Trial Description

Project Rationale Data from public Middle Schools indicate increasing rates of unsafe, disruptive, and event violent behaviors across the US. These incidents may also include peer victimization. Racially and ethnically minoritized youth are disproportionately affected by these incidents and occurrences of racial bias in school. The purpose of the Comprehensive Prevention Strategies (CPS) intervention is to preventatively promote youth safety and belonging across individual, school, and community settings by intervening at multiple entry points. The primary components include: (1) an adapted version of Coping Power and (2) extended PBIS strategies called "ReACT" (Racial equity through Assessing data for vulnerable decision points, culturally responsive behavior strategies, and Teaching about implicit bias and how to neutralize it) is for teachers. This project leverages the evidence-based Coping Power student and parent interventions and Positive Behavioral Interventions and Supports (PBIS) approaches to include much-needed adaptations to address this critical issue. This project has the potential for important public health outcomes: (a) reducing youth violence, (b) improving school climate and (c) improving teacher practices regarding discipline, disproportionate discipline, and bias in public schools. Project Aims The primary purpose of this project is to test a comprehensive, two-part intervention with ReACT and a recently adapted, Coping Power+ Program. ReACT and PBIS are school-wide universal interventions. Coping Power and Coping Power+ are targeted preventive interventions designed to assist at-risk 7th grade students to improve their coping with interpersonal stressors during middle school. This project will evaluate the effects of the program on teacher, student and parent perceptions of school climate, student behavior, social-emotional competence, disciplinary infractions, and identity for 7th grade students in Coping Power or Coping Power+ Funding This project is funded by a 5-year grant awarded by the National Institute of Minority Health and Health Disparities. Sample of Schools A total of 18 middle schools have been recruited for involvement in this project: 11 in Huntsville City Schools and 7 in Jefferson County Public Schools. These schools were chosen for participation based on PBIS implementation to fidelity, and a stated need for decreasing disproportionate discipline and improving equitable access and outcomes for all students through consent decrees with the Department of Justice. Each school was randomized twice in order to determine condition assignments for both the educator (PBIS/ReACT) portion and student (Coping Power/Coping Power+) portion. As such, AAA, Mt. Gap, Chapman, Huntsville Jr, Hampton Cover, and Challenger will receive ReACT teacher training in the 2021-2022 school year. The remaining middle schools will continue to implement PBIS without additional teacher training. Student Participation and Data Collection Students who are identified by teachers and/or school staff as potentially benefiting from Coping Power on the 6-item universal screener completed by 6th grade teachers each project year in the spring, will be contacted by school staff to request active parental consent for participation. Researchers will obtain written consent from the guardian/parent(s) for their child's participation in the Coping Power Program and all data collection activities. Outcomes will be assessed through a set of pre- and post-intervention measures, including (1) the Behavioral Assessment System for Children (BASC), which is a validated measure of behavioral and emotional problems as well as academic engagement and social skills, (2) the UCLA COVID-19 PTSD Screener which will help us identify students who have been critically impacted by the pandemic, and (3) a Identity Measure that will allow students to describe if they have been treated differently than their peers in the community or at school, perceive that they have been treated unfairly by someone at school, or if they have been insulted because of their identity (nationality, race, ethnicity, language). a classroom teacher will complete the BASC at the start of the year, at the end of that school year, and once in May of the next (8th grade) year on each student in the Coping Power groups. Each student in Coping Power groups will complete the COVID screener and identity measure at the start of the year, at the end of that year, and in May the following year. Additionally, all middle school students and their caregivers will have an opportunity once a year to anonymously complete the Georgia School Climate survey which helps schools to better understand the overall sense of belonging, safety. Each year, researchers will request information on disciplinary actions at the school level broadly (no student identification) and for students in Coping Power groups specifically. Benefits to Participating Schools To implement the Coping Power and Coping Power+ Programs, clinicians will be hired by the grant and will be co-trained with one or more school-based staff members (e.g., school counselor, school psychologist). In appreciation of staff time devoted to leading the Coping Power groups, the grant will provide a $25 per session donation to the school ($625 per year). At the end of the project, counselors who have been implementing Coping Power will also receive training in Cooping Power+. This project will increase the school's capacity to implement an evidence-based Tier 3 prevention program to support students and their families. Timeline This 5-year project began in 2019 with the development of CP+ adaptations and ReACT strategies for middle school. Study activities were halted in 2020 due to the pandemic. In August of 2021 researchers will continue with ReACT educator training (on full day), then send parental permission forms for Coping Power participation. Coping Power groups will start in September and run weekly for the rest of the year. ReACT training will be followed by monthly one-hour strategy sessions for the remainder of the school year. While ReACT training will be complete, another cohort of 7th grade students will enter Coping Power (screened in each spring) in September 2022 and September 2023. Each year approximately 17 students from each middle school will participate in Coping Power groups. Expected Outcome Researchers proposed that adapted, culturally responsive Coping Power will be more effective than traditional Coping Power in promoting prosocial behavior for 7th grade participants. Researchers hypothesized that educators who have been provided ReACT training and strategies will demonstrate more proportionate discipline occurrences, decreased overall levels of discipline infractions, and will improve student-teacher relationships at increased rates compared to educators who are implementing PBIS alone. ReACT Teacher Training Because it is a framework for intervention, there is promise in embedding equity interventions within PBIS, to increase motivation, fidelity of implementation, and sustainability (McIntosh, Mercer, et al., 2018). Researchers developed a multicomponent intervention approach based on (a) elements of PBIS that are most strongly related to racial equity in school discipline, (b) a theory of the operation of implicit bias in school discipline decision making, and (c) research on increasing fidelity of school-based interventions (McIntosh, Girvan, et al., 2018). ReACT (Racial equity through Assessing data for vulnerable decision points, Culturally responsive behavior strategies, and Teaching about implicit bias and how to neutralize it) is a universal professional development intervention for all school staff to leverage the PBIS framework for increasing racial equity in school discipline (McIntosh, Barnes, et al., 2014). The intervention includes whole-school professional development sessions delivered throughout the year that focus on understanding discipline decision making and the effects of bias, a root cause analysis of discipline data, and creation of a tailored intervention plan with strategies selected to address these root causes. ReACT Strategies and Content Implicit associations Data and problem solving Vulnerable Decision Points Neutralizing routines Student advisory board Student interest, motivation, strength, preference survey Personal matrix Equitable opportunities to respond and praise Wise and instructive feedback Student-teacher relationship building and repair strategies Middle School Coping Power Child and Parent Program The Coping Power Program is a rigorously tested, multi-component school-based intervention for children and their parents (Lochman & Wells, 1996), that addresses issues related to aggression and problem behavior. Efficacy and effectiveness studies conducted in multiple schools in Alabama and throughout the United States over the past two decades have found Coping Power to reduce students' levels of externalizing and internalizing behaviors, and substance use, and to enhance students' language artss grades through long-term follow-up periods, in comparison to randomized control and comparison students. The original Coping Power Program was created for upper elementary school children, but researchers at the University of Alabama and Johns Hopkins University recently adapted the program for middle school students. T he Middle School Coping Power Program is developmentally appropriate for middle school students (grades 6-8) and their parents and has been implemented in middle schools in the Baltimore area. The program is considered a Tier 3 intervention and is complementary to the PBIS program. It includes parent and student components that address risk factors for aggressive/disruptive behavior problems. Coping Power follows a social-cognitive theoretical framework and provides supports to individual students and families in need of specialized services. The Coping Power student component is offered to groups of six students at the school and features 25 weekly group sessions, each lasting about 45 minutes. The program includes 12 parenting sessions during which parents meet in groups of 10-12 with two co-leaders. As a part of this project, researchers have updated the original Coping Power child program to include instruction around positive identity, coping with distorted perceptions of others, coping with bullying, and development of cross-group interactions and friendships to address core issues related to emotion regulation and peer conflict. CP+ uses culturally responsive instructional procedures, examples, and activities integrated into regular Coping Power objectives. The Coping Power+ parent program will be augmented with greater emphasis on positive parenting practices, and family cohesion and communication. CP/CP+ Child Component Content Outline Session 1: Establish Structure of the Group and Behavioral Goal Setting Procedure Session 2: Setting Long-term and Short-term Personal Goals Session 3: Organizational and Study Skills Session 4: Awareness of Feelings and Physiological feelings Related to Anger Session 5: Practice Anger Coping and Self-Control Session 6: Practice Using Coping Self-statements for Anger Coping: Part I Session 7: Practice Using Coping Self-statements for Anger Coping: Part II Session 8: Relaxation and Overcoming Barriers to Self-Control and Perspective-Taking Session 9: Perspective-Taking Session 10: Perspective Taking and Problem Solving Session 11: Social Problem Solving: Part I Session 12: Social Problem Solving: Part II Session 13: Social Problem Solving: Part III Session 14: Group Creates Own Videotape: Part I Session 15: Group Creates Own Videotape: Part II Session 16: Relationship Development: Part I Session 17: Relationship Development: Part II Session 18: Relationship Development: Part III Session 19: Application of Social Problem Solving to Social Aggression and Romantic Relationships Session 20: More Teen Peer Issues: Problem Solving about Damaged Relationships and Cyber Bullying Session 21: Application of Social Problem Solving to Peer Pressure Session 22: Refusal Skills and Problem Solving about Neighborhood Problems Session 23: Deviant Peer Groups and Centrality of Group Membership Session 24: Positive Quality Development and Peer Relationships Session 25: Review and Termination of the Coping Power Program CP/ CP+ Caregiver Sessions Session 1: Introductions, Overview, and Academic Support - Part 1 Session 2: Academic Support in the Home - Part 2 Session 3: Stress Management - Part 1 Session 4: Stress Management - Part 2 Session 5: Basic Social Learning Theory, Introduce Tracking and Praise, Improving the Parent-Student Relationship Session 6: Ignoring Minor Disruptive Behavior and Giving Effective Directions to Adolescents Session 7: Establishing Rules and Expectation and the Use of Discipline and Punishment Session 8: Discipline and Punishment Part 2 Session 9: Family Bonding Building Session 10: Family Problem Solving for Sibling Conflict and Parent-Adolescent Conflict Session 11: Family Communication: Building and Adapting Structures for Long-Term Planning Needs Session 12: Getting Ready for Summer and Long-Term Planning Strategy Aim 1. To determine the extent to which SWPBIS+ training is more effective than SWPBIS alone as a Tier 1, in reducing disproportionate disciplinary practices, and if differences are moderated by student and teacher race. Aim 2. To determine the extent to which CP+ is more effective than CP as a targeted intervention in reducing interracial and intraracial aggression and if differences are moderated by student race. Aim 3. To determine the extent to which the effects of CP+ relative to CP differ depending on the Tier 1 context (SWPBIS+ vs. SWPBIS) and whether those effects are moderated by student race. In addition, poverty will be included as potential covariates in the model at both the individual (student free/reduced price lunch status) and school (percentage of students receiving free/reduced price lunch) levels. ;

Study Design

Related Conditions & MeSH terms

NCT number NCT05189769
Study type Interventional
Source University of Alabama, Tuscaloosa
Status Enrolling by invitation
Phase N/A
Start date May 15, 2019
Completion date December 1, 2024

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