AzTrials
AzTrials

Behavior ProblemIBISNCT06270914

Inclusive Positive Behaviour Supports

A study testing Inclusive Positive Behavior Interventions and Supports in people with Behavior Problem and Social Skills, run by Uppsala University at 1 site in Sweden.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

Background: While positive school climate is important for students' well-being and mental health, school personnel may experience challenges in creating a nurturing school climate. Read more about this study

Who is it for?
Ages 9 to 15 yearsHealthy volunteers can take part
Conditions the study is for
Behavior Problem, Social Skills
What is being tested?
Inclusive Positive Behavior Interventions and Supports
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5,000 participants
Where
1 siteSweden
Study dates
25 Aug 2023to 31 Dec 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 9 to 15 years
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • compulsory school, grades 4-9;
  • the school have not been previously enrolled in an SWPBIS program by other providers;
  • principal, teachers, students and their parents consent to participate in the study.

Who cannot join

  • grades other than 4-9;
  • the school has previously received or is enrolled in SWPBIS program or other PBS program;
  • students or their parents have not consented to participation in the study.

Trial locations and contacts

1 site in 1 country.

Martin Karlberg, PhD contact

018-471 1669

martin.karlberg@edu.uu.se

Nina Klang, PhD contact

018-471 1674

nina.klang@edu.uu.se

Sweden1 site, 1 recruiting
  • Department of Education

    Uppsala, Uppland, 752 37

    Martin Karlberg, PhD, 018-471 1669, martin.karlberg@edu.uu.se

    Nina Klang, PhD, 018-471 1674, nina.klang@edu.uu.se

    Recruiting

Other trials in Sweden

About this study

Official title: Inclusive Positive Behavior Support in School - the Causal Mechanisms and Interactive Processes. A Study Protocol

Background: While positive school climate is important for students' well-being and mental health, school personnel may experience challenges in creating a nurturing school climate. School-Wide Positive Behavioral Interventions and Supports (SW-PBIS) have shown positive effects on school climate, but fewer studies have been conducted in the European context. Aim: The present project aims to investigate the effectiveness of SW-PBIS programs for students' social-emotional skills and academic achievement as well as teachers' and students' perceptions of the learning environment. Furthermore, the study intends to evaluate how school-level factors mediate or moderate the effects of the intervention. In addition, the study includes a qualitative evaluation of the dynamic interaction processes that occur during program implementation in local school contexts. Methods: Data on school- and individual-level measures are collected in intervention and control schools. With regard to challenges in retaining control groups over extended time periods, two waves of recruitment are used. In the first wave, an active control group is used, and data are collected during three time points. In the second wave, a wait-list control group is used, and data are collected during two time points during one school year. Hierarchical regression analyses will be conducted to explore the effects of SW-PBIS on the outcomes of the study. An ethnomethodological approach will be applied to provide a detailed examination of the social interactional and meaning-making practices of different school implementation teams, and the negotiation of normative expectations and rules of conduct in peer-teacher-student interactions in different classrooms. Discussion: The study is expected to contribute knowledge on the effects of the SWPBIS program and how these effects may be mediated or moderated by school-level factors. Combining quantitative and qualitative methods to explore the significance of school contexts in the implementation of the SWPBIS program constitutes the strength of the study. The challenge in the study is the extended period of implementation of SWPBIS, which entails difficulties in retaining a control group over the required time period. Therefore, two waves of recruitment are used, encompassing different procedures of allocation to intervention or control groups.

Read the detailed description

Aim and Research Questions:

Firstly, the aim is to evaluate the effectiveness of the SWPBIS program for students' socio-emotional skills and academic achievement as well as teachers' and students' perceptions of the learning environment, and to explore how school-level factors may moderate or mediate the effect of SWPBIS on the outcomes. Secondly, the aim is to gain a deeper understanding of the social processes and local meanings that emerge and take form among the students, teachers, and other school professionals as they participate in the SW-PBIS program. The aims are specified in four research questions:

  1. What are the effects of the SW-PBIS program on students' socio-emotional skills and academic achievement as well as teachers' and students' perceptions of the learning environment?
  2. To what extent do school-level factors mediate and moderate the effects of the SW-PBIS program on the study outcomes over time?
  3. How are the central contents of the SW-PBIS program made sense of and negotiated in school teams and classrooms at two schools during the course of program implementation?
  4. How do specific instances of student-teacher interaction lead to changes in students' behavior and responses to the SW-PBIS program, and what forms of ethical dilemmas evolve in the management of behavior problems in classrooms?

Methods:

This study utilizes a quasi-experimental non-randomized design, including two waves of participant recruitment. In the first wave of recruitment, intervention and active control groups are used, and outcomes will be measured at three time points. In addition to quantitative data, qualitative observations and interviews are conducted to gain a deeper understanding of the process of implementing SWPIS. In the second wave of data recruitment, intervention and wait-list control groups are used, and outcomes will be measured at two time points (pre- and post).

The study will be conducted in compulsory schools and will include classes from grade four to grade nine. Each of the two waves of recruitment in the study will include 80 schools. Data will be collected on school-level measures and individual-level measures. School-level measures encompass: (a) Teacher collective self-efficacy; (b) Problem behavior in the classroom and school. Individual-level measures encompass: (a) Social-emotional skills; (b) Classroom environment; (c) Student achievement in national tests of mathematics and literacy.

The intervention is based on the Norwegian manualized program of SW-PBIS, N-PALS (Positiv Atferd, Støttende Læringsmiljø, og Samhandling). The Norwegian model shares its core components with the original SW-PBIS model. The program's core components constitute: (a) Positive behavior support strategies, including positive expectations and classroom rules, which are followed up with positive feedback and encouragement; (b) A system for monitoring student behavior, (c) School-wide corrections using consequences, (d) Instruction in classroom management skills for teachers, and (e) Strategies for collaboration with parents. These components are implemented through activities at the school level and at the classroom level. The implementation at the school level starts with establishing a leadership team, comprised of school leaders, team leaders, and members of the school welfare team. The leadership team assesses the needs and resources at the school and agrees on behavioral expectations and rules. The team monitors student behaviors and provides opportunities for teacher professional development with a focus on classroom management and relationship building. At the classroom level, the teachers incorporate school-wide expected behaviors into their classroom instruction through classroom activities and classroom rules. The teachers also integrate their training in classroom management and relationship building into their teaching practices. The duration of Tier 1 intervention is expected to be three years.

The control group in the first wave of data collection is selected in accordance with a quasi-experimental design with a nonequivalent control group. The teachers in the control group will, instead of a wait-list intervention, receive a shortened version of SW-PBIS containing only classroom leadership lectures. The schools that are part of the classroom management group also send staff for instructor training (ten training sessions, 25 hours in total, just as much as the SW-PBIS schools). Similar to the SW-PBIS group, the instructors in this group educate and supervise school staff, supported by a team at the school. Both groups have access to a manual and supporting materials. This design does not pose threats to the internal validity of the study, as classroom leadership is one of the principles of the PBIS framework. In this way, it will be possible to explore the specific contribution of schoolwide PBS in contrast to classroom leadership only. The control group in the second wave of data collection constitutes a wait-list control group and will not be engaged in any kind of intervention during the intervention period.

Hierarchical regression analyses with a three-level structure will be conducted to explore the effects of SW-PBIS on study outcomes. Hierarchical regression analyses allow for accounting for the nested structure of the data, in which teachers' and students' responses are nested within schools and grade levels. The outcomes at the school and individual levels will be studied as a function of time (three time points for wave 1 and two time points for wave 2) and group belonging (intervention or control group). To take into account the nestedness of the data, a three-level random effect model will be used, varying by school, grade, and the individuals' identification codes. Furthermore, the possible mediators (quality of implementation) and moderators (school characteristics, school-level variables) of the SWPBIS intervention will be analyzed. Missing data will be handled by imputation, provided that the assumption of data missing completely at random is met.

In the qualitative study, a longitudinal ethnographic approach will be used in order to obtain detailed contextualized knowledge on interactions in various contexts in two of the intervention schools, recruited in wave 1, over a longer period of time. Through purposeful sampling, three schools with different characteristics regarding size and catchment area will be selected.

Being tested
Inclusive Positive Behavior Interventions and Supports
Keywords
behavior problem, positive behavior support, prevention, universal
Medical subject headings
Mental Disorders, Social Skills

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Inclusive Positive Behavior Interventions and SupportsBehavioural

    The intervention is based on the Norwegian manualized program of SW-PBIS, N-PALS (Positiv Atferd, Støttende Læringsmiljø, og Sammhandling). The Norwegian model shares its core components with the original SW-PBIS model. The program's core components constitute: (a) positive behavior support strategies, including positive expectations and classroom rules, which are followed up with positive feedback and encouragement; (b) a system for monitoring student behavior, (c) school-wide corrections using consequences, (c) instruction in classroom management skills for teachers, and (e) strategies for collaboration with parents. These components are implemented through activities at school level and at classroom level.

Study groups in NCT06270914
Study groupRoleWhat they receive
InterventionExperimentalThe intervention group will receive the intervention Norwegian manualized program of SW-PBIS, N-PALS (Positiv Atferd, Støttende Læringsmiljø, og Sammhandling).
Receives: Behavioral: Inclusive Positive Behavior Interventions and Supports
Active controlActive comparatorControl group in the first wave of data collection is selected in accordance quasi-experimental design with nonequivalent control group. The teachers in the control group will, instead of a wait-list intervention, a shortened version of SW-PBIS containing only classroom leadership lectures. The schools that are part of the classroom management group also send staff for instructor training (ten training sessions, 25 hours in total, just as much as the SW-PBIS schools). Similar to the SW-PBIS group, the instructors in this group educate and supervise school staff, supported by a team at the school. Both groups have access to a manual and supporting materials. This design does not pose threats to the internal validity of the study, as classroom leadership is one of principles of PBIS framework. In this way it will be possible to explore the specific contribution of schoolwide PBS in contrast to classroom leadership only.
Receives: Behavioral: Inclusive Positive Behavior Interventions and Supports
ControlNo interventionControl group in the second wave of data collection constitutes a wait-list control group and will not be engaged in any kind of intervention during the intervention period.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Social emotional skills

    Social Skills Improvement System - SEL Brief and Mental Health Scales, Teacher K-12 Form contains 20 items related to five competency domains (self-awareness, self-management, social awareness, relationship skills, and responsible decision making) and 10 items encompassing emotional behavior concerns (internalizing and externalizing concerns). Examples of items are "Asks for help when needed" for social-emotional skills competency domains and "Withdraws from others" for emotional behavior concerns. The items are measured on a 4-point scale (1=Never, 2=Seldom, 3=Often, 4=Almost always). The measures have proved to have sufficient validity and reliability in previous studies.

    Measured: 11 months

  2. Classroom environment

    A comprehensive assessment of the classroom learning environment was conducted using questionnaires for teachers and students. The teacher questionnaire consisted of 14 statements, rated on a 4-point scale (1 = does not fit to 4 = fits completely), assessing various aspects of the classroom learning climate. The student questionnaire included 22 statements, also rated on a 4-point scale, gauging students' perceptions of the classroom environment. An example of an item in the teacher questionnaire is "There is a good working climate during lessons". An example of an item in the student questionnaire is "Students in this class are active and interested during lessons".

    Measured: 11 months

  3. Students' achievement

    students' achievement on national tests of Swedish and mathematics will be retrieved from register data provided by Statistics Sweden. The data will be standardized across tests and compared with regard to the national average for those students who enter the project in grade 4 and 7 (national tests in grade 3 and grade 6) and finish the project in grade 6 and 9 (national tests in grade 6 and grade 9).

    Measured: 11 months

Secondary outcomes (2)
  1. Collective self-efficacy

    Collective Self-efficacy questionnaire will be used as a measure of teacher collective beliefs of possibilities to influence student learning. CES contains 12 items and a 6-point scale is used (from 1=Do not agree at all, 2=Do not agree, 3=Do not agree fully, 4=Agree a little, 5=Agree, 6=Agree completely). An example of item is "Teachers in this school are able to get through to difficult students". In previous studies, collective self-efficacy has shown to be influenced by SWPBIS programs.

    Measured: 11 months

  2. Problem behavior in classroom and school

    Problem Behavior in the Classroom Last Week (20 items), in which the teachers are asked to report disruptive behavior on a 5-point Likert scale from 0 (not observed) to 5 (observed several times per day). Problem Behavior in the School Environment is a school level measure with similar structure and rating alternatives and is used with school staff. Examples of behaviors in the scales are "Destroying school environment" or "Physical aggression towards peers and teachers". The scales have shown satisfactory psychometric properties in several prior Norwegian studies.

    Measured: 11 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Feb 2024
  2. Study start25 Aug 2023
  3. Primary completion30 Sep 2025 (estimated)
  4. Study completion31 Dec 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
This study utilizes quasi-experimental non-randomized design, including two waves of participant recruitment. Two waves of recruitment are used. In the first wave of recruitment, intervention and active control group are used and outcomes will be measured at three time points. In addition to quantitative data, qualitative observations and interviews are conducted to get a deeper understanding of the process of implementation of SWPIS. In the second wave of data recruitment, intervention and wait-list control group are used and outcomes will be measured at two time points (pre- and post).
Masking
None (open label)
Enrolment
5,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06270914
Sponsor's protocol ID
IBIS
Acronym
IBIS
Status last verified
Feb 2024
First submitted
27 Jan 2024
Last updated
21 Feb 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Individual participant data will not be made available to other researchers due to ethical considerations.

Publications

  • Karlberg M, Klang N, Svahn J. Positive behavior support in school - a quasi-experimental mixed methods study and a randomized controlled trial. BMC Psychol. 2024 Oct 1;12(1):521. doi: 10.1186/s40359-024-02021-z.

    PubMed 39354572

Questions about this trial

What is this clinical trial studying?

A study testing Inclusive Positive Behavior Interventions and Supports in people with Behavior Problem and Social Skills, run by Uppsala University at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 21 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Martin Karlberg, PhD (018-471 1669, martin.karlberg@edu.uu.se), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Social emotional skills (time frame: 11 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06270914, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Feb 2024.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in