The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial

We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools' important influence on child mental health. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled tr...

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Published inPsychological medicine Vol. 49; no. 5; pp. 828 - 842
Main Authors Ford, Tamsin, Hayes, Rachel, Byford, Sarah, Edwards, Vanessa, Fletcher, Malcolm, Logan, Stuart, Norwich, Brahm, Pritchard, Will, Allen, Kate, Allwood, Matthew, Ganguli, Poushali, Grimes, Katie, Hansford, Lorraine, Longdon, Bryony, Norman, Shelley, Price, Anna, Ukoumunne, Obioha C.
Format Journal Article
LanguageEnglish
Published Cambridge, UK Cambridge University Press 01.04.2019
Subjects
Child
Child & adolescent mental health
Child Behavior
Child, Preschool
Children
Children & youth
Classroom management
Classrooms
Cluster Analysis
Cost analysis
Cost-Benefit Analysis
Data collection
Dominance
Educational Personnel
Elementary schools
England
Female
Humans
Interactive learning
Intervention
Linear Models
Logistic Models
Male
Medical research
Mental disorders
Mental health
Original
Original Articles
Program Evaluation
Public health
Questionnaires
Random effects
Regression analysis
Schools
Social Behavior
Students - psychology
Teachers
Teaching
Uncertainty
England
Online AccessGet full text
ISSN0033-2917
1469-8978
1469-8978
DOI10.1017/S0033291718001484

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Abstract We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools' important influence on child mental health. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes. ISRCTN84130388. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = -1.0; 95% CI-1.9 to -0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health. TCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.
AbstractList BackgroundWe evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.MethodsA two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes. Trial registration: ISRCTN84130388.ResultsEighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health.ConclusionsTCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.
We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools' important influence on child mental health.BACKGROUNDWe evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools' important influence on child mental health.A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes.METHODSA two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes.ISRCTN84130388.TRIAL REGISTRATIONISRCTN84130388.Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = -1.0; 95% CI-1.9 to -0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health.RESULTSEighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = -1.0; 95% CI-1.9 to -0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health.TCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.CONCLUSIONSTCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.
We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools' important influence on child mental health. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the outcomes. ISRCTN84130388. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (s.d.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference = -1.0; 95% CI-1.9 to -0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori subgroup analyses suggested TCM is more effective for children with poor mental health. TCM provided a small, short-term improvement to children's mental health particularly for children who are already struggling.
Author Price, Anna
Edwards, Vanessa
Fletcher, Malcolm
Allen, Kate
Grimes, Katie
Ford, Tamsin
Longdon, Bryony
Ukoumunne, Obioha C.
Byford, Sarah
Logan, Stuart
Hansford, Lorraine
Ganguli, Poushali
Norman, Shelley
Norwich, Brahm
Hayes, Rachel
Pritchard, Will
Allwood, Matthew
AuthorAffiliation 7 NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter , South Cloisters , St Luke's Campus , Exeter, EX1 2LU , UK
1 University of Exeter Medical School , South Cloisters , St Luke's Campus , Exeter, EX1 2LU , UK
5 Educational and Counselling Psychology and Special Education , University of British Columbia , 2125 Main Mall , Vancouver , British Columbia , Canada , V6T 1Z4 , Canada
6 University of Exeter , Sir Henry Wellcome Building , Streatham campus , University of Exeter , EX4 4QG , UK
4 Education and Early Years , Cornwall County Council , 3 West , New County Hall , Treyew Road , Truro, TR1 3AY Truro , TR1 3AY , UK
2 King's College London , King's Health Economics , Box PO24 , Institute of Psychiatry, Psychology & Neuroscience , De Crespigny Park , London, SE5 8AF , UK
3 Graduate School of Education , University of Exeter , North Cloisters , St Luke's Campus , Exeter, EX1 2LU , UK
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/30017006$$D View this record in MEDLINE/PubMed
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Snippet We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given...
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SubjectTerms Child
Child & adolescent mental health
Child Behavior
Child, Preschool
Children
Children & youth
Classroom management
Classrooms
Cluster Analysis
Cost analysis
Cost-Benefit Analysis
Data collection
Dominance
Educational Personnel
Elementary schools
England
Female
Humans
Interactive learning
Intervention
Linear Models
Logistic Models
Male
Medical research
Mental disorders
Mental health
Original
Original Articles
Program Evaluation
Public health
Questionnaires
Random effects
Regression analysis
Schools
Social Behavior
Students - psychology
Teachers
Teaching
Uncertainty
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Title The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial
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