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Effects of school-wide positive behavioral interventions and supports on child behavior problems.

ABSTRACT: School-Wide Positive Behavioral Interventions and Supports (SWPBIS) is a universal prevention strategy currently implemented in >16,000 schools across the United States. SWPBIS intends to reduce students' behavior problems by altering staff behaviors and developing systems and supports to meet children's behavioral needs. The current study reports intervention effects on child behaviors and adjustment from an effectiveness trial of SWPBIS.The sample of 12,344 elementary school children was 52.9% male, 45.1% African American, and 46.1% Caucasian. Approximately 49% received free or reduced-priced meals, and 12.9% received special education services at baseline. The trial used a group randomized controlled effectiveness design implemented in 37 elementary schools. Multilevel analyses were conducted on teachers' ratings of children's behavior problems, concentration problems, social-emotional functioning, prosocial behavior, office discipline referrals, and suspensions at 5 time points over the course of 4 school years.The multilevel results indicated significant effects of SWPBIS on children's behavior problems, concentration problems, social-emotional functioning, and prosocial behavior. Children in SWPBIS schools also were 33% less likely to receive an office discipline referral than those in the comparison schools. The effects tended to be strongest among children who were first exposed to SWPBIS in kindergarten.These findings provide support for the hypothesized reduction in behavior problems and improvements in prosocial behavior and effective emotion regulation after training in SWPBIS. The SWPBIS framework appears to be a promising approach for reducing problems and promoting adjustment among elementary school children.

SUBMITTER: Bradshaw CP

PROVIDER: S-EPMC3483890 | biostudies-literature | 2012 Nov

REPOSITORIES: biostudies-literature

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Effects of school-wide positive behavioral interventions and supports on child behavior problems.

Bradshaw Catherine P CP Waasdorp Tracy E TE Leaf Philip J PJ

Pediatrics 20121015 5

<h4>Objective</h4>School-Wide Positive Behavioral Interventions and Supports (SWPBIS) is a universal prevention strategy currently implemented in >16,000 schools across the United States. SWPBIS intends to reduce students' behavior problems by altering staff behaviors and developing systems and supports to meet children's behavioral needs. The current study reports intervention effects on child behaviors and adjustment from an effectiveness trial of SWPBIS.<h4>Methods</h4>The sample of 12,344 el ...[more]

PMID: 23071207

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Project description:Urban schools lag behind non-urban schools in attending to the behavioral health needs of their students. This is especially evident with regard to the level of use of evidence-based interventions with school children. Increased used of evidence-based interventions in urban schools would contribute to reducing mental health services disparities in low-income communities. School-wide positive behavioral interventions and supports (SWPBIS) is a service delivery framework that can be used to deliver universal preventive interventions and evidence-based behavioral health treatments, such as group cognitive behavioral therapy. In this article, we describe our ongoing research on creating internal capacity for program implementation. We also examine the cost-effectiveness and resulting school climate when two different levels of external support are provided to personnel as they implement a two-tier SWPBIS program.The study follows six K - 8 schools in the School District of Philadelphia randomly assigned to consultation support or consultation-plus-coaching support. Participants are: approximately 48 leadership team members, 180 school staff and 3,900 students in Tier 1, and 12 counselors, and 306 child participants in Tier 2. Children who meet inclusion criteria for Tier 2 will participate in group cognitive behavioral therapy for externalizing or anxiety disorders. The study has three phases, baseline/training, implementation, and sustainability. We will measure implementation outcomes, service outcomes, child outcomes, and cost.Findings from this study will provide evidence as to the appropriateness of school-wide prevention and treatment service delivery models for addressing services disparities in schools. The effectiveness and cost-effectiveness analyses of the two levels of training and consultation should help urban school districts and policymakers with the planning and deployment of cost-effective strategies for the implementation of evidence-based interventions for some of the most common behavioral health problems in school children.ClinicalTrials.gov identifier: NCT01941069.

Project description:ObjectiveThe aim of this study is to perform the first meta-meta-analysis on the effectiveness of parent-based interventions for children with externalizing behavior problems. Even though parent-based interventions are considered as effective treatments the effects reported in meta-analyses are heterogeneous and the implementation in clinical practice is suboptimal. Recapitulative valid effect predictions are required to close the still existing gap between research findings and clinical practice. The meta-meta-analytic results on changes in child behavior shall result in a clear signal for clinical practice.MethodsThis meta-meta-analysis encompasses 26 meta-analyses identified via search in electronic databases (PsycINFO, Medline, PubMed). Meta-analyses had to report effects of parent-based interventions on child behavior and focus on children under the age of 13 years with externalizing behavior problems in a clinical setting. Analyses were based on random-effects models. To combine results, the effect estimates of the meta-analyses were transformed to SMD and weighted to correct for primary study overlap. The meta-meta-analysis is registered on PROSPERO, registration number CRD42016036486 and was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA).ResultsThe results indicate a significant moderate overall effect for child behavior (SMD = 0.46) as well as for parent reports (SMD = 0.51) and observational data (SMD = 0.62). Further analyses focusing on child externalizing behavior yielded significant and moderate effects (SMD = 0.45). All effects remained stable to follow-up. Considerable heterogeneity was observed within results.ConclusionParent-based interventions are shown to be effective in improving behavior in children with externalizing behavior problems, as assessed using parent reports and observational measures. The present results should encourage health care providers to apply evidence-based parent-based interventions.

Dataset Information

Effects of school-wide positive behavioral interventions and supports on child behavior problems.

Publications

Effects of school-wide positive behavioral interventions and supports on child behavior problems.

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