Transporting an Evidence-Based Programme to Jamaican Preschools: Cluster Randomised Controlled Trial

Introduction: Universal school-based interventions involving training teachers in strategies to reduce child conduct problems and promote social skills have shown sustained benefits to child behaviour in the US; however there is limited information on whether these interventions can be effective in low and middle income countries. We tailored the Incredible Years (IY) Teacher Training Programme to the Jamaican setting through a series of steps including a pilot study with a quantitative and qualitative evaluation and we evaluated the adapted version through a cluster randomised trial.

Methods: Twenty four community preschools in Kingston, Jamaica were randomly assigned to an intervention (n=12) or control (n=12) group. The intervention involved training all teachers in intervention schools in classroom management through 8 full-day training workshops and four one-hour individual sessions of classroom support. Each preschool had 3-4 classes, (each staffed by one teacher), giving 37 intervention and 36 control classrooms. Outcome measurements included direct observation of teacher positive and negative behaviours to the whole class and observer ratings of classwide measures of child behaviour and child interest and enthusiasm. These measures were repeated one year after the end of the intervention and classroom quality was also assessed using the Classroom Assessment Scoring System (CLASS).

Results: Significant benefits of intervention were found for direct observations of teachers’ positive behaviours (Effect Size (ES) = 3.35, p<0.0001) and negative behaviours (ES=1.29, p<0.0001) to the whole class and for class-wide child behaviour (ES=0.73, p<0.01) and child interest and enthusiasm (ES=0.98, p<0.001). At one year follow-up, significant benefits of intervention were sustained: positive behaviours ES=2.70, p<0.0001; negative behaviours ES=1.02, p<0.0001; child behaviour ES=0.49, p<0.05, and child interest and enthusiasm ES=0.77, p<0.05. Benefits were also found for the three domains measured by the CLASS: emotional support ES=0.94, p<0.0001; classroom organisation ES=1.03, p<0.0001 and instructional support ES=0.66, p<0.05.

Conclusions: A relatively low cost intervention, integrated into an existing service and implemented in a developing country setting produced large benefits to teacher behaviour and to classwide measures of children’s behaviour. These benefits were sustained at one-year follow-up and significant benefits were also found to classroom quality. The tailored version of the IY Teacher Training programme produced a similar magnitude of benefit to teacher and child behaviour as found in our pilot study of the untailored version but with significantly less in-class support and researcher involvement.