The effectiveness and cost effectiveness of the Incredible Years Teacher Classroom Management programme in primary school children: a cluster randomised controlled trial, with parallel economic and process evaluations

Design: A cluster randomised controlled trial with recruitment staggered over three years. The unit of randomisation is the school, and randomisation will be stratified to ensure balance on the following school characteristics: level of deprivation; rural/urban location; involvement in other emotional enrichment programmes. One teacher per school will participate. Setting: 80 primary schools in Devon, Torbay and Plymouth. Target population: Primary school age children from Reception and Years 1-4 in the class of the one teacher per school recruited to the trial. Teachers with mixed year groups, fewer than 15 children in their class, or in the classroom fewer than four days per week will be excluded. Intervention being evaluated: The IY TCM course; a manualised six-day course delivered to groups of up to 10 teachers. Control teachers will receive the intervention in the following academic year, which is a prerequisite for schools agreeing to participate. Schools will be randomised to intervention (TCM training) or control (teaching as usual). Measurement of outcome and duration of follow up: The primary outcome will be the children’s socio-emotional well-being assessed using the Strengths and Difficulties Questionnaire (SDQ; 22) completed by teachers and parents. The SDQ is a well-validated and widely used measure of behaviour, emotions, pro-social behaviour, peer relationships, and hyperactivity. The secondary outcome will be children’s academic attainment using teachers’ routine assessment of national curriculum levels (23), checked against the Wechsler Individual Achievement Test in a sub-sample (24). For economic evaluation, parent-completed Child and Adolescent Service Use Schedule (25, 26, 27) will report the use of health, education and social services, plus criminal justice sector resources. Responses will be supplemented by interview with a sub-sample of parents and reports from school about education-based services. Structured direct observation of teacher-child interaction using the Teacher Pupil Outcome Tool among a sub-sample of children will assess if TCM changes teachers behaviour (28). Teachers will also complete the Sense of Efficacy Scale (29), Maslach Burnout Inventory (30) and Everyday Feeling Questionnaire (31) to assess the impact on their well-being and efficacy. Our Feasibility Studies include the completed validation of a child-completed measure to assess how happy they feel about their school (32) and the planned validation of the EQ-5D-Y (33; a youth version of the EuroQol measure recommended for 7-19 year olds) among 4-7 year olds, as well as delivering four TCM courses. As illustrated in Appendix 2, we plan to recruit 15 schools in the pilot phase and 65 schools over the two subsequent years. The pilot phase will use the same methodology as the main phase, but will test acceptability of the study for parents, teachers and children, recruitment and data collection procedures, and provide qualitative information to improve recruitment and retention in the main phase. Progression from pilot phase to main phase will depend on being able to recruit at least 14 schools, achieving a 66% response rate among parents and retaining 80% of teachers and parents at first follow up (T1). Data collection for both groups will occur at the beginning (October, T0) and end (June, T1) of the academic year of recruitment, and TCM training will be delivered to the intervention group between these data collection points (See Appendix 3). Further follow up will occur annually in the spring term in the following two academic years (T2 and T3). The teachers and children will separate at the end of the first academic year (between T1 and T2), allowing the control teachers to access TCM without breaking the trial design in relation to the child well-being measures. A parallel process evaluation will use qualitative methods to build on work from the Feasibility Studies. In the pilot phase the process evaluation will seek t