Trials of Early Childhood Violence Prevention Interventions in Jamaica
| Study . | Sample . | Intervention . | Short-Term Outcomes . |
|---|---|---|---|
| Teacher training | |||
| Efficacy trial in 24 preschools.19,23 Children aged 3–6 y | 24 preschools randomly assigned to intervention (n = 12 preschools, 37 classrooms) or control (12 preschools, 36 classrooms). Three children with the highest level of conduct problems from each class participated in the evaluation of individual child outcomes (113 intervention, 112 control). | Teachers in schools allocated to the intervention were trained in classroom behavior management and how to promote young children social-emotional competence through: • 8 full-day teacher training workshops and • Four 1-h individual sessions of in-class support: once a month for 4 mo Intervention used a hybrid of the Incredible Years Teacher Training Program (50%) and the content of the Irie Classroom Toolbox (50%) | Teacher outcomes (measured through observation): • Increased teacher positive behaviors: ES = 3.35 (95% CI, 2.70–3.98) • Decreased teacher negative behaviors: ES = –1.29 (95% CI, –0.87 to –1.71) • Increased teacher warmth: ES = 2.03 (95% CI, 1.41–2.67) Child outcomes Observed class-wide child behavior: • Increased of class-wide appropriate behavior: ES = 0.73 (95% CI, 0.17–1.30) • Increased class-wide child interest and enthusiasm: ES = 0.98 (95% CI, 0.48–1.50) Individual child outcomes: • Reductions in observed conduct problems at school: ES = –0.42 (95% CI, –0.12 to –0.71) • Increased observed friendship skills at school: ES = 0.74 (95% CI, 0.41–1.40) • Decreased teacher-reported behavior difficulties: ES = –0.47 (95% CI, –0.18 to –0.76) • Increased teacher-reported social skills: ES = 0.59 (95% CI, 0.35– 0.84) • Decreased parent reported behavior difficulties: ES = –0.22 (95% CI, –0.03 to –0.42) • Increased child attendance: ES = 0.30 (95% CI, 0.05–0.55) |
| Pilot study in 14 primary schools.14 Children aged 6–7 y | 14 primary schools randomly assigned to intervention (n = 7) or control (n = 7). Teachers of grade 1 children participated in the study (27 intervention, 28 control). Four children from each class were randomly selected to participate in the evaluation of individual outcomes. | Teachers in schools allocated to the intervention were trained in selected content from the first three modules of the Irie Classroom Toolbox through: • 12 h of teacher training workshops • Eight 1-h individual sessions of in-class support | Teacher outcomes • Reductions in teachers’ use of violence against children through observation: ES = –0.73 (95% CI, –0.15 to –1.31) • No benefits to teachers’ professional well-being: ES = –0.11 (95% CI, –0.63 to 0.43) Classroom outcomes Quality of the classroom environment through observation (using the CLASS K-3) • Increased emotional support: ES = 1.22 (95% CI, 0.57–1.87) Child outcomesObserved class-wide child behavior: • No benefits to class-wide aggression: ES = –0.20 (95% CI, –0.73 to 0.33) or prosocial behavior: ES = 0.18 (95% CI, –0.36 to 0.72) Individual child outcomes • Marginal benefits to a composite of child self-regulation, language and math reasoning skills: ES = 0.25 (95% CI, –0.02 to 0.52), P = .07 • No significant benefit to child behavior difficulties or prosocial skills on the SDQ or to a composite of child academic achievement in reading, spelling, and phonics. |
| Effectiveness trial in 76 preschools.15 Children aged 3–6 y | 76 preschools randomly assigned to intervention (n = 38 preschools, 119 classrooms) or control (n = 38 preschools, 110 classrooms). Up to 12 children aged 4 y were randomly selected to participate in the evaluation of individual child outcomes (441 intervention, 424 control) | Teachers in schools allocated to the intervention were trained in the Irie Classroom Toolbox through: • Five full-day teacher training workshops (30 h) • Eight 1-h individual sessions of in-class support | Teacher outcomes • Intervention teachers used less violence against children (measured through observation) than control teachers: –67.12% (95% CI, –53.52 to –80.71). • Benefits to teachers’ professional well-being not significant: ES = 0.18 (95% CI, –0.03 to 0.39) Classroom outcomes Quality of the classroom environment through observation (using the CLASS Pre-K) • Increased emotional support: ES = 0.65 (95% CI, 0.43–0.88) • Increased classroom organization: ES = 0.49 (95% CI, 0.24–0.74) • Increased instructional support: ES = 0.61 (95% CI, 0.31–0.97) Child outcomes Observed class-wide child behavior: • No benefits to class-wide child aggression: ES = 0.07 (95% CI, –0.16 to 0.29) • Increased class-wide prosocial behavior: ES = 0.42 (95% CI, 0.17–0.71) Individual child outcomes • Increased child inhibitory control through direct testing: ES = 0.18 (95% CI, 0.05–0.32) • Fewer children in intervention schools in the clinical range for behavior difficulties: odds ratio, 0.46 (0.22–0.94) • No significant benefits to child behavior difficulties or prosocial skills on the SDQ |
| Parenting interventions | |||
| Efficacy trial in 18 preschools.26 Children aged 2–6 y | 18 preschools randomly assigned to intervention (n = 9) or control (n = 9) Minimum of 12 parents per school recruited into the study (115 intervention, 108 control) | Parents in intervention schools participated in the Irie Homes Toolbox program. Sessions were held once a week for 8 wk with groups of 6 parents on the preschool compound. | Parent outcomes • Reductions in parents’ use of violence against their child: ES = –0.29 (95% CI, –0.05 to 0.52) • Increases in parents’ involvement with their child: ES = 0.30 (95% CI, 0.03–0.57) Child outcomes • No main effects to parent- and teacher-reported child behavior difficulties on the SDQ • Significant reductions in parent-reported child behavior difficulties for children above the 50th percentile on initial behavior difficulties: ES = –0.36 (95% CI, –0.03 to –0.68) |
| Efficacy trial of virtual Irie Homes Toolbox.27 Children aged 2–6 y | 1113 parents (recruited via SMS) randomly assigned to intervention (n = 557) or control (n = 556) | Parents allocated to the intervention group were invited to participate in the Virtual Irie Homes Toolbox delivered over a 10-wk period consisting of: • Access to a data free app • 3 SMS messages/wk • Weekly 1-h virtual parenting sessions with groups of 8–9 parents • Weekly session e-summaries sent via WhatsApp | Parent outcomes • Reductions in parents’ use of violence against their child: ES = –0.12 (95% CI, –0.01 to –0.24) at posttest; ES = –0.13 (95% CI, –0.01 to –0.25) at 9-mo follow-up • Reductions in parents’ attitudes toward violence against children: ES = –0.20 (95% CI, –0.10 to –0.30) at posttest; ES = –0.14 (95% CI, –0.02 to –0.26) at 9- mo follow-up Child outcomes • Reductions to child emotional problems on the SDQ: ES = –0.17 (95% CI, –0.07 to –0.27) • No benefits to child conduct problems on the SDQ |
| Study . | Sample . | Intervention . | Short-Term Outcomes . |
|---|---|---|---|
| Teacher training | |||
| Efficacy trial in 24 preschools.19,23 Children aged 3–6 y | 24 preschools randomly assigned to intervention (n = 12 preschools, 37 classrooms) or control (12 preschools, 36 classrooms). Three children with the highest level of conduct problems from each class participated in the evaluation of individual child outcomes (113 intervention, 112 control). | Teachers in schools allocated to the intervention were trained in classroom behavior management and how to promote young children social-emotional competence through: • 8 full-day teacher training workshops and • Four 1-h individual sessions of in-class support: once a month for 4 mo Intervention used a hybrid of the Incredible Years Teacher Training Program (50%) and the content of the Irie Classroom Toolbox (50%) | Teacher outcomes (measured through observation): • Increased teacher positive behaviors: ES = 3.35 (95% CI, 2.70–3.98) • Decreased teacher negative behaviors: ES = –1.29 (95% CI, –0.87 to –1.71) • Increased teacher warmth: ES = 2.03 (95% CI, 1.41–2.67) Child outcomes Observed class-wide child behavior: • Increased of class-wide appropriate behavior: ES = 0.73 (95% CI, 0.17–1.30) • Increased class-wide child interest and enthusiasm: ES = 0.98 (95% CI, 0.48–1.50) Individual child outcomes: • Reductions in observed conduct problems at school: ES = –0.42 (95% CI, –0.12 to –0.71) • Increased observed friendship skills at school: ES = 0.74 (95% CI, 0.41–1.40) • Decreased teacher-reported behavior difficulties: ES = –0.47 (95% CI, –0.18 to –0.76) • Increased teacher-reported social skills: ES = 0.59 (95% CI, 0.35– 0.84) • Decreased parent reported behavior difficulties: ES = –0.22 (95% CI, –0.03 to –0.42) • Increased child attendance: ES = 0.30 (95% CI, 0.05–0.55) |
| Pilot study in 14 primary schools.14 Children aged 6–7 y | 14 primary schools randomly assigned to intervention (n = 7) or control (n = 7). Teachers of grade 1 children participated in the study (27 intervention, 28 control). Four children from each class were randomly selected to participate in the evaluation of individual outcomes. | Teachers in schools allocated to the intervention were trained in selected content from the first three modules of the Irie Classroom Toolbox through: • 12 h of teacher training workshops • Eight 1-h individual sessions of in-class support | Teacher outcomes • Reductions in teachers’ use of violence against children through observation: ES = –0.73 (95% CI, –0.15 to –1.31) • No benefits to teachers’ professional well-being: ES = –0.11 (95% CI, –0.63 to 0.43) Classroom outcomes Quality of the classroom environment through observation (using the CLASS K-3) • Increased emotional support: ES = 1.22 (95% CI, 0.57–1.87) Child outcomesObserved class-wide child behavior: • No benefits to class-wide aggression: ES = –0.20 (95% CI, –0.73 to 0.33) or prosocial behavior: ES = 0.18 (95% CI, –0.36 to 0.72) Individual child outcomes • Marginal benefits to a composite of child self-regulation, language and math reasoning skills: ES = 0.25 (95% CI, –0.02 to 0.52), P = .07 • No significant benefit to child behavior difficulties or prosocial skills on the SDQ or to a composite of child academic achievement in reading, spelling, and phonics. |
| Effectiveness trial in 76 preschools.15 Children aged 3–6 y | 76 preschools randomly assigned to intervention (n = 38 preschools, 119 classrooms) or control (n = 38 preschools, 110 classrooms). Up to 12 children aged 4 y were randomly selected to participate in the evaluation of individual child outcomes (441 intervention, 424 control) | Teachers in schools allocated to the intervention were trained in the Irie Classroom Toolbox through: • Five full-day teacher training workshops (30 h) • Eight 1-h individual sessions of in-class support | Teacher outcomes • Intervention teachers used less violence against children (measured through observation) than control teachers: –67.12% (95% CI, –53.52 to –80.71). • Benefits to teachers’ professional well-being not significant: ES = 0.18 (95% CI, –0.03 to 0.39) Classroom outcomes Quality of the classroom environment through observation (using the CLASS Pre-K) • Increased emotional support: ES = 0.65 (95% CI, 0.43–0.88) • Increased classroom organization: ES = 0.49 (95% CI, 0.24–0.74) • Increased instructional support: ES = 0.61 (95% CI, 0.31–0.97) Child outcomes Observed class-wide child behavior: • No benefits to class-wide child aggression: ES = 0.07 (95% CI, –0.16 to 0.29) • Increased class-wide prosocial behavior: ES = 0.42 (95% CI, 0.17–0.71) Individual child outcomes • Increased child inhibitory control through direct testing: ES = 0.18 (95% CI, 0.05–0.32) • Fewer children in intervention schools in the clinical range for behavior difficulties: odds ratio, 0.46 (0.22–0.94) • No significant benefits to child behavior difficulties or prosocial skills on the SDQ |
| Parenting interventions | |||
| Efficacy trial in 18 preschools.26 Children aged 2–6 y | 18 preschools randomly assigned to intervention (n = 9) or control (n = 9) Minimum of 12 parents per school recruited into the study (115 intervention, 108 control) | Parents in intervention schools participated in the Irie Homes Toolbox program. Sessions were held once a week for 8 wk with groups of 6 parents on the preschool compound. | Parent outcomes • Reductions in parents’ use of violence against their child: ES = –0.29 (95% CI, –0.05 to 0.52) • Increases in parents’ involvement with their child: ES = 0.30 (95% CI, 0.03–0.57) Child outcomes • No main effects to parent- and teacher-reported child behavior difficulties on the SDQ • Significant reductions in parent-reported child behavior difficulties for children above the 50th percentile on initial behavior difficulties: ES = –0.36 (95% CI, –0.03 to –0.68) |
| Efficacy trial of virtual Irie Homes Toolbox.27 Children aged 2–6 y | 1113 parents (recruited via SMS) randomly assigned to intervention (n = 557) or control (n = 556) | Parents allocated to the intervention group were invited to participate in the Virtual Irie Homes Toolbox delivered over a 10-wk period consisting of: • Access to a data free app • 3 SMS messages/wk • Weekly 1-h virtual parenting sessions with groups of 8–9 parents • Weekly session e-summaries sent via WhatsApp | Parent outcomes • Reductions in parents’ use of violence against their child: ES = –0.12 (95% CI, –0.01 to –0.24) at posttest; ES = –0.13 (95% CI, –0.01 to –0.25) at 9-mo follow-up • Reductions in parents’ attitudes toward violence against children: ES = –0.20 (95% CI, –0.10 to –0.30) at posttest; ES = –0.14 (95% CI, –0.02 to –0.26) at 9- mo follow-up Child outcomes • Reductions to child emotional problems on the SDQ: ES = –0.17 (95% CI, –0.07 to –0.27) • No benefits to child conduct problems on the SDQ |
CI, confidence interval; CLASS, Classroom Assessment Scoring System; ES, effect size; SDQ: Strengths and Difficulties Questionnaire.