Teacher Competence of Delivery of BEST in CLASS as a Mediator of Treatment Effects
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This study investigated if training and practice-based coaching in an evidence-based program was associated with higher observed treatment integrity (adherence and competence) and if these treatment integrity components were associated with teacher report of child behavioral outcomes in the BEST in CLASS efficacy trial. Participants were 462 children (M = 4.32 years, SD = 0.53; 65% male; 17.0% Caucasian, 66.0% African-American, 5.0% Hispanic, and 12.0% other) identified as having problem behavior and their 185 teachers (M = 12.09 years teaching experience; 99% female; 47.0% Caucasian, 48.0% African-American, 1.0% Asian/Pacific Islander, 3.0% Hispanic and 1.0% other). Teachers and focal children were randomly assigned to the intervention (teacher n = 92, children n = 230) or control condition (teacher n = 93, child n = 232). Results of a multilevel mediation analysis indicated that the BEST in CLASS intervention had a positive effect on teacher report of child problem behavior (SSIS-RS) and externalizing problems (C-TRF), as well as having a positive effect on teachers’ adherence and competence of delivery of the intervention. There was an indirect effect through competence of delivery for externalizing problems, but not problem behavior. No indirect effects for adherence were found. Implications of these findings and directions for future research are discussed.
KeywordsTreatment integrity Teacher delivery Problem behavior Evidence-based program
This research was supported by a Grant (R324A110173) from the U. S. Department of Education, Institute for Education Sciences, with additional support from an NIH/NCATS Clinical and Translational Science Award to the University of Florida UL1 TR000064. The opinions expressed by the authors are not necessarily reflective of the position of or endorsed by the U. S. Department of Education.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All study procedures involving human participants were in accordance with the ethical standards of the researchers’ Institutional Review Boards and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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