Co-Principal Investigators:  Witte, Amanda; Wheeler, Lorey; Garbacz, Andy

Purpose: The purpose of this efficacy study is to evaluate a virtual professional development (VPD) approach for consultants implementing Conjoint Behavioral Consultation (CBC) in rural schools with students with or at risk of developing Serious Emotional Disability (SED). Family-school interventions are effective at addressing social behavioral and mental health needs across school and home and are particularly relevant in rural settings. Professional development of rural practitioners in fostering family partnerships for students with SED is a priority, yet current professional models are costly, inflexible, and unsustainable. This study will examine a virtual professional development approach in preparing rural school-based consultants in CBC implementation to support students with or at risk for SED and evaluate the impact on consultant's knowledge, fidelity, and partnership strategy use; parent and teacher process skills and practices; and student social-behavioral skills.

Project Activities: This study will use a 3-cohort cluster-randomized trial with repeated measures design to examine the efficacy of the PD model. A total of 24 school-based consultants in rural communities, and 288 students with or at risk for SED will participate, with consultants randomly assigned to treatment and control (business as usual) groups. Each consultant will work with 12 students and their respective teachers and parents.

Products:  This project will result in evidence of the efficacy of VPD for rural school-based consultants in CBC implementation to support students with or at risk for SED, as well as information about the cost and cost-effectiveness of the programs. The project will also result in a final dataset to be shared, peer-reviewed publications and presentations, and additional dissemination products that reach education stakeholders, such as practitioners and policymakers.

Structured Abstract

Setting: The research will take place in elementary (K–5) schools in rural Nebraska and Colorado.

Population/Sample:  A total of twenty-four school-based consultants and 288 Kindergarten – Grade 5 teachers, students and parents will participate. Eligible students are those with or at risk for developing SED. Consultants will be school psychologists, social workers, counselors, special education coordinators, or behavior specialists, who already have responsibilities for students with or at risk for SED.

Intervention: CBC is an 8-week intervention that focuses on improving student behaviors through structured problem solving and collaborative, consistent implementation of evidence-based interventions across home and school settings. In CBC, parents and teachers serve as joint consultees, and the consultation process is conducted with parents and teachers as partners in addressing student behavior problems that interfere with learning. Problems are identified, defined, analyzed, and treated through mutual and collaborative interactions between parents and teachers with the guidance and assistance of a consultant. The VPD is comprised of seven core structural components, including instruction, active engagement, modeling, practice, feedback, use in practice contexts, and coaching.  VPD training includes engagement with online training modules to learn the CBC process, virtual lounges for interaction with other trainees around the newly learned content, role-play opportunities, and supervision.  Video models, practice scenarios, knowledge assessments, and post-test quizzes are included. All materials will be available in an easy-to-access format for use in rural and other school settings. Virtual coaching will be provided to consultants as they engage in consultation casework over a two-year period.

Research Design and Methods: This study will use a 3-cohort cluster-randomized trial with repeated measures design to examine the efficacy of the PD model. A total of 24 school-based consultants in rural communities (recruited across Years 1–3) will be randomly assigned to treatment (VPD) and control (business as usual; BAU) groups. Teachers (N=288) and parents/students (N=288) will be clustered within consultants. To ensure equivalence between conditions, the research team will match consultants on demographic (e.g., age, race) and experience (e.g., role/position at the school, certification, education, years of experience) variables prior to blocked randomization within each cohort. Data will be collected at pre-test and post-test. Classroom observations and behavioral interview data documenting students' behaviors in classrooms and homes will be collected in a repeated fashion over eight occasions (i.e., three during baseline and five during treatment).

Control Condition:  The school-based practitioners assigned to the business as usual (BAU) control conditions will receive typical PD experiences provided by their schools.

Key Measures:  Consultant, parent, teacher, and student outcomes will be assessed using a multi-source, multi-method, multi-setting approach.  Measures for consultant outcomes include tests of CBC knowledge, observational practice assessments to assess fidelity, and partnership strategy observations. Parent and teacher outcomes will be measured by observation of behavioral strategy use and self-reports of problem solving and communication.  The parent-teacher relationship will be assessed with the Parent-Teacher Relationship Scale - II. Student outcomes will be assessed via direct observations in the classroom, the Parent Daily Report, the Behavioral Assessment Scale for Children (BASC)-3rd ed., and the Social Skills Improvement System (SSIS).  Student eligibility will be determined by responses on the BASC-3 Behavioral and Emotional Screening System (BESS). Fidelity of PD, coaching, and CBC implementation (adherence, quality, dosage) will be assessed.

Data Analytic Strategy: The effects of VPD on consultant outcomes will be assessed using an ANCOVA framework and a single-level model (i.e., consultants are the unit of randomization). The effects of VPD on teachers, parents, and students will be assessed using a multilevel framework implemented as a generalized linear mixed model, with teachers, parents, and children nested within consultants. An intent-to-treat approach will be used to analyze outcomes.

Cost Analysis: The research team will use an ingredients-based approach to outlay essential elements of each arm of the intervention (i.e., training, coaching, and CBC implementation). They will pair the results of the cost analyses with the primary consultant outcomes to perform a cost-effectiveness analysis, yielding a cost-effectiveness ratio.

Related Projects: Evaluation of Efficacy of CBC for Addressing Disruptive Behaviors of Children at Risk for Academic Failure (R305F050284); A Randomized Trial of Conjoint Behavioral Consultation (CBC) in Rural Educational Settings: Efficacy for Elementary Students With Disruptive Behaviors (R324A100115); A Randomized Trial of Conjoint Behavioral Consultation (CBC) with Latino Students: A Replication Study (R324A160017)