Co-Principal Investigators: Reinke, Wendy; Herman, Keith

Purpose: The purpose of this project is to develop an intervention, the Kindergarten Check-up (KCU), to support Kindergarten students who have an increased risk for failure due to poor school readiness skills, including early social behavioral and academic risk. Specifically, the research team will adapt the Family Check-up (FCU), an evidence-based family-centered intervention, and combine it with individually tailored KCU intervention modules thru an iterative process involving parents, teachers, school personnel, and a panel of experts. The KCU will use evidence-based family involvement strategies, such as parent engagement and increased enrichment activities and combine these with individually tailored KCU modules that also address school-related needs for change (teachers' use of academic and social behavior supports). Kindergarten is a critical life stage, and this grant seeks to support school entry for children with early risk for failure and increase their likelihood of success. Without early intervention, children who have deficits in their academic and social readiness for school are at risk for sustained and often exacerbated problems over time.

Project Activities: There are three aims for this project:

1. To develop a targeted, comprehensive intervention, the KCU, using an iterative process, to support Kindergarten students with social/behavioral risk and poor academic school readiness skills.
2. To study key elements of the KCU related to cultural and context responsivity, time and resource demands, and specific skills, competencies, and training needs for KCU consultants, given their integral role in the KCU.
3. To evaluate the feasibility and promise of the fully developed KCU intervention on family, teacher, and child outcomes when implemented by school personnel identified as natural implementers (i.e., KCU consultants).

The research team will develop KCU with parents, teachers, potential KCU consultants, and an expert advisory board through an iterative process of development and refinement of the intervention models, processes, and KCU consultant skills and training needs during the first two years of the project. In Year 3, the research team will conduct two single subject multiple baseline design studies of the KCU. In the final year, the team will conduct a pilot study of the KCU intervention with natural implementers to determine the promise of the intervention.

Products: Products include a carefully developed and field-tested intervention to support young children in kindergarten who are at risk academically and socially. The KCU intervention will be a fully developed intervention with an implementation manual and materials. Peer reviewed publications and presentations of findings are part of the dissemination process.

Structured Abstract

Setting: The research will take place in a mid-sized Midwestern city in Missouri.

Sample: Elementary schools located in Columbia Public School District (CPS) will participate. CPS has 20 elementary schools and approximately 1500 kindergarten students each year. Kindergarten student demographics indicate that 51% are male and 59% White, 19% Black, 12% Multi-racial, 5% Asian, 4% Latinx, and less than 1% American Indian or Pacific Islander/Native Hawaiian.

Intervention: The KCU is a comprehensive and multifaceted intervention intended to offer effective prevention programming in kindergarten. The intervention modules represent a comprehensive approach to supporting children at high risk by targeting specific risk factors across contexts and providing support by building competencies and skills in children, parents, and teachers. All KCU modules are designed to be brief, engaging, and user-friendly to maximize their use and impact. At the end of the four-year period of the project, the KCU intervention will be a fully developed, comprehensive intervention. The KCU intervention will include an implementation manual and materials, including protocols, videos modeling key intervention strategies, attractive and easily understood brochures outlining intervention strategies, assessment tools for progress monitoring, feedback forms, and other materials needed for implementing KCU modules (e.g., home-school communication form, support plans, emergent literacy and mathematics materials).

Research Design and Methods: Years 1 and 2 will focus on developing the KCU processes, procedures, intervention modules, video development, and KCU consultant skills and training needs. The research team will involve stakeholders, including parents, teachers, and potential KCU consultants at the start of the project. Expert advisory board members will also review the intervention early in the process and provide feedback. In Year 3, the team will use and implement the KCU across two single subject multiple baseline design (MBL) studies with eight children meeting inclusion requirements and their families and teachers. They will make final revisions to all KCU materials based on findings from the MBL studies. In the final year, researchers will conduct an underpowered randomized control trial pilot with 50 children meeting the inclusion criteria (and their families and teachers) to evaluate the initial promise of the intervention. With an underpowered pilot randomized control trial (RCT), they will use a design that meets What Works Clearinghouse standards. Due to randomization, the study conditions will be equivalent at baseline with respect to known and unknown prognostic factors. The team will conceptualize the pilot RCT as a feasibility study, focusing on feasibility in terms of recruitment, retention, adherence, and acceptability, as well as data measurement and analysis, putting less emphasis on estimating efficacy effect sizes or predicting the success of a future large-scale RCT. The team will also gather information on feasibility, social validity, and cost-effectiveness with the natural implementers.

Control Condition: In the pilot study, children in the control condition will receive business as usual kindergarten practices.

Key Measures: The research team will use measures to collect data on behavior and academic change, feasibility, social validity, cultural responsiveness, fidelity, and cost-effectiveness of the intervention. Focus groups conducted early in the project will provide important information on the importance of the intervention and on the social validity, contextual and cultural responsivity, and feasibility. Qualitative analyses will inform needs for adaptation and revision. In the quantitative research studies proposed to determine the promise of the KCU, the research team will include screening measures, weekly measures, and pre-post measures. They will use a multiple gating procedure to identify participants. The team will collect behavioral and academic measures 3–5 times per week for all participating children. Trained research personnel will administer all measures and complete direct observations. Real time direct observations sessions will record student-teacher interactions, student disruptive behavior, and off-task behavior. Researchers will assess academic progress using Individual Growth and Development Indicators (IGDI's), which are CBM tools for assessing the development of literacy skills in young children and Early Numeracy Indicators (ENIs) for early mathematic skills. The research team will conduct interviews with all participants to determine the cultural and contextual responsiveness of the intervention. They will administer additional family and teacher measures to determine growth on all proximal targets (e.g., family probes on literacy activities, teacher knowledge test). They plan to use the same measures from the multiple baseline studies in the RCT pilot study. In addition, in the RCT study, independent observers will assess student academic achievement

Data Analytic Strategy: The research team will analyze the focus group data using thematic analysis to identify, analyze, organize, interpret, and present themes within data. For the MBL studies, the team will analyze the behavior and academic outcome data from each phase for changes in trend, level, immediacy of effect, overlap, and similarity of effects in similar conditions and single subject design. In addition, the team will appraise the statistical significance using the percentage of all non-overlapping data (PAND). The proposed pilot study aims to determine pre-post changes between the KCU and control students on measures of social-emotional, behavioral, and academic outcomes. Omnibus tests for primary outcomes will be utilized. To account for multiple testing and to protect the family-wise Type I error, Holm's sequential alpha correction procedure will be used.

Cost Analysis: The research team will complete the full cost analysis of adopting, implementing, and sustaining the KCU by using the ingredients method and the CBCSE Cost Tool Kit. An incremental cost-effectiveness ratio (ICER) will be calculated for each outcome by dividing the difference in cost per student between the intervention and control by the difference in their effect for each of the relevant student outcomes.