The study took place in 100 elementary schools in five school districts in Kentucky and Indiana. The First Step Next (FSN) intervention was administered in traditional classroom settings. The homeBase (HB) intervention was administered in the homes of students over several months. No elements of the HB intervention took place in the child’s school.
Across five school years, the researchers randomly assigned 94 students to the FSN only condition, 96 students to the HB only condition, 94 students to the FSN and HB combined condition, and 95 students to the business-as-usual condition. Students were taught by 379 teachers in 100 schools. Students who were identified as having behavioral challenges were recruited to participate in the study.
This review assesses the contrast between students in the FSN and HB combined condition and the business-as-usual condition. A total of 171 students from kindergarten to grade 3 were included in this analysis.
Among students in the analytic sample, approximately 26% of the students were female, 72% were eligible for free or reduced-price lunch, and 24% had an Individualized Education Plan. Fifty-three percent were African American, 37% were White, and the rest had unknown race. The study did not report student ethnicities.
First Step Next (FSN) draws upon support for multiple stakeholders, such as parents, teachers, and peers. The intervention includes in-school activities as well as home-school communication strategies to engage parents. The primary components of the intervention are direct social skills instruction, the green card game, and home-school connections. The intervention was administered individually to students in whole class settings. A group of 29 trained FSN coaches were tasked with implementing the intervention activities with participating teachers and students. The intervention, which took place over 30 days, also included facilitation with parents.
The homeBase (HB) is a home-visiting intervention that seeks to improve the outcomes of young children by providing home-based support to their caregivers. The intervention consists of three to six 60-minute home visits over several months. During sessions, parents or caregivers are encouraged to align their parenting practices consistent with one or more of the five universal principles of behavioral support: establishing clear expectations, directly teaching expectations, reinforcing the display of expectations, minimizing attention for minor inappropriate behavior, and establishing clear consequences for unacceptable behavior. HB sessions are delivered within a multi-step process for increasing intrinsic motivation to adopt and implement an evidence-based practice with integrity. The four steps are: (1) engage in values discovery (2) assess current practices (3) share performance feedback (4) offer extended consultation, education, and support. During each step, HB coaches use motivational interviewing to guide and strengthen the parent/caregiver’s engagement with and commitment to behavioral change.
Students in the comparison condition received business-as-usual instruction. These students did not have contact with the trained FSN coaches and did not receive caregiver support in their homes.
Support for implementation
There were 29 coaches affiliated with the University of Louisville who served as FSN coaches and assisted in implementing interventions. Project research staff trained all coaches using role playing activities where they practiced implementing FSN to all students and teachers. FSN behavioral coaches were trained via a 2-day workshop where they were introduced to the intervention material, reflected on videos of the intervention being implemented correctly, and role-played several of the procedures. These coaches then practiced implementing the intervention with at least one child who was not enrolled in the study under the supervision of an experienced implementer. Coaches also participated in weekly supervision meetings led by an experienced implementer with other coaches to troubleshoot during the study.
The HB coaches who participated in this study were also university employees. In total, 25 coaches participated in HB implementation. Research staff from the Motivational Interviewing Training and Assessment System provided training to all participating HB coaches. This training involved 12 hours of didactic workshops and simulated practice sessions with an experienced implementer. Coaches also participated in weekly supervision meetings led by an experienced implementer with other coaches to troubleshoot any problems during the study.