Ignite Creation Date:
2024-05-06 @ 12:58 PM
Last Modification Date:
2024-10-26 @ 1:07 PM
Study NCT ID:
NCT03899948
Status:
COMPLETED
Last Update Posted:
2022-09-07
First Post:
2019-03-28
Brief Title:
Teacher Anxiety Program for Elementary Students
Sponsor:
UConn Health
Organization:
UConn Health
Study Overview
Official Title:
Teacher Anxiety Program for Elementary Students
Status:
COMPLETED
Status Verified Date:
2022-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
TAPES
Brief Summary:
The purpose of the study is to compare two teacher trainings developed to assist elementary students who struggle with excessive anxiety The goal of both teacher trainings is to improve teachers knowledge and skills for identifying and assisting students with excessive anxiety The first training program is called TAPES Teacher Anxiety Program for Elementary Students and involves a 6 hour teacher training Teachers in this training program will implement anxiety reduction skills in the classroom and complete 5 brief approximately 30 minute meetings with the student and his or her parentsguardians The second training program Teacher Anxiety Training TAT involves a 3 hour teacher training Teachers in the TAT condition learn to implement anxiety reduction skills in the classroom but do not conduct individual meetings with parents and students The investigators do not know if TAT and TAPES work equally well or if one is better than the other Both will be administered by teachers to see if they help youth with excessive anxiety feel less worried
Detailed Description:
Summary Benefit to Stakeholders and Aims Teachers lack the knowledge and skills to support the learning of students with excessive anxiety who have or at risk of developing an identified disability Excessive student anxiety is a common problem that severely impairs short and long term academic functioning and increases teacher burden Conversely reducing student anxiety has been associated with improvement in educational functioning Because anxiety manifests daily in the classroom teachers are in an ideal position to identify and help students manage their anxiety One universal intervention for anxiety reduction exists but its feasibility and efficacy are not established The aims of this project are to address this gap in teacher training Specifically the aims of this proposal include Aim 1 to develop the Teacher Anxiety Program for Elementary Students TAPES and assess its usability acceptability and feasibility Aim 2 to determine whether teachers can implement TAPES with high fidelity and quality Aim 3 to examine the impact of TAPES compared to a standard professional development condition on teacher a knowledge and b use of anxiety reduction strategies with students with excessive anxiety Primary Outcomes and Aim 4 to examine the impact of TAPES on student outcomes Exploratory aims will examine the mediators predictors and moderators of TAPES impact on teachers knowledge and skill If effective TAPES has the potential to directly benefit 1 teachers--by providing training in an important and relevant but neglected area that will enhance their professional development and effectiveness in the classroom and 2 children--by reducing their anxiety and improving their educational social and behavioral functioning
Description of TAPES The proposed teacher training is appropriate for elementary teachers to enhance their capacity to support students with excessive anxiety The training includes one full day of instruction materials to use with individual students and their parents in 5 meetings and guidelines for classroom-wide strategies to reduce anxiety The section below describes 1 the content of the teacher training and supportive empirical evidence 2 how this training differs from current teacher practices for anxious students 3 a proposed theory of teacher and child behavior change and 4 evidence supporting the feasibility of implementing TAPES in an authentic school environment This teacher training is not intended to replace or change the role of existing mental health providers or other members of schools interdisciplinary teams Given that teachers are members of an interdisciplinary team the study team will obtain input from school personnel to ensure that the teacher-training fits within the goalsmission of the interdisciplinary team
Description of TAPES content Overview The primary goal of TAPES is to enhance teachers capacity to identify and reduce anxiety in their students Toward this end the proposed content of TAPES consists of three core components 1 training in evidenced-based anxiety reduction strategies that teachers will implement to identify and assist specific anxious students and classroom-wide strategies helpful to all students 2 evidenced-based material for teachers to review with parents regarding how to reduce student anxiety at home thus improving school-home communication and shared goals and 3 training in how to conduct conjoint teacher-parent-student meetings to improve the quality of the teacher-parent-student relationship Each component is described below
Training and Evidence Related to Child Anxiety Reduction Skills Teachers will learn skills based on cognitive behavioral strategies CBT including relaxation training to reduce physiological arousal behavioral strategies eg exposure or facing anxiety provoking situations which lowers anxiety via new learning addressing maladaptive thoughts that maintain anxiety and problem solving skills To implement these new skills with specific children teachers will be trained to use a school-home journal that includes a type of daily report card that tracks behavioral exposures and use a reward system for increasing brave behavior adaptive coping skills These common elements of CBT are powerful agents of change and have been implemented by CBT experts and non-experts As such these skills are established and empirically-supported however they have not been evaluated when delivered by teachers
Teachers will also receive training in effective classroom-based accommodations that may be needed eg untimed testing or may need to be gradually faded if they are maintaining anxiety through negative reinforcement eg allowing child to avoid participating in class due to anxiety Another component of the teacher training includes skills that teachers deliver to their classroom ie such as leading the entire class in a relaxation exercise prior to an exam teacher using a coping model or teacher reducing their accommodation of avoidantanxious behavior for all students Finally teachers will be trained in how to modify their own behaviors that have been shown to increase student anxiety eg hostility over-control These modifications are also designed to improve the quality of the teacher-student relationship Research on the role of teacher behavior in the development andor maintenance of child anxiety suggests that teachers who exhibit highly controlling behaviors such as issuing frequent directives tend to increase child anxiety and negatively affect childrens ability to learn Conversely positive teacher-child relationships have been found to protect youth from developing internalizing behavior problems over time Consequently TAPES aims to modify these teacher behaviors
Training and Evidence Related to Conjoint Parent-Teacher-Student Meetings Training teachers in conducting conjoint meetings will enhance teachers ability to formalize mechanisms for sharing information about anxiety reduction and will enhance communication and relationship quality between parent teacher and student Training in these conjoint meeting will also allow the teacher to clarify roles and responsibilities with respect to helping the child and devise a collaborative plan with similar language and tools to facilitate generalization of skills between school and home Implementation of this component will involve approximately 5 conjoint-30 minute meetings over an 8 week period During these meetings parents students and teachers will create and modify anxiety hierarchies mutually decide on practice tasks and develop a contingency management plan Target behaviors are individualized based on the needs of the child eg raising a hand to answer a question in class for a child with social anxiety separating from parents for a child with separation anxiety These meetings can be supplemented by phone and email contacts between teacher and parentsstudents as needed
TAPES Training Format and Implementation Students primary teacher will participate in a one-day training approximately 6 hours One of the most important strategies for ensuring that TAPES is implemented with high fidelity is appropriate training and ongoing consultation Training strategies will be based on published guidelines and will include activeexperiential learning strategies opportunities for observation via video clips live modeling and role plays and coached practice Ongoing performance feedback and consultation has been found to enhance learning and is related to higher fidelity Thus teachers will be offered 30-minutes of weekly consultation by the PIs for each active TAPES students Consultation will include case review skill rehearsal problem-solving obstacles and feedback regarding performance based on audiotaped sessions Meetings will be held in person over the phone or via Skype at times convenient for teachers After each teacher identifies their first child the PIs will attend one conjoint meeting in order to provide performance feedback all conjoint meetings are audiotaped for fidelity The PIs will also provide in classroom coaching for 30-minutes for each student enrolled Training materials will be available on the internet or thumb drive for reference
Research Plan Overview Design and Methods This three-year development project consists of 3 stages Stage one months 1-6 involves establishing a Development Team DT that will review the initial draft of TAPES and provide feedback to ensure that TAPES is acceptable to teachers and feasible for the school setting Stage two months 7-20 involves two successive open trials of the TAPES protocol with 15 teachers and 20 children This stage will allow for trial runs of the training to assess feasibility acceptability and utility of the training Data and qualitative feedback gleaned during the first open trial will inform modifications for the second open trial The investigators will present and discuss data with the DT after each open trial Study staff will also ask 5 teachers from open trial 1 to test out the revisions for open trial 2 Based on knowledge gained in this stage appropriate modifications will be made for stage three Stage three months 21-34 involves a pilot Randomized Controlled Trial RCT using a randomized controlled design comparing TAPES to the Teacher Anxiety Training TAT TAT developed by the PIs for use in other studies and described below will be used to represent typical teacher professional development training The RCT will be conducted in three phases Phase 1 consists of recruiting randomizing and training teachers in either TAPES or TAT Also during this phase but after the training teachers will recruit anxious children and study staff will screen and evaluate them to determine eligibility In Phase 2 teachers will implement TAPES or TAT Phase 3 involves a post-intervention after 8 weeks and a three-month follow-up assessment of the primary teacher behavior and secondary child outcomes Trained independent evaluators IEs will assess primary outcomes teacher behavior The culmination of these iterative stages will be a final version of the training that will be ready for evaluation in a larger efficacy trial
Detailed Description of Each Stage Stage 1 Establish DT and refine initial version of the TAPES Protocol The DT will strive to ensure that the teacher training will be acceptable feasible and usable in the school setting The DT will consist of the PIs two national experts in teacher training two experts in school-home collaborative interventions and two experts in training school-based personnel in CBT techniques for anxious youth A CT school psychologist and two CT elementary teachers will complete the DT DT members will provide detailed feedback about the TAPES strategies study methodsmeasures perceived barriers to successful implementation and adoption by teachers and solutions to potential barriers Information from this meeting will be used to revise the protocol in preparation for the first open trial as well as successive phases of the study
Stage 2 Open Trials During Stage 2 teachers and IEs will be trained and the study team will conduct two sequential open trials Study staff will engage in screening activities of students and IEs will complete baseline evaluations on referred students The purpose of the open trials is to evaluate the feasibility of the training modify methods as needed allow teachers to implement the skills learned in the training and receive real time coaching and consultation with anxious children Data on TAPES usability acceptability fidelity satisfaction and teacher and child outcomes will also be collected After each open trial feedback via exit interviews and standardized measures from teachers students and parents will be integrated by the research team and presented to the DT for another revision of the protocol Teachers will be asked to participate in an exit interview after they implement TAPES with an anxious child
Stage 3 Pilot RCT In stage 3 the study team will conduct a pilot RCT with 40 teachers and a maximum of 60 anxious youth The RCT will be conducted in 3 phases
Phase 1 - Recruitment Randomization Training Student Screening and Baseline Evaluations In Phase 1 teachers will be randomly selected from the pool of interested participants and randomized to TAPES or TAT Once randomized teachers will complete their assigned training Teachers will then identify potentially eligible students from their classes and provide information about the study to their parents Interested parents will contact study staff and complete a brief phone screen Students who appear eligible based on the phone screen eg have elevated anxiety are in elementary school will be invited to complete informed consent and a full baseline evaluation with an IE Families who meet criteria on the baseline evaluation will be considered eligible see InclusionExclusion criteria
Phase 2 - TAPESTAT Implementation Teachers will implement TAPES or TAT depending on their random assignment over 8 weeks from child enrollment
Phase 3 - Post- and Follow-up Evaluations At the end of the 8 weeks teachers and children in both groups will complete a post evaluation Teachers students and parents will complete a TAPES satisfaction measure and provide feedback to enhance the protocol Teachers will complete an exit interview Students who need mental health services will be referred to the school counselor or community provider for treatment A 3 month follow-up evaluation to assess sustained use of TAPESTAT skills will be conducted
Description of TAPES The proposed teacher training is appropriate for elementary teachers to enhance their capacity to support students with excessive anxiety The training includes one full day of instruction materials to use with individual students and their parents in 5 meetings and guidelines for classroom-wide strategies to reduce anxiety The section below describes 1 the content of the teacher training and supportive empirical evidence 2 how this training differs from current teacher practices for anxious students 3 a proposed theory of teacher and child behavior change and 4 evidence supporting the feasibility of implementing TAPES in an authentic school environment This teacher training is not intended to replace or change the role of existing mental health providers or other members of schools interdisciplinary teams Given that teachers are members of an interdisciplinary team the study team will obtain input from school personnel to ensure that the teacher-training fits within the goalsmission of the interdisciplinary team
Description of TAPES content Overview The primary goal of TAPES is to enhance teachers capacity to identify and reduce anxiety in their students Toward this end the proposed content of TAPES consists of three core components 1 training in evidenced-based anxiety reduction strategies that teachers will implement to identify and assist specific anxious students and classroom-wide strategies helpful to all students 2 evidenced-based material for teachers to review with parents regarding how to reduce student anxiety at home thus improving school-home communication and shared goals and 3 training in how to conduct conjoint teacher-parent-student meetings to improve the quality of the teacher-parent-student relationship Each component is described below
Training and Evidence Related to Child Anxiety Reduction Skills Teachers will learn skills based on cognitive behavioral strategies CBT including relaxation training to reduce physiological arousal behavioral strategies eg exposure or facing anxiety provoking situations which lowers anxiety via new learning addressing maladaptive thoughts that maintain anxiety and problem solving skills To implement these new skills with specific children teachers will be trained to use a school-home journal that includes a type of daily report card that tracks behavioral exposures and use a reward system for increasing brave behavior adaptive coping skills These common elements of CBT are powerful agents of change and have been implemented by CBT experts and non-experts As such these skills are established and empirically-supported however they have not been evaluated when delivered by teachers
Teachers will also receive training in effective classroom-based accommodations that may be needed eg untimed testing or may need to be gradually faded if they are maintaining anxiety through negative reinforcement eg allowing child to avoid participating in class due to anxiety Another component of the teacher training includes skills that teachers deliver to their classroom ie such as leading the entire class in a relaxation exercise prior to an exam teacher using a coping model or teacher reducing their accommodation of avoidantanxious behavior for all students Finally teachers will be trained in how to modify their own behaviors that have been shown to increase student anxiety eg hostility over-control These modifications are also designed to improve the quality of the teacher-student relationship Research on the role of teacher behavior in the development andor maintenance of child anxiety suggests that teachers who exhibit highly controlling behaviors such as issuing frequent directives tend to increase child anxiety and negatively affect childrens ability to learn Conversely positive teacher-child relationships have been found to protect youth from developing internalizing behavior problems over time Consequently TAPES aims to modify these teacher behaviors
Training and Evidence Related to Conjoint Parent-Teacher-Student Meetings Training teachers in conducting conjoint meetings will enhance teachers ability to formalize mechanisms for sharing information about anxiety reduction and will enhance communication and relationship quality between parent teacher and student Training in these conjoint meeting will also allow the teacher to clarify roles and responsibilities with respect to helping the child and devise a collaborative plan with similar language and tools to facilitate generalization of skills between school and home Implementation of this component will involve approximately 5 conjoint-30 minute meetings over an 8 week period During these meetings parents students and teachers will create and modify anxiety hierarchies mutually decide on practice tasks and develop a contingency management plan Target behaviors are individualized based on the needs of the child eg raising a hand to answer a question in class for a child with social anxiety separating from parents for a child with separation anxiety These meetings can be supplemented by phone and email contacts between teacher and parentsstudents as needed
TAPES Training Format and Implementation Students primary teacher will participate in a one-day training approximately 6 hours One of the most important strategies for ensuring that TAPES is implemented with high fidelity is appropriate training and ongoing consultation Training strategies will be based on published guidelines and will include activeexperiential learning strategies opportunities for observation via video clips live modeling and role plays and coached practice Ongoing performance feedback and consultation has been found to enhance learning and is related to higher fidelity Thus teachers will be offered 30-minutes of weekly consultation by the PIs for each active TAPES students Consultation will include case review skill rehearsal problem-solving obstacles and feedback regarding performance based on audiotaped sessions Meetings will be held in person over the phone or via Skype at times convenient for teachers After each teacher identifies their first child the PIs will attend one conjoint meeting in order to provide performance feedback all conjoint meetings are audiotaped for fidelity The PIs will also provide in classroom coaching for 30-minutes for each student enrolled Training materials will be available on the internet or thumb drive for reference
Research Plan Overview Design and Methods This three-year development project consists of 3 stages Stage one months 1-6 involves establishing a Development Team DT that will review the initial draft of TAPES and provide feedback to ensure that TAPES is acceptable to teachers and feasible for the school setting Stage two months 7-20 involves two successive open trials of the TAPES protocol with 15 teachers and 20 children This stage will allow for trial runs of the training to assess feasibility acceptability and utility of the training Data and qualitative feedback gleaned during the first open trial will inform modifications for the second open trial The investigators will present and discuss data with the DT after each open trial Study staff will also ask 5 teachers from open trial 1 to test out the revisions for open trial 2 Based on knowledge gained in this stage appropriate modifications will be made for stage three Stage three months 21-34 involves a pilot Randomized Controlled Trial RCT using a randomized controlled design comparing TAPES to the Teacher Anxiety Training TAT TAT developed by the PIs for use in other studies and described below will be used to represent typical teacher professional development training The RCT will be conducted in three phases Phase 1 consists of recruiting randomizing and training teachers in either TAPES or TAT Also during this phase but after the training teachers will recruit anxious children and study staff will screen and evaluate them to determine eligibility In Phase 2 teachers will implement TAPES or TAT Phase 3 involves a post-intervention after 8 weeks and a three-month follow-up assessment of the primary teacher behavior and secondary child outcomes Trained independent evaluators IEs will assess primary outcomes teacher behavior The culmination of these iterative stages will be a final version of the training that will be ready for evaluation in a larger efficacy trial
Detailed Description of Each Stage Stage 1 Establish DT and refine initial version of the TAPES Protocol The DT will strive to ensure that the teacher training will be acceptable feasible and usable in the school setting The DT will consist of the PIs two national experts in teacher training two experts in school-home collaborative interventions and two experts in training school-based personnel in CBT techniques for anxious youth A CT school psychologist and two CT elementary teachers will complete the DT DT members will provide detailed feedback about the TAPES strategies study methodsmeasures perceived barriers to successful implementation and adoption by teachers and solutions to potential barriers Information from this meeting will be used to revise the protocol in preparation for the first open trial as well as successive phases of the study
Stage 2 Open Trials During Stage 2 teachers and IEs will be trained and the study team will conduct two sequential open trials Study staff will engage in screening activities of students and IEs will complete baseline evaluations on referred students The purpose of the open trials is to evaluate the feasibility of the training modify methods as needed allow teachers to implement the skills learned in the training and receive real time coaching and consultation with anxious children Data on TAPES usability acceptability fidelity satisfaction and teacher and child outcomes will also be collected After each open trial feedback via exit interviews and standardized measures from teachers students and parents will be integrated by the research team and presented to the DT for another revision of the protocol Teachers will be asked to participate in an exit interview after they implement TAPES with an anxious child
Stage 3 Pilot RCT In stage 3 the study team will conduct a pilot RCT with 40 teachers and a maximum of 60 anxious youth The RCT will be conducted in 3 phases
Phase 1 - Recruitment Randomization Training Student Screening and Baseline Evaluations In Phase 1 teachers will be randomly selected from the pool of interested participants and randomized to TAPES or TAT Once randomized teachers will complete their assigned training Teachers will then identify potentially eligible students from their classes and provide information about the study to their parents Interested parents will contact study staff and complete a brief phone screen Students who appear eligible based on the phone screen eg have elevated anxiety are in elementary school will be invited to complete informed consent and a full baseline evaluation with an IE Families who meet criteria on the baseline evaluation will be considered eligible see InclusionExclusion criteria
Phase 2 - TAPESTAT Implementation Teachers will implement TAPES or TAT depending on their random assignment over 8 weeks from child enrollment
Phase 3 - Post- and Follow-up Evaluations At the end of the 8 weeks teachers and children in both groups will complete a post evaluation Teachers students and parents will complete a TAPES satisfaction measure and provide feedback to enhance the protocol Teachers will complete an exit interview Students who need mental health services will be referred to the school counselor or community provider for treatment A 3 month follow-up evaluation to assess sustained use of TAPESTAT skills will be conducted
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| R324A170071 | OTHER_GRANT | Institute of Education Sciences | None |