Randomized Trial of the Positive Action Program in Chicago Schools and Extension to Grade 8
NCT ID: NCT01025674
Last Updated: 2015-04-22
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
4230 participants
Study Classification
INTERVENTIONAL
Study Start Date
2004-09-30
Study Completion Date
2010-06-30
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
This project focuses on social and character development of elementary and middle school-aged children and responds to an urgent national need that schools improve their capacity to address a range of student outcomes, including social skills, character, behavior, academic achievement and health outcomes. This study is a school-based randomized trial to evaluate the Positive Action program. The Positive Action program was designed to promote social and character development and improve behavior and school performance.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Multimedia Program to Promote Positive Bus Behavior
NCT02330835
Student Behavior
COMPLETED
PHASE2
Behavioral Mechanisms and Health Outcomes of Positive Psychological Intervention
NCT06483568
Well-Being, Psychological
NOT_YET_RECRUITING
NA
Coronavirus Disease of 2019 (COVID-19) Health Education Initiative for School Safety
NCT06938230
COVID-19
COMPLETED
NA
Healthy ReStart Intervention to Improve Health and Functioning
NCT05544344
Mental Disorder
RECRUITING
NA
Text Message Safety Behavior Fading for Social Anxiety
NCT06168253
Social Anxiety
COMPLETED
NA
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
This project is one of seven in a multi-site trial of different programs that has been nationally implemented. Oregon State University (OSU) and University of Illinois at Chicago (UIC) are conducting a school-based randomized trial to evaluate the efficacy of the Positive Action program (PA) to find out how the program works, to determine the effectiveness of the Positive Action program on reducing negative behaviors (including health-related behaviors), increasing positive behaviors and improving academic achievement of elementary school students. The Positive Action program was designed to promote social and character development (respect, responsibility, altruism, civic virtue, prosocial behavior) in ways that reduce anti-social behavior (violence, substance use, delinquency) and improve school performance (attendance, test scores). Fourteen eligible schools selected during winter 2004 are comprised of 7 matched pairs (treatment and control); the schools were matched on a 'risk score' composed of multiple school characteristics. Students in grade 3 in the 2004-05 school year, their parents, and their teachers and principals were surveyed at baseline (Fall 2004), spring and fall of 2005, spring 2006 and spring 2007. Evaluation is based on multiple kinds of process, mediator variable and outcome data from school records (attendance, transience, grades, test performance, disciplinary actions and suspensions, and changes in school and student population characteristics), student records, student surveys, parent surveys, teacher ratings and surveys, and administrator surveys, collected from schools in both conditions (except information about delivery of the Positive Action program). The work being done at OSU is confined to Dr. Flay's overall supervision of all aspects of the project, and data analysis using de-identified data received from Dr. DuBois at UIC and research paper writing. The work being done at UIC, directed by Dr. David DuBois, includes all of the intervention work, data collection, data entering, and some data analysis and report writing. The U.S. Department of Education/IES hired a national contractor, Mathematica Policy Research, Inc. (MPR) to conduct core surveys at all sites of the multi-site trial through spring 2007. In addition, OSU/UIC is administering a site-specific student survey that is complementary to the multi-site surveys during all waves of data collection. As the project funding followed Dr. Flay's move from UIC to OSU in September 2005, OSU IRB provides a review for the overall project. As of April 2008, new funding allows continuation of the study through March 2012 and follows the target cohort of students through the end of 8th grade as they and their teachers and principals are surveyed fall 2008, spring 2009 and again along with their parents in spring 2010. Data collection for the continuation study also includes collection of height and weight of children and process evaluation data from students and teachers. There will be no involvement of MPR. Data collection was completed June 2010.
Consent Rates and Mobility:
Parental consent was obtained before students, parents or teachers completed surveys when students were in grade 3. Seventy-nine percent of parents provided consent at baseline. Students joining the study at later waves were consented at that time; consent rates for them ranged from 65% to 78% for Waves 2-5. All students were re-consented for the second phase of funding at Wave 6 (beginning of grade 7); consent rates were lower at Waves 6 through 8 ( ≈ 58 to 64%). This is consistent with previous studies that have found that consent rates drop as grade levels increase. The percentages of consenting parents who provided reports on their children were 72.3%, 58.9%, 52.2%, 50.5%, and 72.9% at Waves 1, 2, 4, 5 and 8, respectively. Two factors that likely increased parent response rate at Wave 8 were (1) an increase in the financial incentive for completing the parent report and (2) an intensive period of phone outreach to families to note the incentive increase and to encourage survey completion. Percentages of consented students for whom teachers completed ratings were 74.6%, 74.8%, 72.4%, 78.3%, 74.4%, and 92.7% for Waves 1, 2, 4, 5, 7, and 8, respectively. At Wave 8, we introduced an additional school-level incentive for 100% rates of teacher survey completion, which likely resulted in the increase in completed teacher ratings. Mobility patterns were identified using results from a latent class analysis in which a 5-class solution was found to be the most appropriate fit for the data: 1) stayers (average study duration of 5.72 years, N = 158), 2) temporary participants (1.30 years, only in grades 4 or 5; N=196), 3) late joiners (1.38 years; N=308); 4) early leavers (0.94 years; N=263), and 5) late leavers (3.23 years; N=287).
Planned Statistical Analyses:
Because the trial was cluster-focused, we assessed students who entered schools after the beginning of the trial (joiners), but did not follow individual students who stopped attending the study schools (leavers). From the standpoint of students, across time they could be considered a "dynamic" (i.e. changing) grade cohort. Multilevel models will be used to take into account variation at the school and student levels. Missing data will be addressed using the missing-at-random (MAR) assumption, as it is unlikely that a single unmeasured variable or set of variables would predict missingness for all students who left or joined the trial schools after randomization We propose a three-level (occasions of measurement nested within students nested within schools) growth-curve model for analyzing treatment effects on various student-level outcomes. These models will account for all observations and model school differences. This approach allows for a complete analysis of the multiple waves of available data and takes into account the patterns of change over time. Random-intercept growth-curve models will first be estimated. Following the random-intercept model, a random-coefficient model will be run to test whether there is significant variation in student change across time, rather than all students in each condition having the same change pattern. A Likelihood Ratio Chi-square (LR) test will be used to compare model fit with and without the random coefficient. If a model with a random time coefficient provides a significantly better fit for a given outcome, it will be reported as the final model. Intervention effects on scales collected only at later waves (Waves 5 or 6 onwards) will be tested with the intercept set at the endpoint (Wave 8) with the condition term indicating a possible difference in effects at the last (Wave 8).
Because only 14 schools are in this trial, and the PA effect is tested at the school level in a cluster-randomized trial, we will conduct several sensitivity analyses. First, we will assess the statistical significance of the PA coefficient estimate and its standard error using the t-distribution with 12 degrees of freedom: 14 schools - 1 (the condition effect) - 1 = 12 df providing for a more conservative approach. A second approach will be a pair-level analysis, estimated as a four-level model: occasions of measurement nested within students, nested within schools, nested within matched pairs.
In addition to the student-level survey data, several school-level archival measures will be analyzed. Because these data are at the school level, the growth-curve models will be two-level (observations within schools) rather than three-level. Because of the small amount of data (the number of schools times the number of waves) and the resulting power limitations, these analyses will use the random-intercept model only.
We will test for moderation by gender and by student mobility. The moderation tests will reveal for whom the program has its effects; that is, these tests will allow us to assess whether program effects differ by gender or a child's mobility. We will not test for moderation by ethnicity because it is highly confounded with school, with 3 pairs of schools having a mostly African-American enrollment and 2 pairs of schools having a mostly Hispanic enrollment.
While all 14 schools were retained throughout the CRCT, the student population in this trial was highly mobile. Thus, it is important to test for potential moderating effects of student mobility patterns. A recent approach to analyzing mobility patterns is latent class analysis (LCA). The mobility patterns described above can then be tested as a moderator of program effects; that is, examining whether students with different mobility patterns have different program effects.
Mediation analyses will allow us to examine the PA program's mechanisms of action. We will first estimate the bivariate effect of X on Y without the mediator included in the model. Then, we will simultaneously estimate the direct effect of X on Y with the mediator included in the model, as well as the mediated effect, which consists of the effect of X on M × M on Y.
Consent Rates and Mobility:
Parental consent was obtained before students, parents or teachers completed surveys when students were in grade 3. Seventy-nine percent of parents provided consent at baseline. Students joining the study at later waves were consented at that time; consent rates for them ranged from 65% to 78% for Waves 2-5. All students were re-consented for the second phase of funding at Wave 6 (beginning of grade 7); consent rates were lower at Waves 6 through 8 ( ≈ 58 to 64%). This is consistent with previous studies that have found that consent rates drop as grade levels increase. The percentages of consenting parents who provided reports on their children were 72.3%, 58.9%, 52.2%, 50.5%, and 72.9% at Waves 1, 2, 4, 5 and 8, respectively. Two factors that likely increased parent response rate at Wave 8 were (1) an increase in the financial incentive for completing the parent report and (2) an intensive period of phone outreach to families to note the incentive increase and to encourage survey completion. Percentages of consented students for whom teachers completed ratings were 74.6%, 74.8%, 72.4%, 78.3%, 74.4%, and 92.7% for Waves 1, 2, 4, 5, 7, and 8, respectively. At Wave 8, we introduced an additional school-level incentive for 100% rates of teacher survey completion, which likely resulted in the increase in completed teacher ratings. Mobility patterns were identified using results from a latent class analysis in which a 5-class solution was found to be the most appropriate fit for the data: 1) stayers (average study duration of 5.72 years, N = 158), 2) temporary participants (1.30 years, only in grades 4 or 5; N=196), 3) late joiners (1.38 years; N=308); 4) early leavers (0.94 years; N=263), and 5) late leavers (3.23 years; N=287).
Planned Statistical Analyses:
Because the trial was cluster-focused, we assessed students who entered schools after the beginning of the trial (joiners), but did not follow individual students who stopped attending the study schools (leavers). From the standpoint of students, across time they could be considered a "dynamic" (i.e. changing) grade cohort. Multilevel models will be used to take into account variation at the school and student levels. Missing data will be addressed using the missing-at-random (MAR) assumption, as it is unlikely that a single unmeasured variable or set of variables would predict missingness for all students who left or joined the trial schools after randomization We propose a three-level (occasions of measurement nested within students nested within schools) growth-curve model for analyzing treatment effects on various student-level outcomes. These models will account for all observations and model school differences. This approach allows for a complete analysis of the multiple waves of available data and takes into account the patterns of change over time. Random-intercept growth-curve models will first be estimated. Following the random-intercept model, a random-coefficient model will be run to test whether there is significant variation in student change across time, rather than all students in each condition having the same change pattern. A Likelihood Ratio Chi-square (LR) test will be used to compare model fit with and without the random coefficient. If a model with a random time coefficient provides a significantly better fit for a given outcome, it will be reported as the final model. Intervention effects on scales collected only at later waves (Waves 5 or 6 onwards) will be tested with the intercept set at the endpoint (Wave 8) with the condition term indicating a possible difference in effects at the last (Wave 8).
Because only 14 schools are in this trial, and the PA effect is tested at the school level in a cluster-randomized trial, we will conduct several sensitivity analyses. First, we will assess the statistical significance of the PA coefficient estimate and its standard error using the t-distribution with 12 degrees of freedom: 14 schools - 1 (the condition effect) - 1 = 12 df providing for a more conservative approach. A second approach will be a pair-level analysis, estimated as a four-level model: occasions of measurement nested within students, nested within schools, nested within matched pairs.
In addition to the student-level survey data, several school-level archival measures will be analyzed. Because these data are at the school level, the growth-curve models will be two-level (observations within schools) rather than three-level. Because of the small amount of data (the number of schools times the number of waves) and the resulting power limitations, these analyses will use the random-intercept model only.
We will test for moderation by gender and by student mobility. The moderation tests will reveal for whom the program has its effects; that is, these tests will allow us to assess whether program effects differ by gender or a child's mobility. We will not test for moderation by ethnicity because it is highly confounded with school, with 3 pairs of schools having a mostly African-American enrollment and 2 pairs of schools having a mostly Hispanic enrollment.
While all 14 schools were retained throughout the CRCT, the student population in this trial was highly mobile. Thus, it is important to test for potential moderating effects of student mobility patterns. A recent approach to analyzing mobility patterns is latent class analysis (LCA). The mobility patterns described above can then be tested as a moderator of program effects; that is, examining whether students with different mobility patterns have different program effects.
Mediation analyses will allow us to examine the PA program's mechanisms of action. We will first estimate the bivariate effect of X on Y without the mediator included in the model. Then, we will simultaneously estimate the direct effect of X on Y with the mediator included in the model, as well as the mediated effect, which consists of the effect of X on M × M on Y.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Character
Violence
Substance Use
Pro-Social Behavior
Academic Achievement
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
PREVENTION
Blinding Strategy
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
7 Treatment Schools
The Positive Action program was implemented over 6 years, starting with Grade 3, then continuing through Grade 8.
Group Type
EXPERIMENTAL
Positive Action program
Intervention Type
BEHAVIORAL
Components of the Positive Action program (6 units) use research-supported educational strategies/methods that include active learning, positive classroom management, teacher training, detailed curriculum with almost daily lessons, school-wide climate-change program, and family program of parent support/involvement.
7 Control Schools
Standard educational practice
Group Type
NO_INTERVENTION
No interventions assigned to this group
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Positive Action program
Components of the Positive Action program (6 units) use research-supported educational strategies/methods that include active learning, positive classroom management, teacher training, detailed curriculum with almost daily lessons, school-wide climate-change program, and family program of parent support/involvement.
Intervention Type
BEHAVIORAL
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
Public elementary schools Pre-K or K through grade 5 or 6; Schools were included in the study if they:
* Are community-based (that is, not magnet, academy, special ed., etc.),
* Have at least 60 students and two classrooms of grades 2, 3, 4, and 5,
* Have no more than 100 students or 3 classrooms per grade level,
* Have annual mobility rates no greater than 30% (meaning that approximately 15% move out of the school and 15% more into the school each year),
* Have at least 50% of students eligible for free or reduced price lunch,
* Are relatively low performing on standardized tests,
* Have not used Positive Action program in the last decade,
* Are not doing another social/character program.
All students in the study cohorts - those in grade 3 in 2004-05
\-
* Are community-based (that is, not magnet, academy, special ed., etc.),
* Have at least 60 students and two classrooms of grades 2, 3, 4, and 5,
* Have no more than 100 students or 3 classrooms per grade level,
* Have annual mobility rates no greater than 30% (meaning that approximately 15% move out of the school and 15% more into the school each year),
* Have at least 50% of students eligible for free or reduced price lunch,
* Are relatively low performing on standardized tests,
* Have not used Positive Action program in the last decade,
* Are not doing another social/character program.
All students in the study cohorts - those in grade 3 in 2004-05
\-
Minimum Eligible Age
6 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
University of Illinois at Chicago
OTHER
Sponsor Role
collaborator
Oregon State University
OTHER
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Brian Flay
Professor
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Brian R. Flay, D.Phil.
Role: PRINCIPAL_INVESTIGATOR
Oregon State University
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
University of Illinois at Chicago
Chicago, Illinois, United States
Site Status
Oregon State University
Corvallis, Oregon, United States
Site Status
Countries
Review the countries where the study has at least one active or historical site.
United States
References
Explore related publications, articles, or registry entries linked to this study.
Ji P, Flay BR, Dubois DL, Brechling V, Day J, Cantillon D. Consent form return rates for third-grade urban elementary students. Am J Health Behav. 2006 Sep-Oct;30(5):467-74. doi: 10.5555/ajhb.2006.30.5.467.
Reference Type
BACKGROUND
Ji P, DuBois DL, Flay BR, Brechling V. "Congratulations, you have been randomized into the control group!(?)": issues to consider when recruiting schools for matched-pair randomized control trials of prevention programs. J Sch Health. 2008 Mar;78(3):131-9. doi: 10.1111/j.1746-1561.2007.00275.x.
Reference Type
BACKGROUND
Jarpe-Ratner E, Fagen M, Day J, Gilmet K, Prudowsky J, Neiger BL, DuBois DL, Flay BR. Using the community readiness model as an approach to formative evaluation. Health Promot Pract. 2013 Sep;14(5):649-55. doi: 10.1177/1524839913487538. Epub 2013 May 23.
Reference Type
BACKGROUND
Li KK, Washburn I, DuBois DL, Vuchinich S, Ji P, Brechling V, Day J, Beets MW, Acock AC, Berbaum M, Snyder F, Flay BR. Effects of the Positive Action programme on problem behaviours in elementary school students: a matched-pair randomised control trial in Chicago. Psychol Health. 2011 Feb;26(2):187-204. doi: 10.1080/08870446.2011.531574.
Reference Type
RESULT
Washburn IJ, Acock A, Vuchinich S, Snyder F, Li KK, Ji P, Day J, DuBois D, Flay BR. Effects of a social-emotional and character development program on the trajectory of behaviors associated with social-emotional and character development: findings from three randomized trials. Prev Sci. 2011 Sep;12(3):314-23. doi: 10.1007/s11121-011-0230-9.
Reference Type
RESULT
Lewis KM, Bavarian N, Snyder FJ, Acock A, Day J, Dubois DL, Ji P, Schure MB, Silverthorn N, Vuchinich S, Flay BR. Direct and Mediated Effects of a Social-Emotional and Character Development Program on Adolescent Substance Use. Int J Emot Educ. 2012 Apr;4(1):56-78.
Reference Type
RESULT
Lewis KM, Schure MB, Bavarian N, DuBois DL, Day J, Ji P, Silverthorn N, Acock A, Vuchinich S, Flay BR. Problem behavior and urban, low-income youth: a randomized controlled trial of positive action in Chicago. Am J Prev Med. 2013 Jun;44(6):622-30. doi: 10.1016/j.amepre.2013.01.030.
Reference Type
RESULT
Bavarian N, Lewis KM, Dubois DL, Acock A, Vuchinich S, Silverthorn N, Snyder FJ, Day J, Ji P, Flay BR. Using social-emotional and character development to improve academic outcomes: a matched-pair, cluster-randomized controlled trial in low-income, urban schools. J Sch Health. 2013 Nov;83(11):771-9. doi: 10.1111/josh.12093.
Reference Type
RESULT
Lewis KM, DuBois DL, Bavarian N, Acock A, Silverthorn N, Day J, Ji P, Vuchinich S, Flay BR. Effects of Positive Action on the emotional health of urban youth: a cluster-randomized trial. J Adolesc Health. 2013 Dec;53(6):706-11. doi: 10.1016/j.jadohealth.2013.06.012. Epub 2013 Jul 26.
Reference Type
RESULT
Bavarian N, Lewis KM, Holloway S, Wong L, Silverthorn N, DuBois DL, Flay BR, Siebert C. Mechanisms of Influence on Youth Substance Use for a Social-Emotional and Character Development Program: A Theory-Based Approach. Subst Use Misuse. 2022;57(12):1854-1863. doi: 10.1080/10826084.2022.2120359. Epub 2022 Sep 11.
Reference Type
DERIVED
Related Links
Access external resources that provide additional context or updates about the study.
http://www.positiveaction.net
Click here for more information about the program being evaluated
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
R305L030004
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
R305A080253
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
R305L030072
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
R305A080253
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
A Smartphone Intervention for Relational and Mental Well Being
NCT04629755
COMPLETED
NA
Assessment of the Predictors and Moderators of Behavior Change
NCT03139643
COMPLETED
NA
Weight Management & Wellness for People With Psychiatric Disabilities
NCT05128045
COMPLETED
NA
HEART at Head Start Pilot (Healthy Eating, Activity, Relaxation Trial)
NCT06346574
COMPLETED
NA
Impact Trial of Helping Educational Leaders Mobilize Evidence
NCT06586723
RECRUITING
NA
Healthy Corner Store Initiative
NCT00593749
COMPLETED
NA
Testing Self-Directed Care in Florida
NCT05649449
COMPLETED
NA
Act Healthy! A Controlled Trial of Worksite Health Promotion
NCT00924924
COMPLETED
NA
Effectiveness of a Mobile Texting Intervention for People With Serious Mental Illness
NCT03062267
COMPLETED
NA
Randomized Controlled Trial of Wellness Recovery Action Planning
NCT01024569
COMPLETED
NA
Evaluating Student Wellness Using a Blended Approach of the Roadmap mHealth App Plus Wellness Coaching
NCT05736445
COMPLETED
Efficacy of an Occupational Time Use Intervention for People With Serious Mental Illness
NCT00520728
COMPLETED
PHASE1
Student Wellness 2.0
NCT06804213
COMPLETED
NA
Positive Psychology for ACS Patients: a Factorial Design Study
NCT02754895
COMPLETED
NA
Study of Mental Health and Relationships
NCT06534827
RECRUITING
NA
Integrated Smart Speaker Promoting Positive Parenting Among Caregivers of Youth With Challenging Behaviors
NCT05535387
COMPLETED
NA
Building Financial Wellness Randomized Controlled Trial
NCT06489275
COMPLETED
NA
Validation of Restaurant App
NCT06868056
COMPLETED
NA
NUYou:mHealth Intervention to Preserve and Promote Ideal Cardiovascular Health
NCT02496728
COMPLETED
NA
BASIS Optimization
NCT06672835
RECRUITING
NA
Group Acceptance and Commitment Training (ACT) With Healthy Older Adults
NCT03839329
COMPLETED
NA
Combatting Social Isolation in Older Adults
NCT05426837
COMPLETED
NA
SunSmart Intervention in Schools
NCT03745872
COMPLETED
NA
Evaluation of High School-based Relationship Education
NCT03559855
COMPLETED
NA
A Systems-Level Intervention for Rural Adults With Depression
NCT04502186
COMPLETED
NA