Knowledge translation in child welfare: improving educational outcomes

ISRCTN	ISRCTN38968073
DOI	https://doi.org/10.1186/ISRCTN38968073
Protocol serial number	230009
Sponsor	The Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway
Funders	Norges Forskningsråd, Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Norwegian Center for Child Behavioral Development

Submission date: 14/09/2017
Registration date: 18/09/2017
Last edited: 19/12/2023

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Background and study aims
A disproportionately high number of children in families receiving support from Child Welfare Services (CWS) end up marginalized from society in adulthood. For many of these children, a strong contributing factor to their poor outcomes is academic failure. These are also widespread issues internationally. The researchers have developed an intervention called Enhanced Academic Support (EAS) for children at risk of academic failure. The aim of this study is to assess the effectiveness of the intervention with three municipal CWS agencies in Norway.

Who can participate?
Children aged 6 to13 (primary school grades) and their parents

What does the study involve?
Participating families are randomly allocated to one of two groups. One group receives the EAS intervention from a trained practitioner in six home-visits with support between visits over a period of 6 months. The other (control) group receives regular child welfare support from a practitioner who has not been trained in EAS. Business as usual includes advice and guidance, parent training, financial aid and parent relief. Participating children and parents are assessed before the intervention starts, after the intervention has ended (after about 6 months) and again 6 months later.

What are the possible benefits and risks of participating?
Participation in the study can increase parents', teachers' and child welfare staff’s awareness of the participating children’s academic strengths and needs. The intervention can potentially prevent gaps in the curriculum, and improve children's learning, their homework routines, and their parents' involvement in school. Participating children might not feel motivated to receive academic support if they believe it to be unnecessary. Participants in the control group risk not receiving the intervention after the study period, as the intervention is contingent upon the family still being child welfare recipients. Participating families who are allocated to the control group might feel disappointment.

Where is the study run from?
The Regional Centre for Child and Adolescent Mental Health (Norway)

When is the study starting and how long is it expected to run for?
September 2017 to January 2022

Who is funding the study?
1. The Norwegian Research Council
2. The Regional Centre for Child and Adolescent Mental Health in Norway (RBUP)
3. The Norwegian Center for Child Behavioral Development (NUBU)

Who is the main contact?
Dr Solveig Holen
solveig.holen@r-bup.no

Contact information

Dr Solveig Holen
Scientific

Gullhaugveien 1-3
Oslo
0405
Norway

ORCID ID	0000-0003-4976-4717
Phone	+47 (0)93 01 77 76
Email	solveig.holen@r-bup.no

Study information

Primary study design	Interventional
Study design	Multi-centre hybrid type 2 individually randomized controlled intervention trial
Secondary study design	Randomised controlled trial
Study type	Participant information sheet
Scientific title	Implementation and evaluation of enhanced academic support to improve educational outcomes for children in child welfare
Study acronym	KTCW/KOBA
Study objectives	1. Integrated Knowledge Translation will be a useful strategy to develop and successfully implement Enhanced Academic Support in Child Welfare Services 2. Enhanced academic support delivered by child welfare practitioners to children and families will improve children's educational achievement and parental involvement in school
Ethics approval(s)	Norwegian Centre for Research Data (NSD), 27/10/2016, ref: 47161
Health condition(s) or problem(s) studied	Education for children in families receiving support from Child Welfare services
Intervention	The method of randomization is block randomization with a block size of ten. A computer software (confirmit) generates a random numbers table-approach to assign random numbers to participants within blocks. Randomization is done site-wise. Each family enrolled in the study will be randomized to either receive the EAS intervention from a practitioner trained in the intervention or receive regular child welfare support from a practitioner who has not been trained in EAS. 1. The experimental intervention is Enhanced Academic Support, which is a flexible and locally tailored research supported intervention delivered in-home to families in Child Welfare by Child Welfare practitioners in addition to the help or care the families already receive. Enhanced Academic Support is based on common elements of effective community- and home-based interventions to improve educational attainment for children at risk of failing in school. It includes guidance in positive parental involvement, academic training with direct instruction in reading and math, guidance in structure and routines for homework, and guidance in positive reinforcement, praise and correctional feedback. 2. The comparison condition is business as usual in Norwegian Child Welfare services, which includes a variety of measures such as advice and guidance, parent training, financial aid, parent relief etc. Participating children and parents will be assessed before the intervention starts, after the intervention has concluded (approximately after six months) and again six months later.
Intervention type	Mixed
Primary outcome measure(s)	Primary outcome measure as of 22/10/2018: Primary effectiveness outcomes: 1. Children's reading abilities, assessed using the Oral Reading Fluency Test, Arnesen et al., 2016 2. Children's mathematical abilities, assessed using Regnefaktaprøven, Lesesenteret 3. Parental involvement in school, assessed using Parent and School Survey, Ringenberg et al., 2005 Assessed pre-intervention, post-intervention (after 6 months) and at follow up (after 12 months) in the families homes by trained interviewers Primary implementation outcomes are indexed by intervention specific fidelity-checklists measuring: 1. Adherence to core intervention components and competence in delivery 2. Parent comprehension of core components 3. User involvement and satisfaction with delivery of intervention components Checklists are completed by child welfare practitioners using smartphones after each intervention session, and by parents answering the same questions in telephone interviews after each intervention session. Checklists include: 1. Acceptability of Intervention Measure (AIM, Weiner et al., 2018) 2. Intervention Appropriateness Measure (IAM, Weiner et al., 2018) 3. Feasibility of Intervention Measure (FIM, Weiner et al., 2018) Previous primary outcome measure: Primary effectiveness outcomes: 1. Children's reading abilities, assessed using the Oral Reading Fluency Test, Arnesen et al., 2016 2. Children's mathematical abilities, assessed using Regnefaktaprøven, Lesesenteret 3. Parental involvement in school, assessed using Parent and School Survey, Ringenberg et al., 2005 Assessed pre-intervention, post-intervention (after 6 months) and at follow up (after 12 months) in the families homes by trained interviewers Primary implementation outcomes are indexed by intervention specific fidelity-checklists measuring: 1. Adherence to core intervention components and competence in delivery 2. Parent comprehension of core components 3. User involvement and satisfaction with delivery of intervention components Checklists are completed by child welfare practitioners using smartphones after each intervention session, and by parents answering the same questions in telephone interviews after each intervention session
Key secondary outcome measure(s)	Secondary implementation measures: 1. Organizational readiness for change, assessed using unpublished questionnaire made by study authors, administered pre and post intervention 2. Organizational climate for implementing evidence based practice, assessed using Implementation Climate Scale, Aarons & Ehrhart, administered pre and post intervention 3. Practitioner's perceived competence in providing academic support, assessed using unpublished questionnaire made by study authors, administered pre and post intervention 4. Satisfaction with implementation process and intervention, assessed using focus groups with practitioners and collaborators conducted post intervention Secondary effectiveness measures and covariates, administered pre, post and follow up: 1. Child mental health, assessed using Strengths and Difficulties Questionnaire, Goodman 2. Social skills, assessed using Social Skills Rating System, Gresham & Elliot 3. Executive functions, assessed Five to Fifteen, Kadesjö et al. Semi-structured interviews are also conducted with participating families after the intervention to learn more about their experiences with the intervention.
Completion date	31/01/2022

Eligibility

Participant type(s)	Other
Age group	Child
Sex	All
Target sample size at registration	120
Total final enrolment	82
Key inclusion criteria	1. Children in families receiving services from municipal Child Welfare Services 2. Children (boys and girls) in 1st to 7th grade and their parents/caregivers Consent, assent and the questionnaires will be available in Norwegian, English, Arabic, and Somali. The study also includes practitioners at local child welfare services in and around Oslo, Norway
Key exclusion criteria	1. Developmental disability 2. Parents not able to give informed consent due to language restriction (not able to understand Norwegian, English, Arabic or Somali)
Date of first enrolment	08/09/2017
Date of final enrolment	31/12/2019

Locations

Countries of recruitment

Norway

Study participating centres

Bjerke Barneverntjeneste

Oslo
0580
Norway

Drammen barneverntjeneste

Drammen
3008
Norway

Baerum barneverntjeneste

1346 gjettum
Norway

Results and Publications

Individual participant data (IPD) Intention to share	Yes
IPD sharing plan summary	Available on request
IPD sharing plan	Parts of the datasets generated during the current study will be available upon request after 2020 from Solveig Holen, PI (solveig.holen@r-bup.no). Requests for datasets will be considered by the research team at RBUP. Criteria for granting access to data include non-interference with the planned publications of the PhD and post doc fellows or any other plans for publications from the research team, and that members of the research team are co-authors on all publications of data from this study. Requests will be considered on a case by case basis.

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article	Results and lessons learned	06/05/2023	19/12/2023	Yes	No
Protocol article	protocol	29/12/2018		Yes	No
Other publications	Early academic struggles among children with home-based support from child welfare services	01/12/2021	17/02/2023	Yes	No
Other publications	Exploring how intervention characteristics affect implementability: A mixed methods case study of common elements-based academic support in child welfare services	01/10/2021	17/02/2023	Yes	No
Other publications	Individual level predictors of implementation climate in child welfare services	01/12/2020	17/02/2023	Yes	No
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes
Study website	Study website	11/11/2025	11/11/2025	No	Yes

Editorial Notes

19/12/2023: Publication reference added.
17/02/2023: Publication references added.
17/01/2023: The intention to publish date was changed from 31/01/2023 to 31/12/2023.
13/12/2021: The following changes were made to the trial record:
1. The overall end date was changed from 31/12/2021 to 31/01/2022.
2. The intention to publish date was changed from 31/12/2021 to 31/01/2023.
3. The plain English summary was updated to reflect these changes.
18/05/2021: The following changes were made to the trial record:
1. The overall end date was changed from 31/05/2021 to 31/12/2021.
2. The trial website was changed from "http://www.skolestøtte.no"; to "https://www.r-bup.no/forskningsprosjekter/koba-mestring-i-skolen-for-barn-i-risiko";.
3. The plain English summary was updated to reflect these changes.
02/02/2021: The following changes were made to the trial record:
1. Contact details updated.
2. The overall trial end date was changed from 14/01/2021 to 31/05/2021.
3. The intention to publish date was changed from 01/12/2020 to 31/12/2021.
29/01/2020: The total final enrolment number has been added.
05/07/2019: The following changes were made to the trial record:
1. The recruitment end date was changed from 30/06/2019 to 31/12/2019.
2. The overall end date was changed from 30/06/2020 to 14/01/2021.
3. The plain English summary was updated to reflect these changes.
04/01/2019: Publication reference added.
22/10/2018: The following changes were made:
1. The recruitment end date was updated from 08/09/2018 to 30/06/2019.
2. The overall trial end date was updated from 08/09/2019 to 30/06/2020.
3. The intention to publish date was updated from 01/01/2020 to 01/12/2020.
4. The primary outcome measure was updated.