An interventional study of BEST in CLASS in Evidence Based Programs in Schools, sponsored by Virginia Commonwealth University. Completed at 2 sites in United States. Open to participants aged 5 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-06-02.
Sponsored by Virginia Commonwealth University · Not applicable, Interventional, and Other
The purpose of this study is to learn more about teachers' sustainment of use of core components of BEST in CLASS in a follow-up study.
The goal of this study is to help understand how to successfully implement and sustain evidence based programs (EBP) in the education sector. The study will look at how questions such as what teacher, program, and school characteristics impact sustainment of the EBP BEST in CLASS, what modifications to BEST in CLASS represent a sustained program, and how do teacher, program, and school characteristics influence sustainment of BEST in CLASS.
Virginia Commonwealth University is the lead sponsor of 641 studies on the registry; 82 are open to participants now.
Of its 88 completed or terminated interventional studies of FDA-regulated products, 62 (70%) have results posted.
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Teacher participants
Children participants
Exclusion Criteria:
Teacher participants
Children participants
Teachers will implement the BEST in CLASS treatment in their classrooms. Teachers were trained and coached in delivering the intervention during their participation in the prior efficacy trial. In the school year of the present study, the teacher implements the intervention without further support from a coach.
Behavioral: BEST in CLASS
One to three students within a participating teacher's classroom are nominated by the teacher and screened for elevated risk of emotional behavior challenges. The teacher delivers the BEST in CLASS intervention to the focal child(ren) in their classroom.
Behavioral: BEST in CLASS
BEST in CLASS is a Tier-2 evidence based program (EBP) that has demonstrated effectiveness at reducing children's Disruptive Behavior Problems (DBPs) and risk for Emotional and Behavioral Disorders (EBDs).
Best in Class (BiC) Adherence: Sustainment Average (SU1-SU4) vs. Implementation Post-Baseline Average (IM2-IM4) (Teacher Level Sample)
The difference in the degree to which the 52 teacher sample adheres to the BiC treatment during the post-baseline implementation phase from the prior efficacy trial, in comparison to the same sample's adherence during the present sustainment trial. Adherence is measured during observations as measure by independent observers on the TREATMENT INTEGRITY INSTRUMENT FOR ELEMENTARY SETTINGS (TIES) Adherence scale. TIES-A is a scale of BEST in CLASS practices. Teachers are rated on the presence (use) of each practice on a scale from 1 (not at all) to 7 (extensively). Higher scores are associated with greater adherence.
Time frame: 3 implementation post baseline timepoints: 5 weeks, 10 weeks, 14 weeks AND 4 sustainment timepoints: sustainment baseline, 5 weeks, 10 weeks, 14 weeks
Best in Class (BiC) Competence: Sustainment Average (SU1-SU4) vs. Implementation Post-Baseline Average (IM2-IM4) (Teacher Level Sample)
The difference in the competence with which the teacher sample delivers the BiC treatment during the post-baseline implementation phase from the prior efficacy trial, in comparison to the same sample's competence during the present sustainment trial. Competence is measured during observations as measure by independent observers on the TREATMENT INTEGRITY INSTRUMENT FOR ELEMENTARY SETTINGS (TIES) Competence scale. TIES-C is a scale of BEST in CLASS practices. Teachers are rated on the competence (quality) of each practice on a scale from 1 (not at all) to 7 (extensively). Higher scores are associated with greater competence.
Time frame: 3 implementation post baseline timepoints : 5 weeks, 10 weeks, 14 weeks AND 4 sustainment timepoints: baseline, 5 weeks, 10 weeks, 14 weeks
Social Skills Improvement System (SSIS) to Measure Change in Student Disruptive Behavior Problems (Student Level Sample)
Problem Behaviors (Standard Score) The mean difference between the teacher-reported problem behavior standard score exhibited by the focal student sample (78 enrolled, 72 completed) from Fall (SU1) to Spring (SU4) of the sustainment year. Student (72 sample size) problem behaviors will be measured by the Social Skills Improvement System (SSIS) problem behavior scale. Higher scores represent more problem behaviors. SU1 v. SU4 (sustainment baseline v. sustainment 14 weeks). The core composite scores for Social Skills and Problem Behaviors have a mean of 100. Frequency Ratings: Items are rated on a 4-point scale: 0 = Never, 1 = Seldom, 2 = Often, 3 = Almost Always, 4=Always.
Time frame: Baseline of sustainment intervention baseline and week 14 of sustainment intervention
Social Skills Improvement System (SSIS) Social Skills Scale to Measure Change in Student Prosocial Behavior (Student Level Sample)
The mean difference in teacher-reported social skills exhibited by the focal student sample (78 enrolled, 72 completed) from Fall (SU1) to Spring (SU4) of the sustainment year. Student (72 sample size) prosocial behaviors will be measured by the Social Skills Improvement System (SSIS) social skills scale. Social Skills (Standard Score). Higher scores represent higher level of social skills. SU1 v. SU4 (sustainment baseline v. sustainment 14 weeks). The core composite scores for Social Skills and Problem Behaviors have a mean of 100. Frequency Ratings: Items are rated on a 4-point scale: 0 = Never, 1 = Seldom, 2 = Often, 3 = Almost Always, 4=Always
Time frame: Baseline of sustainment intervention and week 14 week of sustainment intervention
There are 52 subjects in the teacher sample and 78 subjects in the student sample. Only 50 teachers and 72 students completed the study interventions.
| Milestone | Teacher Implementation (52 Subject Sample) | Focal Student (78 Subject Student Sample) |
|---|---|---|
| Started | 52 | 78 |
| Completed | 50 | 72 |
| Not completed | 2 | 6 |
| Withdrew: 3 students w/d when teacher became ineligible | 0 | 3 |
| Withdrew: Students were moved to a non-participating teacher classroom | 0 | 3 |
| Withdrew: Became ineligible due to professional position change | 2 | 0 |
The difference in the degree to which the 52 teacher sample adheres to the BiC treatment during the post-baseline implementation phase from the prior efficacy trial, in comparison to the same sample's adherence during the present sustainment trial. Adherence is measured during observations as measure by independent observers on the TREATMENT INTEGRITY INSTRUMENT FOR ELEMENTARY SETTINGS (TIES) Adherence scale. TIES-A is a scale of BEST in CLASS practices. Teachers are rated on the presence (use) of each practice on a scale from 1 (not at all) to 7 (extensively). Higher scores are associated with greater adherence.
| score on BiC | Teacher Implementation (51 Subject Sample) |
|---|---|
| Best in Class (BiC) Adherence: Sustainment Average (SU1-SU4) vs. Implementation Post-Baseline Average (IM2-IM4) (Teacher Level Sample) | -.075 ± .454 |
The difference in the competence with which the teacher sample delivers the BiC treatment during the post-baseline implementation phase from the prior efficacy trial, in comparison to the same sample's competence during the present sustainment trial. Competence is measured during observations as measure by independent observers on the TREATMENT INTEGRITY INSTRUMENT FOR ELEMENTARY SETTINGS (TIES) Competence scale. TIES-C is a scale of BEST in CLASS practices. Teachers are rated on the competence (quality) of each practice on a scale from 1 (not at all) to 7 (extensively). Higher scores are associated with greater competence.
| score on BiC | Teacher Implementation (52 Subject Sample Enrolled, 50 Subjects Completed This Outcome) |
|---|---|
| Best in Class (BiC) Competence: Sustainment Average (SU1-SU4) vs. Implementation Post-Baseline Average (IM2-IM4) (Teacher Level Sample) | .001 ± .631 |
Problem Behaviors (Standard Score) The mean difference between the teacher-reported problem behavior standard score exhibited by the focal student sample (78 enrolled, 72 completed) from Fall (SU1) to Spring (SU4) of the sustainment year. Student (72 sample size) problem behaviors will be measured by the Social Skills Improvement System (SSIS) problem behavior scale. Higher scores represent more problem behaviors. SU1 v. SU4 (sustainment baseline v. sustainment 14 weeks). The core composite scores for Social Skills and Problem Behaviors have a mean of 100. Frequency Ratings: Items are rated on a 4-point scale: 0 = Never, 1 = Seldom, 2 = Often, 3 = Almost Always, 4=Always.
| score on SSIS | Focal Student (72 Subject Student Sample) |
|---|---|
| Social Skills Improvement System (SSIS) to Measure Change in Student Disruptive Behavior Problems (Student Level Sample) | -3.260 ± 11.646 |
The mean difference in teacher-reported social skills exhibited by the focal student sample (78 enrolled, 72 completed) from Fall (SU1) to Spring (SU4) of the sustainment year. Student (72 sample size) prosocial behaviors will be measured by the Social Skills Improvement System (SSIS) social skills scale. Social Skills (Standard Score). Higher scores represent higher level of social skills. SU1 v. SU4 (sustainment baseline v. sustainment 14 weeks). The core composite scores for Social Skills and Problem Behaviors have a mean of 100. Frequency Ratings: Items are rated on a 4-point scale: 0 = Never, 1 = Seldom, 2 = Often, 3 = Almost Always, 4=Always
| score on SSIS | Focal Student (72 Subject Student Sample) |
|---|---|
| Social Skills Improvement System (SSIS) Social Skills Scale to Measure Change in Student Prosocial Behavior (Student Level Sample) | 4.603 ± 10.892 |
Collected over During both of the study timeframes (IM-Implementation) and SU (Sustainment): IM2 = 5 weeks of implementation IM3 = 10 weeks of implementation IM4 = 14 weeks of implementation SU1 = baseline of sustainment SU2 = 5 weeks of sustainment SU3 = 10 weeks of sustainment SU4 = 14 weeks of sustainment. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Teacher Implementation (52 Subject Sample) | 0/52 (0%) | 0/52 (0%) | 0/52 (0%) |
| Focal Student (78 Subject Student Sample) | 0/78 (0%) | 0/78 (0%) | 0/78 (0%) |
| Age, Categorical(Participants) | Teacher Implementation (52 Subject Sample) | Focal Student (78 Subject Student Sample) | Total |
|---|---|---|---|
| <=18 years | 0 | 78 | 78 |
| Between 18 and 65 years | 52 | 0 | 52 |
| >=65 years | 0 | 0 | 0 |
| Sex: Female, Male(Participants) | Teacher Implementation (52 Subject Sample) | Focal Student (78 Subject Student Sample) | Total |
|---|---|---|---|
| Female | 50 | 26 | 76 |
| Male | 2 | 48 | 50 |
| Ethnicity (NIH/OMB)(Participants) | Teacher Implementation (52 Subject Sample) | Focal Student (78 Subject Student Sample) | Total |
|---|---|---|---|
| Hispanic or Latino | 3 | 6 | 9 |
| Not Hispanic or Latino | 49 | 68 | 117 |
| Unknown or Not Reported | 0 | 4 | 4 |
| Race (NIH/OMB)(Participants) | Teacher Implementation (52 Subject Sample) | Focal Student (78 Subject Student Sample) | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 3 | 0 | 3 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 14 | 36 | 50 |
| White | 33 | 29 | 62 |
| More than one race | 0 | 5 | 5 |
| Unknown or Not Reported | 2 | 8 | 10 |
| Region of Enrollment(participants) | Teacher Implementation (52 Subject Sample) | Focal Student (78 Subject Student Sample) | Total |
|---|---|---|---|
| United States | 52 | 78 | 130 |
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Virginia Commonwealth University