ClinicalTrials.gg
RecruitingNCT06019429Updated Oct 6, 2023

Promoting Social-emotional Development and Self-esteem in Primary School Students

An interventional study of HiRO and HiRO +judo in Prosocial Behavior, Anxiety Disorders and Symptoms and Attention Deficit Hyperactivity Disorder, sponsored by Universiteit Leiden. Recruiting at 1 site in Netherlands. Open to participants aged 4 Years to 13 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-10-06.

Primary conditionAnxiety DisordersRegistry: AltruismReclassifiedWhy we changed it
Registry
Altruism — the first condition term the registry derived for this study.
ClinicalTrials.gg
Anxiety Disorders
Why
  1. Altruism is a broad heading, used only when no more specific condition is named.
  2. The study's listed conditions name Anxiety Disorders.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Universiteit Leiden · Not applicable, Interventional, and Supportive care

From the registry’s dates

  • Primary completion was expected by Sep 2024, 2 years 2 months ago, but the record still lists the study as recruiting.
  • Started Sep 2023; still recruiting 3 years 2 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
400
Allocation
Non-randomized
Ages
4 Years to 13 Years
Sex
All
01

Study summary

This is an effectiveness study into a program ("HiRO") for improving social-emotional development, self esteem and the perceived classroom peer context in primary school students (aged 4-13 years). To this end, schools are divided into three conditions based on the choice of the schools (non-randomized): 1) School As Usual, 2) HiRo without judo classes, and 3) HiRO with judo classes. In all participating schools, social-emotional skills, self-image, emotional problems, and classroom peer context are measured three times by means of questionnaires (both self-report and parent-report).

In The Netherlands primary schools are obliged to offer students training in social-emotional development. Schools can decide to develop their own program or make use of existing programs delivered by third parties, such as HiRO. In this study HiRO is compared to school as usual, that is, any other program offered to promote social -emotional development than HiRO.

The main questions to answer are:

  • What is the effect of HiRO on the development of prosocial behavior?
  • What is the effect of HiRO on the development of emotional problems (depression, anxiety)?
  • What is the effect of HiRO on self-esteem?
  • What is the effect of HiRO on perceived peer context?

Researchers will compare HiRO with and without judo to "school as usual" testing the following hypotheses:

HiRO will result in increased prosocial skills as compared to school as usual. HiRO will result in decreased emotional problems as compared to school as usual.

HiRO will result in increased self-esteem as compared to school as usual. HiRO will result in improved perceived peer context as compared to school as usual.

Read the detailed description

This is a non-randomized trial, with a 3 (time) x 3 (condition) within-between subjects design.

All children (and their parents) within the participating primary schools are asked to join this study. Independent of participation in this study, all children in these schools will receive the intervention as it is part of the curriculum focussing on the development of prosocial skills.

Schools will be called to ask if participants would like to participate in the study: schools choose in what condition participation is desired. In march/april 2023: schools share information letter with parents by email/in school app with a link to the informed consent. In june 2023: during end-of-the-year meetings with parents, teachers will approach parents that have not responded yet whether participation is approved. In addition, children in group 8 (with possible children of 12 years and older) will get information from teachers about the study and an information letter. Subsequently, children will be asked whether participation is approved. Assessements will take place in classrooms of the participating schools during school hours for children 8 years and older. For children younger than 8 years parent report will be used.

This study will obtain a data set with a hierarchical structure. The three observations are nested within students, students are nested within classrooms and classrooms are nested within schools. Therefore, a three-level growth model will be used. Lee and Hong (2021) provided sample size guidelines based on simulation studies for three-level growth models using Monte Carlo methods while considering various realistic ICC values at the three levels. The conservative estimation is made that only 10 out of 23 (average number of students per class) students per class participate in this study. Therefore the simulation results of Lee and Hong (2021) provided for 10 students per group are considered. Across all fixed effects and an intraclass correlation coeffcient at level 3 (schools) of .15, 2 out of 6 power rates were found to be below the .80 level, when 50 groups are included. With 100 groups included, all power rates were found to exceed .87. Based on these numbers, the aim is to include 75 groups in total, bringing the total number of participating students (again assuming 10 participants per group) to 10x75 = 750.

Multilevel regression analyses will be performed to evaluate the effect of HiRO on social-emotional development, self-esteem, and the perceived classroom peer context. Multilevel analyses is an intent-to-treat procedure that does not impute missing data but deals with incomplete data by assuming that the available data for a given subject are representative of that subject's deviation from the average trends across time. The level1 model includes the time variable, which captures within-person variation over time, in the level 2 model between person characteristics such an intervention condition are used to predict the slope estimates. In the level 3 model between group characteristics can be modeled.

02

Conditions studied

  • Prosocial Behavior
  • Anxiety Disorders and Symptoms
  • Attention Deficit Hyperactivity Disorder
  • Healthy
  • Emotional Problem
  • Self Esteem
  • Peer Group

Browse trials for

Keywords

  • prosocial behavior
  • anxiety
  • self esteem
  • classroom peer context
  • attention deficit hyperactivity disorder
03

In context

Anxiety Disorders Reclassified

7,201 studies on the registry are indexed under Anxiety Disorders; 1,682 are open to participants now.

This study's planned enrollment of 400 is above the median of 80 across 6,057 interventional studies indexed under Anxiety Disorders.

Browse Anxiety Disorders studies →

Lead sponsor

Universiteit Leiden is the lead sponsor of 14 studies on the registry; 7 are open to participants now.

Compared within Anxiety Disorders, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Altruism. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
4 Years to 13 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

All primary school children

Exclusion criteria

Exclusion Criteria:

None

05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
400 participants (estimated)

Study arms

  • Experimental
    HiRO plus judo

    In this condition, students receive weekly classes aimed to promote social-emotional development. In addition, they will receive 6 judo classes.

    Behavioral: HiRO +judo

  • Experimental
    HiRO

    In this condition, students receive weekly classes aimed to promote social-emotional development.

    Behavioral: HiRO

  • Active comparator
    School as usual

    In this condition, students receive any amount of classes organized by their school to promote social-emotional development.

    Behavioral: School as usual

Interventions

  • BehavioralHiRO

    HiRO consists of weekly lessons. The lessons are aimed to promote social-emotional development. More specifically, lessons are designed to develop and enhance 1) trust, 2) collaboration, 3) respect, 4) self control, 5) resilience, 6) discipline, 7) joy. The annual program consists of four phases: Phase 1 \& 3: Fundamental phase (6 weeks) Engaging with the values through movement. In these phases, group formation and establishing behavioral expectations are central. In the Fundamental phase, one value is addressed school-wide each week. The entire school starts with trust and ends with discipline. Phase 2 \& 4: Theme weeks (12 lessons) A customized series of Experiential lessons for each class. Experiential learning is the guiding principle of the program, with a strong foundation based on the values upheld in judo. The learning cycle forms the basis for each experiential lesson within HiRO, and focusses on concrete experience, reflective observation, conceptualization, and practice.

  • BehavioralHiRO +judo

    In the condition HiRO with judo, students receive the same treatment as offered in the HiRO condition. In addition, they receive physical judo classes that are designed to translate the above-mentioned values to the behavioral level.

  • BehavioralSchool as usual

    Any amount of classes offered to promote social-emotional development

06

What researchers measure

Primary outcomes

  1. Prosocial behavior

    The Strengths and Difficulties Questionnaire (SDQ) is a self-report and third-party informant (parent and teacher) screening instrument for psychosocial functioning of children and adolescents (Goodman, 1997); Dutch version (Widenfelt, Goedhart, Treffers, \& Goodman, 2003). For 8 to 13 year old participants, both the self-report and parent version is used. For 4-7 year old participants only the parent version is used. The SDQ is comprised of five subscales: (a) emotional symptoms, (b) conduct problems, (c) hyperactivity/ inattention, (d) peer relationship problems, and (e) prosocial behavior. All subscales consist of five items using a 3-point Likert scale (ranging from 0 = ''not true'' to 2 = ''very true'' The SDQ is a reliable and valid screener of psychological difficulties across social-emotional domains (Muris, Meesters, \& Van den Berg, 2003; Van Rooy, Veenstra, Clench-Aas, 2008).

    Time frame: Up to 11 months

Secondary outcomes

  1. Self-esteem

    The child version of the Rosenberg's Self Esteem Scale (CRSES; Wood, Griffin, Barton, Sandercock, 2021) has been developed to assess self esteem in children aged 7-12 years. The CRSES comprises five positive and five negative statements each with four possible responses scored from one to four. Scoring is reversed for responses to negative items so that a higher score indicates better overall self esteem. A validation study has tested the internal consistency, convergent validity, and factor structure of the CRSES. A unidimensional factor structure provided an adequate fit, and total scores were related to life satisfaction. As the sample also consists of children aged 4-7 years of age, a 10-item parent version of the Rosenberg Self Esteem Scale (RSES) was developed that will be validated using the pre-treatment assessment of this trial.

    Time frame: Up to 11 months

Other outcomes

  1. Anxiety and emotional problems

    The Youth Anxiety Measure for the Diagnostic and Statistical Manual of Mental Disorders (YAM-5) is a self- and parent-report questionnaire to assess anxiety disorder symptoms in children and adolescents. Part one, used in this study, consists of 28 items and measures the 5 major anxiety disorders including separation anxiety disorder, selective mutism, social anxiety disorder, panic disorder, and generalized anxiety disorder. The five subscales consist of four to seven items using a 4-point Likert scale (ranging from 0 = ''never'' to 3 = 'always''. Higher scores indicate higher levels of anxiety. A validation study demonstrated that the measure was easy to complete by youngsters, support was found for the psychometric qualities of the measure: that is, the internal consistency was good for both parts, as well as for most of the subscales, the parent-child agreement appeared satisfactory, and there was also evidence for the validity of the scale.

    Time frame: Up to 11 months

  2. Classroom Peer Context Questionnaire (CPCQ)

    The Classroom Peer Context Questionnaire (CPCQ) is a self-report questionnaire that can be used to assess the self-perceived peer context in the classroom. The questionnaire consists of 20 items belonging to 5 scales; comfort, cooperation, conflict, cohesion and isolation.Confirmatory factor analyses supports these 5 dimensions. Good reliability, validity, and stability for each dimension has been demonstrated.

    Time frame: Up to 11 months

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 6, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06019429
Lead sponsor
Universiteit Leiden
Responsible party
Bianca Boyer (Assistant professor, Universiteit Leiden) — Principal investigator
First posted
Aug 31, 2023
Start date
Sep 1, 2023
Primary completion
Sep 1, 2024 (estimated)
Completion
Sep 1, 2024 (estimated)
Last update
Oct 6, 2023

Study contacts

Anne Rongen, MSc
Contact
anne@hiro.school
0031611740033
Marije Kuijper, MSc
Contact
marije@hiro.school
0031611105556
Bianca Boyer, PhD
principal investigator · Leiden University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion