Abstract

BackgroundWhile randomised controlled trials (RCTs) are considered the gold standard of research, prior study is needed to determine the feasibility of a future large-scale RCT study.ObjectivesThis pilot study, therefore, aimed to determine feasibility of an RCT by exploring: (1) procedural issues and (2) treatment effect of the Classroom Communication Resource (CCR), an intervention for changing peer attitudes towards children who stutter.MethodA pilot cluster stratified RCT design was employed whereby the recruitment took place first at school-level and then at individual level. The dropout rate was reported at baseline, 1 and 6 months post-intervention. For treatment effect, schools were the unit of randomisation and were randomised to receive either the CCR intervention administered by teachers or usual practice, using a 1:1 allocation ratio. The stuttering resource outcomes measure (SROM) measured treatment effect at baseline, 1 and 6 months post-intervention overall and within the constructs (positive social distance, social pressure and verbal interaction).ResultsFor school recruitment, 11 schools were invited to participate and 82% (n = 9) were recruited. Based on the school recruitment, N = 610 participants were eligible for this study while only n = 449 were recruited, where there was n = 183 in the intervention group and n = 266 in the control group. The dropout rate from recruitment to baseline was as follows: intervention, 23% (n = 34), and control, 6% (n = 15). At 1 month a dropout rate of 7% (n = 10) was noted in the intervention and 6% (n = 15) in the control group, whereas at 6 months, dropout rates of 7% (n = 10) and 17% (n = 44) were found in the intervention and control groups, respectively. For treatment effect on the SROM, the estimated mean differences between intervention and control groups were (95% Confidence Interval (CI): -1.07, 5.11) at 1 month and 3.01 (95% CI: -0.69, 6.69) at 6 months. A statistically significant difference was observed at 6 months on the VI subscale of the SROM, with 1.35 (95% CI: 0.58, 2.13).ConclusionA high recruitment rate of schools and participants was observed with a high dropout rate of participants. Significant differences were only noted at 6 months post-intervention within one of the constructs of the SROM. These findings suggest that a future RCT study is warranted and feasible.

Highlights

  • Feasibility of randomised controlled trialsAmong the various levels of evidence that are valuable in clinical practice, the randomised controlled trial (RCT) is regarded as the gold standard because of its design strength (Evans, 2003) and its power to draw conclusions (Oakley, Strange, Bonell, Allen, & Stephenson, 2006; Sibbald & Roland, 1998)

  • Recruitment rate A total of 11 schools were invited, 10 schools responded to the invitation to participate, nine schools accepted the invitation and only eight participated in this study, as one school withdrew from the study

  • The recruitment rate was 82%, as 9 out of the 11 schools invited agreed to participate in this study

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Summary

Introduction

Among the various levels of evidence that are valuable in clinical practice, the randomised controlled trial (RCT) is regarded as the gold standard because of its design strength (Evans, 2003) and its power to draw conclusions (Oakley, Strange, Bonell, Allen, & Stephenson, 2006; Sibbald & Roland, 1998). The literature recommends that it is vital to first conduct a comprehensive pilot study to determine feasibility and improve the validity and statistical power of a future RCT (Evans, 2003; Leon, Davis, & Kraemer, 2011; Oakley et al, 2006; Shanyinde, Pickering, & Weatherall, 2011). While randomised controlled trials (RCTs) are considered the gold standard of research, prior study is needed to determine the feasibility of a future large-scale RCT study

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