Small-group Intervention Research Articles

A randomized controlled trial of an oral inferential comprehension intervention for young children with developmental language disorder

Although children with developmental language disorder demonstrate poor inferential comprehension, few studies have evaluated the effect of interventions to improve inferencing. This study aimed to investigate the efficacy of a small-group intervention designed to improve oral inferential comprehension of narrative discourse. Thirty-seven 5- to 6-year-old children with developmental language disorder participated. The participants were randomly allocated to the oral inferential comprehension (IC) intervention or a control phonological awareness (PA) intervention. Small-group sessions took place twice a week over 8 weeks. Participants were assessed on narrative comprehension and phonological awareness skills pre- and post-intervention, and after a maintenance period of 8 weeks. Compared to the control PA group, the participants in the IC group demonstrated a significant increase in inferential comprehension scores from pre- to post-intervention, which was maintained over time. In addition, the IC group scored significantly higher than the PA group for inferential comprehension on a post-intervention generalization measure. There was no significant difference between the two groups for literal comprehension scores at any assessment point. The results demonstrate that the small-group intervention was effective at improving inferential comprehension of narratives in 5- to 6-year-old children with developmental language disorder. Additionally, generalized improvement was shown across the narrative context, and improvements were maintained two months following the intervention.

Intervention Reach and Sexual Risk Reduction of a Multi-level, Community-Based HIV Prevention Intervention for Crack Users in San Salvador, El Salvador.

This article examines the effects of a multi-level, community-based HIV prevention intervention for crack users residing in low-income neighborhoods in San Salvador, El Salvador conducted between August 2011 and June 2016. The intervention consisted of three components introduced sequentially: (1) rapid HIV testing in community settings; (2) a social network HIV testing intervention; and (3) small group interventions with crack users who were members of the same social network. The intervention was evaluated with an interrupted time series design in which we used respondent-driven sampling to conduct 7 cross-sectional surveys with crack users along a 3-4month period for each assessment (total n = 1597). Results revealed a significant increase in exposure to the intervention over time with 50% of the participants reporting exposure to one or more of the three components. Getting an HIV test at the community site was associated with reductions in total times each individual had sex without a condom (p < 0.05) compared to those who had been exposed to no intervention components. Being referred by another crack user through the Social Network HIV intervention was also associated with reductions in total numbers of condomless sex (p < 0.05) The cumulative effect of being exposed to more than one intervention component was associated with reductions in total number of times individuals had condomless sex (p < 0.05). In spite of the high level of intervention reach and that self-reported exposure to intervention components was associated with lower sexual risk, reductions in sexual risk over time were not observed in the full sample, indicating that the penetration of HIV prevention components was not sufficient to produce population level change.

A Community-Based Study of Giving ACTS: Organ Donation Education for African American Adults

BackgroundTransplantation continues to be the therapy of choice for people experiencing end-stage organ failure. African Americans (AAs) are overrepresented among those awaiting an available organ for the purpose of a transplant, yet donate at rates lower than other races due to a list of well-studied barriers. The Giving ACTS (About Choices in Transplantation and Sharing) Intervention was developed to provide culturally appropriate messaging to AAs about organ and tissue donation and transplantation (OTDT). The purpose of this community-based study was to test the extent to which the intervention was effective in (1) improving donation-related knowledge and attitudes among AA participants, and (2) increasing registration on the state donor registry. MethodsUsing a single-group, pre-post design, 1,585 participants received the intervention in small groups hosted in community settings. ResultsFrom baseline to immediate follow-up, participants significantly increased in OTDT-related knowledge, beliefs and attitudes, endorsement of the positive consequences of donation, and willingness to donate (all ps < .001). Participants’ beliefs about the negative consequences of organ and tissue donation, however, did not significantly change, and registration on the state donor registry was negligible (1.3%). ConclusionResults suggest that Giving ACTS was generally successful in improving attitudes and beliefs; the intervention, however, was not effective in changing participants’ beliefs about the negative consequences of OTDT, or increasing actual registration behaviors. Future studies in this area should be conducted to empirically evaluate the role of distrust in healthcare systems among AAs and its possible mediating effect on the relationship between donation-related education and the desired health behaviors.

Evaluating contextually adapted reading interventions with third-grade, Costa Rican students experiencing significant reading difficulties

Scholarship in school psychology has continued to document the need and importance of contextually relevant intervention and prevention research, but this type of research remains relatively scarce. Also problematic, this type of research is even more limited in low- and middle-income countries (LMIC) compared to high-income countries. This situation within school psychology scholarship not only has negative implications for research and practice, it also limits internationalization within the discipline. The geographical context for the present study was in Costa Rica, currently a Latin American LMIC. Given the global importance of literacy, this article describes an experimental evaluation comparing two time- and resource-efficient reading interventions that differed only by instructional grouping: A one-on-one intervention, and an even more resource-efficient small-group intervention. Participants included third-graders experiencing significant reading difficulties. Analyses showed that all students benefitted from intervention, but some students responded somewhat more favorably to one intervention versus the other. Limitations, implications, and future research directions are discussed, particularly within the context of international school psychology and how professionals in the discipline can benefit from more intervention research in otherwise underrepresented global regions.

Investigation of a New Couples Intervention for Individuals With Brain Injury: A Randomized Controlled Trial

ObjectivesThis study aimed to (1) examine the efficacy of a treatment to enhance a couple’s relationship after brain injury particularly in relationship satisfaction and communication; and (2) determine couples’ satisfaction with this type of intervention. DesignRandomized waitlist-controlled trial. SettingMidwestern outpatient brain injury rehabilitation center. ParticipantsParticipants (N=44; 22 persons with brain injury and their intimate partners) were randomized by couples to the intervention or waitlist-controlled group, with 11 couples in each group. InterventionsThe Couples Caring and Relating with Empathy intervention is a 16-week, 2-hour, manualized small group treatment utilizing psychoeducation, affect recognition, empathy training, cognitive-behavioral and dialectical-behavioral strategies, communication skills training, and Gottman’s theoretical framework for couples adjusted for individuals with brain injury. Main Outcome MeasuresThe Dyadic Adjustment Scale, Quality of Marriage Index (QMI), and the Four Horsemen of the Apocalypse communication questionnaire were implemented. Measures were completed by the person with brain injury and that person’s partner at 3 time points: baseline, immediate postintervention, 3-month follow-up. ResultsThe experimental group showed significant improvement at posttest and follow-up on the Dyadic Adjustment Scale and the Horsemen questionnaire compared to baseline and to the waitlist-controlled group which showed no significant changes on these measures. No significant effects were observed on the QMI for either group. Satisfaction scores were largely favorable. ConclusionsResults suggest this intervention can improve couples’ dyadic adjustment and communication after brain injury. High satisfaction ratings suggest this small group intervention is feasible with couples following brain injury. Future directions for this intervention are discussed.

‘Thinking Your Problems Away’: Can maths interventions be developed to address both the academic and affective aspects of learning in primary aged children?

AimThis study sought to identify the impact of a maths intervention aimed at enhancing performance, self-concept and self-regulation, while reducing negative emotional responses.MethodA quantitative, between-group repeated-measure experimental design was used to investigate differences between the groups over time. One-hundred-and-forty-four Year 4 pupils (mean age 8.09 years) from eight schools were matched and randomly allocated to intervention or waiting-list control groups. Trained Teaching Assistants delivered the intervention in small groups for four weeks. Performance, self-regulation, self-concept and anxiety in maths were measured pre- and post-intervention.FindingsMixed ANOVA found a significant difference in maths performance and in the strategising and focusing sub-behaviours of self-regulation. No significant differences in maths anxiety and self-concept were established, although exploratory investigation identified a significant impact on males’ maths self-concept.LimitationsThe placebo effect, variable delivery, alongside appropriate maths anxiety and self-regulation measures in this age group, potentially influenced the results.ConclusionsThe intervention indicates promising results with respect to maths performance; however further refinements of the affective elements are proposed. The negative relationship between maths self-concept and anxiety is discussed and practice implications are highlighted.

I'm Not Throwing Away My Shot: What Alexander Hamilton Can Tell Us about Standard Reading Interventions

AbstractThis article summarizes findings from a two‐year randomized control trial, focusing on a subset of 194 fourth graders with reading comprehension scores at or below the 15th percentile. Students in the treatment condition received an average of 94 daily 30‐min sessions of small group intervention implemented with fidelity by well‐trained research staff. Standardized measures of word identification, vocabulary, and comprehension, and an oral reading fluency measure were administered pre‐ and post‐testing. Results indicated no statistically significant differences between students in the treatment or business‐as‐usual conditions; effect sizes for comprehension were small (0.14 and 0.19); a quantile regression, however, revealed slightly larger effect sizes for students at the 0.25 to 0.50 quantiles. The effect sizes for word identification, fluency, and vocabulary were less than 0.05. We discuss implications of the study, as well as limitations and directions for future research. We conclude with recommendations for intensifying interventions.

Healthy Aging at Work - Group Intervention in Middle Aged Nurses

Demographic change leads to shifting demands in patient care, not only due to older and sicker patients, but also due to ageing and potentially strained nursing staff. High job strain is known to be associated with an intention to leave the job. At the same time prevalence of mental distress is already high. The aim of our work was to develop a small group intervention to prevent mental strain and to enhance healthy ageing at work.

How Much Is Enough? Evaluating Intervention Implementation Efficiently

This study investigated the use of brief observations to measure implementation of small group interventions using the Quality of Intervention Delivery and Receipt (QIDR) tool. Videos of 10-min segments representing the beginning, middle, and end of each 30-min intervention lesson were coded for implementation. Results indicated that (a) reliability can be achieved when observing a portion of a lesson; (b) QIDR scores obtained from 10-min segments are significantly correlated with the 30-min observations; and (c) post hoc analysis indicate the tool may be sensitive to changes in implementation quality at the intervention group level across time. Implications for research and practice are discussed, including the utility of shorter observations to increase the monitoring of intervention implementation to potentially improve outcomes.

Innovation, Dosage and Responsiveness in the Implementation of the Program “Edúcame Primero Perú” for Reducing Child Labour

"Educame Primero Peru" [Educate First, Peru] is a program designed to prevent child labour. It is aimed for 6 to 12 year old children at risk. During the scholastic year 2015–2016, 151 children from three schools in two poor districts of Lima (Peru) participated in the program. In this paper, we examine the impact of various components of program implementation related to psychological well-being and child labour. The qualitative description of the program is based on the participant observation of the 151 children, their families and their teachers. Sixty percent of the participants were boys and 40% girls, all between 8 and 13 years (M = 10.38, DT = 1.22). In a second phase, we collected longitudinal quantitative indicators of innovation, dosage and responsiveness of participants within a group of 36 children who took part throughout a 10 months implementation program in two schools in Villa El Salvador. We describe the process of transfer and adaptation of the program in Peru, from previous experiences in other Latin American countries. Qualitative observation allowed us to document the influence of organizational dynamics and the relationship with families for the proper functioning of the program. The results showed a significant improvement in the responsiveness of the stakeholders in the second phase of the program. Participants positively improved their attitude towards peers and program facilitators, as well as, continued to assist to the workshops. In the discussion, we propose that part of the improvement could be attributed to the reorganization in smaller groups in the program sessions. Small group intervention seems to increase the intensity of implementation. Hence, we explored to what extent small-scale intervention indirectly contributes to improve academic outcomes, psychological adjustment and child labour.

Using Video Self-Modeling as a Small Group Reading Fluency Intervention for Elementary School Students

ABSTRACTVideo self-modeling (VSM) has been used widely in the literature to teach a range of prosocial behaviors. More recently, VSM has been explored as both a supplement and stand-alone option to teach academic skills, particularly oral reading fluency. However, the literature is relatively sparse pertaining to the effects of video modeling, void of any current literature exploring the effects of video modeling as a component to small group reading interventions. The present study implemented a multiple baseline design across participants, with an alternating treatment design directly comparing a small group reading intervention with and without VSM. Nonoverlap of all pairs was used to measure the effects of the small group intervention with and without VSM relative to baseline, as well as to compare the two intervention packages to one another. Nonoverlap of all pairs scores indicated moderate to strong effects for both interventions across all participants, with little difference between the two interventions.

Efficacy of a Small-Group Intervention for Post-Incarcerated Black Men Who Have Sex with Men and Women (MSMW).

We conducted a randomized controlled trial of a six-session behavioral intervention designed to reduce frequency of condomless sex and numbers of sex partners among recently incarcerated, bisexual Black men. One hundred participants were assigned to the small-group intervention, Men in Life Environments (MILE), and 112 were assigned to the control condition. Among those assigned to MILE, 69% attended at least one session, 88% of whom attended all sessions. At 3-months' follow-up, large reductions in risk behaviors were reported by both groups. Means for episodes of condomless sex in the previous 3months declined from 27.7 to 8.0 for the intervention and 25.6 to 6.7 for the control group. Reductions were not greater for the intervention than those of the control group. Regression to the mean, respondent burden, and implementation issues, such as moving from office-based to field-based survey administration at follow-up, may have contributed to the large declines reported by both groups.

Healthy ageing at work- Efficacy of group interventions on the mental health of nurses aged 45 and older: Results of a randomised, controlled trial.

ObjectiveThis multicentre, randomised controlled trial (RCT) aimed to evaluate the efficacy of a small-group intervention promoting successful ageing at work in older nurses (aged ≥45).MethodA sample of 115 nurses aged ≥45 from 4 trial sites in Germany were randomly assigned to either the intervention group (IG), that received a small-group intervention of seven weekly sessions of 120 min with a booster session after six weeks or to a wait-list control condition (WLC). Outcomes were measured via validated self-report questionnaires at baseline (T1) and at post-treatment (T2).Primary outcomes were mental health-related well-being and mental health-related quality of life (QOL). The secondary outcomes included mental health-related and work-related measures.ResultsThe intention to treat (ITT) analysis showed significant positive effects of the intervention on mental health. A significant small effect (d = 0.3) in favour of the IG was found for psychological health-related quality of life. Positive small effects (d = 0.24 to d = 0.31) were also found for work related mental strain.ConclusionsOur small-group intervention based on a theory of successful ageing for nurses aged ≥45 was found to be effective with regard to improvements of psychological health related quality of life and other mental health-related outcomes. Thus, our study shows that the ageing workforce can be reached through specifically designed preventive interventions. The components of our intervention could be easily adapted to the belongings of other professions. Our results suggest that these components should be evaluated in various settings outside the healthcare sector.

Meta-analysis of targeted small-group reading interventions

Small-group reading interventions are commonly used in schools but the components that make them effective are still debated or unknown. The current study meta-analyzed 26 small-group reading intervention studies that resulted in 27 effect sizes. Findings suggested a moderate overall effect for small-group reading interventions (weighted g=0.54). Interventions were more effective if they were targeted to a specific skill (g=0.65), then as part of a comprehensive intervention program that addressed multiple skills (g=0.35). There was a small correlation between intervention effects and group size (r=0.21) and duration (r=0.11). Small-group interventions led to a larger median effect size (g=0.64) for elementary-aged students than for those in middle or high school (g=0.20), but the two confidence intervals overlapped. Implications for research and practice are discussed.

Effectiveness of a theory-based multicomponent intervention (Movement Coaching) on the promotion of total and domain-specific physical activity: a randomised controlled trial in low back pain patients

BackgroundThe promotion of physical activity is a major field in rehabilitation and health promotion but evidence is lacking on what method or strategy works best. Ensuing from this research gap, the present study compared the effectiveness of a comprehensive theory based multicomponent intervention (Movement Coaching) to a low intensity intervention in low back pain patients.MethodsA monocenter randomized controlled trial with three measuring points (T0 = baseline, T1 = six month follow-up, T2 = twelve month follow-up) was conducted. N = 412 chronic low back pain patients participated. The Movement Coaching group (n = 201) received a comprehensive multicomponent intervention with small-group intervention, phone- and web 2.0-intervention. The low intensity control (n = 211) received two oral presentations that were available for download afterwards. Main outcome was total physical activity measured by Global Physical Activity Questionnaire at 12 month follow-up. Additionally, workplace, leisure time and transportation activities were compared. A split-plot anova was conducted for evaluating repeated measure effects and between group effects.ResultsAt six and twelve month follow-up there were no statistically significant between group differences in total (T1: p = 0.79; T2: p = 0.30) as well as domain-specific physical activity (workplace (T1: p = 0.16; T2: p = 0.65), leisure time (T1: p = 0.54; T2: p = 0.89), transportation (T1: p = 0.29; T2: p = 0.77) between Movement Coaching and the control group. In both groups, workplace physical activity showed the highest proportion of total physical activity. From baseline to twelve month follow-up the results showed a decline in total physical activity (Movement Coaching: p = 0.04; control group: p = 0.50).ConclusionsThe comprehensive Movement Coaching intervention was not found to be more effective than a low intensity intervention in promoting total and domain-specific physical activity in chronic low back pain patients.Trial registrationThis study is registered at German Clinical Trials Register (DRKS)-ID: DRKS00004878.

The Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) Model: An Integrated Model for Medical Student Success.

Not all students cope successfully with the demands of medical school, and students' struggles may result in study delay or dropout. To prevent these outcomes, medical schools need to identify students who are experiencing academic difficul ties and provide them with timely interventions through access to support programs. Although the importance of early identification and intervention is well recognized, less is known about successful strategies for identifying and supporting struggling students.Building on the literature and their own empirical findings, the authors propose an integrated, school-wide model for medical student success comprising a continuum of academic and behavioral support. This Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) model focuses on improving both academic and behavioral outcomes by offering support for students at four levels, which range from adequate instruction for all, to targeted small-group interventions, to individualized support, and also include exit support for students who might be better off in another degree program. Additionally, medical schools should provide both academic and behavioral support; set high, yet realistic expectations and clearly communicate these to students; and intervene early, which requires timely identification of at-risk students who would benefit from the different types and tiers of support. Finally, interventions should be evidence based and fit the needs of the identified groups of students. The authors argue that adopting the core principles of the 4T-CABS model will enable medical schools to maximize academic engagement and performance for all students.

Bibliotherapeutic book club intervention to promote reading skills and social–emotional competencies in low SES community‐based high schools: A randomised controlled trial

Reading skills and social–emotional competencies are two important skills for both academic achievement and long‐term quality of life. The present study evaluated the effects of a school‐based intervention to promote reading skills and social–emotional competencies in young adolescents from urban, low socioeconomic status (SES) communities in their first year of secondary education. A small group intervention was conducted, using book clubs in which students read and discussed literature with the objective to enhance reading attitude, reading comprehension and social–emotional competencies. Participants were randomly allocated to either the book club intervention condition (n = 50) or a business‐as‐usual control condition (n = 40). Results revealed that the intervention group accrued significant greater gains than the control group in (recreational) reading attitude, reading comprehension and social emotional competences.HighlightsWhat is already known about this topic The transition from primary to secondary education is accompanied by a sharp decline in reading attitude and a rise in demands on young adolescents' social–emotional competencies. Qualitative research suggests book clubs can be an educational tool to enhance both reading behaviour and social–emotional skills. What this paper adds A bibliotherapeutic book club intervention can be an effective tool to improve reading attitudes, reading comprehension and to strengthen social–emotional competencies in young adolescents from low SES areas. Implications for theory, policy or practice This study supports the inclusion of bibliotherapeutic book clubs in the secondary education curriculum as a mean to address both reading behaviour and social–emotional competencies, two skills that are important for adolescents' academic success.

A GROUP PSYCHOTHERAPY INTERVENTION SUPPORTING DEMENTIA FAMILY CARERS IN MANAGING WORK-LIFE CONFLICTS

The Reitman Centre Working CARERS Program (RCWCP) is an evidence-informed, small-group therapy intervention designed for individuals juggling employment and dementia caregiving. A series of research is underway to ascertain its clinical effectiveness, perceived impact, and rural adaptability. Here, we present a qualitative study employing the life-course role identity theoretical framework. In-depth interview data from 30 former RCWCP participants was analyzed using the narrative analysis approach. Findings indicated that the extent to which knowledge and skills acquired from RCWCP may be applied is related to the working carer’s lived experience, which is shaped by gender-role identity, dyadic relationship, and work-life conflicts. Rich narratives also revealed conflicting demands across the roles of employee and carer. Targeted and tailored carer interventions such as the RCWCP can proactively respond to the shifting demographics and needs of this diverse sub-population of dementia family carers. Our findings will guide the national dissemination and adaptation of RCWCP.

DISSECTING AN AGING-IN-PLACE SCHEME: ACTIVITIES CONTRIBUTING TO POSITIVE OUTCOMES

This study aimed to examine of the type and intensity of activities of an ageing-in-place (AIP) Scheme that might contribute to the positive outcomes of elders. Method: A cohort of 2,081 elders from 11 AIP housing estates and 1 control estate were randomly selected within each age stratum: 65–74 years, 75–84 years, and 85 years. Elders were interviewed face-to-face at baseline and 1 year and their participation in the AIP Scheme activities was recorded. Results: Structured small group intervention and activities that improved the frailty states, mood, and cognitive function increased the likelihood of elder tenants’ to age in place. Implications: Group activities that promote physical, psychological and cognitive outcome all contribute to the positive change in elders’ preference for aging-in-place. Promotion of positive social interaction is crucial in the development of an AIP program.

Using Small-Group Instruction to Improve Students' Reading Fluency: An Evaluation of the Existing Research

ABSTRACTReading fluency is necessary for reading comprehension, but approximately 40% of U.S. fourth-grade students have inadequate reading fluency skills. Because small-group (SG) instruction is often used as a first line of intervention for struggling readers, SG instruction targeting deficiencies in text reading fluency ought to be part of every school's intervention toolbox. The authors summarize the existing research on instruction and interventions that specifically targets reading fluency and is implemented by an adult with 3 or more students at once. Key findings revealed that most studies used a single-case design, nearly all studies were rated positively in terms of methodological quality, and the majority of participants significantly improved as a result of receiving SG intervention. Furthermore, of the five studies examining comparable SG and 1-on-1 interventions, 79% of the students performed equally well from both interventions. Implications and several recommendations for future research are discussed.