Randomised controlled trials in Scandinavian educational research

Background: The Scandinavian countries have a long history of implementing social interventions, but the interventions have not been examined using randomised controlled trials until relatively recently compared with countries like the United States and the United Kingdom. Purpose: The purpose of this paper is to examine the history of randomised controlled trials in Scandinavian compulsory schools (grades 0–10; pupil ages 6–15). Specifically, we investigate drivers and barriers for randomised controlled trials in educational research and the differences between the three Scandinavian countries Denmark, Norway, and Sweden. Methods: To locate relevant trials, we performed a systematic search of four bibliographic databases and a search for grey literature. Results were combined with trials located through direct contact with researchers and government officials. A trial was included if one or more interventions were randomly assigned to groups of students and carried out in a school setting with the primary aim of improving the academic performance of children aged 6–15 in grades 0–10 in Denmark, Norway, or Sweden. We included both conducted and ongoing trials. Publications that seemed relevant were screened based on full-text versions. Data extraction included information from the included studies on grade level, study period, sample size (N), project owner, funding source, and theme. In addition, we conducted two semi-structured interviews by phone or in person with central employees in funding agencies and ministries and 25 correspondences with researchers and policymakers. Findings and conclusion: RCTs in grades 0–10 were few in all of Scandinavia until about 2011, after which there was an increase in all three countries, although at different rates. The largest number of trials has been conducted in Denmark, and the increase is more marked in Denmark and Norway compared with Sweden. International trends towards more impact evaluations and results from international comparisons such as PISA have likely affected the development in all countries, but while many trials in Denmark and Norway are the result of policy initiatives, only one such example in Sweden was identified. We believe the lack of government initiatives to promote RCTs in Sweden is the most likely explanation for the differences across the Scandinavian countries. Funding and coordination from the government are often crucial for the implementation of RCTs and are likely more important in smaller countries such as the Scandinavian ones. Supporting institutions have now been established in all three countries, and we believe that the use of RCTs in Scandinavian educational research is likely to continue.publishedVersio

Holding a foster child’s mind in mind: study protocol for a cluster-randomized controlled trial of mentalization-based therapy (MBT) for foster families

BACKGROUND: Children in foster care are psychologically vulnerable and show more social, developmental, and behavioral problems than those living with their family of origin. Many foster parents struggle to care for these children, some of whom have experienced severe adversity. Research and theory suggest that developing a strong and supportive foster parent-child relationship is essential for foster children to become more well-adjusted and experience a decrease in behavioral problems and emotional maladjustment. Mentalization-based therapy (MBT) for foster families aims at increasing the reflective functioning of the foster parents, thus promoting the development of more secure and less disorganized child attachment representations, which is subsequently proposed as a factor that reduces behavioral problems and emotional maladjustment in children and promotes their overall well-being. METHODS: This is a prospective cluster-randomized controlled trial with two conditions: (1) the intervention group participating in MBT, and (2) the control group who receive usual care. Participants are 175 foster families with at least one foster child aged 4-17 years with emotional or behavioral problems. The intervention will be offered to foster families by 46 foster care consultants from 10 municipalities in Denmark. The foster care consultants will be randomized to MBT training (n = 23) or usual care (n = 23). The primary outcome is the psychosocial adjustment of the foster child measured by the Child Behavior Checklist (CBCL) as reported by foster parents. Secondary outcomes include child well-being, parental stress, parent mental health, parent reflective function and mind-mindedness, parent/child relations, child attachment representations, and placement breakdown. In order to explore implementation fidelity as well as practitioner experiences, we will administer questionnaires designed for this study and conduct qualitative research exploring the practice of the MBT therapists. DISCUSSION: This trial is the first experimental study of a family therapeutic intervention based on attachment theory for foster families within the Scandinavian context. This project will contribute with novel knowledge on attachment representations in foster children and the effects of an attachment-based intervention on essential outcomes for foster families and children. Trial registration ClinicalTrials.gov NCT05196724. Registered on January 19, 2022

Additional file 1: of The effectiveness of the Incredible Years™ Parents and Babies Program as a universal prevention intervention for parents of infants in Denmark: study protocol for a pilot randomized controlled trial

Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) checklist. (PDF 57 kb

Psychometric properties of the Danish Parental Stress Scale: Rasch analysis in a sample of mothers with infants.

The Parental Stress Scale (PSS) was developed as a short measure of perceived stress resulting from being a parent. The current study examined the psychometric properties of the Danish version in a sample of 1110 mothers of children aged 0 to 12 months using Rasch models. Emphasis was placed on the issues of uni-dimensionality and absence of differential item functioning relative to the age and educational level of the mothers. Results showed that no adequate fit could be established for the full PSS scale with 18 dichotomized items. Further analyses showed that items 2 and 11 had to be eliminated from the scale, and that the remaining items did not make up a unidimensional PSS scale, but two subscales measuring different aspect of parental stress: a 9-item scale measuring parental stress and a 7-item scale measuring lack of parental satisfaction. Fit to the Rasch model could not be established for any of the two subscales. For the parental stress subscale, we found evidence of local dependence for four item pairs (3 and 4, 9 and 10, 10 and 16, 12 and 16), as well as evidence of two items functioning differentially: item 16 relative to level of education, and item 3 relative to both age and educational level. For the lack of parental satisfaction subscale, we found evidence of local dependence between some two pairs (1 and 17, 17 and 18), but no evidence of differential item functioning. Both subscales fit graphical loglinear Rasch models adjusting for local dependence and differential item functioning. Plotting the adjusted subscale scores against one another showed that the two-scale solution provides additional information, as some mothers are stressed but not lacking in parental satisfaction