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Published in: BMC Public Health 1/2023

Open Access 01-12-2023 | Study Protocol

Partnering for change (P4C) in Sweden- a study protocol of a collaborative school-based service delivery model to create inclusive learning environments

Authors: Vedrana B. Baric, Moa Yngve, Marie Holmefur, Inna Feldman, Jenny Wilder, Kine Johansen, Nina Klang, Helene Lidström, Maria Borgestig

Published in: BMC Public Health | Issue 1/2023

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Abstract

Background

Inclusive learning environments are considered as crucial for children’s engagement with learning and participation in school. Partnering for change (P4C) is a collaborative school-based service delivery model where services are provided at three levels of intensity based on children’s needs (class, group-, individual interventions). Interventions in P4C are provided universally to support all children with learning, not only children with special education needs (SEN), and as such are expected to be health-promoting.

Aim

The aim of the study is to evaluate the effectiveness and cost-effectiveness of P4C as well as school staff members’ and children’s experiences after P4C.

Methods

In a parallel, non-randomised controlled intervention design, 400 children, aged 6–12 years, and their teachers, will be recruited to either intervention classes, working according to the P4C, or to control classes (allocation ratio 1:1). Data will be collected at baseline, post-intervention (4 months), and 11 months follow-up post baseline. The primary outcome is children’s engagement with learning in school. Secondary outcomes include for example children’s health-related quality of life and wellbeing, occupational performance in school, attendance, and special educational needs. The difference-in-differences method using regression modelling will be applied to evaluate any potential changes following P4C. Focus group interviews focusing on children, and professionals’ experiences will be performed after P4C. A health economic evaluation of P4C will be performed, both in the short term (post intervention) and the long term (11-month follow-up). This study will provide knowledge about the effectiveness of P4C on children’s engagement with learning, mental health, and wellbeing, when creating inclusive learning environments using a combination of class-, group- and individual-level interventions.

Trial registration number

NCT05435937.
Appendix
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Literature
1.
go back to reference Imms C, Granlund M, Wilson PH, Steenbergen B, Rosenbaum PL, Gordon AM. Participation, both a means and an end: a conceptual analysis of processes and outcomes in childhood disability. Dev Med Child Neurol. 2017;59(1):16–25. PubMedCrossRef Imms C, Granlund M, Wilson PH, Steenbergen B, Rosenbaum PL, Gordon AM. Participation, both a means and an end: a conceptual analysis of processes and outcomes in childhood disability. Dev Med Child Neurol. 2017;59(1):16–25. PubMedCrossRef
2.
go back to reference Reschly AL, Christenson SL, editors. Handbook of research on student engagement. 2nd ed. London: Springer New York Dordrecht Heidelberg; 2022. Reschly AL, Christenson SL, editors. Handbook of research on student engagement. 2nd ed. London: Springer New York Dordrecht Heidelberg; 2022.
3.
go back to reference Fredricks JA, Blumenfeld PC, Paris AH. School engagement: potential of the concept, State of the evidence. Rev Educ Res. 2004;74(1):59–109.CrossRef Fredricks JA, Blumenfeld PC, Paris AH. School engagement: potential of the concept, State of the evidence. Rev Educ Res. 2004;74(1):59–109.CrossRef
4.
go back to reference Ritoša A, Danielsson H, Sjöman M, Almqvist L, Granlund M. Assessing school engagement: adaptation and validation of “engagement versus disaffection with learning: teacher report” in the swedish educational context. Front Educ. 2020;5:521972.CrossRef Ritoša A, Danielsson H, Sjöman M, Almqvist L, Granlund M. Assessing school engagement: adaptation and validation of “engagement versus disaffection with learning: teacher report” in the swedish educational context. Front Educ. 2020;5:521972.CrossRef
5.
go back to reference Tam KI, Philpott-Robinson K, Johnson T, Lane AE. Measurement of school engagement in elementary school students: a scoping review. Am J Occup Ther. 2023;77(3):1–13.CrossRef Tam KI, Philpott-Robinson K, Johnson T, Lane AE. Measurement of school engagement in elementary school students: a scoping review. Am J Occup Ther. 2023;77(3):1–13.CrossRef
6.
go back to reference World Health Organization. Comprehensive mental health action plan 2013–2030. Geneva: World Health Organization; 2021. World Health Organization. Comprehensive mental health action plan 2013–2030. Geneva: World Health Organization; 2021.
7.
go back to reference Asherson P. Boys with ADHD are at increased risk of psychosocial, educational and functional impairment in adulthood. Evid Based Ment Health. 2013;16(1):5.PubMedCrossRef Asherson P. Boys with ADHD are at increased risk of psychosocial, educational and functional impairment in adulthood. Evid Based Ment Health. 2013;16(1):5.PubMedCrossRef
8.
go back to reference Vantieghem W, Van Houtte M. Differences in study motivation within and between genders: an examination by gender typicality among early adolescents. Youth Soc. 2018;50(3):377–304.CrossRef Vantieghem W, Van Houtte M. Differences in study motivation within and between genders: an examination by gender typicality among early adolescents. Youth Soc. 2018;50(3):377–304.CrossRef
9.
go back to reference Hung AH, Luebbe AM, Flaspohler PD. Measuring school climate: factor analysis and relations to emotional problems, Conduct problems and victimization in middle school pupils. School Ment Health. 2015;7:105–19.CrossRef Hung AH, Luebbe AM, Flaspohler PD. Measuring school climate: factor analysis and relations to emotional problems, Conduct problems and victimization in middle school pupils. School Ment Health. 2015;7:105–19.CrossRef
10.
go back to reference Nygren K, Bergström E, Janlert U, Nygren L. Adolescent self-reported health in relation to school factors: a Multilevel Analysis. J Sch Nurs. 2014;30(2):114–22.PubMedCrossRef Nygren K, Bergström E, Janlert U, Nygren L. Adolescent self-reported health in relation to school factors: a Multilevel Analysis. J Sch Nurs. 2014;30(2):114–22.PubMedCrossRef
11.
go back to reference O’Donnell KC, Reschly AL. Student engagement and learning: attention, behavioral, and emotional difficulties in school. In: Handbook of educational psychology and students with special needs. 1st ed. New York: Routledge/Taylor & Francis Group; 2020. p. 557–83.CrossRef O’Donnell KC, Reschly AL. Student engagement and learning: attention, behavioral, and emotional difficulties in school. In: Handbook of educational psychology and students with special needs. 1st ed. New York: Routledge/Taylor & Francis Group; 2020. p. 557–83.CrossRef
12.
go back to reference Scott S, Knapp M, Henderson J, Maughan B. Financial cost of social exclusion: follow up study of antisocial children into adulthood. BMJ. 2001;28(323):191.CrossRef Scott S, Knapp M, Henderson J, Maughan B. Financial cost of social exclusion: follow up study of antisocial children into adulthood. BMJ. 2001;28(323):191.CrossRef
13.
go back to reference Havik T, Bru E, Ertesvåg S. Assessing reasons for school non-attendance. Scand J Educ Res. 2015;59(3):316–36.CrossRef Havik T, Bru E, Ertesvåg S. Assessing reasons for school non-attendance. Scand J Educ Res. 2015;59(3):316–36.CrossRef
14.
go back to reference Malmqvist J. Inkludering—en internationell utblick med några nedslag. Stockholm: Skolverket; 2017. Malmqvist J. Inkludering—en internationell utblick med några nedslag. Stockholm: Skolverket; 2017.
15.
go back to reference Morgenthaler T, Kramer-Roy D, Schulze C. Environmental adjustment needs of children with special educational needs in Austrian mainstream schools: the child and teacher perspective. J Occup Ther Sch Early Interv. 2022;16(2):138–59.CrossRef Morgenthaler T, Kramer-Roy D, Schulze C. Environmental adjustment needs of children with special educational needs in Austrian mainstream schools: the child and teacher perspective. J Occup Ther Sch Early Interv. 2022;16(2):138–59.CrossRef
16.
go back to reference Korinek L. Supporting students with mental health challenges in the classroom. Prev Sch Fail. 2021;65(2):97–107.CrossRef Korinek L. Supporting students with mental health challenges in the classroom. Prev Sch Fail. 2021;65(2):97–107.CrossRef
17.
go back to reference Anaby D, Hand C, Bradley L, DiRezze B, Forhan M, DiGiacomo A, et al. The effect of the environment on participation of children and youth with disabilities: a scoping review. Disabil Rehabil. 2013;35(19):1589–98.PubMedCrossRef Anaby D, Hand C, Bradley L, DiRezze B, Forhan M, DiGiacomo A, et al. The effect of the environment on participation of children and youth with disabilities: a scoping review. Disabil Rehabil. 2013;35(19):1589–98.PubMedCrossRef
18.
go back to reference Agrawal J. International policies, identification, and services for students with learning disabilities: an exploration across 10 countries. Learn Disabilities Contemp J. 2019;17(1):95–114. Agrawal J. International policies, identification, and services for students with learning disabilities: an exploration across 10 countries. Learn Disabilities Contemp J. 2019;17(1):95–114.
19.
go back to reference Childs-Fegredo J, Burn AM, Duschinsky R, Humphrey A, Ford T, Jones PB, et al. Acceptability and feasibility of early identification of mental health difficulties in primary schools: a qualitative exploration of UK school staff and parents’ perceptions. School Ment Health. 2021;13(1):143–59.CrossRef Childs-Fegredo J, Burn AM, Duschinsky R, Humphrey A, Ford T, Jones PB, et al. Acceptability and feasibility of early identification of mental health difficulties in primary schools: a qualitative exploration of UK school staff and parents’ perceptions. School Ment Health. 2021;13(1):143–59.CrossRef
20.
go back to reference Camden C, Campbell W, Missiuna C, Berbari J, Héguy L, Gauvin C, et al. Implementing partnering for change in Québec: occupational therapy activities and stakeholders’ perceptions. Can J Occup Ther. 2021;88(1):71–82.PubMedCrossRef Camden C, Campbell W, Missiuna C, Berbari J, Héguy L, Gauvin C, et al. Implementing partnering for change in Québec: occupational therapy activities and stakeholders’ perceptions. Can J Occup Ther. 2021;88(1):71–82.PubMedCrossRef
21.
go back to reference Missiuna C, Pollock N, Campbell W, DeCola C, Hecimovich C, Sahagian Whalen S, et al. Using an innovative model of service delivery to identify children who are struggling in school. Br J Occup. 2017;80(3):145–54.CrossRef Missiuna C, Pollock N, Campbell W, DeCola C, Hecimovich C, Sahagian Whalen S, et al. Using an innovative model of service delivery to identify children who are struggling in school. Br J Occup. 2017;80(3):145–54.CrossRef
22.
go back to reference Missiuna C, Pollock N, Campbell WN, Bennett S, Hecimovich C, Gaines R, et al. Use of the Medical Research Council Framework to develop a complex intervention in pediatric occupational therapy: assessing feasibility. Res Dev Disabil. 2012;33(5):1443–52.PubMedCrossRef Missiuna C, Pollock N, Campbell WN, Bennett S, Hecimovich C, Gaines R, et al. Use of the Medical Research Council Framework to develop a complex intervention in pediatric occupational therapy: assessing feasibility. Res Dev Disabil. 2012;33(5):1443–52.PubMedCrossRef
24.
go back to reference Piškur B, Takala M, Berge A, Eek-Karlsson L, Ólafsdóttir SM, Meuser S. Belonging and participation as portrayed in the curriculum guidelines of five European countries. J Curric Stud. 2022;54(3):351–66.CrossRef Piškur B, Takala M, Berge A, Eek-Karlsson L, Ólafsdóttir SM, Meuser S. Belonging and participation as portrayed in the curriculum guidelines of five European countries. J Curric Stud. 2022;54(3):351–66.CrossRef
25.
go back to reference Meuser S, Piskur B, Hennissen P, Dolmans D. Targeting the school environment to enable participation: a scoping review. Scand J Occup. 2023;30(3):298–210.CrossRef Meuser S, Piskur B, Hennissen P, Dolmans D. Targeting the school environment to enable participation: a scoping review. Scand J Occup. 2023;30(3):298–210.CrossRef
26.
go back to reference VanderKaay S, Dix L, Rivard L, Missiuna C, Ng S, Pollock N, et al. Tiered approaches to rehabilitation services in education settings: towards developing an explanatory programme theory. Int J Disabil Dev Educ. 2023;70(4):540–61.CrossRef VanderKaay S, Dix L, Rivard L, Missiuna C, Ng S, Pollock N, et al. Tiered approaches to rehabilitation services in education settings: towards developing an explanatory programme theory. Int J Disabil Dev Educ. 2023;70(4):540–61.CrossRef
27.
go back to reference Missiuna C. Partnering for change: embedding universal design into school-based occupational therapy. Occup Ther Now. 2015;17:13–5. Missiuna C. Partnering for change: embedding universal design into school-based occupational therapy. Occup Ther Now. 2015;17:13–5.
28.
go back to reference Kennedy JN, Missiuna CA, Pollock NA, Sahagian Whalen S, Dix L, Campbell WN. Making connections between school and home: exploring therapists’ perceptions of their relationships with families in partnering for change. Br J Occup. 2020;83(2):98–106.CrossRef Kennedy JN, Missiuna CA, Pollock NA, Sahagian Whalen S, Dix L, Campbell WN. Making connections between school and home: exploring therapists’ perceptions of their relationships with families in partnering for change. Br J Occup. 2020;83(2):98–106.CrossRef
29.
go back to reference Pollock NA, Dix L, Whalen SS, Campbell WN, Missiuna CA. Supporting occupational therapists implementing a capacity-building model in schools: Appuyer les ergothérapeutes mettant en œuvre un modèle de renforcement des capacités dans les écoles. Can J Occup Ther. 2017;84(4–5):242–52.PubMedCrossRef Pollock NA, Dix L, Whalen SS, Campbell WN, Missiuna CA. Supporting occupational therapists implementing a capacity-building model in schools: Appuyer les ergothérapeutes mettant en œuvre un modèle de renforcement des capacités dans les écoles. Can J Occup Ther. 2017;84(4–5):242–52.PubMedCrossRef
30.
go back to reference Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.PubMedPubMedCentralCrossRef Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.PubMedPubMedCentralCrossRef
31.
go back to reference Campbell W, Kennedy J, Pollock N, Missiuna C. Screening children through response to intervention and dynamic performance analysis: the example of partnering for change. Curr Dev Disord Rep. 2016;3(3):200–5.CrossRef Campbell W, Kennedy J, Pollock N, Missiuna C. Screening children through response to intervention and dynamic performance analysis: the example of partnering for change. Curr Dev Disord Rep. 2016;3(3):200–5.CrossRef
33.
go back to reference Skinner EA, Kindermann TA, Furrer CJ. A motivational perspective on engagement and disaffection: conceptualization and assessment of children’s behavioral and emotional participation in academic activities in the classroom. Educ Psychol Meas. 2009;69(3):493–425.CrossRef Skinner EA, Kindermann TA, Furrer CJ. A motivational perspective on engagement and disaffection: conceptualization and assessment of children’s behavioral and emotional participation in academic activities in the classroom. Educ Psychol Meas. 2009;69(3):493–425.CrossRef
34.
go back to reference Ritoša A. Validation of the school engagement questionnaire engagement versus disaffection with learning: teacher report in Swedish 6th graders. Psychoeduc Assess. 2022;40(4):549–58.CrossRef Ritoša A. Validation of the school engagement questionnaire engagement versus disaffection with learning: teacher report in Swedish 6th graders. Psychoeduc Assess. 2022;40(4):549–58.CrossRef
35.
go back to reference Stevens K. Developing a descriptive system for a new preference-based measure of health-related quality of life for children. Qual Life Res. 2009;18(8):1105–13.PubMedCrossRef Stevens K. Developing a descriptive system for a new preference-based measure of health-related quality of life for children. Qual Life Res. 2009;18(8):1105–13.PubMedCrossRef
36.
go back to reference Ratcliffe J, Huynh E, Chen G, Stevens K, Swait J, Brazier J, et al. Valuing the Child Health Utility 9D: using profile case best worst scaling methods to develop a new adolescent specific scoring algorithm. Soc Sci Med. 2016;157:48–59.PubMedCrossRef Ratcliffe J, Huynh E, Chen G, Stevens K, Swait J, Brazier J, et al. Valuing the Child Health Utility 9D: using profile case best worst scaling methods to develop a new adolescent specific scoring algorithm. Soc Sci Med. 2016;157:48–59.PubMedCrossRef
38.
go back to reference Furber G, Segal L. The validity of the Child Health Utility instrument (CHU9D) as a routine outcome measure for use in child and adolescent mental health services. Health Qual Life Outcomes. 2015;18(13):22CrossRef Furber G, Segal L. The validity of the Child Health Utility instrument (CHU9D) as a routine outcome measure for use in child and adolescent mental health services. Health Qual Life Outcomes. 2015;18(13):22CrossRef
39.
40.
go back to reference Lindvall K, Vaezghasemi M, Feldman I, Ivarsson A, Stevens KJ, Petersen S. Feasibility, reliability and validity of the health-related quality of life instrument child Health Utility 9D (CHU9D) among school-aged children and adolescents in Sweden. Health Qual Life Outcomes. 2021;19(1):193.PubMedPubMedCentralCrossRef Lindvall K, Vaezghasemi M, Feldman I, Ivarsson A, Stevens KJ, Petersen S. Feasibility, reliability and validity of the health-related quality of life instrument child Health Utility 9D (CHU9D) among school-aged children and adolescents in Sweden. Health Qual Life Outcomes. 2021;19(1):193.PubMedPubMedCentralCrossRef
41.
go back to reference Allen K, Edwards V, Hayes R, Price A, Parker C, Rodgers L, et al. “How I feel about my School”: the construction and validation of a measure of wellbeing at school for primary school children. Clin Child Psychol Psychiatry. 2018;23(1):25–41.CrossRef Allen K, Edwards V, Hayes R, Price A, Parker C, Rodgers L, et al. “How I feel about my School”: the construction and validation of a measure of wellbeing at school for primary school children. Clin Child Psychol Psychiatry. 2018;23(1):25–41.CrossRef
42.
go back to reference Riad R, Allodi MW, Siljehag E, Wikman C, Ford T, Bolte S, How I. Feel about my school-adaptation and validation of an educational well-being measure among young children in Sweden. Int J Environ Res Public Health. 2021;18(10):1–14.CrossRef Riad R, Allodi MW, Siljehag E, Wikman C, Ford T, Bolte S, How I. Feel about my school-adaptation and validation of an educational well-being measure among young children in Sweden. Int J Environ Res Public Health. 2021;18(10):1–14.CrossRef
43.
go back to reference Hemmingsson H, Kottorp A, Bernspång B. Validity of the School setting interview: an assessment of the student-environment fit. Scand J Occup. 2004;11(4):171–8.CrossRef Hemmingsson H, Kottorp A, Bernspång B. Validity of the School setting interview: an assessment of the student-environment fit. Scand J Occup. 2004;11(4):171–8.CrossRef
44.
go back to reference Yngve M, Munkholm M, Lidström H, Hemmingsson H, Ekbladh E. Validity of the school setting interview for students with special educational needs in regular high school—A Rasch analysis. Health Qual Life Outcomes. 2018;16(12):1–10. Yngve M, Munkholm M, Lidström H, Hemmingsson H, Ekbladh E. Validity of the school setting interview for students with special educational needs in regular high school—A Rasch analysis. Health Qual Life Outcomes. 2018;16(12):1–10.
45.
go back to reference White H, Sabarwal S. Quasi-experimental Design and Methods, Methodological Briefs: Impact Evaluation 8. Florence: UNICEF Office of Research; 2014. White H, Sabarwal S. Quasi-experimental Design and Methods, Methodological Briefs: Impact Evaluation 8. Florence: UNICEF Office of Research; 2014.
46.
go back to reference Jakobsen JC, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials - a practical guide with flowcharts. BMC Med Res Methodol. 2017;17(1):162.PubMedPubMedCentralCrossRef Jakobsen JC, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials - a practical guide with flowcharts. BMC Med Res Methodol. 2017;17(1):162.PubMedPubMedCentralCrossRef
47.
go back to reference Matthews JNS, Altman DG, Campbell MJ, Royston P. Analysis of serial measurements in medical research. BMJ. 1990;27(300):230–5.CrossRef Matthews JNS, Altman DG, Campbell MJ, Royston P. Analysis of serial measurements in medical research. BMJ. 1990;27(300):230–5.CrossRef
48.
go back to reference Barber J, Thompson S. Multiple regression of cost data: use of generalised linear models. J Health Serv Res Policy. 2004;9(4):197–204.PubMedCrossRef Barber J, Thompson S. Multiple regression of cost data: use of generalised linear models. J Health Serv Res Policy. 2004;9(4):197–204.PubMedCrossRef
49.
go back to reference Fenwick E, Sculpher M, Claxton K. Representing uncertainty: the role of cost-effectiveness acceptability curves. Health Econ. 2001;10(8):779–87.PubMedCrossRef Fenwick E, Sculpher M, Claxton K. Representing uncertainty: the role of cost-effectiveness acceptability curves. Health Econ. 2001;10(8):779–87.PubMedCrossRef
50.
go back to reference Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.PubMedCrossRef Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.PubMedCrossRef
51.
go back to reference Carroll C, Hurry J. Supporting pupils in school with social, emotional and mental health needs: a scoping review of the literature. Emot Behav Diffic. 2018;23(3):310–25.CrossRef Carroll C, Hurry J. Supporting pupils in school with social, emotional and mental health needs: a scoping review of the literature. Emot Behav Diffic. 2018;23(3):310–25.CrossRef
52.
go back to reference Friedman ZL, Hubbard K, Seruya F. Building better teams: impact of education and coaching intervention on interprofessional collaboration between teachers and occupational therapists in Schools. J Occup Ther Sch Early Interv. 2023;16(2):173–93.CrossRef Friedman ZL, Hubbard K, Seruya F. Building better teams: impact of education and coaching intervention on interprofessional collaboration between teachers and occupational therapists in Schools. J Occup Ther Sch Early Interv. 2023;16(2):173–93.CrossRef
53.
go back to reference Frolek Clark G, Polichino J. School occupational therapy: staying focused on participation and educational performance. J Occup Ther Sch Early Interv. 2023;14(1):19–26.CrossRef Frolek Clark G, Polichino J. School occupational therapy: staying focused on participation and educational performance. J Occup Ther Sch Early Interv. 2023;14(1):19–26.CrossRef
Metadata
Title
Partnering for change (P4C) in Sweden- a study protocol of a collaborative school-based service delivery model to create inclusive learning environments
Authors
Vedrana B. Baric
Moa Yngve
Marie Holmefur
Inna Feldman
Jenny Wilder
Kine Johansen
Nina Klang
Helene Lidström
Maria Borgestig
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-17053-0

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