1. Programme Information Incredible Years (IY)Triple P (TP) – Level 4 GroupPromoting Alternative Thinking Strategies (PATHS) IY consists of 12 weekly (2-hour) sessions involving facilitator-led group discussion, videotape modelling and rehearsal of intervention techniques with groups of 12 parents. The objective is to enhance positive relationships between parent and child and to help parents encourage more appropriate social behaviours in their children. This 8-session (2-hour) programme for groups of 12 parents incorporates active skills training methods including modelling, rehearsal, self-evaluation, and homework tasks, and are designed to enhance the knowledge, skills and confidence of parents who have children with behavior problems, or who are at risk of developing behaviour problems. The PATHS curriculum is a programme for teachers that is designed to facilitate the development of self-control, emotional awareness, and interpersonal problem-solving skills amongst primary school children. The curriculum comprises three sessions per week each lasting 20 to 30 minutes. The need to implement and evaluate Incredible Years, Triple P and PATHS in Birmingham The decision to implement these three evidence based programmes in Birmingham was made in the context of developing the Brighter Futures Strategy for children’s services in the city. Brighter futures is a five year strategy that aims to measurably improve children’s outcomes by investing its resources in the prevention and early intervention of problems emerging in children’s lives. A study in Birmingham in 2007 involving 500 parents of children aged 0-6 found a significantly greater proportion of children between the age of five and six were likely to meet a clinical diagnosis for a conduct disorder (20%) compared to 7% in the UK as a whole (based on parent report using the Strengths and Difficulties Questionnaire - SDQ). A parallel study, involving over 10,000 young people aged 7-18, and using the SDQ self-report measure, found that a significantly greater number of children aged 11-15 in Birmingham were likely to meet a clinical diagnosis for a conduct disorder (21%) compared to the UK as a whole (11%). In addition to elevated levels of conduct problems across the city, these studies also identified several other potential targets for intervention including children’s emotional health and social literacy. Birmingham City Council has commissioned the Social Research Unit to design and implement RCTs of these programmes with the primary purpose of determining the effectiveness of the programmes in achieving their stated objectives (and past positive outcomes) and to assess whether they represent good investment of Birmingham’s public funds. Despite strong research evidence confirming the effectiveness of these programmes elsewhere, RCT methods have been selected here because of the uniqueness of the Birmingham context (very high levels of ethnic diversity and a large proportion of residents whose first language is not English), in addition neither Triple P nor PATHS have been rigorously evaluated in the UK before. Overview of research design Research Questions: (1)Do the programmes meet the needs and improve outcomes for children and families who participate? (2)Are the programmes implemented efficiently and effectively with fidelity? (3)Do the programmes offer value for money and net benefit to the Council, Government, society, children and families? The trial started Summer 2009, with end dates during 2011 Results for all three trials will be finalised 2011 NWORTH provide randomisation and statistical support, CEPhI will carry out cost-effectiveness analyses Incredible Years Participants are parents of children aged 3-4 years who rate their child above the clinical cut-off on the SDQ, living in the vicinity of one of nine children’s centres selected for inclusion in the trial. Across the nine participating centres, 162 parents are needed to achieve statistical power of 80%. Randomisation is at a 2:1 ratio, 108 parents will receive the intervention and 54 parents will be allocated to the waiting list control. Data is collected from parents at baseline as well as at 6 and 12 month follow-ups. Outcome measures include parent self-report questionnaires on demographics, parenting behaviour, child behaviour and use of social and health services. Information on programme costs and fidelity are also collected from group leaders. IY is delivered by IY trained Children Centre staff, working towards leader accreditation. Triple P Participants are parents of children aged 4-11 years who rate their child above the clinical cut-off on the SDQ living in the vicinity of one of six extended school clusters selected for inclusion in the trial. Children aged 4-9 will receive the standard Triple P group, children aged 10-11 will receive the teen group. Across the six clusters 288 parents are required to achieve statistical power of 80%. Randomisation is at a ratio of 1:1 - 144 parents will receive Triple P and 144 will be assigned to the waiting list control condition. Data is collected from parents at baseline as well as at 6 and 12 month follow-ups. Outcome measures are the same as for IY. The groups will be facilitated by accredited group leaders from within Birmingham’s Clinical Psychology Service. PATHS Participants are Reception and Year 1 pupils and their teachers in 56 schools across the city. 50 schools (25 in the intervention and 25 in the control group) were required to achieve statistical power. Randomisation was on a 1:1 Baseline data collection was conducted in November 2009, follow-up 1 is due in June 2010 and follow-up 2 in June 2011. Outcome measures include teacher-completed questionnaires on demographics and general school climate as well as on pupil behaviour and emotional well- being. Observations of child behaviour in a subsample of participating schools will be collected at each time point in addition to weekly implementation records from teachers in the intervention condition. The PATHS curriculum is delivered by PATHS trained primary school teachers in their own classrooms.