[Pupil-focused] Child Health Utilities - 9 dimensions (CHU9D)
CHU9D is a self-rated health assessment and will be used in cost-effectiveness analysis. The instrument covers nine dimensions (worried, sad, pain, tired, annoyed, schoolwork/homework, sleep, daily routine, and activities) with the related statements corresponding to five levels of severity of impairment in each dimension ranging from no impairment at to absolute impairment.
[Pupil-focused] KIDSCREEN-10
KIDSCREEN-10 is a 10-items questionnaire for assessing children and adolescents health and well-being.The scores range between 10 and 50 with a higher score indicating higher level of health and well-being.
[Pupil-focused, administered by the teacher] Strengths and Difficulties Questionnaire (SDQ) [the 5-items dysregulation profile]
SDQ is an assessment of children and adolescents' psychiatric health. The 5-item dysregulation profile is the selection of the items that have strongest association with cognitive, behavioral and affective difficulties. The scale will be administered by the class teacher who will fill out the questionnaire for each pupil individually. Each item is represented by a question with 3 response alternatives from "Don't agree" to "Fully agree" and the questionnaire is scored in accordance to a standardazed algorithm.
[Pupil-focused, administered by the teacher] Strengths and Difficulties Questionnaire (SDQ) [the 15-items dysregulation profile]
SDQ is an assessment of children and adolescents' psychiatric health. The 15-item dysregulation profile is the selection of the items that have a strong association with cognitive, behavioral and affective difficulties. The scale will be administered by the class teacher who will fill out the questionnaire for each pupil individually. Each item is represented by a question with 3 response alternatives from "Don't agree" to "Fully agree" and the questionnaire is scored in accordance to a standardazed algorithm.
[Pupil-focused] School absence
School absence measured in hours as reported by the school.
[Pupil-focused] The parents' need to stay home from work in order to take care of a sick child
The total of hours of staying at home for care of a sick child as reported by Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA) held by Statistics Sweden.
[Pupil-focused] Number of primary health contacts
Total number of health-care contacts as reported by regional primary health care databases in regions where such databases exist, for example Stockholm Regional Health Care Data Warehouse (VAL), Skåne Healtcare Register (SHR) and Region Västra Götaland VEGA database. Specialist health care consumption will be analyzed using data from the National Patient Register held by the National Board for Health and Welfare.
[Pupil-focused] Neurodevelopmental diagnoses
Total number of neurodevelopmental diagnoses confirmed by health care providers during the study's measurement periods as reported by the National Patient Register held by the National Board for Health and Welfare.
[Pupil-focused] Heidelberger-Rechen Test 4 dimensions (HRT-4)
HRT-4 measures math skills by providing math tasks and is scored by counting the correct answers.
[Pupil-focused] LegiLexi
LegiLexi measures Swedish language skills by providing tasks in the Swedish language and is scored by counting the correctly solved tasks.
[Teacher-focused] Teacher Stress Inventory (TSI) (a 12 items subscale).
TSI is a self assessment instrument measuring work-related stress in teachers. Following subscales will be used in the current trial: Discipline and motivation, Behavioral Manifestations, Work-related stressor (16 items in total). The total score of the combination of the used subscales ranges between 16 and 80 with higher scores indicating more severe work-related stress in teachers.
[Teacher-focused] The 7-item Stress subscale from the Depression, Anxiety ans Stress Scale (DASS)
The 7-item Stress subscale of the DASS-questionnaire consists of seven statements about general stress during the past week with four response alternatives for each statement ranging between "Did not apply to me at all" and "Applied to me very much or most of the time" and scored from 0 to 3 respectively. The total score ranges between 0 and 21 and higher score indicates more severe stress symptoms.
[Teacher-focused] Single Item Stress
Single Item Stress is the question "How stressful is your job" scored on a 10-points Likert scale from Not at all stressful to Very stressful with a higher score indicating higher levels of stress.
[Teacher-focused] Self-Rated Health-1
The question "In general, would you say that your health is excellent, very good, good, fair, or poor?" where the different answers are treated as an ordinal scale.
[Teacher-focused] Insomnia Severity Index (ISI)
ISI is a self-rated instrument screening for symptoms of insomnia. It consists of 7 items with 5-step response scale scored between 0-4. The total score ranges from 0-28 with higher scores indicating more severe insomnia symptoms.
[Teacher-focused] General Health Questionnaire - 12 items (GHQ-12)
GHQ-12 is a self-rated instrument screening for general symptoms of mental illness. It consists of 12 items with 4-step response scale scored between 0-3. The total score ranges from 0-36 with higher scores indicating more severe symptoms of mental disorders.
[Teacher-focused] Treatment Inventory for Costs in Psychiatric Patients (TIC-P)
TIC-P is constructed to measure self-rated health care consumption, primarily for heath-economic evaluations. The scale is adapted for the specific study and is scored according to a specific algorithm.
[Teacher-focused] Copenhagen Psychosocial Questionnaire Version III (COPSOQ-III)
COPSOQ-III is a questionnaire the measures core aspects of organizational and social work environment. The subscales Meaning of Work, Work Life Conflict, Self Rated Health, Quality of Work, Work Engagement, Emotional Demands, Quantitative Demands will be used in the current project. The subscales are scored individually and the score for each subscale can range between 0-100, with higher score indicating more severe problems in the work environment.
[Teacher-focused] Eighteen items from The Teaching and Learning International Survey (TALIS)
The 18 selected items focus on the attitude to the profession and include statements where the respondents need to indicate how much they agree with the statement using a four-step likert scale (from not at all agree to fully agree). In Sweden the results are usually presented item by item and not composed to a full scale score.
[Teacher-focused] Work Ability Score-1
The Work Ability score (WAS) is a single-item self-assessment of the current ability compared to the lifetime best. It ranges from 0 to 10, namely: poor (0-5 points), moderate (6, 7), good (8, 9), excellent (10).
[Teacher-focused] Teacher Self-Efficacy Scale (TSES)
The four items focus on the teachers' self-efficacy and include statements where the respondents need to indicate how much they agree with the statement using a four-step likert scale (from not at all agree to fully agree). The responses are scored from 0 to 3 and a higher score indicates higher self-efficacy.
[Teacher-focused] Additional questions on the teachers' attitudes towards the profession and their inclination to continue working as teachers
A sample of questions differing in format and not composing a scale focusing on the teachers attitudes towards the profession and their inclination to continue working as teachers
[Teacher-focused] Data on short-term sick-leaves
Data on short-term sick-leaves for the involved teachers will be collected from the schools.
[Teacher-focused] Health care consumption
Primary health care consumption for the participating teachers consist of number of days on sick leave, prescriptive and bought medications, and numbers, length, and types of visits in primary care and specialized care.
Data will be collected from Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA) held by Statistics Sweden, data from the Swedish Social Insurance Agency and regional primary health care databases in regions where such databases exist, for example Stockholm Regional Health Care Data Warehouse (VAL), Skåne Healtcare Register (SHR) and Region Västra Götaland VEGA database. Specialist health care consumption will be analyzed using data from the National Patient Register held by National Board for Health and Welfare.
[Teacher-focused] Consumption of prescription drugs
Consumption of prescription drugs will be analyzed using data from the Register over Prescription Drugs by the National Board for Health and Welfare.
[Classroom-focused] Noise-levels in the classroom
During one week connected to the fixed measurement occasions, data on noise levels will be collected in each classroom. The noise levels will be assessed by a measuring device that will be placed in the classroom without disturbing classroom environment. The device will measure and store very short snippets of sound with random intervals of on average three seconds, making it impossible to identify source and content of the sound activity (e. g. hear a conversation) but being enough to calculate the decibel level at different ranges of frequency.
[Classroom-focused] Frequency of disruptive behaviors, positive/negative interactions and time for transition from one task to another occurring in the classroom during an observation by a research assistant.
Classroom-observations by a trained observer will be conducted during two or three lessons during the same or conceding days, for a minimum time of 20 minutes for each class according to a standardized observational schedule. Actual frequencies of disruptive behaviors, transition times and positive/negative interactions between the teacher and the pupil in the classroom, unrelated to the person performing the behavior, will be counted and measures.
[Teacher-focused] Stress, demands and influence - 4 items
Four questions on Stress, demands and influence selected from a survey conducted by the Swedish Work Environment Authority. The items are collected in order to compare the study population to the population of the the authority's survey.
[Implementation measure] The Normalisation MeAsure Development questionnaire - Swedish version (S-NOMAD)
The Normalisation MeAsure Development questionnaire (NoMAD) is a set of 23 survey items for assessing implementation processes from the perspective of professionals directly involved in the work of implementing complex interventions in healthcare.
[Implementation measure] Teachers' fidelity to the intervention - observer-rated
The observer-rated intervention fidelity will be rated during classroom work using an instrument covering the quality of use of each PAX- tool, with several items addressing the same tool. Each item can be scored between 0 and 2 with a higher score indicating higher quality of the implementation. The total number of items is 71. The observation is conducted by the supervisor.
[Implementation measure] Teachers' fidelity to the intervention - self-rated
The self-rated teacher intervention fidelity will address the week preceding the measurement point using an instrument covering the quality of use of each PAX- tool, with several items addressing the same tool. Each item can be scored between 0 and 2 with a higher score indicating higher quality of the implementation. The total number of items is 71.
[Implementation measure] Pupils' attitudes towards and acceptability of the method
Pupils' attitudes towards and acceptability of the method will be measured by a set of questions about the the pupils's general attitude to PAX- or the control intervention specific phenomena mixed with questions on the attitudes towards other school-specific phenomena (like school lunch, gym lessons, breaks etc) for a reference.
[Implementation measure] The rate of use of PAX-tools: teacher self-rated
Eight yes/no questions on the use of PAX-tools during the period a research assistant observe the classroom, but rated by the teacher after the observed class.
[Implementation measure] The rate of use of PAX-tools: observer-rated
Eight yes/no questions on the use of PAX-tools during the classroom observation conducted by a research assistant. (The questions are answered by the research assistants after the observed class.)
[Implementation measure] Six questions on the use of the PAX-game (only intervention arm): teacher-rated
Six questions on the extend of the use of PAX-game during the two weeks prior to the measurement point.
[Implementation measure] Six questions on the use of Count on Me! (only Count on Me!-arm): teacher-rated
Three questions on the extend of the use of Count on Me! during the two weeks prior to the measurement point.
[Implementation measure] Social validity of PAX/control: teacher-rated
Nine questions on perceived consequences of using PAX/control in the classroom with 7-steps likert-scale response alternatives.
[Implementation measure] Positive and negative effects of PAX/control: teacher-rated
Four open-ended questions on positive and negative effects of PAX/control on teachers and pupils.
[Implementation measure] Social validity of PAX/control: pupil-rated
18 questions (5 in the control arm) on the pupil's attitude towards PAX/control and other school-related activities for comparison with 5-steps likert-scale response alternatives.
[Implementation measure] Social validity of PAX/control: pupil-focused teacher-rated
18 questions (5 in the Count on Me!-arm) on the pupil's attitude towards PAX/control and other school-related activities for comparison rated by the teacher with 5-steps likert-scale response alternatives.
[Negative effects] Questions on negative effects of PAX/control: teacher-reported
Seven questions (six in the case of control group) on the number of occurrences of different adverse effects (e g "How many times a group of pupils having lost a PAX-game was teased by other pupils?")
[Implementation measure] Training assessment (PAX/control): teacher-rated
A number of questions not collected into a scale about the teachers' perception of PAX/control training as well as their possible worries about the implementation before the implementation as well as their perception of the results of the implementation after the implementation is completed.