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Table 3 Table for secondary outcomes in the ECHO study

From: Study protocol of a factorial trial ECHO: optimizing a group-based school intervention for children with emotional problems

Instrument

Description

Beck self-Concept Inventory for Youth (BSCI-Y)

The BSCI-Y [36] is a 20-item 4-point Likert subscale from Beck Youth Inventories—Second Edition (BYI-II). The BSCI-Y subscale measures perceptions about self-competence, potency, and positive self-worth. Reported Cronbach`s alpha for BSCI-Y is .83-.92 [37]

General Self-Efficacy Scale (GSE-6)

The GSE-6 is a short-form of the GSE [38], a psychometric scale designed to assess optimistic self-beliefs to cope with a variety of difficult demands in life. The GSE-6 has shown satisfactory validity and reliability with reported Cronbach’s alpha between .79 and .88 [39]

KIDSCREEN-27

The KIDSCREEN-27 [40] is a 27-item scale used to assess generic health-related quality of life. The scale has five dimensions: Physical Well-Being, Psychological Well-Being, Autonomy & Parents, Peers & Social Support and School Environment. Internal consistency values (Cronbach's alpha) range between .79 (Physical Well-being) and .84 (Psychological Well-being) for the different dimensions for the self-report versions [41]

Revised Child Anxiety and Depression Scale (RCADS C/P)

The RCADS C/P [31] is a 47-item, children self-report questionnaire. Convergent and discriminant validity tests are favorable, and the measure has showed greater correspondence to specific diagnostic syndromes than traditional measures of anxiety and depression [42]

Behavior and Feelings Survey (BFS)

The BFS [27] is a brief, 12-item rating scale designed to facilitate efficient progress-monitoring during youth psychotherapy. Items are rated on a scale from 0 (not a problem) to 4 (a very big problem). Three scale scores can be derived: Internalizing Problems (sum of items 1–6), Externalizing Problems (sum of items 7–12), and Total Problems (sum of items 1–12). Item 1–6 will be used in the MittEcho App

Stigma and Evaluation sheet

The Stigma and Evaluation sheet [43] measures overall user-satisfaction and participants’ experiences of stigmatization. A Norwegian translation of this 10-item instrument with a 10-point scale is used

Idiographic aims

The Idiographic aims are based on a self-report assessment tool for adolescents [44] and have been adjusted for use with children in the ECHO study. The instrument enables the respondents to define their most important aims in the MittEcho App to be addressed during sessions

COVID-19 questions

The COVID-19 questions are 9 self-constructed questions for parents and children measuring the impact of COVID-19, see Additional files 2, 3

Brief problem monitoring –teacher (BPM-T)

The BPM-T is an 18-item version of the Child Behavior Checklist scale (CBCL). The CBCL is a component of the Achenbach System of Empirically Based Assessment (ASEBA, 45). The BPM-T provides a uniform problem scale assessing both behavioral and emotional problems in school with good reliability and construct validity [46]

Teacher’s Report Form (TRF)

Academic performance and school adaptation measures are based on an adapted version of two factors from TRF. The TRF is a component of the ASEBA [45] and is used to investigate problem areas as well as academic achievement and adaptive functioning at school

Performance in the academic subjects

The Performance in the academic subjects Norwegian, English, mathematics, and social studies will be rated by the teacher on a scale from 1 (far below mean) to 5 (far above mean) compared to children of the same age. Based on these ratings a mean score will be calculated representing academic performance. School adaptation is based on evaluations of four elements: how hard the child is working, behavior, learning and how happy the child seems to be compared to children of the same age. The scale ranges from 1 (far below mean) to 5 (far above mean) and a mean score will be calculated

Attitudes towards evidence-based practice (EBP)

Six questions regarding attitudes towards evidence-based interventions will be asked. These questions are previously used in a large Norwegian study, investigating important factors related to cooperation and quality in services for children and their families [47]

Total workload Questionnaire, (TWQ)

The TWQ [48] includes 15 questions regarding autonomy and workload that will be used to assess these important parts of the group leader’s work situation

The Implementation Climate Scale (ICS)

The ICS [49] will be used to assess the implementation context in the participating agencies. The original psychometric properties are good, and the instrument is currently being investigated in a Norwegian context [50]

The Implementation Leadership Scale (ILS)

The ILS [51] will be used to assess to what extent the leaders in the services support and promote implementation of evidence-based interventions. The psychometric properties have shown excellent internal consistency and convergent and divergent validity for the original version

Post-intervention questionnaire (PIE)

The PIE, a self-developed questionnaire (see Additional file 1) regarding experiences and satisfaction with running EMOTION groups. After the groups are finished, the group leaders will be asked to evaluate their experience running the groups, level of supervision, and how satisfied they are in general with the manual and conducting the intervention. Additionally, we will ask more specifically questions regarding the group leader’s experience with the different factors and use of VR technology

Implementation components

From the Measures of Implementation Components [52], we include 43 questions regarding “implementation climate” at post group and one year after finishing the last group to assess how the intervention is integrated into the service

Sustainability

One self-developed question regarding sustainability (“Are your service still running EMOTION groups?”) with a follow-up question on “why/why not” will be included one year after the groups are finished to both group leaders and service leaders

Columbia Impairment Scale (CIS)

The CIS parent version [53] is a 13-item scale assessing general impairment in various functional domains, including relations with family members at home, relations with peers, school functioning, and involvement in general interests and activities. The CIS has shown high internal consistency (a = .89) and test–retest reliability (ICC = 0.89) and strongly correlates with other outcomes, such as mental health service utilization [53, 54]

Parenting to Reduce Child Anxiety and Depression Scale (PaRCADS)

The PaRCADS [55] is a 79-item, 10-subscale instrument developed to assess parenting and 5 of the scales are used in the present study: Rules and consequences for child, Health habits, Managing emotions, Setting goals and dealing with problems, Dealing with negative emotions. Items are scored on a five-point scale (almost never -almost always), or, for hypothetical questions (very unlikely—very likely). The instrument has shown adequate psychometric properties in one study

The General Functioning subscale of the Family Assessment Device (FAD)

The FAD [56] is a 12-item, self-report designed to map families healthy and unhealthy functioning using the General family functioning subscale. Each item is rated on at 4-point scale from strongly agree to strongly disagree. Previous research has shown high validity and test–retest reliability for the scale [57]

Parental Bonding Instrument (PBI)

The PBI [58], is a 16-item scale, answered by parents containing three subscales: warmth, authoritarianism and protection [59]. Psychometric properties of the PBI have been reported in a Norwegian study by Rimehaug and colleagues [60], with alpha coefficients ranging between .76 and .86. Validity has been established in several studies, and the stability of the instrument has been shown to be good

Hopkins Check List (HSCL-10)

The ten-item HSCL-10 has shown good psychometric properties [61]. It has also demonstrated good sensitivity and specificity for detecting psychological symptoms. The HSCL-10 consists of 10 items on a four-point scale ranging from 1 = ‘not at all’ to 4 = ‘extremely’

Cost data

Cost data will be collected regarding direct costs related to material, training, trainer payment, supervision, salary to group leaders for attending training, supervision, conducting sessions, and costs with the technical MFS platform. Costs regarding child use of mental health service, time lost from work for parents will also be estimated