Home » Trials » SLCTR/2019/017


Effectiveness of an intervention package to reduce occupational stress among secondary school teachers in Sinhala medium government schools in the District of Colombo, Sri Lanka – A Cluster Randomized Trial

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SLCTR Registration Number

SLCTR/2019/017


Date of Registration

10 May 2019

The date of last modification

May 13, 2019



Application Summary


Scientific Title of Trial

Effectiveness of an intervention package to reduce occupational stress among secondary school teachers in Sinhala medium government schools in the District of Colombo, Sri Lanka – A Cluster Randomized Trial


Public Title of Trial

Effectiveness of an intervention package to reduce occupational stress among secondary school teachers in Sinhala medium government schools in the District of Colombo, Sri Lanka – A Cluster Randomized Trial


Disease or Health Condition(s) Studied

Occupational Health


Scientific Acronym

None


Public Acronym

None


Brief title

None


Universal Trial Number

U1111-1227-2688


Any other number(s) assigned to the trial and issuing authority

No:EC-18-126 (ERC: University of Colombo)


Trial Details


What is the research question being addressed?

Could an intervention on occupational stress reduce stress among secondary school teachers in Sinhala medium government schools in the District of Colombo?


Type of study

Interventional


Study design

Allocation

Randomized controlled trial


Masking

Masking not used


Control

Standard therapy/practice


Assignment

Parallel


Purpose

Other


Study Phase

Not Applicable


Intervention(s) planned

Study setting – Type 1AB or 1C schools in the Colombo district. A cluster was defined as a Type 1AB or 1C school in the Colombo district where at least 40 secondary school teachers in grades 6 to 13 would be teaching. 10 secondary schools will receive the intervention while other 10 will remain as control. Secondary schools (clusters) will be selected to each arm by simple randomization. The draft design of the frequency and duration of intervention is as follows.

Intervention types - Cognitive-behavioural intervention & relaxation intervention activities targeted at the teachers and organizational intervention activities targeted at the school.

Intervention frequency and duration

(1) Cognitive-behavioural interventions - Includes eight 40 min sessions 2 weekly for 3 months, and monthly for 3 months.

(2) Relaxation interventions - One 80 min session Teachers will also be required to practice relaxation 15 to 20 minutes per day for 6 months and to maintain a mindful emotion diary for one week (They will note their emotions, time, duration, action taken).

(3) Organizational interventions - 6 months

Description of interventions

(1) Cognitive behavioral interventions – • Introducing stress, common causes, consequences, and symptoms of stress and how to identify stress with group activity • Adopting healthy lifestyles (reducing obesity, drinking and smoking) through nutrition advice and exercise • Problem solving skills • Commutation skills • Coping skills • Managing conflict • Time management • Negotiation • Assertiveness life style • Letting go of resentments • Making aware of support systems

(2) Relaxation interventions- • Deep muscle relaxation exercises • Breathing exercises • Cue controlled relaxation • Imagery

(3) Organizational modifications – Organizational modifications will be implemented through the support of the school principals. Advocacy meetings will be held with Principal/Deputy/Assistant Principals. A skill development session including below mentioned topics will be conducted to improve the relevant skills of Principal/Deputy/Assistant Principals and counselling teachers. Follow up meetings will be held to monitor the progress when the other sessions are conducted in each school.

• Redesigning the task Through defining their roles and responsibilities, promote taking on increased responsibilities through using appraisal, providing career development appraisal and involving workers in decision making

• Procedure for redesigning tasks
Defining their roles and responsibilities will be done according to their work load. (If the task (work load) of the teacher is high (>35/40 periods per week), the Principal/Sectional head will not give a class teacher/ other responsibility and redistribute the work among trainee teachers and other teachers at school, marking of the examination papers of the extra subjects they teach will be done with the help of another teacher)

• Promote responsibilities Promote taking on increased responsibilities through using appraisal, (Principal will compliment and appreciate teachers who take extra responsibilities. It will be included to the Agenda of the staff meetings)

• Establishing flexible work schedules Arranging free periods

• Redesigning the work environment Through policy modifications and work environment improvements, teachers and school principal using collaborative problem-solving approach for resolving stress-related issues in staff meetings, building a culture which encourages staff to be more supportive of each other and providing suitable conditions in which the employee can relax from the demands of the job which include facilities for leisure activities

• Establish coworker support group

Intervention for controlled groups Routine services provided by the Ministry of Health through preventive and curative services (Hospitals have psychiatric clinics and they can meet MOH (Medical Officer of Health) in the SMI (School Medical Inspection) if needed)

Research assistant / principal investigator (PI) will assess the psycosocial environment of the schools using a check list. Activities will be conducted by the PI and a research assistant.


Inclusion criteria

Eligibility criteria for clusters

• Type 1AB or 1C school in the Colombo district where at least 40 secondary school teachers in grades 6 to 13 would be teaching

Eligibility criteria for secondary teachers

• Secondary school teachers employed by Types 1AB and 1C Sinhala medium government schools in Colombo district

• Secondary school teachers who will not transfer out for 6 months

• Secondary school teachers who do not plan on long leave within 6 months


Exclusion criteria

Exclusion criteria for the secondary teachers

• Teachers diagnosed as having psychiatric disorders

• Teachers who score “high” OS (Occupational Stress) level in the TSI (Teacher Stress Inventory) (>2.88) and who are subsequently found to be having stress associated psychiatric disorders



Primary outcome(s)

1.

o Proportion of secondary school teachers with OS – using Teacher Stress Inventory (TSI) Questionnaire which was validated to Sri Lanka

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Prior to the study and 6 months after the commencement of the intervention

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2.

o Proportion of secondary school teachers with psychological distress – using GHQ (General Health Questionnaire) 30 questionnaire which was validated to Sri Lanka

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Prior to the study and 6 months after the commencement of the intervention

]
3.

o Mean difference of OCOST score (organizational consequences of OS) of secondary school teachers using a questionnaire developed and validated in Sri Lanka as a part of this MD study

[

Prior to the study and 6 months after the commencement of the intervention

]

Secondary outcome(s)

1.

Secondary outcome measures assessed in teacher are,

o Proportion of secondary school teachers with a good level of knowledge about OS – using a questionnaire developed as a part of this MD study

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Prior to the study and 6 months after the commencement of the intervention

]
2.

o Proportion of secondary school teachers with selected unhealthy life styles related to OS – using a questionnaire developed as a part of this MD study

[

Prior to the study and 6 months after the commencement of the intervention

]
3.

o Proportion of secondary school teachers with good coping strategies - using Brief Cope Questionnaire which was validated to Sri Lanka

[

Prior to the study and 6 months after the commencement of the intervention

]
4.

Secondary outcome measures in the school environment

o Number of schools classified as having a good psychosocial environment - using a check list developed as a part of this MD study

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Prior to the study and 6 months after the commencement of the intervention

]
5.

o Number of schools conducting programmes that prevent occupational stress among teachers - using a check list developed as a part of this MD study

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Prior to the study and 6 months after the commencement of the intervention

]

Target number/sample size

600 secondary school teachers (30 secondary school teachers in each cluster and 10 clusters per each arm)


Countries of recruitment

Sri Lanka


Anticipated start date

2019-06-01


Anticipated end date

2019-11-30


Date of first enrollment


Date of study completion


Recruitment status

Pending


Funding source

None


Regulatory approvals

Not applicable



State of Ethics Review Approval


Status

Approved


Date of Approval

2019-01-17


Approval number

EC-18-126


Details of Ethics Review Committee

Name: Ethics Review Committee, Faculty of medicine, University of Colombo
Institutional Address:No. 25, Kynsey Road, Colombo 00800 Sri Lanka
Telephone:+94-11-2695300 (Extension: 240)
Email: ethicscommitteemfc@gmail.com

Contact & Sponsor Information


Contact person for Scientific Queries/Principal Investigator

Dr. H. M. B. H. Denuwara
Registrar in Community Medicine
No. 25, Kynsey Road, Colombo 00800 Sri Lanka
0112 695 300
0776522499
0112691581
bdenuwara@yahoo.com
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Contact Person for Public Queries

Dr. D. L. Samaranayake
Consultant Community Physician and Senior Lecturer, Department of Community Medicine, Faculty of Medicine, University of Colombo
No. 25, Kynsey Road, Colombo 00800 Sri Lanka
011-2677765
071-6613296
0112691581
dulani_samaranayake@yahoo.com, dulani@commed.cmb.ac.lk
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Primary study sponsor/organization

Faculty of Medicine, University of Colombo

No. 25, Kynsey Road, Colombo 00800, Sri Lanka
+94-11-2695300
0112691581
info@med.cmb.ac.lk

Secondary study sponsor (If any)

None





Trial Completion details


Do the investigators plan to share identified individual clinical trial participant-level data (IPD)?

Yes


IPD sharing plan description

Individual participant data that underlie the results being reported, after de-identification (text, tables, figures and appendices) will be shared immediately following publication, no end date, among investigators whose proposed use of the data has been approved by an independent review committee identified for this purpose. The data may be used to achieve the aims in an approved proposal. Proposals should be directed to bdenuwara@yahoo.com in order to make data available


Study protocol available

No


Protocol version and date

Not Available


Protocol URL

Not Available


Results summary available

No


Date of posting results


Date of study completion


Final sample size

Not available


Date of first publication


Link to results


Brief summary of results

Not available