This study compared three approaches for handling a fourth level of nesting when analyzing cluster-randomized trial (CRT) data. Although CRT data analyses may include repeated measures, individual, and cluster levels, there may be an additional fourth level that is typically ignored. This study examined the impact of ignoring this fourth level,…

In Belize, the percentage of untrained teachers (i.e. teachers with the equivalent of a high school education or less) is one of the highest in the region of Latin America and the Caribbean. In response to growing student cohorts, the increased demand for more classroom teachers has led to significant decrease in the proportion of trained teachers…