Promoting mental health and wellbeing in schools: examining Mindfulness, Relaxation and Strategies for Safety and Wellbeing in English primary and secondary schools: study protocol for a multi-school, cluster randomised controlled trial (INSPIRE)

Abstract

BackgroundThere are increasing rates of internalising difficulties, particularly anxiety and depression, being reported in children and young people in England. School-based, universal prevention programmes are thought to be one way of helping tackle such difficulties. This protocol describes a four-arm cluster randomised controlled trial, investigating the effectiveness of three different interventions when compared to usual provision, in English primary and secondary pupils. The primary outcome for Mindfulness and Relaxation interventions is a measure of internalising difficulties, while Strategies for Safety and Wellbeing will be examined in relation to intended help-seeking. In addition to the effectiveness analysis, a process and implementation evaluation and a cost-effectiveness evaluation will be undertaken.Methods and analysisOverall, 160 primary schools and 64 secondary schools will be recruited across England. This corresponds to 17,600 participants. Measures will be collected online at baseline, 3–6 months later, and 9–12 months after the commencement of the intervention. An economic evaluation will assess the cost-effectiveness of the interventions. Moreover, a process and implementation evaluation (including a qualitative research component) will explore several aspects of implementation (fidelity, quality, dosage, reach, participant responsiveness, adaptations), social validity (acceptability, appropriateness and feasibility), and their moderating effects on the outcomes of interest, and perceived impact.DiscussionThis trial aims to address important questions about whether schools’ practices around the promotion of mental wellbeing and the prevention of mental health problems can: (1) be formalised into feasible and effective models of school-based support and (2) whether these practices and their effects can be sustained over time. Given the focus of these interventions on mirroring popular practice in schools and on prioritising approaches that present low-burden, high-acceptability to schools, if proved effective, and cost-effective, the findings will indicate models that are not only empirically tested but also offer high potential for widespread use and, therefore, potentially widespread benefits beyond the life of the trial.Trial registrationISRCTN16386254. Registered on 30 August 2018.

Multivariate Patterns of Brain-Behavior-Environment Associations in the Adolescent Brain and Cognitive Development Study

“…Importantly, many of these exposures are modifiable and amenable to interventions that fall within the purview of health and education services. We note that the present results provide further support recent initiatives in school-based interventions (49,50) and move the field forward toward neuroscienceinformed public policy for the promotion of mental wellbeing.…”

Children and young people’s experiences of completing mental health and wellbeing measures for research: learning from two school-based pilot projects

“…We used data gathered within a feasibility study for the Education for Wellbeing (EfW) programme, which trialled and evaluated five universal mental health interventions in English primary and secondary schools, commissioned by the Department for Education [ 45 , 46 ]. Of these five interventions, three aimed to reduce emotional difficulties and two aimed to increase help-seeking intentions.…”

A scoping review and assessment of essential elements of shared decision-making of parent-involved interventions in child and adolescent mental health

“…The nine elements defining SDM, according to Makoul and Clayman [36], have been used in previous studies to evaluate decision support tools [30,87] and is one of the most frequently cited SDM models. This model was developed based on a synthesis of other SDM models and, therefore, provides a broad description of the SDM process which allows for comparisons among the identified SDM interventions [85].…”

“…Therefore, it is necessary to understand whether these same barriers extend to the implementation and usage of SDM interventions. Subsequent research in SDM confirms this, with young people stating that when decisions were difficult or when young people lacked capacity, parental involvement was seen as positive [85]. Hence, it was necessary to build on that review, expanding the literature search to examine the grey literature or development studies on decision support interventions.…”