School-based intervention study examining approaches for well-being and mental health literacy of pupils in Year 9 in England: study protocol for a multischool, parallel group cluster randomised controlled trial (AWARE)

Abstract

IntroductionThe prevalence of emotional difficulties in young people is increasing. This upward trend is largely accounted for by escalating symptoms of anxiety and depression. As part of a public health response, there is increasing emphasis on universal prevention programmes delivered in school settings. This protocol describes a three-arm, parallel group cluster randomised controlled trial, investigating the effectiveness and cost-effectiveness of two interventions, alongside a process and implementation evaluation, to improve mental health and well-being of Year 9 pupils in English secondary schools.MethodA three-arm, parallel group cluster randomised controlled trial comparing two different interventions, the Youth Aware of Mental Health (YAM) or the Mental Health and High School Curriculum Guide (The Guide), to Usual Provision. Overall, 144 secondary schools in England will be recruited, involving 8600 Year 9 pupils. The primary outcome for YAM is depressive symptoms, and for The Guide it is intended help-seeking. These will be measured at baseline, 3–6 months and 9–12 months after the intervention commenced. Secondary outcomes measured concurrently include changes to: positive well-being, behavioural difficulties, support from school staff, stigma-related knowledge, attitudes and behaviours, and mental health first aid. An economic evaluation will assess the cost-effectiveness of the interventions, and 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, feasibility, utility), and their moderating effects on the outcomes of interest, and perceived impact.Ethics and disseminationThis trial has been approved by the University College London Research Ethics Committee. Findings will be published in a report to the Department for Education, in peer-reviewed journals and at conferences.Trial registration numberISRCTN17631228.ProtocolV1 3 January 2019. Substantial changes to the protocol will be communicated to the trials manager to relevant parties (eg, ISRCTN).

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.…”

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)

“…The methodology outlined in this protocol follows a similar procedure to that of the AWARE trial [48] in relation to recruitment strategy and the economic evaluation. Both the INSPIRE trial (which this paper describes) and the AWARE trial are being conducted by the same team as part of a wider programme.…”

Adaptation of a school-based mental health literacy curriculum: from Canadian to English classrooms

“…In the current study, school staff adapted some of The Guide's content to ensure a de-stigmatising approach; more research is needed to understand exactly what knowledge and skills must be acquired to promote young people's mental health (Cairns and Rossetto, 2019 ). To ensure that a ‘fidelity with adaptation’ approach recommended by Lendrum and Askell-Williams ( 2019 ) was accounted for in the full trial of The Guide, a full process and implementation evaluation was conducted alongside the AWARE efficacy trial as detailed in the study protocol (Hayes et al ., 2019 ). This will enable the analysis to identify the impact of different dimensions of implementation (e.g.…”

“…The interviews analysed in this paper formed part of the AWARE feasibility study (Approaches for Wellbeing and Mental Health Literacy: Research in Education), one of two parallel group clustered RCTs conducted by the Department for Education (England) funded Education for Wellbeing Programme (Hayes et al ., 2019 ). AWARE is a three-arm, parallel group clustered RCT with the aim of comparing The Guide and Youth Aware of Mental Health (YAM), to a usual provision (control) condition.…”