The PATHS curriculum for promoting social and emotional well-being among children aged 7–9 years: a cluster RCT

BackgroundUniversal social and emotional learning interventions can produce significant practical improvements in children’s social skills and other outcomes. However, the UK evidence base remains limited.ObjectivesTo investigate the implementation, impact and cost-effectiveness of the Promoting Alternative THinking Strategies (PATHS) curriculum.DesignCluster randomised controlled trial. Primary schools (n = 45) were randomly assigned to implement PATHS or to continue with their usual provision for 2 years.SettingPrimary schools in seven local authorities in Greater Manchester.ParticipantsChildren (n = 5218) in Years 3–5 (aged 7–9 years) attending participating schools.InterventionPATHS aims to promote children’s social skills via a taught curriculum, which is delivered by the class teacher, generalisation activities and techniques, and supplementary materials for parents. Schools in the usual provision group delivered the Social and Emotional Aspects of Learning programme and related interventions.Main outcome measuresChildren’s social skills (primary outcome, assessed by the Social Skills Improvement System); pro-social behaviour and mental health difficulties (Strengths and Difficulties Questionnaire); psychological well-being, perceptions of peer and social support, and school environment (Kidscreen-27); exclusions, attendance and attainment (National Pupil Database records); and quality-adjusted life-years (QALYs) (Child Health Utility 9 Dimensions). A comprehensive implementation and process evaluation was undertaken, involving usual provision surveys, structured observations of PATHS lessons, interviews with school staff and parents, and focus groups with children.ResultsThere was tentative evidence (at ap-value of < 0.10) that PATHS led to very small improvements in children’s social skills, perceptions of peer and social support, and reductions in exclusions immediately following implementation. A very small but statistically significant improvement in children’s psychological well-being [d = 0.12, 95% confidence interval (CI) –0.02 to 0.25;p < 0.05) was also found. No lasting improvements in any outcomes were observed at 12- or 24-month post-intervention follow-up. PATHS was implemented well, but not at the recommended frequency; our qualitative analysis revealed that this was primarily due to competing priorities and pressure to focus on the core academic curriculum. Higher levels of implementation quality and participant responsiveness were associated with significant improvements in psychological well-being. Finally, the mean incremental cost of PATHS compared with usual provision was determined to be £29.93 per child. Mean incremental QALYs were positive and statistically significant (adjusted mean 0.0019, 95% CI 0.0009 to 0.0029;p < 0.05), and the incremental net benefit of introducing PATHS was determined to be £7.64. The probability of cost-effectiveness in our base-case scenario was 88%.LimitationsModerate attrition through the course of the main trial, and significant attrition thereafter (although this was mitigated by the use of multiple imputation of missing data); suboptimal frequency of delivery of PATHS lessons.ConclusionsThe impact of PATHS was modest and limited, although that which was observed may still represent value for money. Future work should examine the possibility of further modifications to the intervention to improve goodness of fit with the English school context without compromising its efficacy, and identify whether or not particular subgroups benefit differentially from PATHS.Trial registrationCurrent Controlled Trials ISRCTN85087674 (the study protocol can be found at:www.journalslibrary.nihr.ac.uk/programmes/phr/10300601/#/).FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol 6, No. 10. See the NIHR Journals Library website for further project information.

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The Implementation of the Whole School Approach on Social and Emotional Guidance in Rural Primary Schools in Sarawak, Malaysia: The Perspectives of Regular Teachers

10.31124/advance.14776446.v1 ◽

2021 ◽

Author(s):

Jessie Koh Sing Tnay ◽

Shahren Ahmad Zaidi Adruce ◽

Chuo Yew Ting ◽

Omar Haji Mahli

Keyword(s):

Primary Schools ◽

Well Being ◽

Rural Students ◽

Factors Affecting ◽

Electronic Survey ◽

Social And Emotional ◽

Whole School ◽

The Social ◽

Regular Teachers ◽

Whole School Approach

This study explored the implementation of the whole school approach (WSA) on social and emotional guidance (SEG) in rural primary schools in Sarawak, Malaysia. Regular teachers (<i>N</i> = 2,532) in Sarawak responded to an electronic survey. The theory of planned behavior (TPB) and the socio-emotional guidance model were employed to explore the level of implementing the WSA on SEG among the respondents. Factors affecting the intention to be involved in SEG were also explored. This paper provides insights for policymakers and educational administrators to promote the social and emotional well-being of rural students in a developing country.

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A scoping review of recommendations in the English language on conducting research with trauma-exposed populations since publication of the Belmont report; thematic review of existing recommendations on research with trauma-exposed populations

PLoS ONE ◽

10.1371/journal.pone.0254003 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254003

Author(s):

Kevin Jefferson ◽

Kaitlyn K. Stanhope ◽

Carla Jones-Harrell ◽

Aimée Vester ◽

Emma Tyano ◽

...

Keyword(s):

Public Health ◽

Health Research ◽

English Language ◽

Psychological Impact ◽

Well Being ◽

Public Health Research ◽

Trauma Research ◽

Physical Trauma ◽

Trauma Informed ◽

Gold Standards

Objective To identify recommendations for conducting public health research with trauma-exposed populations. Methods Researchers searched Embase, PubMed, Scopus, Web of Science, Open Grey, and Google Scholar for recommendations. Trauma that causes psychological impact was our exposure of interest and we excluded clinical articles on treating physical trauma. We reviewed titles and abstracts of 8,070 articles and full text of 300 articles. We analyzed recommendations with thematic analysis, generated questions from the existing pool of recommendations, and then summarized select gaps. Results We abstracted recommendations from 145 articles in five categories: community benefit, participant benefit, safety, researcher well-being, and recommendations for conduct of trauma research. Conclusions Gold standards to guide the conduct of trauma-informed public health research do not yet exist. The literature suggests participation in trauma research is not inherently harmful, and current recommendations concern using research to benefit communities and participants, protecting participants and researchers from harm, and improving professional practice. As public health researchers increasingly analyze trauma as a determinant of health, gold standards for the conduct of trauma-informed public health research would be appropriate and timely.

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Mental health support and training to improve secondary school teachers’ well-being: the WISE cluster RCT

Public Health Research ◽

10.3310/phr09120 ◽

2021 ◽

Vol 9 (12) ◽

pp. 1-138

Author(s):

Judi Kidger ◽

Rhiannon Evans ◽

Sarah Bell ◽

Harriet Fisher ◽

Nicholas Turner ◽

...

Keyword(s):

Public Health ◽

Mental Health ◽

Peer Support ◽

Health Research ◽

Well Being ◽

Public Health Research ◽

Support Service ◽

Mental Health Difficulties ◽

Peer Support Service

Background Health and Safety Executive data show that teachers are at heightened risk of mental health difficulties, yet few studies have attempted to address this. Poor teacher mental health may impact on the quality of support provided to young people, who also report increased mental health difficulties themselves. Objective To test the effectiveness of an intervention aiming to improve secondary school teachers’ well-being through mental health support and training. Design A cluster randomised controlled trial with embedded process and economic evaluations. Setting Twenty-five mainstream, non-fee-paying secondary schools in the south-west of England and South Wales, stratified by geographical area and free school meal entitlement, randomly allocated to intervention or control groups following collection of baseline measures (n = 12, intervention; n = 13, control) between May and July 2016. Participants All teachers in the study schools at any data collection. All students in year 8 (baseline) and year 10 (final follow-up). Intervention Each intervention school received three elements: (1) a 1-day mental health first aid for schools and colleges training session delivered to 8% of all teachers; (2) a 1-hour mental health session delivered to all teachers; and (3) 8% of staff trained in the 2-day standard mental health first aid training course set up a confidential peer support service for colleagues. Control schools continued with usual practice. Main outcome measures The primary outcome was teacher well-being (using the Warwick–Edinburgh Mental Wellbeing Scale). Secondary outcomes were teacher depression, absence and presenteeism, and student well-being, mental health difficulties, attendance and attainment. Follow-up was at 12 and 24 months. Data were analysed using intention-to-treat mixed-effects repeated-measures models. Economic evaluation A cost–consequence analysis to compare the incremental cost of the intervention against the outcomes measured in the main analysis. Process evaluation A mixed-methods study (i.e. qualitative focus groups and interviews, quantitative surveys, checklists and logs) to examine intervention implementation, activation of the mechanisms of change outlined in the logic model, intervention acceptability and the wider context. Results All 25 schools remained in the study. A total of 1722 teachers were included in the primary analysis. We found no difference in mean teacher well-being between study arms over the course of follow-up (adjusted mean difference –0.90, 95% confidence interval –2.07 to 0.27). There was also no difference in any of the secondary outcomes (p-values 0.203–0.964 in the fully adjusted models). The average cost of the intervention was £9103 (range £5378.97–12,026.73) per intervention school, with the average cost to Welsh schools being higher because of a different delivery model. The training components were delivered with high fidelity, although target dosage was sometimes missed. The peer support service was delivered with variable fidelity, and reported usage by teachers was low (5.9–6.1%). The intervention had high acceptability, but participants reported low support from senior leadership, and minimal impact on school culture. Limitations Participants and the study team were unblinded, self-report for the main outcome measures and inaccurate measurement of peer support service usage. Conclusions The Wellbeing in Secondary Education (WISE) intervention was not effective at improving teacher or student well-being, or reducing mental health difficulties, possibly because of contextual barriers preventing it becoming embedded in school life. Future work Identification of ways in which to achieve system-level change and sustained support from senior leaders is important for future school-based mental health interventions. Trial registration Current Controlled Trials ISRCTN95909211. Funding This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 12. See the NIHR Journals Library website for further project information. Intervention costs were met by Public Health Wales, Public Health England and Bristol City Council.

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The Implementation of the Whole School Approach on Social and Emotional Guidance in Rural Primary Schools in Sarawak, Malaysia: The Perspectives of Regular Teachers

10.31124/advance.14776446 ◽

2021 ◽

Author(s):

Jessie Koh Sing Tnay ◽

Shahren Ahmad Zaidi Adruce ◽

Chuo Yew Ting ◽

Omar Haji Mahli

Keyword(s):

Primary Schools ◽

Well Being ◽

Rural Students ◽

Factors Affecting ◽

Electronic Survey ◽

Social And Emotional ◽

Whole School ◽

The Social ◽

Regular Teachers ◽

Whole School Approach

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Social skills, social networks and psychological well-being of patiens with spinal cord injury

Medical and Social Expert Evaluation and Rehabilitation ◽

10.18821/1560-9537-2016-19-3-137-142 ◽

2016 ◽

Vol 19 (3) ◽

pp. 137-142

Author(s):

Irina D. Boulyubash ◽

O. S Bashta

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Social Network ◽

Social Skills ◽

Well Being ◽

Hospital Environment ◽

Psychological Well Being ◽

Training Support ◽

The Social ◽

Cord Injury

The paper presents information concerning the relations between the subjective evaluation of social skills, parameters of the social network and the factors determining psychological well-being ofpatients with spinal cord injury sequellae (SCIS). Thus, one of the focuses of the diagnostic and therapeutic work of a clinical psychologist and psychotherapist in the rehabilitation hospital environment becomes as well a subjective assessment by SCIS patients of their own social skills, as the development of these skills, contributing to the expansion of the social network, which is a resource for the provision ofpsychological wellbeing ofpatients. This testifies not only to the need for correction of the emotional state ofpatients, but also the necessity of specific psychotherapeutic interventions. Such interventions should be aimed at the increasing in the level of communication skills which are useful for the formation of new social relationships and the development of the social network of patients (group forms of training, support groups, chat forums, etc.).

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Health Inequality

Justice and Egalitarian Relations ◽

10.1093/oso/9780190084240.003.0009 ◽

2021 ◽

pp. 258-287

Author(s):

Christian Schemmel

Keyword(s):

Public Health ◽

Social Determinants Of Health ◽

Health Inequalities ◽

Health Inequality ◽

Social Determinants ◽

Health Research ◽

Public Health Research ◽

Social Processes ◽

The Social

This chapter argues that relational egalitarianism has distinctive, and plausible, implications not only for the goods directly produced by social cooperation, but also for health. First, it yields a clear ordering of the injustice of different kinds of health inequalities: inequalities caused by inegalitarian relations which are independently unjust are more unjust than those caused by other social processes, which in turn are more unjust (unless justified according to the model developed in the preceding chapter) than those not so caused. The resulting requirements fit well with important strands in public health research on the social determinants of health. Second, it also justifies the universal provision of healthcare, and relational egalitarians need not, and should not, be committed to prioritizing patients with socially caused health deficiencies at the point of delivery of treatment. There are other, better ways to justly prioritize the fight against such health inequalities.

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Pilot study of a randomised trial of a guided e-learning health promotion intervention for managers based on management standards for the improvement of employee well-being and reduction of sickness absence: the GEM (Guided E-learning for Managers) study

Public Health Research ◽

10.3310/phr03090 ◽

2015 ◽

Vol 3 (9) ◽

pp. 1-114 ◽

Cited By ~ 3

Author(s):

Stephen A Stansfeld ◽

Lee Berney ◽

Kamaldeep Bhui ◽

Tarani Chandola ◽

Céire Costelloe ◽

...

Keyword(s):

Public Health ◽

Mixed Methods ◽

Pilot Study ◽

Sickness Absence ◽

Health Research ◽

Well Being ◽

Public Health Research ◽

Control Group ◽

Management Standards ◽

E Learning

BackgroundPsychosocial work environments influence employee well-being. There is a need for an evaluation of organisational-level interventions to modify psychosocial working conditions and hence employee well-being.ObjectiveTo test the acceptability of the trial and the intervention, the feasibility of recruitment and adherence to and likely effectiveness of the intervention within separate clusters of an organisation.DesignMixed methods: pilot cluster randomised controlled trial and qualitative study (in-depth interviews, focus group and observation).ParticipantsEmployees and managers of a NHS trust. Inclusion criteria were the availability of sickness absence data and work internet access. Employees on long-term sick leave and short-term contracts and those with a notified pregnancy were excluded.InterventionE-learning program for managers based on management standards over 10 weeks, guided by a facilitator and accompanied by face-to-face meetings. Three clusters were randomly allocated to receive the guided e-learning intervention; a fourth cluster acted as a control.Main outcome measuresRecruitment and participation of employees and managers; acceptability of the intervention and trial; employee subjective well-being using the Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS); and feasibility of collecting sickness absence data.ResultsIn total, 424 employees out of 649 approached were recruited and 41 managers out of 49 were recruited from the three intervention clusters. Of those consenting, 350 [83%, 95% confidence interval (CI) 79% to 86%] employees completed the baseline assessment and 291 (69%, 95% CI 64% to 73%) completed the follow-up questionnaires. Sickness absence data were available from human resources for 393 (93%, 95% CI 90% to 95%) consenting employees. In total, 21 managers adhered to the intervention, completing at least three of the six modules. WEMWBS scores fell slightly in all groups, from 50.4 to 49.0 in the control group and from 51.0 to 49.9 in the intervention group. The overall intervention effect was 0.5 (95% CI –3.2 to 4.2). The fall in WEMWBS score was significantly less among employees whose managers adhered to the intervention than among those employees whose managers did not (–0.7 vs. 1.6, with an adjusted difference of 1.6, 95% CI 0.1 to 3.2). The intervention and trial were acceptable to managers, although our study raises questions about the widely used concept of ‘acceptability’. Managers reported insufficient time to engage with the intervention and lack of senior management ‘buy-in’. It was thought that the intervention needed better integration into organisational processes and practice.ConclusionsThe mixed-methods approach proved valuable in illuminating reasons for the trial findings, for unpacking processes of implementation and for understanding the influence of study context. We conclude from the results of our pilot study that further mixed-methods research evaluating the intervention and study design is needed. We found that it is feasible to carry out an economic evaluation of the intervention. We plan a further mixed-methods study to re-evaluate the intervention boosted with additional elements to encourage manager engagement and behaviour change in private and public sector organisations with greater organisational commitment.Study registrationCurrent Controlled Trials ISRCTN58661009.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 3, No. 9. See the NIHR Journals Library website for further project information.

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A cluster randomised controlled trial and evaluation and cost-effectiveness analysis of the Roots of Empathy schools-based programme for improving social and emotional well-being outcomes among 8- to 9-year-olds in Northern Ireland

Public Health Research ◽

10.3310/phr06040 ◽

2018 ◽

Vol 6 (4) ◽

pp. 1-108 ◽

Cited By ~ 1

Author(s):

Paul Connolly ◽

Sarah Miller ◽

Frank Kee ◽

Seaneen Sloan ◽

Aideen Gildea ◽

...

Keyword(s):

Health Research ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Well Being ◽

Evidence Base ◽

Public Health Research ◽

Test Time ◽

Prosocial Behaviour ◽

Social And Emotional ◽

Post Test

Background There is growing consensus regarding the importance of attending to children’s social and emotional well-being. There is now a substantial evidence base demonstrating the links between a child’s early social and emotional development and a range of key longer-term education, social and health outcomes. Universal school-based interventions provide a significant opportunity for early intervention in this area and yet the existing evidence base, particularly in relation to their long-term effects, is limited. Objectives and main outcomes To determine the effectiveness and cost-effectiveness of Roots of Empathy (ROE), a universal school-based programme that, through attempting to enhance children’s empathy, seeks to achieve the following two main outcomes: improvement in prosocial behaviour and reduction in difficult behaviour. Design A cluster randomised controlled trial and an economic evaluation. A total of 74 primary schools were randomly assigned to deliver ROE or to join a waiting list control group. Seven schools withdrew post randomisation and a further two withdrew before the immediate post-test time point. Children (n = 1278) were measured pre test and immediately post test, and then for 3 years following the end of the programme. Data were also collected from teachers and parents. Setting and participants The intervention schools delivered ROE to their Year 5 children (aged 8–9 years) as a whole class. Intervention ROE is delivered on a whole-class basis for one academic year (October–June). It consists of 27 lessons based around the monthly visit from a baby and parent who are usually recruited from the local community. Children learn about the baby’s growth and development and are encouraged to generalise from this to develop empathy towards others. Results Although it was developed in Canada, the programme was very well received by schools, parents and children, and it was delivered effectively with high fidelity. ROE was also found to be effective in achieving small improvements in children’s prosocial behaviour (Hedges’ g = 0.20; p = 0.045) and reductions in their difficult behaviour (Hedges’ g = –0.16; p = 0.060) immediately post test. Although the gains in prosocial behaviour were not sustained after the immediately post-test time point, there was some tentative evidence that the effects associated with reductions in difficult behaviour may have remained up to 36 months from the end of the programme. These positive effects of ROE on children’s behaviour were not found to be associated with improvements in empathy or other social and emotional skills (such as emotional recognition and emotional regulation), on which the trial found no evidence of ROE having an effect. The study also found that ROE was likely to be cost-effective in line with national guidelines. Conclusions These findings are consistent with those of other evaluations of ROE and suggest that it is an effective and cost-effective programme that can be delivered appropriately and effectively in regions such as Northern Ireland. A number of issues for further consideration are raised regarding opportunities to enhance the role of parents; how a time-limited programme such as ROE can form part of a wider and progressive curriculum in schools to build on and sustain children’s social and emotional development; and the need to develop a better theory of change for how ROE works. Trial registration Current Controlled Trials ISRCTN07540423. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 4. See the NIHR Journals Library website for further project information.

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Characteristics of Parental Communication as a Factor of Adolescents’ Psychological Well-Being

Psychological Science and Education ◽

10.17759/pse.2020250105 ◽

2020 ◽

Vol 25 (1) ◽

pp. 51-62 ◽

Cited By ~ 2

Author(s):

M.V. Ermolaeva ◽

O.V. Smirnova

Keyword(s):

Social Skills ◽

Well Being ◽

Parental Communication ◽

Psychological Well Being ◽

Self Monitoring ◽

Communicative Skills ◽

Questionnaire Measure ◽

The Social ◽

Mental Well Being ◽

The Relationship

The paper presents results of a study on the relationship between psychological well-being of adolescents and features of their parents’ communication. The study involved 92 subjects: 46 adolescents aged 13—14 years, studying in one of the Moscow schools, and their mothers (46 females). The adolescents’ psychological well-being was measured with the Piers-Harris Self-Concept Scale (scales VI, VII and VIII), the Warwick-Edinburgh Mental Well-Being Scale, and with the questionnaire by I.М. Markovskaya. Features of parental communication were assessed using the social skills questionnaire by V.F. Ryakhovskiy, the Self-Monitoring Scale by M. Snyder, and the Questionnaire Measure of Emotional Empathy by A. Mehrabian and N. Epstein. The study revealed a five-factor structure of psychological well-being of the adolescents and of their perception of childparent relations. It showed a correlation between the level of parental emotional response and the adolescents' assessments of consent in their relationships with the parents. The adolescents’ satisfaction with communication with peers was also related to their parents’ social skills. Low and pronounced communicative skills of the parents are associated with high and average levels of adolescent satisfaction with peer communication respectively; normal communicative skills in the parents is associated with low satisfaction in the adolescents. The paper concludes with a discussion on the application of the obtained results in psychological counseling and psychological education of parents.

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An Interactive Text Message Survey as a Novel Assessment for Bedtime Routines in Public Health Research: Observational Study

JMIR Public Health and Surveillance ◽

10.2196/15524 ◽

2020 ◽

Vol 6 (4) ◽

pp. e15524

Author(s):

George Kitsaras ◽

Michaela Goodwin ◽

Julia Allan ◽

Michael Kelly ◽

Iain Pretty

Keyword(s):

Public Health ◽

Mobile Phones ◽

Health Research ◽

Text Message ◽

Well Being ◽

Public Health Research ◽

Routine Activities ◽

Dynamic Processes ◽

Interactive Text ◽

Bedtime Routine

Background Traditional research approaches, especially questionnaires and paper-based assessments, limit in-depth understanding of the fluid dynamic processes associated with child well-being and development. This includes bedtime routine activities such as toothbrushing and reading a book before bed. The increase in innovative digital technologies alongside greater use and familiarity among the public creates unique opportunities to use these technical developments in research. Objective This study aimed to (1) examine the best way of assessing bedtime routines in families and develop an automated, interactive, text message survey assessment delivered directly to participants’ mobile phones and (2) test the assessment within a predominately deprived sociodemographic sample to explore retention, uptake, feedback, and effectiveness. Methods A public and patient involvement project showed clear preference for interactive text surveys regarding bedtime routines. The developed interactive text survey included questions on bedtime routine activities and was delivered for seven consecutive nights to participating parents’ mobile phones. A total of 200 parents participated. Apart from the completion of the text survey, feedback was provided by participants, and data on response, completion, and retention rates were captured. Results There was a high retention rate (185/200, 92.5%), and the response rate was high (160/185, 86.5%). In total, 114 participants provided anonymized feedback. Only a small percentage (5/114, 4.4%) of participants reported problems associated with completing the assessment. The majority (99/114, 86.8%) of participants enjoyed their participation in the study, with an average satisfaction score of 4.6 out of 5. Conclusions This study demonstrated the potential of deploying SMS text message–based surveys to capture and quantify real-time information on recurrent dynamic processes in public health research. Changes and adaptations based on recommendations are crucial next steps in further exploring the diagnostic and potential intervention properties of text survey and text messaging approaches.

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