Session 3 Schools, study design

Session 3Schools, study design DataPrev Training Module - Session 3 - Schools

Session 3 structure • What works in schools? • Which study designs? DataPrev Training Module - Session 3 - Schools

The importance of educational settings Schools are a key setting for prevention • Children and young people spend a large amount of time in schools • Day-to-day contact with children and, often, families • Schools establish identity and interpersonal relationships • Provide the necessary support system for early identification of difficulties Good mental health supports learning and education attainment • Academic achievements contribute to better health in general and mental health in particular • Educational settings and professional staff play an important role in protecting children’s rights • Social, emotional and decision-making abilities are critical to improved learning • Mental well-being reduces schooldropout DataPrev Training Module - Session 3 - Schools

Costs of childhooddisorders • Childhood disorders are relatively common (9.5%); • They have identifiable and, in many cases, preventable risk factors; • They have long-term damaging consequences for the children themselves and their families. • The costs to the state can be very high for those with complex cases. • Many children with disorders remain unrecognised and untreated. DataPrev Training Module - Session 3 - Schools

What works? • Programme intervention levels: • For whole school • For whole class • For a small group • One to one with individual children. • Programme aims: • Improve mental health and/or • Prevent mental illness/problems and/or • tackle mental health problems • Target groups: • children and young people, • their parents (sometimes) DataPrev Training Module - Session 3 - Schools

What works? Examples of effective programmes found in Europe include: • Second Step to Violence Prevention (UK, Denmark, Iceland, Germany, and Norway). • Promoting Alternative Thinking Strategies (PATHS)(UK the Netherlands, Germany, Switzerland Croatia, Northern Ireland). • Friends (UK Ireland, Germany, Finland, Netherlands. Portugal). • Incredible years (UK, Ireland, and Norway). • Olweus Bully-Victim programme (originated in Norway, found across Scandinavia). DataPrev Training Module - Session 3 - Schools

What works? Effectiveprogrammeshave a range of beneficial outcomes: • Mental health problems (such as depression and anxiety) • Positivemental health and well-being and social and emotional learning • Social and emotional skills • Self-esteem and self confidence • Reduced violence and bullying (stronger for high risk children) • Pro-social behaviour and reduce behavioural problems and school misbehaviour. • Better attitudes to school and academic achievements • Improvements for classroom and family environments DataPrev Training Module - Session 3 - Schools

What works? Key features of effective programmes: • A good balance between targeted and universal approaches– • An overall focus on positive mental health is better than focusing only on problems. • Developing skills and competences(e.g. social problem solving, social awareness and emotional literacy) • Varied and active teaching methods - diverse, participative and experiential • Whole school and multi-modal (in different parts of the school timetable and setting) • Impact on the entire school ethos and process, and are supported by positive whole school environment, leadership and policies DataPrev Training Module - Session 3 - Schools

What works? Key features of effective programmes cont.: • Use a range of agents of transmission (e.g., specialist staff, teachers, and lay people such as peers and parents), and have a qualified intervention leader. • Include community involvement – include a focus on family, home and neighbourhood. • Start early - take a long-term developmental approach through a spiral approach in which key learning is constantly re-visited. • Longer interventions and evaluations - at least 9 months to a year • High quality implementation– solidity, consistency, clarity and programme fidelity. DataPrev Training Module - Session 3 - Schools

Which study designs? Quantitative studies: types of study designs Quantitative designs: Experimental vs. observational DataPrev Training Module - Session 3 - Schools

Which study designs? Quantitative studies: types of study designs Experimental designs 1: controlled vs. not controlled DataPrev Training Module - Session 3 - Schools

Which study designs? Quantitative studies: types of study designs Experimental designs 2: Randomised vs. non-randomised controlled trials DataPrev Training Module - Session 3 - Schools

Which study designs? Scenario 7. Randomisation in a school-based intervention Concerning our school example a RCT would imply: • Choosing individual pupils (or whole school classes) for inclusion in the study, according to predefined inclusion and exclusion criteria; • to randomise either the pupils or the classes (“cluster randomisation”) to an intervention programme or to no intervention; • to assess outcome after implementation at a predetermined time period. DataPrev Training Module - Session 3 - Schools

Which study designs? Quantitative studies: types of study designs Observational studies: Cohort vs. case-control studies DataPrev Training Module - Session 3 - Schools

Which study designs? Scenario 8. School-based cohort study Concerning our school example a cohort study would look into pupils, classes or schools where mental health promotion or mental disorder prevention programmes have been carried out and would follow them over time in order to assess an outcome after a specific time period. For purposes of comparison, also pupils, classes or schools on whom no intervention has been applied could be followed in order to assess possible changes in the outcome variables. DataPrev Training Module - Session 3 - Schools

Which study designs? Scenario 9. School-based case-control study Concerning our school example a group of adolescents or young adults who are depressed at this present time, are compared with a group of adolescents who are not depressed in respect to whether they had taken part in mental health promotion or mental disorder prevention programme while they were still attending school. DataPrev Training Module - Session 3 - Schools

Which study designs? Qualitative methods: complementary methods of evaluation Qualitative studies can help us to: • understand what factors impact on the successful implementation in different contexts. • identify the satisfaction, potential additional outcomes of interest and appropriateness of intervention implementations. DataPrev Training Module - Session 3 - Schools

Which study designs? Scenario 10. Use of qualitative methods for school-based intervention In the case of the school-based intervention, a systematic review of the literature may indicate that mental health promotion interventions in schools are highly effective. However what if most of this evidence comes from studies conducted in the United States? The organisational structure of the education system, differences in culture and attitudes, and training of the professionalsmight be different in a European setting, and alter the programmes effectiveness. Qualitative analysis may identify how the intervention may need to be adapted to be successfully used in another setting. Qualitative methods might also help to identify barriers that impede successful implementation, e.g. language or cultural appropriateness. Perhaps those implementing the school-based programme have not followed implementation guidance correctly or misunderstood it. This is a factor that is assessed through qualitative analysis. DataPrev Training Module - Session 3 - Schools

Which study designs? Some qualitative research methods: In-depth interviews: Face-to-face conversations with the purpose of exploring issues or topics in depth. Focus groups: A method of group interview that explicitly includes and uses group interaction. DataPrev Training Module - Session 3 - Schools

Which study designs? Some qualitative research methods cont.: Observational qualitative studies: The systematic observation of everyday behaviour - organisational settings, team behaviour, and interactions Action research: Emphasises the participation of those being researched in the evaluation.: • flexible planning; • iterative cycle; • subjective meaning (empowering service users); • simultaneous improvement; • unique social context of the research must be considered. DataPrev Training Module - Session 3 - Schools

Which study designs? Scenario 11. Using qualitative methods in evaluating the success of school-based intervention programmes Evaluators spend time observing interaction between pupils and teachers and attitudes following the introduction of the school-based programme. They also use observationto assess how guidelines on implementation of the programme are being followed by the school-based staff. A series of one-to-one in-depth interviews with key staff obtain insights on their attitudes towards the school, children and the intervention. Focus groupsare used to see how the children feel about the new programme and its delivery and whether they think it is relevant or could be improved. A postal or telephone questionnaire might collect parental perceptions of the programme. The various observations and responses can be used to adapt the programme to aid future implementation. DataPrev Training Module - Session 3 - Schools

Session 3 Schools, study design