Abstract
BackgroundSecondary school teachers have low levels of wellbeing and high levels of depression compared with the general population. Teachers are in a key position to support students, but poor mental health may be a barrier to doing so effectively. The Wellbeing in Secondary Education (WISE) project is a cluster randomised controlled trial (RCT) of an intervention to improve the mental health support and training available to secondary school teachers through delivery of the training package Mental Health First Aid and a staff peer support service. We will conduct a process evaluation as part of the WISE trial to support the interpretation of trial outcomes and refine intervention theory. The domains assessed will be: the extent to which the hypothesised mechanisms of change are activated; system level influences on these mechanisms; programme differentiation and usual practice; intervention implementation, including any adaptations; intervention acceptability; and intervention sustainability.MethodsResearch questions will be addressed via quantitative and qualitative methods. All study schools (n = 25) will provide process evaluation data, with more detailed focus group, interview and observation data being collected from a subsample of case study schools (4 intervention and 4 control). Mechanisms of change, as outlined in a logic model, will be measured via teacher and student surveys and focus groups. School context will be explored via audits of school practice that relate to mental health and wellbeing, combined with stakeholder interviews and focus groups. Implementation of the training and peer support service will be assessed via training observations, training participant evaluation forms, focus groups with participants, interviews with trainers and peer support service users, and peer supporter logs recording help provided. Acceptability and sustainability will be examined via interviews with funders, head teachers, trainers and peer support services users, and focus groups with training participants.DiscussionThe process evaluation embedded within the WISE cluster RCT will illuminate how and why the intervention was effective, ineffective or conferred iatrogenic effects. It will contribute to the refinement of the theory underpinning the intervention, and will help to inform any future implementation.Trial registrationInternational Standard Randomised Controlled Trial Number: ISRCTN95909211 registered on 24 March 2016.
Highlights
Secondary school teachers have low levels of wellbeing and high levels of depression compared with the general population
The process evaluation embedded within the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial (RCT) will illuminate how and why the intervention was effective, ineffective or conferred iatrogenic effects
Interviews with peer support service users In the four intervention case study schools, semi-structured interviews will be conducted with teachers who have utilised the peer support service once the WISE intervention has been delivered for approximately one academic year
Summary
Study design and sample The study is a cluster RCT with an embedded process and economic evaluation [19]. Within-school sampling of individuals to participate in data collections will be random where response bias may be a risk (e.g. focus groups with non-trained teachers and with students), but otherwise will be purposive to ensure recruitment of a diverse range of views. The follow-up audit will record relevant policies or interventions introduced during the study period It will explore programme differentiation from usual practice in intervention schools and assess contamination in the control schools by identifying the extent to which any new activities resemble components of the WISE intervention. The baseline audit will permit comparison of preexisting activities in intervention and control schools to explore possible baseline imbalances and generate hypotheses as to how the context may impact upon the Attendance records for the WISE intervention training Attendance records for the training courses will be generated This will assess reach (numbers completing the training).
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