Using qualitative research to explore intervention mechanisms: findings from the trial of the Learning Together whole-school health intervention

Emily Warren,G J Melendez-Torres,Russell Viner,Chris Bonell

doi:10.1186/s13063-020-04688-2

Abstract

BackgroundThis study reports on qualitative research conducted within a randomised controlled trial to explore possible intervention mechanisms. It focuses on the ‘Learning Together’ whole-school intervention delivered in secondary schools in England from 2014 to 2017 aiming to prevent bullying and aggression and improve student health. Intervention schools received staff training in restorative practice, a social and emotional learning curriculum, and an external facilitator and manual to convene and run a student/staff action group tasked with coordinating the intervention, focusing this on local needs.MethodsInformed by realist approaches to evaluation, we analysed qualitative data to explore intervention mechanisms and how these might interact with school contexts to generate outcomes. Qualitative analysis drew on 45 interviews and 21 focus groups across three case-study schools and employed thematic content analysis to explore how intervention resources were taken up and used by local actors, how participants described the intervention mechanisms that then ensued, and how these might have generated beneficial outcomes.ResultsThe thematic content analysis identified three social mechanisms that recurred in participant accounts: (1) building student commitment to the school community, (2) building healthy relationships by modelling and teaching pro-social skills, and (3) de-escalating bullying and aggression and enabling re-integration within the school community.ConclusionsOur analysis provides in-depth exploration of possible mechanisms and the contextual contingencies associated with these, allowing refinement of the initial intervention theory of change.Trial registrationISRCTN registry 10751359. Registered on 11 March 2014

Highlights

This paper draws on qualitative data collected as part of the process evaluation within a randomised controlled trial (RCT) of the ‘Learning Together’ intervention to provide an in-depth description of participant accounts of the processes occurring, how these varied with local conditions in schools, and with what consequences
Thematic content analysis identified a central theme of the intervention resources being used by staff and students to build an inclusive and cohesive school environment
Summary of key findings This study aimed to develop a rich description of participant accounts of, drawing on concepts from dimensional analysis, the processes involved in a whole-school health intervention in secondary schools in South East England and how these might interact with local conditions to generate consequences, drawing on qualitative data from a process evaluation embedded within the RCT

Summary

Introduction

This paper draws on qualitative data collected as part of the process evaluation within a randomised controlled trial (RCT) of the ‘Learning Together’ intervention to provide an in-depth description of participant accounts of the processes occurring, how these varied with local conditions in schools, and with what consequences. Whole-school interventions are a promising approach to promoting student health across a range of outcomes, including bullying and aggression [7,8,9,10] One approach within such interventions for which existing trials report evidence of effectiveness is for schools to convene an action group of students and staff who identify local actions that will encourage a more inclusive and engaging social and learning environment, with positive consequences for student health [11,12,13]. This study reports on qualitative research conducted within a randomised controlled trial to explore possible intervention mechanisms It focuses on the ‘Learning Together’ whole-school intervention delivered in secondary schools in England from 2014 to 2017 aiming to prevent bullying and aggression and improve student health. Intervention schools received staff training in restorative practice, a social and emotional learning curriculum, and an external facilitator and manual to convene and run a student/staff action group tasked with coordinating the intervention, focusing this on local needs

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