Paths to Success: Interim Findings from a Cluster Randomised Trial of a Universal Social-Emotional Learning Intervention

Research indicates a rise in child mental health difficulties in the last several decades.  More broadly, recent international research by UNICEF suggests that children in the UK and US fare very poorly on a range of wellbeing indicators. As one of the most effective agencies for the promotion of health (including mental health), schools have become the main focus of efforts to reverse such trends.  In particular, the utility of universal social-emotional learning (SEL) curricula has received considerable attention in the prevention literature.  However, we do not know whether the effects of proven programmes can be replicated when they are exported (e.g. from the US to the UK). Additionally, implementation research in existing trials has exhibited a rather narrow focus on fidelity and dosage, with factors such as programme differentiation and participant responsiveness largely ignored. Finally, little is known about the potential differential impact of SEL on children exposed to varying levels of risk.  In this proposed paper we report the interim findings of a major study designed to address these issues.

‘PATH to Success’ is a large, cluster randomized trial examining the impact of the Promoting Alternative Thinking Strategies curriculum in Manchester, England.  45 primary schools were randomly allocated to implement PATHS or continue practice as usual over a 2-year period.  This paper will use data collected in the first year of the trial.  The study sample are c.5,000 children aged 7-9 at baseline.  Our outcome assessment protocol spans a range of informants (e.g. children, teachers, parents), domains (e.g. social skills, health-related quality of life, academic attainment) and methods (e.g. survey, standardized assessment).  Implementation in the 23 PATHS schools is being examined via both teacher self-report and direct observation, with attention paid to fidelity/adherence, adaptation, dosage, quality, participant responsiveness, reach and programme differentiation.

Hierarchical linear modeling of study data will be presented using a staged approach as follows: (i) intention-to-treat analysis (e.g. impact of PATHS on study outcomes), (ii) implementation analysis (e.g. association between different aspects of implementation and study outcomes), (iii) sub-group analysis (e.g. differential effects of PATHS on children exposed to varying levels of risk), and finally (iv) the interaction between (ii) and (iii).  In addition to answering key questions that have important implications for school-based prevention, we will also discuss methodological innovations and implications that have arisen through the course of the trial (e.g. use of clustering techniques to capture implementation profiles of teachers/classes).