Learning Together to promote mental health and wellbeing (LTMH)

Research question

Feasibility study: Is it possible to refine the Learning Together (LT) intervention to promote mental health wellbeing (to develop LT-MH)? Background

Schools influence mental health in multiple ways. The most effective interventions in schools are those that address multiple mechanisms operating at multiple levels. Such ‘whole-school’ interventions include environmental and curriculum components and have broad efficacy against a range of health outcomes. Yet existing school environment interventions have little addressed mental health and wellbeing.

We undertook the Inclusive Trial of the Learning Together (LT) intervention, with significant impacts upon a broad range of outcomes including behaviour and mental health. We propose to modify LT to focus on mental health and wellbeing. Aims and objectives i) To refine LT stakeholders and young people

ii) To assess the feasibility and acceptability of implementing the LT-MH intervention in 4 schools iii) To determine whether progression to a phase III trial is justified and disseminate findings Methods Two phases of research, followed by a potential phase III trial

A. Intervention refinement phase: We will work with stakeholders in a period of co-creation and refinement, co-producing an intervention that is likely to be acceptable in schools. Tasks: 1. Elaboration of the intervention theory of change, logic model and overall approaches. 2. Refinement of the student needs survey, manual guiding the Action Group and needs assessment guide/algorithm.

3. Identify best-evidenced SEAL curriculum. For each phase, we will optimise through review of existing systematic reviews and two waves of PPI discussion.

B. Feasibility study phase: feasibility study to test the intervention for one school year. All schools will receive the intervention in order to assess feasibility of implementation across schools varying by need (measured by deprivation level) and by school capacity (Ofsted rating). Setting: Four state secondary schools in southern/central England.

Population: The intervention will target all young people in years 7-11 (age 11-16) in participating schools. The research evaluation will focus on students in year 7 at baseline but on year 10 at 12-month follow-up to pilot response rates and measures rather than to estimate intervention effects. Allocation: All to intervention.

Outcomes: Primary outcome will be feasibility and acceptability of delivery of LTMH, assessed through meeting prespecified progression criteria. We will also measure indicative primary and secondary outcomes to inform a future phase III trial. Indicative primary outcome: Strengths and Difficulties Questionnaire (SDQ

Indicative secondary outcomes: measures of a range of constructs related to mental health Integrated health economic evaluation and process evaluations will be undertaken. Timelines for delivery Month(M)1 (Nov 2021) to M9: refinement of intervention, recruitment of 4 schools M9: Baseline survey M9-22: Feasibility study: intervention delivery, with integral process evaluation

M20-21: Follow-up survey M22-25: write up and dissemination Anticipated impact and dissemination

Key impact will be progression to a phase III trial if progression criteria are met. In addition, we will publish in NIHR Public Health Research journal and two open access papers plus dissemination seminars to policy and practice fora.