Title: Social and Emotional Education and Development (SEED): a Stratified, Cluster Randomised Trial of a Multi-component Primary School Intervention that follows the Pupils’ Transition into Secondary School
Funder: Chief Scientist Office, Scotland

Abstract: Design: SEED will be evaluated using a stratified, cluster randomised trial. Setting: Primary schools within a defined local educational authority. Dundee has expressed strong interest in participating in the trial. Target population: The target population is primary pupils in year 1 (aged 4/5) and year 5 (aged 8/9) who are reached through their teachers and parents. In order to help recruit and retain schools, each will be paid £500 at the start and £500 at completion of school based data collection. Families and teachers will receive annual calendars, change of address cards and project updates. Intervention being evaluated: SEED is based on the Seattle Project, the Gatehouse Project and Growing Confidence. SEED is a school-based programme to promote emotional and social wellbeing in primary school pupils. SEED will provide schools with information about their pupils' social and emotional wellbeing. This information will be based on teacher completed Strengths and Difficulties Questionnaires (SDQs) for the younger group of pupils aged 4 to 5. The older pupils, aged 8 to 9, will complete their own SDQs. The feedback to schools will be grouped by the age of the pupils, to ensure pupil confidentiality. Guided by an educational psychologist and the feedback from the pupils' SDQs, schools will choose from a menu of actions (or develop bespoke actions) to address these needs at each of the following levels: 1) whole school actions to promote and support students’ social and emotional development For example if the SDQ shows that pupils have high levels of conduct problems, then school staff may implement solution oriented approaches, which aim to change school culture and more targeted approaches to address more serious negative behaviour; 2) teacher/classroom actions that promote social and emotional development and engagement with learning. For example if the SDQ shows that pupils have high levels of hyperactivity/inattention, then teachers may implement clear and consistent classroom rules and expectations, create shorter work periods, create more opportunities for individual instruction, adjust the curriculum to maintain pupils’ interest, use interactive learning and positive reinforcement. 3) Social and Emotional Learning (SEL) curriculum for students – identifying the components that they need to work on. For example if SDQ detects high levels of emotional symptoms, then teachers may implement Creating Confident Kids. These actions will be incorporated into the school’s annual Improvement Plans which are required by the Scottish Government to be developed by all schools during June. Measurement of outcomes and duration of follow-up: Children and their current teacher(s) will be followed up annually for 3 years. Children who receive the intervention in P2 (5/6, the baseline data is collected when they are in P1) will be followed through to the end of P5 (8/9 years), and those who receive the intervention in P6 (9/10 years) will be followed through to year 2 of secondary school (12/13 years). Parents will be followed up on completion of the intervention for each of the cohorts (P5 for the younger cohort, P7 for the older). Social and emotional wellbeing at baseline and at follow-up will be measured using the widely used, valid, reliable and sensitive to change Strengths and Difficulties Questionnaire (SDQ), always completed by teachers for the younger cohort and self-completed by the older cohort when pupils are beyond age 10/11 (SDQ can be self-completed from 10/11 years onwards). We will also evaluate: the five SDQ subscales (emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behaviour); primary pupils’ self respect; ability to manage their feelings and behaviour; resilience; respect and empathy for others; relationships with others, attitudes to school, academic performance and school attendance. In addition, we will explore changes in staff and parents’ knowledge, attitudes and behaviour relating to the intervention, their own mental health and wellbeing and to nurturing confident children. We will explore the health behaviours (e.g. smoking and alcohol) of the older cohort at ages 13/14. Economic Evaluation: We will collect data on the costs of the intervention including staff time and consumables as well as the costs incurred by parents such as travel and child care. The Child Health Utility 9D (CHU9D) has recently been developed and validated specifically for use with children aged 7-11 years and it can be used with other age groups (14). This will measure utility change in each arm of the study and, with cost data, will allow us to calculate an incremental cost utility ratio. Sample size: There are an average of 38 pupils per year at each school; a potential 2,736 pupils for recruitment at baseline. We expect few to opt out of participation, and have assumed that 75% of the target population can be followed up to 3 years, a total of 2,052 pupils, 1,026 from each age group, with an average 28.5 pupils per year per school. Assuming a conservative intraclass correlation coefficient of 0.05 (i.e. 5% of the variation in the primary outcome will be attributable to school- and class-level variability), the design effect will be 2.375. Therefore, within each age group, with 513 pupils randomised to both the intervention and control arms of the study (allowing for attrition), the effective sample size will be 216 per group (513÷2.375) within both the P1 and P5 cohorts. This sample size provides 95% power at a 5% significance level to detect a between-group difference of 0.35 standard deviation (SD) units, within each age band. Assuming the SD of the primary outcome (SDQ Total score) to be 6 points, this equates to an average between-group difference of 2.1 points. There is also 80% power to detect differences of 0.27 SD units (i.e. 1.6 points on the SDQ Total score). Assuming an equal split between boys and girls, then within each gender, the study will have 95% power to detect intervention effects of 0.49 SD units (3.0 SDQ Total score points), or 80% power to detect an effect of 0.38 SD units (2.3 SDQ Total points). Planned analyses: Primary analyses: Comparison of SDQ scores – comparing control versus intervention groups, power to run separate analysis by gender and stage of primary school. We will perform clustered (by school), regression analyses with the outcome being the total SDQ score category (normal, borderline or abnormal), adjusting for confounders (SDQ score/category at baseline, age, gender, SES). We will also look at the different SDQ categories – for example, compare the scores for the “Emotional Symptoms”, “Conduct Problems” and “Prosocial” sub-categories. We will perform sub-group analyses to look at the effect of the intervention on boys and girls separately, and on children from different SES groups and/or areas of deprivation. Reflecting the main study, the cost-utility study will conduct a subgroup analysis focusing on young people from lower socio-economic groups. Our results will be subjected to a sensitivity analysis. In line with current recommendations in the UK the costs and outcomes will be discounted at 3.5% per annum (15). In the final part of our analysis we will use information in the literature to model the potential longer term impacts of the trial outcomes on health and wellbeing. Process evaluation: In order to interpret the trial outcomes a process evaluation will investigate the fidelity of intervention delivery, the intended causal pathways, how participants respond, and contextual factors facilitating or inhibiting delivery and therefore shaping external validity. Project timetables including recruitment rate: 5-year study, including follow-up: 2012 – Recruitment of education authorities and schools, randomisation of schools, development and piloting of research tools and data collection methods and refinement of intervention; Autumn Term 2012 – Baseline data collection from teachers, parents and pupils; Whole year 2013 – Intervention with teachers, parents and pupils and process evaluation (which will be ongoing); Autum Term 2014 - Follow-up 1 of all participants both quantitative and qualitative (post-intervention); Autumn Term 2015 – Follow-up 2 of all participants both quantitative and qualitative; Autumn Terms 2016 - Follow-up 3 of all participants (quantitative); 2017 - Final outcome analysis and report/paper writing. A flow diagram and logic model are appended to this application.

Lay abstract: ‘Emotional and social wellbeing’ refers to being self-aware and able to manage one’s feelings, and having empathy and good social skills. It enables people to function well and meet the challenges of life. We propose to evaluate the SEED intervention, a school-based programme to promote emotional and social wellbeing in primary school pupils. SEED will provide schools with information about their pupils' social and emotional wellbeing. This information will be based on teacher completed Strengths and Difficulties Questionnaires (SDQs) for the younger group of pupils aged 4 to 5. The older pupils, aged 8 to 9, will complete their own SDQs. The feedback to schools will be grouped by the age of the pupils, to ensure pupil confidentiality. Guided by an educational psychologist and the feedback from the pupils' SDQs, schools will choose from a menu of actions (or develop bespoke actions) to address these needs at each of the following levels: 1) whole school actions to promote and support students’ social and emotional development For example if the SDQ shows that pupils have high levels of conduct problems, then school staff may implement solution oriented approaches, which aim to change school culture and more targeted approaches to address more serious negative behaviour; 2) teacher/classroom actions that promote social and emotional development and engagement with learning. For example if the SDQ shows that pupils have high levels of hyperactivity/inattention, then teachers may implement clear and consistent classroom rules and expectations, create shorter work periods, create more opportunities for individual instruction, adjust the curriculum to maintain pupils’ interest, use interactive learning and positive reinforcement. 3) Social and Emotional Learning (SEL) curriculum for students – identifying the components that they need to work on. For example if SDQ detects high levels of emotional symptoms, then teachers may implement Creating Confident Kids. These actions will be incorporated into the school’s annual Improvement Plans which are required by the Scottish Government to be developed by all schools during June.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: MENTAL HEALTH