Promoting Positive Adolescent Mental Health (PPAMH!) for school climate: a whole school approach to improving the school environment to support student wellbeing.
| ISRCTN | ISRCTN14856201 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN14856201 |
- Submission date
- 17/07/2024
- Registration date
- 24/09/2024
- Last edited
- 06/11/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Ongoing
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Promoting Positive Adolescent Mental Health (PPAMH!) for School Climate aims to promote a positive environment to support student wellbeing. A ‘well-being mentor’ will work in each school for half of the week. They will do whole-school activities such as assemblies, peer group activities such as workshops, and one-to-one activities with pupils. The PPAMH! for School Climate Intervention focuses on empowering pupils to have their say on school policies and curriculum by creating a participative school environment. Interventions using similar principles have been done in India (called ‘SEHER’ Strengthening Evidence base on scHool-based intErventions for pRomoting adolescents health program) and Australia. PPAMH! for School Climate could improve student attendance. The research trial in India found that it reduced bullying and feelings of depression. The intervention will be adapted to be suitable for schools in Bradford through a series of workshops with students and staff.
Who can participate?
This initial pilot trial will involve the staff and pupils of six secondary schools in Bradford
What does the study involve?
Schools will be randomly assigned to be either a control school (three schools) or to receive the intervention (three schools). The main outcome of this feasibility trial is the successful implementation of the intervention in the secondary schools, for example, looking at how many activities were completed and by how many students. The effect of the intervention on school absences or other aspects of well-being will not be studied in this trial. During the feasibility trial, there will be interviews held with school staff members who are involved in running the intervention in the schools and the well-being mentors. This will highlight barriers to implementation and how these could be overcome and track how schools adjust the intervention. The plan is to do a full trial if the feasibility trial shows that the PPAMH! intervention can be successfully set up in schools. The study will also highlight how easily the data planned to be used in the full trial can be accessed, which include school absences (from routine educational data) and mental health outcomes such as depression and anxiety symptoms (reported by students in surveys).
What are the possible benefits and risks of participating?
Participants will benefit from having access to the intervention resources created, which are hoped to be beneficial to them.
School staff are not expected to be at increased risk from the implementation interviews which might cover sensitive or distressing topics. However, the interview will be paused or stopped if a participant becomes distressed. There is a possibility that school staff could be identifiable, so the study team will be careful with the level of specific details provided in any written reports.
Where is the study run from?
Mental Health and Addiction Research Group, University of York (UK)
When is the study starting and how long is it expected to run for?
April 2023 to December 2025
Who is funding the study?
National Institute for Health and Care Research (NIHR) (UK)
Who is the main contact?
Dr Ruth Wadman, ruth.wadman@york.ac.uk
Contact information
Principal Investigator
Mental Health and Addiction Research Group
Department of Health Sciences
Faculty of Science
Room A/RC/209a, ARRC Building
University of York
Heslington
York
YO10 5DD
United Kingdom
 ORCID ID |
0000-0003-4205-0631 |
|---|---|
| Phone | +44 (0)1904 32 4996 |
| ruth.wadman@york.ac.uk |
Scientific
Mental Health and Addiction Research Group
Department of Health Sciences
Faculty of Science
ARRC Building
University of York
Heslington
York
YO10 5DD
United Kingdom
| ORCID ID |
0000-0002-8236-6983 |
|---|---|
| Phone | +44 (0)1904 321370 |
| simon.gilbody@york.ac.uk |
Public
Mental Health and Addiction Research Group
Department of Health Sciences
Faculty of Science
Room A/RC/209a, ARRC Building
University of York
Heslington
York
Y010 5DD
United Kingdom
| ORCID ID |
0000-0001-7043-1795 |
|---|---|
| Phone | +44 (0)1904 321 514 |
| olivia.taylor@york.ac.uk |
Study information
| Study design | Feasibility cluster randomized trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | School |
| Study type | Prevention |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet. |
| Scientific title | Promoting Positive Adolescent Mental Health (PPAMH!) for school climate: protocol for a feasibility randomised control trial in secondary schools |
| Study acronym | PPAMH! for School Climate |
| Study objectives | As this is a feasibility study no formal hypothesis testing will be undertaken. This study will provide information about the acceptability and feasibility of delivering the school climate intervention in secondary schools. The study aims to carry out a feasibility and external pilot trial to determine if it is possible to implement a cluster-randomised trial of a multi-component whole-school intervention aiming to improve the school climate. The feasibility trial will not aim to estimate the effect of the intervention, but to learn whether the intervention and research are feasible. A full trial is planned if the intervention is feasible, and the resources are identified. |
| Ethics approval(s) |
Approved 15/03/2024, Health Sciences’ Research Governance Committee (University of York, York, YO10 5DD, United Kingdom; +44 (0)1904 321344; stephen.holland@york.ac.uk), ref: HSRGC/2024/616/F |
| Health condition(s) or problem(s) studied | Prevention of early mental health symptoms in adolescents |
| Intervention | The design is a feasibility cluster-randomised trial of an intervention that aims to create a more positive school environment. The feasibility trial will involve randomisation of six schools with a primary outcome of the successful delivery of the intervention in schools determined by 1. Qualitative interview data from staff involved in implementing the intervention and 2. Quantitative data on intervention delivery via an activity log including the number of sessions and attendees. Schools will be randomised to either being a control school (three schools) or receiving the intervention (three schools). Schools randomised to the control arm of the pilot trial will not be required to do anything additional. The control condition is ‘usual care’. Schools will be randomised using minimisation. Minimisation will be undertaken in minimPy (or equivalent package in R) using naïve minimisation. Minimisation factors will include 1) baseline absence rate, 2) percentage of pupils from non-White ethnic groups and 3) percentage of female pupils. The quantitative data accessed in this study is either routine data from the education record or data already being collected as part of the Age of Wonder cohort study. The Age of Wonder study has HRA ethical approval (IRAS number 295413; REC reference number 21/YH/0261) and this approval includes plans for supporting interventions that will use Age of Wonder outcome data. The Age of Wonder study information and informed consent process included information about the use of participant data to evaluate interventions, to ensure that cohort participants are fully informed. The PPAMH! for School Climate intervention is a multi-level whole-school intervention. The intervention’s conceptual framework emphasises the importance of a positive school climate. A positive school climate can be described as one that features a sense of belonging, a participative school environment, student commitment to academic values, and supportive relationships among school students, teachers, parents, and leadership. Improvements to the school climate are targeted using a multi-level school-based intervention, organised at the whole school, peer group and individual. PPAMH! includes four priority areas: promoting social skills; engaging the school community (i.e., pupils, teachers, and parents) in school decision-making processes; improving understanding of health and risk behaviours; and enhancing problem-solving skills. The PPAMH! intervention itself will be delivered by two non-clinical community workers (‘well-being mentors’), most likely employed by the local NHS Trust. A well-being mentor will be in intervention schools for 50% of the school week to facilitate whole school activities. They will also run peer group sessions and 1-1 activities with year 9 pupils. Example activities are awareness generation, policy review, workshops and skills training. Each month will have a different topic of focus, which will have been selected by the students and school staff. Example topics may include mental health and well-being, study skills, and rights and responsibilities. The control condition is usual care. |
| Intervention type | Behavioural |
| Primary outcome measure | 1. Successful delivery of the intervention in schools measured using descriptive quantitative data on intervention delivery via an activity log of the number of sessions, frequency, number of attendees and evidence of training to support delivery throughout the study - implementation data collection (via intervention activity log) – January 2025 to July 2025 2. Assessment of qualitative data regarding and measured using data collected on implementation via interviews with relevant school staff (and the wellbeing mentors) involved in implementing the intervention throughout the study - implementation data collection (via interviews) – January 2025 to July 2025 |
| Secondary outcome measures | 1. Successful collection of school absences data, as a proxy measure of the school environment. This was selected as the planned primary outcome for the full trial by young people and stakeholders. It will be available for all pupils and measured using the educational record (routine data) 2. Access to mental health and well-being data of year 9 students, collected in the Age of Wonder study, including mental health problems such as depression and anxiety (measured using the RCADS-25), mental well-being (measured using the SWEMWBS) and bullying Baseline data collection (via routine and survey data records) September 2024 to January 2025 Outcome data collection (via routine and survey data records) June/July 2025 |
| Overall study start date | 01/04/2023 |
| Completion date | 30/12/2025 |
Eligibility
| Participant type(s) | Employee, Learner/student |
|---|---|
| Age group | Mixed |
| Lower age limit | 11 Years |
| Upper age limit | 90 Years |
| Sex | Both |
| Target number of participants | 6 |
| Key inclusion criteria | Bradford secondary schools who are taking part in the Born in Bradford Age of Wonder Cohort Study. Staff and pupils. |
| Key exclusion criteria | Schools who are not taking part in the Born in Bradford Age of Wonder Cohort Study |
| Date of first enrolment | 01/12/2023 |
| Date of final enrolment | 30/09/2024 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centres
York
YO10 5DD
United Kingdom
Bradford Royal Infirmary
Duckworth Lane
Bradford
Bradford
BD9 6RJ
United Kingdom
Sponsor information
University/education
Heslington
York
YO10 5DD
England
United Kingdom
| Phone | +44 (0)1904 321321 |
|---|---|
| dohs-dshub@york.ac.uk | |
| Website | https://www.york.ac.uk/ |
Funders
Funder type
Government
Government organisation / National government
- Alternative name(s)
- National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 30/09/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Results will be disseminated via peer-reviewed papers, lay summaries, conference presentations and short films. The study team will seek the views of our PPIE group(s) as to how best to share the findings with young people and schools. The study team will use extensive networks in Bradford to share the findings widely with stakeholders. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be available upon request from Dr Ruth Wadman, ruth.wadman@york.ac.uk |
Editorial Notes
06/11/2024: Sponsor contact details updated.
18/07/2024: Study's existence confirmed by the Health Sciences’ Research Governance Committee of the University of York.
