A Systematic Literature Review of Strategies Implemented in Extended Education Settings to Address Children's Mental Health and Wellbeing.

Mental health and wellbeing problems in middle childhood are increasing worldwide which needs more support than just clinical services. Early intervention has been explored in other settings, but not in extended education care settings such as outside school hours care (OSHC). A systematic literature review was undertaken to determine what interventions have been tested in extended education settings to address or promote emotional, behavioural, or social wellbeing in children, and to assess how effective they have been. A PRISMA guided search found seven peer reviewed articles from an initial pool of 458. Data from the articles were extracted and the mixed method appraisal tool (MMAT) was applied to assess methodological quality of the studies design, data collection, and analyses. The final selections were methodologically heterogeneous with an average MMAT quality rating of 71%. All but one of the interventions were delivered to children in small group settings and were a mix of activities. Studies that trained educators to deliver the interventions were limited and no data were collected for them. The two interventions that trained educators to deliver content to children were seen as promising. This review showed an overall paucity of research examining interventions delivered in extended education settings to improve children's wellbeing. Given variations in extended education services and the absence of formal qualifications required for educators, further research is needed to understand what interventions may be effective and what role educators could play in such interventions or in supporting children's wellbeing in extended education.This review protocol was prospectively registered with PROSPERO . Registration ID: CRD42023485541 on 03/12/2023.