Stenfert Kroese Biza, Unwin Gemma, Hastings Richard, Jahoda Andrew, McNamara Rachel, Gillespie David, Segrott Jeremy, Ingarfield Kate, Gianatsi Myrsini, Randell Elizabeth, Mather Zoe, Barrett Barbara, Ganguli Poushali, Rose John, Sahle Mariam, Warren Emily, Da Cruz Nathan
School of Psychology, University of Birmingham, Birmingham, UK.
CEDAR, University of Warwick, Coventry, UK.
Public Health Res (Southampt). 2024 Dec;12(15):1-105. doi: 10.3310/JTJY8001.
Children with a learning disability experience a range of inequalities and adverse life events that put them at greater risk of mental health problems. The construct of emotional literacy has been shown to be a moderating factor of how life stress affects mental health. Teaching emotional literacy in schools may therefore be an effective way to promote positive mental health. There is an identified need for adapted emotional literacy programmes in special schools.
To evaluate whether it is feasible to conduct a large-scale randomised controlled trial of the effectiveness and cost-effectiveness of an emotional literacy programme (Zippy's Friends special educational needs and disabilities) for children with a learning disability in special schools. The key aims were to assess the acceptability and feasibility of participating in the trial, data collection and the Zippy's Friends special educational needs and disabilities intervention through quantitative and qualitative data collection.
A feasibility, cluster randomised controlled trial that aimed to recruit and randomise 12 special schools to either deliver the intervention over 1 academic year or continue with practice as usual and to collect data from 96 pupils at baseline (pre randomisation) and 12 months post randomisation.
Special schools in England and Scotland.
Pupils with a learning disability, aged 9-11 years, attending special schools in England. Follow-up interviews were conducted with 8 pupils, 4 parents/carers and 11 school staff members.
Zippy's Friends for Special Educational Needs and Disabilities is a manual-based, classroom-based emotional literacy programme focused on a problem-solving approach to develop and improve children's emotional literacy. The mainstream programme has been adapted for children with a learning disability by simplifying the activities, shortening the sessions and introducing more repetition.
Feasibility and acceptability of: (1) participation in the research trial; (2) the collection of the outcome measure data and (3) the Zippy's Friends for Special Educational Needs and Disabilities intervention.
A total of 8 schools and 53 pupils were recruited. Retention of schools after randomisation (100%) and retention of pupils (100%) met the prespecified progression criteria. For recruitment of schools (20.5% of those approached), pupil engagement with the intervention (50%) and collection of outcome and service use data (62.3%) the criteria were partially met. Fidelity of the intervention delivery (48%) fell just below the progression criteria. Thus, the feasibility and acceptability outcome progression criteria were largely met, suggesting that progression to a full trial is warranted with amendments to the study design.
This feasibility trial was conducted during the COVID-19 pandemic, resulting in unusually high absences of pupils and teachers, different classroom arrangements (bubbles) and unprecedented stress and emotional challenges for pupils, parents and teaching staff. The findings are therefore specific to that period and all three main outcomes of this feasibility trial were adversely affected.
The findings of this study indicate that a large-scale randomised controlled trial is feasible provided that a number of amendments to the study design are made to improve: (1) the timing of the project to suit the demands of special schools' yearly timetable; (2) recruitment and (3) outcome and service use data collection.
On the basis of the current findings, an application for a full trial will be prepared and submitted with a number of amendments.
This trial is registered as ISRCTN83610691.
This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR129064) and is published in full in Public Health Research; Vol. 12, No. 15. See the NIHR Funding and Awards website for further award information.
有学习障碍的儿童经历了一系列不平等和不良生活事件，这使他们面临更大的心理健康问题风险。情绪素养这一概念已被证明是生活压力影响心理健康的调节因素。因此，在学校教授情绪素养可能是促进积极心理健康的有效途径。特殊学校明确需要适应性的情绪素养计划。
评估对特殊学校中有学习障碍的儿童开展一项关于情绪素养计划（齐皮的朋友特殊教育需求与残疾计划）有效性和成本效益的大规模随机对照试验是否可行。主要目标是通过定量和定性数据收集来评估参与试验、数据收集以及齐皮的朋友特殊教育需求与残疾干预的可接受性和可行性。
一项可行性整群随机对照试验，旨在招募12所特殊学校并将其随机分为两组，一组在1个学年内实施干预，另一组照常开展常规教学，并在基线（随机分组前）和随机分组后12个月从96名学生那里收集数据。
英格兰和苏格兰的特殊学校。
年龄在9至11岁、在英格兰特殊学校就读且有学习障碍的学生。对8名学生、4名家长/照顾者和11名学校工作人员进行了随访访谈。
齐皮的朋友特殊教育需求与残疾计划是一个基于手册、以课堂为基础的情绪素养计划，侧重于采用解决问题的方法来培养和提高儿童的情绪素养。该主流计划已针对有学习障碍的儿童进行了调整，简化了活动、缩短了课时并增加了重复次数。
以下方面的可行性和可接受性：（1）参与研究试验；（2）收集结局指标数据；（3）齐皮的朋友特殊教育需求与残疾干预。
共招募了8所学校和53名学生。随机分组后学校的保留率（100%）和学生的保留率（100%）达到了预先设定的进展标准。在学校招募（占联系学校的20.5%）、学生对干预的参与度（50%）以及结局和服务使用数据的收集（62.3%）方面，部分达到了标准。干预实施的保真度（48%）略低于进展标准。因此，可行性和可接受性结局进展标准在很大程度上得到了满足，这表明在对研究设计进行修改后有必要进行全面试验。
这项可行性试验是在新冠疫情期间进行的，导致学生和教师缺勤率异常高、课堂安排不同（班级气泡），并且给学生、家长和教师带来了前所未有的压力和情绪挑战。因此，这些发现特定于那个时期，并且这项可行性试验的所有三个主要结局都受到了不利影响。
本研究结果表明，只要对研究设计进行一些修改以改进：（1）项目时间安排以适应特殊学校年度时间表的要求；（2）招募工作；（3）结局和服务使用数据收集，大规模随机对照试验就是可行的。
根据当前研究结果，将准备并提交一份包含多项修改内容的全面试验申请。
本试验注册为ISRCTN83610691。
本奖项由国家卫生与保健研究机构（NIHR）公共卫生研究计划资助（NIHR奖项编号：NIHR129064），并在《公共卫生研究》全文发表；第12卷，第15期。有关更多奖项信息，请参阅NIHR资金与奖项网站。
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