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| Name | Class |
|---|---|
| Child Mind Institute | OTHER |
| Secretaria da Educação do Estado do Rio Grande do Sul (SEDUC-RS) | UNKNOWN |
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The goal of this clinical trial is to learn if different formats of a school-based psychosocial support training program can improve teachers' ability to recognize and respond to students' mental health needs. The study will include teachers working in public schools in Brazil.
The main questions it aims to answer are:
Researchers will compare five versions of the program (in-person, online, and asynchronous formats, with or without supervision) to see which approach is more effective, acceptable, and feasible.
Participants will:
The study will measure changes in teachers' knowledge, attitudes, and behaviors related to supporting students' mental health, as well as satisfaction with the program and its feasibility for large-scale implementation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1: In-Person Training + Supervision | Experimental | Participants receive two in-person training sessions on school-based psychosocial support, followed by two supervision sessions (audio-based, small group) focused on case discussion and practical application. Participants also receive brief follow-up materials via mobile messages. |
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| Arm 2: In-Person Training Only | Experimental | Participants receive two in-person training sessions on school-based psychosocial support without additional supervision. Participants also receive brief follow-up materials via mobile messages. |
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| Arm 3: Online Training + Supervision | Experimental | Participants receive two synchronous online training sessions (via videoconference), followed by two supervision sessions (audio-based, small group) focused on case discussion and practical application. Participants also receive brief follow-up materials via mobile messages. |
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| Arm 4: Online Training Only | Experimental | Participants receive two synchronous online training sessions (via videoconference) without additional supervision. Participants also receive brief follow-up materials via mobile messages. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| In-person School-Based Psychosocial Support Training | Behavioral | A structured training program designed to improve teachers' ability to recognize and respond to students' mental health needs. The intervention includes evidence-based content on mental health literacy, identification of emotional and behavioral difficulties, and appropriate support and referral strategies. The training is delivered in-person in two weekly sessions. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the score in the Mental health Knowledge & Attitudes Questionnaire | Psychosocial support skills knowledge and attitudes will be assessed using a multiple choice instrument (Mental health Knowledge & Attitudes Questionnaire) developed for this study and previously piloted in a sample of teachers. Scores will range from 0 to 100%, reflecting the percentage of correct responses. | Baseline (T0) to post-intervention at 4 weeks (T2) |
| Measure | Description | Time Frame |
|---|---|---|
| Early and Sustained change in the score in the Mental health Knowledge & Attitudes Questionnaire | Same instrument used in the primary outcome | Baseline (T0) to 2 weeks (T1); Baseline (T0) to 2-month follow-up (T3) |
| Change in psychosocial support skills score (clinical vignette-based score) |
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Inclusion Criteria:
School-level inclusion criteria:
Participant-level inclusion criteria (teacher level)
Participating teachers must meet all of the following criteria:
Exclusion Criteria:
School-level exclusion criteria:
Participant-level exclusion criteria
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Giovanni A. Salum, MD, PhD | Contact | (+55) 51 3359 8094 | gsalum @hcpa.edu.br |
| Name | Affiliation | Role |
|---|---|---|
| Giovanni A. Salum, MD, PhD | Child Mind Institute | Principal Investigator |
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De-identified individual participant data underlying the results reported in this study (including data dictionaries) will be made available to qualified researchers.
Data will be shared after publication of the primary results, upon reasonable request and subject to approval by the study investigators. Requests will be evaluated based on scientific merit, feasibility, and ethical considerations.
Data will be provided in a de-identified format to ensure participant confidentiality and compliance with applicable data protection regulations.
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This is a cluster randomized, parallel-group trial with five intervention arms. Schools are grouped into clusters of 5 schools. The unit of randomization are those clusters. Teachers within each school are assigned to the same intervention condition. Nine teachers per school will participate in the trial.
The five arms differ based on delivery format (in-person, synchronous online, or asynchronous) and the presence or absence of supervision. Four groups receive synchronous training (either in-person or online), with or without additional supervision sessions, while one group receives the same content delivered in an asynchronous format only.
The intervention duration ranges from 2 to 4 weeks depending on the assigned condition. Outcomes are assessed at baseline, during the intervention, post-intervention, and follow-up. The study is designed to compare the effectiveness, acceptability, and feasibility of different delivery formats and supervision components.
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| Arm 5: Asynchronous Training (Control Condition) | Active Comparator | Participants receive the same training content delivered in a fully asynchronous, self-paced format through digital materials, without live sessions or supervision. |
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| Online School-Based Psychosocial Support Training | Behavioral | A structured training program designed to improve teachers' ability to recognize and respond to students' mental health needs. The intervention includes evidence-based content on mental health literacy, identification of emotional and behavioral difficulties, and appropriate support and referral strategies. The training is delivered trough synchronous videoconference in two weekly sessions. |
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| Asynchronous School-Based Psychosocial Support Training | Behavioral | A structured training program designed to improve teachers' ability to recognize and respond to students' mental health needs. The intervention includes evidence-based content on mental health literacy, identification of emotional and behavioral difficulties, and appropriate support and referral strategies. The training is delivered through an asynchronous self-paced course in a digital platform. |
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| Supervision Sessions | Behavioral | Structured small-group supervision sessions conducted via audio calls, focused on discussion of real-life cases, clarification of concepts, and support for practical application of the training content. |
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| Mobile-Based Reinforcement Materials | Behavioral | Brief follow-up materials delivered via mobile messaging to reinforce key concepts covered in the training sessions. |
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Psychosocial support skills will be assessed using a vignette-based instrument (Psychosocial Support Skills Instrument) developed for this study and previously piloted in a sample of teachers. Each vignette describes a brief clinical scenario, and participants are asked to select the most appropriate level of support for the student. Response options include: (1) Observe and be available; (2) Provide school-based support and accommodations ; (3) Link to a mental health professional ; (4) Act immediately due to safety concerns. Scores will range from 0 to 100%, reflecting the percentage of correct responses. |
| Baseline (T0) to 2 weeks (T1); Baseline (T0) to post-intervention at 4 weeks (T2); Baseline (T0) to 2-month follow-up (T3) |
| Changes in helping behaviors toward students | Assessed using a retrospective self-report scale developed to capture mental health-related helping behaviors toward students ("Helping Behaviors Scale"), including identifying emotional distress, providing support, and facilitating referral to appropriate services. The scale includes five items describing specific helping behaviors. Each item is rated as yes, no, or does not apply. Higher endorsement indicates a greater number of supportive actions taken by the respondent in the past week. | Baseline (T0) to 2 weeks (T1); Baseline (T0) to post-intervention at 4 weeks (T2); Baseline (T0) to 2-month follow-up (T3) |
| Change in the levels of teacher burnout | Teacher burnout will be assessed using the 12-item version of the Burnout Assessment Tool (BAT-12), a self-report questionnaire developed to assess burnout as a multidimensional psychological syndrome. It evaluates four core dimensions of burnout: exhaustion, mental distance, cognitive impairment, and emotional impairment. Each item is rated on a five-point frequency scale ranging from 1 (never) to 5 (always). A total burnout score will be calculated as the mean of the 12 items, with higher scores indicating greater burnout symptoms. | Baseline (T0); 2 weeks (T1); Post-intervention at 4 weeks (T2); 2-month follow-up (T3) |
| Training acceptability, satisfaction, and perceived confidence | Assessed using a post-training self-report questionnaire developed for this study. The questionnaire includes one item assessing perceived adequacy of training length, rated as too short, about right, or too long. Three items assess participants' ratings of the training delivery format, amount of practice, and resources/materials provided, each rated on a five-point scale ranging from very poor to excellent. One additional item assesses participants' confidence in their ability to identify students with psychosocial and mental health difficulties, rated from not at all confident to extremely confident. Higher ratings indicate greater satisfaction with the training components and greater perceived confidence. An optional open-ended item collects additional qualitative feedback about the training. | Post-intervention at 4 weeks (T2) |
| Cost-effectiveness of the intervention | Cost-effectiveness will be calculated as the cost per improvement unit in the Mental health Knowledge & Attitudes Questionnaire described previously | Baseline (T0) to post-intervention at 4 weeks (T2) |