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3rd ENSEC Conference 29th June - 3rd July 2011 University of Manchester, UK Phillip Slee

3rd ENSEC Conference 29th June - 3rd July 2011 University of Manchester, UK Phillip Slee Professor in Human Development Flinders University Adelaide, South Australia www.caper.com.au Director: Flinders Centre Promotion Well-Being: Violence Prevention (SWAPv).

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3rd ENSEC Conference 29th June - 3rd July 2011 University of Manchester, UK Phillip Slee

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  1. 3rd ENSEC Conference29th June - 3rd July 2011University of Manchester, UK Phillip Slee Professor in Human Development Flinders University Adelaide, South Australia www.caper.com.au Director: Flinders Centre Promotion Well-Being: Violence Prevention (SWAPv)

  2. “KidsMatter”- the outcomes of an evaluation of a SEC Initiative in Australian schools Flinders University Evaluation Team :P. T. Slee, M.Lawson, A.Russell, H.Askell-Williams, K.Dix, L.Owens, G.Skryzpiec and B.Spears

  3. …

  4. Outline of Presentation Mental Health ‘KidsMatter Constructs’ KidsMatter Evaluation KidsMatter Evaluation Findings ”KidsMatter & Disability KidsMatter and Academic Outcomes’ The ‘Elephant in the Room’ Translating Research to Policy & Practice Summary & Discussion

  5. KidsMatter Suite of Initiativeshttp://www.flinders.edu.au/ehl/educationalfutures/groups/kidsmatter/kidsmatter_home.cfm • KidsMatter –Primary • KidsMatter –Early childhood • Kidsmatter Quality Assurance • Kidsmatter- Disabilities

  6. Schools as Sites for Interventions • Attention now focussed on working through schools to improve the health & well-being of children (Greenberg, et al,2003) • school–community partnerships positively influence outcomes for students, eg showing increases in attendance rates, resilience, behaviour and attitude (Weare & Nind, 2011) • partnerships between school and community enable students to achieve the best life outcomes, eg academic and non-academic eg SEL (Slee et al, 2009).

  7. KidsMatter conceptual framework KidsMatter process assumptions: protective factors/reduction in risk factors. The factors reside within the school environment, the family context and the psychological world of the child, & include: • Positive school climate • Increases in students’ social-emotional competencies, eg sense of mastery and control • Increases staff knowledge and competence (e.g., in teaching SEL) • effective parenting • effective strategies for identifying and working with at risk students

  8. Two dimensions of mental health • Adaptive defences are essential to positive mental health (Vaillant 2000) • increasing international interest in the concept of positive mental health and its contribution to all aspects of human life (Tennant et al, 2007) • The World Health Organisation • Mental Health is not simply the absence of mental disorder or illness, but also includes a positive state of mental well-being (WHO, 2004). • Mental health can be conceptualised as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (WHO 2001) • Both dimensions of mental health were of interest for us in this evaluation

  9. Representation of the two dimensions in our analytical models? • Representation 1 • The mental health outcome includes both strengths and difficulties as outcomes at the same level in the conceptual model • Representation 2 • The measure of the positive dimension (SEC) is seen as mediating the relationship between the intervention and the level of mental health problems

  10. Schools Participants Quantitative Measures in all 100 schools Qualitative Measures: Visits to 10 Schools Outcomes Longitudinal data collected up to 4 times during 2007 and 2008 • School implementation of: • KidsMatter specifically • Mental health • initiatives generally • Risk and protective factors: • School mental • health approach • Child and family • competencies • Change over time in: • Students (MH) • Parents • Teachers • Schools State Project Officers School engagement & implementation of KM, Facilitators, Barriers 4/3 Parent Focus Groups Parent: Knowledge, Skill, Confidence, etc Parents/Caregivers 3 Student MH: Parent-rated SDQ & SCS KidsMatter Schools 100 schools across Australia - 50 Round 1 started in 2007 50 Round 2 started in 2008 Students N=4980 Student Voice Background: gender, age, ATSI, ESL, Fee, ’at risk’ 1 Student MH: Teacher-rated SDQ & SCS Teachers 4 Teacher Interviews Teacher: knowledge, confidence, SEL, etc Leadership Interviews Principals & KM Leaders KM Executive Summary, ‘pill & dose’ 1

  11. KidsMatter evaluation measures Student Mental Health Outcomes SDQ (Goodman, 2005)

  12. The Four KidsMatter Components how welcomed members feel and their sense of belonging. provision of social and emotional learning, professional development parenting education and support. supporting students who are experiencing, emotional - social - behaviour difficulties.

  13. Background and Research DesignN=4980 students

  14. The analysis of change undertaken in the evaluation used: Latent class analysis Structural equation modelling Multilevel modelling Thematic analysis of qualitative data Effect Size We used the part-correlation coefficient r for reporting all effect sizes. We use correlations of 0.10, 0.24, and 0.37 as indicative of small, medium and large effects, respectively (Hattie,2009)

  15. Impact of KidsMatter Overview “[KidsMatter] has changed school culture, I think. It’s changed the way the school views mental health. It’s given a greater awareness, but it’s also changed the way, people relate to one another, particularly the students, and the way the classrooms operate”. (School Principal)

  16. Impact of KidsMatter on Schools and Teachers • 22% increase in teachers who ‘strongly agreed’ that schools were engaged with KidsMatter • 31% increase in schools using the 7-Step Implementation process • Progress on the four Components: • most progress on 2: Social and Emotional Learning for Students • least progress on 4: Early Intervention for Students Why was least progress made on Component 4?

  17. On developing social and emotional competencies, teachers perceptions were that, as a result of KidsMatter: more knew how to help students more ‘strongly agreed’ that the staff acted to help students more ‘strongly agreed’ that their teaching programs helped students more ‘strongly agreed’ that they had good self-efficacy for teaching SEL Impact of KidsMatter on Schools and Teachers:Teachers’ knowledge, competence and confidence

  18. Impact of KidsMatter on Families Parents perceptions were that, as a result of KidsMatter: more became involved with the school more had increased their capacity to help their children with social and emotional issues more felt their school better catered for their child’s needs Parenting knowledge and approach showed little change from the initial (self-reported) high levels

  19. Impact of KidsMatter on Student Mental Health Strengths go up Difficulties go down KidsMatter achieved its major aims to improve student mental health and well-being and reduce mental health difficulties

  20. Impact of KidsMatter on Student Mental Health KidsMatter achieved a shift for a number of students within the ‘borderline’ and ‘abnormal’ ranges, into the ‘normal’ range The numbers vary depending on how you assess mental health “Mental Health is not simply the absence of mental disorder or illness, but also includes a positive state of mental well-being” (World Health Organisation, 2004)

  21. Methodological Notes and Limitations Strengths of the evaluation design Multi-methods and tools Multiple informants Multiple time points Multiple settings Ecologically valid (based in authentic settings) Stratified school selection process The analysis of change undertaken in this report uses Latent class analysis Structural equation modelling Multilevel modelling Thematic analysis Limitations include The Initiative is not, and was not designed to be, a strict randomly controlled trial. Because the sample is not a true random sample, caution should be taken if generalising findings to other students and other primary schoolsin Australia.

  22. Conclusions KidsMatter had a positive impact on schools, teachers, parents, and children • changed school culture • the ‘whole school’ approach enhanced academic and social competencies • facilitated Social and emotional learning for students, Parenting support & education, and Early intervention • strengthened protective factors within school, family & child • improved student mental health

  23. “Look it really works. It can change school culture, which changes the way kids relate. It really does. By having that focus and by really thinking about how kids relate to one another; how the staff relate to the children and teaching them a set of relationship skills to help them cope. You can really make a profound difference in your school and in those children’s lives” (School Principal) Conclusions

  24. KM & Disability • The parents and teachers of 555 South Australian primary school students participated in the KidsMatter Evaluation. • Of this group, 494 South Australian students 61 students had an identified disability (11%) ,

  25. Results co-morbidity is present and a student with a disability is more likely to also have mental health problems. using the SDQ students without a disability had 1 in 8 chance of having mental health difficulties (i.e.being in the abnormal range), students with one identified disability had a 1 in 3 chance and students with multiple disabilities had a 1 in 2 chance

  26. Results (Cont’) The findings indicate, on average, a practically significant (parents=large & Teachers = medium) improvement in student wellbeing ie increase on the ‘Mental Health Strengths’ scale. and a practically significant (Parents=small effect size & Teachers = medium effect size)decrease in mental health difficulties over time ie reduced SDQ (difficulties) scores What else can be done for students with disabilities?

  27. Findings –SEC & Academic Performance • This research now extended to investigate the impact of KidsMatter on academic performance, based on the National Assessment Program - Literacy and Numeracy 2008 data (NAPLAN). • A two-level hierarchical linear model, using HLM-5 was employed to examine the relationships between school-level characteristics and student-level academic outcomes (Raudenbush &Willms, 1995).

  28. Implementation quality of whole-school mental health promotion and students’ academic performance • a child’s social and emotional wellbeing impacts on their academic performance. (CASEL,2008) • BUT there is growing concern about how schools evaluate the implementation of such programs, and of the program’s effectiveness if the quality of implementation is not maintained. • few studies, internationally, report the relationship between quality of implementation of mental health promotion initiatives and student outcomes, eg academic performance

  29. Implementation Index • An Implementation Quality Index was developed (Greenberg, 2004; Domitrovich,2008; Askell-Williams, 2011). • revealed that the extent to which children’s social-emotional competencies improved over time was dependent, on how well the school had implemented KidsMatter (small effect size=.22).

  30. Findings (cont.) • Schools that implemented KidsMatter well also had improved learning outcomes for students of up to six months more schooling, over and above any influence of socio-economic background (Dix et al, 2011). • Over the 2 years of KM, 14% more teachers strongly agreed (scored 6 or 7) that KidsMatter had led to improvements in students’ schoolwork, equivalent to a medium (b = 0.30, p < .05) effect size.

  31. The ‘Elephant’ in the Room!

  32. Quality Assurance: “If we keep on doing what we have been doing, we are going to keep on getting what we have been getting”. (Wandersman et al, 2008) • The initiative is now approved for broader dissemination to 1700 schools by 2014 • Upscaling of KM affects how KM is being disseminated post pilot • All KM stakeholders have an interest in ensuring that KM continues to be implemented in the manner that optimises the mental health and wellbeing of students, as well as achieving positive outcomes for parents and teachers. .

  33. Quality Assurance has been seen as one way of maintaining and assessing quality outcomes “concerns remain about the transferability of intervention models beyond well-controlled settings” (Humphrey et al,2010,p.215)

  34. Defining Quality Assurance • The development of evaluation standards is one part of a move toward ‘evidence-based’ practice. • “the determination of standards, appropriate methods and quality requirements by an expert body, accompanied by a process of inspection or evaluation that examines the extent to which practice meets the standards”. Murgatroyd and Morgan (1993, p.45)

  35. Quality Assurance Implementation Adoption Readiness Sustainability Promotion Incentives Monitoring How to translate our research to outside settings? (Slee, Murray-Harvey, Dix & van Deur,2011)

  36. Promotion - How well information about the existence and value of the programme is promoted to new schools and the broader service community. Readiness - This outlook refers to the extent to which the school recognises there is a problem to be addressed, is willing to address it, and has the capacity to do so. Adoption –With the support of the staff, parents and carers, the principal commits to implementation on behalf of the school community. This stage may also be informed by local community agencies. Implementation - The program must meet the local needs of the community in which the intervention is taking place and must be responsive to local conditions. Sustainability - Whether the fidelity, dosage and quality are maintained over time Monitoring - An accurate monitoring and feedback system. This aspect is central to quality assurance. Incentive – infrastructure that provides incentives or recognition to schools and individuals within schools for achieving implementation milestones. Slee, P.T., Murray-Harvey, R., Dix, K; van Deur, P (2011).

  37. Researchers need to innovate & take risks in developing partnerships & exchanging knowledge to influence policy & practice

  38. Research to Policy & Practice • “The vitality and sustainability of a society depend on the extent to which it equalizes opportunities early in life for all children to achieve their full potential and engage in responsible and productive citizenship”(Shonkoff & Bales,2011p.117).

  39. Research to Policy & Practice (Cont’) “Science has an important role to play on advising policy makers on crafting effective responses to social problems that affect the development of children” (Shonkoff & Bales, 2011,p.17)

  40. “This is not an initiative for poor schools with disadvantaged families, it’s an initiative for all children in primary schools and all types of schools” (School Principal) SUMMARY The Flinders University’s Evaluation overall main recommendation was “that the broad framework, processes and resources of KidsMatter be maintained as the basis for a national rollout” Federal Minister for Mental Health & Aging announced a rollout to 1700 schools with an additional $18.4m.

  41. The Change Process & ENSEC Gladwell (2002) identifies 3 principals for creating social change: • The law of the few • ‘stickiness’ –the memorable key elements of the message • The power of context

  42. “Do not go where the path may lead, go instead where there is no path, & leave a trail”. Ralph W. Emerson Thank You

  43. The KidsMatter Initiative • KidsMatter (KM) - Australian national primary school mental health promotion, prevention and early intervention initiative. • KM - developed in collaboration with the Australian Government Department of Health and Ageing, beyondblue: the national depression initiative, the Australian Psychological Society, and Principals Australia • KidsMatter uses a whole-school approach. It provides schools with # a framework, # an implementation process, and # key resources to develop and implement evidence-based mental health promotion, prevention & early intervention strategies.

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