Training school teachers to promote mental and social well-being in low and middle income countries : lessons to facilitate scale-up from a participatory action research trial of youth first in India

Abstract

Mental and social wellbeing (MSWB) promotion programs could improve mental health and other outcomes for youth in Low and Middle Income Countries (LMICs). Unfortunately, few such programs have progressed to scale-up and few studies have detailed processes and considerations that could facilitate doing so. This study begins to fill these gaps, describing key findings from training and supporting government middle school teachers to deliver the Youth First Resilience Curriculum, a MSWB promotion program, in Bihar, India. We conducted a Participatory Action Research trial of the resilience curriculum among 792 middle school youth and 55 teachers at 15 government schools. Participant-observations, exit interviews, and group discussions were conducted and analyzed via multiple rounds of coding to generate thematic findings. A number of schools showed relatively high levels of interest, session reliability and fidelity, student interaction and teacher facilitative abilities, but there was great variation within the sample. Three leverage points emerged to facilitate future scale-up: factors for successful site assessment and program initiation, supporting teacher success via interest and motivation, and responding to varied teacher skill levels. These points represent critical focus areas for practitioners and policy-makers as more MSWB promotion programs begin to scale in LMICs.