Early adolescents’ experiences of a school- and community-based prevention program: perceived ‘bridges’ and ‘walls’ to promoting mental health and wellbeing

ABSTRACT

Objective

The prevalence of mental health difficulties among children and adolescents is rising. This study aimed to explore early adolescents’ lived experiences of a school- and community-based prevention program, including what helps, why, and when.

Method

Seventy-eight semi-structured interviews were conducted with early adolescents (aged 10 to 13) as part of the evaluation of HeadStart, a UK-based program. A reflexive thematic analysis was conducted and a typology was developed to facilitate comparisons between participants' experiences.

Results

The typology consisted of five groups, including early adolescents who described positive or helpful experiences of HeadStart support, those who wanted more support, those who described more mixed or unhelpful experiences of support, and those who did not report receiving much or any support. Cross-group themes highlighted the ‘bridges’ that interventions can build to promote mental health and wellbeing, e.g. learning new coping or problem-solving skills. There was more variation between the groups in terms of the ‘walls’ (e.g. issues with intervention content, timing, or location) that may limit intervention effectiveness. There were also some group differences in terms of the other sources of social support that participants had access to and the level of difficulties that they were facing in their lives.

Discussion

The findings suggest that intervention developers should tailor design and delivery according to different profiles of early adolescents who may be more or less able or willing to accept help, and who may experience different formats, structures, and content of support as either more or less useful.

KEYWORDS:

• Qualitative
• prevention
• school
• mental health
• wellbeing
• early adolescents

Acknowledgements

Our utmost thanks to the young people who generously shared their experiences with us. With thanks also to other members of the HeadStart Learning Team (Rosa Town, Charlotte Nicoll, and Parise Carmichael-Murphy) for their vital role in the collection, management, and analysis of data used to inform our research publications. Finally, with thanks also to our colleagues in the National Institute for Health Research (NIHR) Children and Families Policy Research Unit (Ruth Gilbert, Kevin Herbert, Tanya Lereya, and Sarah Cattan) for their helpful feedback on earlier drafts of this paper.

Consent to participate and for publication

As all participants were under the age of 16, written informed consent was sought from participants’ parents or carers and written assent was sought from participants themselves for them to take part and for the publication of their anonymised data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approvals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval for this study was granted by the University College London (UCL) Research Ethics Committee (ID number 7963/002).

Data availability statement

Access to data is restricted to the HeadStart Learning Team to comply with the study’s research ethics approval. Materials (e.g. interview schedules) are available upon request to the corresponding author.

Additional information

Funding

HeadStart is a six-year, £67.4 m National Lottery funded program set up by The National Lottery Community Fund, the largest funder of community activity in the UK. The data used in this study were collected as part of the HeadStart learning program and supported by funding from The National Lottery Community Fund. The content is solely the responsibility of the authors and it does not reflect the views of The National Lottery Community Fund. This study was funded by the National Institute for Health and Care Research (NIHR) Policy Research Program through the NIHR Children and Families Policy Research Unit. ES was also partly supported by the NIHR ARC North Thames. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.