Cultural adaptation of preschool PATHS (Promoting Alternative Thinking Strategies) curriculum for Pakistani children

Children's social emotional competence in Pakistan and Sweden: Factor structure and measurement invariance of the Social Competence Scale (teacher edition)

Introduction

Social emotional competence is fundamental to the positive development of children and youth. Accurately understanding and assessing children's social emotional competencies, using psychometrically sound instruments, are essential to global efforts to support children's social emotional learning, academic achievements, and health. This study examined the psychometric properties of a teacher-reported measure of young children's social emotional competence, the Social Competence Scale - Teacher edition (SCS-T), in two samples of children growing up with varied economic resources/conditions, cultural norms, and educational experiences, namely Pakistan (N = 396) and Sweden (N = 309).

Methods

Participants were aged 4-6 years old. The study design was cross-sectional.

Results and Discussion

Using structural equation modelling, bi-factor confirmatory factor analysis models implying shared variance, among all items and domain-specific shared variance, among the prosocial items, emotion regulation items, and academic skills items resulted in good fitting models in each respective sample. Invariance testing across samples revealed a subset of items from each factor structure with partial scalar invariance, whereby five items had equal thresholds and could be comparable across the two samples. Thus, results provided partial support for hypotheses 1, 2, and 3, in that the posited three factor model (H1) was not clearly supported and a bi-factor model evidenced the best fit, among tested models, for both samples. Further, partial scalar invariance (H3) was found for five items out of 25 items, concerning social competence and academic skills. In regards, to the posited research question, the results of Z-tests showed significant (p < 0.001) latent mean differences between the samples. Compared to the Swedish sample, the Pakistani sample was 1.80 units lower on social competence (z = -6.41, p < 0.001) and 1.86 units lower on academic skills (z = -7.87, p < 0.001). The implications of these findings in light of efforts to promote positive child development in diverse parts of the world are considered.

The role of teachers' commitment to implement in delivering evidence-based social-emotional learning programs

Although there are reasons to believe that teachers' commitment to learn and enact an evidence-based program (i.e., their commitment to implement) predicts their implementation fidelity, there is surprisingly little quantitative research testing this relationship. Using a national large-scale evaluation of three preschool social-emotional interventions, this study investigated how strongly teachers' commitment predicted implementation fidelity and whether commitment was a meaningful predictor of fidelity as compared to other individual factors (i.e., teacher stress at baseline) and contextual factors (i.e., collegial supports, classroom behavioral problems, and classroom quality at baseline). We surveyed 230 preschool teachers in their first year of implementing the interventions; data sources include surveys from teachers and 52 intervention coaches as well as classroom observational data. We found that teachers' baseline commitment consistently predicted implementation fidelity across time and that commitment predicted unique variation in fidelity after accounting for other individual and contextual factors. In addition, implementation fidelity had a moderate positive relationship with teachers' baseline classroom quality and a small negative association with baseline classroom behavior problems. Findings are discussed with respect to implementation science in education.

A Cluster Randomized Trial of Promoting Alternative Thinking Strategies (PATHS®) With Swedish Preschool Children

The preschool edition of Promoting Alternative THinking Strategies (PATHS^®) is a school-based, teacher implemented universal intervention developed in the United States designed to promote social emotional competence (SEC) in children as a foundation for improved mental health. PATHS is delivered as a curriculum and it is based on theories and research regarding SEC, brain development, and optimal school environments. A majority of children in Sweden attend preschool, which is government-subsidized and follows a national curriculum focusing on both academic and social emotional learning. However, there is not so much focus on formal instruction nor manual-based lessons. The purpose of this study was to assess the short-term (pre- to post-test) effects of PATHS in the Swedish preschool setting. Using a two-wave cluster randomized trial with multi-method and informant assessment (N = 285 4 and 5-year-old Swedish children; n = 145 wait-list control; n = 140 intervention; K = 26 preschools; k = 13 intervention; k = 13 control) we assessed changes in child emotional knowledge, emotional awareness, social problem solving, prosocial play, inhibitory control, and working memory using structural equation modeling (SEM). We included schools with at least one classroom of 4–5-year-old children from three municipalities. We excluded open preschools, parent cooperative preschools, and family day homes. After random assignment, schools were informed of condition assignment. Research team members were not blind to assignment. We hypothesized that relative to children in control schools, children in intervention schools would evidence improvements in social emotional competence as well as other outcomes. Children in PATHS, relative to children in the control, evidenced improvements in working memory and prosocial play, but also showed an increase in hyperactive behaviors. Girls in PATHS, relative to girls in the control, showed improvement in emotional knowledge and reduced anxiety. These results are considered in light of efforts to promote positive development and mental health. The trial registration number at ClinicalTrials.gov is NCT04512157. Main funding was from Swedish Council for Working Life and Social Research, the Swedish Research Council, Formas, and VINNOVA (dnr: 259-2012-71).

Adapting evidence-informed population health interventions for new contexts: a scoping review of current practice

BACKGROUND

Implementing evidence-informed population health interventions in new contexts often requires adaptations. While the need to adapt interventions to better fit new contexts is recognised, uncertainties remain regarding why and when to adapt (or not), and how to assess the benefits (or not) of adaptation. The ADAPT Study aims to develop comprehensive guidance on adaptation. This scoping review informs guidance development by mapping and exploring how adaptation has been undertaken in practice, in public health and health services research.

METHODS

We searched seven databases from January 2000 and October 2018 to identify eligible studies for this scoping review and a related systematic review of adaptation guidance. We mapped the studies of adaptation by coding data from all eligible studies describing the methods, contexts, and interventions considered for adaptation. From this map, we selected a sample of studies for in-depth examination. Two reviewers extracted data independently into seven categories: description, key concepts, types, rationale, processes, evaluation methods, evaluation justification, and accounts of failures and successes.

RESULTS

We retrieved 6694 unique records. From 429 records screened at full text, we identified 298 eligible studies for mapping and selected 28 studies for in-depth examination. The majority of studies in our map focused on micro- (i.e., individual-) level interventions (84%), related to transferring an intervention to a new population group within the same country (62%) and did not report using guidance (73%). Studies covered a range of topic areas, including health behaviour (24%), mental health (19%), sexual health (16%), and parenting and family-centred interventions (15%). Our in-depth analysis showed that adaptation is seen to save costs and time relative to developing a new intervention, and to enhance contextual relevance and cultural compatibility. It commonly follows a structured process and involves stakeholders to help with decisions on what to adapt, when, and how.

CONCLUSIONS

Adaptation has been undertaken on a range of health topics and largely in line with existing guidance. Significant gaps relate to adaptation of macro- (e.g., national-) level interventions, consideration of programme theories, mechanisms and contexts (i.e., a functional view of interventions), nuances around stakeholder involvement, and evaluation of the adapted interventions. Registration Open Science Framework, 2019, osf.io/udzma.

Adaptation and Feasibility Testing of a Coping Skills Training Program for Chinese Youth with Type 1 Diabetes

PURPOSE

To adapt an evidence-based coping skills training program to the cultural context and healthcare system for youth with T1D in China, and to evaluate the feasibility, acceptability, and preliminary efficacy of the modified program.

DESIGN AND METHODS

A multiphase process was used based on a heuristic framework for program modification. This included information gathering, preliminary adaptation, and feasibility evaluation.

RESULTS

In Stage 1, the coping skills training protocol was translated and evaluated for relevance by the stakeholders (youth diagnosed with T1D, parents, and healthcare providers). Recommendations for revisions and culturally relevant scenarios were identified. In Stage 2, the program was adapted for youth with a wider age range. Scenarios and logistics of the program were changed, and a session on blood glucose management was added to enhance cultural relevance. In Stage 3, the feasibility of the modified program was evaluated with 15 youth participants diagnosed with T1D (mean age: 13.88 years). Problem-solving coping and the self-efficacy of the youth improved over time (p < .05). High attendance, engagement, and satisfaction were achieved.

PRACTICE IMPLICATIONS

The CST-China program has the potential to provide Chinese youth with T1D an interactive and engaging program to improve health outcomes. The adaptation process of a CST program can provide a reference for pediatric nurses to develop programs which are culturally relevant, acceptable to stakeholders, and aligned with the healthcare system in China.

CONCLUSIONS

A coping skills training program was systematically adapted and aligned to the healthcare system in China, with evidence of feasibility and acceptability in Chinese youth with T1D.

Mental Health Prevention in Preschool Children: study protocol for a feasibility and acceptability randomised controlled trial of a culturally adapted version of the I Can Problem Solve (ICPS) Programme in Chile

Background

Difficulties with delaying gratification, coping with frustration, and regulating emotions are significant predictors of aggression and behavioural and interpersonal problems early in life and mental health disorders during childhood, adolescence, and adulthood. Mental health problems generate a high burden of disease in society in general, and there is a significant treatment gap, especially among economically vulnerable populations. Prevention strategies appear to be the more recommendable options, mainly if these interventions can be implemented early in life and at low cost. Few preventive interventions aiming to increase resilience in the face of adversity have been rigorously evaluated among Chilean preschoolers. Substantial international evidence indicates that strengthening basic psychological skills, such as emotion regulation and social problem-solving, can reduce the incidence of mental pathology and improve various academic indicators. The curriculum of the Interpersonal Cognitive Problem-Solving Programme, also known as I Can Problem Solve (ICPS), is focussed on the development of the cognitive process and children’s social problem-solving skills. ICPS is effective at increasing prosocial behaviours and reducing aggressive behaviour among preschoolers. ICPS provides children with the skills to think about how to solve problems using sequenced games, discussion, and group-interaction techniques focussed on listening to, and observing, others, promoting empathy and alternative and consequential thinking. The aims of this study are (1) to develop a culturally appropriate version of the ICPS programme and (2) to evaluate the acceptability and feasibility of the adapted version of ICPS among vulnerable schools in Santiago, Chile, conducting a pilot randomised controlled trial with three arms: (1) the ICPS programme delivered by an internal early teacher, (2) the ICPS programme delivered by an external early teacher, and (3) a control group.

Methods and design

This is a pilot, three-armed randomised controlled trial of the adapted version of ICPS with an enrolment target of 80 preschoolers attending four schools per arm. Children in both intervention groups will receive the ICPS programme: 59 sessions of 20 min each delivered three times a week by trained internal or external early teachers over 5–6 months. Internal teachers are part of the school staff, and external teachers are facilitators hired by the research team to go to schools and deliver the intervention during a normal school day, working together with the early teacher present in the classroom. The intervention consists of games using pictures, puppets, and simple role-playing techniques to facilitate the learning process. Cognitive regulation, emotion recognition, social-problem-solving skills, and psychological functioning will be measured at baseline and after the intervention.

Discussion

No previous studies in Spanish-speaking Latin American countries have been conducted to explore the acceptability and feasibility of ICPS to provide information to evaluate the effectiveness of this intervention on a larger scale.

Trial registration

ClinicalTrials.gov, ID: NCT03383172. Registered on 26 December 2017.

Electronic supplementary material

The online version of this article (10.1186/s13063-019-3245-3) contains supplementary material, which is available to authorized users.