3 - (IOP 12) The Stress and Coping Toolkit: Development and Pilot Implementation of a Universal Preventive Mental Health Program in Middle Grade Classrooms

Background. Mental health challenges among youth are rising nationally, and youth from marginalized backgrounds are disproportionately exposed to trauma and adversity1,2. Primary prevention targeting those vulnerable to developing mental health problems can mitigate the onset and consequences of mental disorders3. Mental health promotion programs in schools take a public health approach, reducing reliance on specialized services. Classroom programs benefit student mental health outcomes,4,5 and they often focus on Social Emotional Learning (SEL) to foster social skills, self-awareness, decision-making, and self-management.6 Recently, there has been increasing attention to mental health literacy (MHL), or "the knowledge and beliefs about mental disorders which aid their recognition, management or prevention.”7 Most programs do not integrate both SEL and MHL or address common experiences like grief, loss, and trauma8. MHL programs are also rarely delivered by educators. To address these gaps, a pediatric academic medical center partnered with Chicago Public Schools to create the Stress and Coping Toolkit (SCT), a preventive mental health program grounded in cognitive-behavioral skills that integrates SEL and MHL, with an explicit focus on stress, trauma, and grief. This process was guided by the PRECEDE-PROCEED model,9 a framework used to design, implement, and evaluate health promotion programs in partnership with the target community. This study describes the SCT’s initial development and revision, as well as preliminary feedback from educators and students.

Methods. The first open adaptive pilot trial of SCT included 38 educators and school counselors from 11 schools. The second pilot trial collected feedback on the revised SCT from eight implementers and 168 6th-8th grade students from 5 schools. On average, students at participating schools in this trial were 10% Black/African American and 85% Latinx, with 86% from economically disadvantaged backgrounds. Participants completed online surveys assessing feasibility, acceptability, and perceived impact of SCT. Descriptive statistics and qualitative content analysis were conducted.

Results. SCT was feasible and acceptable to educators, who perceived it as helpful to students. SCT also improved educators’ self-efficacy and promoted student identification and referral to mental health supports. Most students agreed that SCT activities were enjoyable and helped them to better cope with their problems. Nearly half of students reported increased likelihood of approaching an adult with a mental health concern.

Discussion. Findings support feasibility, acceptability, and perceived utility of SCT among educators and students. Future work will evaluate SCT’s impact on student MHL and psychosocial functioning.

1. Kalb et al., 2019
2. Shim & Starks, 2021
3. Singh et al., 2022
4. Das et al., 2016
5. Sanchez et al., 2018
6. CASEL, n.d.
7. Jorm et al., 1997
8. Lawson et al., 2018
9. Green & Kreuter, 2005