How can we optimise learning from trials in child and adolescent mental health?

Abstract

Improving child and adolescent mental health requires the careful development and rigorous testing of interventions and delivery methods. This includes universal school-based mindfulness training, evaluated in the My Resilience in Adolescence (MYRIAD) trial reported in this special edition. While discovering effective interventions through randomised controlled trials is our ultimate aim, null or negative results can and should play an important role in progressing our understanding of what works. Unfortunately, alongside publication bias there can be a tendency to ignore, spin or unfairly undermine disappointing findings. This creates research waste that can increase risk and reduce benefits for future service users. We advocate several practices to help optimise learning from all trials, whatever the results: stronger intervention design reduces the likelihood of foreseeable null or negative results; an evidence-informed conceptual map of the subject area assists with understanding how results contribute to the knowledge base; mixed methods trial designs aid explanation of outcome results; various open science practices support the dispassionate analysis of data and transparent reporting of trial findings; and preparation for null or negative results helps to temper stakeholder expectations and increase understanding of why we conduct trials in the first place. To embed these practices, research funders must be willing to pay for pilot studies and ‘thicker’ trials, and publishers should judge trials according to their conduct and not their outcome. MYRIAD is an exemplar of how to design, conduct and report a trial to optimise learning, with important implications for practice.

Effects of parental involvement programs on young children’s academic and social–emotional outcomes: A meta-analysis.

“…Examples include involving parents in school activities and school decisions (Boonk et al, 2018). While the positive value of empowering parents to become more involved in their child’s education during the early childhood years for children’s later educational attainment has been emphasized (Goldstein et al, 2017), more research is needed to understand whether interventions aimed at empowering parents’ involvement relate to changes in parental involvement and in children’s outcomes to shape effective policies and practice (Axford et al, 2019; Goldstein et al, 2017).…”

“…The debate is fueled by research demonstrating weak effects of parental involvement interventions in improving children’s outcomes (Axford et al, 2019). More specifically, when differentiating between outcomes, effect sizes were smaller for academic than for nonacademic outcomes, such as behavior problems and social–emotional skills (Axford et al, 2019). On the contrary, others argue that the evidence is substantial enough to conclude that interventions have considerable positive effects on children’s educational attainment (e.g., Goldstein et al, 2017).…”

Secondary school organisation and home–school collaboration: a tale of two systems

“…Schools readily claim their credentials for collaboration citing exemplars of good practice as evidence (Axford et al. , 2019).…”

“…A major review of home–school collaboration (Axford et al. , 2019) discovered flaws in “all” research papers.…”

“…, 2019) discovered flaws in “all” research papers. More encouragingly, the report (Axford et al. , 2019, p. 166) stated, “The majority of schools surveyed recognise the importance of parent engagement, with the vast majority (80%) believing that engaging parents is the responsibility of all staff”.…”