This Study Aims to Evaluate the Cultural Adaptation, Implementation, and Effectiveness of the RAISE Program Grounded in Malti's 3 E's Model and the Kindness Developmental Paradigm in Portugal (RAISE-PT)

August 6, 2026 updated by: ISPA - Instituto Universitario de Ciencias Psicologicas, Sociais e da Vida

Promoting Early Childhood: Implementation and Evaluation of the RAISE in Portugal

Child mental health has become a pressing global concern, with 13-20% of children and adolescents presenting mental disorders and about half of adult disorders emerging before age 18. Socioemotional development - encompassing emotion regulation, self-empathy, and empathy for others - is considered a cornerstone of mental health and a key protective factor. Although primary caregivers are central to fostering these competencies, educators also play a decisive role once children enter preschool, while being themselves particularly vulnerable to burnout, with consequences for classroom climate and child outcomes. Integrated programs that simultaneously support children's development and adults' socioemotional competencies are therefore needed, yet remain scarce in Portugal. This study aims to evaluate the cultural adaptation, implementation, and effectiveness of the RAISE program (Research and Practice Partnership: Building Awareness and Increasing Social-Emotional Capacity in the Early Years), developed in Canada and grounded in Malti's 3 E's model and the Kindness developmental paradigm. A Randomized Controlled Trial will be conducted with approximately 100 educators from public and private institutions, randomly allocated to an intervention or waitlist control group. RAISE is delivered online over three weeks, combining asynchronous videos and synchronous group sessions across three modules. Assessments at pre-intervention, post-intervention, and follow-up will use multi-informant measures, including the DASS-21, SDQ, and SERT. Data will be analyzed through mixed ANOVA models following intention-to-treat principles. Findings are expected to inform the feasibility and cultural relevance of integrated, prevention-oriented socioemotional programs and to contribute to early childhood mental health promotion in Portugal.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Child mental health has become one of the most pressing public health concerns worldwide. It is estimated that between 13% and 20% of children and adolescents present some form of mental disorder, such as anxiety or depression, and approximately half of adult mental disorders begin before the age of 18 . These figures underscore the importance of promoting psychological well-being from early childhood and of identifying domains that play a protective role for mental health. Among these, socioemotional development has been described as the foundation of mental health, integrating emotional and social competencies that are fundamental for recognizing and self-regulating emotions, constructing identity, establishing positive interpersonal relationships, supporting learning, and making responsible decisions .

Among the theoretical models seeking to explain the development of these competencies, Malti's framework organizes socioemotional development around three components - the 3 E's: Emotion Regulation, Self-Empathy, and Empathy for Others. Emotion regulation, the first of these components, refers to the human capacity to control the occurrence, intensity, and expression of internal states in order to achieve goals and develop morally appropriate behaviors , involving both adaptive strategies (e.g., cognitive reappraisal) and maladaptive strategies (e.g., rumination, suppression) . Emotion regulation develops across the lifespan, initially supported by processes of hetero- and co-regulation with attachment figures and progressively internalized into self-regulatory skills, particularly between the ages of 3 and 4. Empathy, in turn, constitutes a central indicator of socioemotional development and unfolds across three dimensions - affective, cognitive, and behavioral - whose emergence begins in the first months of life and becomes progressively more complex throughout childhood .

Although primary caregivers play a central role in the development of these competencies , as children gain autonomy and enter preschool education, their relational world expands beyond the family context . From this ecological perspective, educators and teachers emerge as authentic agents with a decisive role in promoting children's socioemotional competencies . At the same time, the socioemotional competencies of these professionals themselves shape classroom climate and children's development . Yet the complexity of the profession and continuous exposure to emotional demands make educators and teachers particularly vulnerable to burnout and exhaustion - the so-called "burnout cascade" with direct implications for their well-being and for the quality of their interactions with children .

Considered jointly, these lines of evidence converge on the need for socioemotional learning programs that adopt an integrated approach - one that fosters children's development while simultaneously supporting the socioemotional competencies and well-being of caregivers and educators, and that addresses protective and risk factors for mental health. It is within this framework that the RAISE program (Research and Practice Partnership: Building Awareness and Increasing Social-Emotional Capacity in the Early Years) emerges, developed at the Centre for Child Development, Mental Health, and Policy (Canada), and grounded in Malti's E's model and in the developmental paradigm of Kindness . The program targets caregivers and education professionals working with children aged 3 to 8 and is organized into three modules - socioemotional development, early relationships (the 3 C's: connection, caring, and coaching), and developmental indicators such as well-being and stress - articulating three core pillars: knowledge, practice, and routine .

In Portugal, the scarcity of structured programs aimed at promoting socioemotional competencies among education professionals makes the cultural adaptation and evaluation of RAISE particularly relevant. The present study therefore aims to evaluate the adaptation, implementation, and effectiveness of the program in the Portuguese context, examining its impact on (i) professionals' knowledge and practices, (ii) professionals' mental health, (iii) children's socioemotional competencies, and (iv) children's mental health, as well as (v) the associations between these variables. It is hypothesized that professionals and children allocated to the intervention group will show significantly greater improvements in these indicators over time compared to those in the control group.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
120

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: João Silva, PhD Student
  • Phone Number: 35121881700 35121881700
  • Email: joao.silva@ispa.pt

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • being actively employed as an educator or teacher working with children aged 3 to 8 years;
  • being fluent in Portuguese;
  • having access to an internet-enabled electronic device (e.g., a smartphone, tablet, or computer) to participate in the online training;
  • being available to participate in all phases of the study, including the online training sessions, follow-up assessments, and questionnaire completion;
  • providing informed consent to participate in the training, follow-up sessions, and questionnaire completion.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
No Intervention: Control Group
No Intervention
Active Comparator: Intervention with Raise
Intervention
Behavioral: raise
The RAISE training is delivered over three weeks and comprises three modules. Each module includes an asynchronous session (three self-paced 15-minute videos on definitions, developmental examples, and home strategies) followed by a 90-minute synchronous group session focused on practice, mindfulness, discussion, and interactive activities. The modules cover, respectively, the 3 E's of social-emotional development (emotion regulation, self-empathy, and empathy toward others), the 3 C's of early relationships (connection, caring, and coaching), and developmental indicators such as well-being, resilience, and stress, with educators receiving additional content on assessment tools. Follow-up sessions are held one week and two months after completion, and participants retain unlimited online access to all materials (Speidel et al., 2021, 2023, 2024).

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997)
Time Frame: Baseline, up to five weeks, up to 13 weeks
The SDQ (Goodman, 1997; Portuguese version: Fleitlich, Loureiro, Fonseca, & Gaspar, 2005) assesses children's strengths and difficulties across five domains: (1) emotional symptoms, (2) conduct problems, (3) hyperactivity/inattention, (4) peer problems, and (5) prosocial behavior. The scale has 25 items rated on a 3-point scale (0 = not true, 1 = somewhat true, 2 = certainly true). Children's competencies (strengths) are assessed through the prosocial behavior domain, whereas the total difficulties score is derived from the remaining four domains.
Baseline, up to five weeks, up to 13 weeks
Depression, Anxiety, and Stress Scale - 21 (DASS-21)
Time Frame: Baseline, up to five weeks, up to 13 weeks
The DASS-21 (Lovibond & Lovibond, 1995; Portuguese version: Pais-Ribeiro, Honrado, & Leal, 2004) is a self-report scale designed to assess the emotional states of depression, anxiety, and stress. It comprises 21 items, each rated on a 4-point scale (0 = did not apply to me at all to 3 = applied to me very much, or most of the time). The scale comprises three subscales: (1) depression (7 items), assessing symptoms such as inertia, dysphoria, lack of interest or involvement, anhedonia, self-deprecation, discouragement, and devaluation of life; (2) anxiety (7 items), assessing autonomic arousal, subjective experiences of anxiety, musculoskeletal effects, and situational anxiety; and (3) stress (7 items), assessing difficulty relaxing, ease of being upset or agitated, nervous arousal, irritability, exaggerated reactions, and impatience.
Baseline, up to five weeks, up to 13 weeks
Social-Emotional Responding Task (SERT; Malti, 2017)
Time Frame: Baseline, up to five weeks, up to 13 weeks
The SERT (Malti, 2017) is an instrument for assessing social-emotional development in children aged 4 to 8 years across four domains: (1) emotion regulation, (2) healthy guilt, (3) self-sympathy, and (4) sympathy for others (Malti, 2017; Malti et al., 2021). The 29-item questionnaire uses a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) and asks caregivers and educators/teachers to rate the child's behavior based on interactions with others and reactions to specific scenarios (e.g., "My child feels bad for other children who are sad").
Baseline, up to five weeks, up to 13 weeks

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Satisfaction with the training (Speidel et al., 2021, 2023, 2024)
Time Frame: up to five weeks
After each asynchronous and synchronous session, participants will report their satisfaction with the session on a 10-point scale (1 = very dissatisfied, 4 = to a small extent, 7 = to a moderate extent, 10 = very satisfied).
up to five weeks
Perceptions of learning
Time Frame: one weeks, two weeks, three weeks
participants will report their perceptions of their own learning on a single item rated on a 10-point scale (1 = not at all to 10 =to a very great extent).
one weeks, two weeks, three weeks
Intent to use strategies
Time Frame: one week, two weeks, three weeks
e.g., "To what extent would you use any of the strategies mentioned in the training to promote growth and well-being?").
one week, two weeks, three weeks
Knowledge of training content
Time Frame: Baseline, one week, two weeks, three weeks and up to 13 weeks.
Participants will report their understanding of core social-emotional concepts. These items were developed by Speidel, Colasante, and Malti to assess knowledge of the core social-emotional concepts targeted in the training (e.g., "I understand what empathy for oneself is and how it develops") as well as knowledge of how to apply them (e.g., "I know how to support children's empathy for themselves"). Items are rated on a 10-point scale (1 = entirely disagree, 4 = somewhat disagree, 7 = somewhat agree, 10 = entirely agree).
Baseline, one week, two weeks, three weeks and up to 13 weeks.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
ISPA - Instituto Universitario de Ciencias Psicologicas, Sociais e da Vida

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Câmara Municipal Oeiras

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Manuela Verissimo, PhD, ISPA - Instituto Universitario de Ciencias Psicologicas, Sociais e da Vida

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 30, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 3, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 6, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 12, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 12, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 6, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • E-I-006-03-26

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Intellectual Property Data (IPD) might not be shared due to concerns about confidentiality and legal restrictions. Sharing it could risk exposing proprietary or sensitive information, including details that may affect entire family's privacy.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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