Psychosocial Support Program for Public School Teachers (PSP)

Evaluation of the Effectiveness and Feasibility of Different Formats of a School-Based Psychosocial Support Program for Public School Teachers: A Randomized Clinical Trial

The goal of this clinical trial is to learn if different formats of a school-based psychosocial support training program can improve teachers' ability to recognize and respond to students' mental health needs. The study will include teachers working in public schools in Brazil.

The main questions it aims to answer are:

1. Do teachers who receive the training improve their knowledge on how to better to identify and support students with mental health difficulties?
2. Do different formats of training (synchronous online or self-paced) and the presence of supervision lead to different levels of improvement in this knowledge, in attitudes related to mental health, and helping behaviors?

Researchers will compare three versions of the program (synchronous online with supervision sessions, synchronous online without supervision sessions, and asynchronous format) to see which approach is more effective, acceptable, and feasible.

Participants will:

1. Take part in a training program delivered online or through self-paced materials;
2. In some groups, attend additional supervision sessions to discuss real-life cases;
3. Receive brief follow-up materials through mobile messages after the training
4. Complete online questionnaires at multiple time points (before the training, during the program, after completion, and at follow-up).

The study will measure changes in teachers' knowledge, attitudes, and behaviors related to supporting students' mental health, as well as satisfaction with the program and its feasibility for large-scale implementation.

Study Overview

• Status: Not yet recruiting
• Conditions: Mental Health Literacy; School Mental Health Training of Teachers
• Intervention / Treatment: Behavioral: Supervision Sessions; Behavioral: Mobile-Based Reinforcement Materials; Behavioral: Online School-Based Psychosocial Support Training; Behavioral: Asynchronous School-Based Psychosocial Support Training

• Study Type: Interventional
• Enrollment (Estimated): 2970
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Giovanni A. Salum, MD, PhD; Phone Number: (+55) 51 3359 8094; Email: gsalum @hcpa.edu.br

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

School-level inclusion criteria:

• Public schools from the state education system of Rio Grande do Sul, Brazil, serving students in "Ensino Fundamental" and "Ensino Médio" (equivalent to grades 1-12), and belonging to "Polo 1" or "Polo 2", administrative groupings defined by the Rio Grande do Sul State Department of Education that includes the following Regional Education Coordinators (Coordenadorias Regionais de Educação [CREs]): 1st, 2nd, 11th, 12th, 27th, and 28th CREs (Polo 1) and the 4th, 7th, 15th, 16th, 23rd, 25th, 39th CREs (Polo 2);
• Schools with 10 or more teachers on staff;

Participant-level inclusion criteria (staff level)

Participating teachers must meet all of the following criteria:

• School staff currently working in participating public schools;
• Able and willing to participate in all stages of the intervention and scheduled assessments;
• Provide informed consent prior to participation

Exclusion Criteria:

School-level exclusion criteria:

• Schools with fewer than 10 teachers on staff;
• Youth and Adult Education Centers (Núcleos de Educação de Jovens e Adultos [EJA]);
• Schools that began operating as full-time schools in 2026;
• Schools not belonging to Polo 1 or 2 of the state education system of Rio Grande do Sul;
• Schools that do not serve students in grades 1-12

Participant-level exclusion criteria

• Not currently working in a participating public school;
• Unable to participate in the training in the planned date for the specific school the teacher works at;
• Decline or are unable to provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm 1: Online Training + Supervision; Participants receive two synchronous online training sessions (via videoconference), followed by two supervision sessions (audio-based, small group) focused on case discussion and practical application. Participants also receive brief follow-up materials via mobile messages.	Behavioral: Supervision Sessions; Structured small-group supervision sessions conducted via audio calls, focused on discussion of real-life cases, clarification of concepts, and support for practical application of the training content.; Behavioral: Mobile-Based Reinforcement Materials; Brief follow-up materials delivered via mobile messaging to reinforce key concepts covered in the training sessions.; Behavioral: Online School-Based Psychosocial Support Training; A structured training program designed to improve teachers' ability to recognize and respond to students' mental health needs. The intervention includes evidence-based content on mental health literacy, identification of emotional and behavioral difficulties, and appropriate support and referral strategies. The training is delivered trough synchronous videoconference in two weekly sessions.
Experimental: Arm 2: Online Training Only; Participants receive two synchronous online training sessions (via videoconference) without additional supervision. Participants also receive brief follow-up materials via mobile messages.	Behavioral: Mobile-Based Reinforcement Materials; Brief follow-up materials delivered via mobile messaging to reinforce key concepts covered in the training sessions.; Behavioral: Online School-Based Psychosocial Support Training; A structured training program designed to improve teachers' ability to recognize and respond to students' mental health needs. The intervention includes evidence-based content on mental health literacy, identification of emotional and behavioral difficulties, and appropriate support and referral strategies. The training is delivered trough synchronous videoconference in two weekly sessions.
Active Comparator: Arm 3: Asynchronous Training (Control Condition); Participants receive the same training content delivered in a fully asynchronous, self-paced format through digital materials, without live sessions or supervision.	Behavioral: Asynchronous School-Based Psychosocial Support Training; A structured training program designed to improve teachers' ability to recognize and respond to students' mental health needs. The intervention includes evidence-based content on mental health literacy, identification of emotional and behavioral difficulties, and appropriate support and referral strategies. The training is delivered through an asynchronous self-paced course in a digital platform.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in the score in the Mental health Knowledge & Attitudes Questionnaire	Psychosocial support skills knowledge and attitudes will be assessed using a multiple choice instrument (Mental health Knowledge & Attitudes Questionnaire) developed for this study and previously piloted in a sample of teachers. Scores will range from 0 to 100%, reflecting the percentage of correct responses.	Baseline (T0) to post-intervention at 2-4 weeks (T2)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Early and Sustained change in the score in the Mental health Knowledge & Attitudes Questionnaire	Same instrument used in the primary outcome	Baseline (T0) to after the second training session (approximately 1 week after baseline)/after ending of the asynchronous training (T1); Baseline (T0) to 1-month follow-up (T3)
Appropriate Response to a Student Mental Health Concern: Open-Ended Classroom Scenario	Participants are asked to recall a recent situation in their classroom in which they noticed behaviors in a student that raised a possible concern about the student's mental health or psychosocial well-being. Participants provide an open-ended description of the situation and the behaviors they observed and describe what, if anything, they did to support the student. Responses will be evaluated to determine whether the actions described by the participant are considered appropriate (1) or not (0) based on the principles taught in the training. This assessment will be blind to the allocation group. The percentage of responses classified as appropriate will be calculated and compared across the three intervention arms. The recall period varies by assessment time point: at T1 and T2, situations occurring during the past week; and at T3, situations occurring during the past month.	after the second training session (approximately 1 week after baseline)/after ending of the asynchronous training (T1); post-intervention at 2-4 weeks (T2); 1-month follow-up (T3)
Self-rated knowledge	Assessed using two self-report items developed for this study. One item assesses participants' perceived knowledge of mental health, rated on a five-point scale from very poor to excellent. A second item assesses participants' confidence in their ability to identify students with psychosocial or mental health difficulties, rated on a five-point scale from not at all confident to extremely confident. Higher scores indicate greater self-rated knowledge and confidence. Participants may also select prefer not to answer.	baseline (T0); after the second training session (approximately 1 week after baseline)/after ending of the asynchronous training (T1); post-intervention at 2-4 weeks (T2); 1-month follow-up (T3)
Changes in helping behaviors toward students	Assessed using a retrospective self-report scale developed to capture mental health-related helping behaviors toward students ("Helping Behaviors Scale"), including identifying emotional distress, providing support, and facilitating referral to appropriate services. The scale includes five items describing specific helping behaviors. Each item is rated as yes, no, or does not apply. Higher endorsement indicates a greater number of supportive actions taken by the respondent in the past week.	Baseline (T0) to after the second training session (approximately 1 week after baseline)/after ending of the asynchronous training (T1); Baseline (T0) to post-intervention at 2-4 weeks (T2); Baseline (T0) to 1-month follow-up (T3)
Change in the levels of teacher burnout	Teacher burnout will be assessed using the 12-item version of the Burnout Assessment Tool (BAT-12), a self-report questionnaire developed to assess burnout as a multidimensional psychological syndrome. It evaluates four core dimensions of burnout: exhaustion, mental distance, cognitive impairment, and emotional impairment. Each item is rated on a five-point frequency scale ranging from 1 (never) to 5 (always). A total burnout score will be calculated as the mean of the 12 items, with higher scores indicating greater burnout symptoms.	Baseline (T0); after the second training session (approximately 1 week after baseline)/after ending of the asynchronous training (T1); post-intervention at 2-4 weeks (T2); 1-month follow-up (T3)
Training acceptability & satisfaction	Assessed using a post-training self-report questionnaire developed for this study. The questionnaire includes one item assessing perceived adequacy of training length, rated as too short, about right, or too long; one item assessing whether the training included sufficient practice of the skills taught, rated on a five-point Likert scale ranging from strongly disagree to strongly agree. Higher ratings indicate greater satisfaction with the training components. An optional open-ended item collects additional qualitative feedback about the training.	Post-intervention at 2-4 weeks (T2)
Cost-effectiveness of the intervention	Cost-effectiveness will be calculated as the cost per improvement unit in the Mental health Knowledge & Attitudes Questionnaire described previously	Baseline (T0) to post-intervention at 2-4 weeks (T2)

Collaborators and Investigators

• Sponsor: Hospital de Clinicas de Porto Alegre
• Collaborators: Child Mind Institute; Secretaria da Educação do Estado do Rio Grande do Sul (SEDUC-RS)
• Investigators: Principal Investigator: Giovanni A. Salum, MD, PhD, Child Mind Institute

Study record dates

Study Major Dates

• Study Start (Estimated): September 9, 2026
• Primary Completion (Estimated): November 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: June 1, 2026
• First Submitted That Met QC Criteria: June 22, 2026
• First Posted (Actual): June 24, 2026

Study Record Updates

• Last Update Posted (Actual): September 9, 2026
• Last Update Submitted That Met QC Criteria: September 3, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: Cluster Randomized Controlled Trial; Mental Health Promotion; Psychosocial Support; School Mental Health; Teacher Professional Development; Education Policy
• Other Study ID Numbers: 95402126.0.0000.5327

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

De-identified individual participant data underlying the results reported in this study (including data dictionaries) will be made available to qualified researchers.

Data will be shared after publication of the primary results, upon reasonable request and subject to approval by the study investigators. Requests will be evaluated based on scientific merit, feasibility, and ethical considerations.

Data will be provided in a de-identified format to ensure participant confidentiality and compliance with applicable data protection regulations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No