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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)

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.

Studieoversikt

Status

Har ikke rekruttert ennå

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

120

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: João Silva, PhD Student
  • Telefonnummer: 35121881700 35121881700
  • E-post: joao.silva@ispa.pt

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Ja

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Trippel

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Ingen inngripen: Kontrollgruppe
Ingen inngripen
Aktiv komparator: Intervention with Raise
Intervention
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).

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Satisfaction with the training (Speidel et al., 2021, 2023, 2024)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Samarbeidspartnere

Etterforskere

  • Hovedetterforsker: Manuela Verissimo, PhD, ISPA - Instituto Universitario de Ciencias Psicologicas, Sociais e da Vida

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. oktober 2026

Primær fullføring (Antatt)

30. desember 2027

Studiet fullført (Antatt)

31. desember 2027

Datoer for studieregistrering

Først innsendt

3. august 2026

Først innsendt som oppfylte QC-kriteriene

6. august 2026

Først lagt ut (Faktiske)

12. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

12. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

6. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • E-I-006-03-26

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

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.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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