The Pyramid Club elementary school-based intervention: testing the Circle Time technique to elicit children’s service satisfaction

Children’s views of the social-emotional health services they use are important to service evaluation and development. However, often it is parental or clinician feedback that is gathered. In the current study Circle Time groups were run to identify children’s satisfaction with the Pyramid Club School-based intervention and to test the salience of this technique in eliciting children’s views. Children evaluated Clubs positively, reported no adverse effects and suggested ways to develop the intervention. The efficacy of Pyramid Clubs in building social-emotional competencies is supported by the children’s qualitative reports and Circle Time proved a salient technique for eliciting the views of young children

Barriers to attendance at diabetes education centres: perceptions of education providers

A key global policy initiative in the management of diabetes is empowerment through education. However, implementation of policy in the context of healthcare delivery may be challenging at times and the delivery of multi-disciplinary education is not an exception. Objective: To explore practitioners view about factors associated with non-attendance and identify ways to break some of the barriers to advancing government policy of education for all patients with diabetes. Method: A qualitative approach was adopted using a focus group interview with practitioners in four hospital sites in South East of England. It involves Diabetes Specialist Nurses, Podiatrist and Dietician (n=7) and semi-structured individual interviews (n=3). Thematic analysis was used to analyse the data. Findings: Three main themes emerged (1) Practitioners associated barriers (2) Patients’ associated barriers and (3)Strategies to improve attendance. Conclusion: The findings indicated that the practitioners agreed on the need for improved appointment system, better resources such as more secretarial support to follow-up cases and offering more choice to the patients. Also each locality must consider the cultural needs and background of their patient. However, while some participants felt that non-attendance should attract a sanction, such as a fine, others disagreed

Evaluating the impact of the Pyramid intervention on the emotional health and school performance of students in early secondary education

Background: Poor mental health in childhood and adolescence is associated with a range of negative outcomes. The unique role of schools to support pupils with psychological difficulties has been increasingly recognized (Layard and Clark, 2014; Fazel et al, 2014). However, gaps in school-based research have provoked a demand for real-world evaluations to provide models of good practice (DH, 2013; Fazel et al, 2014). Pyramid is a targeted, school-based intervention which promotes the socio-emotional well-being (SEWB) of vulnerable pupils. Evidence from primary school evaluations has demonstrated improvements in vulnerable children’s SEWB (Ohl et al 2008, 2012; McKenna et al, 2014). Aim(s): To examine the impact of Pyramid on adolescent pupils (aged 11-13), including secondary effects on school performance. To explore intervention facilitators which bring about change. Methods: The impact of the Pyramid intervention on 45 pupils from six secondary schools was examined through a mixed-methods design. Quantitative measures included cross-informant Strengths and Difficulties Questionnaires (SDQ: Goodman, 1997, 1998). Qualitative data was collected from focus groups. Results: Teacher–rated SDQ results demonstrated improvements in the intervention group’s socio-emotional competencies compared to a comparison group. A thematic analysis of the qualitative data supported the findings and also identified potential causal mechanisms facilitating change. Moreover, secondary outcomes on school performance were elicited. Conclusion: These findings will contribute to ongoing research on a larger cohort and provide preliminary support for Pyramid as a developmentally appropriate model for vulnerable young people in early secondary education. The supplementary impact of Pyramid on school performance warrants further investigation

Pyramid therapeutic activity clubs

This document describes the psychological theories underpinning the Pyramid model of early intervention. Pyramid is a school-based intervention targeted at children aged 7-14 who are shy, quiet, withdrawn, isolated and finding friendships difficult. The model is owned and licensed to schools and other partners by the University of West London

Improving socio-emotional health and school performance for pupils in early secondary education with Pyramid: a school-based, early intervention model.

Title of Abstract: Improving socio-emotional health and school performance for pupils in early secondary education with Pyramid: a school-based, early intervention model. Text of Abstract Background: Psychological distress in children and adolescents is increasing, however, many are not able to access appropriate and timely support. Schools have great potential for meeting pupils' mental health needs; effective, early intervention programmes can improve socio-emotional and educational outcomes and there is a demand for evidence-based models of good practice. Aim(s): To evaluate the Pyramid socio-emotional intervention (aimed at shy, withdrawn or socially isolated pupils) through its impact on the socio-emotional well-being (SEWB) and school performance of pupils (11- to 14-years), and to investigate the procedures and mechanisms underlying behaviour change. Methods: A mixed methods design was implemented. A quasi-experiment comprised the quantitative phase. Pyramid pupils (N=66) and a non-intervention comparison group (N=60) were assessed at three time points (baseline, post-test and 12-month follow-up) using measures including the Strengths and Difficulties Questionnaire (Goodman, 1997) and academic progress in English and Mathematics. Focus groups with Pyramid club attendees and group leaders comprised the qualitative phase and data were thematically analysed. Results: Intervention recipients demonstrated significant improvements in targeted aspects of SEWB at short- and longer-term follow-up, showing large effects. School performance findings indicated that Pyramid had a 'buffer effect' on the typical academic 'dip' characteristic of this developmental period. Qualitative findings supported intervention effectiveness and, moreover, identified behaviour change procedures (BCPs) and techniques (BCTs) to facilitate the model's development and diffusion. Conclusion: Findings have important implications for theory and practice. A five-part Pyramid model is proposed to integrate with Health Promoting School strategies to support SEWB and generate 'real world' outcomes

The efficacy of school-based interventions in socio-emotional health and well-being of children in middle childhood: an evaluation.

The development of socio-emotional competence in middle childhood is an essential acquisition that will enable a child to negotiate interaction with peers and others (Robbins & Rutter, 1990). A substantial body of research has arisen concerned with the identification and prevention of risk factors that might impede certain children's ability to thrive socially and emotionally (Doge & Coie, 1987, Parker & Asher, 1993). This expansion in prevention and evidence-based practice has led to changes in national policy. As a consequence of the revised Children's Act (2004) the promotion of emotional health and well-being in schools, through both the curriculum and school-based intervention, has become a recognised priority. The studies in this thesis describe a pragmatic evaluation of a Year 3 intervention, (Pyramid), which is designed to be delivered in school and targeted at children who are quiet, behaviourally inhibited and at risk of social isolation (Pyramid, 2007). Children's socio-emotional health was measured using the teacher-rated version of the Strengths and Difficulties Questionnaire (Goodman, 1997) both pre- and post-intervention and at a twelve-month follow-up. The views of the children who attended were elicited through a series of focus groups. Pyramid attendees showed greater levels of improvement than Comparison group classmates at both post-intervention time-points. Evidence of preservation of gains for Pyramid attendees was also shown at the twelve-month follow-up. Emergent themes from the focus groups supported these results with Pyramid attendee children reporting self-recognised improvements post-intervention and with no personal costs experienced as a result of the intervention. These results augment both the existing evidence base for Pyramid (Davies, 1999, Fitzherbert, 1985, Skinner, 1996) and add to the evidence base regarding the efficacy of school-based preventative interventions. This thesis proposes a novel conceptual model for the monitoring of socio-emotional health and wellbeing in primary schools and highlights the importance of the need to discern how these interventions can influence future policy and practice

Evaluating the nutritional status of children that follow a lacto-vegan Hare Krishna diet in a primary school

Introduction: This research investigated the diet and nutritional value of the pupils at Hare Krishna primary school in London that follow a plant-based (lacto-vegan) diet. A systematic literature review revealed that there is no study investigating the Hare Krishna diet in a primary school in London. Therefore the aim of the current study is to nutritionally evaluate the diets of the children and engage with the parents and school in order to improve provision. Furthermore, this research will bring valuable data about the obesity rate in Hare Krishna children (children that followed the diet since birth) based in London and will raise awareness about the importance of a planned lacto-vegan diet to the parents from the Hare Krishna community. Methodology: After the literature review, there are 3 stages to the study, the (1)baseline where anthropometric data will be collected as well as the 3-day diet plan (one weekend day and two weekdays) reported by parents. Also, the nutritional knowledge of the parents will be evaluated through a validated general nutritional knowledge questionnaire (GNKQ) to evaluate their understanding of food, nutrition and food choices. In the (2)intervention stage, nutritional workshops will be delivered for the parents and a sensory food education programme (Flavour School) for the children in order to inform them about nutrition. (3)Post intervention, the same steps from the intervention stage will be repeated. Conclusion: The preliminary data suggest that the students are motivated to eat healthier after the nutritional sessions and are more mindful about their choices of being a vegetarian. The overall outcome of the research is to support plant-based nutritionally balanced diets for children that could lead to reducing obesity and to engage with the stakeholders in order to improve the nutritional provision at schools following plant-based diets

Improving socio-emotional health for pupils in early secondary education with Pyramid: A school-based, early intervention model

Background. Policy makers are focusing increased attention on the role of schools to promote and support children’s mental health, and evidence-based models of good practice are in demand. Pyramid Club is a school-based, socio-emotional intervention, demonstrably effective with primary-aged pupils. Aims. This study extends previous Pyramid Club evaluations by examining effectiveness with pupils in early secondary education; service users’ perceptions and experiences were investigated to increase understanding of Pyramid’s impact, thus supporting enhanced practice. Sample. Participants (n = 126) comprised selected pupils, aged 11-14 (52 males; 74 females), who completed the 10 week programme (Pyramid group) and a non-intervention comparison group. Club leaders (n = 23) were trained, Pyramid volunteers. Methods. A mixed methods design was implemented. The Strengths and Difficulties Questionnaire (SDQ), informant-rated version (Goodman, 1997) and self-report version (Goodman, Meltzer, & Bailey, 1998), was used to measure socio-emotional well-being: pre-club (baseline assessment), post-test (within two weeks of programme completion), and at 12-month follow-up (informant-rated version only). Focus groups were conducted separately with Pyramid pupils and Club leaders. Results. Findings from informants and self-reports identified significant improvements for the Pyramid group in total difficulties and on pertinent SDQ subscales (e.g. emotional symptoms and peer relationship problems) at post-test. Improvements were sustained at 12-month follow-up. Comparison pupils demonstrated minimal change over time. Thematic analysis of qualitative data supported the quantitative findings and provided valuable insights into the Pyramid Club experience. Conclusions. Findings contribute to evidence-based, preventative models for the early adolescent population and support the social validity of Pyramid Club