Abstract

Background
Adolescence is a period of heightened vulnerability for the onset of mental illness and 75% of all mental health problems are established before 18 years old (1,2). Interventions aimed at building resilience have been shown to prevent mental illness in young people, improve wellbeing, reduce risk factors, increase help-seeking behaviours and reduce health inequalities (3–5). Schools are a key setting for building resilience, playing an important role in ameliorating some of the well-established negative effects of poverty and family difficulties on young people. Schools would welcome effective ways to deliver interventions aimed at building resilience, enhance wellbeing and improve help-seeking behaviour at scale and with low resource requirements. Interactive films potentially offer an accessible and cost-effective preventative tool, but there is lack of evidence evaluating effectiveness of such interventions (6). This feasibility trial presents the first step in establishing the evidence base for this preventative tool.
Intervention
The North East and North Cumbria Child Health and Wellbeing Network, in collaboration with William Howard School, worked with local filmmakers TryLife to create an interactive film for young people focusing on issues relevant to young people, including teenage pregnancy, mental health, building resilience and help-seeking attitudes. TryLife’s digital educational films use a young person focused co-production approach to public health concerns, grounded in the notion of building young people’s capabilities.
Methods
This is a mixed-methods feasibility trial, to evaluate the acceptability and feasibility of a randomised controlled trial of the interactive film intervention aimed to build resilience, enhance mental wellbeing and help-seeking attitudes for young people (14-18) in school settings in the North East and North Cumbria. Three schools were recruited and randomised to condition 1) watching the film in class 2) watching the film in class supported by youth workers or 3) class as usual without watching the film, as a control condition. Between November 2021 and September 2022, 175 students completed surveys about mental wellbeing, help-seeking and resilience before watching the film, and at 3- and 6-month follow-ups. Qualitative data were collected through focus groups with students and interviews with teachers and youth workers.

Findings
Initial evaluation of the process of the trial suggests there is no ‘one-size fits all’, with mixed experiences at schools. Many aspects worked well, such as data collection and analysis, ease of use of showing the film, and enthusiasm for the film and project from participants. There were also challenges to be remedied before beginning a larger-scale trial such as initial school recruitment and engagement, and resource issues within schools. Preliminary analysis suggests that pupils and teachers supported using the film as an intervention in schools.
Conclusion
Preliminary data suggest potential challenges to be addressed ahead of a larger-scale trial. However, the interactive film intervention received positive feedback and support from participants. Further analysis from the feasibility trial and a possible larger future trial will help to understand the impact of the interactive film to support young people’s wellbeing.
Funding
This study received funding from NIHR Applied Research Collaboration NENC.