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. The North East and North Cumbria (NENC) Child Health and Wellbeing Network worked with local filmmakers TryLife to create an interactive film to support young people’s wellbeing. Interactive films potentially offer an accessible and cost-effective preventative tool, but there is lack of evidence evaluating effectiveness of such interventions.
Methods
This mixed-methods feasibility trial aimed to evaluate 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 NENC school settings. Primary outcomes were key parameters of the trial, including willingness of schools to participate, participant recruitment, and retention. Secondary outcomes were mental wellbeing, resilience and help-seeking attitudes, analysed descriptively and with a two-way ANOVA. 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. Between November 2021 and December 2022, 172 students completed surveys about mental wellbeing, help-seeking and resilience before watching the film, and at 3- and 6-month follow-up. Acceptability was assessed qualitatively through three focus groups with students and teacher interviews (n=3).

Findings
Recruitment of schools was challenging due to resource issues and impact of the pandemic. Retention to Follow-up 2 was high in year 10 (96%), but considerably worse in year 12 (60%). Qualitative data indicated acceptability of the intervention and project. Pupils and teachers supported using the film as an intervention in schools, and particularly liked the interactive element to stimulate discussion. Data demonstrated that communication about the project and resource issues within schools were challenges to be remedied before beginning a larger-scale trial. Preliminary analyses showed no significant differences (CI 95%) on wellbeing, resilience and help-seeking outcomes between conditions.

Conclusion
Some trial aspects worked well, including data collection and analysis. However, recruitment, retention and communication with schools were challenging. Participants offered positive feedback both on the film and trial. Although secondary outcomes did not indicate significant differences between groups, sample sizes were small and further analyses need to be conducted to confirm results. Future research could help to understand the film’s impact to support young people’s wellbeing further. However, potential challenges need addressing ahead of a larger-scale trial.