Noriko HIDA

Background/Objectives: School-based universal mental health interventions offer an inclusive and scalable approach to promote mental health and well-being among children. This study evaluates the Let’s Learn About Emotions (Opitaan tunteista in Finnish) program, an evidence-based, teacher-led universal school-based intervention originally developed in Japan and culturally adapted for Finnish primary schools. Methods: A total of 512 fourth-grade students from 14 schools participated in the 12-week program during spring 2023. Using a mixed-methods design, we assessed (1) the program’s acceptability among students, parents, teachers, and school principals, (2) fidelity of implementation, and (3) changes in students’ mental well-being pre- to post-intervention. Quantitative data included standardized questionnaires with valid responses collected from 233 students at baseline and 209 students at post-intervention, as well as parents and teachers. Qualitative data were collected through focus group discussions involving parents, teachers, and school principals during spring 2024. Results: Acceptability was high across all respondent groups. Teachers adhered closely to the teaching manual, as confirmed by self-reports and direct classroom observations. Statistically significant improvements were observed in parent-reported conduct problems, hyperactivity, and peer problems, though student self-reports did not show similar benefits. Conclusions: The program was found to be both acceptable and culturally appropriate in the Finnish context. Findings from this study provide valuable insights for refining and improving the program for future implementation. To more rigorously examine its effectiveness, future studies should employ a randomized controlled trial design.

Introduction Emotional awareness and emotion regulation are crucial for cognitive and socio-emotional development in children. School-based interventions on socio-emotional skills have the potential to prevent these problems and promote well-being of children. The Japanese school-based program, Universal Unified Prevention Program for Diverse Disorders (Up2-D2), has shown preventive effects on mental health of children in Japan. The aims of this protocol paper are to describe the unique process of adapting the Up2-D2 from Eastern to Western context, and to present a feasibility study of the intervention, conducted in Finland. Methods The cultural adaptation process started with the linguistic translation of materials, followed by the modification of language to fit the Finnish context. While the Japanese ideology was saved, some content was adapted to fit Finnish school children. Further modifications were made based on feedback from pupils and teachers. The Finnish version of the program was named “Let’s learn about emotions” and consisted of 12 sessions and targeted 8- to 12-year-old pupils. A teacher education plan was established to assist Finnish teachers with the intervention, including a workshop, teachers’ manual, brief introductory videos, and online support sessions. A feasibility study involving 512 4th graders in the City of Hyvinkää, South of Finland, was conducted. It assessed emotional and behavioral problems, classroom climate, bullying, loneliness, perception of school environment, knowledge of emotional awareness, and program acceptability. Discussion The originality of this study underlies in the East–West adaptation of a cognitive behavioral therapy-based program. If promising feasibility findings are replicated in Finland, it could pave the way for further research on implementing such programs in diverse contexts and cultures, promoting coping skills, awareness, social skills and early prevention of child mental health problems. Ethics The ethical board of the University of Turku gave ethics approval for this research. The educational board of the City of Hyvinkää accepted this study.

This study examined the applicability and preliminary effects of the Universal Unified Program for Diverse Disorders (Up2-D2; Ishikawa et al., 2019) when adapted for adolescents with intellectual disabilities (ID). Modifications included unit division, extended review periods, and the incorporation of peer idea-sharing. Eight students with mild to moderate ID participated in a special needs education high school. Two teachers administered the program as self-supporting activity curricula from April to March. After the participants received the 30 sessions of the Up2-D2, their depression significantly decreased. While there were no clear effects on anxiety, aggression, self-effectiveness and total difficulties, variability was observed in individual changes. This study suggested that the Up2-D2 with adaption for students with ID is feasible in a school for special needs education. Further, it partially improves the mental health problems of the students. In the future implementation of the program, the development of supplemental teaching materials and adding sessions to learn experimentally are needed.

Preventive interventions before the problems occur are not to be implemented, as its effects are less visible than those of treatment to solve existing problems. However, given the deterioration of children’s mental health in school settings and the negative impact of the COVID-19 pandemic, it is an impending issue to promote and implement preventive intervention in school. This review described the current research trends and challenges of mental health prevention education in school through the social implementation of the Universal Unified Prevention Program for Diverse Disorders (Up2-D2). In this review, we discussed research issues in social implementation, such as examining efficacy, selecting measurements, expanding targeted population, sophisticating and shortening of components, selecting from existing programs, and training young researchers. In addition, challenges on the practical side, such as finding key persons, creating class time, training implementers, obtaining funds for management, and doing public relations were also discussed.