Pioneering An Online Module That Will Engage And Help Teens With COVID-19 Stress
By Jennifer Greif Green, Rachael Donalds and Katie Carey
We’ve produced an online model to help teens with stress associated with COVID-19, and we are developing two more modules on depression and suicide, and substance use.
Long before the pandemic, many middle and high school staff knew that their students spent little time in school discussing topics related to mental health. When there were discussions, they often occurred in advisory periods or health and physical education classes, and were sometimes brief and only presented to particular grade levels.
But the pandemic had, and likely will continue to have, a substantial impact on the mental health of youth, underscoring the need for schools to integrate learning opportunities related to mental health. There is a growing interest in online approaches to mental health education, which allow youth access to information privately and anonymously, and can be self-guided, self-paced, and personalized.
Massachusetts school district Medway Public Schools contacted us in fall of 2019 about creating a series of online modules focused on mental health that could complement their existing health curriculum. Although there are a number of programs and curricula that can be used to teach about mental health in schools, district staff were unable to find online materials that matched their interest in providing interactive learning opportunities to middle and high school students about mental health-related topics.
When the pandemic closed school buildings in March of 2020, we were already in the process of developing an online module focused on stress and anxiety. We therefore decided to focus the module specifically on stress in the context of the pandemic. To develop content for the module, we reviewed a number of different sources for recommendations and materials including materials from the National Institute of Mental Health, American Academy of Pediatrics, Centers for Disease Control and Prevention, and National Association of School Psychologists.
The module was designed with four objectives. First, to teach about the nature of stress and anxiety. Second, to provide evidence-informed stress-reduction strategies. Third, to offer, tips for establishing routine during remote learning. Finally, to encourage help-seeking behaviors, in cases where students may want or need additional help.
We designed it to be interactive. For example, in an activity to learn about how stress affects the body, students could click on different parts of a human figure to read about how people experience stress. To learn about coping strategies, students engaged in a card sorting activity where they categorized coping strategies as strategies that could be “healthy,” “unhealthy,” or “either.” In the section on relaxation, we included a video training on diaphragmatic breathing. A section on help-seeking included flip-cards that students could use to identify people in their lives who they could reach out to for help.
The stress-reduction strategies included in the module are:
- Practice relaxation techniques
- Make time for pleasant activities
- Reach out for help
- Be a thoughtful user of technology
- Practice mindfulness
- Help others
Next, we introduced a series of strategies to establish routines during the pandemic. Because we developed the module in spring of 2020, most students in Massachusetts were learning from home and many were learning primarily asynchronously. We introduced strategies for creating a schedule, setting a sleep routine, creating nutritious meals, and adopting an exercise program.
We also had a section on when and how to ask for help and support. We focused specifically on how to ask for support for a friend, because previous research has shown that youth are more receptive to information about helping a friend than helping themselves. We provided a series of resources and encouraged students to reach out to their adults in their community, including their parents and school counselors, and provided online resources.
Once drafted, we received feedback on the module from experts in the areas of stress and anxiety. We also received feedback from 83 high school students in a different school district who reviewed the module as an activity in their Psychology class. For example, students looked at our sample remote learning schedule and suggested that we shift the wake-up time to be more realistic for adolescents.
We have had two opportunities to collect some preliminary data on youth experiences with the module. First, a school district that reached out to us about administering the module agreed to include an online survey at the end of the module. This district asked all students in grades 6 through 11 to complete the module in the final three days of the 2020 school year (12th graders had already graduated). Of the 2,301 students in the school district in those grade levels, a total of 905 (39%) entered the survey and completed at least some evaluation questions.
In total, 871 students completed the full survey, at a completion rate of 97%.
Most students said that the online module was somewhat, very, or extremely interesting and most said that they learned a medium amount, or a lot. We also provided students with a list of each of the components of the module that involved building skills, strategies, and routines. We asked them to rank how helpful they found each of the module components. Students overwhelmingly said that they found all aspects of the module to be somewhat or very helpful.
Nearly 3,000 people from 27 different states have entered the module.
Out of a smaller group of respondents completing the post-survey, most (about 70%) of respondents said that they found the module to be somewhat or very or extremely interesting. Three-quarters (76%) said that they learned a medium amount or a lot, and 92% said that the content was easy to read and understand.
As before, when we asked respondents about how helpful different components of the module were, most respondents said that all components of the module were either somewhat or very helpful.
These results provide some initial support for the feasibility of presenting evidence-informed strategies to support students’ mental health in this online format. Our team is currently developing two additional modules, focused on depression and suicide, and substance use. These will also be made publicly available to schools and families. We hope that these online resources will be useful as schools and communities consider how to support student mental health during and following the pandemic.
Jennifer Greif Green is Associate Professor, Special Education and a Faculty Fellow for the CERES Institute for Children & Youth at the Boston University Wheelock College of Education & Human Development. The Stress & COVID module is available at: www.jenniferggreen.com/stress.
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