Evaluation of Educational Intervention Programs in Mental Health and Their Effects on Academic Performance

The intervention consists of four structured workshops delivered during regular tutorial hours by trained psychologists from Asociación Candelita. Each session lasts approximately 55 minutes and follows a standardized manual to ensure consistency across schools. Specifically, we articulate the intervention into four workshops:

1) Workshop I: Self-Knowledge and Self-Esteem
Focuses on self-awareness, identification of personal strengths, and emotional reflection exercises. These components aim to enhance self-efficacy and internal locus of control, traits linked to educational attainment in the economics literature.
2) Workshop II: Assertive Communication and Conflict Resolution
Introduces communication styles (passive, aggressive, assertive). Students complete adapted assertiveness exercises and engage in structured role-play scenarios. Interpersonal skills are increasingly valued in the labor market (Deming, 2017).
3) Workshop III: Coping Strategies
Introduces adaptive coping mechanisms and emotional regulation tools grounded in cognitive-behavioral principles. Improved coping may mitigate the impact of mental health shocks on schooling (Currie & Stabile, 2006).
4) Workshop IV: Recognition of Warning Signs and Help-Seeking
Provides students with information about mental health warning signs and formal/informal help pathways. Reducing informational frictions and stigma may improve timely help-seeking behavior.

Control classrooms do not receive the intervention during the evaluation period.

(See Documento_3 for a more detailed description of the Workshops)

2026-01-15

2026-02-27

1.A standardized Mental Health Index constructed from validated depression items (6-ITEM Kutcher Adolescent Depression Scale; KADS).

2. Grade Point Average (GPA) and subject-specific grades (administrative records).

In our study, primary outcomes are a mental health index (Kutcher Adolescent Depression Scale) and GPA and subject-specific grades (administrative records).

The Kutcher Adolescent Depression Scale (KADS), a self-reported scale, was designed specifically to diagnose and assess the severity of adolescent depression.
Respondents indicate how frequently they have experienced certain emotions or behaviors—such as low mood, feelings of worthlessness, fatigue, reduced enjoyment, anxiety, or thoughts of self-harm—using a scale that ranges from “Hardly Ever” to “All of the Time.” This measure is especially valuable for screening and identifying young people who may be at risk of depression in environments such as schools and primary care settings.
In particular, the 6 items included in the scale are the following:
1.Low mood, sadness, feeling blah or down, depressed, just can't be bothered.
2.Feelings of worthlessness, hopelessness, letting people down, not being a good person.
3.Feeling tired, feeling fatigued, low in energy, hard to get motivated, have to push to get things done, want to rest or lie down a lot
4.Feeling that lite is not very much fun, not feeling good when usually (before getting sick) would feel good, not getting as much pleasure from fun things as usual (before getting sick).
5.Feeling worried, nervous, panicky, tense, keyed up, anxious.
6.Thoughts, plans or actions about suicide or self-harm.

Academic performance will be measured using students’ grades across the different subjects. Based on these grades, we will also compute either an overall grade point average or an average derived from the most relevant subjects.

1. Heterogeneity Analysis: i) Gender differences; ii) Mental health status (above/below median of baseline index); iii)School type (public vs. semi-private/private).

2. Other potential indexes: i) Assertiveness index: ii) Coping strategy index; iii).Help-seeking knowledge index
All indices are standardized relative to the baseline control-group distribution

As presented before, gender differences in mental health remain inadequately incorporated into intervention research. We pre-specify exploratory heterogeneity analyses by gender.
Additionally, we also present a heterogeneity analysis in terms of baseline mental health status (above/below median of baseline index) and school type (public vs. semi-private/private)

In addition, we will also assess several secondary indicators related to emotional well-being. These include: (i) an Assertiveness Index, capturing students’ ability to express their needs and opinions in an appropriate and effective manner; (ii) a Coping Strategies Index, reflecting the range and adaptiveness of the strategies students employ to manage stress and challenging situations; and (iii) a Help‑Seeking Knowledge Index, which measures students’ understanding of when, how, and from whom to seek support for emotional or psychological difficulties. These secondary outcomes will provide a more comprehensive picture of the potential broader effects of the intervention.

DESIGN OVERVIEW
The study is a classroom-level cluster-randomized controlled trial, with randomization stratified by school.

The intervention is implemented among students enrolled in 2º ESO (second year of compulsory secondary education of the Spanish school system). Within each participating school, all classrooms corresponding to 2º ESO are identified prior to randomization.

Randomization occurs at the classroom level within each school and within this grade. Specifically, at least one 2º ESO classroom per school is randomly assigned to the treatment condition, while at least one other 2º ESO classroom in the same school serves as the control group.

This design is therefore not a school-level randomization, but a within-school, within-grade cluster-randomized design at the classroom level.


WITHIN-SCHOOL AND WITHIN-GRADE STRUCTURE

Because both treatment and control classrooms belong to the same grade (2º ESO) within the same schools, this design has two key implications. First, it enhances internal comparability, as treatment and control students share the same school leadership and infrastructure, the same grade-level curriculum, and the same academic calendar and evaluation system. This reduces confounding from school-level differences and increases comparability across study arms. Second, it introduces the potential for peer spillovers. Because treatment and control classrooms coexist within the same grade cohort, students may interact across classrooms, potentially generating spillover effects if treated students share workshop content or attitudes with control students. Such spillovers, if present, would likely attenuate estimated treatment effects toward zero. The primary estimand therefore remains the intention-to-treat effect of classroom-level assignment, interpreted under potential partial interference across classrooms.


SAMPLE STRUCTURE
We collect our sample using the following procedure. We first run a pilot experiment (Phase I) within 1 public secondary school in Madrid. We randomize between 2º ESO classrooms (how many? ). We end up with a total of 81 students, among which 45 were assigned to treatment classroom and 36 were assigned to control classroom.
In a second phase (Phase 2), we fully implement our experiment in 11 secondary schools in Madrid (7 public and 4 semi-private/private). We end up with a sample of 751 students belonging to 11 treated classrooms and 23 control classrooms. Each school contributes at least two 2º ESO classrooms. In schools with two classrooms, one classroom is assigned to treatment and one to control. In schools with more than two classrooms in the grade, additional classrooms are randomly allocated while ensuring representation in both arms.

Not available

Within each participating school, all 2º ESO classrooms are first enumerated. Randomization is then conducted centrally by the research team using statistical software with a reproducible random seed.

Assignment is stratified by school to ensure that each school contributes both treatment and control classrooms. In schools with exactly two 2º ESO classrooms, one classroom is randomly assigned to treatment and the other to control. In schools with more than two classrooms in the grade, at least one classroom is assigned to each arm, and additional classrooms are randomly allocated while maintaining balance within the school. Assignment is determined prior to intervention delivery and is not based on student characteristics.

The unit of randomization is the classroom (grupo-clase).
Students are not individually randomized within classrooms. All students within a treated classroom are exposed to the intervention during tutorial hours, conditional on parental consent and student assent. Participation in the study is voluntary and requires written parental consent prior to inclusion in the study, as well as written student assent prior to participation in surveys and intervention activities. Students and parents are informed that participation is voluntary, that they may withdraw at any time without penalty, and that refusal to participate does not affect academic standing. Only students with completed consent procedures are included in survey data collection.
Because treatment assignment varies at the classroom level, outcomes of students within the same classroom may be correlated. Statistical inference must account for intra-class correlation.

Accordingly, all primary analyses will report standard errors clustered at the classroom level (Moulton, 1990; Angrist & Pischke, 2009).
The unit of analysis is the individual student.

Yes

40 classrooms

751 pupils

11 schools;
17 classrooms: treatment
23 classrooms: control

Assumptions: - 40 classrooms. - Average classroom size of 19 students. - Intra-cluster correlation (ICC) of 0.05. - Significance level α = 0.05. - Power = 80%. Under these assumptions, the study is powered to detect a minimum standardized effect size of approximately 0.25 standard deviations on the primary mental health index. This calculation will be updated once final cluster counts and ICC estimates are confirmed