Tomas Amare Abraha, Kidisti Tesfay W/Tensay, Merhawi Birhane Gebre, Birhanu Abadi Abrha, Gebrhud Berihu Haile
Opportunities and challenges in clinical learning of midwifery students in public Universities of Tigray Region, Ethiopia, 2020: a qualitative study
BMC medical education
worsening adolescent mental health exacerbated health inequalities covid19 pandemic calls universal preventative strategies mental health foundations schoolbased peer education project seeks improve students mental health literacy peer educators aged 1418 years teaching peer learners aged 1113 years recognise good bad mental health identify risk protective factors seek help accordingly although previous quantitative assessments found intervention effective realist evaluation aimed qualitatively develop theory change exploring mechanisms played different contexts achieve desired outcomes initial programme theory developed following expert stakeholder consultation reviewing literature divided mechanisms resources reasoning explain intervention components ie resources experienced within specific contexts engendered responses participants ie reasoning produce observable outcomes data collected six purposively recruited schools england comprised staff interviews n11 student focus groups n15 observations n5 deductive inductive analysis undertaken using nvivoinformed multiple causal statements represented contextmechanismoutcome configurations cmocs test refine programme theory created several distinct cmocs example learners accustomed didactic teaching methods context conversing educators similar life experience mechanism resource endorsed destigmatised helpseeking behaviour mechanism reasoning facilitated realisation seeking help appropriate acceptable outcome mechanisms included following learners perceiving information tailored relevant educators feeling empowered cultural shift percolating across school findings show peer education work improve mental health literacy inform changes intervention maximise effectiveness different operational contexts future research could test theory change randomised controlled trial examine impacts inequalities diverse sample national institute health care research school public health research