AUTHOR=Ingul Jo Magne , Martinsen Kristin , Adolfsen Frode , Sund Anne Mari , Ytreland Kristin , Bania Elisabeth Valmyr , Lisøy Carina , Rasmussen Lene-Mari Potulski , Haug Ida Mari , Patras Joshua , Collins Linda M. , Kendall Philip C. , Neumer Simon Peter TITLE=Inside the Clockwork of the ECHO Factorial Trial: A Conceptual Model With Proposed Mediators for Prevention of Emotional Problems in Children JOURNAL=Frontiers in Psychology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.703224 DOI=10.3389/fpsyg.2021.703224 ISSN=1664-1078 ABSTRACT=

Having interventions that are not only evidence-based and effective but also cost-effective and efficient is important for the prevention and treatment of child and adolescent emotional problems. A randomized clinical trial (RCT) tests the total interventions effect but does not address specific components of the intervention. In this article the hypothesis and a conceptual model of the ECHO study are presented and discussed. The ECHO intervention consists of three different components each containing two levels of intervention. By using a cluster randomized factorial design, children aged 8–12 at 40 schools across Norway will be randomized to eight different experimental conditions investigating the optimal balance between effect, cost-effectiveness, and efficiency. The article presents the design and the different components being tested and discusses how optimalization can be reached through this innovative design. The article also discusses how interventions can be improved by investigating and understanding the mechanisms of change within psychological interventions. For each of the three components in the study we consider the mediators that could be active within the intervention and how the study investigates such mediation. The results will contribute to a better understanding of how psychological interventions work and how we intend to optimize the EMOTION intervention.