Williamson, Victoria (V);Larkin, Michael (M);Reardon, Tessa (T);Stallard, Paul (P);Spence, Susan H (SH);Macdonald, Ian (I);Ukoumunne, Obioha C (OC);Ford, Tamsin (T);Violato, Mara (M);Sniehotta, Falko F (FF);Stainer, Jason (J);Gray, Alastair (A);Brown, Paul (P);Sancho, Michelle (M);Morgan, Fran (F);Jasper, Bec (B);Taylor, Lucy (L);Creswell, Cathy (C);

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BMJ Open.2025 Feb 20;15(2):e082691.doi:10.1136/bmjopen-2023-082691

Abstract

INTRODUCTION: Anxiety problems are prevalent in childhood and, without intervention, can persist into adulthood. Effective evidence-based interventions for childhood anxiety disorders exist, specifically cognitive-behavioural therapy (CBT) in a range of formats. However, only a small proportion of children successfully access and receive treatment. Conducting mental health screening in schools and integrating evidence-based interventions for childhood anxiety problems may be an effective way to ensure support reaches children in need. The Identifying Child Anxiety Through Schools-Identification to Intervention (iCATS i2i) trial involves screening for childhood anxiety problems and offering a brief online parent-led CBT intervention. This paper presents the protocol for the process evaluation of the iCATS i2i trial, which aims to examine the implementation and acceptability of the study procedures, the mechanisms of change and whether any external factors had an impact on procedure engagement or delivery.

METHODS AND ANALYSIS: This process evaluation will use both quantitative and qualitative methods to evaluate the implementation and acceptability of and barriers/facilitators to engagement and delivery of the iCATS screening/intervention procedures. Quantitative data sources will include opt-out and completion rates of baseline measures and usage analytics extracted from the online intervention platform. Qualitative interviews will be conducted with children, parents, school staff, iCATS i2i clinicians and researchers delivering study procedures. The Medical Research Council framework for process evaluations will guide study design and analysis.

ETHICS AND DISSEMINATION: This study has received ethical approval from the University of Oxford Research Ethics Committee (R66068_RE003). Findings from the study will be disseminated via peer-reviewed publications in academic journals, conferences, digital and social media platforms and stakeholder meetings.

TRIAL REGISTRATION: ISRCTN76119074.