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Intervention Summary

Zippy's Friends

Zippy's Friends is a school-based mental health promotion program for children in kindergarten and first grade (ages 5-7). It is typically conducted with entire classrooms of children in mainstream elementary schools. Zippy's Friends aims to help children to develop coping and social skills and is based on the theoretical concept of coping developed by Lazarus and Folkman. The program includes 24 weekly sessions, each 45-60 minutes, that build on a set of stories involving "Zippy," a stick insect, and his friends, a group of young children. The curriculum is organized into six themes: identifying and describing feelings; communication; friendship; bullying and conflict resolution; change and loss; and coping.

Zippy's Friends is taught by trained classroom teachers or other appropriate educators following manualized lesson plans. Teachers receive 2 days of training before conducting the program. Parents receive an informational guide, which is available in 23 languages.

Descriptive Information

Areas of Interest Mental health promotion
Outcomes
1: Emotional literacy
2: Hyperactivity
3: Coping skills
4: Social skills
Outcome Categories Mental health
Social functioning
Ages 0-5 (Early childhood)
6-12 (Childhood)
Genders Male
Female
Races/Ethnicities Non-U.S. population
Settings School
Geographic Locations Urban
Suburban
Rural and/or frontier
Implementation History Zippy's Friends has been delivered to more than 700,000 children worldwide. The curriculum is currently being taught in schools and kindergartens in 26 countries: Argentina, Belgium, Brazil, Canada, Chile, Costa Rica, Denmark, El Salvador, Iceland, India, Ireland, Lithuania, Mauritius, Mexico, the Netherlands, Norway, Panama, Peru, Poland, Russia (Karelia), Singapore, Trinidad and Tobago, the United Kingdom (England and Wales), the United States, Uruguay, and Vietnam. In the United States, Zippy's Friends was used in New Jersey under exclusive licence to YCS, a nonprofit youth services organization, has been under exclusive licence to Montclair State University.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations Parent materials have been translated from English into 23 languages. Classroom materials have been translated into 13 languages including Arabic, Chinese, Danish, Dutch, French, Icelandic, Konkani (India), Lithuanian, Norwegian, Polish, Portuguese, Russian, and Spanish. The program also has been adapted for use in schools for children with learning difficulties; see Rowley & Cook in the Replications section below.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Clarke, A. M., & Barry, M. M. An evaluation of the Zippy's Friends emotional wellbeing programme for primary schools in Ireland. Health Promotion Research Centre, National University of Ireland, Galway.

Study 2

Mishara, B. L., & Ystgaard, M. Effectiveness of a mental health promotion program to improve coping skills in young children: "Zippy's Friends." Early Childhood Research Quarterly, 21(1), 110-123.

Study 3

Dufour, S., Denoncourt, J., & Mishara, B. L. Improving children's adaptation: New evidence regarding the effectiveness of Zippy's Friends, a school mental health promotion program. Advances in School Mental Health Promotion, 4(3), 18-28.

Supplementary Materials

Clarke, A. M. An evaluation of Zippy's Friends, an emotional wellbeing programme for children in primary schools (Unpublished doctoral thesis). National University of Ireland, Galway.

Ryan-Wenger, N. M. Development and psychometric properties of the Schoolagers' Coping Strategy Inventory. Nursing Research, 39(6), 344-349.  


Outcomes

Outcome 1: Emotional literacy
Description of Measures Emotional literacy was measured using the Emotional Literacy Checklist, a 20-item instrument with 5 subscales: self-awareness, self-regulation, motivation, empathy, and social skills. Items are rated on a scale from 1 (not at all true) to 4 (very true). Items within each subscale are summed to obtain subscale scores, and an overall emotional literacy score is obtained by summing all 20 items. Higher scores indicate greater emotional literacy. Teachers completed the checklist for each student before and after the intervention.
Key Findings In a study in Ireland, students who received the intervention showed a significant increase in emotional literacy from pre- to posttest compared with a control group that received the standard, compulsory social, personal, and health curriculum (p < .001).
Studies Measuring Outcome Study 1
Study Designs Experimental
Quality of Research Rating 2.8 (0.0-4.0 scale)
Outcome 2: Hyperactivity
Description of Measures Hyperactivity was measured using:

  • Strengths and Difficulties Questionnaire (SDQ). This brief, standardized questionnaire is used to measure children's emotional and behavioral well-being. The questionnaire has 25 items divided into 5 subscales (5 items each): emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. All items are scored on a scale from 0 to 2; lower scores on the hyperactivity/inattention subscale indicate less hyperactivity. Teachers used the SDQ to rate each student before and after the intervention.
  • Social Skills Questionnaire Teacher Form (SSQTF), Elementary Level. The questionnaire is used to obtain teacher reports on the frequency of three types of problem behavior: hyperactivity, externalizing, and internalizing. Examples of behavior measured by the hyperactivity subscale include "Interrupts conversations with others" and "Acts impulsively." Assessments occurred before and after the intervention.
Key Findings In a study in Ireland, students who received the intervention showed a significant decrease in hyperactivity from pre- to posttest compared with a control group that received the standard, compulsory social, personal, and health curriculum (p = .05).

In jointly reported studies conducted in Lithuania and Denmark, Lithuanian students who received the intervention had a significant decrease in hyperactivity from pre- to posttest compared with wait-list control students (p < .001). This outcome was not consistently measured in the Denmark study.
Studies Measuring Outcome Study 1, Study 2
Study Designs Experimental, Quasi-experimental
Quality of Research Rating 2.6 (0.0-4.0 scale)
Outcome 3: Coping skills
Description of Measures Coping skills were measured using an observation form developed for the study. The form was based on the Schoolagers Coping Strategies Inventory, a self-report instrument with 26 questions that ask children to rate on a scale of 0-3 how often they take various actions when they feel stressed, nervous, or worried, such as "ask someone for help," "hit someone," or "get mad." In the study, teachers used the form to report on children's behavior observed at school. The form asked teachers to describe the most important conflict or problem the child had recently experienced. Teachers were further asked to describe how the child behaved in that situation and to indicate which of the 26 items of the Schoolagers Coping Strategies Inventory the child used in that situation. The situations were categorized by content, and the frequencies of the individual coping skills were examined individually and together. Teachers completed the form for each student before and after the intervention.
Key Findings In jointly reported studies conducted in Lithuania and Denmark, Lithuanian students who received the intervention had a significant increase in coping strategies compared with wait-list control students (p < .001). This outcome was not consistently measured in the Denmark study.
Studies Measuring Outcome Study 2
Study Designs Quasi-experimental
Quality of Research Rating 2.3 (0.0-4.0 scale)
Outcome 4: Social skills
Description of Measures Social skills were measured using:

  • Emotional Literacy Checklist. This 20-item checklist includes 5 subscales that measure various dimensions of emotional literacy: self-awareness, self-regulation, motivation, empathy, and social skills. Each item is rated from 1 (not at all true) to 4 (very true). Items within each subscale are summed to obtain subscale scores, and an overall emotional literacy score is obtained by summing all 20 items. Higher scores indicate greater emotional literacy. This outcome was measured using scores on the social skills subscale. Teachers completed the checklist for each student before and after the intervention.
  • Social Skills Questionnaire Teacher Form, (SSQTF), Elementary Level. This questionnaire involves teacher ratings of the frequency of various observed behaviors. Subscale scores were calculated for three dimensions of social skills: cooperation, assertion, and self-control. Examples of behaviors specified in the form are "Attends to your instructions," "Easily makes transition from one classroom activity to another" (cooperation); "Joins ongoing activity or group without being told to do so," "Invites others to join in activities" (assertion); and "Controls temper in conflict situations with peers," "Receives criticism well" (self-control). Assessments occurred before and after the intervention.
  • Socio-Emotional Profile. This instrument includes 80 items measuring social competencies and adaptation problems on a 6-point scale (from never to always). Three of the 12 subscales in the Socio-Emotional Profile address social skills: cooperation with adults, autonomy, and internalization of behaviors. Examples of items include "helping teachers" (cooperation); "perseverance in solving their problems themselves" (autonomy); and "anxious behaviors, dependency, nervousness and symptoms of depression such as crying without any reason" (internalization of behaviors). Teachers completed the full Socio-Emotional Profile to rate students before and after the intervention.
Key Findings In a study in Ireland, students who received the intervention showed significant improvement in social skills from pre- to posttest compared with a control group that received the standard, compulsory social, personal, and health curriculum, after controlling for baseline scores (p = .01)

In jointly reported studies conducted in Lithuania and Denmark, Lithuanian students who received the intervention had significantly greater improvement in social skills from pre- to posttest compared with wait-list control students (p < .001). Danish students who received the intervention had significantly greater improvement in social skills from pre- to posttest compared with historical data for students tracked the year prior to program implementation (p < .001).

In a Canadian study, students who received the intervention showed significant pre- to posttest improvements in cooperation with adults (p < .001), autonomy (p < .02), and internalization of behaviors (p = .001) compared with peers in a no-intervention control group.
Studies Measuring Outcome Study 1, Study 2, Study 3
Study Designs Experimental, Quasi-experimental
Quality of Research Rating 2.6 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 0-5 (Early childhood)
6-12 (Childhood)
52.3% Male
47.7% Female
100% Non-U.S. population
Study 2 0-5 (Early childhood)
6-12 (Childhood)
51.3% Male
48.7% Female
100% Non-U.S. population
Study 3 0-5 (Early childhood)
6-12 (Childhood)
52.9% Male
47.1% Female
100% Non-U.S. population

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Emotional literacy 3.0 2.0 2.0 3.0 3.0 3.5 2.8
2: Hyperactivity 3.3 2.0 2.0 2.5 2.8 3.3 2.6
3: Coping skills 3.0 2.0 2.0 1.5 2.5 3.0 2.3
4: Social skills 2.5 2.0 2.0 3.8 2.5 3.0 2.6

Study Strengths

The research design of one study used random assignment. The measures have acceptable and demonstrated reliability and at least face validity. Information on intervention fidelity collected by the investigators generally showed that the program was implemented as planned, even when teachers had the freedom to do otherwise. Missing data and attrition were well described and within an acceptable range given the nature of the study. Some problems with confounding variables were present, but on the whole, these were handled appropriately in the statistical methods. The analytic methodology used by the investigators was appropriate overall.

Study Weaknesses

Validity data were not explicitly presented for most measures, and where validity data were reported, the measure had been modified for use in the study. In the jointly reported Danish and Lithuanian studies, collection of data for the program evaluation was not carried out as intended in one of the two countries. Outcomes were reported using teacher ratings only, even for measures originally intended to collect student ratings. One study reported only one-tailed p values.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Bates Wells & Braithwaite London LLP. Partnership for Children license agreement.

Other program materials:

  • Activities for Parents: Helping Your Child To Cope With Difficult Situations
  • An Introduction to Zippy's Friends [DVD]
  • Copyright Acknowledgment Form
  • Evaluation sheet for Zippy's Friends initial training course
  • 40 Ideas From Around the World
  • Goals of the Modules
  • Logo and PowerPoint presentation of the illustrations and rules for modules 1-6 of the Zippy's Friends teaching materials [CD-ROM]
  • Principles for Implementing the Activities
  • Setting Up Zippy's Friends With a New Partner Organisation
  • Songs for Zippy's Friends
  • Support and Follow-Up of Zippy's Teachers
  • Training Certificate
  • Training Video [DVD]
  • Using Zippy's Friends and the SEAL materials
  • Zippy's Friends Coordinator Role Guidelines
  • Zippy's Friends Criteria for Selecting Partner Agencies
  • Zippy's Friends Module Report
  • Zippy's Friends Programmes Map
  • Zippy's Friends Support Meeting, Questionnaires 1-3

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
4.0 3.5 3.3 3.6

Dissemination Strengths

Teacher materials are comprehensive and easy to understand and use. Multiple resources are available for parents online and in hard copy, including activities to support classroom learning. The developer also recommends additional resources for parents and teachers to extend learning. A standardized training for teachers includes skill practice and classroom observation, with accompanying PowerPoint presentations for the individual modules. Train-the-trainer events and international workshops are also available. On-site consultation is available during the first year of implementation, and phone and email support can be requested beyond the first year. Fidelity monitoring is supported through checklists and classroom observation by the site coordinator. A licensing agreement clearly outlines the responsibilities of implementing sites. Annual reports are submitted to the developer to facilitate quality improvements.

Dissemination Weaknesses

It is unclear what degree of support or coaching the licensed partner organizations provide to sites after initial implementation, other than periodic visits to monitor fidelity. In addition, although partner organizations can contact the developer (based in the United Kingdom) by phone and email for support, it is not clear what that assistance might entail. No standardized protocol for outcome data collection or analysis is provided to sites.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Licensing fee Varies according to duration and scope of license Yes
Implementation materials (includes one teachers' folder, one set of children's items, and a set of eight posters) $390 per set Yes
Additional teachers' folders $300 each No
Additional set of eight posters $40 per set No
Additional set of children's items (includes 60 paper puppets, 30 paper crowns, pencils, cards, certificates, and parent guides) $75 per set No
1- or 2-day teacher training course $3,100 for up to 25 participants, plus travel costs Yes
3-day training for trainers $3,100 for 2-25 participants, plus travel costs Yes
On-site support $930 per day, plus travel costs No
Phone and email support Free No
Partner Organization Annual Report Form Free Yes
Module Report Form and questionnaires for follow-up meetings Included with training materials No

Additional Information

Training and support costs shown here are based on standard charges for two Partnership for Children staff providing training or support within the United Kingdom. Costs for new implementers in other countries will vary depending on the site's particular needs and location.