Barriers and Facilitators to Implementing a School-Based Social and Emotional Learning Program for Rural Children in China: A Qualitative Study Using the Consolidated Framework for Implementation Research.

Rural children in mainland China, particularly those whose parents migrate for economic opportunities, face distinct mental, emotional, and behavioral (MEB) challenges. With few mental health professionals available to address rural student's MEB needs, task-shifting approaches that rely on teacher-led interventions, such as the evidence-based Social and Emotional Learning (SEL) program, are a promising alternative. However, little is known about the implementation determinants of teacher-led SEL programs in rural China, a key gap for sustaining and scaling effective programs. The present study qualitatively explored the contextual determinants of implementing the Positive Growth Curriculum (PGC), an efficacious, teacher-led SEL program delivered to 648 fifth graders in two rural schools in southwest China. We conducted in-depth interviews with all N = 15 schoolteachers and administrators who implemented PGC, with questions guided by the Consolidated Framework for Implementation Research. Interviews were audio recorded and two independent coders conducted Rapid Qualitative Analysis. Codes were organized into four major themes detailing how contextual determinants shaped the acceptability, appropriateness, feasibility, fidelity, and sustainability of PGC. Findings indicated that innovation facilitators, e.g., relative advantage, low complexity, intervention design, and perceived effectiveness, facilitated PGC acceptability and appropriateness (Theme 1) and implementation strategies, e.g., training, facilitation and champions, were vital for ensuring fidelity (Theme 2). However, despite high teacher motivation and buy-in, feasibility and sustainability were threatened by inner setting pressures and administrative burdens that prioritize student's academic success over their SEL (Theme 3) and a lack of community buy-in and low governmental funding for SEL initiatives, two outer setting determinants (Theme 4). These barriers led some teachers to question if they are the optimal deliverers for SEL curricula. Potential PGC adaptations are discussed, as are possible implementation strategies and adjunctive interventions to sustain and scale effective teacher-led programs that can support rural students' MEB health and academic success.