A rapid review describing the scalability of early childhood education and care-based programs targeting children's social and emotional learning

Objectives: To describe: i) how scalability domains (i.e., factors that influence a program's ability to expand to reach a larger population) are assessed and reported within randomised controlled trials (RCTs) of programs to improve child social and emotional learning in early childhood education and care (ECEC) settings; and ii) relative impact of scaled-up programs. Methods: We undertook a rapid review in November 2023 to identify RCTs of universal programs delivered in ECECs which were effective on at least one child social, emotional, and learning outcome. This formed a sample of pre-scale RCTs where additional intervention characteristics and reporting of seven scalability domains were extracted according to the Intervention Scalability Assessment Tool. To identify scale-up evaluations, we searched for related publications of the pre-scale RCTs. For directly comparable outcomes, we calculated the relative effect size between pre-scale and scaled-up programs. Results: Twenty-two RCTs were included. Scalability domains were variably reported with only one study reporting on all assessed domains. Almost all programs were delivered by an external facilitator together with child educators, and none concurrently targeted physical health behaviours, such as physical activity and nutrition. We identified one formal evaluation of a scaled-up trial. Compared to the pre-scale trial, the scaled-up trial had a reduced effect on behavioural difficulties and an increased effect on prosocial behaviour. Conclusions: More comprehensive reporting of scalability domains and formal evaluations of scaled-up social and emotional learning programs in ECEC are needed to ensure the intended outcomes to child health and wellbeing are achieved.