Assessing Multilevel Facilitators and Barriers to Implementing Flourishing Minds, an Evidence-Based Social-Emotional Learning Program In Rural Chinese Schools

Background and Purpose: Approximately 17.5% of rural school-aged children in China experience common mental disorders, while rural communities often face poverty, under-resourced service systems, and shortages of trained mental health professionals. School-based social and emotional learning (SEL) programs may help narrow this gap because they can be delivered within existing school infrastructure and have shown promise for improving children’s social-emotional skills and mental health. However, less is known about what factors support or impede real-world implementation when SEL is delivered by teachers in rural Chinese schools. Guided by the Consolidated Framework for Implementation Research (CFIR) and Proctor’s implementation outcomes framework, this study examined multilevel facilitators and barriers associated with implementation of Flourishing Minds, an evidence-based SEL program delivered in rural China.

Methods: Cross-sectional survey data were collected from 522 rural teachers who had implemented Flourishing Minds for one semester of delivery in December 2025. The survey questionnaire included items assessing implementation outcomes, outer-setting factors, inner setting, and teacher-level characteristics. Participating teachers were predominantly female (84%), 51% had more than 10 years of teaching experience, and 92% held at least a bachelor’s degree. Multivariable regression models examined whether teacher-level factors (age, gender, education level, family SES, number of children, SEL beliefs, perceived burden related to SEL implementation, teaching efficacy, teachers’ social-emotional competencies, mental well-being, job satisfaction, and prior SEL implementation experience), school-level factors (class size and school climate), and outer-setting context were associated with five implementation outcomes: acceptability, appropriateness, feasibility, sustainability (operationalized as likelihood of continued adoption the following year), and fidelity. Outer-setting context was operationalized as teachers implemented SEL in regions with government contracts or implemented on their own initiative.

Results: Teachers reported high implementation across outcomes, including acceptability (M = 4.56/5), appropriateness (M = 4.45/5), feasibility (M = 4.45/5), sustainability (M = 92.42/100), and fidelity (M = 90.01/100). At the teacher level, stronger SEL beliefs emerged as the most consistent facilitator, whereas perceived burden was the most consistent barrier across all five outcomes. Prior SEL implementation experience was positively associated with acceptability and feasibility, and teachers’ own social-emotional competence uniquely was associated with higher fidelity. At the school level, a more positive school climate was associated with greater acceptability, appropriateness, feasibility, and fidelity. Outer-setting context was not significantly associated with any implementation outcome.

Conclusions and Implications: This study offers early evidence regarding the implementation of school-based SEL in rural China. Findings suggest that successful implementation is less associated with fixed teacher characteristics than with modifiable attitudinal and organizational conditions. Implementation strategies that strengthen teachers’ beliefs in SEL, reduce perceived burden, build teachers’ own social-emotional competence, draw on prior SEL implementation experience, and foster supportive school climates may improve implementation quality and support ongoing program use. Findings offer actionable guidance for scaling school-based mental health supports in under-resourced rural settings.