School-Based Universal Mental Health Prevention Programs for Children Aged 6 to 9 Years in Low- and Middle-Income Countries: Protocol for a Scoping Review

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Abstract
Background: While the onset of most mental health conditions occurs in later childhood or adolescence, the early years present an important window for prevention. Worldwide, universal school-based prevention interventions have been shown to be effective in promoting child mental health. Nevertheless, little is known about universal school-based prevention programs targeting children aged 6 to 9 years in low- and middle-income countries (LMICs). Objective: This scoping review aims to identify promising, potentially feasible, and possibly evidence-based school-based universal prevention mental health programs for children aged 6 to 9 years in LMICs. Methods: This scoping review is planned according to the Joanna Briggs Institute framework developed by Arksey and O’Malley, with enhancements proposed by Levac et al. Eligible studies will focus on universal prevention school-based mental health interventions with feasibility and/or mental health outcomes that include children aged 6 to 9 years. Additional inclusion criteria are peer-reviewed published and unpublished studies, including gray literature such as theses and dissertations, preprints, conference proceedings and papers, and government reports and publications. There are no limits to the date of publication, but only studies published in English and conducted in LMICs will be included. The search strategy was iteratively developed and finalized, following which major databases, namely, PubMed (MEDLINE), Scopus (Embase), EBSCOhost (PsycInfo, CINAHL, PsycArticles, ERIC, Teacher Reference Center, Academic Search Premier, and SocINDEX), CENTRAL, ProQuest, the Open Science Framework, and the International Clinical Trials Registry Platform, were searched. Titles and abstracts are being screened in addition to manual searches of the reference lists of previous reviews. Experts will be consulted for further study suggestions, and reference mining will be conducted with the included studies. A descriptive and numerical summary will reflect basic program characteristics. A preliminary data extraction chart curated around the research questions will be used for deductive and inductive data analysis. The entire scoping review will be reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results: In November 2025, the search strategy was finalized. All database searches were completed by early December 2025, yielding 7511 records. After removing duplicates (n=3022), 4489 records underwent title and abstract screening. Of these, 25 records met the criteria for full-text review, which is currently ongoing. Data extraction and analysis should take place between April and May 2026. The scoping review findings will be submitted to a relevant peer-reviewed journal by July 2026 and presented at conferences. Conclusions: This review will provide a description of feasible and potentially effective school-based universal mental health programs specific to children aged 6 to 9 years living in LMICs. The findings may assist with efficient insight into available programs for implementation or adaptation among the stipulated population in the future.

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