Growing with Gratitude (GWG) is a universal prevention program based on positive psychology that aims to prevent anxiety and depression in primary-school-aged children. The mental health of children is a key concern for schools as it has an extensive impact in all areas of life. A cluster randomised controlled trial was implemented in nine primary schools in South Australia to evaluate the program.

Students’ anxiety and depression and wellbeing were measured as outcomes at five time points. There were no significant differences for primary or secondary outcomes between the conditions at any time point. Implementation fidelity was poor across the trial. The GWG program did appear to have some impact on children with clinically significant levels of anxiety and depression at baseline. The findings highlight challenges with implementing prevention programs in primary schools and provide suggestions for future research.