A Systematic Review of Evidence-Based Wellbeing Initiatives for Schoolteachers and Early Childhood Educators

Schoolteacher and early childhood educator wellbeing is associated with their ability to provide high-quality educational experiences to students and children in their care. Given the importance of this topic, this systematic review sought to (1) identify available evidence-based wellbeing initiatives for educators and schoolteachers, (2) appraise the quality of evidence demonstrating the efficacy of these initiatives, and (3) summarise the characteristics of these initiatives. In total, 23 studies on 19 distinct initiatives were identified. Although most initiatives improved schoolteacher wellbeing, the quality of available evidence is modest, especially for early childhood educators. Existing teacher and educator wellbeing initiatives predominantly target individual and not systematic determinants of educator wellbeing, even though wellbeing of these groups is determined by a combination of personal and education setting influences. More research is needed to improve the evidence on teacher and early childhood educator wellbeing initiatives, as well as development of initiatives that aim to change workplace demands and education setting culture.


Introduction
Schoolteachers' and early childhood educators' wellbeing is a fundamental contributor to their ability to support learning and care of children (Gray et al., 2017;Sisask et al., 2014). Teacher wellbeing is a multi-dimensional construct that encompasses physical, psychological, and spiritual health, as well as occupational attachment, stability, commitment, and satisfaction (Granziera et al., 2021). Cumming (2017) described early childhood educator wellbeing as entailing individual determinants, as well as contextual, relational, systemic, and discursive factors. Thus, schoolteacher and educator wellbeing is comprised of more than individual educators' psychosocial, physical, and mental wellbeing, and is determined by relationships with colleagues, the organisational policies and structure, and workplace conditions. Collie and Perry (2019) argued that a sense of wellbeing is integral to teachers' ongoing growth in their role. In this paper, we employ the term "educator" to include early childhood educators of children before they enter primary school, as well as primary and secondary school teachers. We also use this term to refer to pre-service teachers undertaking their initial teacher education to qualify as teachers.

Wellbeing of Educators
Research demonstrates that teaching is a highly complex, stressful, and demanding occupation (Smak & Walczak, 2017). Educators encounter a range of challenges and stressors in their work, including responding to the varied needs of children, navigating interpersonal relationships and expectations of students, parents, and colleagues, time pressures, and balancing the requirements of the profession with their personal life (Herman et al., 2018;Spilt et al., 2011). Additionally, an emphasis on benchmarks and accountability within education systems heightens stress for educators . McCullum and Price's observation that schools are assuming an increasingly prominent role in supporting the emotional wellbeing of school-aged children further illustrates the growing range of responsibilities placed on educators.
Compared to other professions, educators experience higher levels of stress and depression (Reupert, 2020). In particular, educators carry a high stress-load (Herman et al., 2018), and are vulnerable to experiencing emotional exhaustion and burnout (Shen et al., 2015;Skaalvik & Skaalvik, 2010). Low levels of mental health in educators have been associated with absenteeism (Gibbs & Miller, 2014;Kidger, Brockman, et al., 2016;Kidger, Stone, et al., 2016), presenteeism (in which educators are present at work but are under performing; Jain et al., 2013), ill health retirement (Kuoppala et al., 2011), and a high level of attrition in the teaching profession (Liu & Onwuegbuzie, 2012). Educators' wellbeing often affects their teaching competence, which in turn has implications for students' academic achievement and wellbeing (Carroll et al., 2021).

The Impact of Educator Wellbeing
An educator's emotional state influences how they think about and function in their teaching (Sutton & Wheatley, 2003). A recent study demonstrated that poor wellbeing reduces educators' belief that they can help students with behavioural or emotional problems (Sisask et al., 2014). Educators' ability to develop supportive relationships with students, a key factor in promoting children's engagement (Kidger et al., 2012), is negatively impacted by educator stress (Virtanen et al., 2019). Conversely, educator wellbeing is associated with educators' greater commitment to and motivation for work (Collie & Perry, 2019), and job retention (Arens & Morin, 2016). These factors in turn affect children. Harding et al. (2019) showed an association between higher teacher wellbeing and lower student psychological difficulties. Arens and Morin (2016) found educators experiencing greater wellbeing were more likely to have higher academically achieving students. Thus, educator wellbeing is essential for individual teachers, and plays an important part in fostering healthy and effective educational environments.

Theoretical Conceptualisation of Educator Wellbeing
A useful framework for understanding educator wellbeing is Bronfenbrenner's original ecological framework. This framework has been applied in educator wellbeing research and indicates that educator wellbeing is determined by six, interrelated factors, including the following: (1) the individual educator; (2) microsystem; (3) mesosystem; (4) exosystem; (5) macrosystem; and (6) chronosystem (Cumming & Wong, 2019;. The individual educator includes an individuals' predisposing factors that may influence wellbeing, such as life experiences and temperament. The microsystem includes the relationships between teachers, students, and parents, and the influence of classroom and school interactions on educators' wellbeing. The mesosystem encompasses the interactions that take place between two or more people (e.g. students and colleagues) or settings (e.g. work and home) within a teacher's microsystem. The exosystem consists of structures and systemic issues that may indirectly affect educators, such as school district procedures or available social services. The macrosystem describes the board political, economic, legal, and cultural influences on educator wellbeing (e.g. school funding for wellbeing programmes, school culture that supports educator wellbeing), and the chronosystem refers to the influence of changes across time and historical factors on the wellbeing of educators (Cross & Hong, 2012).
The use of this framework is consistent with emerging research in the field of educator wellbeing (Cumming, 2017;Reupert, 2020). Specifically, prior research has shown that educators' wellbeing is determined by individual teacher factors such as coping style, personality, and confidence, alongside organisational factors including, but not limited to, education setting climate, role clarity, and leadership, as well as broad societal factors such as academic benchmarks and national testing procedures (Reupert, 2020). Applying an ecological lens to the extant research on educator wellbeing may help to identity strengths and gaps in the evidence on initiatives to support educator wellbeing and highlight future research, policy, and practice directions. However, as Price and McCallum (2015) state, the influence of the ecological layers on educator wellbeing is not well understood and has not been extensively analysed. Similarly, it is unclear how well educator wellbeing initiatives respond to the individual, organisational, and structural factors that impact educator wellbeing, work performance, and career longevity.

Aims of the Review
To facilitate the translation of the extant body of available research, a systematic review and appraisal of available initiatives is required. The aim of this review was to (1) identify the range of educator wellbeing initiatives currently available, (2) appraise the quality of evidence demonstrating the efficacy of these initiatives for educator wellbeing, and (3) summarise the approaches, contents, and delivery formats that characterise these initiatives. Such information might be used to guide policy, and inform future educator wellbeing initiatives.

Method
A systematic review of research literature was conducted between December 2020 and January 2021 to identify, describe, and appraise evidence-based initiatives supporting educators' wellbeing. The Preferred Reporting Items of Systematic Review and Meta-Analyses (PRISMA) guidelines (Moher et al., 2009) informed the methodology for this review.

Inclusion Criteria
Studies that had investigated educator wellbeing outcomes associated with initiatives implemented in early learning settings, primary or secondary schools, or specialist education settings were included in the review. Early learning settings refer to childcare or kindergarten settings for children aged 0 to 5 years, primary (elementary) and secondary schools refer to educational settings for students aged five to 18 years, and specialist schools are settings that cater for students with additional learning, social, emotional, or behavioural needs. Initiatives targeting pre-service educators completing their initial teacher education training were also eligible for inclusion in the review. To ensure the review focused on contemporary educator wellbeing initiatives and outcomes, a publication date range from 1 January 2010 to 31 December 2020 was applied. Peer-reviewed quantitative and qualitative evaluation studies, published worldwide, in the English language were eligible for inclusion.

Exclusion Criteria
To establish a minimum standard for an initiative to be considered evidence-based, articles that were not peer-reviewed (e.g. book chapters, grey literature), did not report primary data, were study protocols, or were opinion pieces were excluded. Dissertations were also excluded because they are less likely than published journal articles to undergo rigorous peer review. Wellbeing initiatives and outcomes in the context of tertiary and adult education (excluding pre-service educator wellbeing initiatives) were also outside the scope of this review.

Literature Search
Five journal databases were searched: PsycINFO; Scopus; A + Education; ProQuest Education Journals; and ERIC for relevant studies. Table 1 presents the structure of search terms used in the literature search, which was formatted to the conventions of each database. Search limits were utilised according to the options available within each database, including the application of parameters for English language, peer-reviewed journal, and publication date.

Appraisal of Evidence Quality
The Australian National Health and Medical Research Council guidelines, which establishes different levels of evidence based on the robustness of research methodology (NHMRC, 2009), was employed to appraise the level of evidence for each identified initiative (Table 2). These guidelines were selected to classify the review results according to research design, from randomised controlled trials (RCTs) which is the highest standard for studies using original data, to pseudorandomised controlled trials, comparative studies with concurrent controls, comparative studies without concurrent controls, and case series measuring pre-post intervention outcomes (NHRMC, 2009). This evidence hierarchy can be used to assess the likelihood of bias in therapeutic intervention studies (Merlin et al., 2009). However, the NHMRC evidence guidelines are only applicable to quantitative research methodologies. Thus, qualitative studies were assessed using the Critical Appraisal Skills Programme checklist for qualitative research (CASP, 2018). Further, to explore the quality of evidence from the RCTs, the US Department of Education's What Works Clearinghouse (WWC, 2020) guidelines were used.  Figure 1 charts the systematic review process, including database search results and eligibility decisions. The title and abstract of each record returned in the database search were independently screened by two reviewers to ensure the process for establishing the eligibility of studies was robust. In cases where the two reviewers' decisions conflicted (33 of 245 records), a third reviewer assessed the paper and a decision was made through deliberation within the research team. The 51 studies accepted through this initial screening stage of the title and abstract were subjected to a full-text review. In the full-text review, the eligibility of each study was assessed by one researcher according to the inclusion and exclusion criteria, and a second author verified inclusions. Thus, two to three authors (EB, AR, and TC) were involved across title, abstract, and full-text screening, with the other authors providing support to develop the methodology and review the results. The reference lists of these eligible studies were manually checked for additional relevant records, which were then subjected to the full-text review process. From the 23 included studies, data were extracted pertaining to the research methodology implemented, educational setting and sampling, content of the wellbeing initiative (i.e. theoretical framework employed, format, duration, facilitator), reported outcomes for educator wellbeing, and other reported outcomes. The review team determined an NHMRC evidence level, Clearinghouse, or CASP rating as applicable for the methodology in each eligible study. The educator wellbeing initiatives identified across the studies were then grouped according to their underpinning therapeutic approach.

Results
In summary, 23 studies were identified that reported on educator outcomes across 19 different educator wellbeing initiatives. One initiative (Mindfulness-Based Stress Reduction; MBSR) had been the subject of four separate studies, and one  Table 3 presents the 19 initiatives grouped by therapeutic approach and appraisal of evidence quality for each study. Table 4 summarises the sampling, educational context, and educator wellbeing findings reported. Table 5 summarises key characteristics of the 19 educator wellbeing initiatives. The six therapeutic categories of "mindfulness", "social-emotional", "mental health literacy", "cognitive behavioural", "positive psychology", and "integrative" were used to organise the results. A final category, which was not a therapeutic approach, was also included, called "school leadership and policy change".           (1) the use of character strengths in the workplace; (2) utilising social support; (3) fostering work-related attitude; (4) focusing on the positive aspects of one's work An interview is conducted to explain the 4 PERMA strategies and to ask teachers to report on how they are already using them.
Teachers are asked to write daily reflections for 15 working days based on their observations of how they were using these strategies already and any new opportunities they found to use the strategies Records marked with an asterisk were found not to have an effect on educator wellbeing or had a negative effect on educator wellbeing. The studies by Hwang, Goldstein, et

Geographical and Educational Contexts of Studies
Seven of the 23 studies included in the review were conducted in Australia and another seven were conducted in North America (USA: k = 4; Canada: k = 2; both USA and Canada: k = 1), and seven in Europe (UK: k = 4 and Germany: k = 3). A single study was conducted in South America (Brazil) and one in Africa (Tanzania). Studies involved educators in secondary schools (k = 11), primary schools (k = 4), or across multiple school levels (k = 4). Of the studies that sampled educators across multiple school levels, one was conducted with educators teaching in primary, secondary, and specialist schools, one was conducted with pre-service educators completing school placements as part of their university training, one was conducted with primary school and early childhood educators, and one study did not provide sufficient detail to identify the school or year level(s) participating educators were teaching in.

Quality of Evidence across Educator Wellbeing Initiatives
Fourteen studies employed quantitative methodologies, three employed qualitative methodologies, and six employed a mixed-methods approach. According to the NHMRC evidence level guidelines, level I evidence is a systematic review of RCT studies (i.e. a meta-analysis of efficacy findings across multiple RCT studies of an initiative). The review revealed that no educator wellbeing initiative has been the subject of this level of research to date. Furthermore, the review showed that no educator wellbeing initiatives have been the subject of multiple RCTs, which precludes the possibility of conducting a systematic review to establish Level I evidence.
Seven of the included studies involved a RCT which classify as level II evidence, three employed pseudo-randomised controlled trials which classify as level III-1 evidence, five studies involved a non-randomised selection of control participants recruited from the same population as the initiative group and classify as level III-2 evidence, and four studies involved non-randomised recruitment of control participants selected from a different population to the initiative group and classify as level III-3 evidence (see Table 3). One study met criteria for classification as level IV evidence (case studies with pre-test and post-test comparison) in the review. Finally, the three studies that reported qualitative evidence are also presented in Table 3 along with details of how many CASP qualitative study checklist criteria were met and where the higher the score the higher the quality of evidence. The same was done for the seven RCTs assessed using the WWC (2020) guidelines (see Table 3). The RCTs by Roeser et al. (2013) and Taylor et al. (2016) were determined to be eligible to meet WWC group design standards with reservations because of baseline differences between the control and intervention groups that were not adjusted for in the analysis. The RCTs by Hwang, Goldstein, et al. (2019), Hwang, Jae-Eun, et al. (2019) also meet WWC standards with reservations due to high sample attrition but with baseline equivalence between the intervention and control groups. The RCTs by Jennings et al. (2013) and  were eligible to meet WWC group design standards without reservations due to random assignment of participants, limited sample attrition, and equivalent or adjusted differences between the control and intervention groups. Unterbrink et al.'s (2010) RCT was considered not eligible to meet WWC group design standards due to high sample attrition and because the study did not adjust for baseline differences between the intervention and control groups.

A Summary of Evidence-Based Educator Wellbeing Initiatives
Seven of the educator wellbeing initiatives were mindfulness-based initiatives, five were social-emotional initiatives, two focused on educators' mental health literacy, one was a positive psychology initiative, one focused on school leadership and policy change, one cognitive behavioural-based initiative, and two integrated therapeutic interventions.

Initiatives Adopting a Mindfulness-Based Therapeutic Approach
Initiative Structure Eight of the 10 studies on mindfulness investigated mindfulnessbased stress reduction (MBSR) or initiatives based on MBSR, which involves a series of sessions that include activities such as sitting meditation, body scan, yoga, and group work to enhance mental and physical wellbeing (Hofmann & Gómez, 2017). Six of the seven mindfulness initiatives (.b Foundations Course; CALM; MBSR; MT; Reconnected; SMART) were conducted face-to-face by trained facilitators external to the schools, and three of the initiatives (.b Foundations Course; CALM; Reconnected) encouraged educators to continue mindfulness training at home. The one mindfulness initiative not delivered by a facilitator external to schools, Christian Meditation, was a classroom activity engaged in by both teacher and students within a religious-affiliated school; in this initiative the teacher had previously attended a one-day workshop in preparation for leading the classroom meditation. One of the mindfulness initiatives, Reconnected, provided online resources with educators, after their participation in face-to-face workshops. All initiatives were delivered for eight or more weeks and included several sessions per week and/or encouraged educators to practice at home on a daily basis.
For three of these initiatives, it was found that educators were satisfied and/or that they would recommend the initiative to others (Bechai et al., 2016;Harris et al., 2016;Rupprecht et al., 2017). Despite these positive findings, one of the MBSR initiatives did not reduce educators' anxiety (Gold et al., 2010) and one did not reduce educators' stress (MT; Roeser et al., 2013). The CALM initiative, based on MBSR, did not improve educators' sleep, stress, or educator-educator relational trust (Harris et al., 2016), and another MBSR initiative did not reduce educator burnout and mental distress (Frank et al., 2015). Three of the studies demonstrated sustained improvements in educator wellbeing and stress reduction as an outcome of MBSRbased mindfulness initiatives, at 3 months (Rupprecht et al., 2017) or at four months (Gouda et al., 2016;Taylor et al., 2016), post-delivery. The Reconnected initiative demonstrated sustained improvements in stress, sleep, and mindfulness of educators five months after delivery of the initiative (Hwang, Goldstein, et al., 2019;Hwang, Jae-Eun, et al., 2019).

Quality of Supporting Evidence
The NHMRC levels of evidence ratings for the mindfulness initiatives identified here varied from RCTs (k = 4; all rated using WWC guidelines as RCTs with reservations), to pseudo-randomised controlled trials (k = 2), and nonrandomised or qualitative research designs (k = 5). Of all identified initiatives that aim to enhance educator wellbeing identified in this review, mindfulness-based initiatives have the most extensive underlying evidence-base.

Initiatives Adopting a Social-Emotional Therapeutic Approach
Initiative Structure One of the social-emotional initiatives (CARE for Teachers) was delivered to primary and secondary school teachers using face-to-face workshops and coaching, three were delivered using face-to-face workshops alone (EI in the Classroom; IY-TCM; Lange Lehren project), and one was delivered using faceto-face workshops and written reflections from educators (Arts-based reflection). EI in the Classroom was the only initiative to be delivered to pre-service educators, IY-TCM was delivered to early childhood and primary educators, and the Lange Lehran project was delivered to secondary school teachers. A trained facilitator or university course leader working externally to schools (in the case of the EI in the Classroom initiative delivered to pre-service teachers), delivered each of the social-emotional initiatives. Initiatives were delivered over a variety of timelines, ranging from programmes involving weekly sessions for 4-to 6-week (CARE for Teachers; EI in the Classroom), to 6-month (IY-TCM), one-year (Lange Lehren project), and 2-year programmes (Arts-based reflection) involving session spread out over longer intervals. Session lengths ranged from 90 min (CARE for Teachers; EI in the Classroom; Lange Lehren project) to whole-day programmes (Arts-based reflection; IY-TCM).

Reported Outcomes for Educator Wellbeing
The CARE for Teachers initiative was reported to improve educator wellbeing and mindfulness, and reduced stress and burnout (Jennings et al., 2013). Jennings and colleagues also reported that educators had a positive opinion regarding the merits of the initiative. The Lange Lehren project demonstrated a moderate effect on educator mental health (Unterbrink et al., 2010). The Arts-based reflection initiative increased participants' awareness of their character strengths and workplace relationships, to support their resilience and wellbeing (McKay & Barton, 2018). EI in the Classroom and IY-TCM were found not to have an effect on educator wellbeing Vesely et al., 2014); however,  reported that IY-TCM improved educators' relationships with students.
Two of the social-emotional initiatives did not show an effect on educator wellbeing (EI in the Classroom with pre-service educators; IY-TCM with early childhood and primary educators). Regarding the non-efficacious finding for EI in the Classrooms, the researchers argued that their small sample size might have reduced their chances of detecting a significant result (Vesely et al., 2014). For IY-TCM,  explained that one reason why this initiative did not improve educator wellbeing was possibly because the initiative focused on classroom behaviour management and relationships, and did not address other aspects of a teacher's role and workplace that might be relevant to their wellbeing.

Quality of Supporting Evidence
The social-emotional therapeutic approaches identified here include three RCTs constituting level II NHMRC evidence (Hayes et al., 2020 rated using WWC standards as an RCT without reservations; Jennings et al. (2013) rated as meeting WWC RCT standards with reservations; Unterbrink et al. (2010) rated as not meeting WWC group design standards for RCTs), one pseudorandomised controlled trial, and one qualitative research design. The RCT studies identified in this review Jennings et al., 2013;Unterbrink et al., 2010) suggest that social-emotional therapeutic approaches may deliver limited impact on educator wellbeing.

Initiatives Adopting a Mental Health Literacy Approach
Initiative Structure Two initiatives in this review, MHFA and The African Guide, utilised a mental health literacy approach in secondary school settings. The MHFA initiative, was a 2-day training course to prepare selected teachers to assume a peer supporter role. The African Guid, was a culturally adapted version of the "The Guide" (Kutcher et al., 2015) originally developed as a curriculum to promote mental health literacy amongst students in Canada; educators engaged in the training programme in preparation to deliver the course to students. Both of these initiatives were 2-day, face-to-face programmes delivered by trained instructors/mental health professionals. The African Guide initiative also involved a refresher course delivered approximately 6 months after the initial training was completed. Kidger and colleagues (2016) reported that the MHFA improved educators' knowledge about mental health and reduced mental illness stigma amongst educators. Participation in the initiative also increased educators' sense of confidence in helping a colleague in need of mental health support. Educators reported that participation in MHFA reassured them about their current practices in response to mental health issues led to greater consultation with colleagues about challenges encountered with students, and increased awareness of their own mental health. Kutcher et al., (2016aKutcher et al., ( , 2016b found that The African Guide initiative improved educators' confidence to seek help for themselves, colleagues, students, friends, and family. Furthermore, the initiative enhanced mental health knowledge and reduced stigmatising attitudes towards mental illness amongst participating educators.

Quality of Supporting Evidence
Neither of the mental health literacy initiatives were supported by a high NHMRC level of evidence, with Kidger, Brockman, et al. (2016), Kidger, Stone, et al. (2016)) and Kutcher et al.'s (2015) studies meeting criteria for being considered level II-2 and level III-3 evidence respectively. Nonetheless, both initiatives were perceived by educators to be effective in improving their wellbeing and mental health literacy.

Initiatives promoting school leadership and policy change
Initiative Structure The study by Morris et al. (2020) described an initiative designed to facilitate school structural change and thereby enhance educator wellbeing. Specifically, Morris et al. (2020) adopted a Participatory Action Research (PAR) process in a secondary school that targeted leadership and policy to improve the wellbeing of school staff. PAR, in general, is an initiative in which the people who are affected by a particular issue or problem are actively engaged in a research process implemented to generate solutions (Kindon et al., 2009). In Morris et al.'s (2020) study, the PAR initiative was led by the researchers and a retired secondary school principal who facilitated a series of workshops with school staff over a period of 12 months. Educators and school leaders were encouraged to work together to share and develop ideas to improve educators' wellbeing.

Reported Outcomes for Educator Wellbeing
At the beginning of the PAR process, the participating school found that staff morale was low. They believed that the solution resided in promoting changes to leadership style and introducing shared decision making. Positive outcomes reported by Morris et al. (2020) included the professional growth of educators, greater recognition of educators' contributions, improved school-wide decision-making, more supportive leadership, and positive changes to school culture.

Quality of Supporting Evidence
The PAR initiative was demonstrated to have positive outcomes. However, the evaluation involved a comparative study without concurrent controls, and did not evaluate longer-term educator wellbeing outcomes.

Initiatives Adopting a Cognitive Behavioural Approach
Initiative Structure The study by Justo et al. (2018) investigated an initiative grounded in cognitive behavioural theory (Dialectical Behavioural Therapy; DBT). Cognitive behavioural approaches aim to address habitual negative thought patterns and to instil positive thought patterns, improve personal functioning, mental health, and wellbeing (Trower et al., 2015). DBT was originally developed for treating clinically diagnosed borderline personality disorder, and has since been adapted to treat a range of mental health concerns such as mood disorders and suicidal ideation (Chapman & Dixon-Gordon, 2020).
An adaption of the Dialectical Behaviour Therapy Skills Training (DBT-ST; Linehan, 2010) manual was implemented (Justo et al., 2018) to investigate initiative impacts on educator wellbeing. The DBT-ST manual is comprised of four modules which aim to promote educators' (1) mindfulness, (2) distress tolerance, (3) emotional control, and (4) interpersonal functioning (Linehan, 2010). The DBT-ST initiative was delivered by a psychologist who had completed accredited training. The DBT-ST initiative comprised four weekly sessions of approximately 3 h length, and a final follow-up session conducted two months afterward (Justo et al., 2018). Justo et al. (2018) found that educators' wellbeing deteriorated, reporting an increase in negative emotions and a reduction in emotional awareness, after participating in the DBT-ST initiative. These negative outcomes were observed two months after delivery of the initiative. Teachers' ability to explain and evaluate everyday social interactions had improved; however, the researchers argued that teachers' lack of emotional awareness two months after the initiative may have prevented teachers from changing their behaviour. Justo et al.'s (2018) study met criteria for being a comparative study without concurrent controls. At present, there is little evidence available in relation to DBT as an initiative to support educator wellbeing and Justo's study suggests that participating in a DBT-based initiative may be counter-productive to supporting educators' wellbeing.

Initiatives Adopting a Positive Psychology Approach
Initiative Structure Positive psychology has been defined as "the study of the conditions and processes that contribute to the flourishing or optimal functioning of people, groups and institutions" (Gable & Haidt, 2005, p. 103). The one positive psychology initiative identified in this review was the PERMA model. The PERMA model was developed by Martin Seligman, the founder of positive psychology, and includes five domains of positive psychology: positive emotion, engagement, relationships, meaning, and accomplishment (Seligman, 2018).
Delivery of the PERMA initiative involved primary school educators participating in a one-to-one interview with a trained facilitator, followed by educators engaging in personal reflection over 15 days about how they used four PERMA strategies in their work, including the following: (1) the use of personal strengths in the workplace; (2) identifying and drawing on social support; (3) fostering a positive workrelated attitude; and (4) focusing on the positive aspects of one's work as an educator (Turner & Theilking, 2019). Turner and Thielking's (2019) study concluded that the PERMA initiative was well-received by participating educators. Interviews indicated that as a result of participating, educators perceived a reduction in their stress, an increase in their positivity, and felt that their participation in the initiative had also led to better interactions with students. Educators reported that relationships with their students had improved and as a result, students' confidence and learning had improved. Turner and Thielking's (2019) qualitative findings are based on educators' self-perceptions with no further triangulation of data. Nonetheless, the findings indicate that the PERMA initiative may be acceptable to educators and the study received the highest CASP rating of 8 out of 9.

Initiatives Adopting an Integrative Approach
Initiative Structure Integrative initiatives are those which combine several different types of therapies into the one initiative. Integrative therapy can assume various forms, including an eclectic approach involving the assimilation of selected components from across a variety of therapies, augmenting a particular therapeutic approach with the addition of complimentary components associated with other therapeutic approaches, or focusing on practices that are common to all or most therapeutic approaches (Zarbo et al., 2016).
The two integrative approaches included in the review had some overlap in relation to content: the ARC initiative combined cognitive-behavioural therapy (CBT), acceptance and commitment therapy (ACT), and positive psychology (Cook et al., 2017); the CALMERSS initiative adopted CBT, mindfulness, positive psychology, conflict resolution, and sleep hygiene practices (Taylor, 2018). The ARC initiative was delivered online over five weeks, by a trained facilitator; however, Cook and colleagues did not specify whether the initiative was delivered in a primary or secondary, or another school type. The CALMERSS initiative was delivered faceto-face to middle and secondary school educators over a 4-week period by a trained facilitator. Cook et al. (2017) found that the ARC initiative reduced educator stress, improved confidence, and improved job satisfaction. Taylor (2018) reported that educators perceived that the CALMERSS initiative had a positive impact on psychological, physical and personal distress, and improved self-care practices. Cook et al.'s (2017) study of the ARC initiative employed a non-randomised experimental trial research methodology (level III-2 evidence), while Taylor (2018) employed a pre/post-test case research methodology (level IV evidence) to evaluate CALMERSS. A key issue for understanding the results reported in the ARC and CALMERSS initiatives is that because both initiatives included multiple initiatives such as CBT, ACT, and positive psychology, it is not possible to determine which specific element(s), or combination of elements, might account for their effectiveness. In addition, long-term outcomes following delivery of the ARC and CALMERSS initiatives have not yet been investigated.

Discussion
Overall, this review found that educators generally report positive outcomes from engaging in wellbeing initiatives. Three of the 19 initiatives that have been evaluated, namely DBT-ST, EI in the Classroom, and IY-TCM, were reported to have had no positive effect on the wellbeing of educators. Nonetheless, although the evaluation data are generally favourable across the various initiatives that aim to promote educator wellbeing, evaluation data is at best emerging and has some serious limitations. Moreover, considering the results within Bronfenbrenner's ecological model indicates that most initiatives target change at the individual educator and microsystem levels, and do not consider the other layers of Bronfenbrenner's ecological framework, including workplace demands and school/education setting culture.

Gaps and Opportunities in Initiatives from an Ecological Perspective
Educator wellbeing is impacted not only by individual factors but also by contextual, relational, and systemic influences (Acton & Glasgow, 2015;Cumming, 2017;Gray et al., 2017). Likewise, it has been suggested that the most effective initiatives to promote wellbeing in the workplace (outside of education) are those that seek to influence at both an individual level and a wider social or organisational level (Smedley & Syme, 2001;Smith et al., 2011;Tetrick & Quick, 2011). In comparison, this review found that most initiatives in the field of educator wellbeing attend to wellbeing as an individual issue, rather than as an organisation-wide consideration. In other words, most initiatives prompt individual educators to initiate changes that aim to mitigate the impact of stress and/or enhance their wellbeing. For example, mindfulness-based initiatives, the approach employed most commonly, aim to encourage individuals to assume a positive mind set, rather than challenging or changing school structure, work demands, and educational policy which decrease educators' positive affect. Similarly, many of the educator wellbeing initiatives promoted strategies for managing stress or learning adaptive coping skills. Collectively, such strategies may be useful to assist educators to manage work-related challenges, but do not address the structures of the workplace from which these challenges emerge (Hone et al., 2015).
Some initiatives were successful in promoting positive collegial or student relationships (Gouda et al., 2016;Graham & Truscott, 2020;Hwang, Goldstein, et al., 2019;Hwang, Jae-Eun, et al., 2019;Turner & Theilking, 2019), which relate to the microsystem in Bronfenbrenner's model. However, the programme by Harris et al. (2016) did not improve collegial relationships. This is likely because the study by Harris et al. defined school relationships as "relational trust" or trust between colleagues, while other studies defined relational wellbeing as reduced interpersonal problems (Gouda et al., 2016), improved communication, warmth, and caring for others (Graham & Truscott, 2020;Hwang et al., 2019a;Hwang, Jae-Eun, et al., 2019), and greater individualised support for students (Turner & Theilking, 2019). One initiative that demonstrated benefits for educator wellbeing, The Lange Lehren programme, included attending to educators' competency in handling educator-parent relationships (Unterbrink et al., 2010).
Only one initiative, the PAR process, sought to collaborate with educators to improve school leadership and policy (Morris et al., 2020). This programme could be viewed as related to a teacher's mesosystem because it evaluated schoollevel processes and policies impacting educator wellbeing. The two mental health literacy initiatives (Mental Health First Aid; The African Guide) addressed factors related to the exosystem by virtue of increasing educators' awareness of mental health services (Kidger, Brockman, et al., 2016;Kidger, Stone, et al., 2016;Kutcher et al., 2016aKutcher et al., , 2016b. The results of studies by Kidger et al. (2016), Kidger, Stone, et al. (2016)) and Kutcher et al., (2016aKutcher et al., ( , 2016b were consistent in reducing mental illness stigma and increasing educator confidence to seek mental health support. However, these initiatives only increased educators' knowledge about mental health services and did not influence the availability of community health services for educators (nor was this the intention of those initiatives).
Taken together, although educator wellbeing has been defined as comprising individual and school-related factors (e.g. relationships with parents, students and colleagues, school policies, and school structures), the focus of wellbeing programmes for educators is mainly on the individual educator. However, a common criticism of approaches to improve educator wellbeing is the view that educator wellbeing is an individual issue, and schools and governing education authorities ignore systemic, home, and community influences that may also be having an impact on teacher wellbeing (Hine et al., 2022). It is challenging to identify why existing evidence considers educator wellbeing as an individual rather than a systematic issue, but this could be partially explained by the challenge of evaluating the effects of systems-level interventions on outcomes for individual educators (see suggestions for this type of evaluation later in the discussion). It would also be reasonable to assume that the ecological lens has only recently been applied to teacher wellbeing, relative to use of this framework when discussing child development and wellbeing.

Gaps in the Current Knowledge Base and Opportunities for Further Research
Evidence of the longer-term efficacy of educator wellbeing initiatives is integral for understanding the sustainability of initiatives. The economic cost of initiative delivery, including the infrastructure required to deliver the initiatives and educator time to attend professional learning, are factors that are not discussed in the literature. Further, no evaluations were found that ascertained the effectiveness of an initiative beyond six months post-delivery. Only five evaluations (Gouda et al., 2016;Hwang, Goldstein, et al., 2019;Hwang, Jae-Eun, et al., 2019;Rupprecht et al., 2017;Taylor et al., 2016), each in relation to mindfulness-based approaches, reported sustained changes in educator wellbeing between three and five months after delivery. Given educator stress and wellbeing fluctuate throughout the academic year (von der Embse & Mankin, 2020), when to deliver an educator wellbeing initiative is an additional under-researched issue that warrants investigation.
A lack of high-quality evaluation evidence is not an indication that an initiative is unacceptable or does not result in sustained and positive changes for educators. Instead, this review highlights the limited empirical evidence for educator wellbeing initiatives. The absence of RCTs and high-quality RCTs supporting the efficacy of any educator wellbeing initiative emphasises the need for high-level research to be conducted in this area. Though the complexity of ecological models of wellbeing makes such high-quality evaluations challenging, it is incumbent on researchers to employ rigorous evaluation models that identify effective wellbeing initiatives for different educational settings and educator groups. All educator wellbeing outcomes observed in this review were based on educator self-report. Future studies might employ observational research methodologies or draw on administrative records indicative of educator wellbeing, such as staff retention rates, performance metrics, and absences. It is also important to evaluate outcomes of system-wide initiatives (such as workload variations) on educator outcomes. Participatory research design and qualitative methods could be used (similar to the study by Morris et al., 2020) to explore how national or state-level initiatives to enhance educator wellbeing are being interpreted, implemented, and considered at the school-and individual-level.
The lack of differentiation in wellbeing outcomes according to gender, ethnicity, sexuality, and cultural background is another gap. For example, only one of the efficacious initiatives, The African Guide adapted from the Canadian initiative The Guide (Kutcher et al., 2016a(Kutcher et al., , 2016b, had been delivered in a non-Western context; the only other study conducted outside of Western nations was Justo et al.'s (2018) investigation of the non-efficacious DBT-ST initiative delivered in Brazil. Relatedly, only one initiative targeted early childhood educators (IY-TCM; , and only one initiative targeted pre-service educators (IE in the classroom; Vesely et al., 2014); all other initiatives were delivered to primary, secondary, and specialist school teachers. A clear gap in the literature is the lacking evidence-based wellbeing initiatives for early childhood educators, which is in stark contrast to research addressing the significant wellbeing, workplace, and relational stressors faced by these educators (Cumming, 2017). Arguably, there is also much more literature addressing wellbeing programmes for culturally and linguistically diverse students than for educators from similar backgrounds. Research with LGBTQIA + teachers has found these educators experience marginalisation, repressive, and heteronormative attitudes, which warrant addressing in educator preparation and wellbeing programmes (Dykes & Delport, 2018).
Researchers should seek to apply Bronfenbrenner's model in future to promote a more holistic understanding of educator wellbeing, and to guide development and evaluation of educator wellbeing programmes. Using Bronfenbrenner's model, researchers have argued that ecological factors influence educators' interactions with others, their experiences, and their sense of wellbeing as educators . Bronfenbrenner expanded his framework to suggest that interactions (proximal processes) between individuals (e.g. teachers) and their environment (e.g. schools) operate over time to build an individual's capabilities and skills (Bronfenbrenner & Morris, 2006). While this review was unable to determine how a teacher's interactions over time increase their wellbeing and fitness as educators, there is clear evidence that early career teachers are at higher risk of impaired wellbeing and skills when navigating the challenges of teaching compared to more experienced educators (Berger et al., 2020. Based on the results of this review, research with pre-service, early career teachers, and longitudinal research may be able to monitor individual and school factors that influence these educators' wellbeing across time and how these change as a result of wellbeing initiatives.

Limitations of the Review
Given that wellbeing is a broad and loosely defined concept (Dodge et al., 2012), the parameters of the literature search, including the requirement that studies had been subject to peer-review, published no earlier than 2010, and had been published in English language, may have excluded other initiatives. Because the aim of this review was to identify the range of educator wellbeing initiatives currently available, we deliberately did not explore through our search terms a specific type of wellbeing programme or provide a definition of wellbeing for this review. More targeted reviews may be possible when there is more research and evidence-based programmes addressing educator wellbeing. For example, further research and reviews of early childhood educator wellbeing programmes are required to address the individual and contextual factors distinct to early childhood educators' wellbeing compared to schoolteachers. It may also be appropriate to extend searches to earlier than 2010, and to include grey literature/dissertations, especially when reviewing evidence on populations, such as early childhood educators, typically excluded from the published wellbeing literature.
Regarding the need for future reviews and research to explore specific populations and educational settings, the study by Beshai et al. (2016) included a sample of secondary school teachers as well as staff who had direct contact with students in educational, pastoral, or supporting roles, and thus, all results from this review may not be reflective of classroom teachers. There is also a need for evaluation studies in this field to specify the recruitment process and retention rate of participants involved in the evaluation. For example, it was not possible to determine, but highly possible, that only teachers with adequate time or established self-care skills participated in the interventions. Some studies (see for example Cook et al., 2017) indicated that there were several unaccounted factors that either enhanced or limited educator wellbeing after programme delivery. The study by Vesely et al. (2014) found no improvements on educator satisfaction with life, while Cook et al. (2017) identified increased job satisfaction amongst participants. The way these studies conceptualised satisfaction (i.e. life versus job satisfaction) impacted outcomes of the review. Further work to centralise a definition and constructs of educator wellbeing is required. Finally, meta-analysis of future reviews using a more stringent criteria for study selection, such as based on study design, population, or educational setting type, is recommended. Although some educator wellbeing programmes resulted in positive outcomes for teachers, the evidence for these programmes is limited at best.

Concluding Comments
A variety of initiative approaches were identified to promote educator wellbeing. Evidence to date is at best emerging that available initiatives are effective in promoting educator wellbeing. Further longitudinal and triangulated evaluation designs are needed. Although educator wellbeing is shaped by many individual and ecological factors, most available wellbeing initiatives focus at the individual-level of change. More attention is needed to the development and evaluation of initiatives targeting workplace, policy, and relationship changes that will lead to sustainable positive change in relation to educators' wellbeing within educational settings.
Funding Open Access funding enabled and organized by CAUL and its Member Institutions This work was supported by the Commonwealth of Australia represented by Department of Health, Mental Health in Education initiative known as Be You.

Competing Interests None.
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