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Conte E, Cavioni V, Ornaghi V, Agliati A, Gandellini S, Santos MF, Santos AC, Simões C, Grazzani I. Supporting Preschoolers' Mental Health and Academic Learning through the PROMEHS Program: A Training Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1070. [PMID: 37371301 DOI: 10.3390/children10061070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
There is compelling evidence that early school intervention programs enhance children's development of life skills, with a positive knock-on effect on their behaviors and academic outcomes. To date, most universal interventions have displayed gains in children's social-emotional competencies with a limited reduction in problem behaviors. This may depend on programs' curricula focused to a greater extent on preschoolers' social-emotional competencies rather than problem behaviors. Promoting Mental Health at Schools (PROMEHS) is a European, school-based, universal mental health program explicitly focused on both promoting students' mental health and preventing negative conduct by adopting a whole-school approach. In this study, we set out to evaluate the effectiveness of the program for Italian and Portuguese preschoolers. We recruited 784 children (age range = 4-5 years), assigning them to either an experimental group (six months' participation in the PROMEHS program under the guidance of their teachers, who had received ad hoc training) or a waiting list group (no intervention). We found that PROMEHS improved preschoolers' social-emotional learning (SEL) competencies, prosocial behavior, and academic outcomes. The more practical activities were carried out at school, the more children's SEL competencies increased, and the more their internalizing and externalizing behaviors decreased. Furthermore, marginalized and disadvantaged children were those who benefited most from the program, displaying both greater improvements in SEL and more marked decreases in internalizing problems compared to the rest of the sample.
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Affiliation(s)
- Elisabetta Conte
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
| | - Valeria Cavioni
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Humanities, Literature, Cultural Heritage, Education Sciences, University of Foggia, 71121 Foggia, Italy
| | - Veronica Ornaghi
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
| | - Alessia Agliati
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
- Faculty of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Sabina Gandellini
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
| | - Margarida Frade Santos
- Department of Education, Social Sciences and Humanities, Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
| | - Anabela Caetano Santos
- Department of Education, Social Sciences and Humanities, Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
- Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Celeste Simões
- Department of Education, Social Sciences and Humanities, Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
| | - Ilaria Grazzani
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, 20126 Milan, Italy
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Lehner L, Gillé V, Baldofski S, Bauer S, Becker K, Diestelkamp S, Kaess M, Krämer J, Lustig S, Moessner M, Rummel-Kluge C, Thomasius R, Eschenbeck H. Moderators of pre-post changes in school-based mental health promotion: Psychological stress symptom decrease for adolescents with mental health problems, knowledge increase for all. Front Psychiatry 2022; 13:899185. [PMID: 35990085 PMCID: PMC9387723 DOI: 10.3389/fpsyt.2022.899185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background School-based mental health promotion aims to strengthen mental health and reduce stress. Results on the effectiveness of such programs are heterogeneous. This study realized a school-based mental health promotion program (StresSOS) for all students and aimed to identify moderators (mental health status, gender, grade level) of pre- to post-changes in stress symptoms and knowledge. Methods Participants were N = 510 adolescents (from 29 classes; 46.7% female) aged 12-18 years (M = 13.88, SD = 1.00; grade levels 7-10). They were without mental health problems (65.9%), at risk for mental health problems (21.6%), or with mental health problems (12.5%) and participated in a 90 min per week face-to-face training with 8 sessions in class at school. Demographic variables, mental health status, stress symptoms, and knowledge about stress and mental health were collected at baseline. Program acceptance, stress symptoms, and knowledge were collected post-intervention. Multilevel mixed effects models were conducted with the fixed effects time (within factor), mental health status, gender, and grade level (between factors). Random effects for students within classes were included. Results In the pre-post comparison, mental health status moderated the changes on psychological stress symptoms (p < 0.05). In adolescents with mental health problems the largest reduction in stress symptoms was observed between pre- and post-assessment. Gender and grade level were less relevant. For all adolescents knowledge gains were revealed (p < 0.001). Program acceptance was moderated by mental health status and grade level (p < 0.01). Mentally healthy adolescents and within the group of adolescents at-risk or with mental health problems, especially younger students (7th/8th grade), rated program acceptance higher. Conclusion Psychological stress symptoms decreased among adolescents with mental health problems and not among adolescents at risk for or without mental health problems. Mental health-related knowledge increased for all adolescents. The results add to knowledge on school-based mental health intervention research and practice. Its implications for different prevention strategies (universal, selective or a combination of both) are discussed.
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Affiliation(s)
- Laya Lehner
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Vera Gillé
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Marburg and Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Silke Diestelkamp
- University Hospital Hamburg-Eppendorf, German Center for Addiction Research in Childhood and Adolescence, Hamburg, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jennifer Krämer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Marburg and Philipps-University Marburg, Marburg, Germany
| | - Sophia Lustig
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig, Germany
| | - Rainer Thomasius
- University Hospital Hamburg-Eppendorf, German Center for Addiction Research in Childhood and Adolescence, Hamburg, Germany
| | - Heike Eschenbeck
- Department of Educational Psychology and Health Psychology, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
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Wang K, Zhou YE, Xu JX, Yang G. RETRACTED ARTICLE: Reviewing big data based mental health education process for promoting education system. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00800-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Harrison L, Sharma N, Irfan O, Zaman M, Vaivada T, Bhutta ZA. Mental Health and Positive Development Prevention Interventions: Overview of Systematic Reviews. Pediatrics 2022; 149:186940. [PMID: 35503329 DOI: 10.1542/peds.2021-053852g] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
CONTEXT Previous reviews of mental health interventions have focused on adolescents (10-19 years), with a paucity of comprehensive evidence syntheses on preventive interventions for school-aged children (5-10 years). OBJECTIVE To summarize and synthesize the available evidence from systematic reviews of mental health and positive development interventions for children aged 5-14.9 years in both high-income (HIC) and low- and middle-income countries (LMIC), with a focus on preventive and promotive strategies. DATA SOURCES This overview includes all relevant reviews from OVID Medline, The Cochrane Library, and Campbell Systematic Reviews through December 2020. STUDY SELECTION We included systematic reviews that synthesized empirical studies using experimental or quasi-experimental designs to evaluate the effectiveness of interventions in children aged 5-14.9 years. DATA EXTRACTION Data extraction and quality assessment were completed independently and in duplicate by two review authors. The AMSTAR2 tool was used to assess methodological quality. RESULTS We included 162 reviews. The greatest evidence was found in support of school-based universal and anti-bullying interventions in predominantly HIC. Moderate evidence was found for the use of substance abuse prevention, and early learning and positive development interventions in mixed settings. In LMIC-only contexts, the most promising evidence was found for positive youth development programs. LIMITATIONS The review was primarily limited by paucity of high-quality research due to methodological issues and high heterogeneity. CONCLUSIONS This overview of reviews highlights the need for further research to consolidate findings and understand the specific criteria involved in creating positive mental health and development outcomes from the various interventions considered.
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Affiliation(s)
- Leila Harrison
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Naeha Sharma
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Omar Irfan
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Michele Zaman
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Tyler Vaivada
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Center of Excellence in Women and Child Health, Institute for Global Health & Development, Aga Khan University Hospital, Karachi, Pakistan
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Grazzani I, Agliati A, Cavioni V, Conte E, Gandellini S, Lupica Spagnolo M, Ornaghi V, Rossi FM, Cefai C, Bartolo P, Camilleri L, Oriordan MR. Adolescents' Resilience During COVID-19 Pandemic and Its Mediating Role in the Association Between SEL Skills and Mental Health. Front Psychol 2022; 13:801761. [PMID: 35197901 PMCID: PMC8860228 DOI: 10.3389/fpsyg.2022.801761] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
The main purpose of this paper is to investigate the role of social and emotional learning (SEL) skills and resilience in explaining mental health in male and female adolescents, during the COVID-19 pandemic. Three self-report questionnaires were administered to 778 participants aged between 11 and 16 years (mean age = 12.73 years; SD = 1.73) and recruited from 18 schools in Northern Italy. The SSIS-SELb-S and the CD-RISC 10 assessed SEL and resilience skills respectively, while the Strengths and Difficulties Questionnaire (SDQ) was used to measure mental health in terms of internalizing problems, externalizing problems, and prosocial behavior. We found that SEL and resilience skills were positively and significantly associated with each other, negatively associated with internalizing and externalizing problems, and positively related to prosocial behavior. Three linear regression analyses showed the significant role of resilience, age, and gender in explaining the variance of internalizing problems; the significant role of SEL skills, resilience, age, and gender in explaining the variance of externalizing problems; and the role of SEL skills, age, and gender in explaining prosocial behavior. Importantly, we found that resilience fully mediated the relationship between SEL skills and internalizing problems, partially mediated the relationship between SEL skills and externalizing problems and didn't mediate the relationship between SEL skills and prosocial behavior. The paper concludes with a discussion of the limitations of the study as well as its practical implications.
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Affiliation(s)
- Ilaria Grazzani
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Alessia Agliati
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Valeria Cavioni
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Elisabetta Conte
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Sabina Gandellini
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Mara Lupica Spagnolo
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Veronica Ornaghi
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Francesca Micol Rossi
- "R. Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
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Welch V, Dewidar O, Tanjong Ghogomu E, Abdisalam S, Al Ameer A, Barbeau VI, Brand K, Kebedom K, Benkhalti M, Kristjansson E, Madani MT, Antequera Martín AM, Mathew CM, McGowan J, McLeod W, Park HA, Petkovic J, Riddle A, Tugwell P, Petticrew M, Trawin J, Wells GA. How effects on health equity are assessed in systematic reviews of interventions. Cochrane Database Syst Rev 2022; 1:MR000028. [PMID: 35040487 PMCID: PMC8764740 DOI: 10.1002/14651858.mr000028.pub3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Enhancing health equity is endorsed in the Sustainable Development Goals. The failure of systematic reviews to consider potential differences in effects across equity factors is cited by decision-makers as a limitation to their ability to inform policy and program decisions. OBJECTIVES: To explore what methods systematic reviewers use to consider health equity in systematic reviews of effectiveness. SEARCH METHODS We searched the following databases up to 26 February 2021: MEDLINE, PsycINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Hein Index to Foreign Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on 10 June 10 2021. We contacted authors and searched the reference lists of included studies to identify additional potentially relevant studies. SELECTION CRITERIA We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities. We define health inequalities as unfair and avoidable differences across socially stratifying factors that limit opportunities for health. We operationalised this by assessing studies which evaluated differences in health across any component of the PROGRESS-Plus acronym, which stands for Place of residence, Race/ethnicity/culture/language, Occupation, Gender or sex, Religion, Education, Socioeconomic status, Social capital. "Plus" stands for other factors associated with discrimination, exclusion, marginalisation or vulnerability such as personal characteristics (e.g. age, disability), relationships that limit opportunities for health (e.g. children in a household with parents who smoke) or environmental situations which provide limited control of opportunities for health (e.g. school food environment). DATA COLLECTION AND ANALYSIS Two review authors independently extracted data using a pre-tested form. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews. MAIN RESULTS: In total, 48,814 studies were identified and the titles and abstracts were screened in duplicate. In this updated review, we identified an additional 124 methodological studies published in the 10 years since the first version of this review, which included 34 studies. Thus, 158 methodological studies met our criteria for inclusion. The methods used by these studies focused on evidence relevant to populations experiencing health inequity (108 out of 158 studies), assess subgroup analysis across PROGRESS-Plus (26 out of 158 studies), assess analysis of a gradient in effect across PROGRESS-Plus (2 out of 158 studies) or use a combination of subgroup analysis and focused approaches (20 out of 158 studies). The most common PROGRESS-Plus factors assessed were age (43 studies), socioeconomic status in 35 studies, low- and middle-income countries in 24 studies, gender or sex in 22 studies, race or ethnicity in 17 studies, and four studies assessed multiple factors across which health inequity may exist. Only 16 studies provided a definition of health inequity. Five methodological approaches to consider health equity in systematic reviews of effectiveness were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (140 of 158 studies used a type of descriptive method); 2) descriptive assessment of reporting and analysis in original trials (50 studies); 3) analytic approaches which assessed differential effects across one or more PROGRESS-Plus factors (16 studies); 4) applicability assessment (25 studies) and 5) stakeholder engagement (28 studies), which is a new finding in this update and examines the appraisal of whether relevant stakeholders with lived experience of health inequity were included in the design of systematic reviews or design and delivery of interventions. Reporting for both approaches (analytic and applicability) lacked transparency and was insufficiently detailed to enable the assessment of credibility. AUTHORS' CONCLUSIONS There is a need for improvement in conceptual clarity about the definition of health equity, describing sufficient detail about analytic approaches (including subgroup analyses) and transparent reporting of judgments required for applicability assessments in order to consider health equity in systematic reviews of effectiveness.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | | | | | | | - Kevin Brand
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | | | | | | | | | | | | | - Jessie McGowan
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | | | | | - Alison Riddle
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Marmora, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mark Petticrew
- Department of Social & Environmental Health Research, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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Gasol X, Navarro-Haro MV, Fernández-Felipe I, García-Palacios A, Suso-Ribera C, Gasol-Colomina M. Preventing Emotional Dysregulation: Acceptability and Preliminary Effectiveness of a DBT Skills Training Program for Adolescents in the Spanish School System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010494. [PMID: 35010754 PMCID: PMC8744757 DOI: 10.3390/ijerph19010494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 11/18/2022]
Abstract
Emotional dysregulation is a key factor in the development and maintenance of multiple disabling mental disorders through a person’s lifespan. Therefore, there is an urgent need to prevent emotional dysregulation as early as possible. The main aim of this study was to evaluate the acceptability and preliminary effectiveness of an adapted Dialectical Behavior Therapy Skills Training program for Emotional Problem Solving in Adolescents (DBT STEPS-A) during secondary school. The sample included 93 adolescents (mean age = 12.78; SD = 0.54; and 53% female) studying in their 2nd year of secondary school in a public center in Catalonia (Spain). Measures of acceptability, difficulties of emotional regulation, mental health problems, and life satisfaction were completed before and after participation in the DBT STEPS-A program during one academic year. The majority of students rated the program as useful (64%) and enjoyed the classes (62%) and 48% of them reported practicing the newly learned skills. Statistically significant improvements were revealed in some emotional regulation-related variables, namely the number of peer problems (p = 0.003; d = 0.52) and prosocial behaviors (p < 0.001; d = −0.82). Although non-significant, the scores in the remaining outcomes indicated a general positive trend in emotional dysregulation, mental health, and life satisfaction. The adapted DBT STEPS-A was very well-accepted and helped overcome some emotional regulation difficulties in Spanish adolescents.
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Affiliation(s)
- Xavier Gasol
- Borderline Personality Disorder Institute Foundation, 08221 Terrassa, Spain; (X.G.); (M.G.-C.)
| | - María Vicenta Navarro-Haro
- Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain
- Instituto de Investigación Sanitaria de Aragón (IISA), 50009 Zaragoza, Spain
- Correspondence:
| | - Isabel Fernández-Felipe
- Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón de la Plana, Spain; (I.F.-F.); (A.G.-P.); (C.S.-R.)
| | - Azucena García-Palacios
- Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón de la Plana, Spain; (I.F.-F.); (A.G.-P.); (C.S.-R.)
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052 Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Carlos Suso-Ribera
- Department of Basic Psychology, Clinical Psychology and Psychobiology, Universitat Jaume I, 12071 Castellón de la Plana, Spain; (I.F.-F.); (A.G.-P.); (C.S.-R.)
- CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII CB06/03/0052 Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Miquel Gasol-Colomina
- Borderline Personality Disorder Institute Foundation, 08221 Terrassa, Spain; (X.G.); (M.G.-C.)
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Brooks H, Syarif AK, Pedley R, Irmansyah I, Prawira B, Lovell K, Opitasari C, Ardisasmita A, Tanjung IS, Renwick L, Salim S, Bee P. Improving mental health literacy among young people aged 11-15 years in Java, Indonesia: the co-development of a culturally-appropriate, user-centred resource (The IMPeTUs Intervention). Child Adolesc Psychiatry Ment Health 2021; 15:56. [PMID: 34620216 PMCID: PMC8496433 DOI: 10.1186/s13034-021-00410-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Many mental health problems emerge in late childhood and contribute significantly to the global burden of disease. Adverse outcomes can extend into adulthood if left untreated. This impact is exacerbated in low- and middle-income countries where significant treatment gaps persist. Improving mental health literacy may offer an effective strategy for early intervention but remains underexplored in these contexts. METHODS An intervention was co-developed with children and young people (CYP) by undertaking a needs analysis combined with stakeholder consensus activities. A systematic review of mental health literacy interventions in South-East Asia was undertaken in addition to semi-structured interviews with 43 children and young people (19 with and 24 without experience of anxiety and depression), 19 parents of children with experience of mental health problems and 25 education and health professionals. A focus group was also held with 8 key stakeholders immersed nationally in policy and practice. Interview schedules explored participants' experiences of mental health, unmet needs and priorities for intervention. Data were synthesised and presented at a 3-day co-production workshop. Attendees included 13 CYP, 6 parents/guardians, 2 teachers, 8 health professionals, 2 academics and 3 game designers. Consensus exercises were utilised to identify the preferred format, content and delivery of the intervention. A smaller group of patient and public involvement contributors worked with designers to further iterate the intervention. RESULTS An immersive storyline digital application was co-developed for young people aged 11-15 with the primary aim of improving mental health literacy and self-management. The intervention comprises two chapters; one depression focussed, and the other anxiety focussed. The storyline format is interspersed with interactive games and exercises to promote engagement and encourage self-management. CYP also take part in group sessions delivered by trained facilitators before and after intervention use to discuss outcomes of and issues raised during the game. CONCLUSION The IMPeTUs intervention has been co-designed for CYP aged 11-15 to improve mental health literacy and enhance self-management abilities. To the best of our knowledge, this is the first Indonesian digital intervention to improve mental health literacy and self-management for this population. Implementation, acceptability, and impact are currently being explored in a multi-site case study evaluation.
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Affiliation(s)
- Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
| | - Armaji Kamaludi Syarif
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Republic of Indonesia
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Irman Irmansyah
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Republic of Indonesia
- Marzoeki Mahdi Hospital, Bogor, Republic of Indonesia
| | | | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Cicih Opitasari
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Republic of Indonesia
| | | | | | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Soraya Salim
- Pulih@thePeak-Women, Youth and Family Empowerment Centre, Jakarta, Republic of Indonesia
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Castro-Ramirez F, Al-Suwaidi M, Garcia P, Rankin O, Ricard JR, Nock MK. Racism and Poverty are Barriers to the Treatment of Youth Mental Health Concerns. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2021; 50:534-546. [PMID: 34339320 DOI: 10.1080/15374416.2021.1941058] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Traditional studies of treatment moderators have focused largely on psychological factors such as clinical severity. Racial and economic inequity exert large effects on youth mental health, on treatment efficacy, and on the likelihood of receiving treatment altogether. Yet, these factors are studied less often by clinical psychological scientists. METHOD We conducted a narrative review of literature on racial and economic inequities and their impact on youth mental health. RESULTS First, systemic problems such as racism and poverty increase the risk of developing complex health issues and decrease the likelihood of benefiting from treatment. Second, attitudinal barriers, such as mistrust associated with treatments provided by researchers and government agencies, decrease the likelihood that minoritized groups will engage with or benefit from evidence-based treatments. Third, minoritized and underserved communities are especially unlikely to receive evidence-based treatment. CONCLUSION Clinical psychological science has unique insights that can help address systemic inequities that can decrease treatment efficacy for youth mental health treatment. Psychological scientists can help eliminate disparities in accessing evidence-based treatment and help end violent policies in underserved minoritized communities by at the very least (1) building and supporting scalable community-based treatments as well as (2) publicly advocating for an end to violent policies that impose negative social costs.
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Affiliation(s)
| | | | | | | | | | - Matthew K Nock
- Department of Psychology, Harvard University.,Department of Psychiatry, Massachusetts General Hospital.,Mental Health Research Program, Franciscan Children's
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Psychosocial Working Conditions in School and Life Satisfaction among Adolescents in Sweden: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105337. [PMID: 34067815 PMCID: PMC8156610 DOI: 10.3390/ijerph18105337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/24/2022]
Abstract
Poor psychosocial working conditions in school have consistently been shown to be associated with adverse health among adolescents. However, the relationships between school demands, teacher support, and classmate support and positive aspects of health have not been explored to the same extent. The aim of this study was to examine differences in psychosocial working conditions in school and in life satisfaction by gender and by grade, and to investigate the association between psychosocial working conditions in school and life satisfaction among boys and girls, and among students in different grades. Data from the Swedish Health Behavior in School-Aged Children (HBSC) study of 2017/18 were used, consisting of 3614 students in Grades 5, 7, and 9 (~11, 13, and 15 years). Psychosocial working conditions in school were captured by indices of perceived school demands, teacher support, and classmate support. Life satisfaction was measured by the 11-step Cantril’s ladder (using cutoffs at >5 and >8, respectively). Whereas girls reported higher school demands than boys, higher levels of teacher and classmate support were reported by boys. Students in lower grades reported lower school demands but higher levels of teacher and classmate support compared with students in higher grades. Boys and students in lower grades were more likely to report high life satisfaction compared with girls and students in higher grades. Results from binary logistic regression analyzes showed that school demands were inversely associated with life satisfaction, and that higher levels of teacher support and classmate support were associated with high life satisfaction. These results were found for both boys and girls, and for students in all grades. The findings indicate that schools have the potential to promote positive health among students.
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Mishara BL, Dufour S. Randomized Control Study of the Implementation and Effects of a New Mental Health Promotion Program to Improve Coping Skills in 9 to 11 Year Old Children: Passport: Skills for Life. Front Psychol 2020; 11:573342. [PMID: 33192870 PMCID: PMC7658468 DOI: 10.3389/fpsyg.2020.573342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/05/2020] [Indexed: 11/16/2022] Open
Abstract
Passport: Skills for Life is a universal, primary school mental health promotion program to increase children’s coping skills. A stratified randomized control study with pretest, post-test and 1-year follow-up included 1,492 3rd to 6th grade children, from higher and lower socio-economic levels, randomly assigned by school to receive the program or a control group. Implementation and effects were evaluated by questionnaires and focus groups with children, parents and teachers as well as classroom observations. Program activities were well implemented and greatly appreciated, with perceived improvements in resolving conflicts, communicating feelings and coping. Compared to the controls, participants had increased emotional awareness, sustained 1 year later; conceived of more ways to cope in fictitious situations and reported using more, and more useful strategies, sustained 1 year later. Positive Academic Behaviors increased, but were not sustained the following year. This is a promising program to improve coping and emotional awareness that merits further research on its effects.
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Affiliation(s)
- Brian L Mishara
- Psychology Department, Université du Québec à Montréal, Montreal, QC, Canada
| | - Sarah Dufour
- School of Psychoeducation, Université de Montréal, Montreal, QC, Canada
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Jenkins E, McGuinness L, Haines-Saah R, Andres C, Ziemann MJ, Morris J, Waddell C. Equipping youth for meaningful policy engagement: an environmental scan. Health Promot Int 2020; 35:852-865. [PMID: 31325358 PMCID: PMC7414854 DOI: 10.1093/heapro/daz071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To better address the mental health and substance use crises facing youth globally, a comprehensive approach, inclusive of mental health promotion is needed. A key component of mental health promotion is policy intervention to address the social and structural determinants of health. Importantly, youth should be engaged in these efforts to maximize relevancy and impact. Yet, while there is growing interest in the inclusion of youth in the policymaking process, there is a paucity of guidance on how to do this well. This environmental scan reports findings from a comprehensive search of academic and grey literature that was conducted using the electronic databases: CINAHL, ERIC, MEDLINE, PsycINFO, Google Scholar, and Google. Search terms included variations of 'youth*', 'educat*', 'engage*', 'policy' and 'policy training'. Thirteen English language training programmes met inclusion criteria. Analysis identified marked differences in programme philosophy and focus by geographic region and highlights the need for enhanced evaluation and impact measurement moving forward. This paper makes a needed contribution to the evidence-base guiding this key mental health promotion strategy, which holds the potential to address critical gaps in approaches to youth mental health and substance use.
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Affiliation(s)
| | - Liza McGuinness
- University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Rebecca Haines-Saah
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Caitlyn Andres
- University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | | | - Jonny Morris
- Canadian Mental Health Association, BC Division, Vancouver, Canada
| | - Charlotte Waddell
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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Jenkins E, Haines-Saah R, McGuinness L, Hirani S, Boakye-Yiadom N, Halsall T, Rivers R, Morris J. Assessing the impacts of the Agenda Gap intervention for youth mental health promotion through policy engagement: a study protocol. Int J Ment Health Syst 2020; 14:58. [PMID: 32765643 PMCID: PMC7395361 DOI: 10.1186/s13033-020-00390-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/23/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mental health challenges are a leading health concern for youth globally, requiring a comprehensive approach incorporating promotion, prevention and treatment within a healthy public policy framework. However, the broad enactment of this vision has yet to be realized. Further, mental health promotion evidence specific to youth is still emerging and has not yet focused at a policy level. This is a critical gap, as policy is a key mental health promotion lever that can alter the social and structural conditions that contribute to shaping youth mental health outcomes for all youth, across the full spectrum of need. Responsive to this research and intervention priority, our prototype study intervention-the Agenda Gap-is comprised of an innovative, multi-media engagement intervention, developed in collaboration with youth. This intervention aims to equip youth and build capacity for them to lead meaningful policy change reflective of the mental health needs of diverse communities of youth, including those who experience structural vulnerability and who would not typically have had their voice represented in policymaking processes. METHODS This study will use a multiple case study design and mixed methods grounded in a realist approach and will be conducted in three sites across two Canadian provinces (British Columbia and Alberta). In an earlier phase of this research, we collaboratively designed the prototype intervention with youth, community and policy partners. In this phase of the study, the intervention will be implemented and further tested with new groups of youth collaborators (n = 10-15/site). Outcome data will be collected through realist qualitative interviews, validated questionnaires [i.e., Child and Youth Resilience Measure (CYRM-12), General Self-Efficacy (GSE) Scale, and the Critical Consiousness Scale (CCS)] and additional survey items developed by our study team. Analysis will focus on identification of key context-mechanism-outcome configurations to provide comprehensive insights into how this intervention works, for whom, and in what context. DISCUSSION This study is unique in its "upstream" focus on youth-engaged policymaking as a tool for improving the social and structural conditions that influence youth mental health across socioecological levels. Through the implementation and testing of the Agenda Gap intervention with diverse youth, this study will contribute to the evidence base on youth-engaged policymaking as a novel and innovative, mental health promotion strategy.
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Affiliation(s)
- Emily Jenkins
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5 Canada
| | - Rebecca Haines-Saah
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Liza McGuinness
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5 Canada
| | - Saima Hirani
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5 Canada
| | - Noah Boakye-Yiadom
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Tanya Halsall
- The Royal’s Institute of Mental Health Research, 1145 Carling Ave, Ottawa, ON K1Z 7K4 Canada
| | - Robert Rivers
- Senate of Canada, Chambers Building, C112-40 Elgin Street, Ottawa, ON K1P 1C7 Canada
| | - Jonathan Morris
- Canadian Mental Health Association, BC Division, 905-1130 West Pender Street, Vancouver, BC V6E 4A4 Canada
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Ndetei DM, Mutiso V, Gitonga I, Agudile E, Tele A, Birech L, Musyimi C, McKenzie K. World Health Organization life-skills training is efficacious in reducing youth self-report scores in primary school going children in Kenya. Early Interv Psychiatry 2019; 13:1146-1154. [PMID: 30277311 DOI: 10.1111/eip.12745] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 06/28/2018] [Accepted: 09/09/2018] [Indexed: 01/07/2023]
Abstract
AIM Documented evidence shows that training in life skills for school going children improves their physical and mental health status. Although Kenya has a curriculum and a policy for life-skills training in schools, these have not been implemented because lack of local evidence for efficacy. Therefore, the objective of this study was to determine the efficacy and effectiveness of the life-skill training curriculum for primary schools developed by the Ministry of Education, Kenya. METHODS We randomly selected 23 schools from two randomly selected sub-counties representing urban/peri-urban and rural contexts in Kenya. We collected baseline socio-demographic characteristics and administered the locally validated youth self-report (YSR) for 11 to 18 years old at baseline and 9 months post-intervention. We used the Ministry of Education validated curriculum for life-skills training for upper primary school as the intervention immediately after the baseline. RESULTS The World Health Organization life-skills training is efficacious in reducing YSR scores in primary school going children in Kenya. We found that socio-demographic characteristics were predictors for mental health and that there were significant positive improvements in internalizing and externalizing YSR symptoms and syndromes in both sites. The improvement was over 40% and therefore unlikely to be attributable to placebo effect or natural recovery without intervention. However, attention problems worsened more so in rural sites and particularly in girls. CONCLUSIONS Life-skills training is efficacious in improving mental health in school going children in the Kenyan context. However, it is not effective in attention problems which seem to be cognitive in nature.
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Affiliation(s)
- David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Victoria Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Isaiah Gitonga
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Emeka Agudile
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Albert Tele
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Lilian Birech
- Directorate of Policy, Ministry of Education, Nairobi, Kenya
| | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Kwame McKenzie
- Department of Psychiatry, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Brooks H, Irmansyah I, Lovell K, Savitri I, Utomo B, Prawira B, Iskandar L, Renwick L, Pedley R, Kusumayati A, Bee P. Improving mental health literacy among young people aged 11-15 years in Java, Indonesia: co-development and feasibility testing of a culturally-appropriate, user-centred resource (IMPeTUs) - a study protocol. BMC Health Serv Res 2019; 19:484. [PMID: 31299968 PMCID: PMC6626417 DOI: 10.1186/s12913-019-4328-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/05/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Depression and anxiety are two of the leading causes of disease burden in low-to-middle income coutnries. The World Health Organisation has engaged in a programme of scaling-up mental health services, but significant challenges remain. Improving mental health literacy in children and young people, a core part of recent, global health strategies has the potential to address some of these challenges. The study aims to co-develop and feasibility test, a culturally-appropriate toolkit to promote depression and anxiety focused mental health literacy and self-management skills in Indonesia, for children aged 11-15 years. METHODS A mixed methods study comprising four phases. Through a systematic review of existing evidence, phase 1 will review approaches to improve mental health literacy and self-management in South East Asia and critically review current evidence regarding intervention effect. Phase 2 will explore stakeholders' views on depression, anxiety and mental health more broadly and identify priorities for the intervention through the use of semi-structured interviews and/or focus groups with policy makers, clinicians, teachers, adolescent service users, carers and young people aged 11-15. Phase 3 will comprise iterative workshops with local stakeholders to present our findings and co-produce a testable, culturally appropriate toolkit to promote mental health literacy and depression/anxiety focused self-management in 11-15 year olds in Java, Indonesia. Phase 4 comprises feasibility evaluation of our developed intervention via nine in-depth case studies (Jakarta, Bogor and Magelang). We will examine the impact, acceptability and feasibility of our prototype intervention and produce evidence-based guidelines for wider implementation. DISCUSSION Tools to support mental health literacy and self-management are a low cost way in which mental health services in LMICs can attempt to address the burden of anxiety and depression amongst children and young people. However, this is an underexplored area in Indonesia. Working closely with local stakeholders, this study will design and undertake feasibility evaluation of co-produced mental health literacy and anxiety and depression focussed interactive self-management tools. This abstract has also been published on the funders website (UK Research and Innovation. Improving Mental Health Literacy Among Young People aged 12-15 years in Indonesia 2019).
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Affiliation(s)
- Helen Brooks
- Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Irmansyah Irmansyah
- National Institute of Health Research and Development, Jakarta, Indonesia
- Marzoeki Mahdi Hospital, Bogor, Indonesia
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | | | - Benny Prawira
- Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
- Into the Light, Jakarta, Indonesia
| | - Livia Iskandar
- Indonesian Agency for Witness and Victims Protection, Jakarta, Indonesia
- Pulih@thePeak- Women, Youth and Family Empowerment Center, Jakarta, Indonesia
| | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Beaudry MB, Swartz K, Miller L, Schweizer B, Glazer K, Wilcox H. Effectiveness of the Adolescent Depression Awareness Program (ADAP) on Depression Literacy and Mental Health Treatment. THE JOURNAL OF SCHOOL HEALTH 2019; 89:165-172. [PMID: 30644108 PMCID: PMC6370293 DOI: 10.1111/josh.12725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/12/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND Analysis of data from a NIMH-supported study was conducted to evaluate the effectiveness of the Adolescent Depression Awareness Program (ADAP) in promoting depression literacy and help-seeking behavior. METHODS Eighteen Pennsylvania schools were matched on size, sex, race, test scores, median income, and free/reduced lunch status. Schools randomized to the intervention implemented ADAP as a compulsory part of the schools health curriculum, while control schools collected study measures. RESULTS Post-randomization analysis revealed no significant differences by sex on the pre-assessments between intervention and control schools. In the intervention schools, a total of 1427 students received ADAP. Written parental consent and adolescent assent was obtained from 33.7% students. The online REDCap survey was completed by 41.78% of the consenting students. The Adolescent Depression Knowledge Questionnaire (ADKQ) findings suggest that ADAP significantly improved depression knowledge (Est. =1.07, SE =.25, p < .001), compared to those in the control group. ADAP was found to facilitate help-seeking behavior by student report in those participating in the REDCap survey 4 months following the ADAP curriculum. CONCLUSIONS Results of the survey suggests that ADAP facilitates help-seeking behaviors in teens. This study supports the efficacy of a teacher delivered school-based universal prevention program, ADAP, on depression literacy.
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Affiliation(s)
- Mary Beth Beaudry
- Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, Phone: (410) 955-9075
| | - Karen Swartz
- Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287,
| | - Leslie Miller
- Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287,
| | - Barbara Schweizer
- Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287,
| | - Kara Glazer
- Johns Hopkins University School of Medicine, 550 N Broadway, Suite 201, Baltimore, MD 21287,
| | - Holly Wilcox
- Johns Hopkins University School of Medicine, 550 N Broadway, Suite 201, Baltimore, MD 21287,
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Flynn D, Joyce M, Weihrauch M, Corcoran P. Innovations in Practice: Dialectical behaviour therapy - skills training for emotional problem solving for adolescents (DBT STEPS-A): evaluation of a pilot implementation in Irish post-primary schools. Child Adolesc Ment Health 2018; 23:376-380. [PMID: 32677137 DOI: 10.1111/camh.12284] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Whole school approaches to mental health are recommended where schools and community partners work together to support positive mental health for young people. Universal interventions which adopt this approach are limited however. This study evaluates the pilot implementation of DBT STEPS-A, a social-emotional learning programme for adolescents, in Ireland. METHOD Data were collected at the beginning and end of the academic year from students who participated in DBT STEPS-A and a control group. A matched comparison was conducted where a subset of the data was analysed consisting of 72 adolescents aged 15-16 years from two schools in the south of Ireland. Outcomes included emotion symptoms, dysfunctional coping and DBT skill use. Linear mixed-effects models were used to estimate the treatment effect (intervention vs. control). RESULTS A statistically significant treatment effect was observed on two of four outcome measures (emotion symptom index: p = 0.011; internalising problems: p = 0.012). The effect sizes were large (Cohen's F squared = 0.65 and 0.83 respectively). CONCLUSIONS Significant reductions on measures which assess constructs including depression, anxiety and social stress were found for the intervention group. The results suggest that DBT STEPS-A may yield positive effects for adolescents who complete the intervention. Feedback from adolescents and teachers suggests that refinement of content, structure and implementation may make the programme more accessible to an adolescent population.
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Affiliation(s)
- Daniel Flynn
- Cork Mental Health Services, Cork Kerry Community Healthcare, Health Service Executive, St Finbarr's Hospital, Douglas Road, Cork, Ireland
| | - Mary Joyce
- National Suicide Research Foundation, Western Gateway Building, University College Cork, Cork, Ireland
| | - Mareike Weihrauch
- National Suicide Research Foundation, Western Gateway Building, University College Cork, Cork, Ireland
| | - Paul Corcoran
- Department of Epidemiology and Public Health, Western Gateway Building, University College Cork, Cork, Ireland
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18
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Anderson M, Werner-Seidler A, King C, Gayed A, Harvey SB, O’Dea B. Mental Health Training Programs for Secondary School Teachers: A Systematic Review. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9291-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fenwick-Smith A, Dahlberg EE, Thompson SC. Systematic review of resilience-enhancing, universal, primary school-based mental health promotion programs. BMC Psychol 2018; 6:30. [PMID: 29976252 PMCID: PMC6034212 DOI: 10.1186/s40359-018-0242-3] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/14/2018] [Indexed: 01/11/2023] Open
Abstract
Background Wellbeing and resilience are essential in preventing and reducing the severity of mental health problems. Equipping children with coping skills and protective behavior can help them react positively to change and obstacles in life, allowing greater mental, social and academic success. This systematic review studies the implementation and evaluation of universal, resilience-focused mental health promotion programs based in primary schools. Methods A systematic review of literature used five primary databases: PsycINFO; Web of Science; PubMed; Medline; Embase and The Cochrane Library; and keywords related to (a) health education, health promotion, mental health, mental health promotion, social and emotional wellbeing; (b) school health service, student, schools, whole-school; (c) adolescent, child, school child, pre-adolescent; (d) emotional intelligence, coping behavior, emotional adjustment, resilienc*, problem solving, to identify relevant articles. Articles included featured programs that were universally implemented in a primary school setting and focused on teaching of skills, including coping skills, help-seeking behaviors, stress management, and mindfulness, and were aimed at the overall goal of increasing resilience among students. Results Of 3087 peer-reviewed articles initially identified, 475 articles were further evaluated with 11 reports on evaluations of 7 school-based mental health promotion programs meeting the inclusion criteria. Evaluation tools used in program evaluation are also reviewed, with successful trends in evaluations discussed. Encouraging results were seen when the program was delivered by teachers within the schools. Length of programing did not seem important to outcomes. Across all 7 programs, few long-term sustained effects were recorded following program completion. Conclusions This review provides evidence that mental health promotion programs that focus on resilience and coping skills have positive impacts on the students’ ability to manage daily stressors.
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Affiliation(s)
- Amanda Fenwick-Smith
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald St, Geraldton, WA, 6531, Australia
| | - Emma E Dahlberg
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald St, Geraldton, WA, 6531, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, 167 Fitzgerald St, Geraldton, WA, 6531, Australia.
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Jenkins EK, Bungay V, Patterson A, Saewyc EM, Johnson JL. Assessing the impacts and outcomes of youth driven mental health promotion: A mixed-methods assessment of the Social Networking Action for Resilience study. J Adolesc 2018; 67:1-11. [PMID: 29859474 DOI: 10.1016/j.adolescence.2018.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/09/2018] [Accepted: 05/22/2018] [Indexed: 10/14/2022]
Abstract
Mental health challenges are the leading health issue facing youth globally. To better respond to this health challenge, experts advocate for a population health approach inclusive of mental health promotion; yet this area remains underdeveloped. Further, while there is growing emphasis on youth-engaged research and intervention design, evidence of the outcomes and impacts are lacking. The purpose of this paper is to contribute to addressing these gaps, presenting findings from the Social Networking Action for Resilience (SONAR) study, an exploration of youth-driven mental health promotion in a rural community in British Columbia, Canada. Mixed methods including pre- and post-intervention surveys (n = 175) and qualitative interviews (n = 10) captured the outcomes and impacts of the intervention on indicators of mental health, the relationship between level of engagement and benefit, and community perceptions of impact. Findings demonstrate the feasibility and benefits of youth engaged research and intervention at an individual and community-level.
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Affiliation(s)
- Emily K Jenkins
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, Canada, V6T 2B5.
| | - Vicky Bungay
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, Canada, V6T 2B5.
| | - Andrew Patterson
- University of Lethbridge, The Prentice Institute for Global and Population Economy, Suite L1184-4401 University Drive West, Lethbridge, Alberta, T1K 3M4, Canada.
| | - Elizabeth M Saewyc
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia, Canada, V6T 2B5.
| | - Joy L Johnson
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Room 1130, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada.
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Connolly P, Miller S, Hanratty J, Roberts J, Sloan S. Protocol for a systematic review: Universal school-based programmes for improving social and emotional outcomes in children aged 3-11 years: a systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2018; 14:1-39. [PMID: 37131394 PMCID: PMC8427993 DOI: 10.1002/cl2.210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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22
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Connolly P, Miller S, Kee F, Sloan S, Gildea A, McIntosh E, Boyer N, Bland M. A cluster randomised controlled trial and evaluation and cost-effectiveness analysis of the Roots of Empathy schools-based programme for improving social and emotional well-being outcomes among 8- to 9-year-olds in Northern Ireland. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
There is growing consensus regarding the importance of attending to children’s social and emotional well-being. There is now a substantial evidence base demonstrating the links between a child’s early social and emotional development and a range of key longer-term education, social and health outcomes. Universal school-based interventions provide a significant opportunity for early intervention in this area and yet the existing evidence base, particularly in relation to their long-term effects, is limited.
Objectives and main outcomes
To determine the effectiveness and cost-effectiveness of Roots of Empathy (ROE), a universal school-based programme that, through attempting to enhance children’s empathy, seeks to achieve the following two main outcomes: improvement in prosocial behaviour and reduction in difficult behaviour.
Design
A cluster randomised controlled trial and an economic evaluation. A total of 74 primary schools were randomly assigned to deliver ROE or to join a waiting list control group. Seven schools withdrew post randomisation and a further two withdrew before the immediate post-test time point. Children (n = 1278) were measured pre test and immediately post test, and then for 3 years following the end of the programme. Data were also collected from teachers and parents.
Setting and participants
The intervention schools delivered ROE to their Year 5 children (aged 8–9 years) as a whole class.
Intervention
ROE is delivered on a whole-class basis for one academic year (October–June). It consists of 27 lessons based around the monthly visit from a baby and parent who are usually recruited from the local community. Children learn about the baby’s growth and development and are encouraged to generalise from this to develop empathy towards others.
Results
Although it was developed in Canada, the programme was very well received by schools, parents and children, and it was delivered effectively with high fidelity. ROE was also found to be effective in achieving small improvements in children’s prosocial behaviour (Hedges’ g = 0.20; p = 0.045) and reductions in their difficult behaviour (Hedges’ g = –0.16; p = 0.060) immediately post test. Although the gains in prosocial behaviour were not sustained after the immediately post-test time point, there was some tentative evidence that the effects associated with reductions in difficult behaviour may have remained up to 36 months from the end of the programme. These positive effects of ROE on children’s behaviour were not found to be associated with improvements in empathy or other social and emotional skills (such as emotional recognition and emotional regulation), on which the trial found no evidence of ROE having an effect. The study also found that ROE was likely to be cost-effective in line with national guidelines.
Conclusions
These findings are consistent with those of other evaluations of ROE and suggest that it is an effective and cost-effective programme that can be delivered appropriately and effectively in regions such as Northern Ireland. A number of issues for further consideration are raised regarding opportunities to enhance the role of parents; how a time-limited programme such as ROE can form part of a wider and progressive curriculum in schools to build on and sustain children’s social and emotional development; and the need to develop a better theory of change for how ROE works.
Trial registration
Current Controlled Trials ISRCTN07540423.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Paul Connolly
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| | - Sarah Miller
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| | - Frank Kee
- Centre of Excellence for Public Health Research (Northern Ireland), Queen’s University Belfast, Belfast, UK
| | - Seaneen Sloan
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| | - Aideen Gildea
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| | - Emma McIntosh
- Institute of Health and Wellbeing, Public Health and Health Policy, University of Glasgow, Glasgow, UK
| | - Nicole Boyer
- Institute of Health and Wellbeing, Public Health and Health Policy, University of Glasgow, Glasgow, UK
| | - Martin Bland
- Department of Health Sciences, University of York, York, UK
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O’Toole C. Towards dynamic and interdisciplinary frameworks for school-based mental health promotion. HEALTH EDUCATION 2017. [DOI: 10.1108/he-11-2016-0058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to scrutinise two ostensibly disparate approaches to school-based mental health promotion and offer a conceptual foundation for considering possible synergies between them.
Design/methodology/approach
The paper examines current conceptualisations of child and youth mental health and explores how these inform school-based prevention and intervention approaches. The dominance of discrete, “expert-driven” psychosocial programmes as well as the potential of critical pedagogy is explored using frameworks provided by contemporary dynamic systems theories. These theories call for a situated and holistic understanding of children’s development; and they look beyond static characteristics within individuals, to view well-being in relation to the dynamic social and historical contexts in which children develop.
Findings
Psychosocial interventions and critical pedagogies have strengths but also a number of limitations. Traditional psychosocial interventions teach important skill sets, but they take little account of children’s dynamic socio-cultural contexts, nor acknowledge the broader inequalities that are frequently a root cause of children’s distress. Critical pedagogies, in turn, are committed to social justice goals, but these goals can be elusive or seem unworkable in practice. By bringing these seemingly disparate approaches into conversation, it may be possible to harness their respective strengths, in ways that are faithful to the complex, emergent nature of children’s development, as well as committed to correcting inequalities.
Originality/value
The current paper is unique in bringing together contemporary psychological theory with critical pedagogy perspectives to explore the future of school-based mental health promotion.
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Kase C, Hoover S, Boyd G, West KD, Dubenitz J, Trivedi PA, Peterson HJ, Stein BD. Educational Outcomes Associated With School Behavioral Health Interventions: A Review of the Literature. THE JOURNAL OF SCHOOL HEALTH 2017; 87:554-562. [PMID: 28580676 DOI: 10.1111/josh.12524] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/24/2016] [Accepted: 01/19/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND There is an unmet need for behavioral health support and services among children and adolescents, which school behavioral health has the potential to address. Existing reviews and meta-analyses document the behavioral health benefits of school behavioral health programs and frameworks, but few summaries of the academic benefits of such programs exist. We provide exemplars of the academic benefits of school behavioral health programs and frameworks. METHODS A literature review identified school behavioral health-related articles and reports. Articles for inclusion were restricted to those that were school-based programs and frameworks in the United States that included an empirical evaluation of intervention academic-related outcomes. RESULTS Findings from 36 primary research, review, and meta-analysis articles from the past 17 years show the benefits of school behavioral health clinical interventions and targeted interventions on a range of academic outcomes for adolescents. CONCLUSION Our findings are consistent with reports documenting health benefits of school behavioral health frameworks and programs and can facilitate further efforts to support school behavioral health for a range of stakeholders interested in the benefits of school behavioral health programs and frameworks on academic outcomes.
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Affiliation(s)
- Courtney Kase
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | - Sharon Hoover
- University of Maryland School of Medicine
- National Center for School Mental Health, 737 West, Lombard Street 400, Baltimore, MD 21201
| | - Gina Boyd
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | - Kristina D West
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 200 Independence Avenue, SW, Washington, DC 20201
| | - Joel Dubenitz
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 200 Independence Avenue, SW, Washington, DC 20201
| | - Pamala A Trivedi
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 200 Independence Avenue, SW, Washington, DC 20201
| | - Hilary J Peterson
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | - Bradley D Stein
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
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van Genugten L, Dusseldorp E, Massey EK, van Empelen P. Effective self-regulation change techniques to promote mental wellbeing among adolescents: a meta-analysis. Health Psychol Rev 2016; 11:53-71. [PMID: 27796160 DOI: 10.1080/17437199.2016.1252934] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Mental wellbeing is influenced by self-regulation processes. However, little is known on the efficacy of change techniques based on self-regulation to promote mental wellbeing. The aim of this meta-analysis is to identify effective self-regulation techniques (SRTs) in primary and secondary prevention interventions on mental wellbeing in adolescents. Forty interventions were included in the analyses. Techniques were coded into nine categories of SRTs. Meta-analyses were conducted to identify the effectiveness of SRTs, examining three different outcomes: internalising behaviour, externalising behaviour, and self-esteem. Primary interventions had a small-to-medium ([Formula: see text] = 0.16-0.29) on self-esteem and internalising behaviour. Secondary interventions had a medium-to-large short-term effect (average [Formula: see text] = 0.56) on internalising behaviour and self-esteem. In secondary interventions, interventions including asking for social support [Formula: see text] 95% confidence interval, CI = 1.11-1.98) had a great effect on internalising behaviour. Interventions including monitoring and evaluation had a greater effect on self-esteem [Formula: see text] 95% CI = 0.21-0.57). For primary interventions, there was not a single SRT that was associated with a greater intervention effect on internalising behaviour or self-esteem. No effects were found for externalising behaviours. Self-regulation interventions are moderately effective at improving mental wellbeing among adolescents. Secondary interventions promoting 'asking for social support' and promoting 'monitoring and evaluation' were associated with improved outcomes. More research is needed to identify other SRTs or combinations of SRTs that could improve understanding or optimise mental wellbeing interventions.
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Affiliation(s)
- Lenneke van Genugten
- a Department of Public Health , Erasmus MC, University Medical Centre Rotterdam , Rotterdam , The Netherlands.,b Expertise Group Life Style , Netherlands Organization for Applied Scientific Research (TNO) , Leiden , The Netherlands
| | - Elise Dusseldorp
- b Expertise Group Life Style , Netherlands Organization for Applied Scientific Research (TNO) , Leiden , The Netherlands.,d Institute of Psychology, Methodology & Statistics, Leiden University , Leiden , The Netherlands
| | - Emma K Massey
- c Department of Internal Medicine, Section Nephrology & Transplantation , Erasmus MC, University Medical Centre Rotterdam , Rotterdam , The Netherlands
| | - Pepijn van Empelen
- b Expertise Group Life Style , Netherlands Organization for Applied Scientific Research (TNO) , Leiden , The Netherlands
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Milin R, Kutcher S, Lewis SP, Walker S, Wei Y, Ferrill N, Armstrong MA. Impact of a Mental Health Curriculum on Knowledge and Stigma Among High School Students: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry 2016; 55:383-391.e1. [PMID: 27126852 DOI: 10.1016/j.jaac.2016.02.018] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 02/25/2016] [Accepted: 03/02/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study evaluated the effectiveness of a school-based mental health literacy intervention for adolescents on knowledge and stigma. METHOD A total of 24 high schools and 534 students in the regional area of Ottawa, Ontario, Canada participated in this randomized controlled trial. Schools were randomly assigned to either the curriculum or control condition. The curriculum was integrated into the province's grade 11 and 12 "Healthy Living" courses and was delivered by teachers. Changes in mental health knowledge and stigma were measured using pre- and posttest questionnaires. Descriptive analyses were conducted to provide sample characteristics, and multilevel modeling was used to examine study outcomes. RESULTS For the curriculum condition, there was a significant change in stigma scores over time (p = .001), with positive attitudes toward mental illness increasing from pre to post. There was also a significant change in knowledge scores over time (p < .001), with knowledge scores increasing from pre to post. No significant changes in knowledge or stigma were found for participants in the control condition. A meaningful relationship was found whereby increases in knowledge significantly predicted increases in positive attitudes toward mental health (p < .001). CONCLUSION This is the first large randomized controlled trial to demonstrate the effectiveness in mental health literacy of an integrated, manualized mental health educational resource for high school students on knowledge and stigma. Findings also support the applicability by teachers and suggest the potential for broad-based implementation of the educational curriculum in high schools. Replication and further studies are warranted. Clinical trial registration information-Impact of a Mental Health Curriculum for High School Students on Knowledge and Stigma; http://clinicaltrials.gov/; NCT02561780.
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Affiliation(s)
- Robert Milin
- The Royal Ottawa Mental Health Centre, Institute of Mental Health Research, University of Ottawa, Canada.
| | - Stanley Kutcher
- IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | | | - Selena Walker
- The Royal Ottawa Mental Health Centre, Institute of Mental Health Research, University of Ottawa, Canada
| | - Yifeng Wei
- IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Natasha Ferrill
- The Royal Ottawa Mental Health Centre, Institute of Mental Health Research, University of Ottawa, Canada
| | - Michael A Armstrong
- The Royal Ottawa Mental Health Centre, Institute of Mental Health Research, University of Ottawa, Canada
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Kenigsberg TA, Winston W, Gibson PA, Brady SS. African American caregivers' resources for support: Implications for children's perceived support from their caregiver. CHILDREN AND YOUTH SERVICES REVIEW 2016; 61:337-344. [PMID: 26900196 PMCID: PMC4754976 DOI: 10.1016/j.childyouth.2016.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Tat'Yana A Kenigsberg
- University of Minnesota School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN
| | - Willie Winston
- Minnesota Association of Black Psychologists, Minneapolis, MN
| | | | - Sonya S Brady
- University of Minnesota School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN
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Divided and disconnected--an examination of youths' experiences with emotional distress within the context of their everyday lives. Health Place 2015; 35:105-12. [PMID: 26302053 DOI: 10.1016/j.healthplace.2015.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/17/2015] [Accepted: 08/12/2015] [Indexed: 12/31/2022]
Abstract
This paper is based on a qualitative study conducted in a rural community in British Columbia, Canada. Ethnographic methods were used to: (1) to bring youth voice to the literature on emotional distress; and (2) to capture the ways in which context shapes young peoples' experiences of emotional distress within their everyday lives. Our findings demonstrate how socio-structural contextual factors such as the local economy, geographical segregation, racism, ageism, and cutbacks in health and social service programming operate to create various forms of disconnection, and intersect in young peoples' lives to shape their experiences of emotional distress.
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30
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Mental Health Promotion in School: Schoolchildren's and Families' Viewpoint. Nurs Res Pract 2014; 2014:395286. [PMID: 25505985 PMCID: PMC4254067 DOI: 10.1155/2014/395286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 10/15/2014] [Indexed: 11/17/2022] Open
Abstract
While developing mental health work in schools, it is very important to consider the viewpoint of pupils. Parents can also give remarkable information on their children's viewpoint. The purpose of this study was to produce a description of the concepts used by schoolchildren aged 12–16 years and their families associated with promoting mental health in schools. The research material comprised interviews with schoolchildren and mothers, and verbal answers from the school well-being profile survey (n = 426). The analysis was conducted by applying the grounded theory method as introduced by Strauss. The study was conducted in a Finnish comprehensive school.
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31
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Björklund K, Liski A, Samposalo H, Lindblom J, Hella J, Huhtinen H, Ojala T, Alasuvanto P, Koskinen HL, Kiviruusu O, Hemminki E, Punamäki RL, Sund R, Solantaus T, Santalahti P. "Together at school"--a school-based intervention program to promote socio-emotional skills and mental health in children: study protocol for a cluster randomized controlled trial. BMC Public Health 2014; 14:1042. [PMID: 25287298 PMCID: PMC4201723 DOI: 10.1186/1471-2458-14-1042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 09/25/2014] [Indexed: 11/30/2022] Open
Abstract
Background Schools provide a natural context to promote children’s mental health. However, there is a need for more evidence-based, high quality school intervention programs combined with an accurate evaluation of their general effectiveness and effectiveness of specific intervention methods. The aim of this paper is to present a study protocol of a cluster randomized controlled trial evaluating the “Together at School” intervention program. The intervention program is designed to promote social-emotional skills and mental health by utilizing whole-school approach and focuses on classroom curriculum, work environment of school staff, and parent-teacher collaboration methods. Methods/Design The evaluation study examines the effects of the intervention on children’s socio-emotional skills and mental health in a cluster randomized controlled trial design with 1) an intervention group and 2) an active control group. Altogether 79 primary school participated at baseline. A multi-informant setting involves the children themselves, their parents, and teachers. The primary outcomes are measured using parent and teacher ratings of children’s socio-emotional skills and psychological problems measured by the Strengths and Difficulties Questionnaire and the Multisource Assessment of Social Competence Scale. Secondary outcomes for the children include emotional understanding, altruistic behavior, and executive functions (e.g. working memory, planning, and inhibition). Secondary outcomes for the teachers include ratings of e.g. school environment, teaching style and well-being. Secondary outcomes for both teachers and parents include e.g. emotional self-efficacy, child rearing practices, and teacher-parent collaboration. The data was collected at baseline (autumn 2013), 6 months after baseline, and will be collected also 18 months after baseline from the same participants. Discussion This study protocol outlines a trial which aims to add to the current state of intervention programs by presenting and studying a contextually developed and carefully tested intervention program which is tailored to fit a national school system. Identification of effective intervention elements to promote children’s mental health in early school years is crucial for optimal later development. Trial registration ClinicalTrials.gov register: NCT02178332. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-1042) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katja Björklund
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30, Helsinki FI-00271, Finland.
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Clarke AM, Bunting B, Barry MM. Evaluating the implementation of a school-based emotional well-being programme: a cluster randomized controlled trial of Zippy's Friends for children in disadvantaged primary schools. HEALTH EDUCATION RESEARCH 2014; 29:786-798. [PMID: 25113283 DOI: 10.1093/her/cyu047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Schools are recognized as one of the most important settings for promoting social and emotional well-being among children and adolescents. This clustered randomized controlled trial evaluated Zippy's Friends, an international school-based emotional well-being programme, with 766 children from designated disadvantaged schools. The purpose of this study was to evaluate the immediate and long term impact of the programme and to determine the impact of implementation fidelity on programme outcomes. Teachers reported emotional literacy outcomes using the Emotional Literacy Checklist, and emotional and behavioural outcomes using the Strengths and Difficulties Questionnaire. Controlling for the hierarchical structure of the data, path analysis using structural equation modelling revealed that the programme had a significant positive impact on the children's emotional literacy scores including significant improvements in the subscale scores of self-awareness (P < 0.001), self-regulation (P < 0.01), motivation (P < 0.001) and social skills (P < 0.001) at post-intervention. These results were maintained at 12-month follow-up (P < 0.01). The programme, however, did not have a significant impact on children's emotional and behavioural problems. Analysis of programme fidelity indicated that high fidelity was directly related to improved emotional literacy scores at post-intervention.
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Affiliation(s)
- Aleisha M Clarke
- Health Promotion Research Centre, National University of Ireland Galway, Ireland and Psychology Research Institute, University of Ulster, Londonderry, UK
| | - Brendan Bunting
- Health Promotion Research Centre, National University of Ireland Galway, Ireland and Psychology Research Institute, University of Ulster, Londonderry, UK
| | - Margaret M Barry
- Health Promotion Research Centre, National University of Ireland Galway, Ireland and Psychology Research Institute, University of Ulster, Londonderry, UK
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Greyber LR, Dulmus CN, Cristalli M, Jorgensen J. A Pilot Examination of Outcomes From an Adolescent Residential Treatment Facility Health and Wellness Intervention on Body Mass Index. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/0886571x.2013.841918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Barry MM, Clarke AM, Jenkins R, Patel V. A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries. BMC Public Health 2013; 13:835. [PMID: 24025155 PMCID: PMC3848687 DOI: 10.1186/1471-2458-13-835] [Citation(s) in RCA: 210] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 08/20/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This systematic review provides a narrative synthesis of the evidence on the effectiveness of mental health promotion interventions for young people in low and middle-income countries (LMICs). Commissioned by the WHO, a review of the evidence for mental health promotion interventions across the lifespan from early years to adulthood was conducted. This paper reports on the findings for interventions promoting the positive mental health of young people (aged 6-18 years) in school and community-based settings. METHODS Searching a range of electronic databases, 22 studies employing RCTs (N = 11) and quasi-experimental designs conducted in LMICs since 2000 were identified. Fourteen studies of school-based interventions implemented in eight LMICs were reviewed; seven of which included interventions for children living in areas of armed conflict and six interventions of multicomponent lifeskills and resilience training. Eight studies evaluating out-of-school community interventions for adolescents were identified in five countries. Using the Effective Public Health Practice Project (EPHPP) criteria, two reviewers independently assessed the quality of the evidence. RESULTS The findings from the majority of the school-based interventions are strong. Structured universal interventions for children living in conflict areas indicate generally significant positive effects on students' emotional and behavioural wellbeing, including improved self-esteem and coping skills. However, mixed results were also reported, including differential effects for gender and age groups, and two studies reported nonsignficant findings. The majority of the school-based lifeskills and resilience programmes received a moderate quality rating, with findings indicating positive effects on students' self-esteem, motivation and self-efficacy. The quality of evidence from the community-based interventions for adolescents was moderate to strong with promising findings concerning the potential of multicomponent interventions to impact on youth mental health and social wellbeing. CONCLUSIONS The review findings indicate that interventions promoting the mental health of young people can be implemented effectively in LMIC school and community settings with moderate to strong evidence of their impact on both positive and negative mental health outcomes. There is a paucity of evidence relating to interventions for younger children in LMIC primary schools. Evidence for the scaling up and sustainability of mental health promotion interventions in LMICs needs to be strengthened.
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Affiliation(s)
- Margaret M Barry
- WHO Collaborating Centre for Health Promotion Research, National University of Ireland Galway, University Road, Galway, Ireland
| | - Aleisha M Clarke
- WHO Collaborating Centre for Health Promotion Research, National University of Ireland Galway, University Road, Galway, Ireland
| | - Rachel Jenkins
- WHO Collaborating Centre for Research and Training for Mental Health, Institute of Psychiatry, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Vikram Patel
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK and Sangath, Goa, India
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Segrott J, Rothwell H, Thomas M. Creating safe places: an exploratory evaluation of a school-based emotional support service. PASTORAL CARE IN EDUCATION 2013; 31:211-228. [PMID: 24764611 PMCID: PMC3991317 DOI: 10.1080/02643944.2013.788062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 03/16/2013] [Indexed: 06/03/2023]
Abstract
School-based interventions for young people with emotional/mental health problems are often provided by external practitioners and their relationship with host schools is a key influence on implementation. Poor integration within school systems, schools' tendency to define interventions around pupils' behaviour and teachers' control over access, may undermine therapeutic relationships. This study examines how one school-based intervention-Bounceback-addressed these challenges. Methods comprised interviews with programme staff, school staff and service users. Bounceback sought to develop therapeutic relationships through creating a safe, welcoming place and maximising pupils' choice about how they engaged with it. To ensure Bounceback was delivered as intended, staff developed five conditions which schools were asked to meet: adhering to referral criteria, ensuring that attendance was voluntary, appropriate completion of referral forms, mechanisms for contacting pupils and private accommodation to maintain confidentiality. Pupils reported high levels of acceptability and described relationships of trust with Bounceback staff. Although pupils had choice about most aspects of Bounceback, teachers controlled access to it, partly in order to manage demand. The study highlights the need for external agencies to communicate their aims and needs clearly to schools and the importance of peripatetic practitioners being well integrated within their parent organisations.
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36
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O'Mara L, Lind C. What do we know about school mental health promotion programmes for children and youth? ACTA ACUST UNITED AC 2013. [DOI: 10.1080/1754730x.2013.811952] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Puolakka K, Haapasalo-Pesu KM, Konu A, Astedt-Kurki P, Paavilainen E. Mental health promotion in a school community by using the results from the Well-being Profile: an action research project. Health Promot Pract 2012; 15:44-54. [PMID: 23171651 DOI: 10.1177/1524839912464876] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article presents an action research project as a method to combine science and practical expertise in order to develop the practices of the health care system. The project aimed at developing mental health promotion in the school community in general and at finding tools for timely help when mental health is at risk. The underlying idea is that mental health is an integral part of health and by promoting general well-being it is also possible to promote and ensure mental health at school. The study was conducted in a Finnish lower secondary school of 446 pupils where the pupils are aged between 12 and 15 years. The initial survey was conducted using the School Well-being Profile, a tool developed by Anne Konu. A well-being questionnaire was used to identify the areas in need of improvement, providing the basis for planning and implementing development measures together with the local actors. The instrument proved to be a usable way of collecting feedback of the well-being of the school environment. As a result of the action research project, the school's physical conditions and social relationships improved and appropriate practices for future problem situations were set.
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Weare K, Nind M. Mental health promotion and problem prevention in schools: what does the evidence say? Health Promot Int 2012; 26 Suppl 1:i29-69. [PMID: 22079935 DOI: 10.1093/heapro/dar075] [Citation(s) in RCA: 300] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The European Union Dataprev project reviewed work on mental health in four areas, parenting, schools, the workplace and older people. The schools workpackage carried out a systematic review of reviews of work on mental health in schools from which it identified evidence-based interventions and programmes and extracted the general principles from evidence-based work. A systematic search of the literature uncovered 52 systematic reviews and meta-analyses of mental health in schools. The interventions identified by the reviews had a wide range of beneficial effects on children, families and communities and on a range of mental health, social, emotional and educational outcomes. The effect sizes associated with most interventions were generally small to moderate in statistical terms, but large in terms of real-world impacts. The effects associated with interventions were variable and their effectiveness could not always be relied on. The characteristics of more effective interventions included: teaching skills, focusing on positive mental health; balancing universal and targeted approaches; starting early with the youngest children and continuing with older ones; operating for a lengthy period of time and embedding work within a multi-modal/whole-school approach which included such features as changes to the curriculum including teaching skills and linking with academic learning, improving school ethos, teacher education, liaison with parents, parenting education, community involvement and coordinated work with outside agencies. Interventions were only effective if they were completely and accurately implemented: this applied particularly to whole-school interventions which could be ineffective if not implemented with clarity, intensity and fidelity. The implications for policy and practice around mental health in schools are discussed, including the suggestion of some rebalancing of priorities and emphases.
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Affiliation(s)
- Katherine Weare
- Education, University of Southampton, Southampton, Hampshire SO17 1BJ, UK.
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Mihalopoulos C, Vos T, Pirkis J, Carter R. The population cost-effectiveness of interventions designed to prevent childhood depression. Pediatrics 2012; 129:e723-30. [PMID: 22312000 DOI: 10.1542/peds.2011-1823] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Depression in childhood and adolescence is common and often persists into adulthood. This study assessed the population-level cost-effectiveness of a preventive intervention that screens children and adolescents for symptoms of depression in schools and the subsequent provision of a psychological intervention to those showing elevated signs of depression. The target population for screening comprised 11- to 17-year-old children and adolescents in the 2003 Australian population. METHODS Economic modeling techniques were used to assess the incremental cost-effectiveness of the intervention compared with no intervention. The perspective was that of the health sector, and outcomes were measured by using disability-adjusted life-years (DALYs). Multivariate probabilistic and univariate sensitivity testing was applied to quantify variations in the model parameters. RESULTS The modeled psychological intervention had an incremental cost-effectiveness ratio of $5400 per DALY averted, with just 2% of iterations falling above a $50 000 per DALY value-for-money threshold. Results were robust to model assumptions. CONCLUSIONS After school screening, screening and the psychological intervention represent good value-for-money. Such an intervention needs to be seriously considered in any national package of preventive health services. Acceptability issues, particularly to intervention providers, including schools and mental health professionals, need to be considered before wide-scale adoption.
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Murray JA. Approaches to Children, Young People and Mental Health: Confusion in the Ranks, Confusion Among the Commanders. ACTA ACUST UNITED AC 2012. [DOI: 10.1375/ajgc.15.2.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe need to provide support for the mental health needs of children and young people is not in dispute. However, there does exist confusion as to the most appropriate means and methods of providing such support. This confusion is particularly evident among those who work closely in providing daily for the mental health needs of children and young people, yet who lack specific mental health training. The confusion is heightened by the fact that those who have developed expertise in mental health cannot offer a consensual approach. This article discusses this confusion and its implications for other sectors by considering some of the theoretical and practical debates in the psychological literature concerning the most effective approaches to mental health interventions. Some commonsense recommendations from this literature for those working with children are offered.
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Barry MM. Generic Principles of Effective Mental Health Promotion. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2012. [DOI: 10.1080/14623730.2007.9721834] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sun J, Stewart D. How can we Improve the Physical and Social Environment of the School to Promote Student Resilience? Evidence from the Resilient Children and Communities Project in China. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2012. [DOI: 10.1080/14623730.2008.9721762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bagnell AL, Santor DA. Building mental health literacy: opportunities and resources for clinicians. Child Adolesc Psychiatr Clin N Am 2012; 21:1-9, vii. [PMID: 22137807 DOI: 10.1016/j.chc.2011.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Youth mental health is increasingly recognized as a key concern with significant impact on youth and society. School is the one setting where professionals are consistently available to monitor how children are functioning and learning and intervene and support. School psychiatry has expanded beyond individual mental health problems to school-wide and community issues including school violence, sexual harassment, bullying, substance abuse, discrimination, and discipline. This article describes the importance of mental health literacy in health outcomes and research in school-based mental health programs to better position the clinician to advocate at the individual and/or system level.
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Affiliation(s)
- Alexa L Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
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Dufour S, Denoncourt J, Mishara BL. Improving Children's Adaptation: New Evidence Regarding the Effectiveness of Zippy's Friends, a School Mental Health Promotion Program. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1754730x.2011.9715633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Santor DA, Bagnell A. Enhancig the Effectivencess and Sustainability of School-Based Mental Health Programs: Maximizing Program Participation, Knowledge Uptake and Ongoing Evaluation using Internet-Based Resources. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1754730x.2008.9715725] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Puolakka K, Kiikkala I, Haapasalo-Pesu KM, Paavilainen E. Mental health promotion in the upper level of comprehensive school from the viewpoint of school personnel and mental health workers. Scand J Caring Sci 2011; 25:37-44. [DOI: 10.1111/j.1471-6712.2010.00787.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Afifi RA, Makhoul J, El Hajj T, Nakkash RT. Developing a logic model for youth mental health: participatory research with a refugee community in Beirut. Health Policy Plan 2011; 26:508-17. [PMID: 21278370 DOI: 10.1093/heapol/czr001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory research. This paper describes a process leading to the development of a logic model for a youth mental health promotion intervention using a participatory approach in a Palestinian refugee camp in Beirut, Lebanon. First, a needs assessment, including quantitative and qualitative data collection was carried out with children, parents and teachers. The second phase was identification of a priority health issue and analysis of determinants. The final phase in the construction of the logic model involved development of an intervention. The process was iterative and resulted in a more grounded depiction of the pathways of influence informed by evidence. Constructing a logic model with community input ensured that the intervention was more relevant to community needs, feasible for implementation and more likely to be sustainable.
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Affiliation(s)
- Rema A Afifi
- Center for Research on Population and Health, Beirut, Lebanon
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Khan RJ, Bedford K, Williams M. Evaluation of MindMatters Buddy Support to Secondary Schools in South West Sydney. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2011. [DOI: 10.1080/14623730.2011.9715668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Welch V, Tugwell P, Petticrew M, de Montigny J, Ueffing E, Kristjansson B, McGowan J, Benkhalti Jandu M, Wells GA, Brand K, Smylie J. How effects on health equity are assessed in systematic reviews of interventions. Cochrane Database Syst Rev 2010; 2010:MR000028. [PMID: 21154402 PMCID: PMC7391240 DOI: 10.1002/14651858.mr000028.pub2] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Enhancing health equity has now achieved international political importance with endorsement from the World Health Assembly in 2009. The failure of systematic reviews to consider effects on health equity is cited by decision-makers as a limitation to their ability to inform policy and program decisions. OBJECTIVES To systematically review methods to assess effects on health equity in systematic reviews of effectiveness. SEARCH STRATEGY We searched the following databases up to July 2 2010: MEDLINE, PsychINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Index to Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on October 7 2010. SELECTION CRITERIA We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities. DATA COLLECTION AND ANALYSIS Data were extracted using a pre-tested form by two independent reviewers. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews. MAIN RESULTS Thirty-four methodological studies were included. The methods used by these included studies were: 1) Targeted approaches (n=22); 2) gap approaches (n=12) and gradient approach (n=1). Gender or sex was assessed in eight out of 34 studies, socioeconomic status in ten studies, race/ethnicity in seven studies, age in seven studies, low and middle income countries in 14 studies, and two studies assessed multiple factors across health inequity may exist.Only three studies provided a definition of health equity. Four methodological approaches to assessing effects on health equity were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (all 34 studies used a type of descriptive method); 2) descriptive assessment of reporting and analysis in original trials (12/34 studies); 3) analytic approaches (10/34 studies); and 4) applicability assessment (11/34 studies). Both analytic and applicability approaches were not reported transparently nor in sufficient detail to judge their credibility. AUTHORS' CONCLUSIONS There is a need for improvement in conceptual clarity about the definition of health equity, describing sufficient detail about analytic approaches (including subgroup analyses) and transparent reporting of judgments required for applicability assessments in order to assess and report effects on health equity in systematic reviews.
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Affiliation(s)
- Vivian Welch
- University of OttawaCentre for Global Health, Institute of Population Health1 Stewart Street, Room 206OttawaOntarioCanadaK1N 6N5
| | - Peter Tugwell
- Ottawa HospitalCentre for Global Health, Institute of Population Health, Department of Medicine1 Stewart StreetOttawaOntarioCanadaK1N 6N5
| | - Mark Petticrew
- London School of Hygiene and Tropical MedicineDepartment of Social & Environmental Health Research, Faculty of Public Health & Policy15‐17 Tavistock PlaceLondonUKWC1H 9SH
| | | | - Erin Ueffing
- University of OttawaCentre for Global Health, Institute of Population Health1 Stewart Street, Room 206OttawaOntarioCanadaK1N 6N5
| | - Betsy Kristjansson
- University of OttawaSchool of Psychology, Faculty of Social SciencesRoom 407C, Montpetit Hall125 UniversityOttawaOntarioCanadaK1N 6N5
| | - Jessie McGowan
- University of OttawaInstitute of Population Health/Ottawa Health Research Institute1 Stewart St. room 206OttawaOntarioCanadaK1N 6N5
| | - Maria Benkhalti Jandu
- University of OttawaCenter for Global Health, Institute of Population Health1 Stewart StreetOttawaONCanadaK1N 6N5
| | - George A Wells
- University of Ottawa Heart InstituteCardiovascular Research Reference CentreRoom H1‐140 Ruskin StreetOttawaOntarioCanadaK1Y 4W7
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System integration and its influence on the quality of life of children with complex needs. Int J Pediatr 2010; 2010:570209. [PMID: 20976132 PMCID: PMC2957127 DOI: 10.1155/2010/570209] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 08/11/2010] [Indexed: 12/02/2022] Open
Abstract
Purpose. To explore the interactions between child and parents psychosocial factors and team integration variables that may explain improvements in physical dimensions of the PEDS QL quality of life of children with complex needs after 2 years. Methods. In this 2-year study, parents were identified by the Children's Treatment Network. Families were eligible if the child was aged 0–19 years, had physical limitations, resided in either Simcoe County or the Region of York, Ontario, and there were multiple other family needs. Regression analysis used to explore associations and interactions; n = 110. Results. A child's physical quality of life was affected by interacting factors including child's behavior, parenting, and integrated care. Statistically significant interactions between team integration, processes of care, and child/parent variables highlight the complexity of the rehabilitation approach in real-life situations. Conclusions. Rehabilitation providers working with children with complex needs and their families should also address child and parent problematic behaviors. When this was the case in high integrated teams, the child's physical quality of life improved after two years.
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