Effects of three prophylactic interventions on French middle-schoolers' mental health: protocol for a randomized controlled trial

Adolescence is a strategic developmental stage in terms of preventing later difficulties and ensuring good mental health. Prophylactic interventions, which are conducted before the onset, prolongation, or worsening of difficulties, and aim to prevent or reduce symptoms or to promote wellbeing, therefore appear particularly appropriate for adolescents. However, existing prophylactic interventions conducted with adolescents have several weaknesses, including sparse theoretical frameworks, ambivalent evidence of their efficacy, and implementation and dissemination difficulties. In addition, no data are currently available on the effectiveness of such interventions in France. To fill this gap, a four-arm randomized controlled trial will be performed to assess the effectiveness of three prophylactic interventions targeting reactive, proactive and interpersonal adaptation in fourth-grade middle-school students, together with participants' experience and perception of the interventions. Based on existing knowledge about adolescents, their learning mechanisms, and field constraints, these three interventions have been designed to promote their learning and receptiveness to interventions. Compared with baseline (i.e., before the intervention), we expect to observe a significant decrease in the level of distress (anxiety and depressive symptoms, functional impairment, and psychosocial difficulties) and a significant increase in the level of wellbeing after the intervention, across the three intervention groups, but not in the control group. In addition, we expect to observe post-intervention improvements in the processes targeted by the reactive adaptation intervention (operationalized as coping strategy use and flexibility), those targeted by the proactive adaptation intervention (operationalized as the tendency to engage in committed actions and general self-efficacy), and those targeted by the interpersonal adaptation intervention (operationalized as assertiveness in interactions), but only in the corresponding groups, with no change in any of these processes in the control group. The results of this research will not only enrich our knowledge of the processes involved in adolescents' distress and wellbeing, but also provide clues as to the best targets for intervention. Moreover, the material for these interventions will be freely available in French on request to the corresponding author, providing access to innovative and fully assessed interventions aimed at promoting adolescents' mental health in France.This clinical trial is currently being registered under no. 2023-A01973-42 on https://ansm.sante.fr/ . This is the first version of the protocol.

Contributions of universal school-based mental health promotion to the wellbeing of adolescents and preadolescents: a systematic review of educational interventions

Purpose

The study aims to determine the contributions of universal school-based educational programs to the current and future worldwide youth mental health condition.

Design/methodology/approach

A systematic search was conducted in accordance with the PRISMA 2020 guidelines. Academic education and health databases including ERIC, Education Database, APA PsycInfo, APA PsycArticles, Psychology Database, and PubMed were used. Characteristics and outcomes of educational interventions developed in school settings and education potential for mental health promotion were examined.

Findings

Universal school-based mental health educational programs positively affect preadolescents and adolescents. The study review provided further insight into educational programs' characteristics and identified two primary curricula foci: mental health education and development of resiliency traits and skills.

Originality/value

Research on mental health promotion using a pedagogical approach is rare as most studies focus on mental health symptomatology and psychotherapy techniques training.

Building a Culture of Intimate Partner Violence Prevention in Alberta, Canada Through the Promotion of Healthy Youth Relationships

This article explores the design and implementation of the Alberta Healthy Youth Relationships (AHYR) Strategy. The AHYR is a province-wide practice and policy change initiative in Alberta, Canada, that aims to prevent intimate partner violence by promoting service provider and systems capacity to support healthy relationships in adolescence and beyond. Developed in 2012 within a broader initiative called Shift: The Project to End Domestic Violence, the design of the AHYR began with work with provincial policy-makers, in order to create a policy climate that championed primary prevention practice. This policy climate subsequently supported the province-wide implementation of three evidence-based/evidence-informed programs that focus on building the skills and capacities required for healthy youth relationships. Through these programs, the AHYR has reached over 62,000 youth in grades 7-9, 900 teachers, 850 parents, and 1300 adults that work with youth across the province. In addition to these three programs, the AHYR also works with larger systems (e.g., policymakers, local funders, post-secondary institutions) to advance primary prevention practice. In this paper, we describe how the AHYR contributed to a culture of intimate partner violence prevention practice in the province by improving the readiness of funders and system leaders, community organizations, and practitioners to support healthy relationships best practices. We also describe how we used process evaluation to explore the potential for practice change and to inform the design of the next iteration of the AHYR. The article concludes with implications for other researchers and practitioners aiming to build a culture of intimate partner violence prevention practice within their province or state.

A Preliminary Randomized Controlled Evaluation of a Universal Healthy Relationships Promotion Program for Youth

Bullying and mental health problems are pressing concerns for adolescents. Given their burden, we need to find efficacious ways to prevent these experiences. However, existing prevention programs tend to be single-issue and may not focus on the universal capacities required to reduce these problems among youth. To this end, we evaluated the universal, small groups Healthy Relationships Plus (HRP) program, which focuses on the promotion of positive mental health and the reduction of bullying and substance misuse. A sample of 212 youth from Southwestern Ontario were randomly assigned to the HRP or an attention-control condition over an 8-day period during summer 2014. Primary outcome measures (i.e., most important outcomes for this evaluation) were positive mental health, bullying victimization/perpetration, and substance misuse (alcohol, marijuana). We also examined a mediator (help-seeking) and two moderators (sex, adverse childhood experiences) of main effects. Participation in HRP was associated with reduced odds of physical bullying victimization at 1-year follow-up, compared with adolescents in the attention-control condition. This finding was mediated by increased intention to seek help from a mental health professional following HRP participation. We did not find main effects for positive mental health or substance misuse in this sample; however, there was an interaction effect whereby youth with significant trauma experiences reported less marijuana use at 1-year follow-up compared with control students. Findings reiterate the importance of help-seeking for bullying prevention and demonstrate the preliminary efficacy of the HRP as a universal strategy for preventing bullying victimization among mid-adolescents within school and community settings.