Development of a school-based programme for mental health promotion and prevention among adolescents in Nepal and South Africa

IF 4.1 Q1 PSYCHIATRY SSM. Mental health Pub Date : 2023-12-11 DOI:10.1016/j.ssmmh.2023.100289
Christina A. Laurenzi , Stefani du Toit , Tatenda Mawoyo , Nagendra P. Luitel , Mark J.D. Jordans , Indira Pradhan , Claire van der Westhuizen , G.J. Melendez-Torres , Jemma Hawkins , Graham Moore , Rhiannon Evans , Crick Lund , David A. Ross , Joanna Lai , Chiara Servili , Mark Tomlinson , Sarah Skeen
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Abstract

Introduction

Adolescence is a critical time for mental health promotion and prevention and establishing healthy behaviours. Implementing universal, school-based psychosocial interventions can improve short- and long-term health trajectories for adolescents. While these interventions may offer important opportunities for fostering skills and relationships, few school-based interventions have been developed for and tested in low- and middle-income countries (LMICs) where adolescent mental health needs may be significant and under-served. This manuscript details the development of a multi-component, universal school-based intervention, Health Action in ScHools for a Thriving Adolescent Generation (HASHTAG), for adolescents aged 12–15 years in Nepal and South Africa.

Methods and results

We describe HASHTAG's development over four phases, combining methods and results as each phase was iteratively conducted between 2018 and 2021. Phase 1 included a systematic review and components analysis, building from WHO guidelines for adolescent mental health. Seven components were strongly supported by the evidence: emotional regulation, stress management, mindfulness, problem-solving, interpersonal skills, assertiveness training, and alcohol and drug education. Phase 2 encompassed site selection, theory of change development, and formative research engagements; research teams in each site engaged adolescents and key adult stakeholders to identify priorities for intervention. Stakeholders voiced preferences for external facilitators and key content and delivery for intervention sessions. These findings informed Phase 3, a draft manual of HASHTAG, including a whole-school component, called Thriving Environment in Schools, and a classroom-based, six-session component, Thrive Together. In Phase 4, participants engaged in consultative workshops to review and contextualise content by country, preparing HASHTAG for implementation in a feasibility trial. Minor adaptations were made in Nepal, including using school nurses and adjusting take-home materials; both country's workshops identified practical considerations for implementing activities.

Conclusions

HASHTAG was designed around core evidence-based components to increase translatability across LMICs, while enabling country-specific tailoring to enhance feasibility. Future research will test whether this multi-component, whole-school approach can improve adolescent mental health.

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在尼泊尔和南非制定促进和预防青少年心理健康的校本计划
导言青春期是促进和预防心理健康以及建立健康行为的关键时期。实施普遍的、以学校为基础的社会心理干预措施可以改善青少年的短期和长期健康轨迹。虽然这些干预措施可以为培养技能和人际关系提供重要的机会,但很少有校本干预措施是针对中低收入国家(LMICs)开发和测试的,而这些国家的青少年心理健康需求可能很大,而且得不到充分的服务。本手稿详细介绍了针对尼泊尔和南非 12-15 岁青少年开发的多成分、普及型校本干预措施--"青少年一代茁壮成长的健康行动"(Health Action in ScHools for a Thriving Adolescent Generation,简称 HASHTAG)。第 1 阶段包括系统回顾和成分分析,以世界卫生组织青少年心理健康指南为基础。有七项内容得到了证据的有力支持:情绪调节、压力管理、正念、问题解决、人际交往技能、自信训练以及酒精和毒品教育。第二阶段包括选址、制定变革理论和开展形成性研究;每个选址的研究小组都与青少年和主要成人利益相关者进行了接触,以确定干预的优先事项。利益相关者对外部主持人以及干预课程的主要内容和实施方式提出了自己的偏好。这些发现为第三阶段提供了信息,即 HASHTAG 的手册草案,其中包括一个名为 "学校繁荣环境 "的全校部分和一个以教室为基础的六节课部分 "共同繁荣"。在第 4 阶段,参与者参加了咨询研讨会,按国家审查和调整内容,为在可行性试验中实施 HASHTAG 做准备。在尼泊尔进行了细微的调整,包括使用学校护士和调整带回家的材料;这两个国家的研讨会都确定了实施活动的实际注意事项。结论HASHTAG是围绕以证据为基础的核心内容设计的,以提高在低收入与中等收入国家的可转化性,同时使针对具体国家的调整成为可能,以提高可行性。未来的研究将检验这种多要素、全校参与的方法能否改善青少年的心理健康。
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来源期刊
SSM. Mental health
SSM. Mental health Social Psychology, Health
CiteScore
2.30
自引率
0.00%
发文量
0
审稿时长
118 days
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