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The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial

BACKGROUND: Conduct, anxiety, and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests t...

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Autores principales: Parikh, Rachana, Michelson, Daniel, Malik, Kanika, Shinde, Sachin, Weiss, Helen A., Hoogendoorn, Adriaan, Ruwaard, Jeroen, Krishna, Madhuri, Sharma, Rhea, Bhat, Bhargav, Sahu, Rooplata, Mathur, Sonal, Sudhir, Paulomi, King, Michael, Cuijpers, Pim, Chorpita, Bruce F., Fairburn, Christopher G., Patel, Vikram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751586/
https://www.ncbi.nlm.nih.gov/pubmed/31533783
http://dx.doi.org/10.1186/s13063-019-3573-3
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author Parikh, Rachana
Michelson, Daniel
Malik, Kanika
Shinde, Sachin
Weiss, Helen A.
Hoogendoorn, Adriaan
Ruwaard, Jeroen
Krishna, Madhuri
Sharma, Rhea
Bhat, Bhargav
Sahu, Rooplata
Mathur, Sonal
Sudhir, Paulomi
King, Michael
Cuijpers, Pim
Chorpita, Bruce F.
Fairburn, Christopher G.
Patel, Vikram
author_facet Parikh, Rachana
Michelson, Daniel
Malik, Kanika
Shinde, Sachin
Weiss, Helen A.
Hoogendoorn, Adriaan
Ruwaard, Jeroen
Krishna, Madhuri
Sharma, Rhea
Bhat, Bhargav
Sahu, Rooplata
Mathur, Sonal
Sudhir, Paulomi
King, Michael
Cuijpers, Pim
Chorpita, Bruce F.
Fairburn, Christopher G.
Patel, Vikram
author_sort Parikh, Rachana
collection PubMed
description BACKGROUND: Conduct, anxiety, and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests the effects of a classroom-based sensitization intervention on the demand for counselling services in an embedded recruitment trial. METHODS/DESIGN: We will conduct a two-arm, individually randomized controlled trial in six Government-run secondary schools in New Delhi. The targeted sample is 240 adolescents in grades 9–12 with persistent, elevated mental health symptoms and associated distress/impairment. Participants will receive either a brief problem-solving intervention delivered over 3 weeks by lay counsellors (intervention) or enhanced usual care comprised of problem-solving booklets (control). Self-reported adolescent mental health symptoms and idiographic problems will be assessed at 6 weeks (co-primary outcomes) and again at 12 weeks post-randomization. In addition, adolescent-reported distress/impairment, perceived stress, mental wellbeing, and clinical remission, as well as parent-reported adolescent mental health symptoms and impact scores, will be assessed at 6 and 12 weeks post-randomization. We will also complete a parallel process evaluation, including estimations of the costs of delivering the interventions. An embedded recruitment trial will apply a stepped-wedge, cluster (class)-randomized controlled design in 70 classes across the six schools. This will evaluate the added effect of a classroom-based sensitization intervention over and above school-level sensitization activities on the primary outcome of referral rate into the host trial. Other outcomes will be the proportion of referrals eligible to participate in the host trial, proportion of self-generated referrals, and severity and pattern of symptoms among referred adolescents in each condition. Power calculations were undertaken separately for each trial. A detailed statistical analysis plan will be developed separately for each trial prior to unblinding. DISCUSSION: Both trials were initiated on 20 August 2018. A single research protocol for both trials offers a resource-efficient methodology for testing the effectiveness of linked procedures to enhance uptake and outcomes of a school-based psychological intervention for common adolescent mental health problems. TRIAL REGISTRATION: Both trials are registered prospectively with the National Institute of Health registry (www.clinicaltrials.gov), registration numbers NCT03633916 and NCT03630471, registered on 16th August, 2018 and 14th August, 2018 respectively). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13063-019-3573-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-67515862019-09-23 The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial Parikh, Rachana Michelson, Daniel Malik, Kanika Shinde, Sachin Weiss, Helen A. Hoogendoorn, Adriaan Ruwaard, Jeroen Krishna, Madhuri Sharma, Rhea Bhat, Bhargav Sahu, Rooplata Mathur, Sonal Sudhir, Paulomi King, Michael Cuijpers, Pim Chorpita, Bruce F. Fairburn, Christopher G. Patel, Vikram Trials Study Protocol BACKGROUND: Conduct, anxiety, and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests the effects of a classroom-based sensitization intervention on the demand for counselling services in an embedded recruitment trial. METHODS/DESIGN: We will conduct a two-arm, individually randomized controlled trial in six Government-run secondary schools in New Delhi. The targeted sample is 240 adolescents in grades 9–12 with persistent, elevated mental health symptoms and associated distress/impairment. Participants will receive either a brief problem-solving intervention delivered over 3 weeks by lay counsellors (intervention) or enhanced usual care comprised of problem-solving booklets (control). Self-reported adolescent mental health symptoms and idiographic problems will be assessed at 6 weeks (co-primary outcomes) and again at 12 weeks post-randomization. In addition, adolescent-reported distress/impairment, perceived stress, mental wellbeing, and clinical remission, as well as parent-reported adolescent mental health symptoms and impact scores, will be assessed at 6 and 12 weeks post-randomization. We will also complete a parallel process evaluation, including estimations of the costs of delivering the interventions. An embedded recruitment trial will apply a stepped-wedge, cluster (class)-randomized controlled design in 70 classes across the six schools. This will evaluate the added effect of a classroom-based sensitization intervention over and above school-level sensitization activities on the primary outcome of referral rate into the host trial. Other outcomes will be the proportion of referrals eligible to participate in the host trial, proportion of self-generated referrals, and severity and pattern of symptoms among referred adolescents in each condition. Power calculations were undertaken separately for each trial. A detailed statistical analysis plan will be developed separately for each trial prior to unblinding. DISCUSSION: Both trials were initiated on 20 August 2018. A single research protocol for both trials offers a resource-efficient methodology for testing the effectiveness of linked procedures to enhance uptake and outcomes of a school-based psychological intervention for common adolescent mental health problems. TRIAL REGISTRATION: Both trials are registered prospectively with the National Institute of Health registry (www.clinicaltrials.gov), registration numbers NCT03633916 and NCT03630471, registered on 16th August, 2018 and 14th August, 2018 respectively). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13063-019-3573-3) contains supplementary material, which is available to authorized users. BioMed Central 2019-09-18 /pmc/articles/PMC6751586/ /pubmed/31533783 http://dx.doi.org/10.1186/s13063-019-3573-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Parikh, Rachana
Michelson, Daniel
Malik, Kanika
Shinde, Sachin
Weiss, Helen A.
Hoogendoorn, Adriaan
Ruwaard, Jeroen
Krishna, Madhuri
Sharma, Rhea
Bhat, Bhargav
Sahu, Rooplata
Mathur, Sonal
Sudhir, Paulomi
King, Michael
Cuijpers, Pim
Chorpita, Bruce F.
Fairburn, Christopher G.
Patel, Vikram
The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial
title The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial
title_full The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial
title_fullStr The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial
title_full_unstemmed The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial
title_short The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial
title_sort effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in new delhi, india: protocol for a school-based, individually randomized controlled trial with an embedded stepped-wedge, cluster randomized controlled recruitment trial
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751586/
https://www.ncbi.nlm.nih.gov/pubmed/31533783
http://dx.doi.org/10.1186/s13063-019-3573-3
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