Improving adolescent mental health and resilience through a resilience-based intervention in schools: study protocol for a randomised controlled trial.

Julia Dray,Luke Wolfenden,Elizabeth Campbell,Jenny Bowman,John Wiggers,Rebecca K Hodder,Megan Freund

doi:10.1186/1745-6215-15-289

Abstract

BackgroundResearch investigating the effectiveness of universal interventions to reduce the risk of mental health problems remains limited. Schools are a promising setting within which adolescents can receive interventions aimed at promoting their mental health. The aim of this study is to assess the effectiveness of a resilience-based prevention-focused intervention in reducing the risk of mental health problems among adolescents attending secondary school in socio-economically disadvantaged areas.Methods/designA cluster randomised control trial will be conducted, with schools as the unit of randomisation. Initially, 32 secondary schools will be randomly allocated to a control or intervention group (12 control and 20 intervention). An intervention focused on improving student internal and external resilience factors will be implemented in intervention schools. A survey of students in Grade 7 in both intervention and control schools will be conducted (baseline) and repeated three years later when the students are in Grade 10. The Strengths and Difficulties Questionnaire will be used to measure the risk of mental health problems. At follow-up, the risk of mental health problems will be compared between Grade 10 students in intervention and control schools to determine intervention effectiveness.DiscussionThe study presents an opportunity to determine the effectiveness of a comprehensive resilience-based intervention in reducing the risk of mental health problems in adolescents attending secondary schools. The outcomes of the trial are of importance to youth, schools, mental health clinicians and policymakers.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12611000606987, registered 14 June 2011.

Highlights

Research investigating the effectiveness of universal interventions to reduce the risk of mental health problems remains limited
The outcomes of the trial are of importance to youth, schools, mental health clinicians and policymakers
Based on a one-unit increase in total Strengths and Difficulties Questionnaire (SDQ) scores for control students, and a conservative estimate of a two-point reduction in total SDQ scores for intervention students, it is estimated that approximately 11.6% more students at Grade 10 will score in the category of unlikely risk of mental health problems for the intervention group compared to the control group

Summary

Introduction

Research investigating the effectiveness of universal interventions to reduce the risk of mental health problems remains limited. The aim of this study is to assess the effectiveness of a resilience-based prevention-focused intervention in reducing the risk of mental health problems among adolescents attending secondary school in socio-economically disadvantaged areas. The concept of resilience provides one possible explanation for the ability of some individuals to maintain positive mental health in the face of adverse life circumstances [13]. Whilst often an inconsistently defined construct [14,15], the concept involves the ability, when faced with stress or adversity, to actively employ individual traits (internal factors) and wider social, community and environmental supports (external factors) to return to or maintain a positive state of mental health and functioning [16]. External resilience factors include meaningful school, home and community participation, and prosocial peers [18,19]

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