Mental Health Promotion Interventions Research Articles

Mental health literacy interventions for female adolescents: a systematic review and meta-analysis.

Suicide and self-harm are a leading cause of death globally, with females aged 15-24years being a high-risk group requiring urgent intervention. Promoting mental health literacy is a well-established strategy for early intervention. No review has explored the available interventions promoting mental health literacy for female adolescents and their reach, effectiveness, adoption, implementation, and maintenance as a whole remains unknown. This study reviews existing interventions promoting mental health literacy in female adolescents. Searches included original peer-reviewed articles from inception to May 2024 across six databases, identifying twelve studies for review. Five independent meta-analyses were conducted, showing no significant effects immediately post-intervention for mental health literacy, knowledge, stigmatising attitudes, and help-provision. A significant reduction in stigmatising attitudes was found > 6 months post-intervention. Moderation analyses could not be performed due to insufficient data. None of the included studies reported on interventions specifically for female adolescents. This review also evaluated reporting of RE-AIM components, finding limited reporting on reach, adoption, and maintenance. These findings highlight a substantial gap in high-impact and tailored mental health prevention and promotion interventions for female adolescents. Therefore, there is a clear need to understand and target female adolescents' mental health literacy needs to develop and implement more effective interventions.

Does disability modify the association between poor mental health and violence victimisation over adolescence? Evidence from the CoVAC cohort study in Uganda.

We aimed to estimate the impact of poor mental health in early adolescence on subsequent poor mental health, depression, and violence victimisation in late adolescence and to determine whether young people living with disabilities experienced a stronger relationship between mental health and these outcomes. Data from two waves of a longitudinal cohort study of 2773 Ugandan adolescents were used to assess the impact of mental health difficulties in early adolescence (aged 11-14) on presence of subsequent mental health difficulties, depression and past year violence victimisation in later adolescence (aged 15-18). We used g-computation to examine how these outcomes changed dependent on levels of poor mental health in early adolescence and explored functional difficulties as an effect modifier. This study demonstrates high prevalence of mental health difficulties in adolescence. There is a positive association between mental health difficulties in early adolescence and experience of mental health difficulties, depression, and past year violence in later adolescence. The risk of poor outcomes is greater for individuals experiencing poorer mental health in early adolescence. The relationships between early mental health difficulties and both mental health difficulties in later adolescence and past year violence are stronger in young people with functional difficulties. Poor mental health in early adolescence is associated with depression and violence victimisation in later adolescence, and the association is stronger among adolescents living with disabilities. School-aged adolescents would benefit from violence prevention and mental health promotion interventions which are inclusive and engage and respond to the needs and rights of adolescents with disabilities.

ASSISTÊNCIA DE ENFERMAGEM EM SAÚDE MENTAL A POPULAÇÃO ADOLESCENTE BRASILEIRA: REVISÃO DE LITERATURA

Adolescence is an element of the natural process of human growth. During this phase, individuals undergo essential changes to develop their capabilities, acquire experiences, and acquire fundamental values ​​to adapt to adulthood. The changes that occur during this phase can make adolescents' mental health more vulnerable. Nurses are considered essential professionals in mental health promotion and prevention interventions. To this end, the general objective of this study was to understand the role of nurses in mental health care for adolescents. To develop this research, an integrative review of the literature was carried out, of a descriptive and qualitative type, where the BVS and Google Scholar databases were selected, searching through them for delimited descriptors and bibliographic findings published between 2018 and 2024, in Portuguese. After reading, it became clear that the role of the nurse is to develop programs and strategies for intervention and promotion of mental health, which support adolescents and aim to promote social reintegration, autonomy, well-being and the appreciation of the subjectivity of users, with a focus on adherence and awareness of treatment and encouragement for seeking the service. It is concluded that the clinical practices of the nurse for adolescents with mental suffering are of utmost importance, having adequate skills for comprehensive care, which not only involves biological aspects, but also mental health in their professional practice.

Mental health promotion research in co-creation: Lessons from a multisite study in six countries

Abstract Background Mounting public health threats associated with climate change, epidemiological and economic crises, digitalisation, rising migration, and population aging have uncovered at-risk groups’ increased vulnerability to mental ill health. Developing mental health promotion interventions tailored to their specific needs and expectations is essential to protect their wellbeing. However, researchers may find it challenging to identify and implement needed adaptations without engaging with end-users, and other stakeholders, to co-create tailor-made interventions. This study aimed to explore co-creators’ views about opportunities and constraints in participatory mental health promotion research. Methods Between September 2023 and July 2024, a qualitative study drawing on participant observation of bimonthly meetings and semi-structured interviews with six co-creation facilitators was conducted in the scope of Horizon Europe’s project ADVANCE. The multi-methods research approach to co-creation entailed desk reviews and online Delphi surveys co-developed with locally-established Society Advisory Groups, and scenario-based workshops held with stakeholders in the six partner countries: Denmark, Germany, Italy, Lithuania, Netherlands, Switzerland. Thematic analysis of the data was carried out. Results Research teams’ epistemic stances impact research planning, resource allocation, partnership nourishing and the unravelling of co-option risks during participatory research implementation. Research co-creation adds pressure onto research teams’ agenda, skillset and performance, but it also encourages power sharing, mutual learning and greater alignment of research design and implementation with end-users’ priorities and aspirations. Conclusions Research co-creation is a partnership-based and resource-intensive endeavour that can provide a valuable pathway to improve the relevance, acceptability and sustainability of public mental health promotion research. Key messages • Research co-creation demands planning, adequate resource allocation, flexibility and continuous investment to sustain academy-society partnerships. • Engaging stakeholders in knowledge co-creation can increase the relevance, acceptability and sustainability of public mental health promotion research.

Barriers and facilitators for implementing ABCs for Mental Wellbeing intervention model in Finland

Abstract Background The ABCs for Mental Wellbeing study aims to improve mental health and wellbeing by adopting, implementing and evaluating a universal, community-based mental health promotion intervention model in Finland. The study gathers information and experiences of the implementation processes, identifies barriers and facilitators, and best practices for the implementation, and the feasibility and contextual adaptability of the intervention in different settings and specific target groups. Methods The implementation took place in four municipality community settings. In total, 40 participants attended the ABC activities. The study employs a mixed methods approach to look at the implementation processes: a quantitative survey before and after the implementation, and qualitative interviews with the employees implementing the model and the participants involved with the ABC activities. Results Based on qualitative analysis, the most identified facilitator is management support alongside the competencies of professionals. The observed effects of group activities aligned with the ABC model on mental wellbeing show that participants not only experienced the benefits of model-compliant activities on their mental wellbeing but also increased their awareness of factors influencing their mental wellbeing. The results of the quantitative analysis will be ready during the spring. Conclusions The study offers fresh insights into the obstacles and enablers affecting the implementation of a mental health promotion intervention model. The best practice strategies and guidelines identified are being shared both nationally and internationally and utilised to enhance future programme implementation and adaptation of these practices in various settings. Key messages • Best practice strategies and guidelines for successful implementation of mental health promotion identified. • The ABCs for Mental Wellbeing increased participants’ awareness of the factors influencing their mental wellbeing.

Co-creating stigma-prevention strategies for mental health interventions with migrant populations

Abstract Background The ADVANCE project aims to address mental health disparities among people in a situation of vulnerability in Europe. Through a co-creation approach, workshops were conducted to devise stigma prevention strategies during the implementation of mental health promotion interventions for migrant populations in Italy and Denmark. Methods The methodology involved two rounds of scenario-based workshops, a participatory method that elicit expert opinions to solve local problems and anticipate future ones. Round 1 included two separate workshops with (1) end-users and umbrella organizations, and (2) healthcare practitioners and decision-makers, to ensure diverse perspectives and minimize the impact of power imbalances. Participants brainstormed strategies to minimize stigma and optimize the intervention scenario. In Round 2, a mixed-group workshop was held to refine the strategies. Workshops occurred in Copenhagen and Verona in March 2024. Content analysis of the data was carried out. Results In Denmark, discussions emphasized tailored presentation of the intervention promoting shared experiences and normalizing mental health challenges, language sensitivity, participation through self-identification, and attention to relational aspects in intervention delivery to combat stigma effectively and enhance acceptability and engagement with the intervention. In Italy, proposed strategies included group exercises to raise awareness and promote open dialogue about cultural differences, language barriers, and discrimination. Discussions also considered the intersectionality of stigma, including factors like gender, socioeconomic status, and sexual orientation. Common themes included language sensitivity, facilitator training, and inclusive and safe spaces. Conclusions Scenario-based workshops can be a valuable tool to facilitate the co-creation of stigma-prevention strategies while involving all stakeholders in promoting effective mental health interventions. Key messages • Co-creation approach fostered stakeholder collaboration, yielding tailored strategies that promote inclusivity, acceptability and engagement with mental health interventions for migrant populations. • Context-specific approaches that emphasize trust, confidentiality and cultural sensitivity were prioritised to tackle stigma when implementing interventions and promoting mental health equity.

Association Between Diet and Mental Health Outcomes in a Sample of 13,887 Adolescents in Canada.

The high prevalence of mental disorders among adolescents calls for community-based and population-level prevention strategies. Diet is an important intervention target for primary prevention of mental disorders among adolescents. We used data from a large longitudinal study of Canadian adolescents (aged 14-18 y) to examine prospective associations between diet and mental health outcomes. We estimated the effect of diet (ie, consumption of vegetables and fruit and sugar-sweetened beverages [SSBs]) at baseline on depressive symptoms, anxiety symptoms, and psychological well-being (measured by the Center for Epidemiologic Studies Depression Scale-Revised, Generalized Anxiety Disorder 7 scale, and Flourishing Scale, respectively) and at 1-year follow-up in a sample of 13,887 Canadian secondary school students who participated in the 2017-2018 and 2018-2019 cycles of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary (COMPASS) behavior study. We applied linear mixed-effects methods informed by a directed acyclic graph. Sensitivity analyses assessed the robustness of the effect estimates to unmeasured confounding variables. Baseline SSB consumption was associated with greater severity of depressive (β = 0.04; 95% CI, 0.01-0.06) and anxiety (β = 0.02; 95% CI, 0-0.05) symptoms, particularly among male students, and poorer psychological well-being (β = -0.03; 95% CI, -0.05 to -0.01) at follow-up. Baseline vegetables and fruit consumption was positively associated with psychological well-being (β = 0.06; 95% CI, 0.03-0.10) but not other mental health outcomes at follow-up. Our results support the notion that diet should be part of comprehensive mental health prevention and promotion interventions to reduce the prevalence of mental health disorders among adolescents.

Trauma-informed acceptance and commitment therapy with peer coaching for college students: A pilot randomized controlled trial.

The current pilot randomized controlled trial evaluated the acceptability, feasibility, and preliminary efficacy of a mental health promotion intervention for college students based on trauma-focused acceptance and commitment therapy (Harris, 2021). This hybrid intervention combined web-based modules with peer coaching in a research lab setting. Seventy-eight students were randomized to either the intervention group, "Present and Open for Values" training, or an active control group, "Crash Course" training. Psychological distress and life satisfaction levels were assessed at baseline, postintervention, and 3 months postintervention. Open-ended feedback, rating scales, and completion rates suggested that both conditions were well-received and feasible. Longitudinal mixed-effects regression models with subject-specific intercepts were used to examine intervention effects. Participants in the Present and Open for Values condition reported significantly greater reductions in psychological distress levels compared to the control group, both at the end of the intervention and 3-month follow-up. Additionally, they reported significantly greater improvements in life satisfaction levels at these same intervals compared to baseline measurements. No significant changes in these outcomes were observed for the control condition. These findings suggest that the Present and Open for Values intervention with peer coaching is a promising approach for addressing mental health issues among college students, with the potential to be scaled up for broader implementation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluating the core processes of a hybrid trauma-informed acceptance and commitment therapy intervention for college students

Acceptance and commitment therapy (ACT) is based on the psychological flexibility model, underpinned by six core processes: contact with the present moment, acceptance, cognitive defusion, self as context, values, and committed action. The current study examined the roles of these processes in the first randomized controlled trial to examine the efficacy of a mental health promotion intervention for college students based on Trauma-Focused ACT (TFACT; Ajayi et al., 2024; Harris, 2021). The hybrid intervention combined web-based modules with peer coaching in a research laboratory setting. This current study aimed to extend those findings by empirically evaluating the theoretical components of the ACT model of psychological flexibility. Participants were 78 college students ranging between 18 and 32 years of age. It was found that the level of changes in awareness, self as context, values, and committed action were significantly different between the intervention and control groups, while psychological inflexibility, acceptance, and cognitive fusion were not. Simple regressions suggested that changes in psychological inflexibility significantly predicted changes in life satisfaction at post-intervention and 3-month follow-up. Whereas, changes in psychological inflexibility predicted changes in psychological distress only at follow-up. Furthermore, penalized regressions suggested awareness and cognitive fusion significantly predicted changes in psychological distress, but did not predict changes in psychological inflexibility or life satisfaction. The current study adds to the knowledge base regarding the process of change in ACT interventions to inform the design and implementation of more targeted and effective mental health interventions.

Effective Teacher Professional Development for School-Based Mental Health Promotion: A Review of the Literature.

Teachers are critically involved in the delivery of school-based mental health promotion (SMHP) interventions in school, though pre-service teacher education often leaves teachers feeling underprepared in this area. Thus, understanding how best to build teachers' capacity for delivery through effective professional development (PD) is essential for teachers to fulfill their role as delivery agents to achieve SMHP outcomes. This systematized review focuses on identifying components of high-quality teacher PD for SMHP and examining the empirical support for these components. In a two-phase analysis, we examined the descriptive literature regarding teacher PD for SMHP to identify common elements. This resulted in the identification of components relevant to training (interactive, guided by staff input) and technical assistance (TA), including the goals (skill development, motivation, generalization/adaptation), approach (collaborative, individualized, data-driven, strengths-based), and activities (modeling, performance feedback, reflection, problem solving) involved. A second phase focused on the examination of empirical evidence for these PD components. While the empirical evidence for these components was limited, the identified components represent a current standard of practice in teacher PD for SMHP, based on the existing research. These components may provide a framework for practical use in planning teacher PD related to SMHP and for designing future research into effective capacity building in this area.

Cultural and social factors associated with generalized anxiety disorder among adolescent mothers during the postpartum period in Malawi: a cross-sectional survey

BackgroundThe postnatal period is an important time for adolescent mothers to regain their health as they adjust to life with their infants. However, it is also a time when mothers are vulnerable to mental health problems. Generalized anxiety disorders (GADs) are among the common mental disorders that can impact mothers. Anxiety disorders can have adverse effects on a child’s cognitive development. However, there is a scarcity of studies pertaining to anxiety disorders among adolescent mothers in Malawi.MethodsA cross-sectional survey was conducted among adolescent postnatal mothers aged ≤ 19 years to establish the prevalence of probable GAD and identify cultural and social factors that influence anxiety in this population. Adolescent mothers were recruited from the Mitundu Rural Hospital catchment area in Lilongwe district, Malawi. A two-stage random sampling method was employed: clinics were randomly selected, and participants were recruited via systematic random sampling. The Generalized Anxiety Disorder (GAD-7) scale was used to assess anxiety. Data were analyzed using SPSS version 27.ResultsOf the 395 adolescent mothers who participated, 34% were aged 14–17. The prevalence of probable GAD (GAD-7 ≥ 10) was 31.9%. Increased social support decreased the odds of probable GAD (aOR 0.95, 95% CI: 0.91–0.98, p < 0.001). Experiencing intimate partner violence (IPV) increased the likelihood of probable GAD (aOR 4.80, 95% CI: 1.23–18.82, p = 0.02), while those who had contact with a health worker postnatally (aOR 0.38, 95% CI: 0.17–0.83, p = 0.02) and those who were “not prayerful” (aOR, 0.43, 95% CI: 0.21–0.87, p = 0.02) were less likely to report probable GAD.ConclusionsGiven that the prevalence of probable GAD among adolescent mothers in Malawi is higher compared to the global estimates of their peers, policies and guidelines that prioritize the maternal mental health of adolescent mothers in Malawi are required. The findings also highlight the importance of enhancing social support among family and community. Co-designed mental health promotion, prevention, and early interventions to involve health workers and religious leaders are recommended.

Starting conversations about mental health and wellbeing in Australian culturally and linguistically diverse communities.

Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants' mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful, cross-cultural connections, the importance of language, increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people's confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV's collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions.

Group-format, peer-facilitated mental health promotion interventions for students in higher education settings: a scoping review protocol

IntroductionYoung people in higher education face various stressors that can make them vulnerable to mental ill-health. Mental health promotion in this group therefore has important potential benefits. Peer-facilitated and group-format...

Mental health intervention development for indigenous youth: Essential elements and guiding principles

There is a need for intervention studies to address mental health issues with Indigenous youth. The purpose of this work is to: 1) consider calming approaches introduced by Native-American adolescents who described in writing how they manage day-to-day stress; and 2) identify culturally relevant constructs (elements and principles) for development of mental health promotion interventions for use with Indigenous youth. Central ideas shared by Native-American adolescents were merged with existing literature to identify essential elements and guiding principles for intervention development. Three essential elements (talking circles; mindfulness practice; tailored educational content) with associated guiding principles are recommended for intervention development.

Effect of an Internet-based mental health promotion intervention among immigrant Chinese women: A quasi-experimental study

BackgroundOwing to a lack of social support, child-rearing Chinese women in Japan experience mental health disorders, such as depression and parenting stress. Effective interventions to improve the mental health of these women are lacking. This study aimed to develop an Internet-based mental health promotion intervention for this subsection of the population and evaluate the effectiveness of the intervention. MethodsWe used a quasi-experimental pre- and post-test design whereby the results of the intervention group were compared with those of a control group. Seventy-three child-rearing women were recruited from online groups of Chinese residents in Japan. In the Internet-based intervention, participants utilised an information provision application and attended online parenting workshops. The intervention group participated in the online workshops once a week for six weeks and accessed the application, whereas the control group did not. The outcome measures included the levels of mental health distress, depression, social support, and parenting stress. Data were collected from February to April 2022. Data analysis was performed using repeated-measures analysis of variance. ResultsMental health distress (F = 16.478, p < 0.001, η2 = 0.210) and depression (F = 13.078, p = 0.001, η2 = 0.174) were significantly affected in the intervention group compared with the control group. There were no significant differences in social support and parenting stress between the groups. The Internet-based mental health promotion intervention was highly appraised by the participants. ConclusionsThis study developed an Internet-based mental health promotion intervention that involved an information provision application and parenting workshops. The intervention significantly reduced the mental health distress and depression of Chinese women in Japan but did not affect social support and parenting stress. The findings suggest that this intervention could be applied to foreign women with multicultural backgrounds in diverse settings to improve their psychological well-being.

A microcosting approach for planning and implementing community-based mental health prevention programs: what does it cost?

BackgroundEstimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that are ethnically and linguistically diverse and provide an example for estimating the cost of a mental health prevention and promotion programs consisting of multiple evidence-based interventions.MethodsWe used a semi-structured interview process to collect cost data through the first year of program planning, start-up and initial implementation from key staff. We calculated costs for each activity, grouped them by major project categories, and identified the cost drivers of each category. We further validated cost estimates through extensive literature review. The cost analysis was done from the provider’s perspective, which included the implementing agency and its community partners. We delineated costs that were in-kind contributions to the program by other agency, and community partners. Sensitivity analyses were conducted to estimate uncertainty around parameters.ResultsFor the first year of the development and implementation of the program, (funded through program and in-kind) is estimated at $1,382,669 (2022 US$). The costs for the three main activity domains for this project are: project management $135,822, community engagement $364,216 and design and execution $756,934. Overall, the cost drivers for the first year of this intervention were: hiring and onboarding staff, in-person community building/learning sessions, communications and marketing, and intervention delivery.ConclusionImplementation of community-based mental health promotion and prevention programs, when utilizing a participatory approach, requires a significant amount of upfront investment in program planning and development. A large proportion of this investment tends to be human capital input. Developing partnerships is a successful strategy for defraying costs.

Follow-up and Mediation Outcomes of a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda

ABSTRACT Objective There is limited evidence for the effectiveness of mental health promotion interventions in low- and middle-income settings, especially for longer-term benefits. This study evaluates the 5-month follow-up outcomes of a movement-based mental health promotion intervention (TeamUp) for refugee children in Northern Uganda (West Nile) and further investigates what explains longer-term benefits. Methods This quasi-experimental study was conducted in four primary schools, randomly allocated to an experimental or a control condition. Enrolled in the study were 549 children ages 10–15 years (n = 265 TeamUp; n = 284 control group). Primary outcomes were psychosocial well-being (Stirling Children’s Wellbeing Scale), attitude toward school, and satisfaction with friendships (Multidimensional Students Life Satisfaction Scale [Friends and School subscales]). Mediators included social connectedness and sense of agency. Results At 5 months postintervention, 467 (85.1%) children were retained. Intent-to-treat analyses demonstrated sustained benefits for TeamUp for well-being (estimated mean difference −1.88, 95% CI −3.14 to −0.66, p = .003, effect size Cohen’s d = 0.25) and friendships (−1.52, 95% CI −2.55 to −0.48, p = .005, d = 0.25). There were no significant between-group differences for attitude toward school. Secondary benefits were shown for traumatic stress (2.18, 95% CI 0.45 to 3.91, p = .014, d = 0.21), quality of life (−1.29, 95% CI −2.31 to −0.30, p = .014, d = 0.21), bullying (0.53, 95% CI 0.08 to 0.97, p = .020, d = 0.20), and depression symptoms (1.31, 95% CI 0.09 to 2.52, p = .035, d = 0.18). Increased sense of connectedness mediates the effect of TeamUp on improving well-being (indirect effect = 0.30, SE = 0.13, p = .001), explaining 15% of variance. Conclusion This study shows sustained benefits of a mental health promotion intervention 5 months postintervention. Prolonged benefits are explained by an increase in social connectedness.

Evaluating a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda: A Quasi-Experimental Study

ABSTRACT Objective Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the movement-based mental health promotion intervention “TeamUp” in Bidibidi refugee settlement, in Northern Uganda. Method A quasi-experimental study including four schools (two per arm) assessed the outcomes of 10- to 15-year-old South Sudanese and Ugandan children (n = 549). Randomly allocated, they either participated in up to 11 TeamUp sessions (n = 265) provided by trained facilitators; or belonged to a control group, which continued care as usual (n = 284). Primary outcomes measured psychosocial wellbeing, friendships and attitude to school; secondary outcomes included traumatic distress, depressive symptoms, quality of life, physical health, bullying, interoceptive awareness, and irritability. Data were collected at baseline and endline. Results Children joining TeamUp, showed significantly more improvements on primary outcomes: emotional and psychosocial wellbeing (Mdiff = −1.49, SE = 0.6, p = .01), satisfaction with and attitude toward school (−0.57, SE = 0.2, p = .004); and secondary outcomes: traumatic stress (2.64, SE = 0.8, p < .001), health-related quality of life (−1.56, SE = 0.4, p = .001), physical health (−0.78, SE = 0.3, p = .014) and the TeamUp mechanisms of action scale (−3.34, SE = 0.9, p < .001), specifically the subscales social connectedness (−0.74, SE = 0.3, p = .007) and sense of agency (−0.91, SE = 0.3, p = .005), compared to the control group. No significant differences were found on bullying, interoceptive awareness, irritability and depressive symptoms. Conclusion The results are promising for TeamUp as a mental health promotion intervention for children affected by armed-conflict, displacement and on-going adversity. Further research will need to assess the intervention’s effectiveness.

A Pilot Study of the Coping Together Virtual Family Intervention: Exploring Changes in Family Functioning and Individual Well-Being.

In this pilot study, we tested a virtual family strengthening and mental health promotion intervention, Coping Together (CT), during the COVID-19 pandemic. We explored changes at the family and individual levels, as well as mechanisms of change. Participants included 18 families (24 caregivers, 24 youth) with children aged 7 to 18 years. Community health workers delivered the 8-session CT intervention using videoconferencing software. We used qualitative semi-structured interviews with 14 of the families to explore changes and mechanisms of change using a thematic content analysis approach. We also administered pre-post surveys with the 18 families to explore the direction of changes, using only descriptive statistics in this small sample. Qualitative findings supported positive changes across family and individual level outcomes including family functioning, relationship quality, and individual psychosocial well-being. Results also confirmed several hypothesized mechanisms of change with improved communication providing the foundation for increased hope and improved problem solving and coping. Pre-post survey results were mixed, showing positive, but very small, changes in family closeness, caregiver-child communication, and levels of hope; almost no change was observed on measures of caregiver and child mental health. Families reported few problems at baseline quantitatively despite qualitative descriptions of pre-intervention difficulties. Results provide preliminary support for benefits of CT with the most consistent improvements seen across family relationships. Findings were mixed related to individual-level mental health benefits. Results have implications for revising content on mental health coping strategies and suggest the need to revise the quantitative measurement strategy for this non-clinical sample.

A scoping review of the implementation and cultural adaptation of school-based mental health promotion and prevention interventions in low-and middle-income countries.

Effective school-based mental health promotion and prevention interventions in low-and middle-income countries (LMICs) can positively impact the mental health and well-being of large numbers of young people. This scoping review aimed to investigate the implementation of effective mental health promotion and prevention interventions in LMIC schools. A scoping review of the international literature was conducted and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Medline, PsycInfo, Scopus, Embase, CINAHL and Cochrane were searched for peer-reviewed literature published from 2014 to 2022. PsycExtra, Google Scholar and the websites of key organisations were searched for relevant grey literature. Study selection focussed on mental health promotion interventions, including the development of social and emotional skills and mental health literacy, and prevention interventions, including anti-bullying and skill-based interventions for "at-risk" students. Twenty-seven studies evaluating 25 school-based interventions in 17 LMICs were included in the review. Fifteen interventions were developed in the implementing country and 10 were adapted from high-income countries (HICs) or other settings. Findings from the studies reviewed were generally positive, especially when interventions were implemented to a high quality. Universal life-skills interventions were found to increase social and emotional skills, decrease problem behaviours and positively impact students' mental health and well-being. Mental health literacy interventions increased mental health knowledge and decreased stigma among students and school staff. Outcomes for externally facilitated anti-bullying interventions were less positive. All 19 effective studies reported on some aspects of programme implementation, and 15 monitored implementation fidelity. Eleven studies outlined the programme's underpinning theoretical model. Only four studies reported on the cultural adaptation of programmes in detail. Including young people in the adaptation process was reported to facilitate natural cultural adaptation of programmes, while input from programme developers was considered key to ensuring that the core components of interventions were retained. The review findings indicate increasing evidence of effective mental health interventions in LMIC schools. To facilitate the sustainability, replication and scaling-up of these interventions, greater attention is needed to reporting on intervention core components, and the processes of implementation and cultural adaptation in the local setting.