School-Based Prevention of Depression: A 2-Year Follow-up of a Randomized Controlled Trial of the beyondblue Schools Research Initiative

Discipline of Paediatrics, University of Adelaide, South Australia, Australia.
Journal of Adolescent Health (Impact Factor: 3.61). 09/2010; 47(3):297-304. DOI: 10.1016/j.jadohealth.2010.02.007
Source: PubMed


To investigate the effectiveness of a universal intervention designed to reduce depressive symptoms experienced by adolescents at high school. The results from annual assessments during the 3-year intervention and a 2-year follow-up are reported.
Twenty-five pairs of secondary schools matched on socio-economic status were randomly assigned to either an intervention or a comparison group (n = 5,633 year 8 students, mean age = 13.1 years, SD = .5). The intervention used a comprehensive classroom curriculum program, enhancements to school climate, improvements in care pathways, and community forums. A range of measures completed by students and teachers was used to assess changes in depressive symptoms, risk and protective factors relevant to depression, and the quality of the school environment.
Changes in the levels of depressive symptoms and in the levels of risk and protective factors experienced by students in the two groups did not differ significantly over the 5 years of the study. Statistically significant differences in the ratings of school climate across this time were found only for teacher-rated assessments.
There was little evidence that a multicomponent universal intervention delivered over a 3-year period reduced levels of depressive symptoms among participating students. Implementing universal interventions to improve student mental health is difficult in school settings that commonly have a crowded agenda of educational and health-related programs. Successful implementation will require programs which are perceived by teachers and students as relevant to educational and learning goals, and which can be effectively delivered in conjunction with other school programs.

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    • "Additionally, recent universal prevention trials reported no benefits. For example: the Beyond Blue program in Australia (Sawyer et al. 2010), The I Think, Feel and Act program in Chile (Araya et al. 2013), and the RAP program in the UK (Stallard et al. 2012). However, it should be noted that Stallard et al. (2012) reported program effectiveness for adolescents displaying high depressive symptom levels and not for all participating adolescents, and Araya et al. (2013) included adolescents from deprived socioeconomic areas only. "
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    ABSTRACT: The longitudinal effectiveness of a universal, adolescent school-based depression prevention program Op Volle Kracht (OVK) was evaluated by means of a cluster randomized controlled trial with intervention and control condition (school as usual). OVK was based on the Penn Resiliency Program (PRP) (Gillham et al. Psychological Science, 6, 343-351, 1995). Depressive symptoms were assessed with the Child Depression Inventory (Kovacs 2001). In total, 1341 adolescents participated, Mage = 13.91, SD = 0.55, 47.3 % girls, 83.1 % Dutch ethnicity; intervention group n = 655, four schools; control group n = 735, five schools. Intent-to-treat analyses revealed that OVK did not prevent depressive symptoms, β = -0.01, SE = 0.05, p = .829, Cohen's d = 0.02, and the prevalence of an elevated level of depressive symptoms was not different between groups at 1 year follow-up, OR = 1.00, 95 % CI = 0.60-1.65, p = .992, NNT = 188. Latent Growth Curve Modeling over the 2 year follow-up period showed that OVK did not predict differences in depressive symptoms immediately following intervention, intercept: β = 0.02, p = .642, or changes in depressive symptoms, slope: β = -0.01, p = .919. No moderation by gender or baseline depressive symptoms was found. To conclude, OVK was not effective in preventing depressive symptoms across the 2 year follow-up. The implications of these findings are discussed.
    Journal of Abnormal Child Psychology 09/2015; DOI:10.1007/s10802-015-0080-1 · 3.09 Impact Factor
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    • "Merry, McDowell, Wild, Bir, and Cunliffe (2004) suggested the necessity of a study on the optimal delivery of depression prevention programs by teachers in the school curriculum. Sawyer et al. (2010) also investigated the effectiveness of a comprehensive classroom curriculum program as a school-based depression prevention program. "
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    ABSTRACT: The purpose of this study was to evaluate the effects of a school-based intervention program for middle school adolescent girls with depression. The study was a pretest-posttest repeated-measure design with a nonequivalent control group. Fifty eight students with depressive symptoms were recruited from two middle schools in Seoul, Korea. The data were collected from the intervention (n=30) and the comparison group (n=28). The research instrument was Reynolds Adolescent Depression Scale. The intervention group greatly improved from baseline to 10 weeks and then saw a slight positive change between 10 and 13 weeks. The results of this research show that depression intervention programs are effective for young female adolescents. Thus the investigation has important school-based treatment implications, and should be integrated into school curriculums by school health nurses for early intervention of depressive symptoms in middle school adolescent girls.
    Journal of Korean Academy of Nursing 12/2012; 42(7):984-91. DOI:10.4040/jkan.2012.42.7.984 · 0.38 Impact Factor
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    • "Los programas focalizados en población de riesgo (prevención selectiva) y/o con sintomatología subumbral (prevención indicada) muestran una tendencia a presentar efectos preventivos más nítidos que los programas universales (Calear & Christensen, 2010; Collins & Dozois, 2008; Horowitz & Garber, 2006; Merry et al., 2003). Un factor que dificulta una valoración apropiada de la eficacia de los programas es que pocos estudios tienen un seguimiento suficiente como para observar la perdurabilidad de los efectos, si los hay, o posibles efectos latentes o tardíos (Sawyer et al., 2010). En nuestro país existen pocos estudios de la eficacia o efectividad de intervenciones preventivas en este ámbito. "
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    ABSTRACT: This study assesses the impact of a preventive program of depression in female adolescents from first grade of secondary school. The program was implemented in two ways: 1) Indicated: Applied to patients with subthreshold depressive symptoms (experimental group N=101; control group N=108) 2) Universal applied to a class comprised only by girls (experimental group=119; control group N=118). The program had 11 sessions, that lasted 1,5 hours each, with 15 to 23 participants per group. The impact of the program was measured in terms of anxiety, self-damage behavior, and externalized behavior. The program did not show effects in any of the two modalities. The Indicated modality obtained more satisfaction in the group of participants. The limitations of the study and implications for preventive programs in mental health are discussed.
    12/2011; 29(2):245-250. DOI:10.4067/S0718-48082011000200011
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