School-based prevention of depression: a 2-year follow-up of a randomized controlled trial of the beyondblue schools research initiative.
ABSTRACT 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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ABSTRACT: Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT) for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a classroom-based CBT depression prevention programme as part of a large (n = 5,030) randomised controlled trial across eight UK secondary schools which was not found to be effective (PROMISE, ISRCTN19083628). The views of young people (n = 42), teachers (n = 12) and facilitators (n = 16) involved in the Resourceful Adolescent Programme (RAP) were obtained via focus groups and interviews which were thematically analysed. The programme was considered to be well structured and contain useful content, particularly for younger pupils. However, challenges associated with implementation were its age appropriateness for all year groups, its perceived lack of flexibility, the consistency of quality of delivery, the competing demands for teacher time and a culture where academic targets were prioritised over personal, social and health education. Whilst schools are convenient locations for introducing such programmes and allow good reach, the culture around improving well-being of young people in schools, increasing engagement with teachers and young people and sustaining such programmes are issues that need addressing.International Journal of Environmental Research and Public Health 06/2014; 11(6):5951-5969. DOI:10.3390/ijerph110605951 · 1.99 Impact Factor
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ABSTRACT: Adolescence is a developmental period characterised by vulnerability to psychopathology. Previous research has often confused treatment and prevention, and has cited effect sizes in selective or indicated samples as evidence for preventive efficacy without regard to the course of ‘healthy’ participants over time. The present review clarifies the definition of a prevention effect, and reviews universal, school-based prevention studies. It was found that of 36 included studies, 16.7%, 0%, and 21.4% demonstrated a true prevention effect for depression, anxiety, and disordered eating, respectively. No conclusions regarding a ‘gold standard’ approach could be drawn. Future directions for prevention research are discussed.11/2014; DOI:10.1016/j.mhp.2014.11.002
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ABSTRACT: Background The present study evaluates the long-term effects of a universal prevention approach for depression in children. It looks into the 2- and 3-year follow-ups of previously reported postintervention and 1-year outcomes. Method One hundred and eighty-nine 3rd grade (8–9 years old) children participated in a five-session, school-based, universal prevention program designed to encourage social skills and peer support. The study was conducted from 2006 to 2009 in two public schools in Miyazaki, the south main island of Japan. ResultsDepressive symptoms decreased significantly from the pre to the postintervention periods, and this effect was maintained. Furthermore, children in the prevention group showed significantly lower depression than the normative sample. Conclusions This study reveals the beneficial long-term effects of a universal approach.Child and Adolescent Mental Health 05/2013; 18(2). DOI:10.1111/j.1475-3588.2012.00665.x · 0.95 Impact Factor