Effectiveness and Implementation Outcome Measures of Mental Health Curriculum Intervention Using Social Media to Improve the Mental Health Literacy of Adolescents

Abstract

Purpose Globally, adolescent mental health problems reportedly manifest more severely in individuals with lower mental health literacy. Mental health curriculum interventions using social media have been associated with positive implementation outcomes. This study aimed to investigate whether such an intervention significantly improves adolescent mental health literacy and is associated with positive implementation outcome measures. Methods This study employed a quasi-experimental design, comparing the before-and-after difference between the intervention group (n 1 =77) and the control group (n 1 =76). A mental health literacy module was delivered using social media. Data were collected using validated questionnaires. Effect size and difference-in-differences model calculations (and associated 95% confidence intervals, CI) were conducted alongside other descriptive analyses. Results The estimated intervention effect size and difference-in-differences estimates were greater than zero. The effect was greater in the intervention than in the control group (p<0.05) despite sex and age differences. The effect size estimate provided by Cohen’s d and Hedges’ g values was medium-to-large (d/g=0.429–0.767, p<0.05). The difference-in-differences reflected a significant effect (DID=0.348, CI: 0.154–0.542, p<0.001) in increasing mental health literacy despite differences associated with sex, age, and school grade. The intervention program was acceptable, appropriate, feasible, and satisfactory, and more than 80% of participants said they agree to completely agree with these implementation outcomes. Resources and personal and family-related factors were among the perceived influencing factors determining the effectiveness and implementation outcome measures. Conclusion The intervention program effectively improved the mental health literacy of adolescents. It has been highlighted that social media interventions for mental health promotion could be practical and scalable; however, there is a need to take into account socio-demographic differences and barriers to inclusion/compliance.

Health literacy among adolescents and young adults in the Eastern Mediterranean region: a scoping review

“…The identified studies used various types of health literacy related to the following health topics: general health31 32 34 35 42–67; nutrition68–82; non-communicable diseases (NCDs)36 63; HIV83 84; e-health39 85–91; media92; physical health93 94; oral health38 95; medical96; disability67 97 98; mental health37 40 41 99–108; suicide109 110; and depression 33 111. These studies used 36 scales to measure health literacy, and these scales can be grouped into three categories: newly developed scales66 77 82 86 93 98; newly adapted and translated scales33 40 41 43 54 55 64 69 83 96 100 111; and previously adapted and translated scales 34 35 38 39 44–46 49 51–53 56–59 62 65 67 68 71–73 76 78–80 85 87–89 91 95 97 103 104 107–110 112 113…”

“…Among the nine studies that used health literacy-related educational interventions,32 34 38 40 56 62 78 83 99 four studies tested the effectiveness of the interventions, with health literacy as the main outcome 38 56 78 83. A study conducted in Tunisia83 used peer-led education to improve HIV-related health literacy, knowledge, risk perception and preventive behaviours.…”

“…We identified two interventions aimed at improving adolescents’ mental health literacy 40 99. The first was conducted in Ethiopia, and it provided a mental health curriculum in the form of summarised texts, figures and case reports through Facebook and Telegram.…”

“…The first was conducted in Ethiopia, and it provided a mental health curriculum in the form of summarised texts, figures and case reports through Facebook and Telegram. The messages were sent every 72 hours (Monday to Friday) for six consecutive weeks 99. This intervention was effective in improving adolescents’ mental health literacy.…”

“…The quality of four studies was unsatisfactory owing to inappropriate sampling strategies (no clear description of the sampling procedure, no representative sample and unjustified sample size) and inappropriate statistical analyses (online supplemental table 5). 31 40 73 84 Regarding the quasi-experimental studies, seven studies were evaluated as having a serious risk of bias, mostly because of confounding factors34 40 62 78 83 99 and the allocation of participants into intervention or control groups 32 34 78 83. Moreover, these studies had a risk of bias in the outcome assessment because the outcome assessors were not blinded to the intervention status (online supplemental table 6).…”