Feasibility and acceptability of a multicomponent, group psychological intervention for adolescents with psychosocial distress in public schools of Pakistan: A feasibility cluster randomized controlled trial (cRCT)

Abstract

Background Child and adolescent mental health problems are a global public mental health priority. However, there is a lack of evidence-based scalable psychological interventions for adolescents living in low resource settings. This trial was designed to evaluate the feasibility and acceptability of delivering the World Health Organization’s Early Adolescent Skills for Emotions (EASE) intervention at public schools in a rural sub-district in Rawalpindi, Pakistan. Methods A two arm, single blinded, feasibility cluster randomized controlled trial with mixed-methods evaluation was conducted with 59 adolescents and their caregivers from 8 public schools. In the 4 intervention arm schools, 6 non-specialist facilitators delivered the culturally-adapted EASE group sessions to the adolescents (n = 29) and their caregivers with desired fidelity under the supervision of in-country supervisors. Results The participation rate of adolescents in the intervention sessions was 83%. The intervention strategies were implemented by the adolescents. However, attending biweekly sessions at schools was challenging for caregivers with only 50% caregivers attending the sessions. Conclusions The results of this study support the feasibility and acceptability of delivering this culturally adapted intervention through non-specialist facilitators in school settings in Pakistan and pave the way to conduct a fully powered cluster randomized controlled trial to test the effectiveness of intervention to improve psychological outcomes in adolescents. Trial registration: Trial registered with Clinicaltrials.gov prospectively; NCT04254393

Improving psychosocial distress for young adolescents in rural schools of Pakistan: study protocol of a cluster randomised controlled trial

“…All outcome measures have been translated in Urdu and adapted to suit the local cultural context as part of the associated feasibility study (trial registration NCT04254393). 12 …”

“…EASE has been previously translated in Urdu (National Language of Pakistan), culturally adapted for implementation in public schools and feasibility tested in eight public schools of rural Pakistan using a feasibility cluster randomised controlled trial (cRCT) design (trial registration NCT04254393). The results of the evaluation demonstrated the acceptability and feasibility of the adapted intervention to be delivered by non-specialist facilitators in public school settings of Pakistan and exhibited promising effects on improving adolescent’s well-being 12…”

“…The results of the evaluation demonstrated the acceptability and feasibility of the adapted intervention to be delivered by non-specialist facilitators in public school settings of Pakistan and exhibited promising effects on improving adolescent’s well-being. 12 …”

Youth Unemployment and Social Stability: Investigating the Linkages and Possible Solutions in the Context of Pakistan

“…In order to solve youth unemployment in Pakistan, focused initiatives that address the root causes of unemployment and provide young people with long-term work prospects are required. A comprehensive policy framework is proposed by Hamdani et al (2022) that includes actions to increase labor market flexibility, encourage entrepreneurship and innovation, and improve access to education and skill training. Furthermore, in order to guarantee that all young people have fair access to employment prospects, Javed et al, (2022) stress the significance of tackling structural hurdles and inequities in the labor market, such as gender discrimination and geographical discrepancies.…”

Mental Health Issues of Adolescents In Pakistan: A Cry For Help

“…1 in 4 adolescent goes through mental health issues that require immediate attention. 1 It is also well documented that many mental health disorders emerge in late childhood and early adolescence and they exacerbate to the burden of these disorders in youth and later in life. 2 In severe cases of anxiety and depression sufferer may commit suicide, it is reported that every 40 seconds one person dies of suicide.…”