Adolescent Mental Health Program Components and Behavior Risk Reduction: A Meta-analysis

Abstract

CONTEXT: Although adolescent mental health interventions are widely implemented, little consensus exists about elements comprising successful models.OBJECTIVE: We aimed to identify effective program components of interventions to promote mental health and prevent mental disorders and risk behaviors during adolescence and to match these components across these key health outcomes to inform future multicomponent intervention development.DATA SOURCES: A total of 14 600 records were identified, and 158 studies were included.STUDY SELECTION: Studies included universally delivered psychosocial interventions administered to adolescents ages 10 to 19. We included studies published between 2000 and 2018, using PubMed, Medline, PsycINFO, Scopus, Embase, and Applied Social Sciences Index Abstracts databases. We included randomized controlled, cluster randomized controlled, factorial, and crossover trials. Outcomes included positive mental health, depressive and anxious symptomatology, violence perpetration and bullying, and alcohol and other substance use.DATA EXTRACTION: Data were extracted by 3 researchers who identified core components and relevant outcomes. Interventions were separated by modality; data were analyzed by using a robust variance estimation meta-analysis model, and we estimated a series of singlepredictor meta-regression models using random effects.RESULTS: Universally delivered interventions can improve adolescent mental health and reduce risk behavior. Of 7 components with consistent signals of effectiveness, 3 had significant effects over multiple outcomes (interpersonal skills, emotional regulation, and alcohol and drug education).LIMITATIONS: Most included studies were from high-income settings, limiting the applicability of these findings to low-and middle-income countries. Our sample included only trials.CONCLUSIONS: Three program components emerged as consistently effective across different outcomes, providing a basis for developing future multioutcome intervention programs.

The modules of mental health programs implemented in schools in low- and middle-income countries: Findings from a systematic literature review

“…The current review indicated that the effectiveness of the 11 programs varied in relation to the individual outcomes of the programs and the period of follow-up. This nding agrees with that of another study, which revealed that programs implemented by teachers were more effective than those implemented by other stakeholders, such as psychiatrists and researchers [64]. This implies that program development should be outcome-dependent and that it should be followed up effectively and e ciently.…”

Preventing mental health conditions in adolescents living with HIV: an urgent need for evidence

“…Adolescence is thus a critical time to intervene with this vulnerable groupto prevent mental conditions, to promote positive mental health and to strengthen young people's capacity to navigate challenges and protect themselves from risk. Psychosocial interventions have been identified as beneficial when delivered to universal, or general, adolescent populations: these interventions adopt a psychological, behavioural, and/or social approach to improve psychosocial wellbeing and reduce the risk of poor mental health outcomes [24]. Our meta-analysis found that psychosocial interventions that included specific components (emotional regulation, interpersonal skills, mindfulness, assertiveness training, problem solving, stress management, and alcohol and drug education) were associated with more successful programme outcomes for adolescent mental health [24].…”

The modules of mental health programs implemented in schools in low- and middle-income countries: Findings from a systematic literature review

“…In this review, one of the studies did not indicate if there was allocation concealment or random sampling. In the rst review [60], allocation concealment and random sampling were also not done in some studies. In relation to the research designs employed, the current review included studies that utilised both real life setting designs and research setting designs (i.e., RCTs and quasi-experimental designs).…”