Online single-session interventions for Kenyan adolescents: study protocol for a comparative effectiveness randomised controlled trial

Abstract

BackgroundMental health problems are the leading cause of disability among adolescents worldwide, yet access to treatment is limited. Brief digital interventions have been shown to improve youth mental health, but little is known about which digital interventions are most effective.AimsTo evaluate the effectiveness of two digital single-session interventions (Shamiri-Digital and Digital-CBT (cognitive-behavioural therapy)) among Kenyan adolescents.MethodsWe will perform a school-based comparative effectiveness randomised controlled trial. Approximately 926 Kenyan adolescents will be randomly assigned to one of three conditions: Shamiri-Digital (focused on gratitude, growth mindsets and values), Digital-CBT (focused on behavioural activation, cognitive restructuring and problem solving) or a study-skills control condition (focused on note-taking and essay writing skills). The primary outcomes include depressive symptoms (measured by the Patient Health Questionnaire-8), anxiety symptoms (Generalized Anxiety Disorder Screener-7) and subjective well-being (Short Warwick-Edinburgh Mental Well-being Scale). The secondary outcomes include acceptability, appropriateness, primary control and secondary control. Acceptability and appropriateness will be measured immediately post-intervention; other outcomes will be measured 2 weeks, 4 weeks and 12 weeks post-intervention.ResultsWe hypothesise that adolescents assigned to Shamiri-Digital and adolescents assigned to Digital-CBT will experience greater improvements (assessed via hierarchical linear models) than those assigned to the control group. We will also compare Shamiri-Digital with Digital-CBT, although we do not have a preplanned hypothesis.ConclusionsOur findings will help us evaluate two digital single-session interventions with different theoretical foundations. If effective, such interventions could be disseminated to reduce the public health burden of common mental health problems.Trial registration numberPACTR202011691886690.

Long-term health outcomes of adolescent character strength interventions: 3- to 4-year outcomes of three randomized controlled trials of the Shamiri program

“…For example, future research could collect long-term follow-up measures of participants in Shamiri digital, a single-session remote intervention which showed promising reductions in depressive symptoms over the long-term [ 69 ]. This study could also compare the long-term effects of Shamiri digital to digital cognitive behavioral therapy [ 76 ].…”

Economic evaluation of an online single-session intervention for depression in Kenyan adolescents.

“…Nonetheless, studies with longer follow-up periods are needed to understand how long the effects persist, which would have major implications for cost-effectiveness evaluations. Relatedly, our definitions of clinically meaningful change are only meant to describe short-term response to the intervention; future research will be needed to understand if any students experience long-term recovery from online single-session interventions (see Wasil, Osborn, Weisz, et al, 2021). Finally, results from the trial come from students from one Kenyan high school.…”

Community-based models of care for adolescent and adult depression, suicidal behavior, anxiety, trauma, and substance use in Africa: a scoping review

“…After preliminary evaluation of included publications, we developed a categorization for interventions, as follows: psychotherapeutic, social, lifestyle/physical health, economic, and psychopharmacological interventions. About 10% of psychotherapeutic interventions utilized a singlesession intervention approach (14/144) (Stein et al, 1997;Igreja et al, 2004;Connolly and Sakai, 2011;Cubbins et al, 2012;Eller et al, 2013;Pengpid et al, 2013;Morojele et al, 2014;Lasebikan et al, 2017;De Fouchier and Kedia, 2018;Harder et al, 2020;Osborn et al, 2020;Akena et al, 2021;Wasil et al, 2021;Venturo-Conerly et al, 2022). A total of 10 studies quantitively assessed the effect of a single session intervention on MH or SU, of which eight studies indicated a statistically significant MH or SU reduction.…”