The Impact of a Universal Mental Health Intervention on Youth with Elevated Negative Affectivity: Building Resilience for Healthy Kids

Abstract

Objective In response to the rise in mental health needs among youth, a school-based resilience intervention was implemented for sixth graders at an urban middle school. The goal of this analysis is to examine improvements in key mental health parameters among students who endorsed negative affectivity at baseline. Method A total of 285 11–12-year-olds (72% white, 18% Hispanic, 55% female) participated in a single-arm, non-randomized 6-week 1:1 school-based coaching intervention, Healthy Kids. Youth completed validated surveys at baseline and 6-week follow-up assessing depression/anxiety symptoms, bullying, self-efficacy, academic pressure, grit, and resilience. Participants were determined to have elevated negative affectivity if they reported mild-to-severe symptoms for both depression and anxiety symptoms. General linear models examined differences between groups for each mental health parameter, as well as change in outcomes from baseline to follow-up. Results A third of participants (38%) at baseline endorsed negative affectivity. Youth who endorsed negative affectivity were more often female (71% vs 29%; p < 0.001) and identified as victims of cyberbullying (25% vs 8%; p < 0.001). Youth with baseline negative affectivity scored lower for self-efficacy (total 70.5 vs 86.8; p < 0.0001). Baseline negative affectivity was a significant moderator for change in mental health parameters. Post-intervention, those who endorsed baseline negative affectivity, medium effect sizes were observed for self-efficacy ( g = 0.6; 95%CI 0.3, 0.9; p < 0.001) and anxiety symptoms ( g = − 0.70; 95%CI − 1.0, − 0.4; p < 0.001). Among all youth, there were significant medium intervention effects in resilience ( g = 0.5; 95%CI 0.3, 0.7; p < 0.001) and self-efficacy ( g = 0.7; 95%CI 0.4, 0.9; p < 0.001). Conclusions A universal resiliency program may improve self-efficacy and symptoms of anxiety among youth experiencing negative affectivity, while improving resilience and self-efficacy among all youth. Our findings suggest a universal school-based coaching program benefits all youth, while also specifically targeting the needs of youth with negative affectivity who are most at risk for mental health concerns.

An 11-year prospective study of personality X parenting interactions as predictors of self-efficacy in young adults: diathesis-stress or differential susceptibility?

“…Results from this study suggest that targeting children’s feelings of anxiousness and self-confidence in interventions may have promising, long-term effects on their self-efficacy. Indeed, preliminary evidence for this hypothesis exists, with a 6-week school-based resilience intervention for 11–12-year-olds showing improvements in self-efficacy for all youth, and especially targeted the needs of children with negative affectivity [ 66 ]. Thus, especially for children low in emotional stability, such interventions might therefore in the long run improve their sense of self-efficacy.…”

A call to create evidence-based mental health promotion interventions for youth that are equitable across ethnic/racial subgroups: Advocates 4-ALL Youth

“…As a universal program, Healthy Kids was designed with the intention that all students participate in the program and, to ensure buy-in from youth, parents, and the school community, the sessions have been incorporated into the existing school curriculum. Pilot data demonstrated improvements in symptoms of depression and anxiety among students who reported elevated symptoms at baseline, while improving resilience and self-efficacy among all students (16).…”

“…Advocates 4-ALL Youth (ALLY) has been created using best practices and lessons learned from the pilot program, Building Resilience for Healthy Kids (Healthy Kids) (15)(16)(17). Healthy Kids was created and piloted in a local Colorado community with key school and community stakeholders and designed for widespread dissemination using a pragmatic approach that can be highly personalized within the existing school structure.…”

“…The program, Building Resilience for Healthy Kids (Healthy Kids), was developed using a community-based participatory research approach and served as a proof of concept and pilot-tested in Colorado (15)(16)(17). Healthy Kids was a single-arm intervention delivered in January-March 2020 to 6th-grade students attending an urban public middle school.…”