Exploring the role of resilience in selective prevention intervention for adolescents at risk of depression and anxiety in Nepal: findings from a pilot cluster randomized controlled trial
Abstract
Understanding the mechanisms of change has recently been emphasized as crucial for advancing research on preventive interventions. This study, embedded within a pilot trial, aimed to explore the mediating effects of resilience for three preventive interventions focusing on reducing the risk of adolescent depression and anxiety in Nepal. We hypothesized that the self-regulation, economic, and combined interventions would differentially increase internal and external resilience, which in turn would reduce adolescent depressive and anxiety symptoms among adolescents in Nepal, supporting to development of a testable, replicable mediation model of prevention intervention pathways. Data were collected as part of a feasibility cluster-randomized controlled trial. A total of 229 adolescents aged 13–15, identified as living in poverty and at risk of depression or anxiety, were cluster-randomized by school into three intervention arms (self-regulation, economic, combined) and a control group. Assessments for depression and anxiety symptoms, and external and internal resilience were performed at three timepoints, with a six-month interval between each. Twenty school-based group intervention sessions were conducted weekly post-baseline. Linear mixed modeling explored changes in resilience within groups. Exploratory mediation analyses were performed to examine the association between interventions (as predictors), resilience at 6 months (as mediator), and symptoms of depression and…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 229 participants or records.
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