An arts-literacy intervention for adolescent depression and anxiety symptoms: outcomes of a randomised controlled trial of Pre-Texts with Kenyan adolescents
Abstract
Summary Background Mental health problems are prevalent among youth in low-resource countries and are further compounded by stigma and limited access to traditional treatments. The need for scalable, accessible, and stigma-free mental health interventions is urgent. We developed and tested Pre-Texts, an arts-literacy intervention that targets adolescent depression and anxiety, in Kenya. Methods We conducted a universal RCT (Randomized Controlled Trial). Students from Kenyan high schools (N = 235, ages 13–19, 53.19% female) were randomized to either Pre-Texts or a study skills control intervention. Pre-Texts involves the use of a text—such an excerpt from a novel, a physics lesson, or a technical manual—to inspire art-making that is followed by collective reflection on the process of interpretation through artmaking. Participants met daily for a week in groups of 6–12 youths for 1-h sessions. Groups were facilitated by high school graduates trained as lay-providers. This study was pre-registered at the Pan African Clinical Trials Registry (PACTR; registration number: PACTR202111497122432). The trial took place between August 11th 2021 and December 18th 2021. Findings Pre-Texts produced a greater reduction in depression (d = 0.52, 95% CI [0.19, 0.84]) and anxiety (d = 0.51, 95% CI [0.20, 0.81]) symptoms from baseline to 1-month follow-up compared to the control group. Similarly, in a sub-sample of participants with elevated depression and anxiety symptoms, Pre-Texts produced a…
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: 235 participants or records.
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