TY - JOUR
T1 - Strengthening self-regulation and reducing poverty to prevent adolescent depression and anxiety
T2 - Rationale, approach and methods of the ALIVE interdisciplinary research collaboration in Colombia, Nepal and South Africa
AU - Lund, Crick
AU - Jordans, Mark J D
AU - Garman, Emily
AU - Araya, Ricardo
AU - Avendano, Mauricio
AU - Bauer, Annette
AU - Bahure, Vikram
AU - Dua, Tarun
AU - Eleftheriou, Georgia
AU - Evans-Lacko, Sara
AU - García Rodríguez, Juan Felipe
AU - Gautam, Kamal
AU - Gevonden, Martin
AU - Hessel, Philipp
AU - Kohrt, Brandon A
AU - Krabbendam, Lydia
AU - Luitel, Nagendra P
AU - Roy, Sanchari
AU - Seifert Bonifaz, Manuel
AU - Singh, Rakesh
AU - Sinichi, Mohammadamin
AU - Sorsdahl, Katherine
AU - Thornicroft, Graham
AU - Tol, Wietse A
AU - Trujillo, Daniela
AU - van der Merwe, Nicci
AU - Wahid, Syed Shabab
AU - Yarrow, Paula
PY - 2023
Y1 - 2023
N2 - AIMS: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the 'Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)' study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa.METHODS: This aim will be achieved by addressing four objectives: (1) develop a conceptual framework that identifies the causal mechanisms linking poverty, self-regulation and depression and anxiety; (2) develop a multi-component selective prevention intervention targeting self-regulation and poverty among adolescents at high risk of developing depression or anxiety; (3) adapt and validate instruments to measure incidence of depression and anxiety, mediators and implementation parameters of the prevention intervention; and (4) undertake a four-arm pilot cluster randomised controlled trial to assess the feasibility, acceptability and cost of the selective prevention intervention in the three study sites.RESULTS: The contributions of this study include the active engagement and participation of adolescents in the research process; a focus on the causal mechanisms of the intervention; building an evidence base for prevention interventions in LMICs; and the use of an interdisciplinary approach.CONCLUSIONS: By developing and evaluating an intervention that addresses multidimensional poverty and self-regulation, ALIVE can make contributions to evidence on the integration of mental health into broader development policy and practice.
AB - AIMS: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the 'Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)' study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa.METHODS: This aim will be achieved by addressing four objectives: (1) develop a conceptual framework that identifies the causal mechanisms linking poverty, self-regulation and depression and anxiety; (2) develop a multi-component selective prevention intervention targeting self-regulation and poverty among adolescents at high risk of developing depression or anxiety; (3) adapt and validate instruments to measure incidence of depression and anxiety, mediators and implementation parameters of the prevention intervention; and (4) undertake a four-arm pilot cluster randomised controlled trial to assess the feasibility, acceptability and cost of the selective prevention intervention in the three study sites.RESULTS: The contributions of this study include the active engagement and participation of adolescents in the research process; a focus on the causal mechanisms of the intervention; building an evidence base for prevention interventions in LMICs; and the use of an interdisciplinary approach.CONCLUSIONS: By developing and evaluating an intervention that addresses multidimensional poverty and self-regulation, ALIVE can make contributions to evidence on the integration of mental health into broader development policy and practice.
KW - Adolescent
KW - Humans
KW - Anxiety/prevention & control
KW - Colombia/epidemiology
KW - Depression/psychology
KW - Interdisciplinary Research
KW - Nepal
KW - Poverty
KW - Self-Control
KW - South Africa/epidemiology
U2 - 10.1017/S2045796023000811
DO - 10.1017/S2045796023000811
M3 - Journal article
C2 - 38088153
SN - 2045-7960
VL - 32
JO - Epidemiology and Psychiatric Sciences
JF - Epidemiology and Psychiatric Sciences
M1 - e69
ER -