Suicide Prevention by Empowering Adolescents in Pakistan (SEPAK)
- Conditions
- Self-harm
- Interventions
- Other: Screening by Professionals programme plus educational postersOther: LEADS Plus educational postersOther: Question, Persuade, and Refer (Teachers) Plus educational postersOther: educational postersOther: Question, Persuade, and Refer (Parents) Plus educational posters
- Registration Number
- NCT04969718
- Lead Sponsor
- Pakistan Institute of Living and Learning
- Brief Summary
Self-harm is now seen as an epidemic affecting young people across the world and particularly in low and middle-income countries (LMIC) such as Pakistan. Young people in Pakistan often come across many troubles such as mental health and family problems, stress at school and social and economic inequalities. A youth suicide prevention programme is needed in Pakistan. Such programme will be based on secondary schools (where most young people are) and will support schools to work together with many public agencies to tackle the full range of troubles that young people face. Our main research aim is to work together with multiple stakeholders to culturally adapt and test the feasibility of three SEPAK interventions to prevent suicide among students in secondary schools in Pakistan (aged 12 to 17 years).
- Detailed Description
There will be two research phases. In the first phase,
1. Four preventative interventions will be selected and translated after reviewing the international literature on youth suicide prevention programmes (e.g. SEYLE trial in Europe);
2. Focus groups will be undertaken with multiple stakeholders (students, teachers/staff at secondary schools, parents and health professionals) to decide on adaptations needed to the four selected interventions;
3. Adapted versions the four preventative SEPAK interventions will be produced after incorporating the modifications recommended by the focus groups with stakeholders.
In the second phase, the feasibility and acceptability of the four preventative SEPAK interventions will be examined in 4 secondary schools (each site) and one control group (each site) across 8 cities in Pakistan. The four preventative interventions will involve i. Delivering workshops for students at secondary schools to raise awareness on mental health and stresses that students face.
ii. Training school teachers/workers to act as facilitators and identify troubled students iii. Training parents to act as facilitators and identify and support troubled young people iv. Training of health professionals who work with young people to systematically use cut-off scores of established psychometric tools for referring young people to mental and social care services. Six posters on mental health awareness will display in the classrooms of the school allocated to the control group.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1350
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description LEADS Plus educational posters educational posters A total of six group sessions with students using presentations and videos. Screening by Professionals programme Plus educational posters Screening by Professionals programme plus educational posters This is an indicated or selective intervention by health professionals who will review assessments (done using structured questionnaires) and refer students where necessary. LEADS Plus educational posters LEADS Plus educational posters A total of six group sessions with students using presentations and videos. Question, Persuade, and Refer (Teachers) Plus educational posters educational posters It is a manualised programme for gatekeepers (teachers). This includes both presentations and videos. Question, Persuade, and Refer (Parents) Plus educational posters Question, Persuade, and Refer (Parents) Plus educational posters It is a manualised programme for gatekeepers (parents). This includes both presentations and videos. Question, Persuade, and Refer (Teachers) Plus educational posters Question, Persuade, and Refer (Teachers) Plus educational posters It is a manualised programme for gatekeepers (teachers). This includes both presentations and videos. Screening by Professionals programme Plus educational posters educational posters This is an indicated or selective intervention by health professionals who will review assessments (done using structured questionnaires) and refer students where necessary. Educational poster educational posters The control group will be exposed to the six educational posters. Question, Persuade, and Refer (Parents) Plus educational posters educational posters It is a manualised programme for gatekeepers (parents). This includes both presentations and videos.
- Primary Outcome Measures
Name Time Method Feasibility of undertaking a trial of the intervention Change from baseline to 1-month post baseline recruitment rate of the trial
Therapy log Change from baseline to 1-month post baseline acceptability of the interventions that will be evident from the attendance of participants in each session on a therapy log
- Secondary Outcome Measures
Name Time Method Client Service Receipt Inventory Change in scores from baseline to outcome (1-month post baseline) We will collect information on the use of health services (including the informal sector such as faith healers/Imams)
Euro-Qol (EQ-5D-5L) Change in scores from baseline to outcome (1-month post baseline) A standardised instrument to measure health status and associated population utility weights. It consists of a self-report questionnaire covering five dimensions of health (mobility, self-care, usual activities, pain/ discomfort and anxiety/ depression)
The Global school-based student health survey (GSHS) Change in scores from baseline to outcome (1-month post baseline) The is a self-administered questionnaire and covered ten key topics: alcohol use, dietary behaviors, drug use, hygiene, mental health, physical activity, protective factors, sexual behaviors, tobacco use, and violence and unintentional injury
Deliberate Self-Harm Inventory Change in scores from baseline to outcome (1-month post baseline) DSHI will be used to collect information about episode of self-harm. Minimum score is 0 and maximum score is 34. Higher total score indicate the higher intensity of the problem.
Kessler Psychological Distress Scale Change in scores from baseline to outcome (1-month post baseline) This will use to measure psychological distress. It's a 10 item scale measuring emotional states with a 5 level response scale. Minimum score is 10 and a maximum score is 50. Low scores indicate low levels of psychological distress and high scores indicate high levels of psychological distress.
Beck Scale for Suicidal Ideation (BSSI) Change in scores from baseline to outcome (1-month post baseline) This scale is a 19-items instrument that evaluates the presence and intensity of suicidal thoughts in a week. Minimum total score is 0 and maximum total score can be 38. Higher scores indicate worse outcome.
Client Satisfaction Questionnaire Scores reported by the participant on the scale after intervention at 1-month post baseline Participant satisfaction with services will be assessed using the Client Satisfaction. The total score ranges from 8 to 32. Higher scores indicate higher level of satisfaction. Questionnaire (CSQ)
Trial Locations
- Locations (2)
Public schools
🇵🇰Hyderabad, Sind, Pakistan
Public Schools
🇵🇰Nawabshah, Sindh, Pakistan