Strengthening the Evidence Base on Effective scHool Based intErventions for pRomoting Adolescent Health (SEHER)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 14,000
- 试验地点
- 1
- 主要终点
- School Climate
研究概览
简要总结
SEHER- Strengthening Evidence base on scHool-based intErventions for pRomoting adolescent health, seeks to develop and evaluate a school based adolescent health promotion intervention delivered by two different delivery agents viz. teacher-as-SEHER Mitra (TSM) and lay school counsellor called as SEHER Mitra (SM) in government-run secondary schools in Bihar, India. SEHER will implement a three armed clustered randomised trial (CRT) to evaluate the effectiveness and cost-effectiveness of these two models compared with the Tarang-Adolescence Education Programme (usual care) implemented by the State Government of Bihar. The hypothesis is that both interventions, compared to the control arm, will lead to a greater impact on school climate (school connectedness and relationship with teachers and fellow students). In addition, the interventions will increase the knowledge, attitude and awareness, and promoting healthy behaviours in youth on reproductive and sexual health outcomes, mental health and substance use, and gender related attitudes and violence. It is hypothesized that the addition of more resource intensive component (the SM arm) will be associated with the best outcomes.
详细描述
Background and objective:
India is home to 358 million young people in the age group of 10 to 24; of these 243 million are between 10 and 19 years age. This represents a huge opportunity that can transform the social and economic fortunes of the country. Key public health challenges for adolescents in India include unwanted pregnancies, sexually transmitted and reproductive tract infections, injuries, growing misuse of alcohol, tobacco and other substances, and mental health problems such as depression, anxiety disorders and suicide. Schools provide an ideal platform for addressing these health issues and the WHO's Health Promoting Schools framework seeks to address some of the structural determinants of these health concerns. The recent Cochrane review assessed school-based interventions and found that 'whole school' or 'school environment' interventions are effective in addressing a range of health outcomes among adolescents including bullying, aggression, and tobacco use. However, there is no comparable evidence on effectiveness and cost-effectiveness on school-based health promotion programmes in India.
SEHER-Strengthening Evidence base on school-based intErventions for pRomoting adolescent health, is a jointly funded programme (by The MacArthur Foundation and United Nation's Population Development Fund, India) that seeks to develop and evaluate a comprehensive adolescent health promotion intervention delivered by two different delivery agents viz. teacher as SEHER Mitra (TSM) and a lay health worker called as SEHER Mitra (SM) in government run secondary schools in Bihar, India.
Hypotheses:
- For primary outcome measure: It is hypothesized that the intervention strategies in addition to usual intervention (Tarang-AEP) will have a graded effect on overall school climate.
- For secondary outcome measures: The interventions will build positive attitude towards gender equity, build knowledge of and attitude towards reproductive and sexual health, reduce self-reported bullying, violence and depression.
- For exploratory outcome measures : The interventions will decrease tobacco, alcohol and other substance use, reduce suicide behaviour (suicide thoughts and attempts) and increase safe sexual behaviour.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 13 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Inclusion criteria for the clusters:
- •Secondary and higher secondary schools
- •Implementation of Tarang-Adolescence Education Programme
- •100 or more students enrolled in Grade IX
- •5 or more teachers employed in the school Inclusion criteria for participants: All the students (boys and girls) studying in standard IX in all randomly assigned 75 schools in the academic year of April 2015 to March 2016.
排除标准
- •Exclusion criteria for the clusters:
- •Upgraded schools (Grade I-XII)
- •Tarang-Adolescence Education Programme not being implemented
- •Less than 100 students enrolled in Grade IX
- •4 or less teachers employed in the school Exclusion criteria for participants: None
研究组 & 干预措施
TSM Arm
Tarang Adolescence Education Programme + SEHER Intervention (delivered by teachers as SEHER Mitra)
干预措施: Tarang Adolescence Education programme (Other)
TSM Arm
Tarang Adolescence Education Programme + SEHER Intervention (delivered by teachers as SEHER Mitra)
干预措施: SEHER Intervention (Other)
SM Arm
Tarang Adolescence Education Programme + SEHER Intervention (delivered by SEHER Mitra)
干预措施: Tarang Adolescence Education programme (Other)
SM Arm
Tarang Adolescence Education Programme + SEHER Intervention (delivered by SEHER Mitra)
干预措施: SEHER Intervention (Other)
Comparison Arm
Tarang Adolescence Education Programme
干预措施: Tarang Adolescence Education programme (Other)
结局指标
主要结局
School Climate
时间窗: Up to 7 months
The school climate will be measured through Beyond Blue School Climate Scale (28 items)
次要结局
- Depression(Up to 7 months)
- Violence(Up to 7 months)
- Bully behaviour(Up to 7 months)
- Knowledge and attitude towards Reproductive and Sexual Health(Up to 7 months)
- Attitude towards gender equity(Up to 7 months)