Early Adolescent Skills for Emotions (EASE) - A Skills Based Program to Address Psychosocial Distress Among Young Adolescents Studying in Public Schools of Pakistan. Pilot Cluster Randomized Controlled Trial (cRCT)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Psychological Distress
- Sponsor
- Human Development Research Foundation, Pakistan
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Pediatric Symptoms Checklist (PSC)
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Background: Emotional problems such as symptoms of depression, anxiety and psychosocial distress are the leading contributors to health burden among adolescents worldwide. There is an urgent need for evidence-based psychological interventions for young people, especially those living in adversity. WHO has developed Early Adolescent Skills for Emotions (EASE), a brief group psychological intervention delivered by non-specialist providers for young adolescents impaired by distress and exposed to adversity. We aim to evaluate the feasibility of delivering EASE for young adolescents living in public schools of rural Rawalpindi, Pakistan.
Objectives: To evaluate the feasibility of delivering Early Adolescent Skills for Emotions (EASE) program to young adolescents and their caregivers in Rawalpindi, Pakistan to inform the design, including sample size estimation, for a full-scale adequately powered definitive cluster randomised controlled trial.
Methods: A two arm, single blind, pilot cluster randomized controlled trial will be conducted with adolescents of both gender (aged 13-15 years) with high psychological distress, studying in grade 8 and 9th of middle and high public school in rural Rawalpindi.
Schools will be the units of randomization. 8 public schools, stratified by gender, will be randomized into EASE plus Treatment as Usual (TAU) (n=4) and TAU alone (n=6). 60 young adolescents at-risk of psychosocial distress as assessed by Self-Reported-Pediatric Symptom Checklist (PSC), cut-off ≥28 will be included in the study. No power calculations have been calculated for the present pilot trial; however, the sample will be adequate to inform the parameters of planned definitive cRCT. In the intervention arm, adolescents will receive 7-weekly group sessions and their caregivers will receive 3-weekly group sessions in public schools. Data on the number of outcomes will be collected at baseline, immediately and 3-months' post-intervention follow-up. The findings will inform the sample size required for a definitive trial. A detailed mixed-methods process evaluation will be conducted to identify areas of improvements prior to proceeding to a definitive cRCT.
Discussion: The results of pilot trial will be used to inform the design of definitive cluster randomized controlled trial in government led scaled-up implementation of healthy school initiative in Rawalpindi district of Pakistan.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Pediatric Symptoms Checklist (PSC)
Time Frame: At 3-months' post-intervention.
Self-rated Pediatric Symptom Checklist (PSC) will be used to assess psychosocial distress of adolescents. Pediatric symptom checklist has 35 items and assesses psychosocial problems on 3 subscales; externalizing, internalizing and attention problems with cut-offs of 7, 5, 7 respectively. Items are rated on a three-point Likert scale (0= Never, 1= Sometimes, 2=Often). Total score is calculated by summing the responses of all items. Higher score indicates greater psychosocial distress. The recommended cutoff for identifying children and adolescents with psychosocial distress using Pediatric Symptom Checklist in a new setting is ≥ 28.
Secondary Outcomes
- Somatic-symptom questionnaire(At baseline, immediate and 3-months' post-intervention.)
- Short Warwick Edinburgh Wellbeing Scale (SWEWS)(At baseline, immediate and 3-months' post-intervention.)
- Perceived Emotional/Personal Support Scale(At baseline, immediate and 3- months' post-intervention.)
- Patient Health Questionnaire (PHQ-9)- adapted for adolescents(At baseline, immediate and 3-months' post-intervention.)
- Pediatric Quality of Life (Peds-QL)-Family impact module(At baseline, immediate and 3-months' post-intervention.)
- Alabama parenting scale(At baseline, immediate and 3- months' post-intervention.)
- Social Problem-Solving Inventory - Revised Short Form(At baseline, immediate and 3-months' post-intervention.)
- Pediatric Quality of Life (PedsQL)(At baseline, immediate and 3-months' post-intervention.)
- Health Services Utilization:(At baseline and 3-months' post-intervention.)