Mixed-method study on the impact of climate change on mental health among adolescents: Intended to implement climate resilience strategies through Ayushman Bharat’s School Health and Wellness Program.

The study uses a cluster randomized controlled trial design to assess the effectiveness of climate resilience strategies on climate change readiness among adolescents. The study will be conducted in public schools of selected blocks in Khordha district Odisha where the Ayushman Bharat Health and Wellness Programme is implemented.

The sample size was estimated using evidence from a previous study on climate change knowledge gaps. Based on pretest and posttest knowledge scores with alpha 0.05 power 80 percent and effect size 0.32 the initial sample size was 155 participants per group. This was adjusted for the cluster randomized design using a design effect assuming an average cluster size of 40 and an intraclass correlation coefficient of 0.01. After adjusting for 10 percent attrition the final sample size is 240 adolescents in the experimental group and 240 in the control group. A multistage cluster random sampling technique will be used.

The study participants include adolescents studying in 8th to 10th standard who are present during data collection and willing to participate. Adolescents with diagnosed mental illness and currently on treatment will be excluded.

The intervention consists of a classroom based climate change resilience training focusing on heat wave preparedness. The training includes five sessions of 45 to 60 minutes delivered over one month with booster sessions at two months. The module was refined through stakeholder consultations and focus group discussions with adolescents. It includes five components covering climate change and heat waves health impacts of heat waves hydration and nutrition heat wave safety at home and school and building a climate resilience mindset. Control schools will continue routine classroom teaching.

Outcome assessment focuses on climate change readiness across four domains namely awareness and action towards climate change climate change protective behaviors climate change hope and practice of climate change prevention behaviors. Validated structured questionnaires and scales will be used and higher scores indicate better climate change readiness among adolescents.