A Targeted School-Based Intervention for Adverse Childhood Experiences: Integrating Trauma-Informed Care to Promote Mental Health and Mitigate NCD Risk in Indian Adolescents

Rationale/Gaps in Existing Knowledge: Adverse Childhood Experiences (ACEs) significantly predict lifelong mental and physical health outcomes. Despite extensive global evidence, India-specific data remains limited, particularly for adolescents. A comprehensive JAMA meta-analysis (2025) of 65 studies included only one Indian study, highlighting a critical knowledge gap. While Indian adolescents face increasing mental health challenges and academic pressure, evidence-based, culturallyappropriate trauma-informed interventions are notably absent in educational settings. Novelty: This pioneering study in North India integrates Social-Emotional Learning (SEL) with trauma-informed care for adolescents (Classes 8-12) in Mohali and Chandigarh schools. The innovative approach combines capacity building for educators with systematic screening and intervention, aligning with both the National Education Policy (NEP 2020) and National Mental Health Policy (2014). It uniquely addresses the intersection of ACEs, mental health, and early NCD risk factors within the Indian educational context. Objectives: To assess ACE prevalence and patterns among school-going adolescents evaluate associations between ACEs, mental health outcomes, and NCD risk factors and develop, implement, and evaluate a culturally-sensitive, school-based intervention program. Methods: A mixed-methods approach will employ validated ACE questionnaires, mental health assessments, and NCD risk screening tools, complemented by focus group discussions and key informant interviews. A structured 8-12 weeks intervention will be evaluated through pre-post assessments and process documentation. Expected Outcomes: The study will provide region-specific ACE data, establish an evidencebased intervention model, enhance school-based trauma-informed care capacity, and demonstrate improved mental health and NCD risk outcomes among adolescents.