Development and testing the feasibility of a sports-based mental health promotion intervention in Nepal: a protocol for a pilot cluster-randomised controlled trial.
Development and testing the feasibility of a sports-based mental health promotion intervention in Nepal: a protocol for a pilot cluster-randomised controlled trial.
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DOI：
10.1186/s40814-023-01324-z
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发表时间：
2023-08-24
影响因子：
1.7
通讯作者：
Luitel, Nagendra P.
中科院分区：
文献类型：
--
作者：
Rose-Clarke, Kelly;Rimal, Damodar;Morrison, Joanna;Pradhan, Indira;Jaoude, Gerard Abou;Moore, Brian;Banham, Louise;Richards, Justin;Jordans, Mark;Prost, Audrey;Lamichhane, Nabin;Regmee, Jaya;Gautam, Kamal;Luitel, Nagendra P.
关键词：
心理健康包括生活满意度，社会联系，代理和弹性。在青春期，心理健康可以减少性健康风险行为、药物使用和暴力;改善教育成果;并保护成年期的心理健康。心理健康促进旨在改善心理健康，可以包括让参与者参与体育运动的活动。然而，在青少年中进行的促进心理健康干预措施的高质量试验很少，特别是在低收入和中等收入国家。我们试图通过在尼泊尔巴尔迪亚的一项试点随机分组对照试验（cRCT）中测试SMART（基于运动的精神健康预防）来解决这一差距。本试验的目的是评估SMART的可接受性和可行性，测试试验程序，探索干预和对照组的结果分布，并计算干预的年度总成本和每个青少年的单位成本。试验设计是一项平行组、双臂优效性初步cRCT，分配比为1：1，对12-19岁青少年进行了两次横断面普查，一次为干预前（基线），一次为干预后（终点）。研究区域为四个社区，人口约1000人（每个社区166名青少年）。每个社区代表一个集群。SMART包括每周两次的足球、武术和舞蹈辅导，向社区所有青少年开放，由接受过心理社会培训的当地体育教练领导。体育节和戏剧表演将提高社区对SMART、心理健康和体育益处的认识。对照组的青少年将像往常一样参加体育活动。在基线和终点调查中，我们将测量心理健康、自尊、自我效能、情绪调节、社会支持、抑郁、焦虑和功能障碍。使用观察检查表，非结构化的观察和出勤登记从教练会议，以及教练和主管之间的会议记录，我们将评估干预的保真度，曝光和覆盖范围。在与教练、教师、照顾者和青少年的焦点小组讨论和访谈中，我们将探讨干预的可接受性和变化机制。干预费用将从每月项目账户、时间表和与工作人员的讨论中获取。研究结果将确定在全面cRCT之前需要修订的干预和试验程序的要素，以评价SMART的有效性。ISRCTN，ISRCTN 15973986，于2022年9月6日注册; ClinicalTrials.gov，NCT 05394311，于2022年5月27日注册。
Mental wellbeing encompasses life satisfaction, social connectedness, agency and resilience. In adolescence, mental wellbeing reduces sexual health risk behaviours, substance use and violence; improves educational outcomes; and protects mental health in adulthood. Mental health promotion seeks to improve mental wellbeing and can include activities to engage participants in sport. However, few high-quality trials of mental health promotion interventions have been conducted with adolescents, especially in low- and middle-income countries. We sought to address this gap by testing SMART (Sports-based Mental heAlth pRomotion for adolescenTs) in a pilot cluster-randomised controlled trial (cRCT) in Bardiya, Nepal. The objectives of the trial are to assess the acceptability and feasibility of SMART, test trial procedures, explore outcome distributions in intervention and control clusters and calculate the total annual cost of the intervention and unit cost per adolescent. The trial design is a parallel-group, two-arm superiority pilot cRCT with a 1:1 allocation ratio and two cross-sectional census surveys with adolescents aged 12–19, one pre-intervention (baseline) and one post-intervention (endline). The study area is four communities of approximately 1000 population (166 adolescents per community). Each community represents one cluster. SMART comprises twice weekly football, martial arts and dance coaching, open to all adolescents in the community, led by local sports coaches who have received psychosocial training. Sports melas (festivals) and theatre performances will raise community awareness about SMART, mental health and the benefits of sport. Adolescents in control clusters will participate in sport as usual. In baseline and endline surveys, we will measure mental wellbeing, self-esteem, self-efficacy, emotion regulation, social support, depression, anxiety and functional impairment. Using observation checklists, unstructured observation and attendance registers from coaching sessions, and minutes of meetings between coaches and supervisors, we will assess intervention fidelity, exposure and reach. In focus group discussions and interviews with coaches, teachers, caregivers and adolescents, we will explore intervention acceptability and mechanisms of change. Intervention costs will be captured from monthly project accounts, timesheets and discussions with staff members. Findings will identify elements of the intervention and trial procedures requiring revision prior to a full cRCT to evaluate the effectiveness of SMART. ISRCTN, ISRCTN15973986, registered on 6 September 2022; ClinicalTrials.gov, NCT05394311, registered 27 May 2022.