Developing & testing the feasibility of a sports-based mental health promotion intervention for adolescents in Nepal: a community engagement approach

点击翻译按钮获取中文摘要

Each year, one in five adolescents aged 10-19 experiences a mental disorder like depression or anxiety, and the rate is rising. We work in Nepal, a low-income country, where there is a large population of adolescents at risk of mental disorders, but a lack of mental health care. An intervention is needed that can protect adolescents from mental disorders, is accessible to all adolescents, and is cheap and easy to sustain. One such intervention is mental health promotion, which focuses on improving positive behaviours and characteristics that protect mental health. Our research aims to develop a mental health promotion intervention that uses sports to engage and improve the mental health of adolescents in a rural community in Kailali, a district in the Far-Western Region of Nepal. We decided to focus on sports because there is evidence that sports activities improve mental health, adolescent participation in sports is supported by national and global adolescent policy, and adolescents across Nepal are already playing sport through a national network of sports clubs. To develop the intervention, we will work in partnership with three stakeholder groups of: (i) adolescents, (ii) parents and teachers, and (iii) Nepalese mental health and sports experts. We will consult groups throughout the project on our research plans and findings. The adolescent group will specifically help us to understand how to ensure our intervention is accessible, by taking photos on the theme of barriers to participating in sports, and discussing these with the research team. The whole community will be invited to a funfair where, through art, talks and sports, we will help them to learn more about adolescent mental health, and provide opportunities for them to try out some mental health promoting sports activities. We will use this opportunity to collect valuable information about the community's priorities and preferences for a sports-based intervention. To develop the theory and content of our intervention, we will draw on all the information from the stakeholder groups, the photography study, and the funfair, along with evidence from studies of sports interventions in Nepal and other low- and middle-income countries. We will refine the intervention theory through workshops with the stakeholder groups and research team. Finally, we will test the intervention among 200 adolescent boys and girls aged 10-19. We will decide whether sports coaches or adolescents themselves are best to to deliver the intervention, and whether the intervention should be based in communities or schools. Using tools that we have adapted and validated in Nepal, we will measure the intervention's effects on adolescent mental wellbeing and other indicators of mental health promotion.Our research will lead to a larger evaluation of the intervention in Nepal. It will also contribute important knowledge on sports-based mental health promotion that can be used by governments, researchers and organisations working in other low- and middle-income countries. We will set a precedent for stakeholder involvement in intervention development research, building a strong and lasting community partnership for future research in Nepal.