Jordans 2010.
| Study characteristics | |
| Methods |
Study design: cluster‐RCT Duration of study: the study was conducted from December 2006 to March 2007. Country: Nepal Income classification: low‐income country in 2006‐2007 Geographical scope: 4 districts of rural south‐western Nepal (Banke, Dang, Bardia, Kailali) Healthcare setting: school |
| Participants | 1. Age: 11‐14 years 2. Gender: both 3. Socioeconomic background: significant differences in groups despite randomization: more Brahmins in the treatment group, more Terai caste in the waiting list (none in the intervention group) 4. Educational background: there was a higher proportion of participants with higher education among the treatment group. Inclusion criteria: a. school‐aged children; b. positive Child Psychosocial Distress Screener score (cut‐off score unspecified). Exclusion criteria: a. psychiatric problems (mutism, mental retardation, dissociative disorders, epilepsy without medication, panic or phobic disorders, and child psychosis); b. schools excluded if they were in Village Development Committees (VDCs) where the intervention was already implemented and schools in adjoining VDCs to avoid contamination. Note: at baseline, the intervention and control group scores for the Child PTSD Symptom Scale (CPSS) were, respectively, 20.15 (5.47); 21.01 (6.46). Stated purpose: to assess the efficacy of a classroom‐based intervention (CBI) among school‐going children in rural Nepal as a psychosocial intervention to address children affected by armed conflict in LMICs |
| Interventions |
Name: CBI Title/name of PW and number: paraprofessional interventionists/facilitators (16) 1. Selection: gender‐balanced group, from targeted communities 2. Educational background: based on previous experience and affinity to work with children 3. Training: 15‐day skills‐oriented course (duration and trainers not specified) 4. Supervision: regular supervision by an experienced counsellor 5. Incentives/remuneration: information from author: the facilitators received a monthly remuneration of 4000 NPR for running the CBI sessions. Prevention type: indicated – participants were positive according to the Child Psychosocial Distress Screener score, but all those with a diagnosed psychiatric problem were excluded. Intervention details: protocolized group intervention; eclectic intervention based on concepts from creative‐expressive and experiential therapy, co‐operative play, and cognitive behavioural therapy. Use of the same manual as for Tol 2008 (Center for Trauma Psychology in Boston); 5 weeks, 15 sessions (about 60‐minute sessions). The CBI was offered as part of a multilayered care system that included activities geared towards strengthening community resilience through parental support groups, recreational activities, community sensitization, and psycho‐education (tier 1), the CBI to target children with elevated psychosocial distress upon primary screening (tier 2), and individual supportive and problem‐solving counselling and referral to psychiatric care (if available) for children, mainly referred on from the group intervention, in need of more individualized or specialised care (tier 3). Control: waiting list |
| Outcomes |
Participants’outcomes of interest for this review
Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (1‐6 months) |
| Notes |
Source of funding: Save the Children USA (Nepal Office) Notes on validation of instruments (screening and outcomes): measures were translated and validated: “Test–retest reliability of the instruments was determined among 20 participants”; 1 screening measure, the CPDS, was developed for the Nepali context specifically and validated in another study. Additional information: none Handling the data: not applicable Prospective trial registration number: ISRCTN48004304 |