Shinde 2018.

Study characteristics
Methods	Study design: cluster‐RCT Duration of study: the study was conducted between 2015 and 2016. Country: India Income classification: low‐middle‐income country in 2015‐2016 Geographical scope: Nalanda district of Bihar state, India Healthcare setting: government‐run secondary schools
Participants	1. Age: 13‐14 2. Gender: both 3. Socioeconomic background: 65‐70% backward caste, 19‐24% scheduled caste*—“In the caste categories, backward or other caste is a collective term used by the Government of India to classify castes which are socially disadvantaged, while the scheduled castes are officially designated groups of historically disadvantaged people in India. General caste is a term used in India to denote groups of people who do not qualify for any of the affirmative action schemes by the Government of India”. 4. Educational background: grade 9 students Inclusion criteria for clusters: a. secondary and higher secondary schools; b. implementation of Tarang‐Adolescence Education Programme; c. 100 or more students enrolled in grade IX; d. 5 or more teachers employed in the school. Inclusion criteria for individual participants: all the students (boys and girls) studying in standard IX in all randomly assigned 75 schools in the academic year of April 2015 to March 2016. Exclusion criteria for clusters: a. upgraded schools (grade I‐XII); b. Tarang‐Adolescence Education Programme not being implemented; c. less than 100 students enrolled in grade IX; d. 4 or fewer teachers employed in the school. Exclusion criteria for participants: none reported. Note: at baseline, the intervention (1 and 2) and control group scores for Patient Health Questionaire‐9 (PHQ‐9) were, respectively, 6.61 (5.3), 6.51 (5.4), and 6.4 (5.2). Stated purpose: to assess the effectiveness of a multicomponent whole‐school health promotion intervention (SEHER) in grade 9 students (aged 13 to 14 years) at government‐run secondary schools
Interventions	Name: school health promotion intervention (SEHER); school health promotion intervention (SEHER) + government‐run Adolescence Education Program (AEP) Title/name of PW and number: lay counsellor (1 per school) for intervention A, a teacher for intervention B (1 per school) 1. Selection: lay counsellors were selected following structured interview, had to speak the local language; teachers were nominated by school principals, were required to have a minimum of 5 years teaching experience in secondary schools, more than 15 years of service remaining, and not teaching the AEP curriculum. 2. Educational background: lay counsellors were required to have a bachelor degree. 3. Training: the teachers and lay counsellors were trained separately in a 1‐week‐long training, with an identical curriculum. This training session was followed up with in‐service training through separate monthly group meetings. 4. Supervision: 3 planned visits per month; 8 supervisors with master’s degree in psychology, sociology, or social work and to have more than 2 years of experience of working with adolescents 5. Incentives/remuneration: not specified Prevention type: indicated – participants presented with some level of distress as indicated by PHQ‐9 scores. Intervention details School health promotion intervention (SEHER): the school health promotion intervention (SEHER) is a multicomponent intervention emphasizing the importance of a positive school climate. The intervention identifies four priority areas for action: promoting social skills amongst adolescents; engaging the school community (i.e. adolescents, teachers, and parents) in school‐level decision‐making processes; providing access to factual knowledge about health and risk behaviours to the school community; and enhancing problem‐solving skills amongst adolescents. Actions are taken on a whole school level (addressing themes such as hygiene, bullying, mental health, substance use, reproductive and sexual health, gender and violence, rights and responsibilities, and study skills) and individual student level problem‐solving‐based counselling to students who self‐referred or were referred by teachers for health complaints, social difficulties, nutritional problems, and academic difficulties. For those students with serious physical or emotional and behavioural difficulties, referral pathways to specialists were provided. School health promotion intervention (SEHER) + government‐run AEP: in the school health promotion intervention (SEHER) + government‐run AEP group, a trained teacher from each school ran classroom‐based sessions on the process of growing up, establishing positive and responsible relationships, gender and sexuality, prevention of HIV and other sexually transmitted infections, and substance use (16 hours total). Control: usual care – government‐run AEP
Outcomes	Participants’outcomes of interest for this review Depressive symptoms – PHQ‐9 Note: we included data from the SEHER + AEP intervention and the control group. Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (1‐6 months; 7‐24 months)
Notes	Source of funding: John D and Catherine T MacArthur Foundation, USA and the United Nations Population Fund India Office Notes on validation of instruments (screening and outcomes): the selected outcome measure is widely adopted and validated across contexts. Additional information: none Handling the data: not applicable Prospective trial registration number: NCT02484014