Tol 2012.
| Study characteristics | |
| Methods |
Study design: cluster‐RCT Duration of study: the study was started in 2007 and was published in 2012. Country: Tellippalai and Uduvil divisions of the Jaffna district in northern Sri Lanka Income classification: low‐middle‐income country from 2007 to 2012 Geographical scope: not specified Healthcare setting: 12 schools per study condition |
| Participants | 1. Age: 9‐12 years 2. Gender: both 3. Socioeconomic background: not specified 4. Educational background: grade 4 to 7 Inclusion criteria: a. grades 4 through 7 (ages 9‐12); b. the existence of risk factors (i.e. reporting exposure to war‐related events, distress during such exposure, current psychological symptoms, and affected school functioning); c. the absence of protective factors (i.e. reporting a lack of social support and coping capacity); d. screened children for meeting inclusion criteria using the Child Psychosocial Distress Screener (CPDS), a screening instrument with established cross‐cultural construct validity that was developed for use with children affected by armed conflict; e. outcome scores for PTSD‐depressive‐anxiety symptoms not above cut‐off at baseline. Exclusion criteria: a. no children were excluded after meeting inclusion criteria; b. a small group of children reporting severe mental problems during screening was provided individual supportive counselling in addition to being enrolled in the study (N = 19, 4.8%). Note: at baseline, the intervention and control group scores for Child PTSD Symptom Scale (CPSS) were, respectively, 15.03 (8.89) and 15.70 (9.12). At baseline, the intervention and control group scores for Depression Self‐Rating Scale (DSRS) were, respectively, 8.39 (4.54) and 8.56 (4.37). At baseline, the intervention and control group scores for Anxiety Related Emotional Disorders (SCARED‐5) were, respectively, 3.29 (2.13) and 3.17 (2.16). At baseline, the intervention and control group scores for function impairment were, respectively, 3.64 (4.47) and 3.23 (4.37). Stated purpose: to evaluate the outcomes of a school‐based secondary prevention intervention for children affected by the ongoing war in northern Sri Lanka |
| Interventions |
Name: school‐based group intervention Title/name of PW and number: paraprofessionals 1. Selection: selected for their affinity and capacity to work with children demonstrated in role‐plays and interviews 2. Educational background: at least high school diploma 3. Training: trained for 1 year prior to the study 4. Supervision: supervised in implementing the intervention for 1 year prior to the study 5. Incentives/remuneration: not specified Prevention type: indicated – participants presented with some level of distress as indicated by the CPSS, DSRS, and SCARED‐5 scores. Intervention details: the mental health intervention consisted of 15 sessions over 5 weeks of a school‐based group intervention. The manualized intervention consists of cognitive behavioural techniques (psychoeducation, strengthening coping, and guided exposure to past traumatic events through drawing) and creative expressive elements (co‐operative games, structured movement, music, drama, and dance) with groups of around 15 children, aimed at decreasing symptoms of common mental disorders and strengthening protective factors. Each session is divided into four parts, starting and ending with structured movement, songs and dance with the use of a “parachute” (i.e. large circular coloured fabric). The second part is based on a “central activity” focused on the main theme of that week (e.g. a drama exercise to identify social supports in the environment, or drawing of traumatic events), and the third part is a co‐operative game (i.e. a game in which all children have to participate in order to promote group cohesion). The intervention was part of a larger public mental health programme for children affected by war, including primary and tertiary prevention approaches. Control: waiting list |
| Outcomes |
Participants’outcomes of interest for this review
Carers’ outcomes of interest for this review Nil Economic outcomes Cost analysis Time points: baseline, post‐intervention (< 1 month; 1‐6 months) |
| Notes |
Source of funding: PLAN Netherlands Notes on validation of instruments (screening and outcomes) 1. CPSS: internal reliability (Cronbach alpha) in this sample was 0.84. 2. DSRS: internal reliability in this sample was 0.65. 3. SCARED‐5: internal reliability in this sample was 0.52. 4. Not available (constructed scale) Additional information: none Handling the data: not available Prospective trial registration number: not available |