Reynolds 2011.
Methods | Design: cluster‐RCT Conducted by the team who developed the intervention: yes |
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Participants | Description: universal Cut‐point for inclusion for indicated studies: N/A What risk was basis of inclusion for selected studies: N/A Diagnostic interview to exclude those with current or previous depression: not undertaken Baseline severity of depression: DASS‐d: 5.0 (subthreshold) Mean age: 17.9 Age range: not specified Percentage male: 45.7% Setting: college State what psychiatric diagnoses were excluded: exclusion criteria not specified Suicide risk excluded: exclusion criteria not specified Parents with history of schizophrenia/bipolar disorder excluded: exclusion criteria not specified Country: USA |
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Interventions | Broad category: BT (for further information on intervention components, see Table 3) Manualised: yes Online: no Name of programme: Brief Behavioral Activation Treatment for Depression (BATD) Number of sessions: 15 sessions Length of sessions: 120 minutes Intensity (total number of hours): 30 hours Duration of treatment period: 15 weeks Group size: unclear Delivered by: mental health experts Fidelity: not assessed Type of comparison: TAU comprising classes to facilitate student adjustment, including: academic skills, career exploration, library resources, campus safety, sexuality, diversity and responsible decision making. Students were encouraged to make contact with a faculty advisor and to keep diaries reflecting on the process of adjusting to college life. |
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Outcomes | Diagnosis: N/A Name of self‐report depression measure: DASS‐d Name of clinical report depression measure: N/A Name of anxiety measure: N/A Name of general functioning measure: N/A Assessment points: post‐intervention |
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Notes | Author contacted for methodological detail: no Author contacted for treatment manual: yes (provided) Author contacted for outcome data: no |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | No information specified |
Allocation concealment (selection bias) | Unclear risk | No information specified |
Blinding (performance bias and detection bias) Subjects | High risk | The nature of the trial suggests it is unlikely participants could have been blind to the fact they were allocated to treatment as usual. However, without access to the participant information sheets and PLS, level of blinding cannot be ascertained. |
Blinding (performance bias and detection bias) Assessors | Unclear risk | "Research assistants were not affiliated in any way with the courses...Research assistants were blind to the class condition as well as the study hypotheses" (p.557). However, primary outcomes self‐reported. Assessor blinding therefore not applicable. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Proportion of participants with incomplete post‐intervention self‐reported depression scores: 9.6% Means and SDs used in meta‐analysis based on what data: observed cases Intention‐to‐treat analyses: generalised estimating equations |
Selective reporting (reporting bias) | High risk | Protocol not available. Outcomes assessed with the DASS, which includes an anxiety subscale. Data on this outcome not reported, however. |
Other bias | High risk | Trial conducted by those who developed the intervention |
Implementation integrity | Unclear risk | Implementation integrity assessed: unclear if assessed Implementation integrity adequate: N/A Implementation integrity reported: N/A |