TY - JOUR

T1 - Strengthening self-regulation and reducing poverty to prevent adolescent depression and anxiety

T2 - Rationale, approach and methods of the ALIVE interdisciplinary research collaboration in Colombia, Nepal and South Africa

AU - Lund, Crick

AU - Jordans, Mark J D

AU - Garman, Emily

AU - Araya, Ricardo

AU - Avendano, Mauricio

AU - Bauer, Annette

AU - Bahure, Vikram

AU - Dua, Tarun

AU - Eleftheriou, Georgia

AU - Evans-Lacko, Sara

AU - García Rodríguez, Juan Felipe

AU - Gautam, Kamal

AU - Gevonden, Martin

AU - Hessel, Philipp

AU - Kohrt, Brandon A

AU - Krabbendam, Lydia

AU - Luitel, Nagendra P

AU - Roy, Sanchari

AU - Seifert Bonifaz, Manuel

AU - Singh, Rakesh

AU - Sinichi, Mohammadamin

AU - Sorsdahl, Katherine

AU - Thornicroft, Graham

AU - Tol, Wietse A

AU - Trujillo, Daniela

AU - van der Merwe, Nicci

AU - Wahid, Syed Shabab

AU - Yarrow, Paula

PY - 2023

Y1 - 2023

N2 - AIMS: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the 'Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)' study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa.METHODS: This aim will be achieved by addressing four objectives: (1) develop a conceptual framework that identifies the causal mechanisms linking poverty, self-regulation and depression and anxiety; (2) develop a multi-component selective prevention intervention targeting self-regulation and poverty among adolescents at high risk of developing depression or anxiety; (3) adapt and validate instruments to measure incidence of depression and anxiety, mediators and implementation parameters of the prevention intervention; and (4) undertake a four-arm pilot cluster randomised controlled trial to assess the feasibility, acceptability and cost of the selective prevention intervention in the three study sites.RESULTS: The contributions of this study include the active engagement and participation of adolescents in the research process; a focus on the causal mechanisms of the intervention; building an evidence base for prevention interventions in LMICs; and the use of an interdisciplinary approach.CONCLUSIONS: By developing and evaluating an intervention that addresses multidimensional poverty and self-regulation, ALIVE can make contributions to evidence on the integration of mental health into broader development policy and practice.

AB - AIMS: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the 'Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)' study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa.METHODS: This aim will be achieved by addressing four objectives: (1) develop a conceptual framework that identifies the causal mechanisms linking poverty, self-regulation and depression and anxiety; (2) develop a multi-component selective prevention intervention targeting self-regulation and poverty among adolescents at high risk of developing depression or anxiety; (3) adapt and validate instruments to measure incidence of depression and anxiety, mediators and implementation parameters of the prevention intervention; and (4) undertake a four-arm pilot cluster randomised controlled trial to assess the feasibility, acceptability and cost of the selective prevention intervention in the three study sites.RESULTS: The contributions of this study include the active engagement and participation of adolescents in the research process; a focus on the causal mechanisms of the intervention; building an evidence base for prevention interventions in LMICs; and the use of an interdisciplinary approach.CONCLUSIONS: By developing and evaluating an intervention that addresses multidimensional poverty and self-regulation, ALIVE can make contributions to evidence on the integration of mental health into broader development policy and practice.

KW - Adolescent

KW - Humans

KW - Anxiety/prevention & control

KW - Colombia/epidemiology

KW - Depression/psychology

KW - Interdisciplinary Research

KW - Nepal

KW - Poverty

KW - Self-Control

KW - South Africa/epidemiology

U2 - 10.1017/S2045796023000811

DO - 10.1017/S2045796023000811

M3 - Journal article

C2 - 38088153

VL - 32

JO - Epidemiology and Psychiatric Sciences

JF - Epidemiology and Psychiatric Sciences

SN - 2045-7960

M1 - e69

ER -