ABSTRACT
BACKGROUND: The aim of this study is to evaluate the short- and long-term effects of the universal mental health literacy intervention "EspaiJove.net" in increasing mental health knowledge, help seeking and reducing stigma attitudes in the adolescent population. We also examine whether these effects depend on the intervention intensity. METHODS: A clustered school-based randomised controlled trial (cRCT) design. SUBJECTS: 1,298 secondary pupils aged 13 and 14 were recruited from 18 schools in Barcelona (Spain) between September 2016 and January 2018. INTERVENTION: Three programmes were assessed: 1) Sensitivity Programme (SP; 1 h); 2) Mental Health Literacy (MHL; 6 h); 3) MHL plus a first-person Stigma Reduction Programme (MHL + SR; 7 h); 4) Control group (CG): waiting list. OUTCOME MEASURES: 1) MHL: EspaiJove.net EMHL Test (First part and Second Part); 2) Stigma: RIBS and CAMI; 3) Help-seeking and use of treatment: GHSQ. ANALYSIS: The data was collected at baseline, post-intervention and 6 and 12 months later. An intention-to-treat analysis and imputation method was used to analyse the missing data. Intervention effects were analysed using multilevel modelling. RESULTS: One thousand thirty-two students were included (SP = 225; MHL = 261; MHL + SR = 295 and CG = 251). The MHL and MHL + SR interventions showed short- and long-term an increase in knowledge compared to SP and CG, but no significant change post-intervention or over time (First part p = 0.52 and Second part p = 0.62) between intervention groups and CG. No significant changes were found in stigma scores post-intervention or over time (CAMI p = 0.61 and RIBS p = 0.98) or in help-seeking scores (parent p = 0.69; teacher p = 0.23 and healthcare professional p = 0.75). The MHL + SR intervention was the best valued and recommended (p < 0.005). CONCLUSIONS: The three interventions of the EspaiJove.net programme (SP, MHL and MHL + SR) seem not to be effective in terms MHL, Stigma and help-seeking behaviours. The contact with a person who has experimented mental illness first-hand did not reduce stigma attitudes. Further research should deal with the heterogeneity of MHL interventions (concept, duration and measures) and identify which components of stigma interventions are effective. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03215654 (registration date 12 July 2017).
Subject(s)
Health Literacy , Mental Disorders , Humans , Adolescent , Mental Health , Mental Disorders/therapy , Mental Disorders/psychology , Social Stigma , Health Literacy/methods , SchoolsABSTRACT
There is evidence of the effectiveness of implementing mental health literacy (MHL) programs. However, there are substantial limitations in the instruments available for measuring MHL. This study aimed to develop and validate the EspaiJove.net MHL test (EMHL) for Spanish adolescents by assessing its psychometric properties. The development of the EMHL test was conducted using item pool generation and a pilot study. A convenience sample of students aged 13-15 years (n = 355) participated in the validity study. Reliability was assessed for internal consistency and via test-retest. Convergent validity was evaluated by comparing the effect sizes among known groups with different levels of mental health knowledge, the correlation with mental health-related instruments, and the item discrimination index. A final version of a 35-item EMHL test was obtained with two parts: (i) a binary choice format (yes/no) for the identification of mental disorders; (ii) a multiple choice question with four possible answer options. Internal consistency was acceptable in the first part (Cronbach's alpha = 0.744; Guttman's lambda 2 = 0.773) and almost acceptable in the second part (Cronbach's alpha = 0.615; Guttman's lambda 2 = 0.643). The test-retest evaluation supported the stability of the test (first part, ICC = 0.578; second part, ICC = 0.422). No ceiling and floor effects were found. The EMHL test scores discriminated between known groups with different levels of mental health knowledge and it is associated with several-related constructs of MHL. Conclusions: The EMHL test is a relevant measure for assessing MHL in adolescents into Spanish context with acceptable validity and stability.
Subject(s)
Health Literacy , Mental Health/standards , Psychometrics/methods , Adolescent , Female , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Pilot Projects , Reproducibility of Results , Students , Surveys and QuestionnairesABSTRACT
El objetivo del estudio es evaluar la satisfacción de un programa de educación social,emocional y alfabetización (PESEA) en salud mental para adolescentes que viven en centros residenciales deatención educativa (CRAE) de Barcelona, así como describir su salud emocional y mental. Participan 14 jóvenescon una edad media de 13,57 años (DE 1,55) de tres CRAE. El programa PESEA es considerado interesante, útil ypráctico; muestra una adherencia alta y, por tanto, estaría indicado para promover el bienestar mental y la alfa-betización en salud mental en estos jóvenes.(AU)
The study aims to evaluate the satisfaction of a social, emotional, and literacy education programme (PE-SEA) in mental health for adolescents living in residential educational care centres (CRAE) in Barcelona, as wellas to describe their emotional and mental health. Fourteen young people with an average age of 13,57 (SD 1,55)from three CRAE participated. PESEA programmes are considered interesting, useful, and practical; it shows highadherence and would therefore be suitable for promoting mental wellbeing and mental health literacy in theseyoung people.(AU)
L'objectiu de l'estudi és avaluar la satisfacció d'un programa d'educació social, emocional i alfabetitza-ció (PESEA) en salut mental per a adolescents que viuen en centres residencials d'atenció educativa (CRAE) deBarcelona, així com descriuren la salut emocional i mental. Hi participen 14 joves amb una edat mitjana de 13,57anys (DE 1,55) de tres CRAE. El programa PESEA és considerat interessant, útil i pràctic; mostra una adherènciaalta i, per tant, estaria indicat per promoure el benestar mental i l'alfabetització en salut mental en aquests joves.(AU)