Technology addiction among school-going adolescents in India: epidemiological analysis from a cluster survey for strengthening adolescent health programs at district level.

BACKGROUND: There is limited evidence on technology addiction among adolescents in low- and middle-income countries where 90% of global adolescents live. We aimed to investigate the prevalence and correlates of technology addiction (Internet, gaming, smartphone, television) among school-going adolescents in India. METHODS: A cross-sectional survey covering the entire district (administrative unit for health) of India was conducted among representative sample of school-going adolescents using stratified cluster sampling. A total of 1729 adolescents completed the survey (age M = 12.58; SD = 0.97) by responding to Internet Addiction Test-Adolescents, Game Addiction Scale, Smartphone Addiction Scale and Television Addiction Scale. Associated factors were analyzed using binomial logistic regression analysis. RESULTS: Almost all the participants (99.59%; 95% confidence interval (CI): 99.28-99.91%) were using technology in one or other form. Prevalence of technology addiction among the users was 10.69% (95% CI: 5.26-16.11%). Phone addiction (8.91%; 95% CI: 3.31-14.52%) was the most common type followed by gaming addiction (2.55%; 95% CI: 1.16-3.95%). Technology addiction among adolescents was significantly associated with several risk factors at individual, family and school levels. CONCLUSION: Technology addiction emerges as an important public health problem among adolescents in India. An integrated socio-ecological framework with multi-level approach that targets risk factors at various levels is required to promote healthy behaviors towards technology.

Project SUMS (scaling up of mental health in schools): design and methods for a pragmatic, cluster randomised waitlist-controlled trial on integrated school mental health intervention for adolescents.

BACKGROUND: There is an increasing need for Mental Health Promotion (MHP) among adolescents, especially in developing countries with limited resources and rapid socio-demographic transition. With the growing burden of mental health problems among adolescents (suicide, depression) and their preferences to seek help from their peers, improving Mental Health Literacy (MHL) and behaviours for First Aid in Mental Health (MH-FA) becomes crucial to promote their mental health. METHODS: Schools are ideal settings for reaching the vulnerable adolescents. The proposed study evaluates the effectiveness of a classroom-based teacher-led integrated school mental health intervention called SUMS (MHP + MHL + MH-FA). The study will involve a pragmatic, cluster-randomised waitlist-controlled design to evaluate the effectiveness of SUMS intervention using schools as unit-of-randomisation. The study will be conducted in Srinivaspura taluka (Sub-district) of Kolar district (administrative unit of health) of Karnataka in collaboration with a multi-disciplinary expert team from NIMHANS (National Institute of Mental Health And Neuro Sciences), Bangalore-India and Department of Education, Government of Karnataka, India. A total of 8 schools (400 students studying in 6-8 grade) from Srinivaspura taluka will be randomised into intervention and waitlist control group. The intervention group will receive SUMS intervention through 10-15 h of classroom sessions. The primary outcome is the improvement in positive mental health literacy, as measured by the Mental Health-Promoting Knowledge (MHPK-10) scale. Changes in MH-FA knowledge and intentions, Mental health stigma, help-seeking and resilience are assessed as secondary outcomes. Data will be collected at baseline, 6-weeks, 6-months and 12-months post-intervention. The waitlist-control schools will receive the interventions at the end of the 12-month follow-up assessment in intervention-schools. DISCUSSION: This is the first study to integrate Mental Health Literacy with Mental Health Promotion and behaviours for First Aid in Mental Health to promote mental health well-being among adolescent school children in India. With a need to build a more substantial evidence base on School Mental Health Promotion approaches in developing countries, the study findings will have implications for implementing and operationalising Health and Wellness Ambassador initiative in India. TRIAL REGISTRATION: Clinical Trials Registry - India, CTRI/2019/07/020394. Registered prospectively on 29 July 2019. ( ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=35724&EncHid=&userName=sums ).

COVID-19-Hospitalized Patients in Karnataka: Survival and Stay Characteristics.

The information on the clinical course of coronavirus disease 2019 (COVID-19) and its correlates which are essential to assess the hospital care needs of the population are currently limited. We investigated the factors associated with hospital stay and death for COVID-19 patients for the entire state of Karnataka, India. A retrospective-cohort analysis was conducted on 445 COVID-19 patients that were reported in the publicly available media-bulletin from March 9, 2020, to April 23, 2020, for the Karnataka state. This fixed cohort was followed till 14 days (May 8, 2020) for definitive outcomes (death/discharge). The median length of hospital stay was 17 days (interquartile range: 15-20) for COVID-19 patients. Having severe disease at the time of admission (adjusted-hazard-ratio: 9.3 (3.2-27.3);P < 0.001) and being aged ≥ 60 years (adjusted-hazard-ratio: 11.9 (3.5-40.6);P < 0.001) were the significant predictors of COVID-19 mortality. By moving beyond descriptive (which provide only crude information) to survival analyses, information on the local hospital-related characteristics will be crucial to model bed-occupancy demands for contingency planning during COVID-19 pandemic.