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Evaluation of a school-based program aimed at preventing depressive symptoms in adolescents
Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO).ORCID iD: 0000-0003-1643-0171
Center for Primary Health Care Research, Faculty of Medicine, Lund University.
Lund University.
Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
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2015 (English)In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 31, no 2, 117-125 p.Article in journal (Refereed) Published
Abstract [sv]

The aim of this pilot study was to evaluate the implementation of a universal school-based cognitive behavioral program whose target is to prevent depressive symptoms in adolescents. The study had a quasi-experimental design with pretest, posttest, and a 1-year follow-up and provides an illustrative calculation for the implementation costs of the intervention. Sixty-two students (aged 14) and seven tutors participated. A majority of the students and all of the tutors were satisfied with the intervention. The students, both females and males, rated their depressed symptoms as significantly lower after the course; and for the females, this was maintained 1-year postintervention. The implementation costs for the initial 2 years were about US$300 per student. Positive effects of a universal school-based cognitive behavioral intervention aiming at preventing depressive symptoms in adolescents were found, especially among females.

Place, publisher, year, edition, pages
2015. Vol. 31, no 2, 117-125 p.
Keyword [en]
health education, mental health, high school, program development/evaluation
National Category
Nursing
Identifiers
URN: urn:nbn:se:hkr:diva-11779DOI: 10.1177/1059840514523296ISI: 000351473300006PubMedID: 24526572OAI: oai:DiVA.org:hkr-11779DiVA: diva2:696809
Available from: 2014-02-16 Created: 2014-02-16 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Hälsopromotion i skolan: utvärdering av DISA - ett program för att förebygga depressiva symtom hos ungdomar
Open this publication in new window or tab >>Hälsopromotion i skolan: utvärdering av DISA - ett program för att förebygga depressiva symtom hos ungdomar
2016 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Health promoting interventions in schools : evaluation of the DISA program
Abstract [en]

Background: DISA (Depressive Symptoms In Swedish Adolescents) is a cognitive behavioral intervention aimed at preventing stress and depressive symptoms in adolescents. It is frequently used in Swedish schools for students aged 13-15 years. DISA is commonly offered to females, but at some schools, the intervention is also offered to males. In this study, the application of the intervention for both females and males is evaluated.

Aim: The overarching aim of this thesis was to explore the experience, significance, and effectiveness of the school-based intervention DISA. The specific aims were to investigate the effectiveness of depressive symptoms and self-reporting health, and costs and cost-effectiveness as well as to elucidate the experiences of adolescents and tutors.

Methods: The effectiveness of DISA was investigated using method triangulation. The thesis is based on two quantitative and two qualitative studies. The quantitative studies were quasi-experimental trials with an intervention group (I, IV), and a control group (IV), with follow-up measurements obtained at 3 and 12 months after baseline. The qualitative studies were based on focus group interviews with adolescents (II) and tutors (III). The school-based cognitive behavioral prevention program DISA was presented by school health staff and teachers once per week for ten weeks. Students in grade 8 (median age: 14) participated in the intervention in study I (n=62, 52% females) and study IV (n=462, 79% females), and 486 students (46% females) were allocated to the control group (IV). Focus group interviews were conducted with 89 adolescents (II) and 22 tutors (III). The interviews were analyzed with qualitative content analysis.

Findings: The intervention group decreased their self-reported depressive symptoms and improved their self-rated health more than the control group (p<0.05) at the 12-month follow-up. The majority of the adolescents rated the cognitive behavioral program as a positive experience, and the attendance rate was high. The incremental cost-effectiveness ratio was approximately USD 6,300 per quality-adjusted life year (QALY). The focus group interviews with the adolescents revealed that the students found that they developed intrapersonal strategies through DISA, such as directed thinking, improved self-confidence, stress management, and positive activities. They also gained an increased interpersonal awareness regarding trusting the group and considering others. However, structural constraints of the DISA program, such as negative framing and an emphasis on performance, were also noted. The focus group interviews with the tutors identified an overall theme of striking a balance between strictly following the manual and meeting student needs.

Conclusions: The DISA program appears to be a feasible, cost-effective school-based cognitive behavioral program with high levels of student adherence and satisfaction, as well as positive mental health benefits. However, a desire for a more health-promoting approach was expressed. 

Place, publisher, year, edition, pages
Malmö: Institutionen för kliniska vetenskaper, Malmö, Lund universitet, 2016. 93 p.
Series
Doctoral dissertation series (Lund University, Faculty of Medicine), ISSN 1652-8220 ; 2016:12
Keyword
Adolescents, depressive symptoms, school-based program, prevention
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-15243 (URN)978-91-7619-238-2 (ISBN)
Public defence
2016-02-12, SSSH-salen, HSC, Baravägen 3, Lund, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2016-02-03 Created: 2016-01-29 Last updated: 2017-05-08Bibliographically approved

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Garmy, PernillaBerg, AgnetaClausson, Eva K.
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