Harte Patricia, Barry Margaret M
WHO Collaborating Centre for Health Promotion Research, University of Galway, Galway, Ireland.
Glob Ment Health (Camb). 2024 Apr 12;11:e55. doi: 10.1017/gmh.2024.48. eCollection 2024.
Effective school-based mental health promotion and prevention interventions in low-and middle-income countries (LMICs) can positively impact the mental health and well-being of large numbers of young people. This scoping review aimed to investigate the implementation of effective mental health promotion and prevention interventions in LMIC schools. A scoping review of the international literature was conducted and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Medline, PsycInfo, Scopus, Embase, CINAHL and Cochrane were searched for peer-reviewed literature published from 2014 to 2022. PsycExtra, Google Scholar and the websites of key organisations were searched for relevant grey literature. Study selection focussed on mental health promotion interventions, including the development of social and emotional skills and mental health literacy, and prevention interventions, including anti-bullying and skill-based interventions for "at-risk" students. Twenty-seven studies evaluating 25 school-based interventions in 17 LMICs were included in the review. Fifteen interventions were developed in the implementing country and 10 were adapted from high-income countries (HICs) or other settings. Findings from the studies reviewed were generally positive, especially when interventions were implemented to a high quality. Universal life-skills interventions were found to increase social and emotional skills, decrease problem behaviours and positively impact students' mental health and well-being. Mental health literacy interventions increased mental health knowledge and decreased stigma among students and school staff. Outcomes for externally facilitated anti-bullying interventions were less positive. All 19 effective studies reported on some aspects of programme implementation, and 15 monitored implementation fidelity. Eleven studies outlined the programme's underpinning theoretical model. Only four studies reported on the cultural adaptation of programmes in detail. Including young people in the adaptation process was reported to facilitate natural cultural adaptation of programmes, while input from programme developers was considered key to ensuring that the core components of interventions were retained. The review findings indicate increasing evidence of effective mental health interventions in LMIC schools. To facilitate the sustainability, replication and scaling-up of these interventions, greater attention is needed to reporting on intervention core components, and the processes of implementation and cultural adaptation in the local setting.
在低收入和中等收入国家(LMICs)开展有效的校本心理健康促进与预防干预措施,能够对大量年轻人的心理健康和幸福感产生积极影响。本综述旨在调查在LMICs国家的学校中有效开展心理健康促进与预防干预措施的情况。我们对国际文献进行了综述,并遵循了系统评价和Meta分析扩展的范围综述指南中的首选报告项目。检索了Medline、PsycInfo、Scopus、Embase、CINAHL和Cochrane数据库,查找2014年至2022年发表的同行评审文献。还检索了PsycExtra、谷歌学术以及关键组织的网站,查找相关的灰色文献。研究选择聚焦于心理健康促进干预措施,包括社交和情感技能的培养以及心理健康素养,以及预防干预措施,包括反欺凌和针对“高危”学生的技能型干预。本综述纳入了27项评估17个LMICs国家25项校本干预措施的研究。其中15项干预措施是在实施国家开发的,10项是从高收入国家(HICs)或其他环境改编而来的。所审查研究的结果总体上是积极的,特别是当干预措施高质量实施时。发现通用生活技能干预措施能够提高社交和情感技能,减少问题行为,并对学生的心理健康和幸福感产生积极影响。心理健康素养干预措施增加了心理健康知识,并减少了学生和学校工作人员中的污名化现象。外部推动的反欺凌干预措施的效果则不太理想。所有19项有效研究都报告了项目实施的某些方面,15项监测了实施的保真度。11项研究概述了项目的基础理论模型。只有4项研究详细报告了项目的文化适应性。据报告,让年轻人参与适应过程有助于项目的自然文化适应,而项目开发者的投入被认为是确保保留干预措施核心组成部分的关键。综述结果表明,在LMICs国家的学校中,有效心理健康干预措施的证据越来越多。为了促进这些干预措施的可持续性、复制和扩大规模,需要更加关注干预措施核心组成部分的报告,以及在当地环境中的实施和文化适应过程。