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Original research
App-based guided problem-solving intervention for adolescent mental health: a pilot cohort study in Indian schools
  1. Pattie P Gonsalves1,2,
  2. Eleanor Sara Hodgson3,
  3. Bhargav Bhat3,
  4. Rhea Sharma1,
  5. Abhijeet Jambhale3,
  6. Daniel Michelson4,
  7. Vikram Patel3,5
  1. 1Sangath, New Delhi, India
  2. 2Psychology, University of Sussex, Brighton, Brighton and Hove, UK
  3. 3Sangath, Porvorim, Goa, India
  4. 4University of Sussex, Brighton, Brighton and Hove, UK
  5. 5Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Pattie P Gonsalves, Sangath, New Delhi 110030, India; pattie.gonsalves{at}sangath.in

Abstract

Background This paper describes the pilot evaluation of ‘POD Adventures’, a lay counsellor-guided problem-solving intervention delivered via a smartphone app in Indian secondary schools.

Objective To test the feasibility and acceptability of POD Adventures for adolescents with a felt need for psychological support, and to explore the intervention’s effects on self-reported mental health symptoms, prioritised problems, stress and well-being.

Methods We used a mixed-methods pre-post cohort design. Participants were self-referred from grades 9–12 in two coeducational government-aided secondary schools in Goa, India. The intervention was delivered in two formats, ‘mixed’ (comprising individual and small group sessions) and ‘group’ (small group sessions only).

Findings 248 participants enrolled in the study and 230 (92.7%) completed the intervention. Outcomes at 4 weeks showed significant improvements on all measures that were maintained at 12 weeks. Large effects were observed on problem severity scores (4 weeks, d=1.47; 12 weeks, d=1.53) while small to moderate effects were seen on mental health symptoms, stress and well-being. 22 students completed qualitative interviews about their experience of the intervention. Participants found POD Adventures easy to use, engaging and helpful in solving their problems. They were satisfied with the guidance provided by the counsellor irrespective of delivery format.

Conclusions POD Adventures was feasible to deliver with guidance from lay counsellors in Indian schools, acceptable to participants and associated with large improvements in problem severity and mental health symptom severity.

Clinical implications POD Adventures has promise as an early intervention for adolescents with a felt need for psychological support in low-resource settings.

  • child & adolescent psychiatry
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Footnotes

  • DM and VP are joint senior authors.

  • Twitter @pattiegonsalves

  • Contributors PPG: lead author, research design and analysis. ESH: second author, research design and analysis, intervention supervisor. BB: data manager, research analysis. RS: intervention supervisor, reviewing and revising the manuscript. AJ: field research coordination, research analysis. DM, VP: research design, reviewing and revising the manuscript.

  • Funding This work was supported by the Wellcome Trust, UK (grant number 106919/Z/15/Z).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Approvals were obtained from the Indian Council of Medical Research, Archdiocese Board of Education in Goa, Institutional Review Boards of Sangath (the implementing organisation in India) and Harvard Medical School (the sponsor). Written assent (or consent for individuals aged 18 years or older) was obtained from all participating adolescents. Written consent was additionally sought from a parent or guardian for adolescents aged less than 18 years.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Additional information is available by emailing pattie.gonsalves@sangath.in.

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