Programme
Overview
1
Intervention Co-Design
Modify intervention materials such as problem solving and behavioural activation protocols, peer support guidance and engagement strategies with prospective end users.
2
Measure Development
Produce conceptually-equivalent Hindi translations of English-language self-report measures that assess hypothesised PS-specific or BA-specific mediators. Administer the measures to a sample of Delhi university students and assess psychometric performance.
3
Mechanistic Trial
Implement a 3-arm individually randomised controlled trial that compares brief, peer-delivered interventions built around respective active ingredients of PS, BA, and a control group in a sample of university students that screen positive for depression. Evaluate the effectiveness of the PS and BA interventions relative to the control group in reducing self-reported depressive symptoms at 12 months post-randomisation.
4
Process Evaluation
Investigate the experience and outcomes of the single-ingredient PS and BA interventions from the perspective of participants, with a particular focus on elucidating mechanisms of intervention effects.
Timeline
Year 1
Year 2
Year 3
Year 4
Study 1: Intervention co-design
Participatory adaptation of two brief, evidence- based psychological interventions for problem solving and behavioural activation
Study 2: Measure Development
Translation and validation of self-report measures for hypothesised mediators that will be tested in the subsequent trial
Study 3: Mechanistic trial
Three-arm individually randomized controlled trial (problem solving vs. behavioural activation vs. attention control) with mediation analysis
Study 4 Process evaluation
Qualitative interviews to investigate participants’ perspectives on intervention outcomes and how these were achieved.
Study 1: Intervention Co-Design
Participatory adaptation of two brief, evidence based psychological interventions developed originally by our team for school-going adolescents in India based on problem solving and behavioural activation is being undertaken. Adaptations are aimed at identifying modifications needed to the intervention protocols, co-designing updated intervention materials and engagement strategies with prospective end users and incorporating adaptations into intervention training for peer supporters.
Study 2: Measure Development
The measure development study will produce conceptually-equivalent Hindi translations of 8 English- language self-report measures for use in the subsequent trial. The self-report measures include Behavioral Activation for Depression Scale – Short Form (BADS-SF), Social-Emotional, Evidence-based Developmental Strengths Assessment (SEEDS), Problem Solving Inventory-20 (PSI-20) and more.
Study 3: Mechanistic Trial
We will implement a 3-arm individually randomised controlled trial that compares brief, peer-delivered interventions built around respective active ingredients of problem solving, behavioural activation, and an attention control group , in a sample of university students that screened positive for depression to evaluate the effectiveness of the intervention relative to the control group in reducing self-reported depressive symptoms at 12 months post-randomisation. We will also evaluate effectiveness on secondary outcomes (anxiety and social functioning); and assess whether hypothesised mediators mediate intervention effects on depression at 12 months.
The trial will be implemented at university sites in New Delhi, prioritizing students from disadvantaged groups.
Study 4: Process Evaluation
We will undertake a realist process evaluation, using qualitative interviews to investigate participants’ perspectives on intervention outcomes and how these were achieved. Qualitative and quantitative findings will be triangulated to obtain a contextualized understanding of the effectiveness and mechanisms of change for BA and PS.
Wwe will explore the helpful and unhelpful aspects of the intervention, attributions for changes in the mediators of interest, identification of contextual moderators and how these shaped mechanisms and outcomes across two intervention arms using semi-structured interviews.
Lived Experience
METROPOLIS will collaborate with young people who have lived experience of mental health problems at every stage of the research – from co-design to delivery to evaluation to make sure these interventions align with the needs of students. The research team will work closely with a Young People’s Advisory Group to provide regular feedback on the project. They will help ensure the project is accessible to students from diverse backgrounds, including those who experience marginalisation due to their economic status, gender identity, sexuality, religion or caste.
Our network of student mental health volunteers across Delhi university will help to raise awareness of the study and public engagement through student-led groups.