Feasibility and Acceptability of a School-Based Emotion Regulation Prevention Intervention (READY-Nepal) for Secondary School Students in Post-Earthquake Nepal

Authors

Megan K. Ramaiya, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94143, USA.
Caitlin L. McLean, VA San Diego Healthcare System, University of California, San Diego, CA 92161, USA.
Manjila Pokharel, Transcultural Psychosocial Organization Nepal, Kathmandu 44600, Nepal.
Kiran Thapa, College of Public Health, University of Georgia, Athens, GA 30602, USA.
M Andi Schmidt, School of Graduate Psychology, Pacific University Oregon, Forest Grove, OR 97116, USA.
Martha Berg, Department of Psychology, University of Michigan-Ann Arbor, Ann Arbor, MI 48103, USA.
Jane M. Simoni, Department of Psychology, University of Washington, Seattle, WA 98195, USA.
Deepa Rao, Department of Global Health, University of Washington, Seattle, WA 98104, USA.
Brandon A. Kohrt, Division of Global Mental Health, George Washington University, Washington, DC 20052, USA.

Document Type

Journal Article

Publication Date

11-4-2022

Journal

International journal of environmental research and public health

Volume

19

Issue

21

DOI

10.3390/ijerph192114497

Keywords

Nepal; adolescents; dialectical behavior therapy; emotion regulation; global mental health; non-randomized controlled trial; schools

Abstract

BACKGROUND: Child and adolescent mental health problems are major contributors to the global burden of disease in low- and middle-income country (LMIC) settings. To advance the evidence base for adolescent mental health interventions in LMICs, we evaluated the feasibility and acceptability of a school-based emotion regulation prevention intervention (READY-Nepal) for adolescents who had a recent exposure to a humanitarian disaster. METHODS: A mixed-method, non-randomized controlled trial was conducted with Nepali secondary school students in one heavily affected post-earthquake district. Students ( = 102; aged 13 to 17 years) were enrolled in the intervention ( = 42) and waitlist control ( = 60) conditions. Feasibility and acceptability were examined via attendance, and by qualitative interviews with a subset of students ( = 15), teachers ( = 2), and caregivers ( = 3). Preliminary efficacy was examined on primary outcome (emotion regulation) and secondary outcomes (anxiety symptoms, posttraumatic stress symptoms, functional impairment, resilience, coping skills), which were measured at baseline and post-intervention (four weeks). RESULTS: Delivering the intervention was feasible and acceptable, as demonstrated by low dropout (8%) and high program attendance (6.7 of 8 sessions). Qualitative data suggested high uptake of anger regulation skills, but lower uptake of mindfulness skills. Despite this, there were no significant differences by condition on primary or secondary outcomes at four-week follow-up. Students provided suggestions for improvement of the program. CONCLUSION: Further research on longitudinal outcome measurement, use of alternatives to retrospective self-report data, and rigorous development of culturally grounded models of emotion regulation is necessary to explore the utility of school-based emotion regulation interventions in Nepal and other LMICs.

APA Citation

Ramaiya, Megan K.; McLean, Caitlin L.; Pokharel, Manjila; Thapa, Kiran; Schmidt, M Andi; Berg, Martha; Simoni, Jane M.; Rao, Deepa; and Kohrt, Brandon A., "Feasibility and Acceptability of a School-Based Emotion Regulation Prevention Intervention (READY-Nepal) for Secondary School Students in Post-Earthquake Nepal" (2022). GW Authored Works. Paper 1968.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1968

Department

Global Health