Strengthening self-regulation and reducing poverty to prevent adolescent depression and anxiety: Rationale, approach and methods of the ALIVE interdisciplinary research collaboration in Colombia, Nepal and South Africa

Crick Lund, Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London, UK.
Mark J. Jordans, Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London, UK.
Emily Garman, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Ricardo Araya, Centre for Global Mental Health and Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
Mauricio Avendano, Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Lausanne, Switzerland.
Annette Bauer, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
Vikram Bahure, Department of International Development, King's College London, London, UK.
Tarun Dua, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
Georgia Eleftheriou, Center for Global Mental Health Equity, Department of Psychiatry, George Washington University, Washington, DC, USA.
Sara Evans-Lacko, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
Juan Felipe García Rodríguez, Innovations for Poverty Action (IPA), Bogotá, Colombia.
Kamal Gautam, Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal.
Martin Gevonden, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Philipp Hessel, Alberto Lleras Camargo School of Government, Universidad de los Andes, Bogotá, Colombia.
Brandon A. Kohrt, Center for Global Mental Health Equity, Department of Psychiatry, George Washington University, Washington, DC, USA.
Lydia Krabbendam, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Nagendra P. Luitel, Research Department, Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal.
Sanchari Roy, Department of International Development, King's College London, London, UK.
Manuel Seifert Bonifaz, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Rakesh Singh, Research Department, Transcultural Psychosocial Organization Nepal (TPO Nepal), Baluwatar, Kathmandu, Nepal.
Mohammadamin Sinichi, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Katherine Sorsdahl, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Graham Thornicroft, Centre for Global Mental Health and Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
Wietse A. Tol, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Daniela Trujillo, Innovations for Poverty Action (IPA), Bogotá, Colombia.
Nicci van der Merwe, Waves for Change, Cape Town, South Africa.
Syed Shabab Wahid, Department of Global Health, Georgetown University, Washington, DC, USA.
Paula Yarrow, Waves for Change, Cape Town, South Africa.

Document Type

Journal Article

Publication Date

12-13-2023

Journal

Epidemiology and psychiatric sciences

Volume

32

DOI

10.1017/S2045796023000811

Keywords

Adolescence; anxiety; depression; poverty; prevention

Abstract

AIMS: Depression and anxiety are the leading contributors to the global burden of disease among young people, accounting for over a third (34.8%) of years lived with disability. Yet there is limited evidence for interventions that prevent adolescent depression and anxiety in low- and middle-income countries (LMICs), where 90% of adolescents live. This article introduces the 'Improving Adolescent mentaL health by reducing the Impact of poVErty (ALIVE)' study, its conceptual framework, objectives, methods and expected outcomes. The aim of the ALIVE study is to develop and pilot-test an intervention that combines poverty reduction with strengthening self-regulation to prevent depression and anxiety among adolescents living in urban poverty in Colombia, Nepal and South Africa. METHODS: This aim will be achieved by addressing four objectives: (1) develop a conceptual framework that identifies the causal mechanisms linking poverty, self-regulation and depression and anxiety; (2) develop a multi-component selective prevention intervention targeting self-regulation and poverty among adolescents at high risk of developing depression or anxiety; (3) adapt and validate instruments to measure incidence of depression and anxiety, mediators and implementation parameters of the prevention intervention; and (4) undertake a four-arm pilot cluster randomised controlled trial to assess the feasibility, acceptability and cost of the selective prevention intervention in the three study sites. RESULTS: The contributions of this study include the active engagement and participation of adolescents in the research process; a focus on the causal mechanisms of the intervention; building an evidence base for prevention interventions in LMICs; and the use of an interdisciplinary approach. CONCLUSIONS: By developing and evaluating an intervention that addresses multidimensional poverty and self-regulation, ALIVE can make contributions to evidence on the integration of mental health into broader development policy and practice.

Department

Psychiatry and Behavioral Sciences

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