Peer-reviewed article
Combining self-regulation and poverty reduction to prevent depression and anxiety among adolescents experiencing multi-dimensional poverty in Colombia, Nepal and South Africa: study protocol of a pilot 4-arm cluster randomised controlled trial.
Jordans MJD, Lund C, Garman EC, Bonifaz MS, Avendano M et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study protocol describes a pilot trial testing whether combining self-regulation training with poverty reduction interventions can prevent depression and anxiety in adolescents living in poverty. The trial is taking place in Colombia, Nepal, and South Africa, with 628 adolescents and 536 caregivers enrolled across urban settings. Participants receive either self-regulation training (mindfulness, problem-solving), economic intervention (financial training and cash transfers), both combined, or standard care. The study will assess whether the intervention is feasible and acceptable to deliver before testing its effectiveness in a larger trial.
Key points
- The trial combines two intervention types: self-regulation (psychological activities and physical activity) and economic support (financial training, negotiation skills, education information, and monthly cash transfers)
- 628 adolescents aged 12-18 with depression or anxiety symptoms (but not meeting disorder thresholds) living in multidimensional poverty were enrolled
- The pilot uses a 4-arm cluster randomised design with randomisation at school level across 24 schools total
- Interventions consist of 20 weekly group sessions with adolescents and 6 monthly sessions with caregivers
- Primary outcomes measure feasibility and acceptability using traffic light criteria for randomisation, recruitment, retention, fidelity, attendance, and adverse events
Limitations
This is a study protocol describing planned methods, not results; therefore, it cannot provide evidence of whether the intervention actually works or what outcomes were achieved. The document does not report any effectiveness findings or participant outcome data.
Abstract
Background Poverty is associated with depression and anxiety among adolescents, but evidence of interventions that prevent adolescent depression and anxiety among adolescents living in poverty is weak. Interventions either focus on reducing poverty or addressing depression and anxiety, but an approach that combines both may offer larger benefit. This multi-site parallel pilot cluster randomised controlled trial (cRCT) evaluates the feasibility and acceptability of a selective preventive intervention for depression and anxiety that simultaneously intervenes on both poverty and self-regulation among adolescents living in urban poverty. Methods The study takes place in Bogotá (Colombia), Kathmandu (Nepal) and Cape Town (South Africa). The pilot cRCT has four arms: (i) self-regulation intervention, (ii) economic intervention, (iii) combined (self-regulation + economic) intervention, and (iv) control group (care as usual). Interventions consist of 20 weekly group sessions with adolescents, and 6 monthly group sessions with their caregivers. The self-regulation intervention for adolescents includes psychological activities (mindfulness breathing, problem solving, biofeedback and goal setting) and a physical activity. The economic intervention includes three dimensions (financial training, negotiation training, education information) and a monthly cash transfer. In each site, the aim was to recruit 240 adolescents and their caregivers across eight schools (clusters), with two schools randomised to each arm. Adolescents residing in areas at risk of multidimensional poverty and who had symptoms of depression or anxiety, but who did not meet thresholds indicating depression and anxiety disorders, were considered for enrolment. Recruitment into the study is complete: a total of 628 adolescents and 536 caregivers were enrolled. Participants will be assessed four times: at enrolment, post-intervention and at 12 and 18 months post-enrolment. Primary outcomes include feasibility and acceptability criteria for study and intervention delivery procedures (i.e. randomisation, masking, recruitment, retention, missingness, fidelity, attendance, adverse events) defined as traffic light criteria to assess progression to an adequately powered trial. Secondary outcomes include self-report instruments, physiological measures and neuropsychological tasks. Discussion The effectiveness of combining self-regulation and anti-poverty interventions remains untested. This study will establish the feasibility and acceptability of delivering such an intervention, as well as test the trial procedures to inform a future adequately powered trial. Trial registration ISRCTN 14601588. Retrospectively registered. Date: 19 May 2024.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Combined self-regulation intervention (mindfulness, problem-solving, biofeedback, goal-setting, physical activity) plus economic intervention (financial training, negotiation training, education information, and monthly cash transfers)
- Population
- Adolescents aged 12-18 residing in areas of multidimensional poverty with symptoms of depression or anxiety (but not meeting disorder thresholds) in urban Bogotá (Colombia), Kathmandu (Nepal), and Cape Town (South Africa)
Key finding