Long Term Health Outcomes of Adolescent Character Strength Interventions: 3 To 4 Year Outcomes of Three Randomized Controlled Trials of the Shamiri Program
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Date
2022
Authors
Conerly, Katherine E. Venturo
Natalie, E. Johnson
Osborn, Tom L.
Pufer, Eve S.
Rusch, Thomas
Ndetei, David M.
Wasanga, Christine M.
Mutiso, Victoria
Musyimi, Christine
Weisz, John R.
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
Background: Adolescents in low- and middle-income countries in need of mental health care often do not receive
it due to stigma, cost, and lack of mental health professionals. Culturally appropriate, brief, and low-cost interventions
delivered by lay-providers can help overcome these barriers and appear efective at reducing symptoms of depres‑
sion and anxiety until several months post-intervention. However, little is known about whether these interventions
may have long-term efects on health, mental health, social, or academic outcomes.
Methods: Three previous randomized controlled trials of the Shamiri intervention, a 4-week, group-delivered, layprovider-led intervention, have been conducted in Kenyan high schools. Shamiri teaches positively focused interven‑
tion elements (i.e., growth mindset and strategies for growth, gratitude, and value afrmation) to target symptoms
of depression and anxiety and to improve academic performance and social relationships, by fostering character
strengths. In this long-term follow-up study, we will test whether these mental health, academic, social, and characterstrength outcomes, along with related health outcomes (e.g., sleep quality, heart-rate variability and activity level
measured via wearables, HIV risk behaviors, alcohol and substance use), difer between the intervention and control
group at 3–4-year follow-up. For primary analyses (Nanticipated=432), youths who participated in the three previous tri‑
als will be contacted again to assess whether outcomes at 3–4-year-follow-up difer for those in the Shamiri Interven‑
tion group compared to those in the study-skills active control group. Multi-level models will be used to model trajec‑
tories over time of primary outcomes and secondary outcomes that were collected in previous trials. For outcomes
only collected at 3–4-year follow-up, tests of location diference (e.g., t-tests) will be used to assess group diferences
in metric outcomes and diference tests (e.g., odds ratios) will be used to assess diferences in categorical outcomes.
Finally, standardized efect sizes will be used to compare groups on all measures.
Discussion: This follow-up study of participants from three randomized controlled trials of the Shamiri intervention
will provide evidence bearing on the long-term and health and mental health efects of brief, lay-provider-delivered
character strength interventions for youth in low- and middle-income countries.
Description
Article
Keywords
Adolescents, sub-Saharan Africa, Global Mental Health, Depression, Anxiety, Wellbeing, Global Health, Shamiri, Randomized controlled trial
Citation
Venturo-Conerly, K. E., Johnson, N. E., Osborn, T. L., Puffer, E. S., Rusch, T., Ndetei, D. M., ... & Weisz, J. R. (2022). Long-term health outcomes of adolescent character strength interventions: 3-to 4-year outcomes of three randomized controlled trials of the Shamiri program. Trials, 23(1), 1-18.