Abstract
Background: Mental health problems and risk behaviours among young people are of great public health concern. Consequently, within the VII Framework Programme, the European Commission funded the Saving and Empowering Young Lives in Europe (SEYLE) project. This Randomized Controlled Trial (RCT) was conducted in eleven European countries, with Sweden as the coordinating centre, and was designed to identify an effective way to promote mental health and reduce suicidality and risk taking behaviours among adolescents. Objective. To describe the methodological and field procedures in the SEYLE RCT among adolescents, as well as to present the main characteristics of the recruited sample. Methods. Analyses were conducted to determine: 1) representativeness of study sites compared to respective national data; 2) response rate of schools and pupils, drop-out rates from baseline to 3 and 12 month follow-up, 3) comparability of samples among the four Intervention Arms; 4) properties of the standard scales employed: Beck Depression Inventory, Second Edition (BDI-II), Zung Self-Rating Anxiety Scale (Z-SAS), Strengths and Difficulties Questionnaire (SDQ), World Health Organization Well-Being Scale (WHO-5). Results: Participants at baseline comprised 12,395 adolescents (M/F: 5,529/6,799; mean age=14.9±0.9) from Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain. At the 3 and 12 months follow up, participation rates were 87.3% and 79.4%, respectively. Demographic characteristics of participating sites were found to be reasonably representative of their respective national population. Overall response rate of schools was 67.8%. All scales utilised in the study had good to very good internal reliability, as measured by Cronbach's alpha (BDI-II: 0.864; Z-SAS: 0.805; SDQ: 0.740; WHO-5: 0.799). Conclusions: SEYLE achieved its objective of recruiting a large representative sample of adolescents within participating European countries. Analysis of SEYLE data will shed light on the effectiveness of important interventions aimed at improving adolescent mental health and well-being, reducing risk-taking and self-destructive behaviour and preventing suicidality. Trial registration. US National Institute of Health (NIH) clinical trial registry (NCT00906620) and the German Clinical Trials Register (DRKS00000214).
| Original language | English |
|---|---|
| Article number | 479 |
| Journal | BMC Public Health |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| State | Published - 16 May 2013 |
| Externally published | Yes |
Bibliographical note
Funding Information:SEYLE, supported by the European Union Seventh Framework Program (FP7), (Grant agreement number HEALTH-F2-2009-22309), is an RCT to evaluate school-based preventive interventions of risk-taking and self-destructive behaviours in eleven European countries, including: Austria, Estonia, France, Germany, Hungary, Ireland, Israel,a Italy, Romania, Slovenia and Spain, with the National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) at Karolinska Institutet (KI) in Sweden responsible for the scientific coordination of the project. The Child Psychiatric Epidemiology Group at Columbia University and New York State Psychiatric Institute served as methodological experts. SEYLE is registered in both the US National Institute of Health (NIH) clinical trial registry (NCT00906620) and the German Clinical Trials Register (DRKS00000214). The full protocol of the study has been previously published [15]. The key objectives of the study were: (i) to collect assessment data on a cohort of European adolescents, including demographic information, psychopathology, lifestyles, values and risk-behaviours, in order to produce an epidemiological database on the general health status of European adolescents; (ii) to evaluate three types of school-based interventions in comparison to a minimal intervention control group. The three active interventions included (1) teacher training, (2) increasing adolescents’ awareness about mental health, and (3) professional screening of adolescents for mental health problems and risk behaviours. Teachers were trained through the gate-keeper program: Question, Persuade and Refer, developed in the US by the QPR Institute [16]. Pupils were trained through a standardized awareness-increasing program [15,17] designed to promote knowledge of mental health, healthy lifestyles and behaviours among adolescents. A professional screening program performed by psychiatrists and psychologists was specifically designed for the SEYLE study. All pupils were screened with a questionnaire and, if responses exceeded a predetermined cut-off score for depression, anxiety, phobia, alcoholism, substance abuse, non-suicidal self-injury (NSSI) or suicidality, pupils were interviewed and then referred for professional treatment if necessary. More details about the SEYLE interventions have been previously published [15].
Funding Information:
Background: Mental health problems and risk behaviours among young people are of great public health concern. Consequently, within the VII Framework Programme, the European Commission funded the Saving and Empowering Young Lives in Europe (SEYLE) project. This Randomized Controlled Trial (RCT) was conducted in eleven European countries, with Sweden as the coordinating centre, and was designed to identify an effective way to promote mental health and reduce suicidality and risk taking behaviours among adolescents. Objective: To describe the methodological and field procedures in the SEYLE RCT among adolescents, as well as to present the main characteristics of the recruited sample. Methods: Analyses were conducted to determine: 1) representativeness of study sites compared to respective national data; 2) response rate of schools and pupils, drop-out rates from baseline to 3 and 12 month follow-up, 3) comparability of samples among the four Intervention Arms; 4) properties of the standard scales employed: Beck Depression Inventory, Second Edition (BDI-II), Zung Self-Rating Anxiety Scale (Z-SAS), Strengths and Difficulties Questionnaire (SDQ), World Health Organization Well-Being Scale (WHO-5).
Funding Information:
The SEYLE project was supported through Coordination Theme 1 (Health) of the European Union Seventh Framework Program (FP7), Grant agreement number HEALTH-F2-2009-223091. The authors were independent of the funders in all aspects of study design, data analysis, and writing of this manuscript. The Project Leader and Coordinator of the SEYLE project is Professor in Psychiatry and Suicidology Danuta Wasserman, Karolinska Institutet (KI), Head of the National Centre for Suicide Research and Prevention of Mental Ill-Health and Suicide (NASP), at KI, Stockholm, Sweden. Other members of the Executive Committee are Professor Marco Sarchiapone, Department of Health Sciences, University of Molise, Campobasso, Italy; Senior Lecturer Vladimir Carli, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden; Professor of Child and Adolescent Psychiatry Christina Hoven and Anthropologist Camilla Wasserman, Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute and Mailman School of Public Health, Columbia University, New York, USA. The SEYLE Consortium comprises centers in 12 European countries. Site leaders for each respective center and country are: Danuta Wasserman (NASP, Karolinska Institutet, Sweden, Coordinating Centre), Christian Haring (University for Medical Information Technology, Austria), Airi Varnik (Estonian-Swedish Mental Health & Suicidology Institute, Estonia), Jean-Pierre Kahn (University of Nancy, France), Romuald Brunner (University of Heidelberg, Germany), Judit Balazs (Vadaskert Child and Adolescent Psychiatric Hospital, Hungary), Paul Corcoran (National Suicide Research Foundation, Ireland), Alan Apter (Schneider Children's Medical Centre of Israel, Tel-Aviv University, Tel Aviv, Israel), Marco Sarchiapone (University of Molise, Italy), Doina Cosman (Iuliu Hatieganu University of Medicine and Pharmacy, Romania), Vita Postuvan (University of Primorska, Slovenia), Julio Bobes and Pilar Saiz (University of Oviedo, Spain). Dr. Stella Reiter-Theil (Professor in Ethics, Basel University) was the external advisor for ethical issues in the study.
Funding
SEYLE, supported by the European Union Seventh Framework Program (FP7), (Grant agreement number HEALTH-F2-2009-22309), is an RCT to evaluate school-based preventive interventions of risk-taking and self-destructive behaviours in eleven European countries, including: Austria, Estonia, France, Germany, Hungary, Ireland, Israel,a Italy, Romania, Slovenia and Spain, with the National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) at Karolinska Institutet (KI) in Sweden responsible for the scientific coordination of the project. The Child Psychiatric Epidemiology Group at Columbia University and New York State Psychiatric Institute served as methodological experts. SEYLE is registered in both the US National Institute of Health (NIH) clinical trial registry (NCT00906620) and the German Clinical Trials Register (DRKS00000214). The full protocol of the study has been previously published [15]. The key objectives of the study were: (i) to collect assessment data on a cohort of European adolescents, including demographic information, psychopathology, lifestyles, values and risk-behaviours, in order to produce an epidemiological database on the general health status of European adolescents; (ii) to evaluate three types of school-based interventions in comparison to a minimal intervention control group. The three active interventions included (1) teacher training, (2) increasing adolescents’ awareness about mental health, and (3) professional screening of adolescents for mental health problems and risk behaviours. Teachers were trained through the gate-keeper program: Question, Persuade and Refer, developed in the US by the QPR Institute [16]. Pupils were trained through a standardized awareness-increasing program [15,17] designed to promote knowledge of mental health, healthy lifestyles and behaviours among adolescents. A professional screening program performed by psychiatrists and psychologists was specifically designed for the SEYLE study. All pupils were screened with a questionnaire and, if responses exceeded a predetermined cut-off score for depression, anxiety, phobia, alcoholism, substance abuse, non-suicidal self-injury (NSSI) or suicidality, pupils were interviewed and then referred for professional treatment if necessary. More details about the SEYLE interventions have been previously published [15]. Background: Mental health problems and risk behaviours among young people are of great public health concern. Consequently, within the VII Framework Programme, the European Commission funded the Saving and Empowering Young Lives in Europe (SEYLE) project. This Randomized Controlled Trial (RCT) was conducted in eleven European countries, with Sweden as the coordinating centre, and was designed to identify an effective way to promote mental health and reduce suicidality and risk taking behaviours among adolescents. Objective: To describe the methodological and field procedures in the SEYLE RCT among adolescents, as well as to present the main characteristics of the recruited sample. Methods: Analyses were conducted to determine: 1) representativeness of study sites compared to respective national data; 2) response rate of schools and pupils, drop-out rates from baseline to 3 and 12 month follow-up, 3) comparability of samples among the four Intervention Arms; 4) properties of the standard scales employed: Beck Depression Inventory, Second Edition (BDI-II), Zung Self-Rating Anxiety Scale (Z-SAS), Strengths and Difficulties Questionnaire (SDQ), World Health Organization Well-Being Scale (WHO-5). The SEYLE project was supported through Coordination Theme 1 (Health) of the European Union Seventh Framework Program (FP7), Grant agreement number HEALTH-F2-2009-223091. The authors were independent of the funders in all aspects of study design, data analysis, and writing of this manuscript. The Project Leader and Coordinator of the SEYLE project is Professor in Psychiatry and Suicidology Danuta Wasserman, Karolinska Institutet (KI), Head of the National Centre for Suicide Research and Prevention of Mental Ill-Health and Suicide (NASP), at KI, Stockholm, Sweden. Other members of the Executive Committee are Professor Marco Sarchiapone, Department of Health Sciences, University of Molise, Campobasso, Italy; Senior Lecturer Vladimir Carli, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden; Professor of Child and Adolescent Psychiatry Christina Hoven and Anthropologist Camilla Wasserman, Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute and Mailman School of Public Health, Columbia University, New York, USA. The SEYLE Consortium comprises centers in 12 European countries. Site leaders for each respective center and country are: Danuta Wasserman (NASP, Karolinska Institutet, Sweden, Coordinating Centre), Christian Haring (University for Medical Information Technology, Austria), Airi Varnik (Estonian-Swedish Mental Health & Suicidology Institute, Estonia), Jean-Pierre Kahn (University of Nancy, France), Romuald Brunner (University of Heidelberg, Germany), Judit Balazs (Vadaskert Child and Adolescent Psychiatric Hospital, Hungary), Paul Corcoran (National Suicide Research Foundation, Ireland), Alan Apter (Schneider Children's Medical Centre of Israel, Tel-Aviv University, Tel Aviv, Israel), Marco Sarchiapone (University of Molise, Italy), Doina Cosman (Iuliu Hatieganu University of Medicine and Pharmacy, Romania), Vita Postuvan (University of Primorska, Slovenia), Julio Bobes and Pilar Saiz (University of Oviedo, Spain). Dr. Stella Reiter-Theil (Professor in Ethics, Basel University) was the external advisor for ethical issues in the study.
| Funders | Funder number |
|---|---|
| European Commission funded the Saving and Empowering Young Lives in Europe | |
| National Centre for Suicide Research and Prevention of Mental Ill-Health | |
| SEYLE | |
| Seventh Framework Programme | HEALTH-F2-2009-223091, HEALTH-F2-2009-22309 |
| Karolinska Institutet | |
| Seventh Framework Programme |
Keywords
- Adolescents
- Awareness
- Intervention
- Mental Health Promotion
- ProfScreen
- Promotion
- QPR
- RCT
- SEYLE
- Schools
- Suicide prevention
- Well-being
