RecruitingNot ApplicableNCT06248203

Teachers Leading the Front Lines - Adolescent

Teachers Delivering Task-Shifted Mental Health Care to Adolescents in India

Sponsor

University of North Carolina, Chapel Hill

Enrollment

216 participants

Start Date

Feb 29, 2024

Study Type

INTERVENTIONAL

Conditions

Depression Mental Health Issue Anxiety Psychosocial Functioning Adolescent Behavior Adolescent - Emotional Problem

Summary

Purpose: The purpose of this research is to pilot test a novel, alternative, potentially sustainable system of teacher-delivered, task-shifted adolescent mental health care. Participants: Principals of 60 rural, low-cost private secondary schools of the Darjeeling Himalayas will be invited to participate as a school and an individual. Teachers will be approached individually. Two students per teacher who meet inclusion criteria will be randomly chosen for enrollment. Procedures: This is a RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) guided, mixed methods CRCT, clustered at schools, of Tealeaf-A's Reach, Adoption \& Implementation (Primary Outcomes, implementation-based), as well as evaluating for preliminary indicators of Effectiveness \& Maintenance (Secondary Outcomes, clinically-based).

Eligibility

Min Age: 13 Years

Inclusion Criteria22

Schools:
LCP (Low-Cost Private) Secondary Schools
Enrolled families earning \<$10 daily
Located in greater Darjeeling
Principal must also be eligible to participate
Principals:
\>18 years old
Employed at enrolled school
Not suspected or convicted of child maltreatment
Teachers:
\>18 years old
Employed at enrolled school
Not suspected or convicted of child maltreatment
Students:
Age 13 - 17 years
Student of enrolled teacher
Borderline or clinical Total Problem or subscale score of YSR (Youth Self-Report) and TRF (Teacher's Report Form)
Each student has a lead teacher (2/teacher), with their other teachers also involved
Guardians
\>18 years old
Guardian of enrolled student
Not suspected or convicted of child maltreatment

Interventions

BEHAVIORALTealeaf-Mansik Swasta (Tealeaf) as adapted for Adolescents

The investigators will test Tealeaf (Teachers Leading the Frontlines - Mansik Swastha \[Mental Health in Nepali\]) as adapted for adolescents. Tealeaf is a task-shifting intervention in which teachers deliver transdiagnostic mental health care. Created in Darjeeling, Tealeaf centers on training and supervising teachers to deliver "education as mental health therapy" (Ed-MH) to children (age 5-12). Ed-MH is the investigators' novel, task-shifting, therapy modality that minimizes the time teachers need to deliver care by fitting it into their work. In Ed-MH, teachers use evidence-based therapeutic techniques adapted for use in their existing interactions with students in need (e.g., while teaching) and streamlined for care for any diagnosis ("transdiagnostic"). Tealeaf-A's adaptation (inclusive of Ed-MH) is supported by a Doris Duke Charitable Foundation (DDCF), Fund to Retain Clinical Scientists (FRCS), Caregivers at Carolina COVID award.

BEHAVIORALEnhanced Usual Care (EUC)

Enhanced Usual Care (EUC) is a less intensive version of the Tealeaf intervention. The EUC service package has been designed to be the most intensive form of care that could be envisioned as viable in the study setting in the foreseeable future without a significant increase in resource investment.