在学校环境中对儿童进行以弹性为重点的普遍干预的有效性：一项随机对照试验

Effectiveness of a universal resilience-focused intervention for children in the school setting: A randomized controlled trial.

在学校环境中对儿童进行以弹性为重点的普遍干预的有效性：一项随机对照试验

Authors: Wenjuan Huang, Peipei Wu, Jing Li, Yi Zhou, Zhou Xiong, Puyu Su, Yuhui Wan, Fangbiao Tao, Ying Sun.

Source: J Affect Disord. 2024 Sep 19:368:695-703.

doi: 10.1016/j.jad.2024.09.120. 

Abstract

Background:Psychological resilience can be augmented through the acquisition of specific cognitive or emotional regulation skills, enabling children to adapt to or recover from stressful events, disadvantages, or adversities. We aimed to evaluate the efficacy of a Tianchang Resilience-focused inTervention program (TRT¹program) on resilience and mental health conditions of Chinese children.

Methods:This study was a two-arm cluster-randomized controlled trial, performed in Tianchang, a county in China. Students from 20 classes in a local primary school (aged8.7-11.2years) were randomly allocated to receive a resilience-focused intervention or waitlist group. The intervention comprised weekly 40-min sessions for 14 weeks and co-led by lay counsellors. Measures of emotional symptoms, behavioral difficulties, and resilience were collected at pre-, post-intervention, 6-months, and 12-months follow-up.

Results:Between June 16, 2022, and September 4, 2022, 775 eligible students were recruited (mean age 9.93 years; 420 [54.2 %] boys). Relative to the waitlist group (N＝391), the intervention group (N＝384) reported a significant reduction in depressive and anxiety symptoms at post-intervention (all p＜0.001), 6-months (p＝0.007; p＝0.002) and 12-months follow-up (p＝0.018; p＝0.018), respectively. The intervention group effects were also observed on resilience at post-intervention follow-up (p＝0.006), and remained stable over 6-months (p＜0.001) and 12-months follow-up (p＝0.022).

Conclusions:This study demonstrated that the TRT program, a universal resilience-focused intervention for children in the school setting, showed long-term effectiveness in improving resilience and mental health conditions. This minimally trained laypersons-delivered intervention might enhance the program's generalizability to other communities.

Keywords: Child; Intervention; Mental health; Psychological resilience; Randomized controlled trial.

摘要

背景：心理弹性可以通过获得特定的认知或情绪调节技能来增强，使儿童能够适应压力事件、不利因素或逆境或从中恢复。我们旨在评估以天长韧性为重点的 inTervention 计划（TRT¹program）对中国儿童韧性和心理健康状况的疗效。

方法： 本研究是一项双臂整群随机对照试验，在中国田长县进行。来自当地小学20个班级（年龄：8.7～11.2 岁）的学生被随机分配接受以弹性为重点的干预或候补名单组。干预包括每周40分钟的课程，持续14周，由非专业顾问共同领导。在干预前、干预后、 6个月和12个月的随访中收集情绪症状、行为困难和恢复力的测量。

结果：在2022年6月16日至2022年9月4日期间，共招募了775名符合条件的学生（平均年龄9.93 岁;420名男生，占比54.2 %）。相对于候补组（N＝391），干预组（N＝384）报告在干预后（均P＜0.001）、6个月（P＝0.007；P＝0.002）和12个月随访（P＝0.018;P＝0.018）时抑郁和焦虑症状显着减少（P＝0.018；P＝0.018）。在干预后随访（P＝0.006）时还观察到干预组对恢复力的影响，并在6个月（P＜0.001）和12个月随访（P＝0.022）中保持稳定。

结论：本研究证明，TRT计划是一种针对学校环境中儿童的普遍以弹性为重点的干预措施，在改善弹性和心理健康状况方面显示出长期有效性。这种受过最低限度培训的外行提供的干预可能会增强该计划对其他社区的普遍性。

关键词： 儿童；干预；心理健康；心理弹性；随机对照试验