Suicidal Ideation, Suicide, Attempted
Conditions
Keywords
Nai Dish, Suicide ideation, Cue based, suicide attempts
Brief summary
It is Cluster Randomized Control Trial research to examine feasibility and relevance of the modified tool Nae Disha for Life, which will incorporate suicide prevention and resilience to reduce suicide ideation among young people in Bundelkhand region of Madhya Pradesh, India. This intervention will build on existing relationships with at least four Government Middle Schools in Nowgong block of Chhatarpur district, Madhya Pradesh. This preliminary research will develop relationships and evidence for implementation scale-up research.
Detailed description
Madhya Pradesh state in India was ranked as third highest number of suicides reported in 2020 in India. The majority of suicide victims (23.4%) (35,771) were educated up to Matriculation/ Secondary level. A large proportion of suicide deaths occur between the ages 15 and 29. Mental health problems begin during youth (12-24) years of age, however, is often detected later in life. "Nae Disha for Life" is a brief, multi-component, psychosocial promotion and resilience tool developed by Emmanuel Hospital Association, New Delhi. The purpose of this research work is to evaluate the feasibility, acceptance, and effectiveness of "Nae Disha for Life" tool in reducing suicide ideation among youth in Bundelkhand region. This will be implemented among the targeted schools of Nowgong block, Chhatarpur district. There are number of studies on treatment gaps for the mental health problems, suicide statistical analysis, methods of suicides, and causes of suicides. But there is hardly any study on prevention of suicides or suicidal ideation among the youth in India. However, Nae Disha is a youth resilience group-based intervention building on the Ottawa health promotion charter, that aims to increase and strengthen key psycho-social assets in adolescents to moderate the impacts of adversity. It has been successfully implemented amongst out-of-school adolescents in Northern India and studies have demonstrated effectiveness in improving perceptions of social inclusion, attitudes to gender equality, resilience, and mental health among young people affected by mental illness. The Nae Disha would also deliver benefits to other young people similarly affected in other parts of India, and possibly beyond. Building on these studies, I propose to examine feasibility and relevance of the modified tool Nae Disha for Life, which will incorporate suicide prevention and resilience to reduce suicide ideation among young people in Bundelkhand region of Madhya Pradesh. This intervention will build on existing relationships with at least four Government Middle Schools in Nowgong block of Chhatarpur district, Madhya Pradesh. This preliminary research will develop relationships and evidence for implementational scale-up research. The research activities of the study is distributed as follows: 4 months(16weeks), Training of surveyors, Training staff as Facilitators, Meeting with local, stakeholders / communities, Refinement of program content. Next two weeks:Recruiting of subjects from 4 schools, Screening of subjects in 4 schools, Formation of groups in 4 schools,Baseline data collection from subjects, 18 weeks (Week 17-to week 34):Intensive implementation in intervention arm and control arm in 4 schools 2 (Week 35-36) weeks:Endline quantitative and qualitative data collection 6 weeks(week 37-week:43) Data entry, analysis and presentation of data findings After week 43: Dissemination meetings to be held at in schools and Chhatarpur
Interventions
"Nae Disha for Life" is a brief, multi-component, psychosocial promotion and resilience tool developed by Emmanuel Hospital Association, New Delhi. The purpose of this research work is to evaluate the feasibility, acceptance, and effectiveness of "Nae Disha for Life" tool in reducing suicide ideation among youth in Bundelkhand region. This will be implemented among the targeted schools of Nowgong block, Chhatarpur district.
Sponsors
Study design
Intervention model description
The study is a Cluster Randomized Control Trial (CRCT) research / study. The selection and approval of 64 Government schools was obtained will be done by the local PI based on comparable demographics (i.e. similar levels of socio-economic status) in the Nowgong block of Chhatarpur district. Two of the four schools will receive the intervention (intervention arm) and the other two will be the control arm. A sample size of n = 170 young people in each arm will be recruited from participating schools who are studying in 7th and 8th classes, aged between 12 - 17 years old. Sample size was calculated using optimal design software. The demographic data (e.g. age, father and mother completed years of education, caste, religion, etc.) as well as psychometric measures will be collected at baseline (prior to intervention) and endline (post intervention). All participants below 18 years of age will only be recruited after parental consent and self-assent.
Eligibility
Inclusion criteria
* Students of 7th and 8th classes of selected schools between 12 - 17 years old age group,
Exclusion criteria
* a. Students who are planning to move to other schools during intervention period b. Students of 7th/8th grade who turn 18 during the study. c. Those with chronic debilitating diseases or disorders who cannot participate in Nae Disha activities such as heart disease, epilepsy, cystic fibrosis, cerebral palsy, and any other diseases that the doctor has restricted the student to participate in it.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-Reporting Questionnaire-20 (SRQ-20) Score | Baseline and after 18 weeks of intervention (Nae Disha modules) | Mental health was assessed using the Self-Reporting Questionnaire-20 (SRQ-20). The SRQ-20 measures general psychiatric symptomatology. Total scores range from 0 to 20, with higher scores indicating worse mental health or more severe symptoms |
| Beck Depression Inventory-II (BDI-II) Score | Baseline and after 18 weeks of intervention | Beck Depression Inventory-II (BDI-II): The BDI-II is a widely used self-report scale designed to assess the severity of depressive symptoms. It consists of 21 items, each scored on a scale from 0 to 3, with a total score ranging from 0 to 63. Higher scores indicate greater severity of depression and therefore represent a worse outcome. |
| Beck Scale for Suicidal Ideation (BSS) Score | Baseline and after 18 weeks of intervention (Nae Disha modules) | Beck Scale for Suicidal Ideation (BSS): The BSS is a self-report scale used to assess the severity of suicidal ideation. It consists of 21 items, each scored on a scale from 0 to 2, with a total score typically ranging from 0 to 38 based on the first 19 items. Higher scores indicate greater severity of suicidal thoughts and therefore represent a worse outcome. |
| Brief Resilience Scale Score | Baseline and after 18 weeks of intervention (Nae Disha modules) | Connor-Davidson Resilience Scale-10 (CD-RISC-10): The CD-RISC-10 is a self-report scale used to assess psychological resilience. It consists of 10 items, each scored on a scale from 0 to 4, with a total score ranging from 0 to 40. Higher scores indicate greater resilience and therefore represent a better outcome. |
| Generalized Anxiety Disorder-7 (GAD-7) Score | Baseline and after 18 weeks of intervention (Nae Disha Modules) | Generalized Anxiety Disorder-7 (GAD-7): The GAD-7 is a self-report scale used to assess the severity of generalized anxiety disorder. It consists of 7 items, each scored on a scale from 0 to 3, with a total score ranging from 0 to 21. Higher scores indicate greater severity of anxiety and therefore represent a worse outcome. |
Countries
India
Contacts
University of Pittburgh
Participant flow
Recruitment details
This is a Cluster Randomized Controlled design. Participants were recruited from 6 government schools with similar demographics. Consented participants (n=175) from three schools were assigned to the Intervention Group, and participants (n=188) from other three schools were assigned to the Control Group. Started: Total participants=363 recruited. Completed Study: 173+186=359, Not Completed: 4 (Migrated with parents for labour work).
Pre-assignment details
All eligible students consented to participate, and all participating students were recruited.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Customized Age groups 12 to 13 years | 299 Participants |
| Age, Customized Age groups 14 to 15 years | 60 Participants |
| Age, Customized Age groups 16 to 17 years | 4 Participants |
| Below-Poverty Line Family Card Don't know | 101 Participants |
| Below-Poverty Line Family Card No/Don't Have Below Povery line card | 58 Participants |
| Below-Poverty Line Family Card Yes/Have Below Povery Line Card | 107 Participants |
| Caste General Caste | 8 Participants |
| Caste Other Backward Caste | 263 Participants |
| Caste Schedule Caste | 62 Participants |
| Class in School Eighth grade | 175 Participants |
| Class in School Seventh grade | 90 Participants |
| Class in School Sixth grade | 9 Participants |
| Education of father Class 10 completed | 87 Participants |
| Education of father Class 12 completed | 11 Participants |
| Education of father Class 5 completed | 77 Participants |
| Education of father Class 8 completed | 107 Participants |
| Education of father Diploma | 2 Participants |
| Education of father Graduate | 3 Participants |
| Education of father Illiterate/ Never been to school | 65 Participants |
| Education of mother Class 10 completed | 9 Participants |
| Education of mother Class 12 completed | 6 Participants |
| Education of mother Class 5 completed | 67 Participants |
| Education of mother Class 8 completed | 50 Participants |
| Education of mother Illiterate/ Never been to school | 104 Participants |
| Family run out of money for food or essentials last month No | 277 Participants |
| Family run out of money for food or essentials last month Yes | 66 Participants |
| Number of children aged 5- 18 in the family attending school regularly | 3 children |
| Number of children in the family aged 5 - 18 years | 3 children |
| Number of days of school missed in last 3 months | 10 Number of Days |
| Race and Ethnicity Not Collected | 0 Participants |
| Religion Hindu | 188 Participants |
| Religion Muslim | 4 Participants |
| Sex: Female, Male Female | 98 Participants |
| Sex: Female, Male Male | 73 Participants |
| Type of house Don't know | 8 Participants |
| Type of house Kaccha house | 32 Participants |
| Type of house Pucca house | 107 Participants |
| Type of house Semi-pucca house | 78 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 175 | 0 / 188 |
| other Total, other adverse events | 0 / 175 | 0 / 188 |
| serious Total, serious adverse events | 0 / 175 | 0 / 188 |