The INSPIRE (Integrated Network for Student Psychosocial Intervention, Resilience, and Education) intervention is an 8-week, school-based mental health program designed to enhance adolescents' mental health literacy and resilience while addressing symptoms of depression and anxiety. Implementation is conducted by school counselors who undergo an intensive two-day training program. The intervention is supported by comprehensive curriculum materials including detailed lesson plans, activities, discussion prompts, and instructional slides featuring key concepts, visuals, and explanatory content. Supplementary materials are developed for both participating adolescents and their parents. The study aims to: 1. Evaluate the usability and feasibility of the INSPIRE intervention within the school environment. 2. Assess the intervention's effectiveness in improving: * Primary outcome: Mental health knowledge among adolescents * Secondary outcomes: Attitudes toward mental health, help-seeking behaviors, mental health literacy, resilience, and symptoms of depression and anxiety among adolescents * Secondary outcomes: mental health knowledge, attitudes, help-seeking behaviors, and mental health literacy among parents 3. Explore the experiences of intervention participants (both adolescents and parents) against the control group to develop comprehensive insights into the psychosocial intervention's impact. The research hypothesis proposes that the INSPIRE intervention group will demonstrate significantly higher scores in mental health knowledge, more positive attitudes toward mental health, increased help-seeking behaviors, enhanced mental health literacy, and greater resilience, while simultaneously showing reduced symptoms of depression and anxiety compared to the control group receiving standard care. These outcomes will be measured immediately following the intervention (post-test 1) and at one-month follow-up (post-test 2).
Pilot Study The pilot study was conducted as a two-centre, two-arm cluster randomised controlled trial with a pre-test-post-test design and a 1:1 allocation ratio. Randomisation was performed at the school (cluster) level to minimise contamination. The pilot phase was implemented from 28 April to July 2025. Randomised Controlled Trial (RCT) The full-scale randomised controlled trial expanded to a multi-centre design involving five centres, maintaining a two-arm cluster randomised structure with school-level allocation. The RCT commenced in September 2025 and is currently ongoing.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
680
The INSPIRE intervention is an 8-week school-based program aimed at enhancing adolescent mental health, attitudes towards mental health and help-seeking behaviors, mental health literacy, resilience and addressing depression and anxiety. Trained school counsellors deliver this structured curriculum using comprehensive materials including lesson plans, activities, and visual aids. the program provides supplementary resources for both participating students and their parents .
Bandung City Education Office and Junior high schools (Sekolah Menengah Pertama)
Bandung, West Java, Indonesia
Adolescents' mental health knowledge
13-item mental health knowledge scale. Total scores range from 0 to 13, with higher scores indicating better mental health knowledge.
Time frame: Immediately following the intervention (post-test 1)
Adolescents' mental health knowledge
13-item mental health knowledge scale. Total scores range from 0 to 13, with higher scores indicating better mental health knowledge.
Time frame: At one-month follow-up (post-test 2).
Adolescents' attitudes towards mental health
12-item attitude toward mental health scale. Scores range from 12 to 60, with higher scores indicating more positive attitudes.
Time frame: immediately following the intervention (post-test 1)
Adolescents' attitudes towards mental health
12-item attitude toward mental health scale. Scores range from 12 to 60, with higher scores indicating more positive attitudes.
Time frame: At one-month follow-up (post-test 2).
Adolescents' attitudes toward help-seeking behaviors
5-item attitude toward mental help-seeking behaviors questionnaire. Scores range from 5 to 15, with higher scores indicating more positive attitudes toward help-seeking behaviors.
Time frame: Immediately following the intervention (post-test 1)
Adolescents' attitudes toward help-seeking behaviors
5-item attitude toward mental help-seeking behaviors questionnaire. Scores range from 5 to 15, with higher scores indicating more positive attitudes toward help-seeking behaviors.
Time frame: At one-month follow-up (post-test 2).
Adolescents' mental health literacy
the 50-item Knowledge and Attitudes to Mental Health Scales, with total scores ranging from 0 to 200. Higher scores indicated higher mental health literacy.
Time frame: Immediately following the intervention (post-test 1)
Adolescents' mental health literacy
the 50-item Knowledge and Attitudes to Mental Health Scales, with total scores ranging from 0 to 200. Higher scores indicated higher mental health literacy.
Time frame: At one-month follow-up (post-test 2).
Adolescents' resilience
the nine-item resilience evaluation scale, with the total scores ranging from 0 to 36. Higher scores indicated higher psychological resilience.
Time frame: Immediately following the intervention (post-test 1)
Adolescents' resilience
the nine-item resilience evaluation scale, with the total scores ranging from 0 to 36. Higher scores indicated higher psychological resilience.
Time frame: At one-month follow-up (post-test 2).
Adolescents' depression
the nine-item Patient Health Questionnaire, with total scores ranging from 0 to 27. Higher scores indicate more severe depressive symptoms.
Time frame: Immediately following the intervention (post-test 1)
Adolescents' depression
the nine-item Patient Health Questionnaire, with total scores ranging from 0 to 27. Higher scores indicate more severe depressive symptoms.
Time frame: At one-month follow-up (post-test 2).
Adolescents' anxiety
the 7-item Generalized Anxiety Disorder scale, with total scores ranging from 0 to 21. Higher scores indicate more severe anxiety symptoms.
Time frame: Immediately following the intervention (post-test 1)
Adolescents' anxiety
the 7-item Generalized Anxiety Disorder scale, with total scores ranging from 0 to 21. Higher scores indicate more severe anxiety symptoms.
Time frame: At one-month follow-up (post-test 2).
Parents' mental health knowledge
13-item mental health knowledge scale. Total scores range from 0 to 13, with higher scores indicating better mental health knowledge.
Time frame: Immediately following the intervention (post-test 1)
Parents' mental health knowledge
13-item mental health knowledge scale. Total scores range from 0 to 13, with higher scores indicating better mental health knowledge.
Time frame: At one-month follow-up (post-test 2).
Parents' attitudes towards mental health
12-item attitude toward mental health scale. Scores range from 12 to 60, with higher scores indicating more positive attitudes.
Time frame: immediately following the intervention (post-test 1)
Parents' attitudes towards mental health
12-item attitude toward mental health scale. Scores range from 12 to 60, with higher scores indicating more positive attitudes.
Time frame: At one-month follow-up (post-test 2).
Parents' attitudes toward help-seeking behaviors
5-item attitude toward mental help-seeking behaviors questionnaire. Scores range from 5 to 15, with higher scores indicating more positive attitudes toward help-seeking behaviors.
Time frame: Immediately following the intervention (post-test 1)
Parents' attitudes toward help-seeking behaviors
5-item attitude toward mental help-seeking behaviors questionnaire. Scores range from 5 to 15, with higher scores indicating more positive attitudes toward help-seeking behaviors.
Time frame: At one-month follow-up (post-test 2).
Parents' mental health literacy
The 16-item Mental Health Literacy Questionnaire, with total scores ranging from 16 to 80. Higher scores indicated higher mental health literacy.
Time frame: Immediately following the intervention (post-test 1)
Parents' mental health literacy
The 16-item Mental Health Literacy Questionnaire, with total scores ranging from 16 to 80. Higher scores indicated higher mental health literacy.
Time frame: At one-month follow-up (post-test 2).
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