Project HASHTAG: Health Action in Schools for a Thriving Adolescent Generation
Medical Research Council
Stellenbosch University
Background. Adolescents suffer a high burden of disease, mostly injuries and mental disorders. Universal school interventions offer opportunities to address early symptoms and risk factors. We conducted a systematic review and meta-analysis of such interventions, finding that most are 'single-issue' interventions from high-income countries, focused on substances or violence. Aim. Project HASHTAG aims to address the evidence gap by developing and adapting a multicomponent gender-sensitive intervention in low- and middle-income countries targeting negative health outcomes by promoting positive mental health; preventing common mental disorders; and preventing risk behaviours in young at-risk adolescents. Methods. Project HASHTAG will comprise two strategies: 1) a school assessment, planning and action process, Thriving Environment in Schools (TES), to improve school climate; and 2) a group psychosocial intervention, Thrive Together (TT), to equip adolescents 11-12 years old with skills identified as effective components in reducing negative health outcomes. The study will be conducted in 2 low-resource settings in South Africa and Nepal. The development phase aims to co-produce a TES outline and TT draft, together with adolescents, parents, teachers, and other stakeholders in 2 schools per country. This will be achieved through focus groups, interviews and observations, to inform the work of an intervention development group. The aim of the feasibility phase is to assess the feasibility and acceptability of the TT and TES strategies, outcome measures, and intervention processes. To achieve this, we will implement and evaluate both strategies in 4 schools per country, using baseline and follow-up quantitative assessments to measure mental health and risk behaviour outcomes. Qualitative interviews and observations will be conducted to assess acceptability, feasibility, fidelity and barriers to the programme. Process data will be collected to assess feasibility.
3.1 Primary prevention interventions to modify behaviours or promote well-being / Research Grant