The Saving and Empowering Young Lives in Europe (SEYLE) Randomized Controlled Trial (RCT): methodological issues and participant characteristics

BackgroundMental health problems and risk behaviours among young people are of great public health concern. Consequently, within the VII Framework Programme, the European Commission funded the Saving and Empowering Young Lives in Europe (SEYLE) project. This Randomized Controlled Trial (RCT) was conducted in eleven European countries, with Sweden as the coordinating centre, and was designed to identify an effective way to promote mental health and reduce suicidality and risk taking behaviours among adolescents.ObjectiveTo describe the methodological and field procedures in the SEYLE RCT among adolescents, as well as to present the main characteristics of the recruited sample.MethodsAnalyses were conducted to determine: 1) representativeness of study sites compared to respective national data; 2) response rate of schools and pupils, drop-out rates from baseline to 3 and 12 month follow-up, 3) comparability of samples among the four Intervention Arms; 4) properties of the standard scales employed: Beck Depression Inventory, Second Edition (BDI-II), Zung Self-Rating Anxiety Scale (Z-SAS), Strengths and Difficulties Questionnaire (SDQ), World Health Organization Well-Being Scale (WHO-5).ResultsParticipants at baseline comprised 12,395 adolescents (M/F: 5,529/6,799; mean age=14.9±0.9) from Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain. At the 3 and 12 months follow up, participation rates were 87.3% and 79.4%, respectively. Demographic characteristics of participating sites were found to be reasonably representative of their respective national population. Overall response rate of schools was 67.8%. All scales utilised in the study had good to very good internal reliability, as measured by Cronbach’s alpha (BDI-II: 0.864; Z-SAS: 0.805; SDQ: 0.740; WHO-5: 0.799).ConclusionsSEYLE achieved its objective of recruiting a large representative sample of adolescents within participating European countries. Analysis of SEYLE data will shed light on the effectiveness of important interventions aimed at improving adolescent mental health and well-being, reducing risk-taking and self-destructive behaviour and preventing suicidality.Trial registrationUS National Institute of Health (NIH) clinical trial registry (NCT00906620) and the German Clinical Trials Register (DRKS00000214).

[1]  D. Goldston,et al.  Interventions for suicidal youth: a review of the literature and developmental considerations. , 2009, Suicide & life-threatening behavior.

[2]  C. Brindis,et al.  Health of adolescents and young adults: trends in achieving the 21 Critical National Health Objectives by 2010. , 2011, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[3]  Laura Kann,et al.  Methodology of the youth risk behavior surveillance system. , 2004, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[4]  R. Kessler,et al.  National comorbidity survey replication adolescent supplement (NCS-A): I. Background and measures. , 2009, Journal of the American Academy of Child and Adolescent Psychiatry.

[5]  M. Kaess,et al.  STUDY PROTOCOL Open Access Study protocol Saving and Empowering Young Lives in Europe (SEYLE): a randomized controlled trial , 2022 .

[6]  B. Halpern-Felsher,et al.  Influence of physician confidentiality assurances on adolescents' willingness to disclose information and seek future health care. A randomized controlled trial. , 1997, JAMA.

[7]  C. Currie,et al.  Adolescent health in the 21st century , 2015, The journal of the Royal College of Physicians of Edinburgh.

[8]  L. Kann,et al.  Methodology of the Youth Risk Behavior Surveillance System--2013. , 2013, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[9]  E. Sponheim,et al.  A randomized controlled trial of preschool-based joint attention intervention for children with autism. , 2012, Journal of child psychology and psychiatry, and allied disciplines.

[10]  C. Kieling,et al.  Child and adolescent mental health worldwide: evidence for action , 2011, The Lancet.

[11]  Jason L. Horowitz,et al.  Prevention of depressive symptoms in adolescents: a randomized trial of cognitive-behavioral and interpersonal prevention programs. , 2007, Journal of consulting and clinical psychology.

[12]  K. Swartz,et al.  The Effectiveness of a School-Based Adolescent Depression Education Program , 2010, Health education & behavior : the official publication of the Society for Public Health Education.

[13]  Patricia Cohen,et al.  Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. , 2002, Archives of general psychiatry.

[14]  H Meltzer,et al.  The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version , 2003, International review of psychiatry.

[15]  L. Cronbach Coefficient alpha and the internal structure of tests , 1951 .

[16]  Christian Haring,et al.  Suicide prevention for youth - a mental health awareness program: lessons learned from the Saving and Empowering Young Lives in Europe (SEYLE) intervention study , 2012, BMC Public Health.

[17]  L. Jaycox,et al.  A school-based mental health program for traumatized Latino immigrant children. , 2003, Journal of the American Academy of Child and Adolescent Psychiatry.

[18]  M. Weissman,et al.  The NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study: background and methodology. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[19]  W W Zung,et al.  A rating instrument for anxiety disorders. , 1971, Psychosomatics.

[20]  G. Canino,et al.  A study of disruptive behavior disorders in Puerto Rican youth: I. Background, design, and survey methods. , 2006, Journal of the American Academy of Child and Adolescent Psychiatry.

[21]  A. Beck,et al.  Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. , 1996, Journal of personality assessment.

[22]  T. Dishion,et al.  An adaptive approach to family intervention: linking engagement in family-centered intervention to reductions in adolescent problem behavior. , 2007, Journal of consulting and clinical psychology.

[23]  M. Elliott,et al.  A mental health intervention for schoolchildren exposed to violence: a randomized controlled trial. , 2003, JAMA.

[24]  Jami F. Young,et al.  Preventing depression: a randomized trial of interpersonal psychotherapy‐adolescent skills training , 2010, Depression and anxiety.

[25]  R. Goodman,et al.  Psychometric properties of the strengths and difficulties questionnaire. , 2001, Journal of the American Academy of Child and Adolescent Psychiatry.

[26]  C. Brindis,et al.  A midcourse review of the healthy people 2010: 21 critical health objectives for adolescents and young adults. , 2008, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[27]  Han-Yong Jung,et al.  Informed Consent in Psychiatry , 2013 .

[28]  B. Primack The WHO-5 Wellbeing index performed the best in screening for depression in primary care , 2003, ACP journal club.

[29]  R. Engels,et al.  A randomized controlled trial testing the effectiveness of a universal school-based depression prevention program 'Op Volle Kracht' in the Netherlands , 2012, BMC Public Health.

[30]  S. Galea,et al.  Participation rates in epidemiologic studies. , 2007, Annals of epidemiology.

[31]  Neal Halfon,et al.  Life course health development: an integrated framework for developing health, policy, and research. , 2002, The Milbank quarterly.

[32]  Golda S. Ginsburg,et al.  School-based treatment for anxious african-american adolescents: a controlled pilot study. , 2002, Journal of the American Academy of Child and Adolescent Psychiatry.

[33]  R. Viner,et al.  Policy responses to multiple risk behaviours in adolescents. , 2012, Journal of public health.

[34]  C. Brindis,et al.  The health status of young adults in the United States. , 2006, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[35]  Melanie Nind,et al.  Mental health promotion and problem prevention in schools: what does the evidence say? , 2011, Health promotion international.

[36]  Amanda C. Gottschall,et al.  Randomized trial of a broad preventive intervention for Mexican American adolescents. , 2012, Journal of consulting and clinical psychology.