App-based guided problem-solving intervention for adolescent mental health: a pilot cohort study in Indian schools

Gonsalves, Pattie P; Hodgson, Eleanor Sara; Bhat, Bhargav; Sharma, Rhea; Jambhale, Abhijeet; Michelson, Daniel; Patel, Vikram

doi:10.1136/ebmental-2020-300194

Cited by 64Digital Mental Health InterventionsProblem Solving Skills DevelopmentMental Health Treatment and Access

App-based guided problem-solving intervention for adolescent mental health: a pilot cohort study in Indian schools

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Gonsalves, Pattie P, Hodgson, Eleanor Sara, Bhat, Bhargav, Sharma, Rhea, Jambhale, Abhijeet, Michelson, Daniel, Patel, Vikram·2021·Evidence Based Mental Health

DOI 10.1136/ebmental-2020-300194PMC PMC7958086

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Abstract

Background: This paper describes the pilot evaluation of ‘POD Adventures’, a lay counsellor-guided problem-solving intervention delivered via a smartphone app in Indian secondary schools. Objective: To test the feasibility and acceptability of POD Adventures for adolescents with a felt need for psychological support, and to explore the intervention’s effects on self-reported mental health symptoms, prioritised problems, stress and well-being. Methods: We used a mixed-methods pre-post cohort design. Participants were self-referred from grades 9–12 in two coeducational government-aided secondary schools in Goa, India. The intervention was delivered in two formats, ‘mixed’ (comprising individual and small group sessions) and ‘group’ (small group sessions only). Findings: 248 participants enrolled in the study and 230 (92.7%) completed the intervention. Outcomes at 4 weeks showed significant improvements on all measures that were maintained at 12 weeks. Large effects were observed on problem severity scores (4 weeks, d=1.47; 12 weeks, d=1.53) while small to moderate effects were seen on mental health symptoms, stress and well-being. 22 students completed qualitative interviews about their experience of the intervention. Participants found POD Adventures easy to use, engaging and helpful in solving their problems. They were satisfied with the guidance provided by the counsellor irrespective of delivery format. Conclusions: POD Adventures was feasible to deliver with guidance from lay counsellors in Indian schools, acceptable to participants and associated with large improvements in problem severity and mental health symptom severity. Clinical implications: POD Adventures has promise as an early intervention for adolescents with a felt need for psychological support in low-resource settings.

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An alternative digital format of problem solving proved to be feasible and acceptable with in-person guidance, but remote delivery was less viable.
“An alternative digital format of problem solving proved to be feasible and acceptable with in-person guidance, but remote delivery was less viable.”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [341]
The Conclusions report that POD Adventures was feasible and acceptable with counsellor guidance in Indian schools. The Methods describe school-based sessions, not remote delivery, and the Conclusions propose exploring remote delivery in future. The paper therefore does not support the claim that remote delivery was found less viable. (LLM, conf=0.90)
Experimental — accuracy not yet measured
The coach need not be a highly qualified therapist.
“we argue that the coach need not be a highly qualified therapist (Gonsalves et al., 2021; Kazdin, 2019).”
From Intervention for school anxiety and absenteeism in children (ISAAC): Co-designing a brief parent-focused intervention for emotionally-based school avoidance. (2024) · cites this paper as Gonsalves et al., 2021

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Decision: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R1/PR10
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Recommendation: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R1/PR9
Fernandes, D., D’Souza, E., Sambari, S., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr9
Review: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R1/PR8
Fernandes, D., D’Souza, E., Sambari, S., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr8
Review: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R1/PR7
Fernandes, D., D’Souza, E., Sambari, S., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr7
Author comment: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R1/PR6
Nadkarni, A. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr6
Decision: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R0/PR5
Fernandes, D., D’Souza, E., Sambari, S., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr5
Recommendation: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R0/PR4
Fernandes, D., D’Souza, E., Sambari, S., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr4
Review: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R0/PR3
Fernandes, D., D’Souza, E., Sambari, S., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr3
Review: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R0/PR2
Fernandes, D., D’Souza, E., Sambari, S., et al. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr2
Author comment: Experiences of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking: A Qualitative Study nested in the AMBIT trial from Goa, India. — R0/PR1
Nadkarni, A. (2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.51.pr1
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Pranjal, P., Singhal, V., Sarkar, S., & Aggarwal, T. (2024) · Advances in medical education, research, and ethics (AMERE) book series · doi:10.4018/979-8-3693-1178-3.ch009
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Additional file 3 of Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
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Additional file 6 of Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
Venturo-Conerly, K. E., Osborn, T. L., Wasil, A. R., Le, H., Corrigan, E., Wasanga, C., & Weisz, J. R. (2021) · Figshare · doi:10.6084/m9.figshare.17066050
Additional file 5 of Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
Venturo-Conerly, K. E., Osborn, T. L., Wasil, A. R., Le, H., Corrigan, E., Wasanga, C., & Weisz, J. R. (2021) · Figshare · doi:10.6084/m9.figshare.17066047
Additional file 4 of Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
Venturo-Conerly, K. E., Osborn, T. L., Wasil, A. R., Le, H., Corrigan, E., Wasanga, C., & Weisz, J. R. (2021) · Figshare · doi:10.6084/m9.figshare.17066044
Additional file 8 of Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
Venturo-Conerly, K. E., Osborn, T. L., Wasil, A. R., Le, H., Corrigan, E., Wasanga, C., & Weisz, J. R. (2021) · Figshare · doi:10.6084/m9.figshare.17066056
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Additional file 7 of Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
Venturo-Conerly, K. E., Osborn, T. L., Wasil, A. R., Le, H., Corrigan, E., Wasanga, C., & Weisz, J. R. (2021) · Figshare · doi:10.6084/m9.figshare.17066053
Additional file 2 of Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial
Venturo-Conerly, K. E., Osborn, T. L., Wasil, A. R., Le, H., Corrigan, E., Wasanga, C., & Weisz, J. R. (2021) · Figshare · doi:10.6084/m9.figshare.17066038
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Bhagat, L., Sharma, D., & Sharma, S. (2026) · Development · doi:10.1057/s41301-026-00492-8
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Gonsalves, P. P. (2023) · Sussex Research Online (University of Sussex)
Self-citation
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Michelson, D., Malik, K., Parikh, R., Weiss, H. A., Doyle, A. M., Bhat, B., Sahu, R., Chilhate, B., Mathur, S., Krishna, M., et al. (2020) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(20)30173-5 · Cited by 121 · see citing works
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Gonsalves, P. P., Hodgson, E. S., Kumar, A., Aurora, T., Chandak, Y., Sharma, R., Michelson, D., & Patel, V. (2019) · Frontiers in Public Health · doi:10.3389/fpubh.2019.00238 · Cited by 68 · see citing works
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Self-citation
Development of a transdiagnostic, low-intensity, psychological intervention for common adolescent mental health problems in Indian secondary schools
Malik, K., Krishna, M., Sharma, R., Mathur, S., Bhat, B., Parikh, R., Roy, K., Joshi, A., Sahu, R., Chilhate, B., et al. (2019) · Sussex Research Online (University of Sussex)
Self-citation

Authors: Gonsalves, P. P., Hodgson, E. S., Bhat, B., Sharma, R., Jambhale, A., Michelson, D., & Patel, V.
Affiliations: University of Sussex (GB)
Sangath (IN)
Harvard University (US)
Corresponding author: Gonsalves, Pattie P
ORCID: Gonsalves, Pattie P
Hodgson, Eleanor Sara
Bhat, Bhargav
Sharma, Rhea
Jambhale, Abhijeet
Michelson, Daniel
Patel, Vikram
Venue: Evidence Based Mental Health
Publisher: BMJ
Published: 2020-11-18
Volume: 24
Issue: 1
Pages: 11-18
ISSN: 1362-0347 (ISSN-L)
1468-960X
DOI: 10.1136/ebmental-2020-300194
PMC: PMC7958086
OpenAlex: W3104516396
Cited by: 64
References: 28
Citations by year: 2026: 2 · 2025: 7 · 2024: 14 · 2023: 17 · 2022: 12 · 2021: 12
FWCI: 9.26
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
Locations: Evidence-Based Mental Health (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Sussex Research Online (University of Sussex) (submittedVersion, cc-by)
Figshare (submittedVersion, cc-by)
Research Portal (King's College London) (submittedVersion, cc-by)
Greater South Information System
Funders: Wellcome Trust (106919/Z/15/Z)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: adolescent mental health, problem-solving intervention, mobile application, school-based mental health programs, stress, well-being, psychiatric symptoms, problem severity, feasibility and acceptability, resource-limited settings, high school students
MeSH terms: Adolescent, Humans, Mental Health, Pilot Projects, Schools, Cohort Studies, Mobile Applications

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App-based guided problem-solving intervention for adolescent mental health: a pilot cohort study in Indian schools

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