Short Video-Based Mental Health Intervention for Depressive Symptoms in Junior High School Students: A Cluster Randomized Controlled Trial

Yuting Yang; Hao Wang; Wen Sha; Xiaoqin Guo; Wei Deng; Jingyi Wang; Chaowei Fu

doi:10.2147/PRBM.S433467

Short Video-Based Mental Health Intervention for Depressive Symptoms in Junior High School Students: A Cluster Randomized Controlled Trial

Psychol Res Behav Manag. 2023 Oct 16:16:4169-4181. doi: 10.2147/PRBM.S433467. eCollection 2023.

Authors

Yuting Yang^#¹, Hao Wang^#¹, Wen Sha², Xiaoqin Guo³, Wei Deng¹, Jingyi Wang¹, Chaowei Fu¹

Affiliations

¹ School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China.
² Shanghai Municipal Center for Health Promotion, Shanghai, People's Republic of China.
³ Songjiang District Center for Health Promotion, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Digital interventions for adolescent mental health are emerging in high-income countries, but have faced challenges and are scarce in China. This study investigated the effect of a short video-based mental health intervention on depressive symptoms in Chinese adolescents.

Methods: A three-arm cluster randomized controlled trial was conducted in four junior high schools in Shanghai from December 2020 to December 2021 with the measurement at baseline, 6 months after study entry, and 12 months. Outcomes were collected by self-completed questionnaires administered by teachers masked to allocation. The primary outcome was depressive symptoms assessed by the Depression Self-Rating Scale for Children (DSRSC). Mixed effects models were used to compare psychologist-led intervention (n=428 students) and teacher-led intervention (n=385) including six short video-based sessions to usual school provision (n=751).

Results: Using intention-to-treat analyses, psychologist-led intervention showed more reduction in depressive symptoms compared to usual school provision at 6 months (coefficient -1.00, 95% CI -1.94 to -0.05), but not at 12 months. Using per-protocol analyses among participants who watched at least three video episodes, both psychologist-led (-1.14, -2.20 to -0.09) and teacher-led intervention (-1.23, -2.45 to -0.02) reduced depressive symptoms compared to usual school provision at 6 months, and the effect of teacher-led intervention persisted at 12 months (-1.58, -3.13 to -0.03). Further exploration found that compared with urban students, the between-group differences for depressive symptoms in rural students were more significant (p<0.05 for interaction) and the effects were maintained at 12 months.

Conclusion: The short video-based mental health intervention showed potential to reduce depressive symptoms among Chinese adolescents, and the effects were more significant if the minimum video viewing frequency was reached.

Keywords: adolescents; depressive symptoms; mental health; randomized controlled trial; short video-based intervention.

Grants and funding

This work was supported by the China Medical Board (grant number #22-472), Shanghai Health Commission (grant number 202240115), and Shanghai Pujiang Program (grant number 2020PJC005).