JMIR Publications

ABSTRACT

Background:

Colombia has a long history of an armed conflict that has severely affected communities with forced internal displacement and violence. Victims of violence and armed conflicts have higher rates of mental health disorders, and children and adolescents are particularly affected. However, the mental health needs of this population are often overlooked, especially in Low- and Middle-Income countries (LMICs), where scarcity of resources exacerbates the problem that has been further compounded by the COVID-19 global pandemic. Thus, special attention should be placed on the development of interventions that target this population.

Objective:

Our research aims to adapt an existing patient-centred digital intervention called DIALOG+ from a clinical to an educational setting utilising stakeholders (teachers and students) perspectives. We aim to evaluate the feasibility and acceptability of implementing this intervention as a tool for the identification and mobilisation of personal and social resources to mitigate the impact of social difficulties and to promote mental wellbeing.

Methods:

We will conduct an exploratory mixed-methods study in public schools of post-conflict areas in Tolima, Colombia. The study consists of three phases: adaptation, exploration, and consolidation of the DIALOG+ tool. The adaptation phase will identify possible changes that the intervention requires based on data from focus groups with teachers and students. The exploration phase will be an exploratory cluster randomised trial with teachers and school counsellors to assess the acceptability and feasibility of DIALOG+ for adolescents in school settings. Adolescents´ data about mental health symptoms and wellness will be collected before and after the DIALOG+ implementation. As part of this phase, teachers or counsellors who were part of the intervention group will share their opinions through the “think aloud” methodology. Lastly, the consolidation phase consists of two focus groups with teachers and students to discuss their experiences and to understand acceptability.

Results:

Study recruitment was completed in March 2022 and follow up is anticipated to last through November 2022.

Conclusions:

This feasibility study will evaluate the acceptability and feasibility of DIALOG+ for adolescents in post-conflict school settings in Colombia. The use of this technology supported tool aims to support interactions between teachers or counsellors and students and to provide an effective student-centred communication guide. This is an innovative approach in both the school and the post-conflict contexts that could help to improve the mental health and wellness of adolescents in vulnerable zones from Colombia. Subsequent studies will be needed to evaluate the effectiveness of DIALOG+ in an educational context as a viable option to reduce the gap and inequities of mental health care access. Clinical Trial: The study has been prospectively registered on ISRCTN, ISRCTN14396374 https://doi.org/10.1186/ISRCTN14396374