Improving work-life balance among administrative officers in Catholic primary schools: Assessing the effect of a Christian religious rational emotive behavior therapy

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

BACKGROUND

There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma.

OBJECTIVES

To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low- and middle-income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021.

SELECTION CRITERIA

Randomized controlled trials (RCTs) of primary-level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs.

DATA COLLECTION AND ANALYSIS

Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random-effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post-intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2.

MAIN RESULTS

Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta-analyses) for inclusion. Nineteen RCTs were conducted in low-income countries, 27 in low-middle-income countries, 2 in middle-income countries, 58 in upper-middle-income countries and 7 in mixed settings. Eighty-three RCTs included adults and 30 RCTs included children. Cadres of primary-level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate-', 'low-', or 'very low-'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post-intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared to usual care: - probably slightly reduced anxiety symptoms (MD -0.14, 95% confidence interval (CI) -0.27 to -0.01; 1 trial, 158 participants) - may slightly reduce distress/PTSD symptoms (SMD -0.24, 95% CI -0.41 to -0.08; 4 trials, 722 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD -0.69, 95% CI -1.08 to -0.30; 4 trials, 223 participants) Indicated prevention, compared to usual care: - may reduce adverse events (1 trial, 547 participants) - probably slightly reduced functional impairment (SMD -0.12, 95% CI -0.39 to -0.15; 4 trials, 663 participants) Children Promotion/universal prevention, compared to usual care: - may improve the quality of life (SMD -0.25, 95% CI -0.39 to -0.11; 2 trials, 803 participants) - may reduce adverse events (1 trial, 694 participants) - may slightly reduce depressive symptoms (MD -3.04, 95% CI -6 to -0.08; 1 trial, 160 participants) - may slightly reduce anxiety symptoms (MD -2.27, 95% CI -3.13 to -1.41; 1 trial, 183 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD 0, 95% CI -0.16 to -0.15; 2 trials, 638 participants) - may slightly reduce anxiety symptoms (MD 4.50, 95% CI -12.05 to 21.05; 1 trial, 28 participants) - probably slightly reduced distress/PTSD symptoms (MD -2.14, 95% CI -3.77 to -0.51; 1 trial, 159 participants) Indicated prevention, compared to usual care: - decreased slightly functional impairment (SMD -0.29, 95% CI -0.47 to -0.10; 2 trials, 448 participants) - decreased slightly depressive symptoms (SMD -0.18, 95% CI -0.32 to -0.04; 4 trials, 771 participants) - may slightly reduce distress/PTSD symptoms (SMD 0.24, 95% CI -1.28 to 1.76; 2 trials, 448 participants).

AUTHORS' CONCLUSIONS

The evidence indicated that prevention interventions delivered through primary workers - a form of task-shifting - may improve mental health outcomes. Certainty in the evidence was influenced by the risk of bias and by substantial levels of heterogeneity. A supportive network of infrastructure and research would enhance and reinforce this delivery modality across LMICs.

Intervention for depression among undergraduate religious education students: A randomized controlled trial

BACKGROUND

This research was designed to investigate the management of depression among undergraduate religious education students and identify the research implications for school-based religious intervention.

METHODS

This research is a randomized controlled trial. The treatment condition had 34 undergraduate religious education students but 33 undergraduate religious education students were in the control condition. The treatment process involved a 12-week application of religious rational emotive behavior therapy (RREBT). With Beck's depression inventory, version 2 (BDI-II), data collection was made possible.

RESULTS

Compared to students in the control condition, undergraduate religious education students in the treatment condition demonstrated a significant drop in mean BDI-II scores at post-test (F [1, 65] = 592.043, P < .05, η2p = .90). The effect of RREBT among students in the treatment condition stayed consistent at 2 weeks follow-up (F [1, 65] = 786.396, P < .05, η2p = .92, ΔR2 = .922).

CONCLUSION

The effect of RREBT on depression treatment among undergraduate religious education students was positive and can be consistent. The study results underscore the importance of expanding this treatment approach for these undergraduate education students in Nigeria.

Rational emotive intervention for work-family conflict and female primary school teachers' well-being

Globally, work and family conflict has been investigated by many researchers. Yet there is an increased prevalence of work-family conflict and its influence on the well-being of the female teaching population, especially Nigerian primary school teachers. This incidence has kept a good proportion of schoolteachers vulnerable to health problems as well as affected their wellbeing. This study evaluates the effect of rational emotive behaviour therapy on improving the well-being of female teachers with irrational behaviours arising from the work-family conflict. This is a randomized study. A total of 69 female primary school teachers in Enugu state Nigeria who met the criteria for inclusion were used as the study participants. Three self-report measures (Work-Family Conflict questionnaire, Multidimensional Health States Scale-Short Form, and Teacher Irrational Belief Scale) were used to collect data. Repeated measures with analysis of variance (ANOVA) were used to determine the effects of the intervention. The findings of the study revealed that REBT had a significant effect on the well-being scores of Nigerian female primary school teachers with work-family conflict when compared to their counterparts in the no-intervention group at Time 2. In addition, the effect of REBT on improving well-being in female teachers with work-family conflict was significantly maintained at the follow-up measurements (Time 3). In conclusion, it is suggested that REBT is an effective intervention for moderating the effect of work-family conflict on the well-being of career female teachers. As such, cognitive behavioural therapists can further examine the effectiveness of REBT using other constructs and cultures.

Effect of cognitive behavioral active engagement training on test item construction skills among primary school teachers in Nigeria: Implication for educational policy makers

BACKGROUND

Most classroom teachers are weak in constructing test items for assessment of students. This study examined the effects of cognitive behavioral active engagement training on test items construction skills among primary school teachers in Nigeria.

METHODS

We adopted a randomized pretest-posttest control group design. A total of 148 participants served as the study sample. One instrument was used for data collection. The participants were administered the instrument at 4 different times. Test construction guide was employed to implement the training. Data analysis was completed using analysis of covariance.

RESULTS

The researchers found that cognitive behavioral active engagement training had a significant effect on participants' test items construction scores as measured by test construction skills inventory at posttest, first and second follow-up stages.

CONCLUSION

The researchers concluded that cognitive behavioral active engagement training is efficacious in the improvement of test items construction skills among primary school teachers in Nigeria.