Universal school-based intervention: personal competence among public school children.

Abstract

Childhood adversities profoundly affect mental and physical well-being. Effective psychosocial interventions in schools are crucial for mitigating adversities' impacts. Despite availability, many children lack access to those interventions in low-income countries. This study evaluates a universal school-based intervention in Lebanon for children, including refugees, aimed at improving personal competence and reducing mental health symptoms including anxiety, depression, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder. The study involved 1,920 Lebanese and Syrian children in grades 4 to 7, attending public schools in Lebanon. The program comprised 13 sessions administered in classrooms by teachers supervised by fieldworkers. Data collection included pre- and post-intervention assessments using standardized measures to evaluate outcomes. We used linear mixed models to test for intervention effect. Moderators such as childhood adversity, positive home environment, and environmental sensitivity were also tested using three-way interaction. Our intervention led to significant improvements in personal competence and secondary outcomes such as depression, anxiety, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder symptoms. Childhood adversity and environmental sensitivity influenced intervention effects on some secondary outcomes. However, personal competence improvements were consistent across all student subgroups, highlighting the intervention's broad efficacy, even among students with various risk or protective factors. Our study emphasizes the significance of school-based interventions for addressing childhood personal competence and mental health symptoms, especially in low-income countries with limited access to mental health services.