INSPIRE: a pilot cluster randomised feasibility trial of a school-based mental health literacy programme for adolescents and parents in Indonesia.

Abstract

Background: This pilot study primarily aimed to evaluate the feasibility of conducting a cluster randomised controlled trial of the Integrated Network for Student Psychosocial Interventions, Resilience, and Education (INSPIRE) programme, including recruitment, retention, counsellor-led delivery, attendance, and completeness of outcome data. As a secondary aim, the study explored preliminary signals of change in adolescent mental health knowledge and related outcomes to inform the design of a future definitive trial.

Methods: Two-centre, two-arm cluster randomised controlled pilot trial with pretest and posttest design. Adolescents aged 13-15 years and their parents were recruited from public junior high schools in West Java, Indonesia. Two schools were randomly assigned to intervention or control groups using a computer-generated sequence. The eight-week INSPIRE programme, delivered by a school counsellor, included three joint sessions with parents and two home-based activities. Feasibility outcomes included recruitment, retention, intervention fidelity, attendance, and outcome data completeness. Preliminary signals of change were described at baseline and 2‑month follow-up.

Results: Recruitment achieved 74% of eligible adolescent-parent dyads (52/70). Retention was excellent, with 100% of adolescents and 96% of parents completing follow-up assessments, and outcome data were complete. Programme attendance was high (adolescents 91%; parents 79%), and the intervention was delivered as planned by a trained school counsellor, with minor scheduling adjustments for public holidays. Consistent with the primary feasibility objectives, indicators such as recruitment, retention, and delivery were favourable. As secondary findings, adolescents demonstrated preliminary signals of improvement in mental health knowledge and selected literacy domains. In contrast, parents showed gains in mental health knowledge and attitudes, with favourable trends in help-seeking attitudes observed across both groups.

Conclusion: INSPIRE demonstrated feasibility and acceptability, with preliminary signals supporting progression to a fully powered trial. The findings support its further evaluation in a fully powered cluster-randomised trial and its integration into school health programmes involving families and counsellors. Trial registration ClinicalTrials.gov (NCT06942637).