Evaluation of an intervention package to reduce occupational stress among secondary school teachers: a cluster randomized study

Introduction: Prevalence of occupational stress (OS) among seconda ry teachers in the district of Colombo, Sri Lanka was found to be 83.4% in 2017, indicating the need for an intervention t o prevent its effects. Objectives: To evaluate the effectiveness of an intervention to reduc e OS among secondary teachers in Sinhala medium government schools in the district of Colombo Methods: A cluster randomized trial (SLCTR/2019/017) used cluster s of 10 secondary schools in Colombo District, which were assigned randomly to intervention and control arms; each ar m had 300 teachers. A package of nine-sessions of cognitive behavioural (CB) and relaxation technique-based activities  designed through evidence generated in a systematic review was delivered as interactive group sessions over a period of si x months. Effectiveness of the intervention in reducing OS was assessed after four weeks using multivariate Generalized E stimating Equation analysis. Reducing psychological distress and adopting healthy lifestyles were assessed as secondary out comes of the intervention. Results: Intervention was significantly effective in reducing OS  (OR=0.3; 95% CI=0.2, 0.5), psychological distress (OR=0.03; 95% CI=0.01, 0.07) and smoking (OR=0.09; 95% CI= 0.01, 0.7) among the teachers. It also significantly increased the knowledge about OS (OR=0.6; 95% CI=0.5, 0.7), hea lthiness of diet (OR=0.3; 95% CI=0.2, 0.4), level of adequate physical activity (OR=3.2; 95% CI=2.1, 4.9) and effecti ve coping of OS (OR=0.2; 95% CI=0.17, 0.3). The relative risk reduction (RRR) of OS with the intervention remained at  22.6%, the absolute risk reduction (ARR) was 19.4% and the number needed to treat (NNT) was five. Conclusions & Recommendations: The intervention package wa s highly effective to reduce OS among secondary teachers and is recommended to be incorporated to the basic training  of teachers or implemented through the school health programme.