Okki Dhona Laksmita, Min-Huey Chung, Joseph Kondwani Banda, Yann-Yann Shieh, Sumarni Djaka Waluya, Sri Warsini, Pi-Chen Chang
{"title":"综述：针对自然灾害儿童和青少年幸存者的学校干预措施——随机对照试验的系统综述和荟萃分析。","authors":"Okki Dhona Laksmita, Min-Huey Chung, Joseph Kondwani Banda, Yann-Yann Shieh, Sumarni Djaka Waluya, Sri Warsini, Pi-Chen Chang","doi":"10.1111/camh.70029","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although post-disaster interventions can reduce mental health problems in children and adolescents, no systematic review and meta-analysis has synthesized the effects of school-based randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>This study assessed the effects of school-based RCTs on post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in children and adolescents (6-18 years of age) in post-natural disaster settings. Outcomes were evaluated immediately, and in the short term (<6 months) and long term (≥6 months) after the intervention. Eligible studies included RCTs. Seven databases and gray literature were searched through March 2025. Risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions vers. 6.2.</p><p><strong>Results: </strong>Thirteen studies (with 2418 participants) were included. School-based interventions showed significantly large effects on PTSD symptoms (g = -1.203, 95% confidence interval (CI) = -2.202 to -0.203), significant small effects on depression (g = -0.337, CI = -0.673 to -0.001) immediately after the intervention, with sustained medium effects at the short- and long-term follow-ups for PTSD symptoms, but not depression in the long term. Anxiety showed a significantly large immediate effect immediately after the intervention (g = -4.602, CI = -8.807 to 0.396). All tested moderator variables-including the intervention approach, control group type, intervention protocol (duration, length, total sessions), type of analysis, risk of bias, interventionist, country type, and publication time-significantly influenced immediate PTSD outcomes.</p><p><strong>Conclusion: </strong>School-based interventions are effective in reducing PTSD symptoms, depression, and anxiety in children and adolescents following natural disasters. The intervention format and implementation context matter. Future research should strengthen the evidence base for depression and anxiety outcomes and assess long-term effectiveness and scalability.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Review: School-based interventions for child and adolescent survivors of natural disasters - a systematic review and meta-analysis of randomized controlled trials.\",\"authors\":\"Okki Dhona Laksmita, Min-Huey Chung, Joseph Kondwani Banda, Yann-Yann Shieh, Sumarni Djaka Waluya, Sri Warsini, Pi-Chen Chang\",\"doi\":\"10.1111/camh.70029\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although post-disaster interventions can reduce mental health problems in children and adolescents, no systematic review and meta-analysis has synthesized the effects of school-based randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>This study assessed the effects of school-based RCTs on post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in children and adolescents (6-18 years of age) in post-natural disaster settings. Outcomes were evaluated immediately, and in the short term (<6 months) and long term (≥6 months) after the intervention. Eligible studies included RCTs. Seven databases and gray literature were searched through March 2025. Risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions vers. 6.2.</p><p><strong>Results: </strong>Thirteen studies (with 2418 participants) were included. School-based interventions showed significantly large effects on PTSD symptoms (g = -1.203, 95% confidence interval (CI) = -2.202 to -0.203), significant small effects on depression (g = -0.337, CI = -0.673 to -0.001) immediately after the intervention, with sustained medium effects at the short- and long-term follow-ups for PTSD symptoms, but not depression in the long term. Anxiety showed a significantly large immediate effect immediately after the intervention (g = -4.602, CI = -8.807 to 0.396). All tested moderator variables-including the intervention approach, control group type, intervention protocol (duration, length, total sessions), type of analysis, risk of bias, interventionist, country type, and publication time-significantly influenced immediate PTSD outcomes.</p><p><strong>Conclusion: </strong>School-based interventions are effective in reducing PTSD symptoms, depression, and anxiety in children and adolescents following natural disasters. The intervention format and implementation context matter. Future research should strengthen the evidence base for depression and anxiety outcomes and assess long-term effectiveness and scalability.</p>\",\"PeriodicalId\":49291,\"journal\":{\"name\":\"Child and Adolescent Mental Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Child and Adolescent Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/camh.70029\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child and Adolescent Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/camh.70029","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Review: School-based interventions for child and adolescent survivors of natural disasters - a systematic review and meta-analysis of randomized controlled trials.
Background: Although post-disaster interventions can reduce mental health problems in children and adolescents, no systematic review and meta-analysis has synthesized the effects of school-based randomized controlled trials (RCTs).
Methods: This study assessed the effects of school-based RCTs on post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety in children and adolescents (6-18 years of age) in post-natural disaster settings. Outcomes were evaluated immediately, and in the short term (<6 months) and long term (≥6 months) after the intervention. Eligible studies included RCTs. Seven databases and gray literature were searched through March 2025. Risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions vers. 6.2.
Results: Thirteen studies (with 2418 participants) were included. School-based interventions showed significantly large effects on PTSD symptoms (g = -1.203, 95% confidence interval (CI) = -2.202 to -0.203), significant small effects on depression (g = -0.337, CI = -0.673 to -0.001) immediately after the intervention, with sustained medium effects at the short- and long-term follow-ups for PTSD symptoms, but not depression in the long term. Anxiety showed a significantly large immediate effect immediately after the intervention (g = -4.602, CI = -8.807 to 0.396). All tested moderator variables-including the intervention approach, control group type, intervention protocol (duration, length, total sessions), type of analysis, risk of bias, interventionist, country type, and publication time-significantly influenced immediate PTSD outcomes.
Conclusion: School-based interventions are effective in reducing PTSD symptoms, depression, and anxiety in children and adolescents following natural disasters. The intervention format and implementation context matter. Future research should strengthen the evidence base for depression and anxiety outcomes and assess long-term effectiveness and scalability.
期刊介绍：
Child and Adolescent Mental Health (CAMH) publishes high quality, peer-reviewed child and adolescent mental health services research of relevance to academics, clinicians and commissioners internationally. The journal''s principal aim is to foster evidence-based clinical practice and clinically orientated research among clinicians and health services researchers working with children and adolescents, parents and their families in relation to or with a particular interest in mental health. CAMH publishes reviews, original articles, and pilot reports of innovative approaches, interventions, clinical methods and service developments. The journal has regular sections on Measurement Issues, Innovations in Practice, Global Child Mental Health and Humanities. All published papers should be of direct relevance to mental health practitioners and clearly draw out clinical implications for the field.
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