Mental health problems are prevalent among African adolescents, but professional treatment capacity is limited. Shamiri, an efficient lay provider–delivered intervention, has significantly reduced depression and anxiety symptoms in previous randomized controlled trials (RCTs). This trial investigated effects of the full Shamiri intervention and its components (growth-only, gratitude-only, and values-only) against a study skills control. In a 5-group RCT with adolescents from Kenyan high schools, anxiety, depression, and well-being were self-reported through 8-month follow-up. The RCT occurred immediately after an unanticipated government-mandated COVID-19 shutdown forced 3 years of schoolwork into 2 years, escalating academic pressures. Participants (N = 1,252; 48.72% female) were allocated to: growth (n = 249), gratitude (n = 237), values (n = 265), Shamiri (n = 250), and study skills (n = 251) conditions. Longitudinal multilevel models showed that, across all conditions, anxiety scores significantly improved at midpoint ( = −0.847), end point ( = −2.948), 1-month ( = −1.587), 3-month ( = −2.374), and 8-month ( = −1.917) follow-ups. Depression scores also improved significantly at midpoint ( = −0.796), end point ( = −3.126), 1-month ( = −2.382), 3-month ( = −2.521), and 8-month ( = −2.237) follow-ups. Well-being scores improved significantly at midpoint ( = 1.73), end point ( = 3.44), 1-month ( = 2.21), 3-month ( = 1.78), and 8-month ( = 1.59) follow-ups. Symptom reduction with Shamiri matched that of pre–COVID-19 trials, but symptom reduction with study skills far outpaced that of trials before the COVID-19–related school shutdown (31% greater anxiety reduction and 60% greater depression reduction). Thus, in contrast to previous RCTs, this COVID-19–era trial showed no significant differences between outcomes in any intervention and active control groups. Our RCT conducted during a post–COVID-19 period of heightened academic pressure produced unexpected results. Improvements in youth-reported anxiety and depression were consistent with previous trials for Shamiri, but markedly larger than in previous trials for study skills. Control interventions teaching life skills may produce mental health benefits when they convey skills of particular contextual relevance. A large five-group randomized controlled trial involved comparing the Shamiri Intervention to its component interventions (growth mindset, gratitude, and values affirmation) and a study-skills control. In contrast to previous studies of Shamiri, similar effects were observed across all groups (p<.05). This trial was conducted right after an unanticipated government-mandated COVID shutdown forced three years of schoolwork into two. Benchmarking analyses against previous trials showed approximately equal effects of Shamiri over time, but a 31% greater anxiety reduction and 60% greater depression reduction for the study-skills condition; this highlights the potential of interventions teaching highly relevant life-skills for improving mental health. Five-Arm Shamiri Trial; ; PACTR202104716135752.

中文翻译：

---

在 COVID-19 大流行期间对肯尼亚青少年测试 Shamiri 干预措施及其组成部分：通用 5 组随机对照试验的结果


非洲青少年心理健康问题普遍存在，但专业治疗能力有限。 Shamiri 是一位高效的非专业医疗服务提供者提供的干预措施，在之前的随机对照试验 (RCT) 中显着减轻了抑郁和焦虑症状。该试验研究了全面的沙米里干预及其组成部分（仅增长、仅感恩和仅价值观）相对于学习技能控制的效果。在一项针对肯尼亚高中青少年的 5 组随机对照试验中，通过 8 个月的随访自我报告了焦虑、抑郁和幸福感。随机对照试验是在政府意外地强制实施的 COVID-19 停课迫使 3 年的学业变成 2 年、学业压力不断升级之后立即进行的。参与者（N = 1,252；48.72% 女性）被分配为：成长（n = 249）、感恩（n = 237）、价值观（n = 265）、沙米里（n = 250）和学习技能（n = 251）状况。纵向多水平模型显示，在所有条件下，焦虑评分在中点 ( = -0.847)、终点 ( = -2.948)、1 个月 ( = -1.587)、3 个月 ( = -2.374) 和 8 时显着改善- 月 ( = −1.917) 次随访。抑郁评分在中点 (= -0.796)、终点 (= -3.126)、1 个月 (= -2.382)、3 个月 (= -2.521) 和 8 个月 (= -2.237) 时也显着改善。 UPS。在中点 ( = 1.73)、终点 ( = 3.44)、1 个月 ( = 2.21)、3 个月 ( = 1.78) 和 8 个月 ( = 1.59) 随访时，幸福感得分显着改善。 Shamiri 的症状减轻效果与 COVID-19 之前的试验相当，但通过学习技能减轻症状的效果远远超过了与 COVID-19 相关的学校停课之前的试验（焦虑减少了 31%，抑郁减少了 60%）。 因此，与之前的随机对照试验相比，这项 COVID-19 时代的试验显示任何干预组和主动对照组的结果之间没有显着差异。我们在 COVID-19 后学术压力加大的时期进行的随机对照试验产生了意想不到的结果。青少年报告的焦虑和抑郁的改善与沙米里之前的试验一致，但明显大于之前学习技能的试验。当教授生活技能的控制干预措施传达特定情境相关的技能时，可能会产生心理健康益处。一项大型五组随机对照试验将沙米里干预与其组成部分干预（成长心态、感恩和价值观肯定）和学习技能控制进行比较。与 Shamiri 之前的研究相比，所有组中都观察到了类似的效果 (p<.05)。这项试验是在政府出乎意料地强制实施的新冠疫情停课迫使三年的学业变成两年之后进行的。对之前试验的基准分析显示，随着时间的推移，沙米里的效果大致相同，但在学习技能条件下，焦虑减少了 31%，抑郁减少了 60%；这凸显了教授与改善心理健康高度相关的生活技能的干预措施的潜力。五臂沙米里试验； ; PACTR202104716135752。