In Phase 1, the PLH for Parents and Teens program and the Helping Adolescents Thrive (HAT) Comics were adapted to local contexts and languages through feedback from advisory focus groups, expert interviews, and input from program developers as well as clinical experts in the consortium. Various other materials essential for Phase 1 were prepared and translated, including ethical forms, informed consents, assessments, focus group/interview guides, and recruitment materials. The adapted program was pilot tested among 64 adolescents aged 10-14 years and their caregivers in North Macedonia and Moldova. Based on findings from Phase 1, adjustments were made to the intervention content, the three intervention components (buddy, mental health, and incentives) and the assessment measures for Phase 2.
Phase 2 implemented the optimized intervention through a multi-country randomized factorial trial with an embedded process evaluation, assessing implementation, effectiveness, and cost among over 650 families. Primary outcomes included adolescent internalizing problems, social support, family functioning, and program attendance, while secondary outcomes examined broader adolescent and caregiver mental health, as well as implementation and cost indicators. Post-program focus groups and data analyses informed key adaptations to the intervention content, informed consent forms, and assessment tools. The FLOURISH Meetings in June & September 2025 supported planning for Phase 3.
Phase 3 (ongoing): Phase 3 aims to test the overall effectiveness, cost-effectiveness and scalability of the intervention program with a randomized trial. Enrolment started at the end of October.
