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Saving and Empowering Young Lives in Europe: Promote health through prevention of risk-taking and self-destructive behaviors

Periodic Report Summary - SEYLE (Saving and empowering young lives in Europe: promote health through prevention of risk-taking and self-destructive behaviors)

'Saving and empowering young lives in Europe' (SEYLE) is a mental health promoting programme for adolescents in European schools: http://www.seyle.org. The programme involves 11 000 pupils recruited from randomised schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the coordinating centre. Its main objectives are to lead adolescents to better mental health through decreased risk-taking and suicidal behaviours, to evaluate outcomes of different preventive programmes and to recommend effective culturally-adjusted models for promoting adolescent mental health in different European countries.

Each country performs three active interventions and one minimal intervention in a control group. The active interventions include gatekeeper training (QPR), awareness training on mental health promotion for adolescents (awareness), and screening for at-risk adolescents by health professionals (ProfScreen). Consistent with the timeframe of the interventions, evaluation instruments were developed for administration at baseline, 3-month follow-up and 12-month follow-up for pupils, teachers, school staff and professionals to assess their respective responses to the different interventions of the SEYLE project. Supplemental assessment instruments were also designed to evaluate intervention quality control, participant satisfaction, public health system referrals, and the intervention itself. Pupil questionnaires were constructed with validated scales and administered at each assessment to determine over time the impact of the different interventions on changing adolescent behaviours and improving their mental health.

Interventions have been developed by experts in the field of child psychiatry, anthropology and suicidology and have been implemented in 8 SEYLE countries thus far producing baseline data on nearly 9 000 school-based adolescents. Moreover, all SEYLE centres have applied and obtained ethical approval for SEYLE.

Because the SEYLE study is a randomised controlled trial, it has been registered at the National Institute of Health (NIH) clinical trial registry (NCT00906620), as well as the German Clinical Trials Register (DRKS00000214), and its methodology has been published in BMC-Public Health (Wasserman et al., 2010).

SEYLE materials (evaluation instruments and prevention kits) were originally developed in English and later translated into nine languages. The translation scheme and cultural adaptation protocol were collectively formulated to run simultaneously and were distributed to all centres. A systematic assessment of the content for cultural appropriateness was performed. If discrepancies were detected, consultation with a cultural linguistic advisor was sought.

Standardised encoding frames for data entry have also been developed in English and tested. The SPSS encoding frame is accompanied by data entry instructions and encoding documentation to guarantee unequivocal understanding and interpretation. Quality control procedures have been designed and implemented at each participating centre. Sites that have finalised (or started) baseline data collection have entered the data into the local epidemiological database according to the coding documentation. Data collection and analysis are ongoing.

In several countries, it is worth noting that initial analysis indicates that risk behaviours among adolescents are much higher than previously estimated. In addition, SEYLE has been disseminated throughout Europe in the form of media exposure, presentations at international congresses, and collaborative efforts with local policy-makers. The future impact and results from SEYLE are expected to add vital understanding of unhealthy behaviours in adolescents, identifying the most cost-effective intervention strategy and promoting mental health.

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