Ahtisham Younas, Marty Lewis-Hunstiger
Creative Nursing: History and Future Directions
Creative nursing
depression anxiety increasingly prevalent adolescents brief educational workshops secondary schools trial investigated effectiveness brief accessible stress workshop programme 1618yearolds aimed investigate clinical effectiveness costeffectiveness discover cognitive behavioural therapy cbt workshop symptoms depression 1618yearolds 6 months compared treatmentasusual conducted multicentre cluster randomised controlled trial uk schools colleges sixth forms evaluate clinical effectiveness costeffectiveness brief cbt workshop discover compared treatmentasusual planned enrol 60 schools 900 adolescents using selfreferral system recruit participants schools randomised 11 ratio participants receive either discover workshop treatmentasusual stratified site balanced school size index multiple deprivation participants included 1618 years old attending full school year seeking help stress fluent english able provide written informed consent outcome assessors senior health economist senior statistician chief investigator masked people lived experience involved study primary outcome depression symptoms measured mood feelings questionnaire mfq 6month followup intentiontotreat population participants full covariate data trial registered isrctn registry isrctn90912799 111 schools invited participate study seven deemed ineligible 47 provide consent oct 4 2021 nov 10 2022 933 students 57 schools screened eligibility seven eligible inclusion 26 attend baseline meeting assessment resulting 900 adolescents participating study discover group included 443 participants 295 67 female 136 31 male treatmentasusual group included 457 participants 346 76 female 92 20 male 468 52 900 participants white overall age participants 172 years sd 06 873 97 adolescents followed intentiontotreat population primary intentiontotreat analysis n854 found adjusted mean difference mfq 206 95 ci 335 076 cohens d017 p00019 6month followup indicating clinical improvement discover group probability discover cost effective compared treatmentasusual ranged 61 78 20 000 30 000 per qualityadjusted lifeyear threshold nine adverse events two classified serious reported discover group 14 two classified serious reported treatmentasusual group findings indicate discover intervention modestly clinically effective economically viable could promising early intervention schools given importance addressing mental health needs early adolescent population additional research warranted explore intervention national institute health care research health technology assessment programme