ALIVE: Improving Adolescent mentaL health by reducing the Impact of poVErty

Depression and anxiety are leading contributors to the burden of disease among adolescents in low- and middle-income countries (LMIC), and they disproportionally affect adolescents living in poverty.

Yet, the evidence base for interventions that effectively prevent depression and anxiety among adolescents living in poverty is weak.

One major shortcoming is that interventions often fail to address poverty-related social determinants of mental health and neuropsychological consequences of poverty (such as impaired self-regulation).

The aim of this study is to develop and pilot-test an intervention that equips adolescents with skills to escape poverty and strengthens self-regulation, thus preventing adolescent depression and anxiety in urban LMIC settings.The study objectives are to: (1) develop a theoretical model of the causal mechanisms linking poverty, self-regulation, and depression and anxiety among adolescents (age 10-19-years); (2) collaboratively develop a multi-component selective prevention intervention targeting self-regulation and skills for academic and employment success among adolescents at high risk of developing depression or anxiety living in urban poverty in Colombia, Nepal and South Africa; (3) adapt and validate key instruments to measure eligibility, implementation, mediators, and outcomes of the intervention; and (4) undertake a 4-arm pilot randomized controlled trial of the selective prevention intervention in each site.