Effectiveness of an intervention package to reduce anxiety among children aged 13-15 years attending Sinhala medium government schools in Colombo district: A Cluster Randomized trial

INTERVENTION: • One educational zone out of four educational zones in Colombo district will be selected as the study setting to carry out the study by drawing lots. • Sinhala medium schools in the selected zone will be stratified according to the functional types; Class 1AB , 1C and type 2. • 14 Schools will be selected and out of those schools, number of schools from each strata will be proportionately to the student population in each strata e.g. 1AB 40% ‐ 6 schools 1C 30%‐4 schools Type 2 30%‐ 4 Schools • Stipulated number of schools for each stratum will be selected randomly. • Schools in each strata will be randomized to study and control arm. • From randomized each school two classes will be selected randomly from grade 8,9,10 (grades which has the study population)(Each class with 30 students) • Teachers of the selected classes in the intervention arm will be trained to deliver the intervention package by a team which includes a consultant psychiatrist by conducting two half day training sessions on what is anxiety, how to identify anxiety and measures to reduce anxiety among children Parents of the children in intervention arm will be educated simultaneously by using materials such as e.g. leaflets that will be developed by panel of experts after pre testing them Intervention will be delivered as lecture discussion, role plays, relaxation exercises, home work It consists of 8 sessions (30 minutes per week for 8 week in a schedule agreed by school authorities in intervention arm ) All the selected classes(i.e. whole class/universally) of the randomized schools into intervention arm will receive the intervention at school setting in following order: 1. Introduction to feelings 2. The relationship between thoughts and feelings 3. Learning to cope with worries – emotional recognition, relaxation and how to feel good 4. Learning to cope with worries – challenging negative/unhelpful t CONDITION: Mental Health PRIMARY OUTCOME: Change of anxiety level determined by comparison of scores obtained for SCARED tool before and after the intervention; SECONDARY OUTCOME: • Change of level of depression determined by scores obtained for DASS‐21 Depression tool ; ; • Change of level of self‐ esteem determined by ROSENBERG SELF‐ESTEEM SCALE ; ; INCLUSION CRITERIA: • Children aged 13‐15 years • Male and female • Attending Sinhala Medium government schools in Colombo district