SEYLE - Saving and Empowering Young Lives in Europe
The Saving and Empowering Young Lives in Europe (SEYLE) is a mental health promoting programme for adolescents in European schools. The programme involved adolescents recruited from randomized schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the coordinating centre.
SEYLEs main objectives are to lead adolescents to better mental health through decreased risk-taking and suicidal behaviours. Outcomes of different preventive programmes are evaluated and culturally-adjusted models are established for promoting adolescent mental health in different European countries.
Each participating 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). Structured questionnaires were developed and administered to different target groups (pupils, teachers, school staff, professionals) at baseline, with 3-month and 12-month follow-ups to examine and compare the effects of the interventions.
Consistent with 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 could be administered in at each assessment to determine over time the impact of the different interventions on changing adolescent behaviours and improving their mental health. Upon their completion and prior to the start of the interventions, the evaluation instruments were distributed to all SEYLE centres for review. Each centre provided detailed comments on how to improve the the accuracy and utility of the questionnaires, and these suggestions were then integrated into the instruments to formulate a final version.
The final version of instruments were pilot tested in several EU partner countries to establish a timeline for completion of the self-administered questionnaires and to receive input from the target groups. The results and comments were incorporated into the final version of the SEYLE questionnaire. This was then made available for evaluation by the local ethics committees
Independent ethics advisor
An independent ethics advisor supervised the implementation of the SEYLE project overall in order to ensure maximum protection of vulnerable individuals such as adolescents and to identify any sensitive issues. Each participating centre submitted an application to their local ethics committee before performing any type of SEYLE intervention in their respective country. A protocol comprising timelines, milestones and outcomes for the ethics committee application process was distributed to all the centres. Templates for consent forms for pupils and parents and data protection forms were disseminated to all SEYLE centres. Procedures for coding pupil data anonymously were included as part of the data collection procedures. All evaluation instruments and prevention kits were translated into the appropriate languages and culturally adapted, and then submitted for local ethics review. Support was provided to all SEYLE centres by the Hungarian and Spanish centres, as well as the coordinating centre in Sweden. Eight out of eleven countries received ethics approval on the first submission, with minor comments and/or requests for clarifications. The SEYLE centres in France, Austria and Slovenia were required to submit supplemental information before approval was granted. The main concerns raised by the local ethics committees were about the potentially sensitive items in the questionnaire on topics such as religion, sexuality and discrimination. However, after the supplemental information and explanation was submitted, the remaining three countries obtained ethics approval. The coordinating centre worked with each individual centre to provide official documents, address specific ethical concerns, and to maintain high ethical standards throughout the entire programme. It was therefore possible to use the same questionnaire in all countries participating in SEYLE.
SEYLE materials (evaluation instruments & prevention kits) were originally developed in English and later translated into the following languages: German, Gaelic (Irish), Estonian, French, Hungarian, Hebrew, Italian, Romanian, Slovenian and Spanish. Translation coordinators were elected in each participating country by the respective site leader. All site leaders were requested to implement the cultural adaptation protocol during the translation process and pilot testing. Focus groups were developed in each participating country to facilitate open discussions and feedback of cultural adaptability of SEYLE materials. A systematic assessment of the content for cultural appropriateness was performed. If discrepancies were detected, consultation with a cultural linguistic advisor was sought. Based on those results, items were incorporated into the final versions accordingly.
A comprehensive epidemiological database regarding mental health, suicidal behaviour and at risk-behaviours of European adolescents has been collected within the framework of the SEYLE project. The database contains information regarding 12395 subject with age comprised between 14 and 17.
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