Outcome | Denominator used for analysis | Control Condition (no, percentages or mean score) | Intervention Condition (no, percentages, or mean score) | Immediate effect of classroom sensitisation (intervention) | Continued effect of classroom sensitisation (intervention) | Effect of time | |
Period 2 | Period 3 | ||||||
Primary outcome | |||||||
Referral proportion† | 3587 students | 55 (1.5%) | 780 (21.7%) | OR=111.36*** (95% CI 35.56 to 348.77; p<0.001) | OR=5.80** (95% CI 1.33 to 25.29; p=0.02) | OR=0.12** (95% CI 0.03 to 0.49, p=0.003) | OR=0.21** (95% CI 0.05 to 0.93, p=0.04) |
Secondary outcomes‡ | |||||||
Eligible-proportion of referred adolescents† | 835 referred students§ | 9 (28.1% of 32 trial participants)¶ | 185 (32.0% of 578 trial participants)¶ | OR=0.27 (95% CI 0.02 to 3.11, p=0.29) | OR=0.16 (95% CI 0.01 to 2.30, p=0.18) | OR=5.52 (95% CI 0.55 to 55.8, p=0.15) | OR=4.5 (95% CI 0.40 to 50.44, p=0.22) |
Eligible-proportion of all students† | 3587 students§ | 9 (0.3%) | 185 (5.2%) | OR=52.39*** (95% CI 12.49 to 219.66, p<0.001) | OR=2.25 (95% CI 0.34 to 14.96, p=0.40) | OR=0.30 (95% CI 0.04 to 2.51, p=0.27) | OR=0.42 (95% CI 0.05 to 3.86, p=0.45) |
Exploratory outcomes | |||||||
Severity of mental health symptoms†† (total difficulties score of SDQ- continuous outcome) | 835 referred students‡‡ | Mean score=17.81 (95% CI 15.64 to 19.98)§§ | Mean score=17.63 (95% CI 17.18 to 18.08)§§ | β=−1.89* (95% CI −3.78 to 0.01, p=0.05) | β=−2.45 (95% CI −5.69 to 0.79, p=0.14) | β=2.39** (95% CI 0.06 to 4.72, p=0.04) | β=1.18 (95% CI −1.35 to 3.72, p=0.36) |
Internalising symptoms subscale of SDQ†† | 835 referred students‡‡ | Mean score=10.31 (95% CI 9.12 to 11.50)§§ | Mean score=9.06 (95% CI 8.78 to 9.33)§§ | β=−2.70*** (95% CI −3.33 to −2.08, p<0.001) | β=−3.68*** (95% CI −5.24 to −2.11, p<0.001) | β=1.81*** (95% CI 0.73 to 2.89, p=0.001); | β=1.42** (95% CI 0.2 to 2.64, p=0.02) |
Externalising symptoms subscale of SDQ†† | 835 referred students‡‡ | Mean score=7.50 (95% CI 6.28 to 8.74)§§ | Mean score=8.57 (95% CI 8.31 to 8.83)§§ | β=0.82 (95% CI −0.79 to 2.43, p=0.32) | β=1.28 (95% CI −0.91 to 3.48, p=0.25) | β=0.68 (95% CI −1.06 to 2.42, p=0.44) | β=−0.16 (95% CI −1.97 to 1.66, p=0.87) |
β, Population averaged regression coefficients describing the mean change in the response variable for every 1- unit of change in the predictor variable.
***Results significant with p<0.0001, **results significant at p<0.05, *results trending to be statistically significant.
†Binary outcome, GEE model specified Binomial family distribution of the response variable, logit link function and independent correlation structure as the GEE model did not converge with exchangeable correlation structure with robust SE type.
‡The secondary outcome pertaining to self-referral proportion was not analysed using GEE owing to very few cases of non-self-referrals (21 referrals by teachers).
§Analysed after multiple imputations using chained equations were done for the missing data of 225 students related to mental health assessments.
¶Denominator =610 trial participants for whom complete data for the outcome were available.
††Continuous outcome, GEE model specified Gaussian family distribution of the response variable, identity link function and exchangeable correlation structure with robust SE type.
‡‡Analysed after multiple imputations using chained equations were done for the missing data of 226 students related to mental health assessments.
§§Denominator=609 trial participants for whom complete data for the outcome were available.
GEE, generalised estimating equations; SDQ, Strengths and Difficulties Questionnaire.