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Future Proofing Study: a cluster randomised controlled trial evaluating the effectiveness of a universal school-based
Aliza Werner-Seidler1,2, Andrew Mackinnon3, Philip J Batterham4
1Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia a.werner-seidler@blackdog.org.au.
BMJ Mental Health
|March 14, 2025
Summary
A school-based digital program (SPARX) did not reduce depression symptoms in students. Low engagement and inconsistent school support limited the effectiveness of this digital cognitive-behavioural intervention.
Area of Science:
- Mental Health Research
- Digital Health Interventions
- Adolescent Psychology
Background:
- School-based psychological prevention programs show potential for reducing depression.
- High-quality, large-scale trials are needed to validate these interventions.
- Digital cognitive-behavioural programs offer scalable solutions for mental health support.
Purpose of the Study:
- To evaluate the efficacy of the digital cognitive-behavioural program 'SPARX' delivered at scale in schools.
- To assess the impact of SPARX on depressive symptoms over a 12-month period.
- To examine secondary outcomes including anxiety, psychological distress, and insomnia.
Main Methods:
- A cluster randomised controlled trial involving 134 Australian schools and 6388 students.
- Intervention group received the SPARX app, control group received standard care.
- Outcomes assessed at baseline, 6 weeks, 6 months, and 12 months.
- Primary outcome: change in depressive symptoms from baseline to 12 months.
Main Results:
- No significant difference in depressive symptom reduction between the SPARX intervention and control groups at 12 months.
- Secondary outcomes (anxiety, distress, insomnia) also showed no significant differences.
- Low student engagement (22% completion rate) and inconsistent school support in providing in-class time were noted.
Conclusions:
- Large-scale implementation of the SPARX digital program in schools did not effectively reduce depressive symptoms.
- Variability in program engagement and delivery necessitates caution before widespread adoption.
- Future research should address barriers to engagement and optimize delivery in school settings.
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