Effectiveness of Integrated Network for Student Psychosocial Intervention, Resilience, and Education (INSPIRE) on Mental Health Outcomes Among Indonesian Adolescents in Bandung: A Randomised Controlled Trial and Process Evaluation
Effectiveness of Integrated Network for Student Psychosocial Intervention, Resilience, and Education (INSPIRE) on Mental Health Outcomes Among Indonesian Adolescents in Bandung: A Randomised Controlled Trial and Process Evaluation
The INSPIRE (Integrated Network for Student Psychosocial Intervention, Resilience, and Education) intervention is an 8-week, school-based mental health program designed to enhance adolescents' mental health literacy and resilience while addressing symptoms of depression and anxiety. Implementation is conducted by school counselors who undergo an intensive two-day training program. The intervention is supported by comprehensive curriculum materials including detailed lesson plans, activities, discussion prompts, and instructional slides featuring key concepts, visuals, and explanatory content. Supplementary materials are developed for both participating adolescents and their parents.
The study aims to:
Evaluate the usability and feasibility of the INSPIRE intervention within the school environment.
Assess the intervention's effectiveness in improving:
Explore the experiences of intervention participants (both adolescents and parents) against the control group to develop comprehensive insights into the psychosocial intervention's impact.
The research hypothesis proposes that the INSPIRE intervention group will demonstrate significantly higher scores in mental health knowledge, more positive attitudes toward mental health, increased help-seeking behaviors, enhanced mental health literacy, and greater resilience, while simultaneously showing reduced symptoms of depression and anxiety compared to the control group receiving standard care. These outcomes will be measured immediately following the intervention (post-test 1) and at one-month follow-up (post-test 2).
Pilot Study The pilot study was conducted as a two-centre, two-arm cluster randomised controlled trial with a pre-test-post-test design and a 1:1 allocation ratio. Randomisation was performed at the school (cluster) level to minimise contamination. The pilot phase was implemented from 28 April to July 2025.
Randomised Controlled Trial (RCT) The full-scale randomised controlled trial expanded to a multi-centre design involving five centres, maintaining a two-arm cluster randomised structure with school-level allocation. The trial was conducted in two phases. Phase 1 randomised two schools (School 1 and School 2), with one allocated to the control group and the other to the intervention group. Phase 2 randomised three additional schools (Schools 3, 4, and 5) with a 1:2 allocation ratio (one to control, two to intervention) to address recruitment shortfalls.
The RCT commenced in September 2025. Participant recruitment and baseline data collection occurred between 12 September and 21 November 2025. Follow-up for primary and secondary outcomes was completed on 27 March 2026.
Process Evaluation Process evaluation was conducted from 18 December 2025 to 7 April 2026.
Inclusion Criteria:
Participants were initially restricted to students aged 13-15 years. However, the inclusion criteria in the RCT were subsequently broadened to encompass all junior high school students (grades 7-9) to ensure adequate recruitment and representativeness. Eligible students were required to be able to read, understand, and converse in Bahasa Indonesia.
The inclusion criteria for parents are as follows:
Exclusion Criteria: