Methods: The development of depression prevention model for Thai adolescents involved a spiral of self-reflective cycles (plan, act and observe, and reflect) and methodology of the participatory action research (PAR). Twenty adolescents aged 10-14 years old, five parents and seven teachers identify critical components of depression prevention throughout four focus group discussions and 17 in-depth interviews. The eleven participants consisted of four teachers, five adolescents and two parents who volunteered to take part in the research team, four teachers and two of the adolescents acted as co-researchers in order to develop depression prevention model for adolescents based on the critical components. All of them worked on the participatory depression prevention model development cycle, namely 5Ps: 1) problem identification, 2) planning to collaboratively identify appropriate solution, 3) production of essential media and materials, 4) putting plan into action, and 5) propose depression prevention model. Descriptive statistics were employed for data analysis while qualitative data from focus group discussions and in-depth interviews were analyzed through content analysis.
Findings: The depression risk problems were decreased by a collaborative mutual communication and creating easy and enjoyable activities for depression prevention among adolescents, parents, and teachers based on three critical components of the participatory depression prevention model for Thai adolescents: 1) early detection of depression risks among adolescents, 2) self-worth enhancement activities for depression prevention, and 3) effective communication regarding depression prevention. Feasibility testing of the appropriate depression prevention model for adolescents demonstrated that six adolescents aged 12-13 years old who received PDP training, which led to the understanding of the key concepts for depression prevention, the practice of the depression risk assessment, and the skill training to minimize the risk of depression, enhance self-esteem and promote problem-solving skill through media and activities. They had lower depression mean scores (pre-post: 9.33 and 7.17), higher mean scores for self-esteem (pre-post: 27.83 and 32.00), resilience (pre-post: 109.67 and 113.00), and problem solving (pre-post: 92.83 and 97.33). The research participants reflected satisfaction with the PDP model.
Conclusions: The PDP model was developed based on PAR approach, which is empowering the participants to collaborate and create depression prevention for Thai adolescent. The findings provide three critical components of depression prevention model are that; early detection of depression risks among adolescents, self-worth enhancement activities for depression prevention, and effective communication regarding depression prevention. The model would be suitable for the prevention of depression by adolescents themselves as well as their peers, their school teachers, and their family members. Health care providers can employ the participatory depression prevention model training guide to prevent depression in adolescents. Additionally, the findings of this study can be the knowledge based for further study regarding depression prevention for adolescents. The government could set up a depression prevention policy and enhance collaborative early depression prevention in adolescents.