title: Outcome of a school-based intervention to promote life-skills among young people in Cambodia.
abstract: BACKGROUND
  Most of the school-based interventions to prevent suicide are from high income countries and there is a need for evidence based interventions in resource-poor settings. The aim of this study is to evaluate the outcome of a school based intervention to reduce risk factors for suicide among young people in Cambodia by promoting life skills.
  
  
  METHODS
  Six classes were randomly selected from two schools each, one designated as experimental and the other as control school, respectively. In experimental school 168 young people (M=92, F=76) received 6 sessions of life skills education and in the control school 131 students (M=53, F=78) received three general sessions on health. We looked at the pre-post differences on Life-Skills Development Scale Adolescent Form (LSDS-AF)- and Youth Self-Report (YSR) questionnaire to measure the effect size (ES) from the intervention after 6 months. We analyzed the data by stratifying for gender and for those who reported more severe suicidal expressions at baseline (high-risk group).
  
  
  RESULTS
  The girls showed improvement in Human Relationship (ES=0.57), Health Maintenance (ES=0.20) and the Total Life Skills Dimensions (ES=0.24), whereas boys with high-risk behavior improved on Human Relationship (ES=0.48), Purpose in Life (ES=0.26) and Total Life Skills Dimensions (ES=0.22). Effect size for YSR-syndrome scores among all individuals showed no improvement for either gender. Among high-risk individuals boys had a small to moderate effect size from intervention on Withdrawn/Depressed (ES=0.40), Attention problems (ES=0.46), Rule breaking behavior (ES=0.36), Aggressive behavior (ES=0.48) and Externalizing syndrome (ES=0.64).
  
  
  CONCLUSIONS
  Promoting life skills in schools may enhance the overall mental health of young people, indirectly influencing suicide, particularly among boys with high-risk behavior in Cambodia.
authors.affiliation: Center for Child and Adolescent Mental Health, Chey Chumneas Hospital Takhmau, Kandal Province, Cambodia; Psychiatry, Department of Clinical Sciences, University of Umeå, 901 85 Umeå, Sweden. Electronic address: drbhoomikumarj@gmail.com.
authors.forename: Bhoomikumar
authors.initials: B
authors.lastname: Jegannathan
authors.affiliation: Epidemiology and Global Health, Department of Public Health and Clinical Medicine, University of Umeå, 901 87 Umeå, Sweden. Electronic address: kjerstin.dahlblom@epiph.umu.se.
authors.forename: Kjerstin
authors.initials: K
authors.lastname: Dahlblom
authors.affiliation: Psychiatry, Department of Clinical Sciences, University of Umeå, 901 85 Umeå, Sweden. Electronic address: gunnarkullgren@gmail.com.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Kullgren
mesh_terms: D000293:Adolescent; D002160:Cambodia; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D012574:Schools; D013334:Students
keywords: Cambodia; Life skills; Outcome; School based intervention