Becoming Protagonists: Effectiveness of a digital intervention to promote youth participation for mental health in Brazil

Interventions aimed at influencing adolescent behaviour often fall short due to their failure to align with adolescents' fundamental need to be acknowledged, heard, and respected. Digital interventions are often perceived as condescending, resulting in attrition. Additionally, most existing interventions target only the symptoms or behaviours of adolescents, overlooking the significant role of factors such as identity and social environment play in adolescent development. Given the pivotal role of peer relationships during adolescence, empowering young people as agents of change can enhance their mental health and wellbeing (MHWB) and have ripple effects on the wellbeing of peer communities. This proposal builds on the foundation laid by the Engajadamente Project (www.engajadamente.org), which revealed that adolescents are motivated to promote the MHWB of their peers but often lack the necessary skills. We have developed "Cadê o Kauê?," a digital chat-story to bolster Brazilian adolescents' skills to promote their peers' mental health within schools. Cadê o Kauê? has undergone two proof-of-concept studies, showing high acceptability and positive impact on youth skills and motivation. However, initial implementation revealed challenges such as inadequate digital infrastructure in Brazilian schools and external barriers such as the need for teacher training to deliver the intervention effectively and the support of young people's agencies. This project aims to address these challenges and develop a framework for implementation at scale of "Cadê o Kauê?" nationally in Brazilian schools. An interdisciplinary research team, spanning psychology, ethics, design, and population health, will collaborate with school communities, policymakers, filmmakers, and game designers across five work packages (WP). WP1 creates an offline version of the chat-story, optimised for state high schools. WP2 systematically reviews the literature on teacher skills for youth participation and will expand the intervention to include them. Working with a team of six teachers known for their youth activism and digital influence, we will co-design a multimedia training program to equip teachers with the skills to support adolescents as agents of change, thereby transforming Cadê o Kauê? into a multi-agent intervention toolkit. In WPs 3-4, we will investigate its effectiveness in Brazilian state high schools across five macro-regions (90 classrooms). Using a national, cluster-randomised controlled trial, we will assess the impact of Cadê o Kauê? (with teacher training) on adolescents' intentions and confidence to promote their peers' mental health. Subsequently, we will conduct an arts-based, realist evaluation to understand how adolescents and teachers perceive the intervention's contexts, mechanisms, and outcomes, culminating in a short documentary. WP5 will engage regional and national policymakers to discuss the findings and explore potential integration of Cadê o Kauê? into education policies supporting youth participation. This project will form a collaborative network of researchers in the UK and Brazil, of stakeholders committed to enhancing youth MHWB and creating supportive school environments. We envisage that the initiative will benefit school communities by offering evidence-based pathways through which adolescents become protagonists of social change. Ultimately we will make recommendations for the implementation of culturally-sensitive, socially-oriented interventions that are closely aligned with the values and priorities of young people.