Evaluating a School-based Mental Health Program on Self-esteem, Stress, and Anxiety Among Adolescent Girls in Yemen.

November 8, 2026 updated by: Al-Razi University

Educational Program on Self-Esteem, Stress and Anxiety Among Adolescent Girls in Public Schools in Sana'a, Yemen: A Controlled Trial

The goal of this interventional study was to learn if a mental health educational program can improve self-esteem and reduce stress and anxiety in school girls in Sana'a, Yemen.

The main question aims to answer:

Is there a significant difference in self-esteem, stress, and anxiety outcomes between the intervention group participating in the mental health educational program and the control group?

Participants will:

Complete self-reported questionnaires assessing self-esteem (RSES), stress (PSS-10), and anxiety (GAD-7) at baseline pre-test, immediate post-intervention post-test, and 3 months follow up post-test.

Attend interactive 5-days psychoeducational program sessions delivered within their school setting (intervention school), and 5-days placebo program for (control school).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The trial incorporates two schools: an Intervention and an Active Control conducted in two public schools in Sana'a city and was randomly assigned to either an intervention arm or a control arm. The study was conducted in these phases:

  1. Pre-test phase (before intervention): Both school's participants completed self-administration questionnaires to assess baseline levels of self-esteem, stress and anxiety.
  2. Intervention phase: Two programs were facilitated by the researcher at each target school. A 5-day interventional mental health educational program (Understanding the self, Emotional resilience, Cognitive awareness, Psychosocial self-care and integration and empowerment) 2 to 3 hours per day, for the intervention group (Juwayriyah Bint Al-Harith School) and a 5-day general health program (Personal hygiene, Health emergencies, Cholera awareness, Healthy boundaries and Health systems), 2 to 3 hours per day, for the control group (Ibn Seena School). One teacher assigned from each school administration helped the researcher by providing logistical support while the researcher facilitated the sessions. Each student was gifted a booklet that summarized the program they participated in.
  3. First post-test phase (at the end of fifth day): After completing both programs for each school, both groups re-took the same questionnaire to measure changes in the intervention group compared to the control group.
  4. Three month follow up phase: Simple follow-up was conducted by the assigned teachers by handing girls a printed paper designed by the researcher that had simple questions and activities about related programs for each school. The participants were encouraged to follow the instructions once a week by the assigned teacher.
  5. Second post-test phase: Three months after the programs and follow up, both groups re-took the same self-administrated questionnaire for the third time to measure the effectiveness of the mental health educational program in the longer term.

The intervention school participated in 5-days "Mental health educational program" 2 to 3 hours per day. The program was delivered with lecture-based PowerPoints, interactive activities and role plays, emotional expression exercises, repetition of empowering messages, storytelling, visualization and Islamic integration, breathing and other techniques.

The entire program was developed by the researcher based on a comprehensive review of international and local frameworks and manuals from the WHO (Mental Health in Schools: Manual) (WHO, 2021), UNICEF (Helping Adolescents Thrive Toolkit) (UNICEF, 2022) and (National Community-Based Mental Health and Psychosocial Support Guideline) (MoPHP, 2021) along with peer-review from diverse school interventions in several settings that were taken as structural inspiration. However, the program was independently developed and adapted for the targeted participants.

On the other hand, the control school participated in a 5-day general health program -non mental-(Personal hygiene, Health emergencies, Cholera awareness, Healthy boundaries and Health systems), 2 to 3 hours per day. Similar to the intervention program, the supporting materials of the program were customized simple Arabic PowerPoint presentations, illustration posters and cards, daily blank papers for the girls to do activities given and a booklet (summary of the program subjects) as a gift at the end of the program.

The results were compared between the two groups to evaluate the effectiveness of the "mental health educational program" on self-esteem, stress, and Anxiety.

This study was conducted in two girls' public schools in Sana'a Yemen (Al Sabeen District). The schools selected for the study were Juwayriyah Bint Al-Harith and Ibn Seena Schools. Juwayriyah Bint Al-Harith school was the intervention School and Ibn Seena school was the control group. This was assigned in a simple random selection.

Study Type

Interventional

Enrollment (Actual)

227

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Yemen
    • Al-Sabeen District
      • Sanaa, Al-Sabeen District, Yemen, 00000
        • Al-Razi University and Schools in Al-Sabeen District

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

12 years to 18 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

Inclusion Criteria:

The inclusion criteria for both intervention and control group were:

  • Adolescent girls aged (12-18) studying in Juwayriyah Bint Al-Harith School and Ibn Seena School in Sana'a Yemen.
  • Students without any attendance issues to ensure attendance and completion of the programs.
  • Students from middle and secondary school classes.
  • Students who agreed to enroll and provided signed approval from their parents to participate in the study.

Exclusion Criteria:

The exclusion criteria for both Intervention and control group were:

  • Students who didn't fulfill the inclusion criteria.
  • Drop outs: Students who didn't attend the entire program (more than 1 day absent)
  • Students who didn't take the three tests (pre-test, immediate posttest or three-month post-test)
  • The student who did not provide parental consent.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention arm

Participants receive the school-based Mental Health Educational Program designed to improve self-esteem and reduce stress and anxiety.
Behavioral: Mental Health Educational Program

A structured school-based 5-days, 2 to 3 hours per day, mental health educational program designed to enhance self-esteem and reduce stress and anxiety among female students.

The program was delivered with lecture-based PowerPoints, interactive activities and role plays, emotional expression exercises, repetition of empowering messages, storytelling, visualization and Islamic integration, breathing and other techniques.

Other Names:
  • Psychoeducational Program
Placebo Comparator: Control Arm

Participants receive a general health education program unrelated to psychological or mental health, serving as an placebo program.
Other: General Health Education program

A 5-day general health program (Personal hygiene, Health emergencies, Cholera awareness, Healthy boundaries and Health systems), 2 to 3 hours per day, for the control group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Self-Esteem Score
Time Frame: Baseline and immediately post-intervention (at the end of the intervention period) and 3 months after intervention. From September 2025 until January 2026.

Assessed using the Rosenberg Self-Esteem Scale (RSES). Scores range from 0 to 30, with higher scores indicating higher self-esteem.
Baseline and immediately post-intervention (at the end of the intervention period) and 3 months after intervention. From September 2025 until January 2026.
Change in Perceived Stress Score
Time Frame: Baseline and immediately post-intervention (at the end of the intervention period) and 3 months after intervention. From September 2025 until January 2026.

Assessed using the Perceived Stress Scale (PSS-10). Scores range from 0 to 40, with higher scores indicating higher perceived stress levels.
Baseline and immediately post-intervention (at the end of the intervention period) and 3 months after intervention. From September 2025 until January 2026.
Change in Generalized Anxiety Score
Time Frame: Baseline and immediately post-intervention (at the end of the intervention period) and 3 months after intervention. From September 2025 until January 2026.

Assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7). Scores range from 0 to 21, with higher scores indicating higher anxiety severity.
Baseline and immediately post-intervention (at the end of the intervention period) and 3 months after intervention. From September 2025 until January 2026.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Al-Razi University

Investigators

  • Study Director: Yahia Ahmed Raja'a, Professor in Public Health, Al-Razi University, Sana'a University.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 23, 2025

Primary Completion (Actual)

January 3, 2026

Study Completion (Actual)

May 5, 2026

Study Registration Dates

First Submitted

November 8, 2026

First Submitted That Met QC Criteria

November 8, 2026

First Posted (Actual)

November 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 13, 2026

Last Update Submitted That Met QC Criteria

November 8, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • RU/21/FMSH/2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified participant data that do not compromise participant confidentiality or privacy may be made available or shared with qualified reasearchers for scientific research purposes upon reasonable request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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