A Study Protocol of Primary Prevention Interventions for Substance Use and Suicide Prevention Among Youth in Kashmir: Development, Administration, and Evaluation

Background: Given the unique geopolitical positioning of Kashmir and its susceptibility to addiction and suicide, we present a protocol study that aims to design culturally tailored primary prevention for youth in Kashmir.Novelty: This study is the first attempt in the region to design and test a culturally tailored primary prevention intervention for youth mental health in Kashmir.Objectives: It aims to design culturally tailored primary prevention for youth in Kashmir and test it on the high-risk population.Methods: The study has three stages. (a) estimating risk factors for substance-use disorders (SUDs) and suicide in Kashmir among youth (16-24 years of age), (b) adapting an existing primary prevention intervention and psycho-social interventions to the culture-specific risk factors operating in Kashmir, (c) screening the at-risk youth in schools and colleges, (d) selecting suitable sample for pre/post-evaluation design, (e) administering a culturally-tailored primary-prevention intervention to the selected sample, and (f) evaluating the outcome variables which include parameters of symptom reduction and improved well-being. Data shall be analyzed utilizing both qualitative and quantitative methods. Risk factors will be estimated using thematic analysis. A culturally tailored primary prevention intervention will be designed by adapting an existing dialectical behavioral therapy skill training module to the Kashmir context. The effectiveness of the designed intervention will be evaluated through pre-and post-tests.Expected Outcomes: The study will provide a solid foundation for the mental health curriculum in schools and colleges. It is expected to reduce the number of mental disorders and contribute to a sustainable, mentally healthy Kashmir.