Preliminary Effectiveness of a Brief School-Based HERO Intervention: Improving the Wellbeing of Final Year Adolescent Female Students

Preliminary Effectiveness of a Brief School-Based HERO Intervention: Improving the Wellbeing of Final Year Adolescent Female Students | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Preliminary Effectiveness of a Brief School-Based HERO Intervention: Improving the Wellbeing of Final Year Adolescent Female Students Reetta Heikkila, Jules Finch, Allison M Waters, Lara J Farrell This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3075824/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Dec, 2023 Read the published version in Child Psychiatry & Human Development → Version 1 posted 7 You are reading this latest preprint version Abstract Young people face multiple challenges, including appearance dissatisfaction, academic stressors, anxiety and depression. This study examines the preliminary effectiveness of a brief, school-based intervention aimed at enhancing Psychological Capital (PsyCap), consisting of positive resources of hope, self-efficacy, resilience and optimism (HERO), and reducing mental health symptoms among female year 12 students ( n = 95, M age= 16.78, SD = 0.45). Outcomes on measures of HERO and secondary outcomes of flourishing, appearance dissatisfaction, anxiety and depression were measured at pre and post-intervention. In the overall cohort, no significant changes were found on the HERO outcomes or flourishing post-intervention, while symptoms of depression, anxiety and appearance dissatisfaction decreased significantly. For students with higher baseline anxiety, optimism and anxiety symptoms improved significantly at post-intervention. However, students with lower baseline anxiety experienced significant decreases in self-efficacy and optimism, as well as a significant increase in anxiety symptoms post-intervention. Baseline depression levels did not impact intervention outcomes. The findings, although mixed, suggest that a brief intervention grounded in PsyCap theory may improve student wellbeing. PsyCap HERO Intervention School Adolescent Positive Psychology Figures Figure 1 Introduction Adolescence is a uniquely formative time of rapid physiological, cognitive and psychosocial development, that paired with increased societal and interpersonal stress, may increase susceptibility to developing mental health symptomology (Rapee et al., 2019). Youth mental health is recognised as a global health concern, and according to the WHO, an estimated 10–20% of adolescents worldwide experience a mental health condition, with 75% of mental health disorders emerging by 24 years of age (Kessler et al., 2007). Further, representative data indicate that youth mental health problems are becoming increasingly prevalent (Twenge et al., 2019; Wiens et al., 2020), and concerningly, most young people who need help remain undiagnosed and untreated (Kessler et al., 2007; Slade et al., 2009). Thus, adolescence is a crucial time to intervene and serves as a window of opportunity to address mental health concerns early so health and functional outcomes can be maximised into adulthood. Gender Differences in Mental Health During Adolescence In Australia, female adolescents present with a higher prevalence of mental health disorders than their male counterparts. According to the National Australian Child and Adolescent Survey of Mental Health and Wellbeing ( n = 2,968), in the years 2013 to 2014, 4.3% of males aged 12–17 years and 5.8% of females aged 12–17 years had a major depressive disorder, while 7.7% of females and 6.3% of males aged between 12 and 17 had an anxiety disorder (Lawrence et al., 2015). These findings also reflect the prevalence of psychological distress, which refers to non-specific symptoms of stress, anxiety and depression, which may indicate impaired mental and common mental disorders like depressive and anxiety disorders (Cuijpers et al., 2009 ). According to Brennan et al., ( 2021 ), who conducted an extensive survey (n = 25,800) on Australian youth aged 15 to 19 years, 34% of the female participants reported significant psychological distress compared to their male counterparts, of which 15.3% reported significant psychological distress. Adolescence is also a period of risk for developing body image disturbances, as adolescent psychosocial development is characterised by a high inclination for introspection and self-scrutiny, social comparisons, and self-awareness connected to physical image and social development (Helfert & Warschburger, 2013). In Australia, body dissatisfaction is more prevalent in females, with 42.8% of females compared with 14.5% of males, being very or extremely concerned about body image (Brennan et al., 2021 ). Poor body image has been associated with several negative outcomes such as low self-esteem, depression and anxiety (Ter Bogt et al., 2006). Further, body dissatisfaction has been found to be a significant prospective predictor of diagnosed eating disorders (Rohde et al., 2015). Eating disorders such as Anorexia Nervosa and Bulimia have been found to have an average onset age of 16–18 years (Volpe et.al., 2016) and are estimated to affect 16.3% of the Australian population (Hay et al., 2015). Thus, the unique mental health concerns of female youth require individualised intervention efforts that target the most relevant issues, including body image concerns, that significantly impact mental health in this population. School-Based Interventions Schools have unparalleled access to youth and represent a unique context where most adolescents can be reached near-universally (Masia-Warner et al., 2006). Schools may present an ideal environment for the early detection of mental health problems and an appropriate setting for prevention and early intervention programs (Werner-Seidler et al., 2017). Many of the barriers that are common to traditional mental health service provision can be reduced in the school environment, including the stigma associated with seeing professionals in typical medical settings, reduced cost and time associated with seeking services (Barrett & Pahl, 2006 ; Masia-Warner et al., 2006). Universal programs, which refer to intervention programs delivered to all students regardless of symptom level designed to enhance general psychological wellbeing or mental health (Barrett & Pahl, 2006 ), have many advantages. In addition to their ability to reach a demographically broad range of adolescents, school administrators may prefer universal interventions because of their broad applicability and reduced time requirement for screening and selecting participants (Horowitz et al., 2007). Universal school-based interventions have been widely recommended and successfully implemented to promote mental health in young people (O'Mara & Lind, 2013). Despite the potential of the educational context in preventing mental health problems, schools are currently underutilised for mental health interventions (Moon et al., 2017). However, due to the growing recognition of the necessity for school- based interventions and evidence for their effectiveness, the demand for universal wellbeing interventions in the educational context is rapidly increasing (Fazel & Kohrt, 2019). In recent years, especially interventions with positive, strengths-based approaches have gained popularity within schools (Owens & Waters, 2020). Multicomponent Positive Psychology Interventions Positive psychology is a theoretical perspective introduced at the turn of the century, which proposes that mental health is not defined as the mere absence of mental disorder, but instead, includes the presence of positive qualities and attributes that encourage positive functioning (Seligman & Csikszentmihalyi, 2000). The recent shift of emphasis from targeting student deficits and disorders towards enhancing students' psychological strengths and positive resources has resulted in the development and implementation of positive psychology interventions (Chodkiewicz & Boyle, 2016 ). According to Sin & Lyubomirsky (2009), positive psychology interventions aim to promote wellbeing by increasing positive feelings, cognitions, or behaviours, in contrast to interventions aiming to reduce symptoms, problems, or disorders. Wellbeing can be defined in various ways. One well established indicator of wellbeing is flourishing, which can be considered as the opposite end of the mental health spectrum to common mental disorders, characterised by positive mental health including positive emotions, engagement in meaningful activities and sense of purpose (Keyes, 2002). Adolescents within the school context present with varied and often complex needs, across the full spectrum of risk. Multicomponent positive psychology interventions (MPPIs) are based on multiple individual exercises targeting two or more theoretically relevant wellbeing components that resemble the critical elements of positive education and are conducted within an integral program (Seligman., 2018). The literature argues that multidimensional interventions and interventions with greater variety may be especially effective (King & Caleon., 2020) and more likely to provide long-term effects (Rusk et al., 2017). A recent meta-analysis of nine studies ( n = 4,898 youth) by Tejada-Gallardo et al., (2020) found that school-based MPPIs enhanced subjective and psychological wellbeing and reduced depression symptoms in the short and long-term among adolescents. For example, a randomised controlled trial (Burckhardt et al., 2016 ) investigated the effectiveness of an intervention that targeted multiple components of subjective wellbeing (i.e., mindfulness, gratitude, character strengths, optimism and hope) via 16 half-hour sessions ( n = 267). The results showed that participation in the intervention was significantly associated with reductions in depression, stress and anxiety, and increased wellbeing, with more significant changes observed in the participants who commenced the program with high depression and anxiety scores. Thus, brief multidimensional intervention programs grounded in theory and empirical evidence may be viable in enhancing the wellbeing and mental health outcomes of students with varied needs. Despite the promising evidence of the advantages, there is currently a scarcity of research on the effectiveness of MPPI in adolescents, particularly in the school setting (Tejada-Gallardo et al., 2020). Psychological Capital One potential multidimensional positive psychology construct that has attracted a great deal of empirical support in organisational psychology is psychological capital (PsyCap). PsyCap is defined as “an individual’s positive psychological state of development characterised by having confidence (self-efficacy) to take on and put in the necessary effort to succeed at challenging tasks; making a positive attribution (optimism) about succeeding now and in the future; persevering toward goals and, when necessary, redirecting paths to goals (hope) to succeed; and when beset by problems and adversity, sustaining and bouncing back and even beyond (resilience) to attain success” (Luthans et al. 2007). A large body of literature suggests that interventions targeting PsyCap constructs in the organisational context effectively enhance PsyCap, which in turn results in a multitude of positive outcomes, such as increased psychological wellbeing and reduced psychological distress, including stress and anxiety (Lupșa et al., 2019). For instance, Harty et al., (2016) found that a 10-week group intervention targeting PsyCap ( n = 66) was effective in increasing the level of positive emotions, self-efficacy and job satisfaction among employees, with the positive changes observed at the end of the program maintained at the six-month follow-up assessment. Currently, most of the PsyCap literature has been confined to organisational contexts. However, an emerging body of research has demonstrated a relationship between PsyCap and positive mental health outcomes among youth (Preston et al., 2023). For instance, PsyCap has been found to be a better predictor of student wellbeing outcomes than the individual HERO constructs according to Finch et al., (2020), who examined the association between both overall PsyCap and the individual HERO constructs with mental health symptoms and subjective wellbeing among Australian school-aged children and adolescents ( n = 456). The study found that while higher levels of each of the HERO constructs were associated with lower levels of depression and anxiety symptoms and greater levels of flourishing, PsyCap was found to be a stronger predictor of decreased levels of student depression and anxiety symptoms and increased levels of flourishing, than the individual HERO constructs. The association between PsyCap and wellbeing was further supported by King & Caleon (2020), who found that PsyCap predicted the positive indicators of wellbeing such as life satisfaction, positive affect, and happiness, and negatively predicted ill-being indicators such as negative affect and depression among high school students. The benefits of increased PsyCap in the school context may be far-reaching, as preliminary evidence suggests that PsyCap may be an essential predictor of ideal academic outcomes such as engagement (Datu et al., 2016 ; Datu & Valdez, 2015 ), motivation (Siu et al., 2013; Datu et al., 2016 ) and achievement (Carmona-Halty et al., 2019 ; Datu & Valdez, 2015 ) among high school students. For example, Datu et al. ( 2016 ) discovered that higher PsyCap was associated with lower levels of school absenteeism and greater motivation to achieve academic goals among Filipino adolescents ( n = 384). Furthermore, Carmona-Halty et al., ( 2019 ) discovered that Chilean high school students ( n = 771) with higher PsyCap levels were more likely to achieve better academic performance, such as higher exam grades than their counterparts with lower PsyCap levels. Given the contextual similarities between employees within organisations and students within schools, it is an apparent gap in the literature that PsyCap has not been investigated as a potential intervention framework for school-based positive psychology education programs. School-Based Psychological Capital Interventions Despite the evidence of the benefits and potential of PsyCap among adolescents, there are currently very few intervention efforts aimed at increasing youth PsyCap in schools. Recently, some efforts have been directed toward PsyCap intervention research in the educational context. Katajisto et al., (2021) investigated whether a guidance intervention aimed at increasing character strengths (8 x 75-minute group sessions and 1x 60-minute individual session) could increase PsyCap in Finnish high school students ( n = 57). The study discovered a more significant increase in the test group's PsyCap scores, strengths, and resources compared to a control group. Furthermore, a group-based acceptance and commitment intervention (10 x 1-hour workshops) aimed at increasing PsyCap among Chinese adolescents ( n = 35) found a significant increase in the participants' PsyCap and school engagement post-intervention (Fang & Ding, 2020). Although preliminary evidence suggests that PsyCap can be successfully cultivated in adolescents through school-based interventions, the existing literature consists of small pilot studies that use interventions that are yet to be well-established and approaches that do not directly target PsyCap. However, a pilot study by Finch et al., (2023) examined the effectiveness of an intervention that targeted PsyCap directly. The study aimed to increase PsyCap and decrease perfectionism and mental health symptoms in an adolescent female student cohort via a brief, 4-session intervention ( n = 82). Significant increases in PsyCap and significant decreases perfectionism were found post-intervention, which supports the preliminary evidence suggesting that PsyCap may be successfully cultivated among youth in a school context. The Current Study The current study responds to the growing interest and demand to increase youth wellbeing and mental health within the school context, using positive, strengths-based perspectives (Tejada-Gallardo et al., 2020; Owens & Waters, 2020). The purpose of the study was to examine the preliminary effectiveness and acceptability of brief, novel multi- component school-based intervention aimed at enhancing psychological capital and subsequent wellbeing and mental health among adolescent females aged between 16 and 18 years during the final year of high school. The uniqueness of the current intervention is in its flexibility. In addition to targeting the PsyCap constructs, the program has been tailored through a co-design framework to respond to the current cohort’s specific concerns. As schools have limited time available for interventions, the study examined whether a brief intervention program consisting of four 50-minute sessions may be of value. This study expands upon the intervention study conducted by Finch et al., (2023) by examining the effectiveness of a similar intervention program, modified based on the needs of the current cohort. An open-trial design was implemented, with student outcomes assessed at pre-, post- and 6 weeks following the intervention. The primary outcomes included the PsyCap constructs of hope, self-efficacy, resilience and optimism. The secondary outcomes included the wellbeing outcome of flourishing and the self-perception construct of appearance satisfaction, as well as the mental health outcomes of anxiety and depression. Further, although the current intervention was universal and delivered to all students regardless of symptom level, the study aimed to explore whether the HERO intervention may have a differential impact on the participants who are at greater risk for mental health problems, as indexed by elevated self-reported depression and anxiety symptoms at baseline, relative to students with lower symptoms. Based on previous findings of the PsyCap and MPPI studies to date, it was hypothesised that (1) there would be a significant increase in the primary PsyCap outcomes of hope, efficacy, resilience and optimism from pre to post-intervention, and (2) there would be a significant increase in the secondary wellbeing outcomes appearance satisfaction and flourishing, and a significant decrease in the secondary mental health outcomes of anxiety and depression from pre to post-intervention. Furthermore, (3) students with higher mental health symptomology at baseline (as indexed by elevated scores on self-reported anxiety and depression) would experience a greater increase in the primary PsyCap outcomes of hope, efficacy, resilience and optimism and a greater reduction in the secondary mental health outcomes of anxiety and depression across time, relative to students lower on anxiety and depression at baseline. Finally, (4) it was hypothesised that outcomes outlined in H1-H3 would be maintained to the 6- week follow-up, and (5) the intervention would be found acceptable by the participants based on student evaluations of the program at post- intervention. Method Participants The participants consisted of a school-based convenience sample of 95 Year 12 students aged between 16 and 18 years from Brisbane, Australia. The participants were recruited via a pre-existing partnership with the school, an all-girls Catholic College, engaged with a broader continuing research program with the affiliated university. The mean age of the participants was 16.78 years ( SD = 0.45), and 98.8% of the participants identified as female, with 1.2% as other. English was the primary language spoken at home for 97.6% of the sample. In terms of living arrangements, 79.5% reported that they lived with both parents, 10.8% with mother only, 8.4% shared between mother and father, and 1.2% lived with other guardians (e.g. aunt or grandparents). Measures Demographics The participants' demographic information, including age, gender, primary language spoken at home and living arrangements, were collected at the baseline pre-survey. HERO-constructs The Measure of Youth Hope, Self-Efficacy, Resilience and Optimism is an unpublished measurement tool that consists of 63 items (MY-HERO; Finch et al., 2019). The scale assesses students’ self-reported levels of the PsyCap-HERO constructs. The items for each of the MY HERO subscales of hope (10 items), self-efficacy (27 items), resilience (15 items), and optimism (11 items) consist of items adapted from previously validated measures of the individual HERO constructs in children and youth. The hope scale is adapted from The Children’s Hope Scale (Snyder et al., 1997), the self-efficacy scale is adapted from the Self- Efficacy Scale for Children (Gambin & Święcicka, 2012), the resilience scale is adapted from The Children and Youth Resilience Measure (Liebenberg et al., 2013) and the optimism scale is adapted from the optimism subscale of the Youth Life Orientation Test (Ey et al., 2005). The items were modified to be relevant to the educational context to ensure that the final measure appropriately represented PsyCap in a school environment. All subscales are scored on a six-point scale ( 1 = I can't do this at all, 6 = I definitely can do this). Previous studies using this measure (Finch et al., 2023) have reported good to excellent internal reliabilities across the sub-scales (i.e., α = .84 to .93). The sample internal reliability alphas in the study were .93 (hope), .94 (self-efficacy), .91 resilience and .94 (optimism). Self-Perception The Self-Perception Profile for Adolescents developed by Harter (2012) consists of nine subscales, one of which was of interest for this study. The questions are formatted in a structured alternative format. The adolescent is first asked to decide which kind of adolescents they are most like from two options in each statement. Next, the adolescent decides whether the chosen description is "Really True for Me" or "Sort of True for Me". The items are scored on a 4-point scale ( 1 = lowest level of competence, 4 = highest level of competence ). Rose et al., (2012) validated the scale for use with Australian adolescents, finding the scale to have good internal consistency ( α = .82). Physical Appearance. The physical appearance sub-scale contains five items that measure the extent to which one feels happy with one's looks. According to the original authors, this measure demonstrated good internal consistency ( α = .84). The sample internal reliability alpha was very good ( α = .91). Flourishing The Flourishing Scale (Diener et al., 2019) is an 8-item measure of one’s self- perceived achievement in areas of relationships, self-esteem and purpose. The answers are made on a 7-point scale ( 1 = strongly disagree, 7 = strongly agree ). According to Romano et al., (2020), the scale has been found to be a valid measurement among adolescents, demonstrating good internal consistency ( α = .87). The sample internal reliability was good ( α = .90). Anxiety and Depression The Revised Children’s Anxiety and Depression Scale Short Version (Ebesutani et al., 2012 ) comprises 25 items that measure the extent to which one experiences the common symptoms of depression and anxiety. The scale is scored on a four-point scale (0 = never, 3 = always ). The scale has been validated to be used among children and adolescents aged 12 to 18 (Donnelly et al., 2018 ). The anxiety subscale is a 15-item measure that assesses the common symptoms and severity of general anxiety. According to Klaufus et al., (2020), the scale has good internal consistency ( α = .82). The sample internal reliability was very good ( α = .90). The depression subscale is a 10-item scale that measures the common depressive symptoms. According to Klaufus et al., (2020), the scale has acceptable internal consistency (α = .71). The sample internal reliability was very good ( α = .91). Intervention Acceptability The acceptability of the intervention and the perceived helpfulness of the program were assessed via two items. The first item was “Did you find the PsyCap-HERO wellbeing program helpful”. The participants could enter free text to describe aspects that were helpful and/or not helpful. The responses for the first item were coded as “no” (0), “yes” (1) and “both” (2). The second item asked “Do you think it would be useful to run this program for future year 12 students and why”. The participants could freely describe their reasoning for or against the usefulness to run the program in the future. The responses for the second items were in a dichotomous response format, coded as “yes” (1) and “no” (0). Procedure Ethical approval was granted by the Griffith University Human Research Ethical Committee (ref: GU2019/801) and Brisbane Catholic Education (ref: BCE414). Following approval by the school principal, informed consent was obtained from all individual participants included in the study via parental written consent. An information sheet and consent form was sent to parents in the target cohort level at the school to describe the purpose, risk and benefit of the research. The consent process was facilitated by school staff who provided a list of student emails of consenting students to the second author from which online surveys were sent. Participation in the study was voluntary, and the students had the right to refuse completion of the survey or withdraw their participation at any point in time without explanation or penalty. The study commenced in April of 2021, coinciding with the end of term 1 of the school year (school year consists of 4 terms), when the participants completed the online pre-intervention survey. The survey was planned to be completed at school; however, it was completed at home during class time due to the COVID-19 lockdown at the time of data collection. The survey began with the collection of demographical information and took approximately 40 minutes to complete. The series of the four PsyCap HERO workshops commenced one month later. The four workshops each targeted one of the PsyCap HERO constructs (hope, efficacy, resilience, and optimism). The workshops were delivered in May, during term two of the school year. There was a two-week interval between the first and the second workshop and the remaining workshops were delivered weekly. The workshops were 50 minutes in duration and were delivered in a whole year cohort format, in person, in the school’s main auditorium during Positive Education classes. The intervention program was delivered in a co-facilitation format by five Clinical Psychology Master's students registered as provisional psychologists. The facilitators were trained before the intervention delivery by the second and fourth authors. The participants completed the pen-and-paper feedback survey in person at the end of the final of the four workshops. The post-intervention online survey was completed one week after the final workshop at school, during class time, 10 weeks after the baseline. The number of workshops attended by each participant was recorded in the post-survey. The follow-up survey was completed six weeks after the final workshop, 16 weeks after the baseline at school during class time. Intervention The Modules for Youth Hope, Efficacy, Resilience and Optimism (MY HERO) in an unpublished intervention program that comprises of four modules, each aiming to cultivate and develop one of the constructs of hope, self-efficacy, resilience, and optimism, based on previous program developed by Finch and Farrell (2020). The intervention program was designed to be delivered in four 50-minute workshops to fit into a typical class duration. The intervention was designed to be flexibly delivered in either a classroom format for a smaller group or an entire school level cohort, provided there is space and co-facilitators available to run the program in a large group setting. The materials and the concepts included in the intervention program are designed to fit specifically into the educational context and target the challenges that youth face at school (e.g. time management and stress). Although the materials were originally developed based on the central concept of psychological capital, the materials were also designed to be modifiable to target specific and unique needs of the cohort to which the intervention is delivered, taking into account the age and gender of the participants. In the present study, the materials were modified to fit the needs of a female cohort aged between 16 and 18 years. The current cohort’s specific areas of concern were identified based on a consultation with the school principal and the teaching team. The areas of tailoring for this specific cohort included body image, self-esteem and mood concerns. Therefore, the development and design of the final intervention activities for this study incorporated content to increase students’ HERO resources in the context of self- compassion and self-care, with one session specifically devoted to positive body image. All workshops included an interactive activity for the students to practice identifying and developing the construct or capability taught in that module (i.e., hope), using cognitive behaviour principles and techniques. See Table 1 for the outline of the components included in the content of the sessions. ---------- INSERT TABLE 1 HERE ----------- Results Data Screening Of the complete sample ( n = 130) who consented to participate, the pre-intervention survey was commenced by 97 students at time point 1 (T1), and 87 students completed all measures within the pre-survey. The post-intervention survey was commenced by 91 students at time point 2 (T2), and 87 students completed all measures within the post-survey. The follow-up survey was commenced by 92 students at time point 3 (T3), and 87 students completed all measures within the follow-up survey. Only the data from the participants who attended at least two of the four workshops (hope, self-efficacy, resilience and optimism were included in the final sample ( n = 95). To address hypothesis one, a series of paired-samples t-test were conducted to evaluate the mean change of hope, self-efficacy, resilience and optimism from T1 to T2, from T2 to T3 and from T1 to T3. To address hypothesis two, series of paired samples t-test were performed to measure the mean change of flourishing, physical appearance, anxiety and depression from T1 to T2, from T2 to T3 and from T1 to T3. Given the variation in missing data at each time point due to the high level of school absentees at testing, paired samples t- tests were conducted over repeated measures ANOVAs to maximise cell sizes and statistical power in analyses. To address hypothesis three, a series of median splits were conducted to divide the sample into two groups (below the median and above the median) based on anxiety ( Mdn = 15) and depression ( Mdn = 12) measured at the pre-intervention baseline. A series of 2(symptom level groups at baseline: high symptoms, low symptoms) x3(time) mixed design ANOVA’s with repeated measures on time (pre, post and follow-up) were conducted. Post Hoc tests were conducted to compare the mean differences across time and groups (youth below and above the mean level of mental health symptomology). Intervention Outcomes Analyses of the differences across time on primary constructs of hope, efficacy, resilience and optimism indicated that there was a statistically significant mean increase in scores for hope from T2 to T3, 95% CI [-2.38,-.29], t (61) = -2.65, p = .013, d = 0.33 (small effect). However, there was no significant difference between hope scores from T1 to T3. There was a significant decrease in optimism scores from T1 to T2, 95% CI [.31, 5.02], t (68)= 2.26, p = .027, d = 0.27 (small effect), and a significant increase in optimism scores from T2 to T3, 95% CI [ -3.65, − .35], t (61) = -2.42, p = .018, d = 0.31 (small effect). Paired samples t- test indicated no statistically significant changes in the outcomes of resilience and self-efficacy between T1, T2 and T3. See Table 2 for means and standard deviations across time for all study variables. ----------- INSERT TABLE 2 HERE ----------- Analyses of time effects for the secondary constructs of flourishing, physical appearance, anxiety and depression indicated that there was a statistically significant mean increase in scores for appearance satisfaction from T1 to T3, 95% CI [-1.81, − .30], t (56) =-2.79, p = .007, d = 0.37 (small effect). Further, there was a was a statistically significant mean decrease in scores for anxiety from T2 to T3, 95% CI [ .31, 3.14), t(58) = 2.45, p = .018, d = 0.32 (small effect), and depression from T2 to T3, 95% CI[.025, 2.14), t (58) = 2.05, p = .045, d = 0.27 (small effect). Paired samples t-test indicated no statistically significant changes in the outcome of flourishing between T1, T2 and T3. The results of anxiety symptom groups across the 3 (time: pre, post and follow-up) x 2 (group: below and above median anxiety score) mixed ANOVAs, indicated that the interaction across the time points and anxiety level groups (high anxious, low anxious) was statistically significant on the outcomes of efficacy F ( 2, 80) = 5.13, p = .008, η p 2 = .11 (medium effect), optimism F (2, 80) = 4.02, p = .031, η p 2 = .091 (medium effect) and anxiety F (2, 80) = 5.07, p = .008, η p 2 = .11 (medium effect). See Table 3 for means and standard deviations of students with higher and lower baseline anxiety on the primary and secondary outcomes before, after and at the 6-week follow-up. ----------- INSERT Table 3 HERE ----------- Post-hoc analysis of the significant interactions using pairwise comparisons investigated the differences across the timepoints separately for the high symptom and low symptom groups on anxiety. For the high anxiety group, a statistically significant decrease was found in anxiety scores from T1 to T3, p = .033, d = .24 (small effect). In contrast, for the low anxious youth, a statistically significant increase was found in anxiety scores from T1 to T2 p = .014, d = .25 (small effect). See Fig. 1 for this significant interaction. ----------INSERT FIGURE 1 HERE------------ Further, a statistically significant increase was found in optimism scores for the high anxious group from T2 to T3 p = .035, d = 0.20 (small effect); whereas for the low anxious group, a statistically significant decrease was found in optimism scores from T1 to T2 p =.026, d = 0.22 (small effect). For efficacy, there was no statistically significant change for the outcome of efficacy for the high anxious group; however, there was a statistically significant decrease in efficacy scores from T1 to T2 p = .035, d = 0.20 and from T1 to T3 p = .004, d =0.25 (small effect) for the low anxious group. Finally, the results of the depression symptom level group for the 3 (time: pre, post and follow-up) x2 (group: below and above median depression score) analysis revealed no significant interactions between time and symptom level group on any of the preliminary or secondary outcomes. Intervention Acceptability Eighty-seven participants responded to the post-intervention feedback survey. 73.8% of the participants found the MY HERO intervention program helpful, 4.8% unhelpful, and 21.4% found parts of the intervention helpful and other parts unhelpful. 97.5% of the respondents indicated that running the intervention program for future year 12 students would be useful. Discussion The current study evaluated the preliminary effectiveness and acceptability of a school-based program targeting the Psychological Capital constructs of hope, self-efficacy, resilience an optimism of a female adolescent student sample. The study aimed to equip adolescents with practical positive psychology resources (i.e., HERO) that would reduce mental health risk (i.e., anxiety and depression symptoms) and support wellbeing (i.e., flourishing and appearance satisfaction) in the school environment and beyond. Contrary to the hypothesis that a significant increase in the constructs comprising psychological capital would be found from pre- to post-intervention (1), and that the increases would be maintained in the 6-week follow-up period (4), no meaningful changes were found on any of the HERO constructs across time. While a significant increase in hope from post-intervention to the follow-up was detected, the mean hope scores were not significantly higher than the baseline scores. Therefore, the significant increase was not meaningful. Further, despite the significant decrease in optimism scores from pre- to post- intervention, optimism increased back to the level commensurate with baseline scores at the follow-up. Given that no further changes in resilience or efficacy were observed, it can be concluded that the participant’s psychological capital remained comparatively stable throughout and beyond the intervention program. The findings contradict previous findings for adult sample intervention studies aimed at cultivating PsyCap (Lupșa et al., 2019), which have found that overall, interventions tend to result in significantly increasing PsyCap constructs. However, the intervention dose in the current study was very brief in duration (4 x 50-minute sessions). The findings of comparatively brief PsyCap interventions, for example, one intervention consisting of one 3-hour session (Dello Russo & Stoykova, 2015 ) and one 2- hour session (Luthans et al., 2008), found only small effect sizes in the PsyCap outcomes ( d = .19 to .34). Moreover, many schools in Australia subscribe to positive education approaches, and as such, often include positive psychology curriculum in various forms, from informal, incidental learning to more formal classes and instruction (Slemp et al., 2017). The school involved in the current project has focused on positive psychology teaching in numerous health and wellbeing classes. With this in mind, intervention effects on PsyCap constructs might be more substantial for intervention-naïve cohorts of students. As the research of the role of PsyCap in the school context is still in its infancy (King & Caleon., 2020), the current study contributed significantly to the PsyCap literature by trialling a novel approach that attempted to cultivate adolescent’s PsyCap in the educational context, adding to the knowledge on how PsyCap interventions impact on student mental health and wellbeing. Despite the MY HERO program not showing any preliminary effectiveness in cultivating the participant’s psychological capital for the overall cohort, promisingly, a significant mean decrease was observed in the mental health outcomes of anxiety and depression from post- intervention to the 6-week follow-up from the intervention. Further, the participants reported more satisfaction with their physical appearance from pre-intervention to the 6-week follow-up. Thus, the hypotheses that there will be a significant increase in self- perception outcomes and a significant decrease in the mental health outcomes (2) and that the positive impacts would be maintained in the follow-up (4) were partly supported. The findings of the decreased mental health symptomology align with previous school- based multicomponent positive psychology interventions that reported reduced anxiety and depression levels post-intervention, finding a small effect size (Shoshani et al., 2014; Burckhardt et al., 2016 ). Thus, the findings offer preliminary support to the effectiveness of school-based MPPI's, which, although promising, are still rarely implemented (Tejada- Gallardo et al., 2020). Furthermore, the MY HERO program provided a novel contribution to the MPPI literature by targeting the participant's appearance concerns, which have not been targeted in previous MPPI's that the author is aware of. The MPPI based on the PsyCap theory implemented in the current study may offer a valuable and modifiable framework through which the adolescent-specific needs, in this occasion adolescent females' body image concerns, can be targeted. Finally, contrary to the expectations, no statistically significant changes were observed in the outcome of flourishing. One potential explanation to these findings is that these variables measure traits that have been found to be relatively stable over time (Keyes et al., 2014; Harter & Whitesell, 2003) and were not the primary concepts targeted in the MY HERO program. Given the relatively small sample and the brief mode of intervention, larger controlled trials are necessary to determine outcomes at cohort and sub-group levels across these broad domains of functioning. The Role of Pre-Existing Mental Health Symptomology The component of the current study which compared the participants with higher and lower levels of anxiety and depression, offered some preliminary evidence that the MY HERO intervention may have a more substantial influence on participants with greater levels of anxiety symptomology measured at baseline. Interestingly, the preliminary effects of the MY HERO intervention appeared to exert opposite outcomes based on the participant’s pre-existing level of anxiety on study outcomes of optimism and anxiety. The results revealed a significant increase in optimism for the youth with higher baseline anxiety from post-intervention to follow-up, along with a significant decrease in anxiety symptoms from pre- to post- intervention. In contrast, anxiety symptoms increased from pre- to post-intervention for students lower on anxiety at baseline, although they remained at a low level. Surprisingly, there was a significant decrease in hope from pre- to post-intervention for the less anxious youth. Further, unexpectedly for the less anxious youth, efficacy significantly decreased from pre to post-intervention, further decreasing in the six-week follow-up. In contrast, there were no significant time by symptom level effects observed for youth at different levels of depressive symptoms. Therefore, although the hypothesis that students with higher baseline mental health symptomology would experience a greater increase in the PsyCap constructs and mental health outcomes (3) was partly supported, the opposite effects observed within the group with lower baseline anxiety levels were unanticipated. It is currently unclear whether MPPI’s such as the MY HERO program may have more robust effects on youth with clinical anxiety levels, as there are currently no PsyCap intervention studies specifically targeting anxious populations that the author is aware of. However, MPPI’s have been found to have more significant intervention effects on students with higher mental health symptomology measured at baseline (e.g., Burckhardt et al., 2016 ). Thus, future research might examine school-based PsyCap interventions delivered at multiple levels of intervention, from universally delivered (cohort level) to more targeted delivery among youth at risk of anxiety or already with symptomatic levels. Finally, the great majority of the participants found the intervention program helpful and reported that it would be valuable to run the program for future final year students, reflecting the rapidly increasing need and demand for wellbeing-enhancing interventions in schools (Fazel & Kohrt, 2019). Limitations and Future Directions The convenience sampling of only female participants from a private school that already follows a positive education curriculum, as well as the lack of a control group limit the generalisation of the current findings. Despite the need for interventions specifically designed for female adolescents, randomised controlled trials that include a more diverse sample of youth (i.e. gender and different school types) are necessary for the future evaluation of the effectiveness of the MY HERO program in a school context. Furthermore, the pre-intervention survey coincided with the last day of term 1 of the school year and a COVID-19 lockdown, while the timing of the post-survey overlapped with the examination period. COVID-19 restrictions have been found to negatively impact the mental health of adolescents, who heavily rely on their peer connections for emotional support (Magson et al., 2020). The participants’ psychological distress may have been especially pronounced during examination periods, while potentially alleviated during or close to school holiday periods. In future research, more effort should be directed into establishing an appropriate schedule for interventions such as the MY HERO program. However, intervention efforts may be especially valuable during times of increased uncertainty and potential distress. Summary The current study contributed to the PsyCap and MPPI research by implementing a novel intervention aiming to increase the psychological resources and consequent mental wellbeing of adolescent female youth. Although no significant increases in PsyCap were detected post-intervention in the whole sample level, the reductions found in anxiety and depression and improvement in appearance satisfaction were significant. The findings suggest that the MY HERO program may flexibly help address youth mental health needs, and may be particularly effective for those with higher anxiety levels. The research on the effectiveness of school-based MPPI’s is still in its infancy, and the idea that Psychological Capital can be cultivated in the educational context requires further development. However, as the world grows more complex and unpredictable, young minds are becoming increasingly burdened. Consequently, evidence-based intervention programs addressing youth psychological wellbeing via the development of psychological resources are becoming progressively crucial to assist youth to progress into adulthood successfully. Declarations Ethical Approval: All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Competing interests: The authors have no competing interests to declare that are relevant to the content of this article. Authors contributions: The research question, study design, and methodology were developed by R.H., J.F. and L.F. The intervention program and measurement tool were developed by J.F. R.H. collected the primary data, conducted all data analyses, interpreted the findings, prepared the tables and figures and wrote the manuscript with direction from L.F. and J.F. All authors reviewed the manuscript. Funding: No funding was received to assist with the preparation of this manuscript. Availability of data and materials : Due to the nature of this research, participants of this study did not agree for their data to be shared publicly and therefore supporting data is not available. References Barrett, P. M., & Pahl, K. M. (2006). School-Based Intervention: Examining a Universal Approach to Anxiety Management. Australian Journal of Guidance and Counselling , 16 (1), 55–75. https://doi.org/10.1375/ajgc.16.1.55 Burckhardt, R., Manicavasagar, V., Batterham, P. J., & Hadzi-Pavlovic, D. (2016). A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology. Journal of School Psychology , 57 (1), 41–52. https://doi.org/10.1016/j.jsp.2016.05.008 Brennan, N., Beames, J. R, Kos, A., Reily, N., Connell, C., Hall, S., Yip, D., Hudson, J., O’Dea, B., Di Nicola, K., and Christie, R. (2021) Psychological Distress in Young People in Australia Fifth Biennial Youth Mental Health Report: 2012-2020. Mission Australia: Sydney, NSW. Carmona-Halty, M., Schaufeli, W. B., & Salanova, M. (2019). Good Relationships, Good Performance: The Mediating Role of Psychological Capital – A Three-Wave Study Among Students. Frontiers in Psychology , 10 (1). https://doi.org/10.3389/fpsyg.2019.00306 Chodkiewicz, A. R., & Boyle, C. (2016). Positive psychology school-based interventions: A reflection on current success and future directions. Review of Education , 5 (1), 60–86. https://doi.org/10.1002/rev3.3080 Cuijpers, P., Smits, N., Donker, T., ten Have, M., & de Graaf, R. (2009). Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory. Psychiatry Research , 168 (3), 250–255. https://doi.org/10.1016/j.psychres.2008.05.012 Datu, J. A. D., King, R. B., & Valdez, J. P. M. (2016). Psychological capital bolsters motivation, engagement, and achievement: Cross-sectional and longitudinal studies. The Journal of Positive Psychology , 13 (3), 260–270. https://doi.org/10.1080/17439760.2016.1257056 Datu, J. A. D., & Valdez, J. P. M. (2015). Psychological Capital Predicts Academic Engagement and Well-Being in Filipino High School Students. The Asia-Pacific Education Researcher , 25 (3), 399–405. https://doi.org/10.1007/s40299-015-0254-1 Dello Russo, S., & Stoykova, P. (2015). Psychological Capital Intervention (PCI): A Replication and Extension. Human Resource Development Quarterly , 26 (3), 329– 347. https://doi.org/10.1002/hrdq.21212 Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D.-w., Oishi, S., & Biswas-Diener, R. (2010, 06//). New Well-being Measures: Short Scales to Assess Flourishing and Positive and Negative Feelings [Article]. Social Indicators Research, 97 (2), 143-156. https://doi.org/10.1007/s11205-009-9493-y Donnelly, A., Fitzgerald, A., Shevlin, M., & Dooley, B. (2018). Investigating the psychometric properties of the revised child anxiety and depression scale (RCADS) in a non-clinical sample of Irish adolescents. Journal of Mental Health . https://doi.org/10.1080/09638237.2018.1437604 Ebesutani, C., Reise, S. P., Chorpita, B. F., Ale, C., Regan, J., Young, J., Charmaine, H.-M., & Weisz, J. R. (2012). The Revised Child Anxiety and Depression Scale-Short Version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor. Psychological Assessment, 24 (4), 833-845. https://doi.org/10.1037/a0027283 Ey, S., Hadley, W., Allen, D. N., Palmer, S., Klosky, J., Deptula, D., Thomas, J., & Cohen, R. (2005). A new measure of children's optimism and pessimism: the Youth Life Orientation Test. Journal of Child Psychology & Psychiatry, 46 (5), 548-558. https://doi.org/10.1111/j.1469-7610.2004.00372.x Fang, S., & Ding, D. (2020). The efficacy of group-based acceptance and commitment therapy on psychological capital and school engagement: A pilot study among Chinese adolescents. Journal of Contextual Behavioral Science , 16 (1), 134–143. https://doi.org/10.1016/j.jcbs.2020.04.005 Fazel, M., & Kohrt, B. A. (2019). Prevention versus intervention in school mental health. The Lancet Psychiatry , 6 (12), 969–971. https://doi.org/10.1016/s2215-0366(19)30440-7 Finch, J., Farrell, L. J., & Waters, A. M. (2020). Searching for the HERO in Youth: Does Psychological Capital (PsyCap) Predict Mental Health Symptoms and Subjective Wellbeing in Australian School-Aged Children and Adolescents? Child Psychiatry & Human Development . https://doi.org/10.1007/s10578-020-01023-3 Finch, J., Waters, A. M., & Farrell, L. J. (2023). Developing the HERO within: Evaluation of a brief intervention for increasing Psychological Capital (PsyCap) in Australian female students during the final year of school in the first year of COVID-19. Journal of Affective Disorders , 324 , 616–623. https://doi.org/10.1016/j.jad.2022.12.169 Gambin, M., & Święcicka, M. (2012). Construction and validation of Self-Efficacy Scale for early school-aged children. European Journal of Developmental Psychology, 9 (6), 723-729. https://doi.org/10.1080/17405629.2012.688100 Harter, S. (2012). Self-perception profile for adolescents: Manual and questionnaires. Denver, CO: Univeristy of Denver, Department of Psychology . Harter, S., & Whitesell, N. R. (2003). Beyond the Debate: Why Some Adolescents Report Stable Self-Worth Over Time and Situation, Whereas Others Report Changes in Self- Worth. Journal of Personality , 71 (6), 1027–1058. https://doi.org/10.1111/1467- 6494.7106006 Harty, B., Gustafsson, J.-A., Björkdahl, A., & Möller, A. (2016). Group intervention: A way to improve working teams’ positive psychological capital. Work , 53 (2), 387–398. https://doi.org/10.3233/wor-152227 Hay, P., Girosi, F., & Mond, J. (2015). Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. Journal of Eating Disorders , 3 (1). https://doi.org/10.1186/s40337-015-0056-0 Helfert, S., & Warschburger, P. (2013). The face of appearance-related social pressure: gender, age and body mass variations in peer and parental pressure during adolescence. Child and Adolescent Psychiatry and Mental Health , 7 (1), 16. https://doi.org/10.1186/1753-2000-7-16 Horowitz, J. L., Garber, J., Ciesla, J. A., Young, J. F., & Mufson, L. (2007). Prevention of depressive symptoms in adolescents: A randomized trial of cognitive-behavioral and interpersonal prevention programs. Journal of Consulting and Clinical Psychology , 75 (5), Katajisto, M., Hyvärinen, S., & Uusiautti, S. (2021). Changes in Finnish ninth graders’ positive psychological capital (PsyCap) in a strength-based student guidance intervention. International Journal of Adolescence and Youth , 26 (1), 321–339. https://doi.org/10.1080/02673843.2021.1943469–706. https://doi.org/10.1037/0022-006x.75.5.693 Keski-Rahkonen, A., Raevuori, A., & Hoek, H. W. (2018). Epidemiology of eating disorders: an update. Annual Review of eating disorders , 66-76. Kessler, R. C., Angermeyer, M., Anthony, J. C., DE Graaf, R., Demyttenaere, K., Gasquet, I., DE Girolamo, G., Gluzman, S., Gureje, O., Haro, J. M., Kawakami, N., Karam, A., Levinson, D., Medina Mora, M. E., Oakley Browne, M. A., Posada-Villa, J., Stein, D. J., Adley Tsang, C. H., Aguilar-Gaxiola, S., Alonso, J., … Ustün, T. B. (2007). Lifetime prevalence and age-of- onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World psychiatry : official journal of the World Psychiatric Association (WPA) , 6 (3), 168–176. Keyes, C. L. M. (2002). The Mental Health Continuum: From Languishing to Flourishing in Life. Journal of Health and Social Behavior , 43 (2), 207. https://doi.org/10.2307/3090197 Keyes, C. L. M., Kendler, K. S., Myers, J. M., & Martin, C. C. (2014). The Genetic Overlap and Distinctiveness of Flourishing and the Big Five Personality Traits. Journal of Happiness Studies , 16 (3), 655–668. https://doi.org/10.1007/s10902-014-9527-2 King, R. B., & Caleon, I. S. (2020). School Psychological Capital: Instrument Development, Validation, and Prediction. Child Indicators Research , 14 (1). https://doi.org/10.1007/s12187-020-09757-1 Klaufus, L., Verlinden, E., van der Wal, M., Kösters, M., Cuijpers, P., & Chinapaw, M. (2020). Psychometric evaluation of two short versions of the Revised Child Anxiety and Depression Scale. BMC Psychiatry , 20 (1). https://doi.org/10.1186/s12888-020- 2444-5 Lawrence D., Johnson S., Hafekost J., Boterhoven De Haan K., Sawyer M., Ainley J., Zubrick SR. (2015). The Mental Health of Children and Adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Department of Health, Canberra. Liebenberg, L., Ungar, M., & LeBlanc, J. C. (2013). The CYRM-12: A brief measure of resilience. Canadian Journal of Public Health, 104 (2), e131-e135. https://www.springer.com/public+health/journal/41997 Lupșa, D., Vîrga, D., Maricuțoiu, L. P., & Rusu, A. (2019). Increasing Psychological Capital: A Pre‐ Registered Meta‐Analysis of Controlled Interventions. Applied Psychology , 69 (4), 1506– 1556. https://doi.org/10.1111/apps.12219 Luthans, F., Avey, J. B., & Patera, J. L. (2008). Experimental Analysis of a Web-Based Training Intervention to Develop Positive Psychological Capital. Academy of Management Learning & Education , 7 (2), 209–221. https://doi.org/10.5465/amle.2008.32712618 Luthans, F., Avolio, B. J., Avey, J. B., & Norman, S. M. (2007). Positive Psychological Capital: Measurement And Relationship With Performance And Satisfaction Personnel Psychology , 60 (3), 541–572. https://Doi.Org/10.1111/J.1744-.00083 Magson, N. R., Freeman, J. Y. A., Rapee, R. M., Richardson, C. E., Oar, E. L., & Fardouly, J. (2020). Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. Journal of Youth and Adolescence , 50 (1). https://doi.org/10.1007/s10964-020-01332-9 Masia-Warner, C., Nangle, D. W., & Hansen, D. J. (2006). Bringing evidence-based child mental health services to the schools: General issues and specific populations. Education and Treatment of Children , 29 (2), 165-172 Moon, J., Williford, A., & Mendenhall, A. (2017). Educators’ perceptions of youth mental health: Implications for training and the promotion of mental health services in schools. Children and Youth Services Review , 73 (1), 384–391. https://doi.org/10.1016/j.childyouth.2017.01.006 O’Mara, L., & Lind, C. (2013). What do we know about school mental health promotion programmes for children and youth? Advances in School Mental Health Promotion , 6 (3), 203–224. https://doi.org/10.1080/1754730x.2013.811952 Owens, R. L., & Waters, L. (2020). What does positive psychology tell us about early intervention and prevention with children and adolescents? A review of positive psychological interventions with young people. The Journal of Positive Psychology , 15 (5), 588-597. https://doi.org/10.1080/17439760.2020.1789706 Preston, A., Rew, L., & Young, C. C. (2023). A systematic scoping review of psychological capital related to mental health in youth. The Journal of School Nursing , 39 (1), 72-86. https://doi.org/10.1177/10598405211060415 Rapee, R. M., Oar, E. L., Johnco, C. J., Forbes, M. K., Fardouly, J., Magson, N. R., & Richardson, C. E. (2019). Adolescent development and risk for the onset of social-emotional disorders: A review and conceptual model. Behaviour Research and Therapy , 123 (1), 103501. https://doi.org/10.1016/j.brat.2019.103501 Rusk, R. D., Vella-Brodrick, D. A., & Waters, L. (2017). A complex dynamic systems approach to lasting positive change: The Synergistic Change Model. The Journal of Positive Psychology , 13 (4), 406–418. https://doi.org/10.1080/17439760.2017.1291853 Rohde, P., Stice, E., & Marti, C. N. (2014). Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. International Journal of Eating Disorders , 48 (2), 187–198. https://doi.org/10.1002/eat.22270 Romano, I., Ferro, M. A., Patte, K. A., Diener, E., & Leatherdale, S. T. (2020). Measurement Invariance of the Flourishing Scale among a Large Sample of Canadian Adolescents. International Journal of Environmental Research and Public Health , 17 (21), 7800. https://doi.org/10.3390/ijerph17217800 Seligman, M. (2018). PERMA and the building blocks of well-being. The Journal of Positive Psychology , 13 (4), 333–335. https://doi.org/10.1080/17439760.2018.1437466 Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist , 55 (1), 5–14. https://doi.org/10.1037/0003-066x.55.1.5 Shoshani, A., & Steinmetz, S. (2013). Positive Psychology at School: A School-Based Intervention to Promote Adolescents’ Mental Health and Well-Being. Journal of Happiness Studies , 15 (6), 1289–1311. https://doi.org/10.1007/s10902-013-9476-1 Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. Journal of Clinical Psychology , 65 (5), 467–487. https://doi.org/10.1002/jclp.20593 Siu, O. L., Bakker, A. B., & Jiang, X. (2013). Psychological Capital Among University Students: Relationships with Study Engagement and Intrinsic Motivation. Journal of Happiness Studies , 15 (4), 979–994. https://doi.org/10.1007/s10902-013-9459-2 Slade, T., Johnston, A., Oakley Browne, M. A., Andrews, G., & Whiteford, H. (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. The Australian and New Zealand Journal of Psychiatry , 43 (7), 594–605. https://doi.org/10.1080/00048670902970882 Slemp, G. R., Chin, T. C., Kern, M. L., Siokou, C., Loton, D., Oades, L. G., ... & Waters, L. (2017). Positive education in Australia: Practice, measurement, and future directions. In Social and emotional learning in Australia and the Asia-Pacific (pp. 101-122). Springer, Singapore https://doi.org/10.1007/978-981-10-3394-0_6 Snyder, C. R., Hoza, B., Pelham, W. E., Rapoff, M., Ware, L., Danovsky, M., Highberger, L., Rubinstein, H., & Stahl, K. J. (1997). The development and validation of the Children's Hope Scale. Journal of Pediatric Psychology, 22 (3), 399 - 421.https://doi.org/10.1093/jpepsy/22.3.399 Tejada-Gallardo, C., Blasco-Belled, A., Torrelles-Nadal, C., & Alsinet, C. (2020). Effects of School-based Multicomponent Positive Psychology Interventions on Well-being and Distress in Adolescents: A Systematic Review and Meta-analysis. Journal of Youth and Adolescence , 49 (10), 1943–1960. https://doi.org/10.1007/s10964-020-01289-9 ter Bogt, T. F. M., van Dorsselaer, S. A. F. M., Monshouwer, K., Verdurmen, J. E. E., Engels, R. C. M. E., & Vollebergh, W. A. M. (2006). Body Mass Index and Body Weight Perception as Risk Factors for Internalizing and Externalizing Problem Behavior Among Adolescents. Journal of Adolescent Health , 39 (1), 27–34. https://doi.org/10.1016/j.jadohealth.2005.09.007 Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology , 128 (3), 185–199. https://doi.org/10.1037/abn0000410 Volpe, U., Tortorella, A., Manchia, M., Monteleone, A. M., Albert, U., & Monteleone, P. (2016). Eating disorders: What age at onset? Psychiatry Research , 238 (1), 225–227. https://doi.org/10.1016/j.psychres.2016.02.048 Werner-Seidler, A., Perry, Y., Calear, A. L., Newby, J. M., & Christensen, H. (2017). School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis. Clinical Psychology Review , 51 (51), 30–47. https://doi.org/10.1016/j.cpr.2016.10.005 Wiens, K., Bhattarai, A., Pedram, P., Dores, A., Williams, J., Bulloch, A., & Patten, S. (2020). A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018. Epidemiology and Psychiatric Sciences , 29 (1). https://doi.org/10.1017/s2045796020000281 Tables Table 1. The content included in the PsyCap-HERO program Workshop Content 1. Hope & Self-Care Introduction to the workshop series and PsyCap theory, psychoeducation and quiz on hope theory, case study video and worksheet assisted group activity on self-care. 2. Efficacy & Body- Image Psychoeducation and quiz on self-efficacy theory and self-efficacy in the context of body image, case study video and worksheet assisted group activity on self-efficacy and body image. 3. Resilience & Self- Worth Psychoeducation and quiz on resilience theory and resilience in the context of self-worth, video on self-worth and worksheet assisted individual activity on resilience and self-worth. 4. Optimism & Mood Psychoeducation and quiz on optimism theory, video on learned optimism and cultivating optimism, group activity on comparing optimism to pessimism and worksheet assisted individual activity on optimism. Table 2. Mean scores at pre-, post- and at follow-up for students participating in the PsyCap-HERO intervention on primary and secondary outcome variables Variable Pre (T1) Mean (SD) n = 83 Post (T2) Mean (SD) n = 80 Follow-up (T3) Mean (SD) n = 77 1. Hope 44.54(7.75) 43.09 (9.06) 44.21 (8.39) 2. Efficacy 121.99(20.54) 123.44(20.03) 119.49(23.0) 3. Resilience 68.70(10.42) 66.90(12.03) 67.64(10.24) 4. Optimism 44.50(9.91) 42.76(10.58) 44.58(10.69) 5. Appearance Satisfaction 10.71(3.75) 11.42(4.12) 11.48(4.02) 6. Global Self-Worth 13.24(3.02) 13.42(3.29) 13.00(3.45) 7. Flourishing 43.65(7.37) 43.56(7.82) 42.82(7.74) 8. Anxiety 15.88(8.79) 15.55(8.84) 14.01(8.87) 9. Depression 13.16(6.68) 13.74(6.98) 12.66(7.32) Table 3. Means and Standard Deviations of students with higher and lower baseline anxiety scores on the primary and secondary outcomes before, after and at the 6-week follow-up High Anxiety Group Mean (SD) n =22 Low Anxiety Group Mean (SD) n = 20 T1. T2. T3. T1. T2. T3. Variable 1. Hope 41.41(1.78) 41.54(1.97) 43.09(2.28) 47.35(1.14) 45.40(1.56) 46.25(1.32) 2. Efficacy 114.50(4.4) 116.82(4.67) 118.59(4.86) 134.85(2.58) 128.30(4.25) 125.90(4.14) 3.Resilience 65.23(1.87) 65.41(2.32) 66.09(2.64) 72.85(1.82) 70.40(2.36) 71.15(1.84) 4. Optimism 40.05(1.98) 39.77(2.10) 43.41(2.46) 49.80(1.40) 45.70(2.15) 47.00(2.18) 5. Physical Appearance 9.05(.69) 9.45(.89) 10.27(.83) 13.25(.86) 14.10(.89) 13.90(.87) 6. Global Self-Worth 12.09(.60) 12.23(.73) 11.86(.69) 14.70(.70) 14.85(.72) 14.50(.64) 7.Flourishing 40.73(1.63) 40.27(2.07) 40.09(1.82) 47.45(1.08) 45.30(1.50) 44.80(1.67) 8. Anxiety 22.05(1.47) 21.55(71.53) 18.64(1.43) 8.75(.85) 11.60(1.47) 10.50(1.46) 9.Depression 17.55(1.10) 17.68(1.27) 16.18(1.43) 8.50(.91) 11.40(1.40) 10.25(1.60) Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 05 Dec, 2023 Read the published version in Child Psychiatry & Human Development → Version 1 posted Editorial decision: Major revision 09 Sep, 2023 Reviews received at journal 16 Aug, 2023 Reviewers agreed at journal 26 Jul, 2023 Reviewers invited by journal 14 Jul, 2023 Editor assigned by journal 05 Jul, 2023 Submission checks completed at journal 29 Jun, 2023 First submitted to journal 17 Jun, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3075824","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":214263776,"identity":"990c5ccf-c979-4ede-969a-2e9683c2b4f5","order_by":0,"name":"Reetta Heikkila","email":"","orcid":"","institution":"Griffith University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Reetta","middleName":"","lastName":"Heikkila","suffix":""},{"id":214263777,"identity":"66bb41c1-f460-48b2-b6ba-b62e24a6143f","order_by":1,"name":"Jules Finch","email":"","orcid":"","institution":"Griffith University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jules","middleName":"","lastName":"Finch","suffix":""},{"id":214263779,"identity":"400dcb71-932a-4d2b-9eae-5460bcbcb88c","order_by":2,"name":"Allison M Waters","email":"","orcid":"","institution":"Griffith University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Allison","middleName":"M","lastName":"Waters","suffix":""},{"id":214263781,"identity":"c2026263-127f-4083-96d3-8e9e79368aed","order_by":3,"name":"Lara J Farrell","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEElEQVRIie3Qv0vEMBTA8RceJMvzura0nP9CjpuEav+VlEKn2wTBLXDQ0fkE/R/8AxwiN7gcjqJbQdBF4cDlRMF79Rc45OgomO/Ql0I+pClAKPQHG4Bou5kNlAUw+ZAg5lfaQCSg7iZJckzqMVF/Ehse9Rj6EPF8eJ6TTB6ul63RWZFa0T41sK2dl2CyuK9JppP9mTGaKHM4Om1gdOYlkUusm3ekgnL1xncxMt1qQPgJ4ot17/xhiwo+TomNemVSbCCST3F8fTX/JhKZlF6CKHesq/gnT/CT3JTT5OQqro49JFJTvLVubxipyzuxMrpQs+pi+XiQ7x55CODPivTXQlh+xJ79v1Jtn12hUCj0D1sD5s1KW5NpHqIAAAAASUVORK5CYII=","orcid":"","institution":"Griffith University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Lara","middleName":"J","lastName":"Farrell","suffix":""}],"badges":[],"createdAt":"2023-06-17 12:14:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3075824/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3075824/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10578-023-01629-3","type":"published","date":"2023-12-05T15:01:33+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":39467578,"identity":"c3d67fab-35e8-4cf7-b534-769d8d2d5332","added_by":"auto","created_at":"2023-07-03 14:14:12","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":37015,"visible":true,"origin":"","legend":"\u003cp\u003eChanges in anxiety scores across the intervention program in groups with high anxiety (above the median, n =22 ) and low anxiety (below the median, n =20 ) measured at baseline\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3075824/v1/22e45406f202517b260472d3.png"},{"id":47989240,"identity":"2617f7b3-5141-4227-82d1-3e8518c7f85f","added_by":"auto","created_at":"2023-12-11 15:08:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":433702,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3075824/v1/d4417a66-d9dc-4e5a-b778-02c235553d73.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Preliminary Effectiveness of a Brief School-Based HERO Intervention: Improving the Wellbeing of Final Year Adolescent Female Students","fulltext":[{"header":"Introduction","content":"\u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eAdolescence is a uniquely formative time of rapid physiological, cognitive and psychosocial development, that paired with increased societal and interpersonal stress, may increase susceptibility to developing mental health symptomology (Rapee et al., 2019). Youth mental health is recognised as a global health concern, and according to the WHO, an estimated 10\u0026ndash;20% of adolescents worldwide experience a mental health condition, with 75% of mental health disorders emerging by 24 years of age (Kessler et al., 2007). Further, representative data indicate that youth mental health problems are becoming increasingly prevalent (Twenge et al., 2019; Wiens et al., 2020), and concerningly, most young people who need help remain undiagnosed and untreated (Kessler et al., 2007; Slade et al., 2009). Thus, adolescence is a crucial time to intervene and serves as a window of opportunity to address mental health concerns early so health and functional outcomes can be maximised into adulthood.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eGender Differences in Mental Health During Adolescence\u003c/h3\u003e\n\u003cp\u003eIn Australia, female adolescents present with a higher prevalence of mental health disorders than their male counterparts. According to the National Australian Child and Adolescent Survey of Mental Health and Wellbeing (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2,968), in the years 2013 to 2014, 4.3% of males aged 12\u0026ndash;17 years and 5.8% of females aged 12\u0026ndash;17 years had a major depressive disorder, while 7.7% of females and 6.3% of males aged between 12 and 17 had an anxiety disorder (Lawrence et al., 2015). These findings also reflect the prevalence of psychological distress, which refers to non-specific symptoms of stress, anxiety and depression, which may indicate impaired mental and common mental disorders like depressive and anxiety disorders (Cuijpers et al., \u003cspan class=\"CitationRef\"\u003e2009\u003c/span\u003e). According to Brennan et al., (\u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e), who conducted an extensive survey (n\u0026thinsp;=\u0026thinsp;25,800) on Australian youth aged 15 to 19 years, 34% of the female participants reported significant psychological distress compared to their male counterparts, of which 15.3% reported significant psychological distress.\u003c/p\u003e\n\u003cp\u003eAdolescence is also a period of risk for developing body image disturbances, as adolescent psychosocial development is characterised by a high inclination for introspection and self-scrutiny, social comparisons, and self-awareness connected to physical image and social development (Helfert \u0026amp; Warschburger, 2013). In Australia, body dissatisfaction is more prevalent in females, with 42.8% of females compared with 14.5% of males, being very or extremely concerned about body image (Brennan et al., \u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e). Poor body image has been associated with several negative outcomes such as low self-esteem, depression and anxiety (Ter Bogt et al., 2006). Further, body dissatisfaction has been found to be a significant prospective predictor of diagnosed eating disorders (Rohde et al., 2015). Eating disorders such as Anorexia Nervosa and Bulimia have been found to have an average onset age of 16\u0026ndash;18 years (Volpe et.al., 2016) and are estimated to affect 16.3% of the Australian population (Hay et al., 2015). Thus, the unique mental health concerns of female youth require individualised intervention efforts that target the most relevant issues, including body image concerns, that significantly impact mental health in this population.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eSchool-Based Interventions\u003c/h2\u003e\n \u003cp\u003eSchools have unparalleled access to youth and represent a unique context where most adolescents can be reached near-universally (Masia-Warner et al., 2006). Schools may present an ideal environment for the early detection of mental health problems and an appropriate setting for prevention and early intervention programs (Werner-Seidler et al., 2017). Many of the barriers that are common to traditional mental health service provision can be reduced in the school environment, including the stigma associated with seeing professionals in typical medical settings, reduced cost and time associated with seeking services (Barrett \u0026amp; Pahl, \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e; Masia-Warner et al., 2006).\u003c/p\u003e\n \u003cp\u003eUniversal programs, which refer to intervention programs delivered to all students regardless of symptom level designed to enhance general psychological wellbeing or mental health (Barrett \u0026amp; Pahl, \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e), have many advantages. In addition to their ability to reach a demographically broad range of adolescents, school administrators may prefer universal interventions because of their broad applicability and reduced time requirement for screening and selecting participants (Horowitz et al., 2007). Universal school-based interventions have been widely recommended and successfully implemented to promote mental health in young people (O\u0026apos;Mara \u0026amp; Lind, 2013). Despite the potential of the educational context in preventing mental health problems, schools are currently underutilised for mental health interventions (Moon et al., 2017). However, due to the growing recognition of the necessity for school- based interventions and evidence for their effectiveness, the demand for universal wellbeing interventions in the educational context is rapidly increasing (Fazel \u0026amp; Kohrt, 2019). In recent years, especially interventions with positive, strengths-based approaches have gained popularity within schools (Owens \u0026amp; Waters, 2020).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eMulticomponent Positive Psychology Interventions\u003c/h2\u003e\n \u003cp\u003ePositive psychology is a theoretical perspective introduced at the turn of the century, which proposes that mental health is not defined as the mere absence of mental disorder, but instead, includes the presence of positive qualities and attributes that encourage positive functioning (Seligman \u0026amp; Csikszentmihalyi, 2000). The recent shift of emphasis from targeting student deficits and disorders towards enhancing students\u0026apos; psychological strengths and positive resources has resulted in the development and implementation of positive psychology interventions (Chodkiewicz \u0026amp; Boyle, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e). According to Sin \u0026amp; Lyubomirsky (2009), positive psychology interventions aim to promote wellbeing by increasing positive feelings, cognitions, or behaviours, in contrast to interventions aiming to reduce symptoms, problems, or disorders. Wellbeing can be defined in various ways. One well established indicator of wellbeing is flourishing, which can be considered as the opposite end of the mental health spectrum to common mental disorders, characterised by positive mental health including positive emotions, engagement in meaningful activities and sense of purpose (Keyes, 2002).\u003c/p\u003e\n \u003cp\u003eAdolescents within the school context present with varied and often complex needs, across the full spectrum of risk. Multicomponent positive psychology interventions (MPPIs) are based on multiple individual exercises targeting two or more theoretically relevant wellbeing components that resemble the critical elements of positive education and are conducted within an integral program (Seligman., 2018). The literature argues that multidimensional interventions and interventions with greater variety may be especially effective (King \u0026amp; Caleon., 2020) and more likely to provide long-term effects (Rusk et al., 2017). A recent meta-analysis of nine studies (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4,898 youth) by Tejada-Gallardo et al., (2020) found that school-based MPPIs enhanced subjective and psychological wellbeing and reduced depression symptoms in the short and long-term among adolescents. For example, a randomised controlled trial (Burckhardt et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e) investigated the effectiveness of an intervention that targeted multiple components of subjective wellbeing (i.e., mindfulness, gratitude, character strengths, optimism and hope) via 16 half-hour sessions (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;267). The results showed that participation in the intervention was significantly associated with reductions in depression, stress and anxiety, and increased wellbeing, with more significant changes observed in the participants who commenced the program with high depression and anxiety scores. Thus, brief multidimensional intervention programs grounded in theory and empirical evidence may be viable in enhancing the wellbeing and mental health outcomes of students with varied needs. Despite the promising evidence of the advantages, there is currently a scarcity of research on the effectiveness of MPPI in adolescents, particularly in the school setting (Tejada-Gallardo et al., 2020).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003ePsychological Capital\u003c/h2\u003e\n \u003cp\u003eOne potential multidimensional positive psychology construct that has attracted a great deal of empirical support in organisational psychology is psychological capital (PsyCap). PsyCap is defined as \u0026ldquo;an individual\u0026rsquo;s positive psychological state of development characterised by having confidence (self-efficacy) to take on and put in the necessary effort to succeed at challenging tasks; making a positive attribution (optimism) about succeeding now and in the future; persevering toward goals and, when necessary, redirecting paths to goals (hope) to succeed; and when beset by problems and adversity, sustaining and bouncing back and even beyond (resilience) to attain success\u0026rdquo; (Luthans et al. 2007). A large body of literature suggests that interventions targeting PsyCap constructs in the organisational context effectively enhance PsyCap, which in turn results in a multitude of positive outcomes, such as increased psychological wellbeing and reduced psychological distress, including stress and anxiety (Lupșa et al., 2019). For instance, Harty et al., (2016) found that a 10-week group intervention targeting PsyCap (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;66) was effective in increasing the level of positive emotions, self-efficacy and job satisfaction among employees, with the positive changes observed at the end of the program maintained at the six-month follow-up assessment.\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eCurrently, most of the PsyCap literature has been confined to organisational contexts. However, an emerging body of research has demonstrated a relationship between PsyCap and positive mental health outcomes among youth (Preston et al., 2023). For instance, PsyCap has been found to be a better predictor of student wellbeing outcomes than the individual HERO constructs according to Finch et al., (2020), who examined the association between both overall PsyCap and the individual HERO constructs with mental health symptoms and subjective wellbeing among Australian school-aged children and adolescents (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;456). The study found that while higher levels of each of the HERO constructs were associated with lower levels of depression and anxiety symptoms and greater levels of flourishing, PsyCap was found to be a stronger predictor of decreased levels of student depression and anxiety symptoms and increased levels of flourishing, than the individual HERO constructs. The association between PsyCap and wellbeing was further supported by King \u0026amp; Caleon (2020), who found that PsyCap predicted the positive indicators of wellbeing such as life satisfaction, positive affect, and happiness, and negatively predicted ill-being indicators such as negative affect and depression among high school students.\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003eThe benefits of increased PsyCap in the school context may be far-reaching, as preliminary evidence suggests that PsyCap may be an essential predictor of ideal academic outcomes such as engagement (Datu et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e; Datu \u0026amp; Valdez, \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e), motivation (Siu et al., 2013; Datu et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e) and achievement (Carmona-Halty et al., \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e; Datu \u0026amp; Valdez, \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e) among high school students. For example, Datu et al. (\u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e) discovered that higher PsyCap was associated with lower levels of school absenteeism and greater motivation to achieve academic goals among Filipino adolescents (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;384). Furthermore, Carmona-Halty et al., (\u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e) discovered that Chilean high school students (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;771) with higher PsyCap levels were more likely to achieve better academic performance, such as higher exam grades than their counterparts with lower PsyCap levels. Given the contextual similarities between employees within organisations and students within schools, it is an apparent gap in the literature that PsyCap has not been investigated as a potential intervention framework for school-based positive psychology education programs.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003eSchool-Based Psychological Capital Interventions\u003c/h2\u003e\n \u003cp\u003eDespite the evidence of the benefits and potential of PsyCap among adolescents, there are currently very few intervention efforts aimed at increasing youth PsyCap in schools. Recently, some efforts have been directed toward PsyCap intervention research in the educational context. Katajisto et al., (2021) investigated whether a guidance intervention aimed at increasing character strengths (8 x 75-minute group sessions and 1x 60-minute individual session) could increase PsyCap in Finnish high school students (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;57). The study discovered a more significant increase in the test group\u0026apos;s PsyCap scores, strengths, and resources compared to a control group. Furthermore, a group-based acceptance and commitment intervention (10 x 1-hour workshops) aimed at increasing PsyCap among Chinese adolescents (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;35) found a significant increase in the participants\u0026apos; PsyCap and school engagement post-intervention (Fang \u0026amp; Ding, 2020). Although preliminary evidence suggests that PsyCap can be successfully cultivated in adolescents through school-based interventions, the existing literature consists of small pilot studies that use interventions that are yet to be well-established and approaches that do not directly target PsyCap. However, a pilot study by Finch et al., (2023) examined the effectiveness of an intervention that targeted PsyCap directly. The study aimed to increase PsyCap and decrease perfectionism and mental health symptoms in an adolescent female student cohort via a brief, 4-session intervention (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;82). Significant increases in PsyCap and significant decreases perfectionism were found post-intervention, which supports the preliminary evidence suggesting that PsyCap may be successfully cultivated among youth in a school context.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003eThe Current Study\u003c/h2\u003e\n \u003cp\u003eThe current study responds to the growing interest and demand to increase youth wellbeing and mental health within the school context, using positive, strengths-based perspectives (Tejada-Gallardo et al., 2020; Owens \u0026amp; Waters, 2020). The purpose of the study was to examine the preliminary effectiveness and acceptability of brief, novel multi- component school-based intervention aimed at enhancing psychological capital and subsequent wellbeing and mental health among adolescent females aged between 16 and 18 years during the final year of high school. The uniqueness of the current intervention is in its flexibility. In addition to targeting the PsyCap constructs, the program has been tailored through a co-design framework to respond to the current cohort\u0026rsquo;s specific concerns.\u003c/p\u003e\n \u003cp\u003eAs schools have limited time available for interventions, the study examined whether a brief intervention program consisting of four 50-minute sessions may be of value. This study expands upon the intervention study conducted by Finch et al., (2023) by examining the effectiveness of a similar intervention program, modified based on the needs of the current cohort. An open-trial design was implemented, with student outcomes assessed at pre-, post- and 6 weeks following the intervention. The primary outcomes included the PsyCap constructs of hope, self-efficacy, resilience and optimism. The secondary outcomes included the wellbeing outcome of flourishing and the self-perception construct of appearance satisfaction, as well as the mental health outcomes of anxiety and depression. Further, although the current intervention was universal and delivered to all students regardless of symptom level, the study aimed to explore whether the HERO intervention may have a differential impact on the participants who are at greater risk for mental health problems, as indexed by elevated self-reported depression and anxiety symptoms at baseline, relative to students with lower symptoms.\u003c/p\u003e\n \u003cp\u003eBased on previous findings of the PsyCap and MPPI studies to date, it was hypothesised that (1) there would be a significant increase in the primary PsyCap outcomes of hope, efficacy, resilience and optimism from pre to post-intervention, and (2) there would be a significant increase in the secondary wellbeing outcomes appearance satisfaction and flourishing, and a significant decrease in the secondary mental health outcomes of anxiety and depression from pre to post-intervention. Furthermore, (3) students with higher mental health symptomology at baseline (as indexed by elevated scores on self-reported anxiety and depression) would experience a greater increase in the primary PsyCap outcomes of hope, efficacy, resilience and optimism and a greater reduction in the secondary mental health outcomes of anxiety and depression across time, relative to students lower on anxiety and depression at baseline. Finally, (4) it was hypothesised that outcomes outlined in H1-H3 would be maintained to the 6- week follow-up, and (5) the intervention would be found acceptable by the participants based on student evaluations of the program at post- intervention.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003eParticipants\u003c/h2\u003e\n \u003cp\u003eThe participants consisted of a school-based convenience sample of 95 Year 12 students aged between 16 and 18 years from Brisbane, Australia. The participants were recruited via a pre-existing partnership with the school, an all-girls Catholic College, engaged with a broader continuing research program with the affiliated university. The mean age of the participants was 16.78 years (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.45), and 98.8% of the participants identified as female, with 1.2% as other. English was the primary language spoken at home for 97.6% of the sample. In terms of living arrangements, 79.5% reported that they lived with both parents, 10.8% with mother only, 8.4% shared between mother and father, and 1.2% lived with other guardians (e.g. aunt or grandparents).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003eMeasures\u0026nbsp;\u003c/h2\u003e\n \u003ch2\u003eDemographics\u003c/h2\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eThe participants\u0026apos; demographic information, including age, gender, primary language spoken at home and living arrangements, were collected at the baseline pre-survey.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eHERO-constructs\u003c/h2\u003e\n \u003cp\u003eThe Measure of Youth Hope, Self-Efficacy, Resilience and Optimism is an unpublished measurement tool that consists of 63 items (MY-HERO; Finch et al., 2019). The scale assesses students\u0026rsquo; self-reported levels of the PsyCap-HERO constructs. The items for each of the MY HERO subscales of hope (10 items), self-efficacy (27 items), resilience (15 items), and optimism (11 items) consist of items adapted from previously validated measures of the individual HERO constructs in children and youth. The hope scale is adapted from The Children\u0026rsquo;s Hope Scale (Snyder et al., 1997), the self-efficacy scale is adapted from the Self- Efficacy Scale for Children (Gambin \u0026amp; Święcicka, 2012), the resilience scale is adapted from The Children and Youth Resilience Measure (Liebenberg et al., 2013) and the optimism scale is adapted from the optimism subscale of the Youth Life Orientation Test (Ey et al., 2005).\u003c/p\u003e\n \u003cp\u003eThe items were modified to be relevant to the educational context to ensure that the final measure appropriately represented PsyCap in a school environment. All subscales are scored on a six-point scale ( \u003cem\u003e1\u0026thinsp;=\u0026thinsp;I can\u0026apos;t do this at all, 6\u0026thinsp;=\u0026thinsp;I definitely can do this).\u003c/em\u003e Previous studies using this measure (Finch et al., 2023) have reported good to excellent internal reliabilities across the sub-scales (i.e., \u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.84 to .93). The sample internal reliability alphas in the study were .93 (hope), .94 (self-efficacy), .91 resilience and .94 (optimism).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003eSelf-Perception\u003c/h2\u003e\n \u003cp\u003eThe Self-Perception Profile for Adolescents developed by Harter (2012) consists of nine subscales, one of which was of interest for this study. The questions are formatted in a structured alternative format. The adolescent is first asked to decide which kind of adolescents they are most like from two options in each statement. Next, the adolescent decides whether the chosen description is \u003cem\u003e\u0026quot;Really True for Me\u0026quot;\u003c/em\u003e or \u003cem\u003e\u0026quot;Sort of True for Me\u0026quot;.\u003c/em\u003e The items are scored on a 4-point scale \u003cem\u003e( 1\u0026thinsp;=\u0026thinsp;lowest level of competence, 4\u0026thinsp;=\u0026thinsp;highest level of competence\u003c/em\u003e). Rose et al., (2012) validated the scale for use with Australian adolescents, finding the scale to have good internal consistency (\u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.82).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical Appearance.\u003c/strong\u003e The physical appearance sub-scale contains five items that measure the extent to which one feels happy with one\u0026apos;s looks. According to the original authors, this measure demonstrated good internal consistency (\u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.84). The sample internal reliability alpha was very good (\u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.91).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003eFlourishing\u003c/h2\u003e\n \u003cp\u003eThe Flourishing Scale (Diener et al., 2019) is an 8-item measure of one\u0026rsquo;s self- perceived achievement in areas of relationships, self-esteem and purpose. The answers are made on a 7-point scale (\u003cem\u003e1\u0026thinsp;=\u0026thinsp;strongly disagree, 7\u0026thinsp;=\u0026thinsp;strongly agree\u003c/em\u003e). According to Romano et al., (2020), the scale has been found to be a valid measurement among adolescents, demonstrating good internal consistency (\u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.87). The sample internal reliability was good (\u003cem\u003e\u0026alpha;\u0026nbsp;\u003c/em\u003e=\u0026thinsp;.90).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003eAnxiety and Depression\u003c/h2\u003e\n \u003cp\u003eThe Revised Children\u0026rsquo;s Anxiety and Depression Scale Short Version (Ebesutani et al., \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e) comprises 25 items that measure the extent to which one experiences the common symptoms of depression and anxiety. The scale is scored on a four-point scale \u003cem\u003e(0\u0026thinsp;=\u0026thinsp;never, 3\u0026thinsp;=\u0026thinsp;always\u003c/em\u003e). The scale has been validated to be used among children and adolescents aged 12 to 18 (Donnelly et al., \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). The anxiety subscale is a 15-item measure that assesses the common symptoms and severity of general anxiety. According to Klaufus et al., (2020), the scale has good internal consistency (\u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.82). The sample internal reliability was very good (\u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.90).\u003c/p\u003e\n \u003cp\u003eThe depression subscale is a 10-item scale that measures the common depressive symptoms. According to Klaufus et al., (2020), the scale has acceptable internal consistency (\u0026alpha;\u0026thinsp;=\u0026thinsp;.71). The sample internal reliability was very good (\u003cem\u003e\u0026alpha;\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.91).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003ch2\u003eIntervention Acceptability\u003c/h2\u003e\n \u003cp\u003eThe acceptability of the intervention and the perceived helpfulness of the program were assessed via two items. The first item was \u0026ldquo;Did you find the PsyCap-HERO wellbeing program helpful\u0026rdquo;. The participants could enter free text to describe aspects that were helpful and/or not helpful. The responses for the first item were coded as \u0026ldquo;no\u0026rdquo; (0), \u0026ldquo;yes\u0026rdquo; (1) and \u0026ldquo;both\u0026rdquo; (2). The second item asked \u0026ldquo;Do you think it would be useful to run this program for future year 12 students and why\u0026rdquo;. The participants could freely describe their reasoning for or against the usefulness to run the program in the future. The responses for the second items were in a dichotomous response format, coded as \u0026ldquo;yes\u0026rdquo; (1) and \u0026ldquo;no\u0026rdquo; (0).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eProcedure\u003c/h2\u003e\n \u003cp\u003e\u003cstrong\u003eEthical approval\u0026nbsp;\u003c/strong\u003ewas granted by the Griffith University Human Research Ethical Committee (ref: GU2019/801) and Brisbane Catholic Education (ref: BCE414). Following approval by the school principal, informed consent was obtained from all individual participants included in the study via parental written consent. An information sheet and consent form was sent to parents in the target cohort level at the school to describe the purpose, risk and benefit of the research. The consent process was facilitated by school staff who provided a list of student emails of consenting students to the second author from which online surveys were sent. Participation in the study was voluntary, and the students had the right to refuse completion of the survey or withdraw their participation at any point in time without explanation or penalty. The study commenced in April of 2021, coinciding with the end of term 1 of the school year (school year consists of 4 terms), when the participants completed the online pre-intervention survey. The survey was planned to be completed at school; however, it was completed at home during class time due to the COVID-19 lockdown at the time of data collection. The survey began with the collection of demographical information and took approximately 40 minutes to complete.\u003c/p\u003e\n \u003cp\u003eThe series of the four PsyCap HERO workshops commenced one month later. The four workshops each targeted one of the PsyCap HERO constructs (hope, efficacy, resilience, and optimism). The workshops were delivered in May, during term two of the school year.\u003c/p\u003e\n \u003cp\u003eThere was a two-week interval between the first and the second workshop and the remaining workshops were delivered weekly. The workshops were 50 minutes in duration and were delivered in a whole year cohort format, in person, in the school\u0026rsquo;s main auditorium during Positive Education classes. The intervention program was delivered in a co-facilitation format by five Clinical Psychology Master\u0026apos;s students registered as provisional psychologists. The facilitators were trained before the intervention delivery by the second and fourth authors. The participants completed the pen-and-paper feedback survey in person at the end of the final of the four workshops. The post-intervention online survey was completed one week after the final workshop at school, during class time, 10 weeks after the baseline. The number of workshops attended by each participant was recorded in the post-survey. The follow-up survey was completed six weeks after the final workshop, 16 weeks after the baseline at school during class time.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eIntervention\u003c/h2\u003e\n \u003cp\u003eThe Modules for Youth Hope, Efficacy, Resilience and Optimism (MY HERO) in an unpublished intervention program that comprises of four modules, each aiming to cultivate and develop one of the constructs of hope, self-efficacy, resilience, and optimism, based on previous program developed by Finch and Farrell (2020). The intervention program was designed to be delivered in four 50-minute workshops to fit into a typical class duration. The intervention was designed to be flexibly delivered in either a classroom format for a smaller group or an entire school level cohort, provided there is space and co-facilitators available to run the program in a large group setting. The materials and the concepts included in the intervention program are designed to fit specifically into the educational context and target the challenges that youth face at school (e.g. time management and stress).\u003c/p\u003e\n \u003cp\u003eAlthough the materials were originally developed based on the central concept of psychological capital, the materials were also designed to be modifiable to target specific and unique needs of the cohort to which the intervention is delivered, taking into account the age and gender of the participants. In the present study, the materials were modified to fit the needs of a female cohort aged between 16 and 18 years. The current cohort\u0026rsquo;s specific areas of concern were identified based on a consultation with the school principal and the teaching team. The areas of tailoring for this specific cohort included body image, self-esteem and mood concerns. Therefore, the development and design of the final intervention activities for this study incorporated content to increase students\u0026rsquo; HERO resources in the context of self- compassion and self-care, with one session specifically devoted to positive body image. All workshops included an interactive activity for the students to practice identifying and developing the construct or capability taught in that module (i.e., hope), using cognitive behaviour principles and techniques. See Table\u0026nbsp;1 for the outline of the components included in the content of the sessions.\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e---------- INSERT TABLE 1 HERE -----------\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\n \u003ch2\u003eData Screening\u003c/h2\u003e\n \u003cp\u003eOf the complete sample (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;130) who consented to participate, the pre-intervention survey was commenced by 97 students at time point 1 (T1), and 87 students completed all measures within the pre-survey. The post-intervention survey was commenced by 91 students at time point 2 (T2), and 87 students completed all measures within the post-survey. The follow-up survey was commenced by 92 students at time point 3 (T3), and 87 students completed all measures within the follow-up survey. Only the data from the participants who attended at least two of the four workshops (hope, self-efficacy, resilience and optimism were included in the final sample (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;95).\u003c/p\u003e\n \u003cp\u003eTo address hypothesis one, a series of paired-samples t-test were conducted to evaluate the mean change of hope, self-efficacy, resilience and optimism from T1 to T2, from T2 to T3 and from T1 to T3. To address hypothesis two, series of paired samples t-test were performed to measure the mean change of flourishing, physical appearance, anxiety and depression from T1 to T2, from T2 to T3 and from T1 to T3. Given the variation in missing data at each time point due to the high level of school absentees at testing, paired samples t- tests were conducted over repeated measures ANOVAs to maximise cell sizes and statistical power in analyses. To address hypothesis three, a series of median splits were conducted to divide the sample into two groups (below the median and above the median) based on anxiety (\u003cem\u003eMdn\u003c/em\u003e\u0026thinsp;=\u0026thinsp;15) and depression (\u003cem\u003eMdn\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12) measured at the pre-intervention baseline. A series of 2(symptom level groups at baseline: high symptoms, low symptoms) x3(time) mixed design ANOVA\u0026rsquo;s with repeated measures on time (pre, post and follow-up) were conducted. Post Hoc tests were conducted to compare the mean differences across time and groups (youth below and above the mean level of mental health symptomology).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\n \u003ch2\u003eIntervention Outcomes\u003c/h2\u003e\n \u003cp\u003eAnalyses of the differences across time on primary constructs of hope, efficacy, resilience and optimism indicated that there was a statistically significant mean increase in scores for hope from T2 to T3, 95% CI [-2.38,-.29], \u003cem\u003et\u003c/em\u003e(61) = -2.65, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.013, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.33 (small effect). However, there was no significant difference between hope scores from T1 to T3. There was a significant decrease in optimism scores from T1 to T2, 95% CI [.31, 5.02], \u003cem\u003et\u003c/em\u003e(68)=\u0026thinsp;2.26, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.027, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.27 (small effect), and a significant increase in optimism scores from T2 to T3, 95% CI [ -3.65, \u0026minus;\u0026thinsp;.35], \u003cem\u003et\u003c/em\u003e(61) = -2.42, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.018, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.31 (small effect). Paired samples t- test indicated no statistically significant changes in the outcomes of resilience and self-efficacy between T1, T2 and T3. See Table 2 for means and standard deviations across time for all study variables.\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e----------- INSERT TABLE 2 HERE -----------\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003eAnalyses of time effects for the secondary constructs of flourishing, physical appearance, anxiety and depression indicated that there was a statistically significant mean increase in scores for appearance satisfaction from T1 to T3, 95% CI [-1.81, \u0026minus;\u0026thinsp;.30], \u003cem\u003et\u003c/em\u003e(56) =-2.79, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.007, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.37 (small effect). Further, there was a was a statistically significant mean decrease in scores for anxiety from T2 to T3, 95% CI [ .31, 3.14), t(58)\u0026thinsp;=\u0026thinsp;2.45, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.018, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.32 (small effect), and depression from T2 to T3, 95% CI[.025, 2.14), \u003cem\u003et\u003c/em\u003e(58)\u0026thinsp;=\u0026thinsp;2.05, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.045, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.27 (small effect). Paired samples t-test indicated no statistically significant changes in the outcome of flourishing between T1, T2 and T3. The results of anxiety symptom groups across the 3 (time: pre, post and follow-up) x 2 (group: below and above median anxiety score) mixed ANOVAs, indicated that the interaction across the time points and anxiety level groups (high anxious, low anxious) was statistically significant on the outcomes of efficacy \u003cem\u003eF (\u003c/em\u003e2, 80)\u0026thinsp;=\u0026thinsp;5.13, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.008, \u0026eta;\u003cem\u003ep\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;.11 (medium effect), optimism \u003cem\u003eF\u003c/em\u003e (2, 80)\u0026thinsp;=\u0026thinsp;4.02, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.031, \u0026eta;\u003cem\u003ep\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;.091 (medium effect) and anxiety \u003cem\u003eF\u003c/em\u003e (2, 80)\u0026thinsp;=\u0026thinsp;5.07, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.008, \u0026eta;\u003cem\u003ep\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;.11 (medium effect). See Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e for means and standard deviations of students with higher and lower baseline anxiety on the primary and secondary outcomes before, after and at the 6-week follow-up.\u0026nbsp;\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e----------- INSERT Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e HERE -----------\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003ePost-hoc analysis of the significant interactions using pairwise comparisons investigated the differences across the timepoints separately for the high symptom and low symptom groups on anxiety. For the high anxiety group, a statistically significant decrease was found in anxiety scores from T1 to T3, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.033, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.24 (small effect). In contrast, for the low anxious youth, a statistically significant increase was found in anxiety scores from T1 to T2 \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.014, \u003cem\u003ed\u0026thinsp;=\u003c/em\u003e\u0026thinsp;.25 (small effect). See Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e for this significant interaction.\u003c/p\u003e\n \u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003e----------INSERT FIGURE \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e HERE------------\u003c/p\u003e\n \u003c/div\u003e\n \u003cp\u003eFurther, a statistically significant increase was found in optimism scores for the high anxious group from T2 to T3 \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.035, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.20 (small effect); whereas for the low anxious group, a statistically significant decrease was found in optimism scores from T1 to T2 \u003cem\u003ep\u003c/em\u003e =.026, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.22 (small effect). For efficacy, there was no statistically significant change for the outcome of efficacy for the high anxious group; however, there was a statistically significant decrease in efficacy scores from T1 to T2 \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.035, \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.20 and from T1 to T3 \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.004, \u003cem\u003ed\u003c/em\u003e =0.25 (small effect) for the low anxious group. Finally, the results of the depression symptom level group for the 3 (time: pre, post and follow-up) x2 (group: below and above median depression score) analysis revealed no significant interactions between time and symptom level group on any of the preliminary or secondary outcomes.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\n \u003ch2\u003eIntervention Acceptability\u003c/h2\u003e\n \u003cp\u003eEighty-seven participants responded to the post-intervention feedback survey. 73.8% of the participants found the MY HERO intervention program helpful, 4.8% unhelpful, and 21.4% found parts of the intervention helpful and other parts unhelpful. 97.5% of the respondents indicated that running the intervention program for future year 12 students would be useful.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eThe current study evaluated the preliminary effectiveness and acceptability of a school-based program targeting the Psychological Capital constructs of hope, self-efficacy, resilience an optimism of a female adolescent student sample. The study aimed to equip adolescents with practical positive psychology resources (i.e., HERO) that would reduce mental health risk (i.e., anxiety and depression symptoms) and support wellbeing (i.e., flourishing and appearance satisfaction) in the school environment and beyond.\u003c/p\u003e\n \u003cp\u003eContrary to the hypothesis that a significant increase in the constructs comprising psychological capital would be found from pre- to post-intervention (1), and that the increases would be maintained in the 6-week follow-up period (4), no meaningful changes were found on any of the HERO constructs across time. While a significant increase in hope from post-intervention to the follow-up was detected, the mean hope scores were not significantly higher than the baseline scores. Therefore, the significant increase was not meaningful. Further, despite the significant decrease in optimism scores from pre- to post- intervention, optimism increased back to the level commensurate with baseline scores at the follow-up. Given that no further changes in resilience or efficacy were observed, it can be concluded that the participant\u0026rsquo;s psychological capital remained comparatively stable throughout and beyond the intervention program. The findings contradict previous findings for adult sample intervention studies aimed at cultivating PsyCap (Lupșa et al., 2019), which have found that overall, interventions tend to result in significantly increasing PsyCap constructs. However, the intervention dose in the current study was very brief in duration (4 x 50-minute sessions). The findings of comparatively brief PsyCap interventions, for example, one intervention consisting of one 3-hour session (Dello Russo \u0026amp; Stoykova, \u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e) and one 2- hour session (Luthans et al., 2008), found only small effect sizes in the PsyCap outcomes (\u003cem\u003ed\u003c/em\u003e=\u0026thinsp;.19 to .34).\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eMoreover, many schools in Australia subscribe to positive education approaches, and as such, often include positive psychology curriculum in various forms, from informal, incidental learning to more formal classes and instruction (Slemp et al., 2017). The school involved in the current project has focused on positive psychology teaching in numerous health and wellbeing classes. With this in mind, intervention effects on PsyCap constructs might be more substantial for intervention-na\u0026iuml;ve cohorts of students. As the research of the role of PsyCap in the school context is still in its infancy (King \u0026amp; Caleon., 2020), the current study contributed significantly to the PsyCap literature by trialling a novel approach that attempted to cultivate adolescent\u0026rsquo;s PsyCap in the educational context, adding to the knowledge on how PsyCap interventions impact on student mental health and wellbeing.\u003c/p\u003e\n\u003cp\u003eDespite the MY HERO program not showing any preliminary effectiveness in cultivating the participant\u0026rsquo;s psychological capital for the overall cohort, promisingly, a significant mean decrease was observed in the mental health outcomes of anxiety and depression from post- intervention to the 6-week follow-up from the intervention. Further, the participants reported more satisfaction with their physical appearance from pre-intervention to the 6-week follow-up. Thus, the hypotheses that there will be a significant increase in self- perception outcomes and a significant decrease in the mental health outcomes (2) and that the positive impacts would be maintained in the follow-up (4) were partly supported.\u003c/p\u003e\n\u003cp\u003eThe findings of the decreased mental health symptomology align with previous school- based multicomponent positive psychology interventions that reported reduced anxiety and depression levels post-intervention, finding a small effect size (Shoshani et al., 2014; Burckhardt et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e). Thus, the findings offer preliminary support to the effectiveness of school-based MPPI\u0026apos;s, which, although promising, are still rarely implemented (Tejada- Gallardo et al., 2020). Furthermore, the MY HERO program provided a novel contribution to the MPPI literature by targeting the participant\u0026apos;s appearance concerns, which have not been targeted in previous MPPI\u0026apos;s that the author is aware of. The MPPI based on the PsyCap theory implemented in the current study may offer a valuable and modifiable framework through which the adolescent-specific needs, in this occasion adolescent females\u0026apos; body image concerns, can be targeted. Finally, contrary to the expectations, no statistically significant changes were observed in the outcome of flourishing. One potential explanation to these findings is that these variables measure traits that have been found to be relatively stable over time (Keyes et al., 2014; Harter \u0026amp; Whitesell, 2003) and were not the primary concepts targeted in the MY HERO program. Given the relatively small sample and the brief mode of intervention, larger controlled trials are necessary to determine outcomes at cohort and sub-group levels across these broad domains of functioning.\u003c/p\u003e\n\u003cdiv id=\"Sec23\" class=\"Section2\"\u003e\n \u003ch2\u003eThe Role of Pre-Existing Mental Health Symptomology\u003c/h2\u003e\n \u003cp\u003eThe component of the current study which compared the participants with higher and lower levels of anxiety and depression, offered some preliminary evidence that the MY HERO intervention may have a more substantial influence on participants with greater levels of anxiety symptomology measured at baseline. Interestingly, the preliminary effects of the MY HERO intervention appeared to exert opposite outcomes based on the participant\u0026rsquo;s pre-existing level of anxiety on study outcomes of optimism and anxiety. The results revealed a significant increase in optimism for the youth with higher baseline anxiety from post-intervention to follow-up, along with a significant decrease in anxiety symptoms from pre- to post- intervention. In contrast, anxiety symptoms increased from pre- to post-intervention for students lower on anxiety at baseline, although they remained at a low level. Surprisingly, there was a significant decrease in hope from pre- to post-intervention for the less anxious youth.\u003c/p\u003e\n \u003cp\u003eFurther, unexpectedly for the less anxious youth, efficacy significantly decreased from pre to post-intervention, further decreasing in the six-week follow-up. In contrast, there were no significant time by symptom level effects observed for youth at different levels of depressive symptoms. Therefore, although the hypothesis that students with higher baseline mental health symptomology would experience a greater increase in the PsyCap constructs and mental health outcomes (3) was partly supported, the opposite effects observed within the group with lower baseline anxiety levels were unanticipated.\u003c/p\u003e\n \u003cp\u003eIt is currently unclear whether MPPI\u0026rsquo;s such as the MY HERO program may have more robust effects on youth with clinical anxiety levels, as there are currently no PsyCap intervention studies specifically targeting anxious populations that the author is aware of.\u003c/p\u003e\n \u003cp\u003eHowever, MPPI\u0026rsquo;s have been found to have more significant intervention effects on students with higher mental health symptomology measured at baseline (e.g., Burckhardt et al., \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e). Thus, future research might examine school-based PsyCap interventions delivered at multiple levels of intervention, from universally delivered (cohort level) to more targeted delivery among youth at risk of anxiety or already with symptomatic levels. Finally, the great majority of the participants found the intervention program helpful and reported that it would be valuable to run the program for future final year students, reflecting the rapidly increasing need and demand for wellbeing-enhancing interventions in schools (Fazel \u0026amp; Kohrt, 2019).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\n \u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e\n \u003cp\u003eThe convenience sampling of only female participants from a private school that already follows a positive education curriculum, as well as the lack of a control group limit the generalisation of the current findings. Despite the need for interventions specifically designed for female adolescents, randomised controlled trials that include a more diverse sample of youth (i.e. gender and different school types) are necessary for the future evaluation of the effectiveness of the MY HERO program in a school context. Furthermore, the pre-intervention survey coincided with the last day of term 1 of the school year and a COVID-19 lockdown, while the timing of the post-survey overlapped with the examination period. COVID-19 restrictions have been found to negatively impact the mental health of adolescents, who heavily rely on their peer connections for emotional support (Magson et al., 2020). The participants\u0026rsquo; psychological distress may have been especially pronounced during examination periods, while potentially alleviated during or close to school holiday periods. In future research, more effort should be directed into establishing an appropriate schedule for interventions such as the MY HERO program. However, intervention efforts may be especially valuable during times of increased uncertainty and potential distress.\u003c/p\u003e"},{"header":"Summary","content":"\u003cdiv id=\"Sec25\" class=\"Section3\"\u003e\n \u003cp\u003eThe current study contributed to the PsyCap and MPPI research by implementing a novel intervention aiming to increase the psychological resources and consequent mental wellbeing of adolescent female youth. Although no significant increases in PsyCap were detected post-intervention in the whole sample level, the reductions found in anxiety and depression and improvement in appearance satisfaction were significant. The findings suggest that the MY HERO program may flexibly help address youth mental health needs, and may be particularly effective for those with higher anxiety levels. The research on the effectiveness of school-based MPPI\u0026rsquo;s is still in its infancy, and the idea that Psychological Capital can be cultivated in the educational context requires further development. However, as the world grows more complex and unpredictable, young minds are becoming increasingly burdened.\u003c/p\u003e\n \u003cp\u003eConsequently, evidence-based intervention programs addressing youth psychological wellbeing via the development of psychological resources are becoming progressively crucial to assist youth to progress into adulthood successfully.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical\u0026nbsp;Approval:\u0026nbsp;\u003c/strong\u003eAll\u0026nbsp;procedures\u0026nbsp;performed\u0026nbsp;in\u0026nbsp;the\u0026nbsp;studies\u0026nbsp;involving\u0026nbsp;human\u0026nbsp;participants\u0026nbsp;were in\u0026nbsp;accordance\u0026nbsp;with the\u0026nbsp;ethical\u0026nbsp;standards\u0026nbsp;of\u0026nbsp;the\u0026nbsp;institutional and/or\u0026nbsp;national\u0026nbsp;research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting\u0026nbsp;interests:\u0026nbsp;\u003c/strong\u003eThe\u0026nbsp;authors\u0026nbsp;have\u0026nbsp;no\u0026nbsp;competing\u0026nbsp;interests\u0026nbsp;to\u0026nbsp;declare\u0026nbsp;that\u0026nbsp;are\u0026nbsp;relevant\u0026nbsp;to the content of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contributions:\u0026nbsp;\u003c/strong\u003eThe research question, study design, and methodology were developed by R.H., J.F. and L.F. The intervention program and measurement tool were developed by J.F. R.H. collected the primary data, conducted all data analyses, interpreted the findings, prepared the tables and figures and wrote the manuscript with direction from L.F. and J.F. All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eNo\u0026nbsp;funding\u0026nbsp;was\u0026nbsp;received\u0026nbsp;to\u0026nbsp;assist\u0026nbsp;with the\u0026nbsp;preparation\u0026nbsp;of\u0026nbsp;this\u0026nbsp;manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e: Due to the nature of this research, participants of this study did not agree for their data to be shared publicly and therefore supporting data is not available.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBarrett, P. M., \u0026amp; Pahl, K. M. (2006). School-Based Intervention: Examining a Universal Approach to Anxiety Management. \u003cem\u003eAustralian Journal of Guidance and Counselling\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 55\u0026ndash;75. https://doi.org/10.1375/ajgc.16.1.55\u003c/li\u003e\n \u003cli\u003eBurckhardt, R., Manicavasagar, V., Batterham, P. J., \u0026amp; Hadzi-Pavlovic, D. (2016). A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology. \u003cem\u003eJournal of School Psychology\u003c/em\u003e, \u003cem\u003e57\u003c/em\u003e(1), 41\u0026ndash;52. https://doi.org/10.1016/j.jsp.2016.05.008\u003c/li\u003e\n \u003cli\u003eBrennan, N., Beames, J. R, Kos, A., Reily, N., Connell, C., Hall, S., Yip, D., Hudson, J., O\u0026rsquo;Dea, B., Di Nicola, K., and Christie, R. (2021) \u003cem\u003ePsychological Distress in Young People in Australia Fifth Biennial Youth Mental Health Report: 2012-2020.\u0026nbsp;\u003c/em\u003eMission Australia: Sydney, NSW.\u003c/li\u003e\n \u003cli\u003eCarmona-Halty, M., Schaufeli, W. B., \u0026amp; Salanova, M. (2019). Good Relationships, Good Performance: The Mediating Role of Psychological Capital \u0026ndash; A Three-Wave Study Among Students. \u003cem\u003eFrontiers in Psychology\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(1). https://doi.org/10.3389/fpsyg.2019.00306\u003c/li\u003e\n \u003cli\u003eChodkiewicz, A. R., \u0026amp; Boyle, C. (2016). Positive psychology school-based interventions: A reflection on current success and future directions. \u003cem\u003eReview of Education\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e(1), 60\u0026ndash;86. https://doi.org/10.1002/rev3.3080\u003c/li\u003e\n \u003cli\u003eCuijpers, P., Smits, N., Donker, T., ten Have, M., \u0026amp; de Graaf, R. (2009). Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory. \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e168\u003c/em\u003e(3), 250\u0026ndash;255. https://doi.org/10.1016/j.psychres.2008.05.012\u003c/li\u003e\n \u003cli\u003eDatu, J. A. D., King, R. B., \u0026amp; Valdez, J. P. M. (2016). Psychological capital bolsters motivation, engagement, and achievement: Cross-sectional and longitudinal studies. \u003cem\u003eThe Journal of Positive Psychology\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(3), 260\u0026ndash;270. https://doi.org/10.1080/17439760.2016.1257056\u003c/li\u003e\n \u003cli\u003eDatu, J. A. D., \u0026amp; Valdez, J. P. M. (2015). Psychological Capital Predicts Academic Engagement and Well-Being in Filipino High School Students. \u003cem\u003eThe Asia-Pacific Education Researcher\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(3), 399\u0026ndash;405. https://doi.org/10.1007/s40299-015-0254-1\u003c/li\u003e\n \u003cli\u003eDello Russo, S., \u0026amp; Stoykova, P. (2015). Psychological Capital Intervention (PCI): A Replication and Extension. \u003cem\u003eHuman Resource Development Quarterly\u003c/em\u003e, \u003cem\u003e26\u003c/em\u003e(3), 329\u0026ndash; 347. https://doi.org/10.1002/hrdq.21212\u003c/li\u003e\n \u003cli\u003eDiener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D.-w., Oishi, S., \u0026amp; Biswas-Diener, R. (2010, 06//). New Well-being Measures: Short Scales to Assess Flourishing and Positive and Negative Feelings [Article]. \u003cem\u003eSocial Indicators Research, 97\u003c/em\u003e(2), 143-156. https://doi.org/10.1007/s11205-009-9493-y\u003c/li\u003e\n \u003cli\u003eDonnelly, A., Fitzgerald, A., Shevlin, M., \u0026amp; Dooley, B. (2018). Investigating the psychometric properties of the revised child anxiety and depression scale (RCADS) in a non-clinical sample of Irish adolescents. \u003cem\u003eJournal of Mental Health\u003c/em\u003e. https://doi.org/10.1080/09638237.2018.1437604\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eEbesutani, C., Reise, S. P., Chorpita, B. F., Ale, C., Regan, J., Young, J., Charmaine, H.-M., \u0026amp; Weisz, J. R. (2012). The Revised Child Anxiety and Depression Scale-Short Version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor. \u003cem\u003ePsychological Assessment, 24\u003c/em\u003e(4), 833-845. https://doi.org/10.1037/a0027283\u003c/li\u003e\n \u003cli\u003eEy, S., Hadley, W., Allen, D. N., Palmer, S., Klosky, J., Deptula, D., Thomas, J., \u0026amp; Cohen, R. (2005). A new measure of children\u0026apos;s optimism and pessimism: the Youth Life Orientation Test. \u003cem\u003eJournal of Child Psychology \u0026amp; Psychiatry, 46\u003c/em\u003e(5), 548-558. https://doi.org/10.1111/j.1469-7610.2004.00372.x\u003c/li\u003e\n \u003cli\u003eFang, S., \u0026amp; Ding, D. (2020). The efficacy of group-based acceptance and commitment therapy on psychological capital and school engagement: A pilot study among Chinese adolescents. \u003cem\u003eJournal of Contextual Behavioral Science\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 134\u0026ndash;143. https://doi.org/10.1016/j.jcbs.2020.04.005\u003c/li\u003e\n \u003cli\u003eFazel, M., \u0026amp; Kohrt, B. A. (2019). Prevention versus intervention in school mental health. \u003cem\u003eThe Lancet Psychiatry\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(12), 969\u0026ndash;971. https://doi.org/10.1016/s2215-0366(19)30440-7\u003c/li\u003e\n \u003cli\u003eFinch, J., Farrell, L. J., \u0026amp; Waters, A. M. (2020). Searching for the HERO in Youth: Does Psychological Capital (PsyCap) Predict Mental Health Symptoms and Subjective Wellbeing in Australian School-Aged Children and Adolescents? \u003cem\u003eChild Psychiatry \u0026amp; Human Development\u003c/em\u003e. https://doi.org/10.1007/s10578-020-01023-3\u003c/li\u003e\n \u003cli\u003eFinch, J., Waters, A. M., \u0026amp; Farrell, L. J. (2023). Developing the HERO within: Evaluation of a brief intervention for increasing Psychological Capital (PsyCap) in Australian female students during the final year of school in the first year of COVID-19. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e, \u003cem\u003e324\u003c/em\u003e, 616\u0026ndash;623. https://doi.org/10.1016/j.jad.2022.12.169\u003c/li\u003e\n \u003cli\u003eGambin, M., \u0026amp; Święcicka, M. (2012). Construction and validation of Self-Efficacy Scale for early school-aged children. \u003cem\u003eEuropean Journal of Developmental Psychology, 9\u003c/em\u003e(6), 723-729. https://doi.org/10.1080/17405629.2012.688100\u003c/li\u003e\n \u003cli\u003eHarter, S. (2012). Self-perception profile for adolescents: Manual and questionnaires. \u003cem\u003eDenver, CO: Univeristy of Denver, Department of Psychology\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003eHarter, S., \u0026amp; Whitesell, N. R. (2003). Beyond the Debate: Why Some Adolescents Report Stable Self-Worth Over Time and Situation, Whereas Others Report Changes in Self- Worth. \u003cem\u003eJournal of Personality\u003c/em\u003e, \u003cem\u003e71\u003c/em\u003e(6), 1027\u0026ndash;1058. https://doi.org/10.1111/1467- 6494.7106006 Harty, B., Gustafsson, J.-A., Bj\u0026ouml;rkdahl, A., \u0026amp; M\u0026ouml;ller, A. (2016). Group intervention: A way to improve working teams\u0026rsquo; positive psychological capital. \u003cem\u003eWork\u003c/em\u003e, \u003cem\u003e53\u003c/em\u003e(2), 387\u0026ndash;398. https://doi.org/10.3233/wor-152227\u003c/li\u003e\n \u003cli\u003eHay, P., Girosi, F., \u0026amp; Mond, J. (2015). Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. \u003cem\u003eJournal of Eating Disorders\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(1). https://doi.org/10.1186/s40337-015-0056-0\u003c/li\u003e\n \u003cli\u003eHelfert, S., \u0026amp; Warschburger, P. (2013). The face of appearance-related social pressure: gender, age and body mass variations in peer and parental pressure during adolescence. \u003cem\u003eChild and Adolescent Psychiatry and Mental Health\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(1), 16. https://doi.org/10.1186/1753-2000-7-16\u003c/li\u003e\n \u003cli\u003eHorowitz, J. L., Garber, J., Ciesla, J. A., Young, J. F., \u0026amp; Mufson, L. (2007). Prevention of depressive symptoms in adolescents: A randomized trial of cognitive-behavioral and interpersonal prevention programs. \u003cem\u003eJournal of Consulting and Clinical Psychology\u003c/em\u003e, \u003cem\u003e75\u003c/em\u003e(5),\u003c/li\u003e\n \u003cli\u003eKatajisto, M., Hyv\u0026auml;rinen, S., \u0026amp; Uusiautti, S. (2021). Changes in Finnish ninth graders\u0026rsquo; positive psychological capital (PsyCap) in a strength-based student guidance intervention. \u003cem\u003eInternational Journal of Adolescence and Youth\u003c/em\u003e, \u003cem\u003e26\u003c/em\u003e(1), 321\u0026ndash;339. https://doi.org/10.1080/02673843.2021.1943469\u0026ndash;706. https://doi.org/10.1037/0022-006x.75.5.693\u003c/li\u003e\n \u003cli\u003eKeski-Rahkonen, A., Raevuori, A., \u0026amp; Hoek, H. W. (2018). Epidemiology of eating disorders: an update. \u003cem\u003eAnnual Review of eating disorders\u003c/em\u003e, 66-76.\u003c/li\u003e\n \u003cli\u003eKessler, R. C., Angermeyer, M., Anthony, J. C., DE Graaf, R., Demyttenaere, K., Gasquet, I., DE Girolamo, G., Gluzman, S., Gureje, O., Haro, J. M., Kawakami, N., Karam, A., Levinson, D., Medina Mora, M. E., Oakley Browne, M. A., Posada-Villa, J., Stein, D. J., Adley Tsang, C. H., Aguilar-Gaxiola, S., Alonso, J., \u0026hellip; Ust\u0026uuml;n, T. B. (2007). Lifetime prevalence and age-of- onset distributions of mental disorders in the World Health Organization\u0026apos;s World Mental Health Survey Initiative. \u003cem\u003eWorld psychiatry : official journal of the World Psychiatric Association (WPA)\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(3), 168\u0026ndash;176.\u003c/li\u003e\n \u003cli\u003eKeyes, C. L. M. (2002). The Mental Health Continuum: From Languishing to Flourishing in Life.\u0026nbsp;\u003cem\u003eJournal of Health and Social Behavior\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e(2), 207. https://doi.org/10.2307/3090197\u003c/li\u003e\n \u003cli\u003eKeyes, C. L. M., Kendler, K. S., Myers, J. M., \u0026amp; Martin, C. C. (2014). The Genetic Overlap and Distinctiveness of Flourishing and the Big Five Personality Traits. \u003cem\u003eJournal of Happiness Studies\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(3), 655\u0026ndash;668. https://doi.org/10.1007/s10902-014-9527-2\u003c/li\u003e\n \u003cli\u003eKing, R. B., \u0026amp; Caleon, I. S. (2020). School Psychological Capital: Instrument Development, Validation, and Prediction. \u003cem\u003eChild Indicators Research\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(1). https://doi.org/10.1007/s12187-020-09757-1\u003c/li\u003e\n \u003cli\u003eKlaufus, L., Verlinden, E., van der Wal, M., K\u0026ouml;sters, M., Cuijpers, P., \u0026amp; Chinapaw, M. (2020). Psychometric evaluation of two short versions of the Revised Child Anxiety and Depression Scale. \u003cem\u003eBMC Psychiatry\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(1). https://doi.org/10.1186/s12888-020- 2444-5\u003c/li\u003e\n \u003cli\u003eLawrence D., Johnson S., Hafekost J., Boterhoven De Haan K., Sawyer M., Ainley J., Zubrick SR. (2015). The Mental Health of Children and Adolescents. \u003cem\u003eReport on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.\u0026nbsp;\u003c/em\u003eDepartment of Health, Canberra.\u003c/li\u003e\n \u003cli\u003eLiebenberg, L., Ungar, M., \u0026amp; LeBlanc, J. C. (2013). The CYRM-12: A brief measure of resilience. \u003cem\u003eCanadian Journal of Public Health, 104\u003c/em\u003e(2), e131-e135. https://www.springer.com/public+health/journal/41997\u003c/li\u003e\n \u003cli\u003eLupșa, D., V\u0026icirc;rga, D., Maricuțoiu, L. P., \u0026amp; Rusu, A. (2019). Increasing Psychological Capital: A Pre‐ Registered Meta‐Analysis of Controlled Interventions. \u003cem\u003eApplied Psychology\u003c/em\u003e, \u003cem\u003e69\u003c/em\u003e(4), 1506\u0026ndash; 1556. https://doi.org/10.1111/apps.12219\u003c/li\u003e\n \u003cli\u003eLuthans, F., Avey, J. B., \u0026amp; Patera, J. L. (2008). Experimental Analysis of a Web-Based Training Intervention to Develop Positive Psychological Capital. \u003cem\u003eAcademy of Management Learning \u0026amp; Education\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(2), 209\u0026ndash;221. https://doi.org/10.5465/amle.2008.32712618\u003c/li\u003e\n \u003cli\u003eLuthans, F., Avolio, B. J., Avey, J. B., \u0026amp; Norman, S. M. (2007). Positive Psychological Capital: Measurement And Relationship With Performance And Satisfaction \u003cem\u003ePersonnel Psychology\u003c/em\u003e, \u003cem\u003e60\u003c/em\u003e(3), 541\u0026ndash;572. https://Doi.Org/10.1111/J.1744-.00083\u003c/li\u003e\n \u003cli\u003eMagson, N. R., Freeman, J. Y. A., Rapee, R. M., Richardson, C. E., Oar, E. L., \u0026amp; Fardouly, J. (2020). Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. \u003cem\u003eJournal of Youth and Adolescence\u003c/em\u003e, \u003cem\u003e50\u003c/em\u003e(1). https://doi.org/10.1007/s10964-020-01332-9\u003c/li\u003e\n \u003cli\u003eMasia-Warner, C., Nangle, D. W., \u0026amp; Hansen, D. J. (2006). Bringing evidence-based child mental health services to the schools: General issues and specific populations. \u003cem\u003eEducation and Treatment of Children\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e(2), 165-172\u003c/li\u003e\n \u003cli\u003eMoon, J., Williford, A., \u0026amp; Mendenhall, A. (2017). Educators\u0026rsquo; perceptions of youth mental health: Implications for training and the promotion of mental health services in schools. \u003cem\u003eChildren and Youth Services Review\u003c/em\u003e, \u003cem\u003e73\u003c/em\u003e(1), 384\u0026ndash;391. https://doi.org/10.1016/j.childyouth.2017.01.006\u003c/li\u003e\n \u003cli\u003eO\u0026rsquo;Mara, L., \u0026amp; Lind, C. (2013). What do we know about school mental health promotion programmes for children and youth? \u003cem\u003eAdvances in School Mental Health Promotion\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(3), 203\u0026ndash;224. https://doi.org/10.1080/1754730x.2013.811952\u003c/li\u003e\n \u003cli\u003eOwens, R. L., \u0026amp; Waters, L. (2020). What does positive psychology tell us about early intervention and prevention with children and adolescents? A review of positive psychological interventions with young people. \u003cem\u003eThe Journal of Positive Psychology\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(5), 588-597. https://doi.org/10.1080/17439760.2020.1789706\u003c/li\u003e\n \u003cli\u003ePreston, A., Rew, L., \u0026amp; Young, C. C. (2023). A systematic scoping review of psychological capital related to mental health in youth. \u003cem\u003eThe Journal of School Nursing\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(1), 72-86. https://doi.org/10.1177/10598405211060415\u003c/li\u003e\n \u003cli\u003eRapee, R. M., Oar, E. L., Johnco, C. J., Forbes, M. K., Fardouly, J., Magson, N. R., \u0026amp; Richardson, C. E. (2019). Adolescent development and risk for the onset of social-emotional disorders: A review and conceptual model. \u003cem\u003eBehaviour Research and Therapy\u003c/em\u003e, \u003cem\u003e123\u003c/em\u003e(1), 103501. https://doi.org/10.1016/j.brat.2019.103501\u003c/li\u003e\n \u003cli\u003eRusk, R. D., Vella-Brodrick, D. A., \u0026amp; Waters, L. (2017). A complex dynamic systems approach to lasting positive change: The Synergistic Change Model. \u003cem\u003eThe Journal of Positive Psychology\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(4), 406\u0026ndash;418. https://doi.org/10.1080/17439760.2017.1291853\u003c/li\u003e\n \u003cli\u003eRohde, P., Stice, E., \u0026amp; Marti, C. N. (2014). Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. \u003cem\u003eInternational Journal of Eating Disorders\u003c/em\u003e, \u003cem\u003e48\u003c/em\u003e(2), 187\u0026ndash;198. https://doi.org/10.1002/eat.22270\u003c/li\u003e\n \u003cli\u003eRomano, I., Ferro, M. A., Patte, K. A., Diener, E., \u0026amp; Leatherdale, S. T. (2020). Measurement Invariance of the Flourishing Scale among a Large Sample of Canadian Adolescents. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(21), 7800. https://doi.org/10.3390/ijerph17217800\u003c/li\u003e\n \u003cli\u003eSeligman, M. (2018). PERMA and the building blocks of well-being. \u003cem\u003eThe Journal of Positive Psychology\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(4), 333\u0026ndash;335. https://doi.org/10.1080/17439760.2018.1437466\u003c/li\u003e\n \u003cli\u003eSeligman, M. E. P., \u0026amp; Csikszentmihalyi, M. (2000). Positive psychology: An introduction. \u003cem\u003eAmerican Psychologist\u003c/em\u003e, \u003cem\u003e55\u003c/em\u003e(1), 5\u0026ndash;14. https://doi.org/10.1037/0003-066x.55.1.5\u003c/li\u003e\n \u003cli\u003eShoshani, A., \u0026amp; Steinmetz, S. (2013). Positive Psychology at School: A School-Based Intervention to Promote Adolescents\u0026rsquo; Mental Health and Well-Being. \u003cem\u003eJournal of Happiness Studies\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(6), 1289\u0026ndash;1311. https://doi.org/10.1007/s10902-013-9476-1\u003c/li\u003e\n \u003cli\u003eSin, N. L., \u0026amp; Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. \u003cem\u003eJournal of Clinical Psychology\u003c/em\u003e, \u003cem\u003e65\u003c/em\u003e(5), 467\u0026ndash;487. https://doi.org/10.1002/jclp.20593\u003c/li\u003e\n \u003cli\u003eSiu, O. L., Bakker, A. B., \u0026amp; Jiang, X. (2013). Psychological Capital Among University Students: Relationships with Study Engagement and Intrinsic Motivation. \u003cem\u003eJournal of Happiness Studies\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(4), 979\u0026ndash;994. https://doi.org/10.1007/s10902-013-9459-2\u003c/li\u003e\n \u003cli\u003eSlade, T., Johnston, A., Oakley Browne, M. A., Andrews, G., \u0026amp; Whiteford, H. (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. \u003cem\u003eThe Australian and New Zealand Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e(7), 594\u0026ndash;605. https://doi.org/10.1080/00048670902970882\u003c/li\u003e\n \u003cli\u003eSlemp, G. R., Chin, T. C., Kern, M. L., Siokou, C., Loton, D., Oades, L. G., ... \u0026amp; Waters, L. (2017). Positive education in Australia: Practice, measurement, and future directions. In \u003cem\u003eSocial and emotional learning in Australia and the Asia-Pacific\u0026nbsp;\u003c/em\u003e(pp. 101-122). Springer, Singapore https://doi.org/10.1007/978-981-10-3394-0_6\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSnyder, C. R., Hoza, B., Pelham, W. E., Rapoff, M., Ware, L., Danovsky, M., Highberger, L., Rubinstein, H., \u0026amp; Stahl, K. J. (1997). The development and validation of the Children\u0026apos;s Hope Scale. \u003cem\u003eJournal of Pediatric Psychology, 22\u003c/em\u003e(3), 399 - 421.https://doi.org/10.1093/jpepsy/22.3.399\u003c/li\u003e\n \u003cli\u003eTejada-Gallardo, C., Blasco-Belled, A., Torrelles-Nadal, C., \u0026amp; Alsinet, C. (2020). Effects of School-based Multicomponent Positive Psychology Interventions on Well-being and Distress in Adolescents: A Systematic Review and Meta-analysis. \u003cem\u003eJournal of Youth and Adolescence\u003c/em\u003e, \u003cem\u003e49\u003c/em\u003e(10), 1943\u0026ndash;1960. https://doi.org/10.1007/s10964-020-01289-9\u003c/li\u003e\n \u003cli\u003eter Bogt, T. F. M., van Dorsselaer, S. A. F. M., Monshouwer, K., Verdurmen, J. E. E., Engels, R. C. M. E., \u0026amp; Vollebergh, W. A. M. (2006). Body Mass Index and Body Weight Perception as Risk Factors for Internalizing and Externalizing Problem Behavior Among Adolescents. \u003cem\u003eJournal of Adolescent Health\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(1), 27\u0026ndash;34. https://doi.org/10.1016/j.jadohealth.2005.09.007\u003c/li\u003e\n \u003cli\u003eTwenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., \u0026amp; Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005\u0026ndash;2017. \u003cem\u003eJournal of Abnormal Psychology\u003c/em\u003e, \u003cem\u003e128\u003c/em\u003e(3), 185\u0026ndash;199. https://doi.org/10.1037/abn0000410\u003c/li\u003e\n \u003cli\u003eVolpe, U., Tortorella, A., Manchia, M., Monteleone, A. M., Albert, U., \u0026amp; Monteleone, P. (2016). Eating disorders: What age at onset? \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e238\u003c/em\u003e(1), 225\u0026ndash;227. https://doi.org/10.1016/j.psychres.2016.02.048\u003c/li\u003e\n \u003cli\u003eWerner-Seidler, A., Perry, Y., Calear, A. L., Newby, J. M., \u0026amp; Christensen, H. (2017). School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis. \u003cem\u003eClinical Psychology Review\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e(51), 30\u0026ndash;47. https://doi.org/10.1016/j.cpr.2016.10.005\u003c/li\u003e\n \u003cli\u003eWiens, K., Bhattarai, A., Pedram, P., Dores, A., Williams, J., Bulloch, A., \u0026amp; Patten, S. (2020). A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018. \u003cem\u003eEpidemiology and Psychiatric Sciences\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e(1). https://doi.org/10.1017/s2045796020000281\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. The content included in the PsyCap-HERO program\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.744027303754265%\" valign=\"top\"\u003e\n \u003cp\u003eWorkshop\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.25597269624573%\" valign=\"top\"\u003e\n \u003cp\u003eContent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.744027303754265%\" valign=\"top\"\u003e\n \u003cp\u003e1.\u0026nbsp;Hope\u0026nbsp;\u0026amp;\u0026nbsp;Self-Care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.25597269624573%\" valign=\"top\"\u003e\n \u003cp\u003eIntroduction to the workshop series and PsyCap theory, psychoeducation\u0026nbsp;and\u0026nbsp;quiz\u0026nbsp;on\u0026nbsp;hope\u0026nbsp;theory,\u0026nbsp;case\u0026nbsp;study\u0026nbsp;video\u0026nbsp;and worksheet assisted group activity on self-care.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.744027303754265%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e2.\u0026nbsp;Efficacy\u0026nbsp;\u0026amp;\u0026nbsp;Body- Image\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.25597269624573%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003ePsychoeducation\u0026nbsp;and\u0026nbsp;quiz\u0026nbsp;on\u0026nbsp;self-efficacy\u0026nbsp;theory\u0026nbsp;and\u0026nbsp;self-efficacy\u0026nbsp;in the context of body image, case study video and worksheet assisted group activity on self-efficacy and body image.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.744027303754265%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e3.\u0026nbsp;Resilience\u0026nbsp;\u0026amp;\u0026nbsp;Self- Worth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.25597269624573%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003ePsychoeducation\u0026nbsp;and\u0026nbsp;quiz\u0026nbsp;on\u0026nbsp;resilience\u0026nbsp;theory\u0026nbsp;and\u0026nbsp;resilience\u0026nbsp;in\u0026nbsp;the context of self-worth, video on self-worth and worksheet assisted individual activity on resilience and self-worth.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.744027303754265%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e4.\u0026nbsp;Optimism\u0026nbsp;\u0026amp;\u0026nbsp;Mood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"75.25597269624573%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003ePsychoeducation and quiz on optimism theory, video on learned optimism and cultivating optimism, group activity on comparing optimism\u0026nbsp;to\u0026nbsp;pessimism\u0026nbsp;and\u0026nbsp;worksheet\u0026nbsp;assisted\u0026nbsp;individual\u0026nbsp;activity\u0026nbsp;on\u003c/p\u003e\n \u003cp\u003eoptimism.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 2. Mean scores at pre-, post- and at follow-up for students participating in the PsyCap-HERO intervention on primary and secondary outcome variables\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003ePre (T1)\u003c/p\u003e\n \u003cp\u003eMean\u0026nbsp;(SD)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003en = 83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003ePost (T2)\u003c/p\u003e\n \u003cp\u003eMean\u0026nbsp;(SD)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003en = 80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003eFollow-up\u0026nbsp;(T3)\u003c/p\u003e\n \u003cp\u003eMean\u0026nbsp;(SD)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003en = 77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e1. Hope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e44.54(7.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e43.09 (9.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cp\u003e44.21 (8.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e2. Efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e121.99(20.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e123.44(20.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e119.49(23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e3.\u0026nbsp;Resilience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e68.70(10.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e66.90(12.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e67.64(10.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e4.\u0026nbsp;Optimism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e44.50(9.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e42.76(10.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e44.58(10.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e5.\u0026nbsp;Appearance Satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e10.71(3.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e11.42(4.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e11.48(4.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e6.\u0026nbsp;Global\u0026nbsp;Self-Worth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e13.24(3.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e13.42(3.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e13.00(3.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e7. Flourishing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e43.65(7.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e43.56(7.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e42.82(7.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e8. Anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e15.88(8.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e15.55(8.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e14.01(8.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"26.006711409395972%\" valign=\"top\"\u003e\n \u003cp\u003e9.\u0026nbsp;Depression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.818791946308725%\" valign=\"top\"\u003e\n \u003cp\u003e13.16(6.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.671140939597315%\" valign=\"top\"\u003e\n \u003cp\u003e13.74(6.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.503355704697988%\" valign=\"top\"\u003e\n \u003cp\u003e12.66(7.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 3. Means and Standard Deviations of students with higher and lower baseline anxiety scores on the primary and secondary outcomes before, after and at the 6-week follow-up\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.30781499202552%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eHigh\u0026nbsp;Anxiety\u0026nbsp;Group Mean (SD)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026nbsp;\u003c/em\u003e=22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.427432216905903%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.280701754385966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.427432216905903%\" valign=\"top\"\u003e\n \u003cp\u003eLow\u0026nbsp;Anxiety\u0026nbsp;Group Mean (SD)\u003c/p\u003e\n \u003cp\u003e\u003cem\u003en\u0026nbsp;\u003c/em\u003e=\u0026nbsp;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.556618819776714%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003eT1.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003eT2.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003eT3.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003eT1.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003eT2.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003eT3.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e1. Hope\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e41.41(1.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e41.54(1.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e43.09(2.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e47.35(1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e45.40(1.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e46.25(1.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e2. Efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e114.50(4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e116.82(4.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e118.59(4.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e134.85(2.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e128.30(4.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e125.90(4.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e3.Resilience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e65.23(1.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e65.41(2.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e66.09(2.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e72.85(1.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e70.40(2.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e71.15(1.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e4. Optimism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e40.05(1.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e39.77(2.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e43.41(2.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e49.80(1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e45.70(2.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e47.00(2.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e5. Physical Appearance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e9.05(.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e9.45(.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e10.27(.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e13.25(.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e14.10(.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e13.90(.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e6. Global Self-Worth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e12.09(.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e12.23(.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e11.86(.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e14.70(.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e14.85(.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e14.50(.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e7.Flourishing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e40.73(1.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e40.27(2.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e40.09(1.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e47.45(1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e45.30(1.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e44.80(1.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e8. Anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e22.05(1.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e21.55(71.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e18.64(1.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e8.75(.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e11.60(1.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e10.50(1.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.898089171974522%\" valign=\"top\"\u003e\n \u003cp\u003e9.Depression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.171974522292993%\" valign=\"top\"\u003e\n \u003cp\u003e17.55(1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.331210191082803%\" valign=\"top\"\u003e\n \u003cp\u003e17.68(1.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e16.18(1.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.261146496815286%\" valign=\"top\"\u003e\n \u003cp\u003e8.50(.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.401273885350317%\" valign=\"top\"\u003e\n \u003cp\u003e11.40(1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.535031847133759%\" valign=\"top\"\u003e\n \u003cp\u003e10.25(1.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"child-psychiatry-and-human-development","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"chud","sideBox":"Learn more about [Child Psychiatry \u0026 Human Development](http://link.springer.com/journal/10578)","snPcode":"10578","submissionUrl":"https://submission.nature.com/new-submission/10578/3","title":"Child Psychiatry \u0026 Human Development","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"PsyCap, HERO, Intervention, School, Adolescent, Positive Psychology","lastPublishedDoi":"10.21203/rs.3.rs-3075824/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3075824/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eYoung people face multiple challenges, including appearance dissatisfaction, academic stressors, anxiety and depression. This study examines the preliminary effectiveness of a brief, school-based intervention aimed at enhancing Psychological Capital (PsyCap), consisting of positive resources of hope, self-efficacy, resilience and optimism (HERO), and reducing mental health symptoms among female year 12 students (\u003cem\u003en\u003c/em\u003e = 95, \u003cem\u003eM\u003c/em\u003eage= 16.78, \u003cem\u003eSD\u003c/em\u003e = 0.45). Outcomes on measures of HERO and secondary outcomes of flourishing, appearance dissatisfaction, anxiety and depression were measured at pre and post-intervention. In the overall cohort, no significant changes were found on the HERO outcomes or flourishing post-intervention, while symptoms of depression, anxiety and appearance dissatisfaction decreased significantly. For students with higher baseline anxiety, optimism and anxiety symptoms improved significantly at post-intervention. However, students with lower baseline anxiety experienced significant decreases in self-efficacy and optimism, as well as a significant increase in anxiety symptoms post-intervention. Baseline depression levels did not impact intervention outcomes. The findings, although mixed, suggest that a brief intervention grounded in PsyCap theory may improve student wellbeing.\u003c/p\u003e","manuscriptTitle":"Preliminary Effectiveness of a Brief School-Based HERO Intervention: Improving the Wellbeing of Final Year Adolescent Female Students","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-07-03 14:14:07","doi":"10.21203/rs.3.rs-3075824/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-09-09T10:18:10+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-08-17T00:20:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"da235897-ee10-4cdd-9a03-cb937d1f5601","date":"2023-07-26T20:22:40+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-07-14T13:49:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-07-05T12:25:01+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-06-29T09:12:06+00:00","index":"","fulltext":""},{"type":"submitted","content":"Child Psychiatry \u0026 Human Development","date":"2023-06-17T12:04:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"child-psychiatry-and-human-development","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"chud","sideBox":"Learn more about [Child Psychiatry \u0026 Human Development](http://link.springer.com/journal/10578)","snPcode":"10578","submissionUrl":"https://submission.nature.com/new-submission/10578/3","title":"Child Psychiatry \u0026 Human Development","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"c3b78aa9-e18e-4623-9676-ff4daf882c2c","owner":[],"postedDate":"July 3rd, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-12-11T15:04:41+00:00","versionOfRecord":{"articleIdentity":"rs-3075824","link":"https://doi.org/10.1007/s10578-023-01629-3","journal":{"identity":"child-psychiatry-and-human-development","isVorOnly":false,"title":"Child Psychiatry \u0026 Human Development"},"publishedOn":"2023-12-05 15:01:33","publishedOnDateReadable":"December 5th, 2023"},"versionCreatedAt":"2023-07-03 14:14:07","video":"","vorDoi":"10.1007/s10578-023-01629-3","vorDoiUrl":"https://doi.org/10.1007/s10578-023-01629-3","workflowStages":[]},"version":"v1","identity":"rs-3075824","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3075824","identity":"rs-3075824","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}