WP6: Randomised controlled trials (RCTs) to test clinical and cost-effectiveness
We will conduct RCTs in Pakistan, Japan and Chile to evaluate the clinical and costeffectiveness of OSI+therapist support delivered by school counsellors for children with anxiety problems. Recruitment will involve collaboration with local education authorities and health systems to align with current school mental health policies. In addition to country-specific analyses, we will conduct random-effects meta-analysis to pool the results across the trials and explore outcome moderators across settings, informing implementation strategies and future developments. Country-specific and pooled economic evaluations (Jovanovic et al., 2020; Feng et al., 2022) will be conducted using World Health Organization (Bertram et al., 2016; Oppong et al., 2015) and country-specific thresholds (Hasegawa et al., 2020) to establish value-for-money and provide detailed information on intervention delivery costs to inform future implementation. Process evaluation (within and across trials) using quantitative and qualitative data will also inform future roll-out.