Our group believes that the investigators used an appropriate type of evaluation for the study design. Although school-based mental health services have been successfully used in schools over the U.S.A for non-immigrant children, it is essential for the investigators to use formative evaluation during the planning and implementation phases in the intervention, in order to identify potential and actual influences on the progress and effectiveness of implementation efforts. The Cognitive Behavioral Intervention, which has been shown in many studies to be an effective way for a wide variety of mental illnesses, including depression, was appropriately adopted in the study to examine the association among the cognitive, social, and psychological well-being of the SEA refugee children. Similarly, the investigators also used process and outcome objectives in which the cognitive-behavioral and school-based approach was used along with the collaboration of bilingual teachers, school nurses and nurse researchers to decrease children's depression symptoms among SEA refugee children. For operationalization, the construct was the effectiveness of the intervention on reducing depressive symptoms. The indicators were the S.E.A’s drawing responses to the question of how they were feeling that day and their answers to the checklist. The variables were the results of the forms and the percent of children who were feeling better during and after the intervention.
The small sample size is a problem, because, we are unable to make a larger generalization of the target population. Also the fact that they are excluding other refugee populations from the study shows selection bias. In addition, the short period of time for the intervention is not enough to measure the effectiveness of the program because the Cognitive Behavioral Intervention requires more time commitment. The amount of data collectioned is not sufficient enough to conclude the effectiveness of the intervention because the symptoms of depression would change over time and it is important to repeat the test over time to record a more accurate score.
As a group we would recommend that this study be given a longer time -span so that they can better test if their intervention is working. Also we believe that a larger group of kchildsren be tested from different schools to see if the intervention would work in different school environments. Schools such as private, Ccatholic and Ccity schools could require less or more attention. The addition of other refugee groups could also be a possibility as SEA’s are not the only groups of refugees affected by this problem. Another recommendation for future study is to divide students into two groups, the- control and experimental groups. The experimental group would receive both intervention and screening for depression, meanwhile, the control group would only be screened for depression. After the intervention is proved effective, the control group could begin the interventional program.