Can medical students look after themselves? Participatory action research to promote well-being and decrease depression in Riga, Latvia

Cindy Heaster, Sandra Gintere, Vija Silina, Ilze KoreŇ°kova

Keywords: Action Research, well-being, depression, medical students,


Medical students worldwide experience a high prevalence of depression, and Latvia is no exception. To improve student well-being and decrease the prevalence of depression, we need a better understanding of stressors and coping mechanisms and to act on this understanding. Participatory Action Research (PAR) works with the stakeholders through an iterative process of planning, action and reflection to enact change. Medical students are a group who could be empowered to produce, together with the researchers, their own solutions to improve well-being and decrease depression.

Research questions:

How do medical students experience stress and how do they cope with it?
Which interventions improve well-being and decrease depression?


This mixed methods, PAR study will use in-depth interviews and focus group discussions in the initial exploratory phase. The aim of this phase is to explore themes related to student well-being and depression, and define together with the students which interventions would be the most acceptable. These interventions include, but are not limited to, peer support programmes, physical activity, organisational changes and individual and group psychotherapy. The second, pre-action phase will involve quantitatively measuring well-being and depression using the WHO-5 and PHQ-9. In the third, action phase, we will implement interventions found to be the most feasible, and acceptable to students using a PAR reflective cycle of information collection, reflection, and action. In the fourth phase, the WHO-5 and PHQ-9 will again be used to measure well-being and depression.


Results will be presented at the end of each phase.


We have known for many years that medical students experience a higher rate of depression than the general population. We need to move beyond numbers to an understanding of lived experience in context, and then act collaberatively on this understanding to promote medical student well-being.

Points for discussion:

The advantages and disadvantages of participatory action research

The feasibility of decreasing stressors in medical education