Validation of a Locally Developed Life Skills Development Package (the Manohari Module) for Adolescents in Sri Lanka: Evidence From Expert Review and Adolescent Feedback.

Background Adolescent mental health is a growing public health concern, particularly in low- and middle-income countries where access to mental health services is limited. Life skills-based interventions have been identified as effective strategies for promoting mental well-being. This study aimed to validate the locally developed life skill developmental package (the Manohari module) using a mixed-methods approach to support its implementation among adolescents. Methods A mixed-methods approach was employed. Expert validation was conducted using the modified Delphi method with a panel of six experts, including two psychiatrists, two community physicians, and two Zonal Directors of Education (ZDEs). The panel evaluated the module's content validity, cultural appropriateness, and clinical relevance. Perspectives from the ZDEs were obtained to evaluate feasibility and integration within the school system. A structured evaluation form, adapted from the literature, was used, comprising eight core items rated on a five-point Likert scale, along with subject-specific items and open-ended questions, to gather qualitative feedback. Additionally, a focus group discussion (FGD) was conducted with six Grade 12 students to explore acceptability, understanding, and perceived usefulness. Expert ratings for each assessment item were summarized using percentage agreement. Items with less than 65% agreement were identified for further review based on expert feedback. Qualitative data from the FGD were analyzed using thematic analysis. Ethical approval was obtained from the Ethics Review Committee, Faculty of Medicine, University of Jaffna. Results Overall, the module evaluation gave positive responses, with most expert responses falling within the "agree" and "strongly agree" categories; five of the eight core items achieved over 65% agreement. The majority of experts agreed that the module content was relevant, culturally appropriate, and practical for delivery by non-health professionals. However, variability in agreement was observed regarding clinical relevance and developmental appropriateness. Qualitative feedback highlighted the need for improved developmental targeting and inclusion of context-specific adolescent challenges. ZDEs indicated strong agreement for integration within the school system, although further contextual adaptation was recommended. Findings from the FGD demonstrated high acceptability, with participants reporting the module was engaging, relatable, and easy to understand. However, the perceived impact on behavior change was moderate, suggesting the need for stronger motivational and interactive elements. Conclusion This study provides preliminary evidence supporting the acceptability, content validity, and cultural relevance of the Manohari module as a life skills development package for adolescents in Sri Lanka. Experts' and adolescents' feedback highlighted areas for improvement, particularly developmental appropriateness and contextual adaptation, which will guide future refinement of the module. Further validation with larger and more diverse populations is needed before wider implementation, along with research evaluating the module's impact on adolescent mental health outcomes to support its integration into educational and community settings.