Paper Title
Efficacy of Modified Betty Neumann Theory to Develop Evidence Based Pandemic Care Pathway for Preadolescents Going to School

Abstract
Introduction: Preadolescents experienced amplified psychological stress during the pandemic due to disruptions in daily routines, academic pressures, and limited coping abilities. Conventional Betty Neumann’s Theory includes lines of defense but does not sufficiently address primordial prevention for early stressor management. This gap highlighted the need for a comprehensive, evidence-based care pathway to strengthen resilience and reduce stress among school-going preadolescents.Aim:To develop, validate, and evaluate the Stress-Releasing Preadolescent Pandemic Care Pathway based on a modified Betty Neumann’s Theory and compare its efficacy with the conventional model.Methodology:A two-phase research design was used. Phase I involved the generation and validation of the TAPPS tool for pandemic stress assessment and the development of the Stress-Releasing Preadolescent Pandemic Care Pathway through qualitative analysis and expert validation. Reliability and accuracy were assessed, followed by a pilot study. Phase II consisted of a randomized controlled trial with 100 preadolescents divided into experimental and control groups. Outcomes included the Pubertal Development Scale, Paediatric Symptom Checklist, Beliefs and Values Scale, and Perceived Stress Scale, assessed at baseline, 7 days, 3 months, and 6 months. Data were analyzed using SPSS 26.Result:Both the TAPPS tool and the pathway were found valid and reliable. At the 6-month evaluation, the experimental group showed significantly reduced stress levels and improved developmental, behavioral, and spiritual parameters compared with the control group. Highly significant differences were observed for perceived stress (p<0.01) and other outcome measures. Results showed observed value = 19.850 > (critical value) = 6.2467 at 20 % superiority, thus observed value is greater than critical value for area of not retaining the null hypothesis.Conclusion:The Stress-Releasing Preadolescent Pandemic Care Pathway, developed through modified Betty Neumann’s Theory, was significantly more effective than the conventional model in reducing stress and enhancing well-being among school-going preadolescents. Keywords - Preadolescents, Stress, Pandemic, Care Pathway, Neumann Theory