Intervention Schools Research Articles

Advancing implementation of single session interventions in schools: a protocol for a qualitative study

BackgroundSchools are one of the most common settings in which youth seek mental health services, yet existing school-based mental health interventions are often difficult to implement due to time, cost, and staffing limitations. Digital, self-administered Single Session Interventions (SSIs) are evidence-based supports that are intentionally structured to deliver a clinically-meaningful dosage of evidence-based content within one session. Although multiple studies have demonstrated the clinical effectiveness of school-based SSIs, there have been no systemic efforts to understand how SSIs can be practically implemented in schools. The goal of this project is to partner with students, parents, and school staff to identify factors that impact the implementation of SSIs and understand how SSIs can be sustainably integrated as mental health supports into school mental health infrastructure.MethodsWe will conduct focus groups (five groups, total n = 35–45) among community members (i.e., students, parents/caregivers, teachers, school administrators, and school mental health providers) to assess perceived facilitators and barriers to the effective implementation of evidence-based SSIs in schools (Aim 1). We will then work in partnership with community members (n = 10–15) to co-design multi-level implementation strategies (i.e., student-directed, staff-directed, system-directed) for increasing uptake and promoting sustainability of school-based SSIs (Aim 2). We will use inductive coding to thematically analyze qualitative data from group sessions. This study is being conducted within the Lake Washington School District in the Seattle, Washington region.DiscussionThe proposed project will be the first to investigate facilitators and barriers to real-world implementation of SSIs in schools and strategies to improve implementation. Future studies may test the effectiveness of the generated implementation strategies on outcomes such as SSI uptake over time.

The implementability and proximal effects of a transdiagnostic mental health intervention for adolescents (Kort): protocol for a mixed-methods intensive longitudinal study

BackgroundThis protocol describes a study designed to test the implementability and proximal effects of a transdiagnostic mental health intervention for adolescents in school health services. The study is driven by the urgent need to address the rising mental health challenges among adolescents, exacerbated by the COVID-19 pandemic. Leveraging implementation science and evidence-informed intervention elements, this co-designed intervention focuses on emotion regulation (ER) as a central target for usable prevention and support.MethodsThe study employs a mixed-methods approach, integrating intensive longitudinal experience sampling (daily measures for 13 weeks), a micro trial, pre-, post-, and follow-up measures, audio recordings, and qualitative interviews to triangulate data from school nurses and adolescent participants. The research questions span the domains of intervention implementability, barriers and facilitators to implementation, proximal outcomes for adolescents’ emotion regulation, the mechanisms driving the intervention’s proximal effects, and response burden in experience sampling. The study aims to recruit a minimum of 25 health nurses and 46 adolescents.DiscussionThe study is novel in using mixed methods from multiple theoretical paradigms to examine ER as a dynamic process and transdiagnostic target outcome for promoting mental health and preventing disorders. Through daily diary and ecological momentary assessments, the study explores the intricacies of ER in real-life settings. Coupling the experience sampling with highly detailed fidelity measurement, we will observe adolescents’ day-to-day responses to intervention elements and how they affect emotion regulation. The integrated micro-trial also addresses concerns about response burden in experience sampling to optimize data collection strategies for future studies.The findings from this study can increase our understanding of ER as a mental health process, and contribute to the development of scalable, efficient, and context-appropriate mental health interventions in school nursing.Trial registrationThe ISRCTN-registry: ISRCTN14932526, registration date 04/04/2023.

Assessing PrEP Initiation and Adherence Among High-Risk, Sexually Active Adolescents and Young Adults: A Population-Based Prospective Study Across Diverse Service Delivery Models in a High HIV Prevalent District in South Africa.

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy for high-risk populations, including adolescent girls and young women (AGYW) and adolescent boys and young men (ABYM). While various PrEP-delivery models exist in South Africa, little is known about optimizing PrEP-uptake and adherence for AGYW and ABYM. This study explored preferred and feasible PrEP care models to enhance initiation and adherence among at-risk adolescents and young adults (AYAs) in a high-HIV prevalent rural district in South Africa. We conducted a longitudinal, population-based cohort study from August 2021 to July 2022 across 22 service delivery points (SDPs) in KwaZulu-Natal. High-risk, sexually active HIV-negative AGYW (15-24 years) and ABYM (15-35 years) were recruited from clinics, schools, and community-based youth zones. PrEP-uptake and adherence, based on national guidelines, were assessed using Pearson's Chi square test and binomial regression. Of 2,772 HIV-negative AYA, 781 (28%) initiated PrEP. Despite 65% being classified as high risk for HIV (p < 0.001), only 22% initiated PrEP. Initiation was higher in female (82%, p < 0.001) and among the 15-19 years (51%, p = 0.11). PrEP uptake varied significantly by SDPs, lowest in clinics (9%, p < 0.001), higher in youth zones (58%, p < 0.001), and highest in schools (73%, p < 0.001). Adherence declined significantly over time, dropping from 12% at one month to 2% at six months (p < 0.001). These findings highlight the need for targeted interventions in schools and communities, addressing barriers such as awareness, side effects, and accessibility. Expanding PrEP services to non-traditional settings may enhance uptake and adherence, reducing HIV risk among young people.

A pilot cluster-randomized controlled trial of an audit, feedback, and coaching intervention on compliance with elementary physical education laws and student physical activity during lesson time.

A pilot cluster-randomized controlled trial of an audit, feedback, and coaching intervention on compliance with elementary physical education laws and student physical activity during lesson time.

Association of High Levels of Bullying and Cyberbullying with Study Time Management and Effort Self-Regulation in Adolescent Boys and Girls

This study examined the association between bullying and cyberbullying (both victims and perpetrators) and resource management strategies for learning in students aged 10 to 16. A cross-sectional study was conducted with 1330 Spanish students (48.95% boys; mean age = 13.22 ± 1.75 years). Learning strategies were assessed using the Motivated Strategies for Learning Questionnaire (MSLQ), bullying levels with the European Bullying Intervention Project Questionnaire (EBIP-Q), and cyberbullying with the European Cyberbullying Intervention Project Questionnaire (ECIP-Q). ANCOVA and binary logistic regression were used to analyze associations and exposure risk. Girls who were victims of bullying and cyberbullying showed significantly lower scores in study time management (−5.9%, p = 0.001 for bullying; −6.2%, p = 0.025 for cyberbullying) and effort self-regulation (−7.7%, p &lt; 0.001; −8.3%, p = 0.002). Victimized girls were also up to 4.2 times more likely to struggle with effort self-regulation. Female aggressors exhibited up to 10.2% lower effort self-regulation, while male cyberbullies had 9.6% lower study time management compared to their peers and a 4.4 times greater risk of low effort self-regulation (p &lt; 0.001). These findings emphasize the importance of designing targeted school interventions to strengthen self-regulation strategies, particularly for female victims and male cyberbullies, contributing to improved academic outcomes.

Effects of school menstrual hygiene management, water, sanitation, and hygiene interventions on girls' empowerment, health, and educational outcomes: Lasta district, Amhara regional state, Ethiopia.

This study assessed the effects of school-based menstrual hygiene management (MHM) and water, sanitation, and hygiene (WASH) interventions on the empowerment, health, and educational outcomes of menstruating girls using cross-sectional and experimental designs. It examined whether access to MHM education and WASH facilities could enhance girls' self-confidence, physical, emotional, and social health, class attendance, and academic performance. The results showed significant improvements in empowerment at intervention schools, with 54% of girls feeling confident purchasing sanitary products, compared to 18% in control schools, indicating better emotional well-being. Additionally, 21% and 22% of girls in intervention schools felt comfortable discussing MHM with boys and mothers, respectively, compared to just 9% in control schools, reflecting improved social health. Regarding physical health, 51% of menstruating girls in intervention schools practiced genital hygiene three to four times a day, compared to 33% in control schools. Educational outcomes were also improved, with 68% of girls in intervention schools attending class during menstruation, compared to 30% in control schools, and 78% reporting adequate study time at home, compared to 41% in control schools. However, no significant difference in academic performance was found between the two groups. Overall, the findings suggest that school-based MHM and WASH interventions can significantly empower menstruating girls, improve their physical, emotional, and social health, and reduce menstrual-related absenteeism.

Expansive learning actions for leadership in a teacher training school’s Change Laboratory

ABSTRACT Drawing from cultural-historical activity theory and the theory of expansive learning, our study investigates an expansive learning process in a Change Laboratory intervention in a Finnish teacher training elementary school, facing a transformational curriculum reform. New subtypes of expansive learning actions and a novel analytical category within expansive learning are induced, employed and discussed for a more nuanced understanding of the learning process in which the participants tackled a contradiction between historically formed individualistic teacher-autonomy vs. collectivistic curricular demands of collaboration and interdisciplinarity. As an outcome, a model of distributed leadership was produced and later implemented as new school practice.

Indoor Allergen Interventions in Homes and Schools for Managing Asthma.

Indoor Allergen Interventions in Homes and Schools for Managing Asthma.

Disability and Bullying Victimization Among Adolescents in Nepal: The Influence of Community Gender Norms.

Disability and Bullying Victimization Among Adolescents in Nepal: The Influence of Community Gender Norms.

A multifaceted menstrual health intervention to improve psychosocial outcomes and menstrual practices among secondary schoolgirls in Northwest Tanzania: a pilot intervention study

IntroductionSchools provide an important opportunity to sustainably reach and improve menstrual experiences and outcomes among adolescent girls. This study examined changes in psychosocial outcomes and menstrual practices after a pilot menstrual health intervention in schools in Northwest Tanzania.MethodsWe conducted a pre/post evaluation of a pilot menstrual health intervention in four schools in Mwanza region. The intervention included: (i) 10-hours comprehensive menstrual sexual and reproductive health (MSRH) education curriculum delivered over 5 days, (ii) distribution of menstrual management kits, (iii) improvement of school WASH facility guided by needs, and (iv) training on menstrual pain management strategies, supply of pain killers and training a specific teacher on dispensing. The primary outcome was measured using the Menstrual Practices Need Scale (MPNS). We assessed seven secondary outcomes: menstrual pain management practice; self-efficacy in managing menstruation; menstrual-related anxiety; self-reported urogenital infection symptoms; MSRH knowledge; participation in school during menstruation; and school climate score. We used linear (for MPNS, and school climate score), and logistic (for remaining secondary outcomes) random-effect regression models to examine changes in outcomes between baseline and endline.ResultsA total of 486 schoolgirls (mean age 15.6 years [SD 1.3]) were recruited for the baseline survey; of these 396 participated in the endline survey. At 12-months follow up, menstrual experience improved for MPNS-36 subscales of transport and menstrual material needs, (mean difference (MD), 0.52; 95% CI 0.38–0.66), and menstrual material reuse needs, (MD 0.32; 0.14–0.50), while menstrual materials reuse insecurity did not change, (MD -0.08; -0.27–0.11). For the secondary outcomes, there was an increased use of analgesics for menstrual pain management, (OR 2.21; 95% CI 1.33–3.67); improved self-efficacy for managing menstruation, (OR 2.02; 1.35–3.04); MSRH knowledge, (OR 5.23; 3.25–8.39), participation in school (OR 2.80; 1.89–4.16) and reduced menstrual-related anxiety, (OR 0.38; 0.25–0.59). There was no evidence of change in self-reported urogenital symptoms, (OR 0.71; 0.49–1.01) or school climate, (MD 0.05; -0.19–0.28).ConclusionThe pilot intervention showed improvements in menstrual practices, psychosocial outcomes and school participation among schoolgirls but had no effect on school climate or self-reported urogenital symptoms. Stronger evidence from rigorously designed trials is needed to confirm the effectiveness of the intervention and scalability of these findings.

School-Based Transdisciplinary Teaming to Maximize Behavioral Supports

Abstract In the United States school system, there is an increasing number of students who need behavioral support. Board Certified Behavior Analysts (BCBAs) utilize the science of applied behavior analysis and are uniquely qualified to provide such support. However, for many reasons, BCBAs may not have the knowledge and skills to capitalize on their services in schools, including collaboration skills that can result in goals, intervention procedures, and outcomes that are not socially and ecologically valid. The current article provides a transdisciplinary model of school-based collaboration for BCBAs to maximize the effectiveness of behavioral interventions in schools. Adapted for school-based BCBAs from Boyer and Thompson's (2014) transdisciplinary model, the current model includes the elements of (a) extending BCBAs’ knowledge regarding school systems, (b) establishing rapport with team members, (c) enriching team members’ understanding of everyone’s role and expectations, and (d) exchanging feedback and praise.

Subjective well-being and parenting in adolescence: Do peers matter when things are not so good?

Objective: The study aimed to investigate the association between adolescents’ subjective well-being and parenting, as well as the moderating role of peer relationships between the negative aspects of parenting and subjective well-being. Method: Adolescents (n = 331) attending Junior High School and High School (aged 12-18 years) in the broader area of Attica, Greece, participated in the study. Participants completed the Berne Questionnaire of Subjective Well-Being/Youth Form, the 40-item Egna Minnen Beträffande Uppfostran Child Version (EMBU-C) questionnaire (for ages 7–16 years), and the Friendship Quality Scale. Results: There was a positive association between parental emotional warmth and adolescents’ satisfaction, as well as between parental rejection and adolescents’ ill-being. Furthermore, closeness to friends moderated the association between adolescents’ ill-being and rejection by mothers and fathers. Girls and older adolescents had higher scores in the negative factors of subjective well-being, while girls scored higher in all friendship factors. Finally, based on adolescents’ perceptions, mothers had significantly higher scores than fathers in all parenting variables. Conclusions: Findings highlight the significance of the implementation of tailored interventions in schools and families for promoting adolescents’ well-being.

Enhancing school performance through whole school intervention: a case study

Whole School Intervention (WSI) is a school improvement approach that engages the entire school community to enhance various aspects of the school, addressing the needs of every child and ensuring opportunities for success. This study, grounded in the theory of complex adaptive systems, investigates the implementation of the WSI approach in a private school in Nepal to assess its impact on school improvement. The central research question is: How does WSI improve the school system? The study examines multiple areas for intervention by involving members of the entire school community through a qualitative case study methodology. Various data collection techniques, including participatory needs analysis, in-depth interviews, focus group discussions, and video recordings, were employed to understand the school context and the transformation occurring during the intervention, which was carried out in four phases. The findings indicate that WSI served as a practical approach to school improvement by transforming leadership capacity. It shifted traditional authoritative leadership to distributed, democratic, and participatory practices. Additionally, WSI nurtured a positive school culture and supported teacher professional development, thereby improving pedagogical knowledge and skills, which, in turn, enhanced student learning outcomes. The collective efforts of all school stakeholders also contributed to maintaining a conducive learning environment, exemplified through initiatives like school gardening. The article concludes by emphasizing that empowering participation and fostering a long-term shared vision are critical for the sustainability of overall school improvement.

Effects of the Informed Health Choices secondary school intervention on the ability of lower secondary students in Kenya to think critically about health choices: 1-year follow-up of a cluster-randomized trial

IntroductionThe Informed Health Choices (IHC) secondary school intervention aimed to teach students to assess claims about treatments. This follow-up of a cluster randomized trial assessed the retention of knowledge and the application of the nine prioritized IHC key concepts 1 year after the intervention.MethodsWe conducted a random assignment of 80 secondary schools in Western Kenya into either the intervention (n = 40) or control (n = 40) group. Both groups adhered to the standard curriculum. Teachers from the intervention group were invited to participate in a 2-day training workshop and were granted access to “Be Smart About Your Health” digital resources, comprising 10 lessons. These lessons, focused on nine prioritized IHC concepts, delivered over a single school term from May to August 2022. The digital resources were accessible online via smartphones or computers and could also be downloaded for offline use. The primary outcome measure, assessed at the end of the school term and again after 1 year, was the percentage of students achieving a passing score (defined as ≥ 9 out of 18 correct answers) on the “Critical Thinking about Health” test.ResultsOut of the total 3360 students involved in the trial, 2446 (72.8%) completed the test after 1 year. Within the intervention group, 728 out of 1369 students (53.2%) achieved a passing score after 1 year, compared to 61.7% immediately post-intervention. In contrast, in the control group, 347 out of 1077 students (32.2%) had a passing score after 1 year. The adjusted difference in passing rates between the intervention and control groups after 1 year was 20.8% (with a 95% confidence interval of 13.6 to 28.0%), compared to 27.3% (with a 95% confidence interval of 19.6 to 34.9%) immediately after the intervention.ConclusionThis study demonstrates that students were able to retain knowledge and the ability to apply the IHC key concepts, 1 year after the intervention. But fewer students in the intervention group had a passing score after 1 year compared to just after the intervention. Highlighting follow-up training is likely necessary to reinforce these skills over time.Trial registrationPan African Clinical Trial Registry, trial identifier: PACTR202204883917313. Registered on 05/04/2022.

Centering Adolescents' Voices: Informing a Middle School‐Based Well‐Being Intervention

ABSTRACTMany youth seek and receive mental health treatment in schools, yet research on their perceptions of these interventions remains uncommon. This qualitative study explored how student perspectives on social validity informed the ongoing implementation and evaluation of the Well‐Being Promotion Program (WBPP), a Tier 2 positive psychology intervention in middle schools. The study was conducted during the initial years of a larger ongoing randomized control trial evaluating the WBPP's effectiveness. Themes from student interviews conducted during Year 1 of the larger study were used to inform implementation supports during Year 2 to enhance student acceptability. Thirty student interviews were conducted during Year 2 of the larger study. Overall, most students found the intervention content, group process, and delivery to be acceptable. The findings identified ways to further enhance the implementation of the WBPP and indicate accessing student voice is an important way to engage in program implementation and evaluation of a middle school‐based intervention. Recommendations are provided for those interested in centering student voices regarding social validity to inform program implementation and evaluation.

Exploring Factors of Trauma-Related Preparation and Trauma-Related Agency Among School Counselors

Abstract School counselors support students who have experienced trauma in schools worldwide. Increased awareness of the gravity of childhood trauma (CT) and relationships between exposure to trauma and personal, social, and academic development have advanced the need for schools to provide trauma-informed care. School counselors play a critical role in providing trauma-informed care in the school environment, as they are trained mental health professionals whose roles include supporting all students’ personal, social, and academic development. This study explores the relationship between school counselors’ professional and personal backgrounds and exposure to trauma and their trauma-related agency, which is identified in this study as a construct including variables of secondary traumatic stress, secondary trauma self-efficacy, and implementation of trauma-related interventions. With a sample of 210 US school counselors, canonical correlation analysis revealed significant relationships among counselors’ various backgrounds, including trauma-related exposure, training, self-efficacy, and implementation of trauma-related interventions in schools. We discuss these relationships and the implications for school counselor educators and school counselors.

A Child-Centred Care Approach to the Learning Process: Lessons Learned from a Participatory Intervention in Primary Schools in Afghanistan and Pakistan

ABSTRACT About 240 million children have disabilities globally. Sustainable Development Goal 4 calls for inclusive and equitable quality education for all, including children with disabilities. Compared to children without disabilities, children with disabilities are more likely to never attend school or to drop out from school due to barriers such as negative attitudes among teachers, parents and peers, lack of trained teachers, inadequate learning materials and inaccessible facilities. Our study examines the effect of a participatory child-centred pedagogy intervention on academic and non-academic learning outcomes of children with disabilities in primary rural schools of Afghanistan and Pakistan. We use an ICF-based disability measure, the Child Functioning Module, to identify children with disabilities. We built a participatory intervention on the ethics of care and the capability approach that aimed at improving the learning process. It did not significantly improve the learning outcomes of children with disabilities compared to non-disabled children. However, we found that children with disabilities overall progressed significantly more than non-disabled children on several learning outcomes while benefiting from a larger reduction in stigma and discrimination. The impact was secured overall for children despite school lockdowns associated with the COVID-19 pandemic and political unrest in both countries. Therefore, we argue that this type of intervention could potentially improve the inclusion of children with disabilities in school with more time for implementation and circumstances allowing schools to stay opened.

Evaluating university sport science students' perceptions following a service-learning intervention in high schools

Perceived emotional support from professors is a well-documented factor influencing students’ motivation, participation, perseverance, and well-being. However, its influence on students’ sedentary lifestyle behaviors remains underexplored. This study assessed the direct influence of perceived professor’s emotional support on the sedentary lifestyle behaviors of undergraduate students at a state university in the Philippines. Utilizing a multiple regression approach, this study analyzed data collected from 1,128 randomly selected students through an online survey conducted from January to February 2024. The survey included the Sedentary Behavior Questionnaire and the Teacher’s Emotional Support Scale. Results indicate that perceived professor’s emotional support significantly predicts students’ sedentary behaviors during weekdays [F(3, 1124) = 3.104, p = .026] and weekends [F(3, 1124) = 4.837, p = .002]. Professor’s sensitivity and Regard to adult perspective were significant predictors of reduced sedentary behavior, whereas Positive Climate was not. Specifically, Professor’s Sensitivity (β = -.189, p = .012) and Regard to adult perspective (β = .201, p &lt; .001) influenced weekday behaviors, while Professor’s Sensitivity (β = -.295, p &lt; .001) and Regard to adult perspective (β = .218, p = .005) influenced weekend behaviors. The study concludes that professor’s emotional support plays a crucial role in mitigating sedentary behaviors among students. These findings underscore the importance of professor-student relationships extending beyond academics to foster healthier lifestyle choices. Further research is recommended to explore the underlying mechanisms and contextual factors affecting this relationship, aiming to develop targeted interventions and policies that enhance both academic performance and physical well-being, thus fostering supportive learning environments

La téléconsultation, une modalité prometteuse pour les programmes psychoéducatifs destinés aux parents d’enfants ayant un trouble du spectre de l’autisme

La téléconsultation, une modalité prometteuse pour les programmes psychoéducatifs destinés aux parents d’enfants ayant un trouble du spectre de l’autisme

School violence and its psychological impacts: A comparative analysis in the context of Vietnam.

Globally, school violence affects kids' academic performance, mental health, and social development. International research uses varied methods to study school violence, but Vietnamese studies are mostly quantitative and lack methodological rigor and psychological analysis. Synthesizing global and Vietnamese school violence literature to identify trends, research constraints, and intervention techniques attempts to fill these gaps. This systematic literature analysis investigated empirical studies from Google Scholar, UNESCO, UNICEF, and WHO databases from 2000 to 2024. Relevant studies were chosen for school violence prevalence, causes, psychological effects, and interventions. A thematic analysis categorized findings by methodological approach and study emphasis, followed by a comparative analysis of international and Vietnamese studies. Physical, psychological, social, and cyber school violence exists, with psychological violence being more common. International studies use standardized instruments and mixed-method approaches, while Vietnamese research uses self-constructed assessment tools with inadequate validation. Family environment, peer dynamics, school atmosphere, and media influence are important. Life skills education and punishment dominate Vietnamese intervention efforts, while international programs emphasize social-emotional learning, teacher training, and community involvement. Qualitative research in Vietnam needs better methods and established measurement tools. Effective prevention should move from punitive to evidence-based, multi-stakeholder interventions. Future school violence intervention program evaluations should use mixed-method approaches and longitudinal assessments. This review helps Vietnamese policymakers and educators create more comprehensive school violence prevention strategies.