School-based Intervention Research Articles

Gender-transformative school-based sexual health intervention: study protocol for a randomized controlled trial

BackgroundThere is general agreement that sexuality is a central aspect of human development; it is key in sexual health and reproductive education during adolescence. However, in spite of the existing interventions on this topic and the evidence generated, the inclusion of a gender focus in sexuality is relatively recent and there is little evidence available, thus structured and corroborated interventions with a gender-transforming perspective in sexuality are required.MethodsWe will use a mixed method experimental design with a parallel cluster-randomized trial (GRTs) that will evaluate the effectiveness of a comprehensive gender-transformative intervention of sexual education (ENFOCATE -Focus-on-), which will be complemented with qualitative studies to understand the implementation process. The participants will be 609 10th and 11th-grade students. The randomization will be by grade, and the data will be collected at three moments (pre-intervention, post-intervention, and a 3-month follow-up).DiscussionComprehensive, gender-focused, and culturally pertinent interventions in sexuality are needed for adolescents of countries with high, middle, and low incomes. These produce better results in terms of sexual health, and including a gender-transformative focus contributes to equity in health. Focus-on is unique since it uses a comprehensive gender-transformative intervention in sexual education that will allow putting into practice a program based both on international evidence and that which arises from the object population. It also uses a culturally-sensitive focus, since it is designed based on the characteristics of the object population; it will allow adapting some activities to the needs of the context in which it is developed.Trial registrationThe study was prospectively registered on June 6, 2023, at ClinicalTrials.gov ID: NCT05896540. Protocol version number 1.0. May 22, 2023.

Feasibility, acceptability, and perceived benefits of a creative arts intervention for elementary school children living with speech, language and communication disorders

BackgroundChildren with speech, language, and communication disorders require specialized support in response to their emotional expression challenges. Not only is such support key for their development, but it is also essential for their mental well-being. Art making emerges as a valuable tool for enabling these children to convey emotions both verbally and non-verbally, fostering a positive self-concept. School-based arts interventions have the potential to improve self-concept and emotional expression, and more generally, the quality of life. However, there is limited empirical evidence regarding the feasibility, acceptability, and perceived effectiveness of a manualized, school-based creative arts intervention for this specific group.AimThis study aimed to develop and evaluate the feasibility, acceptability, and perceived benefits of an art-based intervention for elementary school students with speech, language, and communication disorders, using qualitative methods to obtain diverse perspectives.ResultsThe findings indicate that the intervention was feasible and well received, as reported by teachers, students, and facilitators. Participants also discussed potential positive outcomes, including emotional expression, emotional growth, and fulfilment of autonomy, competence, and relatedness needs. Students found the workshops conducive to sharing emotions and took pride in the creative process. Teachers gained deeper insights into their students, fostering positive classroom relationships. Observational data triangulated these findings.ConclusionThis innovative project suggests that art-based interventions can potentially benefit students’ emotional expression, but further experimental studies are needed to substantiate these effects.

Factors affecting continuous participation in follow-up evaluations during a lifestyle intervention programme for type 2 diabetes prevention: The Feel4Diabetes-study.

Community- and school-based lifestyle interventions are an efficient method of preventing type 2 diabetes in vulnerable populations. Many participants, however, fail to complete the necessary follow-ups. We investigated factors affecting the continuous participation in follow-up evaluations during the Feel4Diabetes-study, a multilevel intervention programme implemented across Europe. Socioeconomic, sociodemographic and clinical factors were assessed for 2702 participants within six participating countries: Bulgaria and Hungary (low-to-middle-income countries, LMIC), Belgium and Finland (high-income countries, HIC) and Greece and Spain (high-income countries under austerity measures, HICAM). Statistically significant differences were detected with respect to sex, control group, education level, employment status, BMI and blood pressure measurements (systolic and diastolic blood pressure). Post hoc analysis revealed significant differences within socioeconomic regions. Higher levels of education were associated with significantly lower attrition in HIC (p < 0.05) and HICAM (p < 0.001), higher employment status was associated with lower attrition in HICAM (p < 0.001) and being female was associated with lower attrition in LMIC (p < 0.001). Surprisingly, the intervention group exhibited higher-than-expected attrition in HIC (p < 0.001) and HICAM (p = 0.003), and lower attrition in LMIC (p = 0.007). When tested together in the same multivariable predictive model, all sociodemographic and socioeconomic variables along with higher BMI retained their statistical significance, while systolic and diastolic blood pressure failed to remain significant. Key socioeconomic and sociodemographic factors along with BMI play a significant role in determining continuous participation in follow-up evaluations during school- and community-based intervention programmes.

Efeitos de intervenções de base escolar na pressão arterial de crianças com obesidade: metanálise

Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA), a systematic review with metanalysis was conducted to identify and summarize the effects of school-based physical activity interventions that sought to control and / or reduce blood pressure (systolic and diastolic) in children and / or adolescents with overweight and / or obesity. In September 2022, potential studies were searched in five electronic databases (Pubmed, Scielo, Scopus, Sportdiscus, and Web of Science) and in reference lists. Randomized controlled trials conducted in schools with interventions involving physical activity and assessment of systolic and diastolic blood pressure in children and adolescents aged 6 to 19 years with overweight and / or obesity were considered for synthesis. The risk of bias was assessed using an adapted version of the Effective Public Health Practice Project tool (EPHPP). Metanalysis was developed from the random model. Four studies were included. For systolic blood pressure, a summary effect of -0.10 (95% CI: -0.39; 0.19; I2 = 0%) was observed. For diastolic pressure, the metanalysis indicated -0.33 (95% CI: -0.62; -0.04; I2 = 11%). Considering the promising effects on diastolic blood pressure, we suggest the development of more school-based interventions based on physical activity practice for overweight and / or obese populations, which may also add environmental elements, longer duration, multicomponent approaches, and parent / guardian involvement to their strategies.

A 10-Week School-Based Mindfulness Intervention and Symptoms of Depression and Anxiety Among School Children and Adolescents: A Controlled Study

Mental health problems are increasing among children and adolescents. School-based mindfulness interventions are gaining popularity worldwide and may be a way to decrease depression and anxiety symptoms in students. However, before introducing large-scale mindfulness interventions in school settings, more research is needed on feasible, easily applicable practices that are possible to fit in the school schedule. In this controlled intervention study, a total of 1399 students aged 9–16 were included. The 10-week classroom-based mindfulness intervention comprised daily, brief mindfulness sessions led by schoolteachers or via audio files. Symptoms of depression and anxiety were evaluated with Beck scales prior to and after the intervention. In addition to whole group analyses, subgroup analyses on age, sex as well as mode of delivery were performed. ClinicalTrials.gov ID: NCT03327714. No significant differences between the intervention and control group in change of depression or anxiety symptoms after the intervention were detected. However, the subgroup of students who received teacher-led mindfulness sessions (16%) had a significant decrease of depression and anxiety symptoms after 10 weeks compared to those who received the sessions via audio files. Brief mindfulness sessions on daily basis did not have any detectable overall effect on depression and anxiety symptoms among schoolchildren. Our findings do not support an introduction of large-scale mindfulness interventions in schools although the potential influence of mode of delivery needs to be further examined.Clinical trial registration The study was registered at ClinicalTrials.gov (identifier: NCT03327714).

Risk ambassadors and saviours: Children and futuring public health interventions.

Schools are increasingly positioned as sites for intervening on the bodies and minds of children in the here and now in order to bring about health gain for the future. Public health interventions for schools bring together coalitions of commercial, statutory and philanthropic actors with children and their teachers and carers. Drawing on ethnographic case studies in London, UK, this paper explores two such interventions: one aiming to increase levels of physical activity and one to reduce exposure to air pollution. Both interventions not only evoke care for children's own current and future wellbeing but also fold in imaginaries of collective health futures, which orient and legitimise particular intervention logics and actions. As interventions unfold, children are recruited as monitors of health risks in the present. They are also positioned as risk ambassadors, who will leverage care about unhealthy environments and lifestyles across space, to risky domestic environments, and into imagined health futures. These 'futuring' school-based interventions open up small alternative spaces in which imaginaries of collective and resistant public health practices emerge. However, in the here and now, children appear to be bearing a disproportionate burden of responsibility, as ambassadors for, and imagined saviours of, public and environmental health.

School-Based Anti-Bullying Program on Reducing Violence among High School Students in Indonesia: A Quasi-Experimental study

Background and Objectives Bullying is a form of aggression that has detrimental effects on the physical, emotional, and psychological well-being of youths. The study sought to investigate the impact of school-based anti-bullying initiatives on mitigating violence among high school students in Indonesia. Patient and Methods This study employed a quasi-experimental design, including a pretest and post-test, with a non-equivalent control group. This study included a total of 160 high school students. Results The findings indicated that school-based anti-bullying interventions had a substantial impact on the attitudes and behaviors of the experimental group, who received the program, in comparison to the control group, who received the standard care provided by the school. Nevertheless, there was no notable disparity in students’ understanding of anti-bullying between the experimental group and the control group both before and during the implementation of the school-based anti-bullying program. Conclusion Ultimately, school-based anti-bullying initiatives have proven to be efficacious and have the potential to be widely deployed as a means of curbing violence within educational environments. Additional research is required to carry out randomized control trials in order to ascertain the efficacy of the program in different educational institutions.

Comparing the Effectiveness of Solution-Focused Brief Therapy for Adolescent Outcomes in Schools Between the U.S. and East Asian Studies: A Systematic Review and Meta-Analysis

Solution-focused brief therapy (SFBT) can be a culturally adaptive school-based intervention for youth. Despite the evidence that supports the practical use of SFBT with various populations, its effectiveness particularly among East Asian American (EAA) youth outcomes in school settings requires further study. For this systematic review and meta-analysis, we searched U.S. and East Asian studies (e.g., Chinese, Korean, and Japanese) published from 1995 to 2022 and compared the treatment effects of SFBT on youth outcomes. This study looked at results from 110 studies from the U.S., Chinese, and Korean literatures and revealed stronger treatment effects of SFBT in Chinese and Korean studies compared with U.S. studies. The moderation effects of country showed that the overall treatment effect size was greater among Korean studies compared with U.S. studies. Implications for the use of SFBT among EAA youth are discussed.

Effectiveness of video-based and traditional intervention in school on anxiety among primary school children

Despite widespread remote psychological interventions during the COVID-19 pandemic, the difference between the effectiveness of remote digital and face-to-face methods in school-based intervention programs remains unclear. This study examined the difference between the effectiveness of video and face-to-face based problem-solving training on primary (elementary) school students’ anxiety and cognitive bias. Participants included 125 Grades 5 and 6 students. One group was assigned the video-based intervention, and another group was assigned the face-to-face intervention. The face-to-face group experienced a reduction in levels of anxiety, whereas the video group did not. The main effect of time suggested a reduction in cognitive bias across both groups. Although both groups understood the intervention content, the face-to-face group may have experienced more immediate anxiety-reducing effects.

Effects of school-based physical activity on volition in exercise, sleep quality and internet addiction in Italian adolescents

School-settings represent ideal context to promote healthy habits as in adolescence most risk factors may occur or intensify leading to the adoption of unhealthy lifestyles. Thus, a deeper understanding of the factors promoting healthy lifestyles in adolescents is of utmost importance.This observational study aims to investigate: 1) gender-related differences in physical activity (Physical Activity Questionnaire for Adolescets – PAQ-A), sleep quality (Pittsburgh Sleep Quality Index - PSQI) and internet addiction (Internet Addiction Test – IAT) levels and Volition in Exercise (VE); 2) the relationship between PAQ-A and VE, PSQI and IAT; 3) the effects of a five-month (T0; T5) school-based physical activity (PA) intervention on the above-mentioned factors. PAQ-A,VE, PSQI and IAT were assessed before (T0) and after (T5) a school-based PA intervention. The PA intervention consisted of coordinative exercises and team sports performed for 1 h twice a week. At T0, girls showed lower PAQ-A, PSQI scores, lower volition facilitators (“self-confidence” and “coping with failure”) and higher volition inhibitor (“postponing training”) than boys. Significant correlations were observed for volition factors an IAT in males and volition and PSQI and IAT in females. After the PA intervention (T5), “postponing training” and “self-confidence” factors were reduced compared to T0.Exercise specialists should consider gender differences in volition in exercise factors during a school-based PA to plan and realize PA protocols aiming at maximizing exercise adherence to tackle sedentary behaviors in adolescents.

Longitudinal Profiles of Cultural Identity Processes and Associations with Psychosocial Outcomes Among Adolescents Participating in the Identity Project in Italy

Cultural identity formation is a complex developmental task that influences adolescents’ adjustment. However, less is known about individual variations in trajectories of cultural identity processes and how they relate to youth psychosocial outcomes. Using a person-centered approach, this study investigated patterns of change over a year in cultural identity exploration and resolution, respectively, among ethnically diverse adolescents in Italy. The sample included 173 high school students (Mage = 15 yrs, SD = 0.62, range = 14–17; 58.4% female; 26% immigrant background) who had participated in the Identity Project, a school-based intervention targeting ethnic-racial identity development. Longitudinal latent profile analysis revealed only one profile of change for exploration, whereas four unique profiles for resolution emerged (“stable low,” “stable average,” “increase low-to-average,” “increase high-to-higher”). Overall, youth in the resolution-increase profiles reported the best outcomes. The findings highlight the heterogeneity of adolescents’ resolution trajectories and the benefits of an increased sense of clarity concerning one’s cultural identity for positive psychosocial functioning.

Barriers to Mental Health Support in Cyberbullying: A Thematic Analysis of What Mental Health Professionals and Cyber Experts Think

Background: Cyberbullying can be a traumatic experience for adolescents. It can affect their psychosocial functioning, development, and mental well-being in the long term. Though mental health support is needed to help adolescents, parents, and schools, they do not seek appropriate support. Aim: This article describes the viewpoint of mental health and cyber experts on the barriers to seeking mental health support among adolescents, parents, and school administrators and identifies approaches to intervention. Methods: The qualitative research study was conducted in Bengaluru Urban, India. Ten specialists were interviewed, including mental health professionals and cyber experts who work with children and adolescents. The data were analyzed using thematic analysis. Results: Seven major themes emerged from the study as follows: (a) knowledge of cyberbullying, (b) negative impact of cyberbullying, (c) attributed factors for cyberbullying, (d) barriers for help-seeking, (e) child-centric intervention, (f) parental intervention, and (g) whole-school approach to cyberbullying. Conclusion: Several factors would affect help-seeking by adolescents, parents, and schools in the context of cyberbullying. These factors need to be considered in developing a comprehensive, school-based intervention on cyberbullying for adolescents.

Promoting Adolescents’ Heritage Cultural Identity Development: Exploring the Role of Autonomy and Relatedness Satisfaction in School-Based Interventions

Given the significance of heritage cultural identity for optimal adolescent development, it is imperative to investigate factors influencing the efficacy of interventions aimed at promoting heritage cultural identity. Using latent profile cluster analysis and multinomial logistic regressions, this longitudinal study examined how autonomy and relatedness need satisfaction at school (1) related to heritage cultural identity development trajectories, and (2) moderated effects of a school-based intervention. The study included N = 198 adolescents (Mage = 12.86 years, SDage = 0.75, 52% female, 41% immigrant descent, 49% intervention group) in Germany. Teacher-student relationships played an important role in facilitating intervention effects on identity development trajectories, emphasizing the importance of the relational context when implementing school-based interventions to promote heritage cultural identity development.

School prevention of non-consensual sexting among middle adolescents: Does sexual preoccupation awareness matter?

Although non-consensual sexting seems to concern not only adults but also middle adolescent students, with detrimental consequences on their well-being, the related research-based effective school prevention programs are almost absent. Furthermore, there is an unanswered research question as to whether sex-related issues, such as sexual preoccupation, matters in adolescents’ non-consensual sexting and its prevention. The present study investigated the effectiveness of a school-based intervention against non-consensual sexting among middle adolescents, based on the European funded program TABBY (Threat Assessment of Bullying Behavior in Youth). Furthermore, the predictive role of sexual preoccupation was examined. Overall, 280 Greek students from randomly selected junior high school responded to self-report scales on non-consensual sexting and sexual preoccupation. Based on an experimental longitudinal research design, only the experimental (N = 131), but not the control group of students (N = 149), participated in the intervention. To test the effectiveness of the intervention, both student groups completed the scales before (1st phase), immediately after (2nd phase), and six months after the intervention (3rd phase), which was implemented by trained teachers. The results showed both, the short-term and long-term effectiveness of the intervention. Also, the study highlighted the significant contribution of sexual preoccupation awareness in reducing non-consensual sexting, especially immediately after and six months after the intervention. The study implies the necessity to adapt existed prevention programs to the specific parameters of non-consensual sexting, integrating at the same time sexual preoccupation awareness activities to better address this issue.

Effectiveness of school oral health programs in children and adolescents: an umbrella review.

To evaluate the systematic reviews assessing the effectiveness of any type of school-based oral health programs in children and adolescents. A two-staged search strategy comprising electronic databases and registries based on systematic reviews was employed to evaluate the effectiveness of school-based interventions. The quality assessment of the systematic reviews was carried out using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) tool. The Corrected Covered Area was used to evaluate the degree of overlap. Nine reviews were included in this umbrella review. The Critical Covered Area reported moderate overlap (5.70%) among the primary studies. The assessment of risk of bias revealed one study with a high level confidence; one with moderate whereas all other studies with critically low confidence. Inconclusive evidence related to improvements in dental caries and gingival status was reported whereas, plaque status improved in a major proportion of the reviews. Knowledge, attitude, and behavior significantly increased in students receiving educational interventions when compared to those receiving usual care. The evidence points to the positive impact of these interventions in behavioral changes and clinical outcomes only on a short term basis. There is a need for long-term follow-up studies to substantiate the outcomes of these interventions.

Do Cognitive and Non-Cognitive Factors Predict Responses to Reading Fluency Interventions?

We investigated whether emotional and motivational factors had predictive effects beyond those of cognitive factors on responses to two reading fluency interventions. Eighty-two dysfluent readers (Grades 3–5) participated in a 12-week school-based fluency intervention, either combined with or without self-efficacy support. Response to the intervention was determined by the fluency gain score and the Reliable Change Index. In the skill-focused intervention, cognitive predictors contributed to the response, and reading-related anxiety and self-efficacy had effects beyond the cognitive predictors. Weaker initial reading skills and older age predicted response in the combined intervention. Thus, children's personal characteristics may have a greater influence on their responses in a skills-focused intervention than in an intervention that also considers emotional and motivational aspects.

Unveiling school community perceptions of nutrition-friendly school initiatives in preschool settings in rural Sindh province, Pakistan: an exploratory study.

In 1995, the World Health Organization launched its Global School Health Initiative to expand the Health Promoting School (HPS). The objective of this study was to explore the perception of the school community in implementing nutrition-friendly school initiatives in preschool settings. This paper delineates the exploratory phase of a mixed-method study, which broadly aims to assess the adoption of the Nutrition Friendly School Initiative (NFSI) through a preschool preparedness intervention package in rural Sindh province, Pakistan. The study sites include three campuses of the Aga Khan School (Mirpur Sakro, Junior Campus Vur, and a community-based school in Sujawal). Participants were selected purposively from these campuses and constituted a committee named 'school community,' which was responsible for implementing all activities outlined in the intervention package. Data was gathered through in-depth interviews and consultative meeting with the school community. Thematic analysis was employed for data analysis. The analysis established five major themes that represent the participants' perception of school-based nutrition interventions in preschool settings. These five themes include (i) Challenges in health and nutrition for pre-school age children, (ii) Clarity in roles and responsibilities for school-based nutrition intervention, (iii) Advancing school-based nutrition activities and interventions, (iv) Recognizing resources requirements, (v) Opportunities and challenges for the way forward in school-based nutrition. Findings also suggest sustainability and scalability measures that include the aligning School Nutrition Policy with the school handbook, ways to engage with parents, a nutrition theme corner, the inclusion of a parenting component in the nutrition manual, and capacity building of the school community. Qualitative findings have guided the refinement of the intervention package, proposing additional measures for sustainability and scalability across AKES, P. The school community is hopeful that the implementation of the refined intervention package will enhance preschool preparedness toward achieving nutrition-friendly school checklist items. This study holds strong potential for replication in a public school setting and presents an opportunity to launch a school accreditation program to certify schools as Nutrition-friendly.

Remediation of Learning Difficulty Utilizing School-Based Cognitive Behavioral Intervention Measured by EEG Theta-Alpha and Theta-Beta Ratio During Resting and Cognitive Task Performance Conditions.

Background. EEG is an effective tool due to its ability to capture and interpret the changes in brain activity under different situations. Quantitative EEG (qEEG) can be essential in evaluating and treating children's learning problems. Methods and procedure. Fifty school-going children with difficulty in learning were studied. Analysis of the difference between pre-intervention and postintervention EEG power ratio of frequency bands, including Theta to Beta and Theta to Alpha, while eyes-closed, eyes-open, hyperventilation, writing, and reading conditions and the values for relative powers were calculated. The study correlated postintervention theta/beta ratio (TBR) and theta/alpha ratio (TAR) values with behavioral measures. Results. The findings suggested that there was a significant difference in pre-intervention and postintervention relative TAR and TBR power values. A significant increase of TAR and TBR power values was observed in eyes-closed (resting), hyperventilation, writing, and reading task conditions, indicative of a state of arousal at FP1FP2, T3T4, and O1O2 scalp locations. During eye open conditions, the TAR and TBR were significantly low at all 3 scalp locations, indicating a relaxed, conscious, and aware state of mind. Postintervention TAR and TBR values were significantly correlated with behavioral measures during 5 task conditions on several scalp locations. Conclusion. These quantitative electroencephalogram findings in children with learning problems indicate that with the increased complexity of the cognitive tasks, TAR and TBR increase, while postintervention, children could attain a relaxed and conscious state of mind during eyes-open condition.

School-based interventions to support mental health in adolescents: what works BESST?

School-based interventions to support mental health in adolescents: what works BESST?

Assessing the Evidence Base for School-Based Promotion and Prevention Interventions: Introduction to the Series.

Schools are an important component in the mental health system of care for youths. Teachers and other school staff have unique opportunities to promote emotional wellness and prevent mental health conditions. Although numerous programs are available, identifying evidence-based and effective options is a significant challenge. This introduction lays out the rationale and methodology of the Assessing the Evidence Base (AEB) series, a collection of systematic reviews of school-based mental health promotion and prevention approaches recommended by the National Academies of Sciences, Engineering, and Medicine for students in kindergarten through grade 12. Authors of the current AEB series used the rating criteria derived from the 2014 AEB series, which provided systematic reviews of a wide spectrum of interventions for mental and substance use disorders. Like its predecessor, the current series upholds a high standard of scientific rigor while ensuring that the information is easily accessible to various stakeholders in education, behavioral health, and communities. It describes the universal features included in each systematic review, such as a rating of the level of evidence for interventions, intervention program components, identification of interventions that have yielded positive outcomes for students from underserved populations, and a review of cost data. The AEB systematic reviews will serve as an important tool for decision makers involved in managing limited resources for various programs in school-based mental health services by synthesizing large bodies of research for use by leaders in education and behavioral health.