School-based Prevention Programs Research Articles

Effectiveness of School-based Substance abuse Prevention Programme (SSPP) on awareness, attitude, peer pressure, and life skills among adolescents in selected public schools of Pokhara, Nepal–A cluster randomized trial protocol

ObjectiveEarly substance use has been linked to various adverse outcomes and escalates quickly during adolescence. Delaying the onset of substance use among adolescents is a primary public priority as it is associated with severe effects. The objective of the study is to develop and determine the effectiveness of a School-based Substance Abuse Prevention Programme (SSPP) on awareness, attitude, peer pressure, and life skills towards preventing substance abuse among adolescents. MethodPhase I of the study is a qualitative approach, where a focus group discussion (FGD) will be conducted among different stakeholders to explore their perceptions regarding the prevention of substance use among adolescents. The anticipated sample size is 38. Thematic analysis will be done by using ATLAS.ti software. The inputs given by the stakeholders will be incorporated in developing the intervention (SSPP). Phase II is a cluster randomized controlled trial. A minimum of 210 adolescents (105 each in the intervention and control groups) between the age group of 13 to 15 years from 8th and 9th grade will be recruited for the study. In this study, the school will be the cluster and will be randomly assigned either to an intervention or control arm. The data will be collected at pre, post, 3-month, and 6-month intervals. The ethical approval was obtained from the Nepal Health Research Council Committee, Nepal (NHRC 276/2023). The trial was also registered under the Clinical Trial Registry of USA-Clinical Trials.gov (CTRI 06004726/2023/08/22/). Descriptive and inferential statistics will be used to analyze the data. Expected resultsImplementation of the SSPP module will improve the awareness, attitude, peer pressure, and life skills of adolescents toward preventing substance use behavior. Overall, the study aims to achieve Sustainable Development Goal (SDG) 3.5- ‘Good Health and Well-being; strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.’ ConclusionThe present study protocol will help to develop a unique training module (SSPP) focused on preventing substance use behaviour among adolescents in Nepal.

Association between self-efficacy and anxiety symptoms in adolescents: Secondary analysis of a preventive program

Anxiety disorders are common among adolescents. To avert long-term adverse consequences, several school-based prevention programs have been created, yet few have explored the influence of emotional and social self-efficacy as a psychosocial competence on anxiety symptoms. In the context of the implementation of a school-situated anxiety prevention program named HORS-PISTE, the present study examines descriptions of anxiety symptoms associated with social anxiety, generalized anxiety, separation anxiety and panic anxiety, and two domains of self-efficacy (social and emotional), as well as an exploration of the association between these two elements, and the predictive effect of self-efficacy on anxiety symptoms. The present study included 1705 adolescents from 15 different schools in 4 different regions of Québec, Canada. Participants completed questionnaires assessing their anxiety symptoms and self-efficacy levels before and after completing the HORS-PISTE program. Our findings suggest that: emotional/social self-efficacy and anxiety symptoms differ according to certain characteristics in adolescents; self-efficacy and anxiety symptoms present a strong association in the context of the implementation of a school-based anxiety prevention program; self-efficacy has a predictive effect on anxiety symptoms; and self-efficacy presents a moderate interaction effect on anxiety symptoms change over time.

Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs.

Adolescents are considered one of the most vulnerable groups affected by suicide. Rapid changes in adolescents' physical and mental states, as well as in their lives, significantly and undeniably increase the risk of suicide. Psychological, social, family, individual, and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct, indirect, or combined pathways. Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide. When deliberately cultivated, fostered, and enhanced, self-awareness, self-management, social awareness, interpersonal skills, and responsible decision-making, as the five core competencies of social-emotional learning, can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support. Among numerous suicide intervention methods, school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents. The characteristics of school-based interventions based on social-emotional competence, including their appropriateness, necessity, cost-effectiveness, comprehensiveness, and effectiveness, make these interventions an important means of addressing the crisis of adolescent suicide. To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide, additional financial support should be provided, the combination of social-emotional learning and other suicide prevention programs within schools should be fully leveraged, and cooperation between schools and families, society, and other environments should be maximized. These efforts should be considered future research directions.

Adapting a youth suicide prevention program for rural communities in the United States: a feasibility study

Rural youth suicide represents a major source of mental health inequity in the United States (US). School-based suicide prevention programs may provide an effective avenue to address this mental health crisis among rural youth. This study’s primary goal is to demonstrate the feasibility and acceptability of a novel implementation approach (utilizing teachers from a neighboring school) for delivering the Youth Aware of Mental Health (YAM) program, an evidence-based, universal youth suicide prevention curriculum, to high school students in rural Montana. We will recruit approximately 1300 9th grade student in four Montana schools. Using a non-inferiority design, we will randomize classrooms in each school to be instructed by a teacher from another school (YAM-TE; experimental) or a traditional external instructor (YAM-EXT; control). We will assess program fidelity of both YAM training and implementation via independent observer and instructor-reporter ratings. Youth will complete measures of acceptability at post-YAM and outcome measures at pre-YAM, post-YAM, and 12 month follow-up. Standard and mixed linear and logistic regression models will be used to test the main hypothesis that the YAM-TE does not differ from YAM-EXT regarding fidelity (teachers) and acceptability (teachers and youth). Exploratory analyses will test moderation of the intervention effect (e.g., sex, poverty) and the mediating effect of mental health literacy, belongingness, and perceived burdensomeness on the intervention effect. Results of this pilot study will inform the development of subsequent, fully powered noninferiority trials. Our long-term goal is to scale YAM-TE for implementation across rural US communities or, if culturally appropriate, more globally.

Changes in Anxiety Symptoms and Their Correlates in Adolescents Participating in a School-Based Anxiety Prevention Program During the COVID-19 Pandemic

Anxiety disorders have been on the rise among adolescents over the past decade. The COVID-19 pandemic appears to have contributed to this increase, putting further pressure on often already overburdened health systems. Universal prevention programs may offer a potential solution, but few have been evaluated in the context of a pandemic. The objective of this article is to measure the impact of a universal prevention program—the HORS-PISTE program—on several anxiety-related variables in the context of a pandemic. The HORS-PISTE program consists of 10 workshops spread over the two first years of high school, secondary 1 and 2 (grade 7 and 8 equivalent). Workshops are held in a classroom setting and focus on the development of psychosocial skills. The study was conducted in Quebec with 1,202 secondary 1 and 2 students (48.7% girls, 51.3% boys) with an average age of 12.58 years ( SD = 0.75). They completed an assessment protocol before and after participating in the HORS-PISTE program in the autumn of 2020. Their answers were subjected to descriptive analysis and multivariate analysis of variance. Results indicate a significant decrease in symptoms for several of the measured variables between the two measurement times, such as those associated with panic disorder, generalized anxiety disorder, and test anxiety. The results also show a decrease in some variables related to the interference of anxiety symptoms and the cognitive and behavioral vulnerabilities targeted by the program. The discussion highlights possible explanations for the results, as well as how universal prevention programs may contribute to the prevention of anxiety during adolescence, especially in a pandemic context.

The Effectivity of a School-Based Early Intervention Targeting Psychological Complaints and Non-Suicidal Self-Injury in Adolescents.

Background: Recent research suggests a concerning trend of non-suicidal self-injury (NSSI) and suicidal behaviors emerging at younger ages (as early as age 12). Early onset of NSSI is linked to more severe outcomes. While universal school-based prevention programs have shown promise in addressing suicidal behaviors, there is limited research on their effectiveness in preventing NSSI onset among adolescents. This study aims to evaluate the efficacy of a universal prevention program in schools for NSSI and mental complaints while enhancing resilience and mental health in 11-14-year-old adolescents. Methods: In total, 329 Flemish secondary school students (55.6% female), aged 11 to 14 years, participated in a 4 h classroom universal prevention, with a focus on emotion regulation, mental health, and specific strategies to prevent NSSI and reduce stigma. For both the intervention and control group (N = 124), a pre-, post-, and one-month follow-up questionnaire was administered, containing reliable and valid measures for NSSI and suicidality, emotion regulation, help-seeking behaviors, well-being, and psychological distress. Results: The prevention program effectively reduced NSSI and psychological distress, particularly for adolescents with a history of NSSI. Conclusions: These findings support previous research on the effectiveness of school-based programs in reducing mental complaints and suggest promising outcomes for NSSI prevention.

The effectiveness of school-based child sexual abuse prevention programmes among primary school-aged children: A systematic review

This systematic review provides a comprehensive overview of child sexual abuse prevalence globally, along with an examination of the effectiveness of school-based prevention education programmes for primary school-aged children. These prevention programmes utilise social cognitive learning theories to teach children the importance of identifying and responding to abusive situations. A total of 676 papers were evaluated with 13 Randomised Controlled Trial (RCT) or cluster RCT design studies identified as meeting the study's inclusion criteria. These studies were published in English between January 2000 and May 2022, and focus on outcomes of school-based prevention programmes designed for primary school-aged children (5–12 years old). To ensure a comprehensive and academically rigorous analysis, the following databases were included: Science Direct, Web of Science, Scopus, the American Psychiatric Association (APA) PsycINFO, Ovid Medline, and Embase. The studies reviewed aim to evaluate the effectiveness of various child sexual abuse prevention programmes in improving children's knowledge and recognition of, and response to potentially unsafe situations. In terms of outcomes and results, the interventions have significantly impacted knowledge, skills, confidence, and awareness in the short and long term. These studies used different intervention methods, including mobile applications, personal safety programmes, and protective behaviour programmes, delivered in various formats such as web-based, textbooks, and in-person sessions. This systematic review highlights the importance of child sexual abuse prevention programmes in schools and the need for further research.

"It's like an epidemic, we don't know what to do": The perceived need for and benefits of a suicide prevention programme in UK schools.

Despite emerging evidence for the effectiveness of school-based suicide prevention programmes worldwide, there are few being implemented in the United Kingdom, and their social validity (i.e., the feasibility, acceptability, and utility) is not yet known. We aimed to conduct a scoping study to determine: (1) the social validity and potential benefits of school-based suicide prevention interventions, (2) the perceived need for such interventions, and (3) barriers and facilitators to implementation. A total of 46 participants took part. Semi-structured interviews were conducted with mental health professionals (N = 8), school staff (N = 8), and parents whose children had experienced suicidal ideation/behaviours (N = 3) in England. Focus groups were also completed with children and young people (N = 27) aged 15-18 across three state secondary schools. Data were analysed using thematic framework analysis. Three themes were identified: (1) the need for and importance of suicide prevention in children and young people, (2) schools as a setting for delivery, and (3) key components of suicide prevention programmes. Participants overwhelmingly agreed that there is a need for a greater and more consistent emphasis on school-based suicide prevention. School appears to be an acceptable location for suicide prevention, and participants felt discussions about suicide should begin at the start of secondary school. However, there are potential barriers that need to be considered, including tailoring for neurodiversity, challenging cultural/family beliefs and stigma, managing personal experiences of suicidal thoughts or previous bereavement from suicide, and a lack of existing training for school staff.

Universal School-Based Substance Use Prevention Using Technology-Supported Cooperative Learning.

Substance use in adolescence is a significant public health issue, particularly in early-to-mid adolescence, which represents a window of risk in the etiology of substance abuse and dependence. Substance use during this development period often results from affiliation with deviant peers, who model, facilitate, and reinforce use. Existing school-based substance use prevention programs have historically aimed to build adolescent knowledge regarding the dangers of substance use and/or enhance peer refusal skills. Research finds that these programs have had some success in reducing substance use, but meta-analyses report that average effect sizes are small. In a small one-year cluster randomized trial (12 middle and high schools; N = 813 students; ClinicalTrials.gov: NCT04478240), cooperative learning (CL) was implemented with the support of specialized technology and evaluated for its ability to reduce deviant peer affiliation and, in turn, reduce substance use. CL is a structured approach to small-group learning that provides at-risk youth with the opportunity to build friendships with more prosocial youth, interrupting the process of deviant peer clustering. Multi-level modeling revealed intervention effects for deviant peer affiliation and alcohol use across the sample, while tobacco use was significantly reduced among non-White students; intervention effects for marijuana use were only marginally significant. Effects for dosage were found for all outcomes, suggesting that every lesson taught had a significant impact. We conclude that CL, delivered with the aid of specialized technology, represents a viable option for universal substance use prevention. Future research should attempt to combine this approach with evidence-based prevention curricula.

On the Evidence of Things Not Seen: A Systems-Driven Analysis of LifeSkills Training, University and Tobacco Industry Efforts in School-Based Drug Prevention

ABSTRACT Background Despite recent declines, youth nicotine vaping remains seen by experts as a national public health epidemic. Few, if any, researchers have examined how related high-profile and school-based prevention programs such as LifeSkills Training (LST) are further disseminated with cooperation from research-to-practice entities as well as the tobacco industry. Purpose Provides a systems-driven documentary analysis of efforts pertaining to prevention entities at the University of Colorado, Boulder, as well as LST, and the tobacco industry. Methods Employs focused synthesis data collection with constant comparative analyses. Results Likely previously unseen and related to LST, is the degree to which prevention entities with a public mission appear to cooperate among themselves and with the tobacco industry as part of a longstanding, if not elaborate, school-based drug prevention social system characterized by patterned evidence of opaque or furtive representations and/or activities. Discussion Along with limitations, summarizes a research-to-practice social system likely compromising school-based prevention and, in turn, the health of the young people they serve. Theorizes a symbolic politics explanatory mechanism while providing recommendations toward transparency for more informed school-based prevention decision-making. Translation to Health Education Practice Emphasizes the National Commission for Health Education Credentialing Inc. (NCHEC) critical thinking and program evaluation competencies.

Exposure to school-based tobacco prevention interventions in low-income and middle-income countries and its association with psychosocial predictors of smoking among adolescents: a pooled cross-sectional analysis of Global Youth Tobacco Survey data from 38 countries

ObjectivesTo describe the prevalence of school-based tobacco prevention programme exposure among adolescents in low-income and middle-income countries (LMICs) and its association with psychosocial predictors of smoking.DesignAnalysis of pooled cross-sectional data.SettingGlobal...

Cost-effectiveness of system-level mental health strategies for young people in the Australian Capital Territory: a dynamic simulation modelling study

Regional mental health planning is a key challenge for decision makers because mental health care is a complex, dynamic system. Economic evaluation using a system dynamics modelling approach presents an opportunity for more sophisticated planning and important evidence on the value of alternative investments. We aimed to investigate the cost-effectiveness of eight systems-based interventions targeted at improving the mental health and wellbeing of children, adolescents, and young adults in the Australian Capital Territory (ACT). We assessed eight interventions for children and young people (aged ≤25 years) with low, moderate, and high-to-very-high psychological distress: technology-enabled integrated care, emergency department-based suicide prevention, crisis response service, family education programme, online parenting programme, school-based suicide prevention programme, trauma service for youths, and multicultural-informed care. We developed a system dynamics model for the ACT through a participatory process and calibrated the model with historical data, including population demographics, the prevalence of psychological distress, and mental health services provision. We calculated incremental cost-effectiveness ratios compared with business as usual for cost (AU$) per: quality-adjusted life-year (QALY), suicide death avoided, self-harm related hospital admissions avoided, and mental health-related emergency department presentation, using a 10-year time horizon for health-care and societal perspectives. We investigated uncertainty through probabilistic sensitivity analysis and deterministic sensitivity analysis, including using a 30-year timeframe. From a societal perspective, increased investment in technology-enabled integrated care, family education, an online parenting programme, and multicultural-informed care were expected to improve health outcomes (incremental QALYs 4517 [95% UI -3135 to 14 507] for technology-enabled integrated care; 339 [91 to 661] for family education; 724 [114 to 1149] for the online parenting programme; and 137 [88 to 194] for multicultural-informed care) and reduce costs ($-91·4 million [-382·7 to 100·7]; $-12·8 million [-21·0 to -6·6]; $-3·6 million [-6·3 to 0·2]; and $-3·1 million [-4·5 to -1·8], respectively) compared with business as usual using a 10-year time horizon. The incremental net monetary benefit for the societal perspective for these four interventions was $452 million (-351 to 1555), $40 million (14 to 74), $61 million (9 to 98), and $14 million (9 to 20), respectively, compared with business as usual, when QALYs were monetised using a willingness to pay of $79 930 per QALY. Synergistic effects are anticipated if these interventions were to be implemented concurrently. The univariate and probabilistic sensitivity analyses indicated a high level of certainty in the results. Although emergency department-based suicide prevention and school-based suicide prevention were not cost effective in the base case (41 QALYs [0 to 48], incremental cost $4·1 million [1·2 to 8·2] for emergency department-based suicide prevention; -234 QALYs [-764 to 12], incremental cost $90·3 million [72·2 to 111·0] for school-based suicide prevention) compared with business as usual, there were scenarios for which these interventions could be considered cost effective. A dedicated trauma service for young people (9 QALYs gained [4 to 16], incremental cost $8·3 million [6·8 to 10·0]) and a crisis response service (-11 QALYs gained [-12 to -10], incremental cost $7·8 million [5·1 to 11·0]) were unlikely to be cost effective in terms of QALYs. Synergistic effects were identified, supporting the combined implementation of technology-enabled integrated care, family education, an online parenting programme, and multicultural-informed care. Synergistic effects, emergent outcomes in the form of unintended consequences, the capability to account for service capacity constraints, and ease of use by stakeholders are unique attributes of a system dynamics modelling approach to economic evaluation. BHP Foundation.

Assessment of Effectiveness of School-Based Child Sexual Abuse Prevention Programs: A Meta-Analysis

Assessment of Effectiveness of School-Based Child Sexual Abuse Prevention Programs: A Meta-Analysis

Unmet Dental Needs in Children Following Suspension of School-Based Oral Health Services Due to COVID-19.

Dental caries (tooth decay) is the world's most prevalent noncommunicable disease and can lead to pain, infection, and edentulism. Many children with caries lack access to traditional dental services. School-based caries prevention can increase access to care and reduce health inequities. Disruptions in school-based care due to pandemic control policies may result in children losing access to their primary dental care option. The CariedAway project was a school-based caries prevention program in operation from 2019 to 2023 in urban schools with a high proportion of low-income, minority students. Program operations were suspended for 2 years due to the COVID-19 pandemic. We estimated the prevalence of untreated decay, swelling, fistula, and pulpal involvement in participants at baseline and again after restrictions were lifted. A total of 2998 children between the ages of 5 and 13 years were enrolled and received preventive care prior to pandemic shutdowns, and 1398 (47%) completed a follow-up observation after 2 years. At baseline, approximately 30% had untreated caries on any dentition, 11% of children presented with evidence of dental sealants, and no participants had swelling, fistula, or pulpal involvement. After 24 months, 12% of participants had swelling fistula, or pulpal involvement that was not treated during the pandemic period. There are considerable unmet dental needs in high-risk children that may be further exacerbated by a lack of access to care during disease outbreaks.

Effectiveness of a blended school-based mindfulness program for the prevention of co-rumination and internalizing problems in Dutch secondary school girls: a cluster randomized controlled trial

BackgroundA growing body of literature indicates that adolescent girls who talk with close friends about interpersonal problems or worries in an excessive, speculative way, and with an intense focus on distress (i.e., co-rumination) are at heightened risk for developing internalizing symptoms and disorders as well as reduced friendship quality. However, to date, there are no prevention programs available that target high levels of co-rumination between adolescent girls. As such, we developed the blended school-based mindfulness prevention program Happy Friends, Positive Minds (HFPM) that targets co-rumination at the dyadic level, i.e., between two close female friends. The aim of this trial is to evaluate the effectiveness of HFPM to reduce co-rumination and internalizing problems and to enhance wellbeing and social-emotional behavior in Dutch adolescent girls.MethodsA cluster Randomized Controlled Trial (cRCT) will be conducted to evaluate HFPM effectiveness. We will recruit 160 female friendship dyads (n = 320 girls) aged 13 to 15 years who will be characterized by high levels of self-reported co-rumination. The cRCT has two arms: (1) an intervention condition in which 160 girls (80 friendship dyads) will receive the 14-week HFPM program in two consecutive cohorts (cohort 1 in academic year 2023/2024 and cohort 2 in academic year 2024/2025, and (2) a control condition in which 160 girls (80 dyads) will receive care-as-usual (CAU) in two consecutive cohorts (cohort 1 in academic year 2023/2024 and cohort 2 in academic year 2024/2025). Data will be collected at baseline (T0), during the program (T1;T2; T3), immediately after the program (T4), and at 1-year follow-up (T5). Participant-level self-reported risk for (early onset) depression and anxiety, self-reported and observed co-rumination, self- and friend-reported friendship quality, self-reported positive and negative affect, self-reported interpersonal responses to positive affect, and self-reported anhedonia symptoms will be the outcome variables.DiscussionThis study will provide insights into the short-term and long-term effects of the HFPM program on girls’ internalizing problems, wellbeing, and social-emotional behavior.Trial registrationInternational Standard Randomized Controlled Trials, identifier: ISRCTN54246670. Registered on 27 February 2023.

Addressing help-seeking, stigma and risk factors for suicidality in secondary schools: short-term and mid-term effects of the HEYLiFE suicide prevention program in a randomized controlled trial

BackgroundSuicidal ideation and suicide attempts present a serious public health concern among adolescents and young adults. School-based suicide prevention programs are a key tool for addressing this problem. However, more research is necessary to assess their effectiveness, acceptability, and safety. In response, the HEYLiFE suicide prevention program was developed to enhance help-seeking, reduce stigma towards suicidal peers and diminish risk factors for suicidality. This article presents the evaluation findings of the HEYLiFE program in German secondary schools.MethodsWe conducted a randomized-controlled trial measuring short-term pre-post within-group effects in the intervention group only and mid-term effects at 6-months-follow-up compared to a waitlist-control group. Schools were assigned randomly to the intervention or control group (no blinding). We recruited students ≥12 years of age. Primary outcomes were knowledge about suicidality, attitudes towards suicidality, stigma towards a suicidal peer, help-seeking intentions and behaviours, risk factors for suicidality. The data was analysed with linear mixed models and generalized linear mixed models.ResultsA total of N = 745 students participated (n = 353 intervention group, n = 392 control group). We observed favourable short-term effects on knowledge, attitudes towards suicidality and fear towards a suicidal peer. Unexpectedly, the program also led to an increase in desire for social distance and a decrease in prosocial emotions towards a suicidal peer. The mid-term effects of the program were exclusively favourable, resulting in enhanced attitudes towards help-seeking while protecting from a sharper rise in risk-factors for suicidality and from an increase in social distance. The program had more favourable effects on females and on students aged >13 years. The program was well-received by the students, and no serious adverse events were reported.ConclusionsThese findings demonstrate the effectiveness of the HEYLiFE universal suicide prevention program in addressing variables associated with suicidal ideation and suicide attempts among adolescents on the mid-term. The short-term negative effects on stigma and more negative effects on males should be addressed in the future. Future evaluation studies should examine its effects on suicidality and its effectiveness within populations at high risk.Trial registrationThe study was preregistered in the German Clinical Trials Register (registration number: DRKS00017045; registration date: 02/04/2019).

Protocol for a hybrid type 3 effectiveness-implementation trial of a pragmatic individual-level implementation strategy for supporting school-based prevention programming

BackgroundFor approximately one in five children who have social, emotional, and behavioral (SEB) challenges, accessible evidence-based prevention practices (EBPPs) are critical. In the USA, schools are the primary setting for children’s SEB service delivery. Still, EBPPs are rarely adopted and implemented by front-line educators (e.g., teachers) with sufficient fidelity to see effects. Given that individual behavior change is ultimately required for successful implementation, focusing on individual-level processes holds promise as a parsimonious approach to enhance impact. Beliefs and Attitudes for Successful Implementation in Schools for Teachers (BASIS-T) is a pragmatic, multifaceted pre-implementation strategy targeting volitional and motivational mechanisms of educators’ behavior change to enhance implementation and student SEB outcomes. This study protocol describes a hybrid type 3 effectiveness-implementation trial designed to evaluate the main effects, mediators, and moderators of the BASIS-T implementation strategy as applied to Positive Greetings at the Door, a universal school-based EBPP previously demonstrated to reduce student disruptive behavior and increase academic engagement.MethodsThis project uses a blocked randomized cohort design with an active comparison control (ACC) condition. We will recruit and include approximately 276 teachers from 46 schools randomly assigned to BASIS-T or ACC conditions. Aim 1 will evaluate the main effects of BASIS-T on proximal implementation mechanisms (attitudes, subjective norms, self-efficacy, intentions to implement, and maintenance self-efficacy), implementation outcomes (adoption, reach, fidelity, and sustainment), and child outcomes (SEB, attendance, discipline, achievement). Aim 2 will examine how, for whom, under what conditions, and how efficiently BASIS-T works, specifically by testing whether the effects of BASIS-T on child outcomes are (a) mediated via its putative mechanisms of behavior change, (b) moderated by teacher factors or school contextual factors, and (c) cost-effective.DiscussionThis study will provide a rigorous test of BASIS-T—a pragmatic, theory-driven, and generalizable implementation strategy designed to target theoretically-derived motivational mechanisms—to increase the yield of standard EBPP training and support strategies.Trial registrationClinicalTrials.gov ID: NCT05989568. Registered on May 30, 2023.

Individual and social predictors of Greek early adolescents’ self-determination: A longitudinal structural equation analysis

Given that early adolescence is a dynamic and vulnerable developmental period, it is important to examine factors that promote adolescents’ individual development and, more specifically, the satisfaction of psychological needs within the framework of self-determination theory. In a two-wave longitudinal sample (N = 218) of Greek adolescents (eighth grade in autumn 2020 and ninth grade in autumn 2021), we used structural equation modeling to determine which individual and social factors longitudinally predict autonomy, competence, and relatedness. The examination of these psychological needs is regarded as a necessary step in designing school-based prevention and intervention programs for adolescents. Individual factors, such as self-esteem, self-efficacy, and depression or anxiety, foster self-determination through social factors, such as recognition and support from teacher and parents, and social resources. Adolescents with a migration background showed lower levels of social factors. The model was gender invariant and indicated that social agents (teachers and parents) and social resources predict a very large proportion of variance in early adolescents’ individual development. These findings support the view that early adolescents’ development depends on social factors through the satisfaction of psychological needs.

Secondary Principals’ Perceptions and Practices for Implementing Student Suicide Prevention Programs

We explored secondary school principals’ knowledge of suicide prevention programs, their perceptions of the logistical and cultural barriers associated with suicide prevention program adoption, and their justification for adopting (or not adopting) suicide prevention programs in their schools. Principals, as positional leaders of schools, can lead the adoption and support of school-based suicide prevention programs for their students. Using a phenomenology framework, we conducted semi-structured interviews of eight secondary school principals working in public schools in the south-central United States. The principals readily identified the importance of supporting students’ mental health to enhance their learning as a justification for implementing suicide prevention programs for their students. They shared how limited staffing, time, perception of school responsibility for student mental health, and lack of knowledge of available suicide prevention resources were logistical, cultural, and knowledge barriers to adopting suicide prevention programs for students. Our research has profound implications for practice.

Improving the implementation of KiVa antibullying program with tailored support: Study protocol for a cluster randomized controlled trial

BackgroundThere are no evidence-based models to support the implementation of school-based bullying prevention programs. Our primary objective is to examine the impact of tailored support on the implementation of the KiVa antibullying program. Our second objective is to evaluate whether the offered support influences student outcomes (e.g., victimization, bullying perpetration). We also assess the cost-effectiveness of the provided support and conduct a process evaluation. MethodsIn a cluster randomized control trial (cRCT), we compare program fidelity between schools that receive implementation support and those that do not. Twenty-four (N = 24) schools in Finland were randomized to either the IMPRES condition (receiving support, n = 12) or the control group (KiVa as usual, n = 12). In the IMPRES condition, pre-assessment and staff training were organized, and a selected team of staff members received four mentoring sessions during one academic year.Staff and students answer questionnaires at the end of school year 0, at post-intervention (year 1) and again at the 1-year follow-up (year 2). Our primary outcomes concern two main program components — universal and indicated actions — reflecting program fidelity. As secondary outcomes, we examine the level of bullying victimization and perpetration as well as students' perception of several program fidelity indicators. Finally, we assess several tertiary outcomes, collect resource data and conduct qualitative interviews to perform additional analyses. ConclusionThis trial will inform us of whether implementation support can boost program fidelity and have a distal impact on bullying prevalence.Trial Registration: ISRCTN15558617 https://doi.org/10.1186/ISRCTN15558617.