School-based Treatment Research Articles

Retrospective analysis of a school-based malaria treatment programme demonstrates a positive impact on health and education outcomes in Mangochi district, Malawi

This report presents a retrospective evaluation of the school-based malaria treatment programme implemented in Mangochi district, Malawi. The teachers were trained to identify and treat children suffering from malaria. The evaluation was undertaken using the school administrative records. The intervention and comparison schools were matched using propensity score matching. The impact was assessed using generalised linear modelling of family Poisson and also Kaplan–Meier for survival analysis. The results showed significant reductions in general absenteeism and grade repetition by students. Treating the cost-savings arising from the reduced rate of repetition as the benefits of the programme, the study showed that benefits far outweighed costs.

Changing Patterns of Soil-Transmitted Helminthiases in Zanzibar in the Context of National Helminth Control Programs

Helminth control programs have been implemented in Zanzibar for over a decade. In June/July 2007, approximately 6 months after the last school-based anthelmintic treatment, a cross-sectional survey was carried out in two schools, and results were compared with data obtained in the same schools in 1994. Multiple stool samples collected from 368 school children were subjected to the Kato-Katz, Koga agar plate, and Baermann methods. The prevalence of Trichuris trichiura, hookworm, Ascaris lumbricoides, and Strongyloides stercoralis was 46.6%, 21.6%, 16.9%, and 10.2%, respectively. Infection intensities were generally low. Compared with 1994, the prevalence of S. stercoralis, hookworm, A. lumbricoides, and T. trichiura decreased by 81.0%, 80.5%, 70.6%, and 48.6%, respectively. Infection intensities decreased by > 95% for all helminth species studied. Our study confirms that preventive chemotherapy successfully reduces the level and intensity of helminth infections. To consolidate achievements made, additional control measures such as health education and environmental sanitation are needed.

Bringing Science to the School Community

The Adolescent Coping With Depression Course (CWD-A) is cognitive–behavioral treatment (CBT) group program targeting adolescents with unipolar depression and their parents ( Clarke et al., 1990 Clarke G.N. Lewinsohn P.M. Hops H. Adolescent coping with depression course. Castalia Publishing Company, Eugene, OR1990 Google Scholar ). The program has been tested in National Institutes of Health-supported studies and is manualized to be delivered in sixteen 2-hour sessions. In real-world treatment settings, it is not always possible to deliver the full 16-session dose or the parental component. However, a pilot study by Esposito, 2005 Esposito, J. (2005). A school-based treatment for depression: A pilot study. Dissertation Abstracts International: Section B: The Sciences and Engineering. 65(11-B). p. 6064. Google Scholar demonstrated effectiveness (significant reduction in depressive symptoms) of adapting CWD-A in an 8-session school-based program.

Community violence and youth: affect, behavior, substance use, and academics.

Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health,2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities while treatment and prevention focuses on the perpetrators of the violence, not on the youth who are its direct or indirect victims. School-based treatment and preventive interventions are needed for children at elevated risk for exposure to community violence. In preparation, a longitudinal, community epidemiological study, The Multiple Opportunities to Reach Excellence (MORE) Project, is being fielded to address some of the methodological weaknesses presented in previous studies. This study was designed to better understand the impact of children’s chronic exposure to community violence on their emotional, behavioral, substance use, and academic functioning with an overarching goal to identify malleable risk and protective factors which can be targeted in preventive and intervention programs. This paper describes the MORE Project, its conceptual underpinnings, goals, and methodology, as well as implications for treatment and preventive interventions and future research.

Can coverage of schistosomiasis and soil transmitted helminthiasis control programmes targeting school-aged children be improved? New approaches

Control programmes generally use a school-based strategy of mass drug administration to reduce morbidity of schistosomiasis and soil-transmitted helminthiasis (STH) in school-aged populations. The success of school-based programmes depends on treatment coverage. The community-directed treatment (ComDT) approach has been implemented in the control of onchocerciasis and lymphatic filariasis in Africa and improves treatment coverage. This study compared the treatment coverage between the ComDT approach and the school-based treatment approach, where non-enrolled school-aged children were invited for treatment, in the control of schistosomiasis and STH among enrolled and non-enrolled school-aged children. Coverage during the first treatment round among enrolled children was similar for the two approaches (ComDT: 80.3% versus school: 82.1%, P=0.072). However, for the non-enrolled children the ComDT approach achieved a significantly higher coverage than the school-based approach (80.0 versus 59.2%, P<0.001). Similar treatment coverage levels were attained at the second treatment round. Again, equal levels of treatment coverage were found between the two approaches for the enrolled school-aged children, while the ComDT approach achieved a significantly higher coverage in the non-enrolled children. The results of this study showed that the ComDT approach can obtain significantly higher treatment coverage among the non-enrolled school-aged children compared to the school-based treatment approach for the control of schistosomiasis and STH.

School-Based Treatment to Improve Asthma Control

For children with persistent asthma, adherence to inhaled corticosteroid controller medication is crucial to prevent exacerbations. Results from three small studies suggested that supervised asthma therapy administered at school improves outcomes. To build on these results, researchers randomized 290 urban children with persistent asthma (mean age, 11 years; 91% black) to receive usual care at home or supervised administration of inhaled budesonide by trained study staff members at school. Using an Internet-based data collection system, …

Assessment of polyparasitism with intestinal parasite infections and urinary schistosomiasis among school children in a semi-urban area of south eastern Nigeria

Polyparasitism with intestinal parasites and schistosomiasis constitutes a major pubic health challenge in Nigeria especially among school age children. Using standard parasitological techniques, intestinal parasitic infections and urinary schistosomiasis were assessed among school age children in Edda a semi-urban area of south-eastern Nigeria. Of the 300 children screened, 32(10.7%) had intestinal parasitic infections while 41(13.6%) of the children were infected with S. haematobium. Up to seven intestinal parasites were identified. E. histolytica was more commonly observed than other parasites. Children of age group 11-12years old were more infected with intestinal parasites than other age categories, statistically, there was a significant difference in the trend (χ= 16.48, df=2, P<0.05). Males had slightly higher prevalence (14.7%) of S. haematobium infection than the females (12.5%) and age-specific prevalence showed that those aged 10-11 years old had the highest prevalence (14.6%). School-based treatment campaigns and health education can improve children health.

School-based obesity treatment and prevention programs: all in all, just another brick in the wall?

School-based obesity treatment and prevention programs: all in all, just another brick in the wall?

The effect of the community-directed treatment approach versus the school-based treatment approach on the prevalence and intensity of schistosomiasis and soil-transmitted helminthiasis among schoolchildren in Tanzania

This study compared the effect of the community-directed treatment (ComDT) approach and the school-based treatment approach on the prevalence and intensity of schistosomiasis and soil-transmitted helminthiasis (STH) among schoolchildren. Following a parasitological survey in a randomly selected sample of 1140 schoolchildren, school-age children in 10 study villages received one dose of praziquantel (40 mg/kg body weight) against schistosomiasis and one dose of albendazole (400mg) against STH. Five of these villages implemented the ComDT approach and received treatment by community drug distributors, while school teachers administered treatment in five other villages using the school-based approach. At 12 months follow-up, the prevalence of Schistosoma mansoni and Trichuris trichiura infections were similar between the ComDT and the school-based approaches when examined in randomly selected schoolchildren (10.1 vs. 9.4%, P=0.66 and 0.8 vs. 1.4%, P=0.37). However, the prevalence of S. haematobium and hookworm infections were significantly lower in the ComDT approach villages compared to the school-based approach villages (10.6 vs. 16.3%, P=0.005 and 2.9 vs. 5.8%, P=0.01, respectively). The results showed that the ComDT approach is at least as effective as the school-based approach in reducing prevalence and intensity of schistosomiasis and STH among schoolchildren.

Cognitive Behavioral Intervention for Trauma in Schools (CBITS): School-based treatment on a rural American Indian reservation

This study examines a pilot school-based treatment program for American Indian adolescents residing on a reservation who presented with symptoms of Posttraumatic Stress Disorder (PTSD) and symptoms of depression. This is the first study directed at treating American Indian children with trauma; seven case studies demonstrate our findings that a manualized cognitive behavior therapy intervention delivered in group format for 10 weeks has potential for helping some children who experience PTSD symptoms and depression. The findings generally replicate previous research conducted with groups of non-Indian adolescents in urban settings. PTSD and depressive symptoms decreased for three of the four students who completed treatment. Directions for future research include the need to understand and control attrition and to address cultural influences, including making adaptations in the cognitive behavioral formulations and techniques regarding feelings as operant behaviors. Results contribute to knowledge of feasibility and acceptability of cultural adaptations of CBT for trauma in an under-served population.

Cost-effectiveness of screening methods for urinary schistosomiasis in a school-based control programme in Ibadan, Nigeria

To carry out a comparative cost-effectiveness analysis of screening methods for urinary schistosomiasis; terminal haematuria, unqualified haematuria, dysuria, visual urine examination and chemical reagent strip technique, in a school-based control programme. Estimation of costs and determination of cost-effect ratios of the screening methods applied in a school-based screening and treatment programme, from the perspective of a programme manager. A junior secondary school in Ibadan, Nigeria. Cost per number of cases correctly diagnosed. Unqualified haematuria was found to be the most cost-effective method costing N51.06 (US$ 2.16) to diagnose a case correctly, followed by terminal haematuria N58.91 (US$ 2.50) and dysuria N84.24 (US$ 3.57). Despite the relatively high input costs of chemical reagent strip technique over visual urine examination (N22.12 (US$ 0.94) per student vs. N6.44 (US$ 0.27) per student), it was found to be more cost effective costing N304.56 (US$ 12.91) to diagnose a case correctly than visual examination of urine cost of N317.58 (US$ 13.46) per correct case diagnosed. From the viewpoint of a programme manager, interview method of screening by asking for blood in the urine remains the most efficient means of screening for urinary schistosomiasis in school-based control programmes in our environment.

Transition From Tube to Oral Feeding in the School Setting

A school-based treatment program for tube-fed children with medically complex conditions and food refusal was implemented to facilitate the children's transition to oral feeding and advance their eating skills. The program combined educational and therapeutic goals. It was implemented in a regional public school for children with hearing impairments. A team approach was used. Collaboration with the student's families, medical care providers, personal assistants, and classroom staff was maintained. Detailed case reviews are provided for 2 of the children who completed the program at age 8;1 (years;months) and 7;8 after 29 and 26 months of treatment, respectively. At the end of the program, tube feeding was discontinued; the children were feeding themselves and taking medications orally. One child was using mature eating skills to eat an unrestricted diet; the other was eating a modified diet consisting of a full nutrient drink and limited smooth and lightly textured solids. Successful transition to oral feeding and advancement of developmental eating skills were accomplished in a school setting for long-term tube-fed children with medically complex conditions. The program included collaboration with family and medical personnel as well as integrated therapeutic and educational goals.

Malaria in African schoolchildren: options for control

SummaryIntensified malaria control efforts among young African children may increase disease risks among older children who attend school and whose education may be impaired by malaria. However, there is currently no consensus as to the approach to malaria control in schools, with relevant intervention strategies varying according to patterns of malaria transmission. Life skills messages regarding prevention and accessing prompt treatment are important everywhere. Providing free bed nets to schoolchildren may bring individual and community benefits and should be widely promoted. New approaches to school-based chemoprevention and treatment may also be able to play an important role in school-based malaria control, although these require further investigation.

Evidence-Based Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events

The article reviews the current status (1993–2007) of psychosocial treatments for children and adolescents who have been exposed to traumatic events. Twenty-one treatment studies are evaluated using criteria from Nathan and Gorman (2002) along a continuum of methodological rigor ranging from Type 1 to Type 6. All studies were, at a minimum, robust or fairly rigorous. The treatments in each of these 21 studies also are classified using criteria from Chambless et al. (1996), and Chambless and Hollon (1998). Trauma-Focused Cognitive-Behavioral Therapy met the well-established criteria; School-Based Group Cognitive-Behavioral Treatment met the criteria for probably efficacious. All the other treatments were classified as either possibly efficacious or experimental. Meta-analytic results for four outcomes (i.e., posttraumatic stress, depressive symptoms, anxiety symptoms, and externalizing behavior problems) across all treatments compared to waitlist control and active control conditions combined reveal that, on average, treatments had positive, though modest, effects for all four outcomes. We also cover investigative work on predictors, moderators, and mediators of treatment outcome, as well as the clinical representativeness and generalizability of the studies. The article concludes with a discussion of practice guidelines and future research directions.

Balancing Feasibility and Treatment Adherence in School Mental Health Research

There are many challenges to developing flexible school mental health programs that achieve adequate adherence to treatment protocols. While we must consider how educators and school systems perceive school mental health programs (acceptability and feasibility), to ensure that treatment research and development follow scientific principles, interventions must be implemented as intended. The present study examines issues of feasibility and adherence in a school-based psychosocial treatment program for young adolescents with attention deficit/hyperactivity disorder (ADHD). Consistent with recommendations from a treatment development team of stakeholders, a multiple-informant questionnaire system was designed to assess treatment adherence. Preliminary data that demonstrate the utility of this method and the role of various informants are presented. We also discuss how treatment procedures could be modified to improve adherence to the key elements of the treatment, and provide recommendations for adding to an...

Cost and cost-effectiveness of nationwide school-based helminth control in Uganda: intra-country variation and effects of scaling-up.

Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intra-country variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with district officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated, and an incremental cost-effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$0.54 and the cost-effectiveness was US$3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children who received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$0.41-0.91) and cost per anaemia case averted (US$1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations.

Satisfaction with Components of the Therapeutic Model: Perspectives of Consumers and Professionals

We provide information about consumer and provider perceptions using a mixed-model pilot study within the Intensive Mental Health Project (IMHP), a school-based treatment service for children with SED and their families. Caregiver, youth, and provider questionnaires developed for this project elicited quantitative and qualitative information on treatment satisfaction, therapeutic alliance, and active involvement in treatment. Caregivers and children overall had positive perceptions of the services they received through IMHP. Providers reported very good working relationships with most children and families. Consumers also provided constructive comments about how to improve services. Our results add support to the importance of therapeutic alliance and collaboration, which are guiding principles of the IMHP.

A School-Based Treatment Model for Pediatric Obsessive-Compulsive Disorder

School psychologists have expertise in the realm of school-based assessment and intervention for behavioral, educational, and psychological difficulties. Recent evidence indicates that many school psychologists lack evidenced based knowledge about assessment and treatment of pediatric Obsessive-Compulsive Disorder (OCD). Pediatric OCD is a relatively common disorder that contributes to substantial impairment in educational and psychosocial domains. Evidence based treatment of pediatric OCD, particularly cognitive-behavioral therapy, has shown to be efficacious. Therefore, the aims of this paper are to provide a review of empirically established treatments for pediatric OCD, and present a school-based problem-solving model that school psychologists can utilize to conceptualize, assess, and treat OCD.

Drug and alcohol use among the Bedouin of the Negev: Prevalence and psychosocial correlates

The primary aim of this study was to estimate the prevalence of drug and alcohol use among the Bedouin of the Negev. A representative sample of 821 adults and 440 adolescents were surveyed using the Arabic version of the Israeli National Epidemiological Questionnaire. Almost 14% of adult Bedouins used alcohol and 11.1% used illicit drugs during the past year, with rates higher among individuals living in government settlements than those living in unrecognized traditional villages. Among adolescents, 21.9% used alcohol and 20.4% used drugs over the past year, with rates higher for high school students than for school attritters. Drug use was positively associated with being male, having a tolerant attitude toward drug use, the perception that drugs were not dangerous, being secular, low family cohesion and either low or high family adaptability. These data suggest that drug use is prevalent among the Bedouin of the Negev, particularly among adolescents, who report using drugs such as narcotics, cocaine, and hallucinogens at rates 3 to 8 times greater than Israeli Jewish secular students. School-based and family-based prevention and treatment programs may be most effective for this population.

FAMILY THERAPY WITH SELECTIVELY MUTE CHILDREN: A CASE STUDY

Due to its rarity (<1% of all clinical cases), few Marriage and Family Therapists have significant expertise in dealing with children who have become selectively mute, and little research has been conducted to determine the effectiveness of family therapy in treating this disorder. Much of what has been researched does not serve to provide a cohesive or uniform road map to follow in determining the course of treatment. The purposes of this article are (a) to present a case study outlining specific treatment interventions in a specific case used over the course of 2 years in a school-based setting, (b) to demonstrate the efficacy of utilizing school-based family-centered treatment, and (c) to stimulate further research and development on the efficacy of family therapy in alleviating anxiety and stress in children who have developed this disorder.