Universal School-based Program Research Articles

Resilience-based intervention for youth: An initial investigation of school social work program in Kuwait

This article describes the preliminary investigation of the initial feasibility of the ‘ Fostering Youth Resilience Project’, a universal school-based program delivered by school social workers to 54 high school students in Kuwait. Results reported significant positive change and high satisfaction with the program. The study provided initial evidence support to the applicability of the program for youth in a non-Western culture. Future research needs to evaluate the effect of the program in larger groups, using controlled trials and longer term follow ups. Discussion of limitations and practical implications for the social work profession are presented.

Contextual Moderators of a School-Based Ethnic-Racial Identity Intervention: The Roles of Family Ethnic Socialization and Ethnic-Racial Background.

Ethnic-racial identity (ERI) formation is a key developmental competency that contributes to adolescents' sense of self and psychosocial adjustment. A randomized controlled trial (RCT) has demonstrated the efficacy of a universal school-based health promotion intervention program to positively influence adolescents' ERI exploration and ERI resolution, compared to an attention control curriculum that was delivered by the same facilitators, had equivalent contact hours, and focused on post-secondary career and educational options. The current study extended prior tests of the RCT to better understand (a) how intervention-based ERI changes unfolded over two phases-temporally proximal pre- to post-test effects and long-term post-test effects across a 1-year follow-up period, and (b) identify for whom the intervention was more effective by testing theorized contextual moderators-baseline family ethnic socialization practices and youth ethnic-racial background (i.e., White majority vs. ethnic-racial minority). Bilinear spline growth models were used to examine longitudinal ERI trajectories in intervention and control groups across four survey assessments (baseline, 12weeks, 18weeks, 67weeks; N = 215; Mage = 15.02; 49.1% female; 62.6% ethnic-racial minority). In support of an additive effect for the role of families in school-based interventions, post-test ERI exploration significantly increased (relative to thecontrol group) to a greater extent for youth with higher (compared to lower) baseline levels of family ethnic socialization. ERI resolution significantly increased from pre- to post-test for ethnic-racial minority youth and also increased across the 1-year follow-up period for White youthin the intervention. These results highlight family ethnic socialization as a developmental asset for school-based ERI interventions and demonstrate differential pathways by which such interventions support ERI development for ethnic-racial minority and majority adolescents.

Effects of a Universal School-Based Mental Health Program on the Self-concept, Coping Skills, and Perceptions of Social Support of Students with Developmental Disabilities.

In a cluster randomized control trial, a school-based mental health program combining mental health literacy and dialectical behavior skills was implemented by teachers to determine effects on protective factors related to resilience for students in 3rd-12th grade. As part of a larger study, a subsample of 113 students with developmental disabilities attending 37 classrooms participated. Student-reported measures of self-concept, coping skills, and social support were collected three times in the year. Results indicated large effect sizes for the program on all measures, which pertain to time × group interactions (g = 1.53, 1.91, and 0.86 for self-concept, coping, and social support respectively). Follow-up analyses indicated that gains for the intervention schools primarily occurred between the first two assessment periods when the majority of program content was delivered. Implications for universal school-based mental health programming for students with developmental disabilities are discussed.

Influence of coping strategies on the efficacy of YAM (Youth Aware of Mental Health): a universal school-based suicide preventive program.

The school-based mental health promotion and suicide prevention universal program Youth Aware of Mental Health (YAM) significantly reduces incident suicide attempts and severe suicidal ideation. This paper aims at elucidating psychological mechanisms underlying YAM's efficacy. Our hypothesis is that YAM operates through interactions with coping strategies (CS) on the reduction of suicidal ideation (SI). In the Saving and Empowering Young Lives in Europe (SEYLE) study, five coping strategies were assessed at baseline (T0) and 12-month follow-up (T12): "learning", "help-seeking", "arts", "sports" and "fight". We analyzed interactions between the YAM intervention, coping strategies and SI in the YAM group (N = 1693) and the minimal intervention group (N = 1909), after excluding prevalent cases with SI and previous suicide attempts from our total sample (N = 5654). General Linear Mixed Model regressions were performed. The present study confirms that coping strategies play an influential role on suicidal ideation. Our results showed that YAM acts whatever the prevailing coping strategies used. It is particularly efficient for pupils insufficiently using adaptive coping strategies such as LEARN and HELP-SEEKING or using maladaptive coping strategies, such as ARTS and FIGHT. The socialization induced by the YAM intervention seems to be a strong component of its efficiency.

A Call for the Integration of Mental Health Literacy into School Curriculum

Growing recognition of the burden of mental illness on Canadian youth has triggered the need for preventative action. Schools hold great potential for supporting student mental-health with universal school-based programs being offered in many Alberta schools. The aim of this inquiry is to examine the real-world applicability of the Mental Health and High School Curriculum Guide, by observing its implementation in four grade nine classrooms in Central Alberta. This inquiry also explores if the topics covered in The Guide align with the mental health needs of Canadian youth, supporting a call for standard, regular implementation of evidence-based mental health programs across school boards.

Preventing Adolescent Substance Use: A Content Analysis of Peer Processes Targeted Within Universal School-Based Programs.

Universal school-based substance use prevention programs are widely disseminated and often include a focus on peer relationships. Network theory and social network analysis (SNA) have emerged as useful theoretical and methodological frameworks for examining the role of peer relationships in prevention and intervention research. We used content analysis to systematically code the peer processes targeted by three universal school based prevention programs. We found that programs focused on peer socialization more than peer selection, and programs focused about evenly on descriptive and injunctive norms. Programs varied in their focus on positive and negative peer processes and behaviors, but most references to peer processes focused on positive processes and negative behaviors. The focus on peer processes at the dyadic, subgroup, and network levels varied across the three programs, with the heaviest focus on network level processes. When peer processes were targeted, it was rare that lessons focused on peer processes for an extended (> 50%) amount of the lesson content. However, when peer processes were a focus, discussion and reflection were commonly encouraged. These patterns are considered in the context of non-intervention research on adolescent peer relations, which highlights the importance of peer selection and dyad-level processes, and the existence of positive peer processes that promote adolescent development. In doing so, we provide a framework that can be used to (1) examine the extent to which a particular program focuses on the different peer processes, and (2) inform systematic experimental studies of the extent to which particular peer processes are malleable in response to intervention efforts.

School-based mental health promotion in children and adolescents with StresSOS using online or face-to-face interventions: study protocol for a randomized controlled trial within the ProHEAD Consortium

BackgroundSchools are an ideal setting in which to promote health. However, empirical data on the effectiveness of school-based mental health promotion programs are rare, and research on universal Internet-based prevention in schools is almost non-existent. Following the life skills approach, stress management training is an important component of health promotion. Mental health literacy is also associated with mental health status, and it facilitates formal help-seeking by children and adolescents (C&A). The main objectives of this study are (1) the development and evaluation of an Internet-based version of a universal school-based health promotion program called StresSOS and (2) demonstrating non-inferiority of the online setting compared to the face-to-face setting. StresSOS aims to improve stress management and mental health literacy in C&A.Methods/designA school-based sample of 15,000 C&A (grades 6–13 and older than 12 years) will be recruited in five regions of Germany within the ProHEAD Consortium. Those with a screening result at baseline indicating no mental health problems will be invited to participate in a randomized controlled trial comparing StresSOS online to an active online control condition (Study A). In addition, 420 adolescents recruited as a separate school-based sample will participate in the StresSOS face-to-face intervention. Participants in both intervention groups (online or face-to-face) will receive the same eight treatment modules to allow for the comparison of both methods of delivery (Study B). The primary outcome is the number of C&A with symptoms of mental health problems at a 12 months follow-up. Secondary outcomes are related to stress/coping (i.e., knowledge, symptoms of stress, coping resources), mental health literacy (knowledge and attitudes toward mental disorders and help-seeking), program usage patterns, cost-effectiveness, and acceptability of the intervention.DiscussionThis study represents the first adequately powered non-inferiority trial in the area of school-based mental health promotion. If online StresSOS proves efficacious and non-inferior to face-to-face delivery, this offers great potential for health promotion in youths, both in and outside the school environment.Trial registrationGerman Clinical Trials Register, DRKS00014693. Registered on 14 May 2018.

An update on social and emotional learning outcome research

Joseph Mahoney, Joseph Durlak, and Roger Weissberg compare results from four large-scale meta-analyses of student outcomes related to participation in universal, school-based social and emotional learning (SEL) programs. Their examination includes 356 research reports with rigorous designs and outcome data at post or follow-up from hundreds of thousands of K-12 students within and outside the U.S. on a range of SEL programs. The reviews indicate that universal school-based SEL programs produce positive benefits for participating students on a range of important behavioral and academic outcomes that are evident immediately following the end of intervention and that persist during various follow-up periods. Therefore, current data indicate that SEL programs are both feasible and effective in a variety of educational contexts in many countries around the world.

A cluster randomised controlled trial and evaluation and cost-effectiveness analysis of the Roots of Empathy schools-based programme for improving social and emotional well-being outcomes among 8- to 9-year-olds in Northern Ireland

BackgroundThere is growing consensus regarding the importance of attending to children’s social and emotional well-being. There is now a substantial evidence base demonstrating the links between a child’s early social and emotional development and a range of key longer-term education, social and health outcomes. Universal school-based interventions provide a significant opportunity for early intervention in this area and yet the existing evidence base, particularly in relation to their long-term effects, is limited.Objectives and main outcomesTo determine the effectiveness and cost-effectiveness of Roots of Empathy (ROE), a universal school-based programme that, through attempting to enhance children’s empathy, seeks to achieve the following two main outcomes: improvement in prosocial behaviour and reduction in difficult behaviour.DesignA cluster randomised controlled trial and an economic evaluation. A total of 74 primary schools were randomly assigned to deliver ROE or to join a waiting list control group. Seven schools withdrew post randomisation and a further two withdrew before the immediate post-test time point. Children (n = 1278) were measured pre test and immediately post test, and then for 3 years following the end of the programme. Data were also collected from teachers and parents.Setting and participantsThe intervention schools delivered ROE to their Year 5 children (aged 8–9 years) as a whole class.InterventionROE is delivered on a whole-class basis for one academic year (October–June). It consists of 27 lessons based around the monthly visit from a baby and parent who are usually recruited from the local community. Children learn about the baby’s growth and development and are encouraged to generalise from this to develop empathy towards others.ResultsAlthough it was developed in Canada, the programme was very well received by schools, parents and children, and it was delivered effectively with high fidelity. ROE was also found to be effective in achieving small improvements in children’s prosocial behaviour (Hedges’g = 0.20;p = 0.045) and reductions in their difficult behaviour (Hedges’g = –0.16;p = 0.060) immediately post test. Although the gains in prosocial behaviour were not sustained after the immediately post-test time point, there was some tentative evidence that the effects associated with reductions in difficult behaviour may have remained up to 36 months from the end of the programme. These positive effects of ROE on children’s behaviour were not found to be associated with improvements in empathy or other social and emotional skills (such as emotional recognition and emotional regulation), on which the trial found no evidence of ROE having an effect. The study also found that ROE was likely to be cost-effective in line with national guidelines.ConclusionsThese findings are consistent with those of other evaluations of ROE and suggest that it is an effective and cost-effective programme that can be delivered appropriately and effectively in regions such as Northern Ireland. A number of issues for further consideration are raised regarding opportunities to enhance the role of parents; how a time-limited programme such as ROE can form part of a wider and progressive curriculum in schools to build on and sustain children’s social and emotional development; and the need to develop a better theory of change for how ROE works.Trial registrationCurrent Controlled Trials ISRCTN07540423.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 6, No. 4. See the NIHR Journals Library website for further project information.

Protocol for a systematic review: Universal school-based programmes for improving social and emotional outcomes in children aged 3-11 years: a systematic review and meta-analysis.

Protocol for a systematic review: Universal school-based programmes for improving social and emotional outcomes in children aged 3-11 years: a systematic review and meta-analysis.

Do universal school-based mental health promotion programmes improve the mental health and emotional wellbeing of young people? A literature review.

To examine evidence-using a range of outcomes-for theeffectiveness of school-based mental health and emotional well-being programmes. It is estimated that 20% of young people experience mental health difficulties every year. Schools have been identified as an appropriate setting for providing mental health and emotional well-being promotion prompting the need to determine whether current school-based programmes are effective in improving the mental health and emotional well-being of young people. A systematic search was conducted using the health and education databases, which identified 29 studies that measured the effectiveness of school-based universal interventions. Prisma guidelines were used during the literature review process. Thematic analysis generated three key themes: (i) help seeking and coping; (ii) social and emotional well-being; and (iii) psycho-educational effectiveness. It is concluded that whilst these studies show promising results, there is a need for further robust evaluative studies to guide future practice. All available opportunities should be taken to provide mental health promotion interventions to young people in the school environment, with a requirement for educational professionals to be provided the necessary skills and knowledge to ensure that the school setting continues to be a beneficial environment for conducting mental health promotion.

School-Based Curriculum to Improve Depression Literacy Among US Secondary School Students: A Randomized Effectiveness Trial.

To determine the effectiveness of a universal school-based depression education program. In 2012-2015, we matched 6679 students from 66 secondary schools into pairs by state (Maryland, Delaware, Pennsylvania, Michigan, and Oklahoma) and randomized to the Adolescent Depression Awareness Program (ADAP; n = 3681) or to a waitlist control condition (n = 2998). Trained teachers delivered ADAP as part of the health education curriculum to students aged 14 to 15 years. The primary outcome was depression literacy. Secondary outcomes included mental health stigma and, in a subset of the sample, the receipt of mental health services. Follow-up was at 4 months. ADAP resulted in significantly higher levels of depression literacy among participating students than did waitlist controls, after adjusting for pretest assessment depression literacy (P < .001). Overall, ADAP did not significantly affect stigma (P = .1). After ADAP, students approached 46% of teachers with concerns about themselves or others. Of students who reported the need for depression treatment, 44% received treatment within 4 months of ADAP implementation. ADAP is an effective public health intervention for improving depression literacy among students. Clinicaltrials.gov NCT02099305.

Is pre-K classroom quality associated with kindergarten and middle-school academic skills?

We employed data from a longitudinal investigation of over 1,000 children who participated in Tulsa's universal school-based pre-K program in 2005, and path modeling techniques, to examine the contribution of pre-K classroom quality to both kindergarten- and middle-school academic skills. We also examined gender and income-related differences in quality-outcome associations. Both Instructional and Emotional Support in pre-K classrooms, but not Classroom Management, assessed with the Classroom Assessment Scoring System (CLASS), were associated with kindergarten academic skills and, modestly indirectly associated through these immediate impacts, to middle-school test scores. Linear associations were found for Instructional Support whereas nonlinear patterns of association were evident for Emotional Support. Gender and income differences characterized Instructional Support-outcome associations. Results are discussed in terms of implications for improving pre-K quality as one avenue for supporting the ongoing development of academic skills. (PsycINFO Database Record

Preliminary evaluation of a school-based resilience-promoting intervention in a high-risk population: Application of an exploratory two-cohort treatment/control design.

Applying innovative methodology, we explored the efficacy of SPARK Resilience Programme––a new universal school-based resilience-promoting programme––regarding effects on depression symptoms and resilience in a high risk population in England. Quantitative and qualitative methods were combined in an exploratory two cohort treatment/control design with one cohort serving as the control group (single assessment) and a subsequent cohort as the treatment group (assessed before and immediately after treatment as well as 6 and 12 months after treatment ended), involving a total of 438 11–13 year old girls, According to analyses, depression symptoms were significantly lower directly after treatment and at 6 months but no longer at 12 months. Resilience scores, on the other hand, were significantly higher in the treatment cohort compared to the year-ahead control cohort at post-treatment and both follow-up assessments. Qualitative results demonstrated beneficial teacher experience overall. The current study provides first evidence for the efficacy of SPARK Resilience Programme. Furthermore, the applied two cohort treatment/control mixed methods design proved helpful for the preliminary testing of a school-based universal intervention programme efficacy in an authentic setting.

Trends in the prevalence of hepatitis B infection among women giving birth in New South Wales.

To evaluate the effect of targeted and catch-up hepatitis B virus (HBV) vaccination programs in New South Wales on HBV prevalence among women giving birth for the first time. Observational study linking data from the NSW Perinatal Data Collection for women giving birth during 2000-2012 with HBV notifications in the NSW Notifiable Conditions Information Management System. HBV prevalence in Indigenous Australian, non-Indigenous Australian-born, and overseas-born women giving birth. Of 482 944 women who gave birth to their first child, 3383 (0.70%) were linked to an HBV notification. HBV prevalence was 1.95% (95% CI, 1.88-2.02%) among overseas-born women, 0.79% (95% CI, 0.63-0.95%) among Indigenous Australian women, and 0.11% (95% CI, 0.09-0.12%) among non-Indigenous Australian-born women. In Indigenous Australian women, prevalence was significantly lower for those who had been eligible for inclusion in the targeted at-risk newborn or universal school-based vaccination programs (maternal year of birth, 1992-1999: 0.15%) than for those who were not (born ≤ 1981: 1.31%; for trend, P <0.001). There was no statistically significant downward trend among non-Indigenous Australian-born or overseas-born women. HBV prevalence was higher among Indigenous women residing in regional and remote areas than those in major cities (adjusted odds ratio [aOR], 2.23; 95% CI, 1.40-3.57), but lower for non-Indigenous (aOR, 0.39; 95% CI, 0.28-0.55) and overseas-born women (aOR, 0.61; 95% CI, 0.49-0.77). Among women giving birth, there was a significant reduction in HBV prevalence in Indigenous women associated with the introduction of the HBV vaccination program in NSW, although prevalence remains higher than among non-Indigenous Australian-born women, and it also varies by region of residence. Continuing evaluation is needed to ensure that the prevalence of HBV infections continues to fall in Australia.

Potential Moderators of the Effects of a School-Based Mindfulness Program on Symptoms of Depression in Adolescents

An essential step to wide-scale dissemination is to investigate moderators of intervention effectiveness. This study examined moderators of the effects of a universal school-based mindfulness program on adolescents’ depressive symptoms. Based on theory and previous research, we identified the following potential moderators: (1) severity of symptoms of depression at baseline, (2) gender, (3) age, and (4) school track. The study uses a pooled dataset from two consecutive randomized controlled trials in adolescents (13–18 years) in secondary schools in Belgium. Results on effectiveness based on the first trial were published in this journal (Raes et al. 2014). A second consecutive trial was conducted to obtain a more equal distribution between school tracks and to enlarge power, yielding a total of 605 students from nine schools. In each school, parallel classes were randomized to the mindfulness condition or usual curriculum control condition. Data were collected 1 week before and 1 week after delivery of the training and at 6-month follow-up. Moderation was tested longitudinally with multilevel models across the three repeated measures and across condition. We found no moderation effects of gender, age, and school track. Six months after the training, we found a marginally significant moderation effect for severity of symptoms of depression at baseline with greater decrease in symptoms for students with high levels of depression. The general absence of differential intervention effects for gender, age, and school track supports the broad scope of the school-based mindfulness group intervention.

Preventing Internalizing Problems in 6-8 Year Old Children: A Universal School-Based Program.

The Aussie Optimism Program: Feelings and Friends (AOP-FF) is a 10 week, universal mental health promotion program based on social/emotional and cognitive and behavioral strategies. The aim of the current study was to evaluate the efficacy of a universal Cognitive Behavioral Therapy based program in preventing and reducing internalizing problems in 6–8 year olds (Years 1–3 in Australia). Year 1–3 students from a low SES primary school (N = 206) were randomly assigned in classes to either an intervention or a control group and assessed at baseline and post-test. Results showed a significant (p = 0.009) and small to moderate (partial eta-squared = 0.034) pre-post decrease in parent-reported anxiety symptoms for the intervention group, in conjunction with a non-significant (p = 0.708) and negligible (partial eta-squared = 0.001) pre-post increase for the control group. A larger randomized controlled trial assessing longer term effects is needed. In addition the program needs to be simplified for year 1–2 students with a separate more developmentally appropriate program for year 3 students.

Effectiveness of Universal School-Based Mental Health Awareness Programs Among Youth in the United States: A Systematic Review.

Stigmatizing attitudes toward mental illness and low mental health literacy have been identified as links to social adversity, and barriers to seeking and adhering to treatment among adolescents suffering from mental illness. Prior research has found that it is possible to improve these outcomes using school-based mental health awareness interventions. The purpose of this study was to review empirical literature pertaining to universal mental health awareness interventions aiming to improve mental health related outcomes among students enrolled in US K-12 schools, especially minorities vulnerable to health disparities. PsycINFO, Cochrane Library, PUBMED, and reference lists of relevant articles were searched for K-12 school-based mental health awareness interventions in the United States. Universal studies that measured knowledge, attitudes, and/or help-seeking pertinent to mental health were included. A total of 15 studies were selected to be part of the review. There were 7 pretest/post-test case series, 5 nonrandomized experimental trial, 1 Solomon 4-groups, and 2 randomized controlled trial (RCT) designs. Nine studies measuring knowledge, 8 studies measuring attitudes, and 4 studies measuring help-seeking, indicated statistically significant improvements. Although results of all studies indicated some level of improvement, more research on implementation of universal school-based mental health awareness programs is needed using RCT study designs, and long-term follow-up implementation.

A critical discourse analysis of the New Labour discourse of Social and Emotional Learning (SEL) across schools in England and Wales: Conversations with policymakers

This paper reports on a critical discourse analysis (CDA) of the New Labour (1997-2010) discourse of Social and Emotional Learning (SEL) in schools, and how it was understood and enacted by policymakers in England and in Wales within the context of devolved government across the UK. By SEL I mean universal school-based programs, located in the concept of children’s emotional wellbeing and concerned with developing children’s ability to understand, express and manage their emotions. Through a series of in-depth interviews with national level SEL policy actors this investigation worked to understand and identify how the SEL policy discourse worked “to privilege certain ideas and topics and speakers and exclude others” (Ball, 2008, p. 5). Through shining a critical light on the discourse of New Labour SEL policy makers this work responds to the call of Gunter et al. (2014) for critical education researchers to develop and amplify voices which challenge the current hegemonic “common sense” discourse. The findings identify that the relationship between language and political ideology in England and Wales during the New Labour years powerfully shaped the SEL policy discourse.

A school-based intervention for reducing posttraumatic symptomatology and intolerance during political violence.

Studies indicate that individuals who are exposed to political violence and who experience personal threat and posttraumatic distress might also develop prejudicial and exclusionist attitudes toward outgroup members. To tackle this destructive dynamics in children, the authors implemented a 2-pronged approach, combining stress-reduction interventions with strategies geared to reducing stereotyping and discriminatory tendencies toward the other. A teacher-delivered universal school-based program, ERASE-Stress-Pro-Social (ESPS), was designed and implemented with Jewish Israeli students exposed to the 2008 Gaza War. Two hundred students from third to sixth grade were assigned to either 16 sessions of ESPS intervention (n = 99) or to a regular social skills (SS) program as a control group (n = 101). They were assessed on posttraumatic symptomatology (PTS), anxiety, somatic complaints, and functional problems, as well as stereotyping and discriminatory tendencies toward White, Arab, and Ethiopian children at 2 time-points: before the intervention and 2 months later. Elementary school students exposed to security threats and war exhibited significant levels of PTS distress as well as stereotyping and discriminatory tendencies toward Arab and Ethiopian children. Two months after the program ended, students in the ESPS group showed significant reduction on all measures compared to the SS group. Results show a strong link between PTS reduction and changes in attitudes toward Arabs. The ESPS program might help reduce PTS as well as prejudicial attitudes and discriminatory tendencies toward minorities in children exposed to political violence, thereby helping to preserve the democratic values and the delicate fabric of our multicultural societies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)