Journal articles on the topic 'Christian parent controlled schools'
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Gerami, Shahin. "Christianity in Public Schools: Perspective of a Non‐Christian Immigrant Parent." Early Child Development and Care 147, no. 1 (January 1998): 33–41. http://dx.doi.org/10.1080/0300443981470105.
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Gracie, Anita, and Andrew W. Brown. "Controlled schools in Northern Ireland – de facto Protestant or de facto secular?" International Journal of Christianity & Education 23, no. 3 (August 13, 2019): 349–68. http://dx.doi.org/10.1177/2056997119868819.
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The Controlled Schools’ sector in Northern Ireland is usually described as de facto Protestant. By examining its history and current context, this article considers the veracity of that statement. In many schools RE is often ‘squeezed out’ of an already overcrowded timetable. This results in the quantity and quality of RE teaching varying widely, unlike other areas of the curriculum. The article explores whether the sector's ethos is Protestant, secular, Christian or multi-faith. It concludes that, although perhaps unclear about their Protestant identity and uncomfortable about being deemed secular, schools are clear about their de facto Christian status.
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Brown, Martin, Gerry McNamara, Shivaun O’Brien, Craig Skerritt, Joe O’Hara, Jerich Faddar, Sakir Cinqir, Jan Vanhoof, Maria Figueiredo, and Gül Kurum. "Parent and student voice in evaluation and planning in schools." Improving Schools 23, no. 1 (December 24, 2019): 85–102. http://dx.doi.org/10.1177/1365480219895167.
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Current approaches to the regulation of schools in most jurisdictions tend to combine elements of external inspection with systems of internal self-evaluation. An increasingly important aspect of the theory and practice of both, but particularly the latter, revolves around the role of other actors, primarily parents and students, in the process. Using literature review and documentary analysis as the research method, this article explores the research literature from many countries around the concerns of schools and teachers about giving a more powerful voice to parents and pupils. Then, focusing on Ireland, this article tries to clarify three things, official policy concerning stakeholder voice in school self-evaluation and decision making, the efforts by schools to implement this policy and the response to date of school leaders and teachers to this rather changed environment. Using Hart’s ladder of genuine, as opposed to token, participation, it is argued that policy mandating parental and student involvement has evolved significantly, that schools have responded positively and that there is little evidence, as yet, of teacher concern or resistance. This response is explained by the low stakes and improvement-focused education environment; the controlled, structured and simplified nature of the self-evaluation process; and the limited extent of parental and student participation in decision making.
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Fennimore, Beatrice S. "Permission Not Required: The Power of Parents to Disrupt Educational Hypocrisy." Review of Research in Education 41, no. 1 (March 2017): 159–81. http://dx.doi.org/10.3102/0091732x16687974.
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This review is focused on literature documenting the experiences of nondominant and minoritized parents who challenge injustice and inequity in the public schools attended by their children. It interrogates hegemonic approaches to parent involvement favoring dominant groups and silencing efforts of nondominant parents to confront discriminatory assumptions and unequal opportunities. Research studies generally published between 1995 and 2016 reflecting grassroots parent activism encountering conflict and tension and exposing racism, classism, and discrimination in public school practices and policies were selected. Using the lens of critical race and social justice theories, the review is structured on three major public school hypocrisies: (1) hegemonic traditional school-controlled parent involvement that privileges dominant groups and devalues contributions of nondominant groups, (2) false claims of equity in schools characterized by stratified and differential opportunities, and (3) discriminatory market-based choice and privatization schemes. Ultimately the review calls on researchers to acknowledge ethical issues that arise when their work “confirms” nondominant parent and child inferiority. Further, it calls for observer–activist–participant research paradigms that acknowledge school-based resistance to critical nondominant parent activism and respectfully document the continuing struggle of nondominant parents for equal educational opportunities.
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McDonald, Lynn, Hannah Miller, and Jen Sandler. "A social ecological, relationship-based strategy for parent involvement: Families And Schools Together (FAST)." Journal of Children's Services 10, no. 3 (September 21, 2015): 218–30. http://dx.doi.org/10.1108/jcs-07-2015-0025.
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Purpose – Most schools struggle to get busy and stressed parents to come repeatedly to the school building for events. At primary schools, especially those with pupils living in low-income communities or with many immigrants, involving parents to come at all is seen as a challenge. The purpose of this paper is to present a social ecological strategy of using the school building as a site for families to gather and for community networks to grow by building relationships between parents who have same-aged children attending that school. When families know other families, they feel more comfortable coming into the school building, and probably will return frequently. Design/methodology/approach – A large randomised controlled trial of 52 urban schools with an average of 73 per cent Latino students situated in disadvantaged neighbourhoods in the USA has data to examine the impact of this strategy on parent involvement. Parents of all first-grade students (age 6 or 7) at schools assigned either to Families and Schools Together (FAST) or services-as-usual were invited to participate. At schools with the social ecological strategy universal invites were made to those in the study to attend any one of eight weekly multi-family group sessions offered after-school at the building. Trained teams were culturally representative of the families (language, ethnicity) and made up of local parents and professionals; each team hosted up to ten families in a hub for two and a half hours (83 families attended at one session). Parents were socially included, treated with respect, coached by the team to lead a family meal, singing, family crafts and games at a family table. Parent time (respite) was provided with chat-time in pairs, followed by parent-led discussion groups. Parents were coached in one to one time, “child-led” responsive play for 15 minutes. Findings – Parent involvement data showed that on average, 43.6 per cent of all first-graders’ families (an average of 44 families per school) attended at least one session; of those, who attended at least one session, 69 per cent returned for another. On average, of those families who attended at least once, the average family went four times; an average of 22 families per school attended six or more sessions. Parent graduates led monthly booster sessions open to all families. In half of the families, both fathers and mothers attended; immigrant parents attended statistically significantly more than native-born ones. In surveys, more parents in schools with FAST vs control reported attending three or more events at school. Practical implications – The FAST programme encourages the involvement of reluctant parents in school events. This benefits both children’s general well-being and academic attainment and so contributes to preventative public health strategies. Originality/value – This paper brings new perspectives to the challenges faced by educators in involving parents at school by a sociologist-led research team introducing a social worker-developed social ecological, systemic strategy to schools in low-income communities using a randomised controlled design. This novel social ecological approach has consistently and effectively engaged whole families into increased involvement in schools in 20 countries, especially in low-income communities. Headteachers consistently report increased school engagement of FAST parent graduates for years, suggesting that the early intensity builds ongoing relationships of trust and reciprocity across home, school and community. Policy makers should note that building social capital in disadvantaged communities through partnerships with parents and schools can result in decreased disparities in health, social care and education.
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Baker-Henningham, Helen, Stephen Scott, Kelvyn Jones, and Susan Walker. "Reducing child conduct problems and promoting social skills in a middle-income country: cluster randomised controlled trial." British Journal of Psychiatry 201, no. 2 (August 2012): 101–8. http://dx.doi.org/10.1192/bjp.bp.111.096834.
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BackgroundThere is an urgent need for effective, affordable interventions to prevent child mental health problems in low- and middle-income countries.AimsTo determine the effects of a universal pre-school-based intervention on child conduct problems and social skills at school and at home.MethodIn a cluster randomised design, 24 community pre-schools in inner-city areas of Kingston, Jamaica, were randomly assigned to receive the Incredible Years Teacher Training intervention (n = 12) or to a control group (n = 12). Three children from each class with the highest levels of teacher-reported conduct problems were selected for evaluation, giving 225 children aged 3–6 years. The primary outcome was observed child behaviour at school. Secondary outcomes were child behaviour by parent and teacher report, child attendance and parents' attitude to school. The study is registered as ISRCTN35476268.ResultsChildren in intervention schools showed significantly reduced conduct problems (effect size (ES) = 0.42) and increased friendship skills (ES = 0.74) through observation, significant reductions to teacher-reported (ES = 0.47) and parent-reported (ES = 0.22) behaviour difficulties and increases in teacher-reported social skills (ES = 0.59) and child attendance (ES = 0.30). Benefits to parents' attitude to school were not significant.ConclusionsA low-cost, school-based intervention in a middle-income country substantially reduces child conduct problems and increases child social skills at home and at school.
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Fernando, Sr Mary, Kennedy D Gunawardana, and Y. K. Banda. "Assisted Christian Schools Governance, Practices, Boards Commitments and Performance Measures in Sri Lanka." International Business Research 11, no. 8 (July 19, 2018): 97. http://dx.doi.org/10.5539/ibr.v11n8p97.
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Education has been playing the most important pivoting role in the development of human civilization in the present. Hence, education is inseparable and it is imperative to cater to the present needs of the society and prepare the society for a better future. One of the most valuable gifts that the Catholic Church has contributed is the holistic approach in the education, as we need to compete for Knowledge and wisdom; true education is not only training the mind but also the heart leading to wisdom. However the overall performance of the holistic education system faced wide spread controversy and continuing concern about how schools are being managed and controlled has led to many studies on school performance. The purpose of the study is provided evidence from single or a few perspectives such as selected indicators and school governance principals. In addition, there are many inconsistencies in the finding across the world that shows no signal school governance model is appropriate for all schools, countries and economic environments. The study has considered the three different school governance practicess of board clear funtion, sustainable policy, and board charter in capturing the effect of board governance on school performance. In addition, to elucidate school performance is dealing with board governance; the study used four perspective of balance score card as a determinant of school performance. The estimation results suggested that the board clear function, sustainable policy and board charter had significant positive driving forces on school performance.
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Cramer, Nicole, Miriam J. Haviland, Chuan Zhou, and Jason A. Mendoza. "Impact of Walking School Bus Programs on Self-Efficacy and Outcome Expectations." Journal of Physical Activity and Health 18, no. 7 (July 1, 2021): 858–62. http://dx.doi.org/10.1123/jpah.2020-0453.
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Background: A walking school bus (WSB) consists of students and adults walking to and from school and promotes active commuting to school. Self-efficacy (SE) and outcome expectations (OE) are behavioral constructs associated with active commuting to school. The authors sought to assess the impact of a WSB program on child SE, and parent SE, and OE. Methods: The authors conducted a cluster randomized controlled trial of a WSB intervention from 2012 to 2016 among 22 elementary schools serving racially diverse, low-income populations in Houston, TX and Seattle, WA. Surveys collected data from third- to fifth-grade students and their parents, (n = 418) child-parent dyads, before school randomization and at the school year’s end. Child surveys included 16 SE items, while parent surveys included 15 SE items and 14 OE items. Scores were averaged from responses ranging from 1 to 3. The authors compared changes in SE and OE between groups over time and accounted for clustering using linear mixed-effects models. Results: The intervention group had increases in child SE of 0.12 points (P = .03), parent SE of 0.11 points (P = .048), and parent OE of 0.09 points (P = .02) compared to controls over time. Conclusions: As hypothesized, the WSB improved child SE, parent SE, and parent OE related to active commuting to school.
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Huang, Cathy, Andrew L. Dannenberg, Wren Haaland, and Jason A. Mendoza. "Changes in Self-Efficacy and Outcome Expectations From Child Participation in Bicycle Trains for Commuting to and From School." Health Education & Behavior 45, no. 5 (April 9, 2018): 748–55. http://dx.doi.org/10.1177/1090198118769346.
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Background. Active commuting to school (ACS) is associated with increased physical activity and lowered risk of obesity. In observational studies, ACS was associated with child self-efficacy, parent self-efficacy, and parent outcome expectations, although few experiments have assessed changes in these behavioral constructs. Aim. This study examined the effects of a bicycle train intervention (BTI) on child self-efficacy, parent self-efficacy, and parent outcome expectations in a diverse, low socioeconomic status population. Method. Data were from a 2014 BTI pilot randomized controlled trial (RCT) on fourth to fifth graders aged 9 to 12 years, n = 54, from four schools serving low-income populations in Seattle, Washington. The BTI was a group of children and study staff who cycled together to/from school daily, while controls received no intervention. Responses to validated child self-efficacy, parent self-efficacy, and parent outcome expectations questionnaires ranged from 1 to 3. Adjusted linear mixed effects models estimated standardized coefficients for child self-efficacy, parent self-efficacy, and parent outcome expectations comparing intervention and controls from Time 1 (preintervention) to Time 2 (final 4-6 weeks of intervention). Results. The intervention group had increases in child self-efficacy of 0.84 standard deviations (95% confidence interval [CI] [0.37, 1.31]), parent self-efficacy of 0.46 standard deviations (95% CI [0.05, 0.86]), and parent outcome expectations of 0.47 standard deviations (95% CI [0.17, 0.76]) compared with controls from Times 1 to 2 (all ps <.05). Conclusion. A BTI improved child self-efficacy, parent self-efficacy, and parent outcome expectations, which warrants a larger RCT to examine long-term changes to these behavioral constructs and ACS.
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Aina, Adebunmi Yetunde, and Keshni Bipath. "School financial management: Insights for decision making in public primary schools." South African Journal of Education 40, no. 4 (November 30, 2020): 1–9. http://dx.doi.org/10.15700/saje.v40n4a1756.
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To realise the ideal of quality inclusive education, proper financial management is vital. Existing literature indicates that the mismanagement of school funds is largely due to principals and the school governing bodies (SGB) in many schools not having good working relationships with stakeholders and lacking the necessary financial skills, more specifically in schools in townships and rural areas. The study we report on in this article investigated the financial management of public primary schools situated in urban areas by adopting a qualitative research approach and employing a multiple case study research design. Five schools participated and data were collected through individual semi-structured interviews with the principal, school accountant and chairperson of the SGB of the selected schools. Findings revealed that, despite the fact that all South African schools are governed and controlled by the South African Schools Act, the financial management of fee-paying schools differs from no-fee schools situated in townships and rural areas. In many schools, the unavailability of the parent members of SGBs and their limited financial skills were barriers to effective financial decisions. Based on these findings, we recommend that the relevant stakeholders involved in school financial management obtain continuous training from the Department of Basic Education, in order to empower and support school governors to effectively carry out their financial functions.
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Quach, Jon L., Ben Deery, Margaret Kern, Janet Clinton, Lisa Gold, Francesca Orsini, and Emma Sciberras. "Can a teacher-led mindfulness intervention for new school entrants improve child outcomes? Protocol for a school cluster randomised controlled trial." BMJ Open 10, no. 5 (May 2020): e036523. http://dx.doi.org/10.1136/bmjopen-2019-036523.
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IntroductionThe first years of school are critical in establishing a foundation for positive long-term academic, social and well-being outcomes. Mindfulness-based interventions may help students transition well into school, but few robust studies have been conducted in this age group. We aim to determine whether compared with controls, children who receive a mindfulness intervention within the first years of primary school have better: (1) immediate attention/short-term memory at 18 months post-randomisation (primary outcome); (2) inhibition, working memory and cognitive flexibility at 18 months post-randomisation; (3) socio-emotional well-being, emotion-regulation and mental health-related behaviours at 6 and 18 months post-randomisation; (4) sustained changes in teacher practice and classroom interactions at 18 months post-randomisation. Furthermore, we aim to determine whether the implementation predicts the efficacy of the intervention, and the cost effectiveness relative to outcomes.Methods and analysisThis cluster randomised controlled trial will be conducted in 22 primary schools in disadvantaged areas of Melbourne, Australia. 826 students in the first year of primary school will be recruited to detect between groups differences of Cohen’s d=0.25 at the 18-month follow-up. Parent, teacher and child-assessment measures of child attention, emotion-regulation, executive functioning, socio-emotional well-being, mental health-related behaviour and learning, parent mental well-being, teacher well-being will be collected 6 and 18 months post-randomisation. Implementation factors will be measured throughout the study. Intention-to-treat analyses, accounting for clustering within schools and classes, will adopt a two-level random effects linear regression model to examine outcomes for the intervention versus control students. Unadjusted and analyses adjusted for baseline scores, baseline age, gender and family socioeconomic status will be conducted.Ethics and disseminationEthics approval has been received by the Human Research Ethics Committee at the University of Melbourne. Findings will be reported in peer-review publications, national and international conference presentations and research snapshots directly provided to participating schools and families.Pre-Results Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000326190).
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Schmidt, Sabrina K., Michael S. Reinboth, Geir K. Resaland, and Solfrid Bratland-Sanda. "Changes in Physical Activity, Physical Fitness and Well-Being Following a School-Based Health Promotion Program in a Norwegian Region with a Poor Public Health Profile: A Non-Randomized Controlled Study in Early Adolescents." International Journal of Environmental Research and Public Health 17, no. 3 (January 31, 2020): 896. http://dx.doi.org/10.3390/ijerph17030896.
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The purpose of this study was to examine the changes in physical activity (PA), physical fitness and psychosocial well-being in early adolescents following implementation of a school-based health promotion program in secondary schools. Methods: Six municipalities in Telemark County, Norway, were recruited into intervention (6 schools) or control groups (9 schools). A total of 644 pupils participated in the study (response rate: 79%). The schools in the intervention group implemented the Active and Healthy Kids program, where the PA component consisted of (1) 120 min/week of physically active learning (PAL) and (2) 25 min/week of physical active breaks. Furthermore, both the intervention and control schools carried out 135 min/week of physical education. The primary outcome was PA. Secondary outcomes were sedentary time, physical fitness, subjective vitality and health-related quality of life (HRQoL) in five domains: physical health, psychological well-being, parent, peers and school. Results: There was a group x time effect on school-based PA (p < 0.05), but not total PA, as well as on physical fitness (p < 0.05) and vitality (p < 0.01). In girls, there also was a group x time effect on three out of the five domains on HRQoL (p < 0.05). Conclusions: A multi-component, school-based health-promotion program with emphasis on the use of PAL led to positive changes in school-based PA levels. Furthermore, positive changes were seen in physical fitness, vitality and HRQoL among early adolescents in a county with a poor public health profile. This might have implications for the development and promotion in schools of general health and well-being throughout adolescence.
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Topham, Glade L., Isaac J. Washburn, Laura Hubbs-Tait, Tay S. Kennedy, Julie M. Rutledge, Melanie C. Page, Taren Swindle, Lenka H. Shriver, and Amanda W. Harrist. "The Families and Schools for Health Project: A Longitudinal Cluster Randomized Controlled Trial Targeting Children with Overweight and Obesity." International Journal of Environmental Research and Public Health 18, no. 16 (August 19, 2021): 8744. http://dx.doi.org/10.3390/ijerph18168744.
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This cluster randomized controlled trial aimed at overweight and obese children compared three treatments. Two psychoeducation interventions for parents and children were conducted: Family Lifestyle (FL) focused on food and physical activity; Family Dynamics (FD) added parenting and healthy emotion management. A third Peer Group (PG) intervention taught social acceptance to children. Crossing interventions yielded four conditions: FL, FL + PG, FL + FD, and FL + FD + PG—compared with the control. Longitudinal BMI data were collected to determine if family- and peer-based psychosocial components enhanced the Family Lifestyle approach. Participants were 1st graders with BMI%ile >75 (n = 538: 278 boys, 260 girls). Schools were randomly assigned to condition after stratifying for community size and percent American Indian. Anthropometric data were collected pre- and post-intervention in 1st grade and annually through 4th grade. Using a two-level random intercept growth model, intervention status predicted differences in growth in BMI or BMI-M% over three years. Children with obesity who received the FL + FD + PG intervention had lower BMI gains compared to controls for both raw BMI (B = −0.05) and BMI-M% (B = −2.36). Interventions to simultaneously improve parent, child, and peer-group behaviors related to physical and socioemotional health offer promise for long-term positive impact on child obesity.
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Segrott, Jeremy, Heather Rothwell, Gillian Hewitt, Rebecca Playle, Chao Huang, Simon Murphy, Laurence Moore, Matthew Hickman, and Hayley Reed. "Preventing alcohol misuse in young people: an exploratory cluster randomised controlled trial of the Kids, Adults Together (KAT) programme." Public Health Research 3, no. 15 (November 2015): 1–188. http://dx.doi.org/10.3310/phr03150.
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BackgroundInvolvement of parents/carers may increase the effectiveness of primary school-based alcohol-misuse prevention projects. However, few interventions have been designed for pre-adolescent children, or specifically involve parents/carers. The Kids, Adults Together (KAT) programme in primary schools aimed to reduce alcohol misuse through such an approach.ObjectiveTo determine the value and feasibility of conducting an effectiveness trial of KAT.DesignParallel-group cluster randomised exploratory trial with an embedded process evaluation. Schools were the unit of randomisation.SettingPrimary schools (n = 9) in south Wales, UK.ParticipantsPupils in Year 5/6 (aged 9–11 years) and their parents/carers; school staff.InterventionThe Kids, Adults Together programme consisted of (1) classwork addressing the effects of alcohol; (2) a family event for children and parents/carers; and (3) a ‘goody bag’ containing fun items, including a digital versatile disc (DVD) for families to watch together. The intervention comprised KAT plus existing alcohol-related activities and lessons. Control-group schools continued with existing alcohol-related lessons and activities.Main outcome measuresKey outcomes related to the progression criteria for a potential future effectiveness trial. These included the acceptability, participation equity, feasibility and implementation of KAT; the recruitment and retention of research participants; and the acceptability and feasibility of research processes, including data collection methods and outcome measures.ResultsNine schools (free school meal entitlement ranging from 1% to 37.2%) participated. Two of five intervention schools withdrew but all four control schools were retained, and these seven schools facilitated all research data collections. Programme acceptability and participation rates were high in all three intervention schools (parent/carer participation rates ranged from 45.1% to 65.7%), although implementation quality varied. At baseline, approximately 75% of eligible children (n = 418) provided data, of whom 257 also provided data at follow-up. Only 27 parents/carers (estimated response rate 6.5%) completed interviews. Most children were willing to complete questionnaires but measures were not appropriate for this age group. Measures of alcohol consumption produced inconsistent responses. Intermediate outcomes on family communication showed no evidence of intervention effectiveness.ConclusionsIn the three schools that received the KAT intervention, it was found to be acceptable to schools and pupils and there were good levels of participation from parents/carers from across a range of socioeconomic groups. However, two intervention schools withdrew from the trial. Findings from intermediate outcomes on family communication did not support programme theory. In addition, the study highlighted challenges in identifying suitable outcome measures for children aged 9–11 years and the feasibility of long-term follow-up via secondary schools.Future workIt would not be appropriate to proceed to an effectiveness trial of KAT. There are doubts/uncertainties about the potential effects of KAT; suitability of measures; the large number of schools which would be required for an effectiveness trial of KAT, and the cost of this; feasibility of follow-up in secondary schools; and programme implementation and theory. There is a need to develop and validate measures for children aged 9–11 years; to test the feasibility of follow-up data collection methods in secondary schools; and to further consider sample size requirements and feasibility.Trial registrationCurrent Controlled Trials ISRCTN80672127.FundingThe exploratory trial of this project was funded by the National Institute for Health Research Public Health Research programme and the process evaluation was funded by the Economic and Social Research Council. The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This project will be published in full inPublic Health Research; Vol. 3, No. 15. See the NIHR Journals Library website for further project information.
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Sumnall, Harry, Ashley Agus, Jon Cole, Paul Doherty, David Foxcroft, Séamus Harvey, Michael McKay, Lynn Murphy, and Andrew Percy. "Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school- and community-based cluster randomised controlled trial." Public Health Research 5, no. 2 (April 2017): 1–154. http://dx.doi.org/10.3310/phr05020.
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BackgroundAlcohol use in young people remains a public health concern, with adverse impacts on outcomes such as health, well-being, education and relationships.ObjectivesTo assess the effectiveness and cost-effectiveness of a combined classroom curriculum and parental intervention on self-reported alcohol use [heavy episodic drinking (HED)] and alcohol-related harms (indicators such as getting into fights after drinking, poorer school performance and trouble with friends and family).DesignA two-arm, cluster randomised controlled trial with schools as the unit of randomisation.SettingA total of 105 post-primary schools in Northern Ireland (NI) and Glasgow/Inverclyde Educational Authority areas.ParticipantsA total of 12,738 male and female secondary school students (intervention delivered when students were in school year 9 in NI or S2 in Scotland in the academic year 2012–13 and aged 12–13 years) were randomised. Randomisation and baseline (T0) surveys took place when children were in school year 8 or S1. Schools were randomised (1 : 1) by an independent statistician to the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) or to education as normal (EAN). All schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational).InterventionsSTAMPP combined a school-based alcohol harm reduction curriculum [an adapted version of the School Health and Alcohol Harm Reduction Project (SHAHRP)] and a brief parental intervention designed to support parents in setting family rules around drinking. The classroom component comprised two phases delivered over 2 years, and the parental component comprised a standardised presentation delivered by a trained facilitator at specially arranged parent evenings on school premises. This was followed up a few weeks later by an information leaflet mailed to all intervention pupils’ parents highlighting the main points of the evening.Main outcome measures(1) Self-reported HED (defined as self-reported consumption of ≥ 6 units in a single episode in the previous 30 days for male students and ≥ 4.5 units for female students) assessed at 33 months from baseline (T3); and (2) the number of self-reported harms (harms caused by own drinking) assessed at T3.Data sourcesSelf-completed pupil questionnaires.ResultsAt final follow-up (T3), data were available for 5160 intervention and 5073 control pupils for the HED outcome, and for 5234 intervention and 5146 control pupils for the self-reported harms outcome. The intervention reduced self-reported HED compared with EAN (p < 0.001), but did not reduce self-reported harms associated with own drinking. The odds ratio for the intervention effect on HED was 0.596 (standard error 0.0596, 95% confidence interval 0.490 to 0.725). The mean cost of delivery per school was £818 and the mean cost per individual was £15. There were no clear cost savings in terms of service utilisation associated with the intervention. The process evaluation showed that the classroom component engaged and was enjoyed by pupils, and was valued by teachers. Schools, students, intervention trainers and delivery staff (teachers) were not blind to study condition. Data collection was undertaken by a team of researchers that included the trial manager and research assistants, some of whom were not blinded to study condition. Data analysis of primary and secondary outcomes was undertaken by the trial statistician, who was blinded to the study condition.LimitationsAlthough the classroom component was largely delivered as intended, there was very low attendance at the parent/carer event; however, all intervention pupils’ parents/carers received an intervention leaflet.ConclusionsThe results of this trial provide some support for the effectiveness and cost-effectiveness of STAMPP in reducing heavy episodic (binge) drinking, but not in reducing self-reported alcohol-related harms, in young people over a 33-month follow-up period. As there was low uptake of the parental component, it is uncertain whether or not the intervention effect was accounted for by the classroom component alone.Trial registrationCurrent Controlled Trials ISRCTN47028486.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. 5, No. 2. See the NIHR Journals Library website for further project information. The Public Health Agency of NI and Education Boards of Glasgow/Inverclyde provided some intervention costs. Diageo provided funds to print some workbooks. The remaining intervention costs were internally funded.
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Landry, Matthew J., Alexandra E. van den Berg, Deanna M. Hoelscher, Fiona M. Asigbee, Sarvenaz Vandyousefi, Reem Ghaddar, Matthew R. Jeans, et al. "Impact of a School-Based Gardening, Cooking, Nutrition Intervention on Diet Intake and Quality: The TX Sprouts Randomized Controlled Trial." Nutrients 13, no. 9 (September 1, 2021): 3081. http://dx.doi.org/10.3390/nu13093081.
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School gardens have become common school-based health promotion strategies to enhance dietary behaviors in the United States. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, cooking, and nutrition cluster randomized controlled trial, on students’ dietary intake and quality. Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016–2019). The intervention arm received: formation and training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly in the teaching garden during school hours; and nine parent lessons, taught monthly. Dietary intake data via two 24 h dietary recalls (24 hDR) were collected on a random subsample (n = 468). Dietary quality was calculated using the Healthy Eating Index 2015 (HEI-2015). The intervention group compared to control resulted in a modest increase in protein intake as a percentage of total energy (0.4% vs. −0.3%, p = 0.021) and in HEI-2015 total vegetables component scores (+4% vs. −2%, p = 0.003). When stratified by ethnicity/race, non-Hispanic children had a significant increase in HEI-2015 total vegetable scores in the intervention group compared to the control group (+4% vs. −8%, p = 0.026). Both the intervention and control groups increased added sugar intake; however, to a lesser extent within the intervention group (0.3 vs. 2.6 g/day, p = 0.050). School-based gardening, cooking, and nutrition interventions can result in significant improvements in dietary intake. Further research on ways to scale and sustain nutrition education programs in schools is warranted. The trial is registered at ClinicalTrials.gov (NCT02668744).
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Bellis, Jennifer. "6 Medicines in schools – a survey of stakeholders." Archives of Disease in Childhood 103, no. 2 (January 19, 2018): e2.46-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.6.
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AimTo determine the perspectives of stakeholders on how children’s medicines are dealt with in schools.MethodsStakeholders were children with long-term conditions or receiving intermittent medicines and their families, school staff and healthcare professionals. Between August 2015 and July 2016, children on long term therapy and their parents/guardians completed a paper-based questionnaire. Parents of children receiving intermittent medicines took part in a telephone survey. Other stakeholders completed electronic questionnaires. Questions related to medicine type, administration, storage, record-keeping, staff training, communication and problems encountered. Quantitative data are presented using summary statistics, free text responses were categorised by theme.ResultsResponses were received from 59 healthcare professionals, 24 parents of children with long term conditions and 15 children with long term conditions, 10 parents of children receiving intermittent medicines, 40 school staff and 11 school nurses. The age range of the children who completed the questionnaire (or had it completed by their parent) was 4–16 years. The number of regular medicines taken at school ranged from 0 to 4, the number of medicines taken at school when required ranged from 0% to 12. 72.5% of school staff respondents were from primary schools (±nursery), 20.0% from secondary and 7.5% from schools for pupils with special needs. Children needed to take oral and buccal medicines, inhalers, nebulised treatment, topical, rectal and injectables at school.57.6% of healthcare professional respondents were aware of problems encountered by patients with medicines at school. 47.1% of school staff respondents said there were challenges with the administration of medicines. 52.5% said there was some room for improvement in how they managed medicines at their school. 54.5% of school nurse respondents were aware of problems with medicines at school. 41.7% of parent and 66.7% of child respondents reported at least one problem. Four parents of children receiving intermittent treatment said that their child needed to take their medicine during the school day. One was very unsatisfied with how the medicines were dealt with at school. The most common problems reported by all stakeholder groups were missed doses, medicine not available when required and medicine supply running out. Medicines perceived to cause particular problems were: medicines needing fridge storage, antibiotics, inhalers, nebulisers, controlled drugs, buccal midazolam, rectal diazepam, insulin, hydrocortisone, Creon, carnitine, baclofen and Epipen. Clinicians and parents try to avoid children and young people needing to take medicines at school but this isn’t always possible. In general, schools are accommodating of the needs of children requiring medication at school but school staff reported a number of challenges such as appropriate storage and access to medicines, clear instructions, and liaising with healthcare practitioners. Schools reported a lack of expertise about medicines and therefore relied on adherence to systems, policies and procedures as an indication of the quality of medicines management.ConclusionThere are challenges associated with medicines management at school. Future work should focus on addressing the areas of concern highlighted by stakeholders, in particular: storage of, and access to, medicines and communication about medicines.
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Lohan, Maria, Áine Aventin, Mike Clarke, Rhonda M. Curran, Lisa Maguire, Rachael Hunter, Clíona McDowell, et al. "JACK trial protocol: a phase III multicentre cluster randomised controlled trial of a school-based relationship and sexuality education intervention focusing on young male perspectives." BMJ Open 8, no. 7 (July 2018): e022128. http://dx.doi.org/10.1136/bmjopen-2018-022128.
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IntroductionTeenage pregnancy remains a worldwide health concern which is an outcome of, and contributor to, health inequalities. The need for gender-aware interventions with a focus on males in addressing teenage pregnancy has been highlighted as a global health need by WHO and identified in systematic reviews of (relationship and sexuality education (RSE)). This study aims to test the effectiveness of an interactive film-based RSE intervention, which draws explicit attention to the role of males in preventing an unintended pregnancy by reducing unprotected heterosexual teenage sex among males and females under age 16 years.Methods and analysisA phase III cluster randomised trial with embedded process and economic evaluations.If I Were Jackencompasses a culturally sensitive interactive film, classroom materials, a teacher-trainer session and parent animations and will be delivered to replace some of the usual RSE for the target age group in schools in the intervention group. Schools in the control group will not receive the intervention and will continue with usual RSE. Participants will not be blinded to allocation. Schools are the unit of randomisation stratified per country and socioeconomic status. We aim to recruit 66 UK schools (24 in Northern Ireland; 14 in each of England, Scotland and Wales), including approximately 7900 pupils. A questionnaire will be administered at baseline and at 12–14 months postintervention. The primary outcome is reported unprotected sex, a surrogate measure associated with unintended teenage pregnancy. Secondary outcomes include knowledge, attitudes, skills and intentions relating to avoiding teenage pregnancy in addition to frequency of engagement in sexual intercourse, contraception use and diagnosis of sexually transmitted infections.Ethics and disseminationEthical approval was obtained from Queen’s University Belfast. Results will be published in peer-reviewed journals and disseminated to stakeholders. Funding is from the National Institute for Health Research.Trial registration numberISRCTN99459996
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Ha, Amy S., Angus Burnett, Raymond Sum, Nikola Medic, and Johan Y. Y. Ng. "Outcomes of the Rope Skipping ‘STAR’ Programme for Schoolchildren." Journal of Human Kinetics 45, no. 1 (March 1, 2015): 233–40. http://dx.doi.org/10.1515/hukin-2015-0024.
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Abstract Physical activity in children and adolescents is on a decline trend. To this end, we conducted a matched-pair randomized controlled trial to examine the effects of a 4-week STAR (School-based; Train-the-trainer; Accessibility of resources; Recreational) skipping programme. 1,386 schoolchildren from 20 primary and secondary schools were recruited. Schools were randomized into the experimental or wait-list control group. Participants self-reported their health-related quality of life using the KIDSCREEN-27. Accelerometers were used to measure the time a subgroup of participants (n = 480) spent in moderate-to-vigorous physical activity during school hours on five consecutive days. Measures were taken at pre- and post-test. At post-test, students in the experimental group, compared to those in the control group, engaged in less moderate-to-vigorous physical activity during school hours. Health-related quality of life from two groups of students was similar, but the experimental group reported higher levels of autonomy and parent relationships. Results suggested that although the intervention did not increase students’ physical activity levels, it slightly improved their health-related quality of life. Future studies should explore personal factors that might mediate the effect of the intervention.
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Kortekaas-Rijlaarsdam, Anne Fleur, Marjolein Luman, Edmund Sonuga-Barke, Pierre Bet, and Jaap Oosterlaan. "Methylphenidate-Related Improvements in Math Performance Cannot Be Explained by Better Cognitive Functioning or Higher Academic Motivation: Evidence From a Randomized Controlled Trial." Journal of Attention Disorders 24, no. 13 (June 13, 2017): 1824–35. http://dx.doi.org/10.1177/1087054717713640.
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Objective: This study investigated whether improvements in working memory, reaction time, lapses of attention, interference control, academic motivation, and perceived competence mediated effects of methylphenidate on math performance. Method: Sixty-three children (ADHD diagnosis; methylphenidate treatment; age 8-13; IQ > 70) were randomly allocated to a 7-day methylphenidate or placebo treatment in this double-blind placebo-controlled crossover study and compared with 67 controls. Data were collected at schools and analyzed using mixed-model analysis. Methylphenidate was hypothesized to improve all measures; all measures were evaluated as potential mediators of methylphenidate-related math improvements. Results: Controls mostly outperformed the ADHD group. Methylphenidate did not affect measures of cognitive functioning ( p = .082-.641) or academic motivation ( p = .199-.865). Methylphenidate improved parent ratings of their child’s self-perceived competence ( p < .01), which mediated methylphenidate efficacy on math productivity. Conclusion: These results question the necessity of improvements in specific cognitive and motivational deficits associated with ADHD for medication-related academic improvement. They also stimulate further study of perceived competence as a mediator.
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Crawford, Mike J., Christian Gold, Helen Odell-Miller, Lavanya Thana, Sarah Faber, Jörg Assmus, Łucja Bieleninik, et al. "International multicentre randomised controlled trial of improvisational music therapy for children with autism spectrum disorder: TIME-A study." Health Technology Assessment 21, no. 59 (October 2017): 1–40. http://dx.doi.org/10.3310/hta21590.
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Background Preliminary studies have indicated that music therapy may benefit children with autism spectrum disorders (ASD). Objectives To examine the effects of improvisational music therapy (IMT) on social affect and responsiveness of children with ASD. Design International, multicentre, three-arm, single-masked randomised controlled trial, including a National Institute for Health Research (NIHR)-funded centre that recruited in London and the east of England. Randomisation was via a remote service using permuted blocks, stratified by study site. Setting Schools and private, voluntary and state-funded health-care services. Participants Children aged between 4 and 7 years with a confirmed diagnosis of ASD and a parent or guardian who provided written informed consent. We excluded children with serious sensory disorder and those who had received music therapy within the past 12 months. Interventions All parents and children received enhanced standard care (ESC), which involved three 60-minute sessions of advice and support in addition to treatment as usual. In addition, they were randomised to either one (low-frequency) or three (high-frequency) sessions of IMT per week, or to ESC alone, over 5 months in a ratio of 1 : 1 : 2. Main outcome measures The primary outcome was measured using the social affect score derived from the Autism Diagnostic Observation Schedule (ADOS) at 5 months: higher scores indicated greater impairment. Secondary outcomes included social affect at 12 months and parent-rated social responsiveness at 5 and 12 months (higher scores indicated greater impairment). Results A total of 364 participants were randomised between 2011 and 2015. A total of 182 children were allocated to IMT (90 to high-frequency sessions and 92 to low-frequency sessions), and 182 were allocated to ESC alone. A total of 314 (86.3%) of the total sample were followed up at 5 months [165 (90.7%) in the intervention group and 149 (81.9%) in the control group]. Among those randomised to IMT, 171 (94.0%) received it. From baseline to 5 months, mean scores of ADOS social affect decreased from 14.1 to 13.3 in music therapy and from 13.5 to 12.4 in standard care [mean difference: music therapy vs. standard care = 0.06, 95% confidence interval (CI) –0.70 to 0.81], with no significant difference in improvement. There were also no differences in the parent-rated social responsiveness score, which decreased from 96.0 to 89.2 in the music therapy group and from 96.1 to 93.3 in the standard care group over this period (mean difference: music therapy vs. standard care = –3.32, 95% CI –7.56 to 0.91). There were seven admissions to hospital that were unrelated to the study interventions in the two IMT arms compared with 10 unrelated admissions in the ESC group. Conclusions Adding IMT to the treatment received by children with ASD did not improve social affect or parent-assessed social responsiveness. Future work Other methods for delivering music-focused interventions for children with ASD should be explored. Trial registration Current Controlled Trials ISRCTN78923965. Funding This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 59. See the NIHR Journals Library website for further project information.
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Ramalingam, Sandeep, Catriona Graham, Katherine Oatey, Phillip Rayson, Andrew Stoddart, Aziz Sheikh, and Steve Cunningham. "Study protocol of the Edinburgh and Lothian Virus Intervention Study in Kids: a randomised controlled trial of hypertonic saline nose drops in children with upper respiratory tract infections (ELVIS Kids)." BMJ Open 11, no. 5 (May 2021): e049964. http://dx.doi.org/10.1136/bmjopen-2021-049964.
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IntroductionEdinburgh and Lothians’ Viral Intervention Study Kids is a parallel, open-label, randomised controlled trial of hypertonic saline (HS) nose drops (~2.6% sodium chloride) vs standard care in children <7 years of age with symptoms of an upper respiratory tract infection (URTI).Methods and analysisChildren are recruited prior to URTI or within 48 hours of developing URTI symptoms by advertising in areas such as local schools/nurseries, health centres/hospitals, recreational facilities, public events, workplaces, local/social media. Willing parents/guardians, of children <7 years of age will be asked to contact the research team at their local site. Children will be randomised to either a control arm (standard symptomatic care), or intervention arm (three drops/nostril of HS, at least four times a day, until 24 hours after asymptomatic or a maximum of 28 days). All participants are requested to provide a nasal swab at the start of the study (intervention arm: before HS drops) and then daily for four more days. Parent/guardian complete a validated daily diary, an end of illness diary, a satisfaction questionnaire and a wheeze questionnaire (day 28). The parent/guardian of a child in the intervention arm is taught to prepare HS nose drops. Parent/guardian of children asymptomatic at recruitment are requested to inform the research team within 48 hours of their child developing an URTI and follow the instructions already provided. The day 28 questionnaire determines if the child experienced a wheeze following illness. Participation in the study ends on day 28.Ethics and disseminationThe study has been approved by the West of Scotland Research Ethics Service (18/WS/0080). It is cosponsored by Academic and Clinical Central Office for Research and Development—a partnership between the University of Edinburgh and National Health Service Lothian Health Board. The findings will be disseminated through peer-reviewed publications, conference presentations and via the study website.Trial registration numberNCT03463694.
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Takens, Froukje E., Vincent Busch, Joanne K. Ujčič-Voortman, Manon van Eijsden, and Mai J. M. Chinapaw. "The Unique Extended Selection Cohorts Design for the Evaluation of the School-Based Jump-In Intervention on Dietary Habits: A Study Protocol." International Journal of Environmental Research and Public Health 17, no. 4 (February 11, 2020): 1145. http://dx.doi.org/10.3390/ijerph17041145.
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Background: To promote healthy dietary and physical activity behaviour among primary school children, the city of Amsterdam structurally implements the school-based Jump-in intervention in over half of its primary schools. Previously shown to be effective in stimulating physical activity and outside recess play, our study is the first to evaluate Jump-in’s effect on children’s dietary behaviour. Evaluating the effectiveness and implementation process of an intervention in a real-life setting requests an alternative study design. Methods: we chose a mixed-methods, quasi-experimental Extended Selection Cohorts design to evaluate Jump-in’s effectiveness and implementation process. Children and parents from the first ten primary schools that enrolled in the programme in 2016–2017 were invited to participate. The primary outcomes were children’s dietary behaviour and behavioural determinants, assessed by child and parent questionnaires, and photographs of the food and drinks children brought to school. Process indicators, contextual factors and satisfaction with the programme were assessed by interviews with health promotion professionals, school principals, school project coordinators, and teachers; focus group discussions with parents and children; and document analysis. Discussion: Conducting research in a real-life setting is accompanied by methodological challenges. Using an Extended Selection Cohorts design provides a valuable alternative when a Randomized Controlled design is not feasible.
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Watanabe, Junko, Mariko Watanabe, Kazue Yamaoka, Misa Adachi, Asuka Nemoto, and Toshiro Tango. "School-based lifestyle education involving parents for reducing subjective psychosomatic symptoms in Japanese adolescents: study protocol for a cluster randomised controlled trial." BMJ Open 8, no. 2 (February 2018): e018938. http://dx.doi.org/10.1136/bmjopen-2017-018938.
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IntroductionSevere subjective psychosomatic symptoms (SPS) in adolescents are a major public health concern, and lifestyle modification interventions for reducing SPS are important topics. Recently, we developed a school-based lifestyle education involving parents for reducing SPS of adolescents (SPRAT), an improved version of the programme from our previous study Programme for adolescent of lifestyle education in Kumamoto (PADOK). This study aimed to evaluate the effectiveness of SPRAT in reducing SPS among adolescents.Methods and analysisThis is a 6-month, cluster randomised clinical trial with two intervention arms (SPRAT vs usual school education). The study population will be composed of middle school students (aged 12–14 years) with their parents/guardians in Japan. SPRAT is expected to be a more powerful programme than PADOK as it reinforces the role of parent participation. The primary endpoint will be the change from baseline SPS scores to those obtained after 6 months. Between-group differences will be analysed following the intention-to-treat principle. Crude and multivariate adjusted effects will be examined using a general linear mixed-effects model for continuous variables and a logistic regression model for dichotomous variables. The sample size required was determined based on the information needed to detect a difference in the primary outcome with a significance level of 5% and power of 80% under the assumptions of 40 students per cluster (assuming the same sample size for each cluster), an effect size of 0.3 and an intraclass correlation coefficient of 0.02. In total, participation by 28 schools (14 schools in each arm) (students: n=1120) will be needed.Ethics and disseminationThis study was approved by the Medical Ethical Committee of Minami Kyushu University in 2017 (number 137). The findings will be disseminated widely through peer-reviewed publications and conference presentations.Trial registration numberUMIN000026715; Pre-results.
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Williamson, Victoria, Michael Larkin, Tessa Reardon, Samantha Pearcey, Claire Hill, Paul Stallard, Susan H. Spence, et al. "Codesign and development of a primary school based pathway for child anxiety screening and intervention delivery: a protocol, mixed-methods feasibility study." BMJ Open 11, no. 4 (April 2021): e044852. http://dx.doi.org/10.1136/bmjopen-2020-044852.
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IntroductionAnxiety difficulties are among the most common mental health problems in childhood. Despite this, few children access evidence-based interventions, and school may be an ideal setting to improve children’s access to treatment. This article describes the design, methods and expected data collection of the Identifying Child Anxiety Through Schools – Identification to Intervention (iCATS i2i) study, which aims to develop acceptable school-based procedures to identify and support child anxiety difficulties.Methods and analysisiCATS i2i will use a mixed-methods approach to codesign and deliver a set of procedures—or ‘pathway’—to improve access to evidence-based intervention for child anxiety difficulties through primary schools in England. The study will consist of four stages, initially involving in-depth interviews with parents, children, school staff and stakeholders (stage 1) to inform the development of the pathway. The pathway will then be administered in two primary schools, including screening, feedback to parents and the offer of treatment where indicated (stage 2), with participating children, parents and school staff invited to provide feedback on their experience (stages 3 and 4). Data will be analysed using Template Analysis.Ethics and disseminationThe iCATS i2i study was approved by the University of Oxford’s Research Ethics Committee (REF R64620/RE001). It is expected that this codesign study will lead on to a future feasibility study and, if indicated, a randomised controlled trial. The findings will be disseminated in several ways, including via lay summary report, publication in academic journals and presentation at conferences. By providing information on child, parent, school staff and other stakeholder’s experiences, we anticipate that the findings will inform the development of an acceptable evidence-based pathway for identification and intervention for children with anxiety difficulties in primary schools and may also inform broader approaches to screening for and treating youth mental health problems outside of clinics.
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Yap, Marie Bee Hui, Mairead C. Cardamone-Breen, Ronald M. Rapee, Katherine A. Lawrence, Andrew J. Mackinnon, Shireen Mahtani, and Anthony F. Jorm. "Medium-Term Effects of a Tailored Web-Based Parenting Intervention to Reduce Adolescent Risk of Depression and Anxiety: 12-Month Findings From a Randomized Controlled Trial." Journal of Medical Internet Research 21, no. 8 (August 15, 2019): e13628. http://dx.doi.org/10.2196/13628.
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Background Prevention of depression and anxiety disorders early in life is a global health priority. Evidence on risk and protective factors for youth internalizing disorders indicates that the family represents a strategic setting to target preventive efforts. Despite this evidence base, there is a lack of accessible, cost-effective preventive programs for parents of adolescents. To address this gap, we recently developed the Partners in Parenting (PiP) program—an individually tailored Web-based parenting program targeting evidence-based parenting risk and protective factors for adolescent depression and anxiety disorders. We previously reported the postintervention outcomes of a single-blinded parallel-group superiority randomized controlled trial (RCT) in which PiP was found to significantly improve self-reported parenting compared with an active-control condition (educational factsheets). Objective This study aimed to evaluate the effects of the PiP program on parenting risk and protective factors and symptoms of adolescent depression and anxiety using data from the final assessment time point (12-month follow-up) of this RCT. Methods Parents (n=359) and adolescents (n=332) were recruited primarily from secondary schools and completed Web-based assessments of parenting and adolescent depression and anxiety symptoms at baseline, postintervention (3 months later), and 12-month follow-up (317 parents, 287 adolescents). Parents in the PiP intervention condition received personalized feedback about their parenting and were recommended a series of up to 9 interactive modules. Control group parents received access to 5 educational factsheets about adolescent development and mental health. Both groups received a weekly 5-min phone call to encourage progress through their program. Results Intervention group parents completed an average of 73.7% of their intended program. For the primary outcome of parent-reported parenting, the intervention group showed significantly greater improvement from baseline to 12-month follow-up compared with controls, with a medium effect size (Cohen d=0.51; 95% CI 0.30 to 0.72). When transformed data were used, greater reduction in parent-reported adolescent depressive symptoms was observed in the intervention group (Cohen d=−0.21; 95% CI −0.42 to −0.01). Mediation analyses revealed that these effects were mediated by improvements in parenting (indirect effect b=−0.08; 95% CI −0.16 to −0.01). No other significant intervention effects were found for adolescent-reported parenting or adolescent depression or anxiety symptoms. Both groups showed significant reductions in anxiety (both reporters) and depressive (parent reported) symptoms. Conclusions PiP improved self-reported parenting for up to 9 months postintervention, but its effects on adolescent symptoms were less conclusive, and parent-reported changes were not perceived by adolescents. Nonetheless, given its scalability, PiP may be a useful low-cost, sustainable program to empower parents of adolescents. Trial Registration Australian Clinical Trials Registration Number (ACTRN): 12615000328572; http://www.anzctr.org.au/ACTRN12615000328572.aspx (Archived by WebCite at http://www.webcitation.org/6qgsZ3Aqj).
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Gibbons, Kathleen. "Moses, Statesman and Philosopher: The Philosophical Background of the Ideal of Assimilating to God and the Methodology of Clement of Alexandria’s Stromateis 1." Vigiliae Christianae 69, no. 2 (March 6, 2015): 157–85. http://dx.doi.org/10.1163/15700720-12341202.
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Clement’s so-called ‘eclectic’ style has long been noted by his modern readers, with several suggesting that this approach reflects his idea of Mosaic philosophy as having been scattered among the different philosophical traditions of his period. Here, I wish to argue that in his portrait of Moses in Strom. 1, Clement draws on Platonic and Stoic sources to provide a coherent picture of what it is to assimilate to God as a unification of the civic and contemplative lives. In doing so, Clement exploits actual historical connections between the two schools in using Stoicism as a hermeneutical lens through which to unify Plato’s dialogues, which themselves offer conflicting interpretations of the relationship between the statesman and the philosopher. This study also hopes to illuminate the ways in which conceptualizations of Judaism at times informed and controlled early Christian constructions of their relationship with pagan culture.
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Srihati Dyah Permatasari, Tjokronegoro, Advani Najib, and Firmansyah Agus. "Effectiveness of Probiotics in the Management of Functional Constipation in Children: A Randomized, Double-Blind, Placebo-Controlled Trial." International Journal of Probiotics and Prebiotics 15, no. 1 (January 21, 2020): 1–6. http://dx.doi.org/10.37290/ijpp2641-7197.15:1-6.
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A randomized, double-blind, placebo-controlled trial was conducted to assess the efficacy of probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) in 78 children aged 4–10 years old with functional constipation (Rome III criteria) at several schools in Jakarta, Indonesia. The case finding used a validated parent-report questionnaire. Subjects were randomly assigned to receive either oral probiotics (L. acidophilus, B. longum, and S. thermophylus 1 × 109 cfu/day) or placebo twice a day for 4 weeks. There were more subjects in the probiotics group who had improvement in stool consistency (P = 0.022) and difficulty/painful defecation (P = 0.009) than in the placebo group. Other symptoms (frequency of bowel movements, withholding behavior, fecal incontinence, and presence of stool mass in abdomen) also improved, but no statistically significant differences were found. Constipation severity significantly improved in the probiotics group (P = 0.026). Overall improvement (defined as decrease of constipation severity score >60% at the end of evaluation) was higher in the probiotics group than the placebo group (31/39 versus 18/39, P = 0.002) with number needed to treat (NNT) of 3 (95%CI 2;8). The present study shows that probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) are effective in the management of functional constipation in children.
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Al Agili, Dania E., and Hamisu M. Salihu. "Effectiveness of a School-Based Tobacco Prevention Program for Middle School Students in Saudi Arabia: A Quasi-Experimental Controlled Trial." Tobacco Use Insights 13 (January 2020): 1179173X2095340. http://dx.doi.org/10.1177/1179173x20953403.
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Objective: To evaluate the effect of a school-based tobacco program in preventing initiation of tobacco use among adolescents in Saudi Arabia. Methods: We used a quasi-experimental controlled design. Four intervention and four control schools were selected from the regional education registry. A baseline questionnaire was administered to all grade 7 students before implementing the tobacco prevention program, Dentists Fighting Nicotine Dependence (DFND). The intervention group (n =379) received the DFND program whereas the control group (n = 255) received the regular tobacco program administered by the Department of Education. The program was delivered by trained health educators over 5 weeks. Pre- and post-test surveys (immediate and 2-year post-intervention) were collected. Study outcomes were current tobacco use, tobacco knowledge, attitude towards not using tobacco, and perceived behavioral control (PBC) of tobacco use. Covariates included sex, parent education, academic performance, absenteeism, student allowance, and religiosity. Data were analyzed using a two-level hierarchical mixed models. Results: In the immediate post-test, 597 participants (intervention, n = 366; control, n = 231) were surveyed. There was no difference in tobacco use between intervention and control schools, however, the intervention group had significantly higher mean scores for knowledge (β = 1.27, SE = 0.27, P < .01) and attitude toward not using tobacco (β = 5.17, SE = 2.48, P < .05) after adjusting for covariates. At 2-year post-intervention, 463 participants (intervention, n = 289; control, n = 173) were surveyed. There were no differences in tobacco use, knowledge, attitude or PBC between intervention and control groups. Conclusions: Our program did not impact tobacco use. In the short-term, the program significantly improved knowledge and attitude towards not using tobacco. These effects decayed 2 years post-intervention without additional programming. Increasing the effectiveness of DFND may be achieved by expanding curriculum content and practice time throughout the school years and by targeting high-risk adolescents within the program.
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Farmer, Erin, Nicole Papadopoulos, Chloe Emonson, Ian Fuelscher, Caterina Pesce, Jane McGillivray, Christian Hyde, Lisa Olive, and Nicole Rinehart. "A Preliminary Investigation of the Relationship between Motivation for Physical Activity and Emotional and Behavioural Difficulties in Children Aged 8–12 Years: The Role of Autonomous Motivation." International Journal of Environmental Research and Public Health 17, no. 15 (August 3, 2020): 5584. http://dx.doi.org/10.3390/ijerph17155584.
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While motivation for physical activity (PA) and PA participation have been linked, research on the relationship between motivation for PA and mental health outcomes is scant, with studies involving children largely underrepresented. Grounded in self-determination theory, this cross-sectional study aimed to determine whether autonomous motivation versus external motivation (a form of controlled motivation) for PA is associated with fewer emotional and behavioural difficulties and higher levels of PA in children. A sample of 87 children (aged 8–12 years) were recruited from five primary schools in Victoria, Australia. An adapted version of the Behavioural Regulation in Exercise Questionnaire (BREQ) was used to measure motivation for PA and structured parent-report questions were used to assess moderate-to-vigorous PA (MVPA) levels. Parents also completed the Strengths and Difficulties Questionnaire (SDQ) to measure children’s emotional and behavioural difficulties. Children’s autonomous motivation was associated with fewer emotional and behavioural difficulties (β = −0.25, p = 0.038) and higher levels of MVPA (β = 0.24, p = 0.014). These results indicate autonomous motivation is associated with improved mental health outcomes and higher levels of PA in children. Thus, PA interventions that promote autonomous motivation may enhance children’s mental health compared to interventions that promote mainly controlled forms of motivation.
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Wyatt, Katrina, Jenny Lloyd, Siobhan Creanor, Colin Green, Sarah G. Dean, Melvyn Hillsdon, Charles Abraham, et al. "Cluster randomised controlled trial and economic and process evaluation to determine the effectiveness and cost-effectiveness of a novel intervention [Healthy Lifestyles Programme (HeLP)] to prevent obesity in school children." Public Health Research 6, no. 1 (January 2018): 1–204. http://dx.doi.org/10.3310/phr06010.
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BackgroundApproximately one-third of children in England leave primary school overweight or obese. There is little evidence of effective obesity prevention programmes for children in this age group.ObjectiveTo determine the effectiveness and cost-effectiveness of a school-based healthy lifestyles programme in preventing obesity in children aged 9–10 years.DesignA cluster randomised controlled trial with an economic and process evaluation.SettingThirty-two primary schools in south-west England.ParticipantsChildren in Year 5 (aged 9–10 years) at recruitment and in Year 7 (aged 11–12 years) at 24 months’ post-baseline follow-up.InterventionThe Healthy Lifestyles Programme (HeLP) ran during the spring and summer terms of Year 5 into the autumn term of Year 6 and included four phases: (1) building a receptive environment, (2) a drama-based healthy lifestyles week, (3) one-to-one goal setting and (4) reinforcement activities.Main outcome measuresThe primary outcome measure was body mass index (BMI) standard deviation score (SDS) at 24 months post baseline measures (12 months post intervention). The secondary outcomes comprised waist circumference SDS, percentage body fat SDS, proportion of children overweight and obese at 18 and 24 months, accelerometer-assessed physical activity and food intake at 18 months, and cost-effectiveness.ResultsWe recruited 32 schools and 1324 children. We had a rate of 94% follow-up for the primary outcome. No difference in BMI SDS was found at 24 months [mean difference –0.02, 95% confidence interval (CI) –0.09 to 0.05] or at 18 months (mean difference –0.02, 95% CI –0.08 to 0.05) between children in the intervention schools and children in the control schools. No difference was found between the intervention and control groups in waist circumference SDS, percentage body fat SDS or physical activity levels. Self-reported dietary behaviours showed that, at 18 months, children in the intervention schools consumed fewer energy-dense snacks and had fewer negative food markers than children in the control schools. The intervention effect on negative food markers was fully mediated by ‘knowledge’ and three composite variables: ‘confidence and motivation’, ‘family approval/behaviours and child attitudes’ and ‘behaviours and strategies’. The intervention effect on energy-dense snacks was partially mediated by ‘knowledge’ and the same composite variables apart from ‘behaviours and strategies’. The cost of implementing the intervention was approximately £210 per child. The intervention was not cost-effective compared with control. The programme was delivered with high fidelity, and it engaged children, schools and families across the socioeconomic spectrum.LimitationsThe rate of response to the parent questionnaire in the process evaluation was low. Although the schools in the HeLP study included a range of levels of socioeconomic deprivation, class sizes and rural and urban settings, the number of children for whom English was an additional language was considerably lower than the national average.ConclusionsHeLP is not effective or cost-effective in preventing overweight or obesity in children aged 9–10 years.Future workOur very high levels of follow-up and fidelity of intervention delivery lead us to conclude that it is unlikely that school-based programmes targeting a single age group can ever be sufficiently intense to affect weight status. New approaches are needed that affect the school, the family and the wider environment to prevent childhood obesity.Trial registrationCurrent Controlled Trials ISRCTN15811706.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. 1. See the NIHR Journals Library website for further project information.
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Emilda, Febriani, Carla Machira, and Abdul Wahab. "The familiarity of parents-teenagers and depressed high school adolescents in the city of Yogyakarta." Berita Kedokteran Masyarakat 32, no. 10 (October 1, 2016): 379. http://dx.doi.org/10.22146/bkm.8184.
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Familiarity of teens-parents and high school teenagers with incidence of depression in Yogyakarta CityPurposeThis study aimed to determine the differences in the incidence of depression in high school teenagers who are familiar and not familiar with their parents in Yogyakarta City.MethodsThis research was a cross-sectional study, involving 200 high school teenagers in Yogyakarta city and conducted in five high schools in Yogyakarta city. The independent variable was familiarity of parent-teens, the dependent variable was teenager depression and external variables were gender, parental employment status, and socioeconomic status. Data analysis included univariable, and bivariable analysis with Chi-square tests, to determine the strength of the relationship between independent and dependent variable and multivariable analysis with logistic regression tests.ResultsBivariable analysis showed a significant correlation between familiarity of parent-teens with teenagers’ depression. Teenagers who were not familiar with their parents were potentially 3.7 times more likely to get depressed than teenagers who were familiar with their parents. Multivariable analysis showed that there was a significant relationship between parental familiarity with teenagers’ depression when controlled for the variable of gender. Teenagers who are not familiar with their parents and female gender have 7.6 times greater potential to become depressed than teenagers who are familiar with their parents and male gender.ConclusionThe incidence of depression in high school teenagers who are not familiar with their parents was higher than teenagers who are familiar with their parents.
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Geller, Karly S., Margaret J. Melbye, Richard R. Rosenkranz, Candice Shoemaker, and David A. Dzewaltowski. "Measuring Elementary-aged Children’s Self-efficacy and Proxy Efficacy for Gardening and Related Health Behaviors." HortTechnology 25, no. 6 (December 2015): 731–41. http://dx.doi.org/10.21273/horttech.25.6.731.
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After-school garden programs may be an effective setting to reach school-age children to promote nutritious diets and physical activity, while reducing sedentary behavior. The current analyses drew data from Project PLANTS (i.e., promoting lifelong activity and nutrition through schools), an after-school randomized controlled trial focusing on the prevention of obesity among children through garden clubs. The purpose of the current study was to evaluate the psychometric properties of a scale measuring children’s self-efficacy and proxy efficacy within the after-school, gardening context. In addition to children’s garden self-efficacy, measurement scales for gardening, physical activity, and fruit and vegetable proxy efficacy were also examined. Proxy efficacy was defined as children’s confidence that they have the skills and abilities to get their parent to provide behavior-specific opportunities. Participants (N = 969) were fourth grade students (n = 611; age 9.4 years, sd = 0.6; 63% white, 50% female) and fifth grade students (n = 358; age 10.4 years, sd = 0.6; 57% white, 54% female) attending eight elementary schools. Exploratory factor analysis (EFA) (n = 484), confirmatory factor analysis (CFA) (n = 485), multigroup invariance, and tests to examine the sensitivity in detecting expected mean differences determined scale construct and criterion validity. The measurement model included five constructs: garden self-efficacy (seven items), garden barrier self-efficacy (four items), parent-directed proxy efficacy for physical activity opportunities (six items), fruit and vegetable availability (seven items), and opportunities to garden (four items). The five-factor model fit the data well [comparative fit index (CFI) = 0.958], demonstrating factor determinacy coefficients ≥0.940. Tests of invariance (equal form, factor loadings, and indicator intercepts) were acceptable between genders [change in CFI (ΔCFI) = 0.000], fourth and fifth graders (ΔCFI = 0.000), and normal and overweight/obese weight status children (ΔCFI = 0.000). Females had greater garden self-efficacy, garden barrier self-efficacy, garden proxy efficacy, and fruit and vegetable proxy efficacy. The current measurement model demonstrated good factorial validity, confirming the unbiased generalizability across gender, grade level, and body mass index subgroups. Further validation is suggested in additional populations and across time points.
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Véronneau, Marie-Hélène, Thomas J. Dishion, Arin M. Connell, and Kathryn Kavanagh. "A randomized, controlled trial of the family check-up model in public secondary schools: Examining links between parent engagement and substance use progressions from early adolescence to adulthood." Journal of Consulting and Clinical Psychology 84, no. 6 (June 2016): 526–43. http://dx.doi.org/10.1037/a0040248.
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Lee, Si Xian Jasmine, Tracy Burrows, Serene Yoong, and Rebecca Wyse. "Association of parental investment of time and cost in food provisioning with adherence to dietary guidelines for the consumption of fruits, vegetables and non-core foods in pre-schoolers." Public Health Nutrition 21, no. 13 (June 1, 2018): 2434–42. http://dx.doi.org/10.1017/s1368980018001465.
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AbstractObjectiveTo assess whether parent-reported time and cost for provision of food is associated with consumption of fruits, vegetables and non-core foods in pre-schoolers.DesignCross-sectional analysis of baseline data from the Healthy Habits randomised controlled trial. Two subscales of the Children’s Dietary Questionnaire (CDQ) were used to assess fruit and vegetable, and non-core food consumption.SettingThirty pre-schools in the Hunter Region of New South Wales, Australia.SubjectsParents (n 396) with a child aged 3–5 years attending a participating pre-school were recruited. Parents needed to reside with that child for at least four days per week and have primary responsibility for providing meals and snacks to their child.ResultsSixty-three per cent of children had a parent-reported subscale score indicating adherence to dietary guidelines for fruit and vegetable intake, while 64% of children had a subscale score indicating they were exceeding dietary guidelines for non-core foods. Regression models revealed significant positive associations between higher CDQ scores for non-core foods (indicating higher consumption levels) and minutes that parents spent preparing food (P=0·032 and 0·025) and amount spent on purchasing food (P=0·043 and 0·020). The magnitude of the effects was small (estimate=0·003 and 0·001).ConclusionsTime and cost spent by parents on provision of food was not significantly associated with child fruit and vegetable consumption. Further explorations into time spent on food preparation and cost of food procurement are warranted to help address the increased consumption of non-core foods by pre-school children.
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Haerens, Leen, Ilse De Bourdeaudhuij, Lea Maes, Carine Vereecken, Johannes Brug, and Benedicte Deforche. "The effects of a middle-school healthy eating intervention on adolescents' fat and fruit intake and soft drinks consumption." Public Health Nutrition 10, no. 5 (May 2007): 443–49. http://dx.doi.org/10.1017/s1368980007219652.
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AbstractObjectivesTo evaluate the effects of a middle-school healthy eating promotion intervention combining environmental changes and computer-tailored feedback, with and without an explicit parent involvement component.DesignClustered randomised controlled trial.SettingFifteen West-Flemish (Belgian) middle schools.SubjectsA random sample of 15 schools with 2991 pupils in 7th and 8th grades was randomly assigned to an intervention group with parental support (n = 5), an intervention group without parental support (n = 5) and a control group (n = 5). In these 15 schools an intervention combining environmental changes with computer-tailored feedback was implemented. Fat and fruit intake, water and soft drinks consumption were measured with food-frequency questionnaires in the total sample of children.ResultsIn girls, fat intake and percentage of energy from fat decreased significantly more in the intervention group with parental support, compared with the intervention alone group (all F>3.9, P < 0.05) and the control group (all F>16.7, P < 0.001). In boys, there were no significant decreases in fat intake (F = 1.4, not significant (NS)) or percentage of energy from fat (F = 0.7, NS) as a result of the intervention. No intervention effects were found in boys or in girls for fruit (F = 0.5, NS), soft drinks (F = 2.6, NS) and water consumption (F = 0.3, NS).ConclusionsCombining physical and social environmental changes with computer-tailored feedback in girls and their parents can induce lower fat intake in middle-school girls. However, to have an impact on the consumption of soft drinks and water, governmental laws that restrict the at-school availability of low-nutritive products may be necessary.
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Lawlor, Debbie A., Ruth R. Kipping, Emma L. Anderson, Laura D. Howe, Catherine R. Chittleborough, Aida Moure-Fernandez, Sian M. Noble, et al. "Active for Life Year 5: a cluster randomised controlled trial of a primary school-based intervention to increase levels of physical activity, decrease sedentary behaviour and improve diet." Public Health Research 4, no. 7 (June 2016): 1–156. http://dx.doi.org/10.3310/phr04070.
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BackgroundPrevious studies of the effect of school-based interventions to improve healthy behaviours have had important limitations.ObjectiveTo investigate the effectiveness of a school-based intervention to increase physical activity, reduce sedentary behaviour and increase fruit and vegetable consumption.DesignCluster randomised controlled trial.SettingSixty English primary schools.ParticipantsChildren in year 4 (aged 8–9 years) at recruitment, year 5 (aged 9–10 years) during the intervention and immediate follow-up and year 6 (aged 10–11 years) during 1 year of follow-up.InterventionActive for Life Year 5 (AFLY5) included teacher training, lesson plans, materials for 16 lessons, parent-interactive homework and written materials for school newsletters and parents.Main outcome measuresPrimary outcome measures included accelerometer-assessed levels of physical activity and sedentary behaviour, and child-reported consumption of fruit and vegetables. Secondary outcome measures included child-reported screen viewing; consumption of snacks, high-fat food and high-energy drinks; body mass index; and waist circumference.ResultsWe recruited 60 schools (2221 children). At the immediate follow-up, no difference was found between children in intervention and control schools for any of the three primary outcomes. The intervention was effective on three of the nine secondary outcomes; children in intervention schools reported spending less time screen viewing at weekends [–21 minutes per day, 95% confidence interval (CI) –37 to –4 minutes per day], eating fewer servings of snacks per day (–0.22, 95% CI –0.38 to –0.05 servings of snacks per day) and drinking fewer servings of high-energy drinks per day (–0.26, 95% CI –0.43 to –0.10 servings of high-energy drinks per day) than the children in control schools. The results remained consistent 1 year later. The intervention increased children’s perception of maternal efforts to limit the time they spent screen viewing and children’s knowledge about healthy physical activity and fruit and vegetable consumption, with these two mediators explaining approximately one-quarter of the effect of the intervention on screen viewing. The intervention did not affect other mediators. The cost of implementing the intervention from a provider perspective was approximately £18 per child. Process evaluation showed that AFLY5 was implemented with a high degree of fidelity. Teachers supported the aims of AFLY5, but their views of the programme itself were mixed.LimitationsResponses to parental questionnaires for the economic evaluation were low and we struggled to engage all teachers for the process evaluation. Although the participating schools included a range of levels of socioeconomic deprivation, class sizes and rural and urban settings, we cannot assume that results generalise to all primary schools.ConclusionsAFLY5 is not effective at increasing levels of physical activity, reducing sedentary behaviour and increasing fruit and vegetable consumption in primary school children, but may be effective in reducing time spent screen viewing at weekends and the consumption of snacks and high-energy drinks.Future workOur findings suggest that school-based interventions are unlikely to have a major impact on promoting healthy levels of physical activity and healthy diets in primary school children. We would recommend trials of the effect and cost-effectiveness of more intensive family and community interventions.Trial registrationCurrent Controlled Trials ISRCTN50133740.FundingThis project was funded by the National Institute for Health Research Public Health Research programme and will be published in full inPublic Health Research; Vol. 4, No. 7. See the NIHR Journals Library website for further project information.
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Meiring, James E., Rodrick Sambakunsi, Elvis Moyo, Theresa Misiri, Felistas Mwakiseghile, Pratiksha Patel, Priyanka Patel, et al. "Community Engagement Before Initiation of Typhoid Conjugate Vaccine Trial in Schools in Two Urban Townships in Blantyre, Malawi: Experience and Lessons." Clinical Infectious Diseases 68, Supplement_2 (March 7, 2019): S146—S153. http://dx.doi.org/10.1093/cid/ciy1110.
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Abstract Background To determine the efficacy of a new typhoid conjugate vaccine in an endemic setting in sub-Saharan Africa, the Typhoid Vaccine Acceleration Consortium is conducting a phase-3 randomized controlled trial in Blantyre, Malawi. This article describes community and stakeholder engagement activities before and during the trial, challenges, and lessons learned. Methods In October 2017, Malawi-Liverpool Wellcome Trust (MLW) organized a wide range of community engagement activities, including meetings with Ministry of Health and Education officials at the district and facility level, local community leadership, and parent teacher association groups. We engaged media outlets to include local and international television, radio, and print media. Community members were informed directly through a study jingle played via loudspeaker from a van and by community-based activities. To review engagement activity effectiveness: The MLW team met to discuss progress and challenges; and a focus group discussion (FGD), consisting of trial staff, sought feedback from the community on each engagement modality. Results The school-based vaccine campaign increased community participation exceeding recruitment targets to date (on average, >200 children/day). Conclusions The FGD concluded that the van and local activities improved awareness and turnout for the trial, but prior engagement with local government and community leadership is an essential mechanism to provide details of the study, answer questions, communicate the value of the study, and address safety concerns. Effective community engagement is essential in a large intervention trial. Multiple channels of communication are required to reach the community and deliver information needed for participation and provide opportunity for dialogue with the trial team.
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Regalla, Maria Angélica Rates, Daniel Segenreich, Priscilla Rodrigues Guilherme, and Paulo Mattos. "Resilience levels among adolescents with ADHD using quantitative measures in a family-design study." Trends in Psychiatry and Psychotherapy 41, no. 3 (September 2019): 262–67. http://dx.doi.org/10.1590/2237-6089-2018-0068.
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Abstract Objectives To investigate resilience levels in adolescents with attention-deficit hyperactivity disorder (ADHD) using quantitative measures when compared to their non-affected siblings and controls. We also aimed to investigate the correlation between resilience and depression, anxiety, intelligence quotient (IQ) and socioeconomic status, which may affect resilience levels and be potential confounders. Methods Adolescents (n=45) diagnosed with ADHD referred to an outpatient ADHD clinic, and their siblings without ADHD (n=27), with ages ranging from 12 to 17 years, were interviewed along with their parents using a semi-structured interview (Children’s Interview for Psychiatric Syndromes - Parent Version). Intelligence was measured with the Block Design and Vocabulary subtests from the Wechsler Battery. Anxiety and depression were investigated using the Children State-Trait Anxiety Inventory (CSTAI) and the Child Depression Inventory (CDI), respectively. Resilience was investigated using the Resilience Scale. A control group (typically developing adolescents [TDA] and their siblings; n=39) was recruited in another outpatient facility and at two schools using the same methodology. Results Socioeconomic status and intelligence levels, which may affect resilience, were similar in all groups. Adolescents with ADHD showed lower resilience levels compared to siblings and TDA even when controlled for anxiety and depression levels, which were higher in ADHD. Resilience levels were higher in siblings than in adolescents with ADHD, and lower than in TDA – this last result without statistical significance. Conclusion In our sample, ADHD in adolescents was associated with lower resilience, even when controlled for confounders often seen in association with the disorder.
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Bergee, Martin J., and Kevin M. Weingarten. "Multilevel Models of the Relationship Between Music Achievement and Reading and Math Achievement." Journal of Research in Music Education 68, no. 4 (August 5, 2020): 398–418. http://dx.doi.org/10.1177/0022429420941432.
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We used multilevel mixed modeling to test the extent to which students’ music achievement scores were related to their reading and math achievement scores. Of the four levels examined (individual students, classrooms, schools, and districts), only individuals and districts accounted for a significant portion of the total variance in achievement scores. We studied several background variables potentially affecting academic achievement among individuals: grade level, gender, educational attainment of parents/guardians, free/reduced-price lunch, ethnicity, and urbanicity. We also incorporated district-level variables of sex, ethnicity, parent/guardian education level, and free/reduced-price lunch along with principal component scores for four district-level latent variables—district achievement, district behavior, available funds, and local revenue. Fourth through eighth graders ( N = 1,081) from seven midwestern school districts participated in the study. Students sat for a representative portion of the first two of the Music Achievement Tests (MAT-1 and MAT-2). We developed separate models for reading and math achievement. No significant differences were found among the districts’ intercepts or slopes. With the aforementioned variables controlled for, both MAT-1 and MAT-2 (controlling for one another as well) demonstrated a strong relationship with reading and math achievement ( ps < .0001).
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Ponsford, Ruth, Sara Bragg, Elizabeth Allen, Nerissa Tilouche, Rebecca Meiksin, Lucy Emmerson, Laura Van Dyck, et al. "A school-based social-marketing intervention to promote sexual health in English secondary schools: the Positive Choices pilot cluster RCT." Public Health Research 9, no. 1 (January 2021): 1–190. http://dx.doi.org/10.3310/phr09010.
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Background The UK still has the highest rate of teenage births in western Europe. Teenagers are also the age group most likely to experience unplanned pregnancy, with around half of conceptions in those aged < 18 years ending in abortion. After controlling for prior disadvantage, teenage parenthood is associated with adverse medical and social outcomes for mothers and children, and increases health inequalities. This study evaluates Positive Choices (a new intervention for secondary schools in England) and study methods to assess the value of a Phase III trial. Objectives To optimise and feasibility-test Positive Choices and then conduct a pilot trial in the south of England assessing whether or not progression to Phase III would be justified in terms of prespecified criteria. Design Intervention optimisation and feasibility testing; pilot randomised controlled trial. Setting The south of England: optimisation and feasibility-testing in one secondary school; pilot cluster trial in six other secondary schools (four intervention, two control) varying by local deprivation and educational attainment. Participants School students in year 8 at baseline, and school staff. Interventions Schools were randomised (1 : 2) to control or intervention. The intervention comprised staff training, needs survey, school health promotion council, year 9 curriculum, student-led social marketing, parent information and review of school/local sexual health services. Main outcome measures The prespecified criteria for progression to Phase III concerned intervention fidelity of delivery and acceptability; successful randomisation and school retention; survey response rates; and feasible linkage to routine administrative data on pregnancies. The primary health outcome of births was assessed using routine data on births and abortions, and various self-reported secondary sexual health outcomes. Data sources The data sources were routine data on births and abortions, baseline and follow-up student surveys, interviews, audio-recordings, observations and logbooks. Results The intervention was optimised and feasible in the first secondary school, meeting the fidelity targets other than those for curriculum delivery and criteria for progress to the pilot trial. In the pilot trial, randomisation and school retention were successful. Student response rates in the intervention group and control group were 868 (89.4%) and 298 (84.2%), respectively, at baseline, and 863 (89.0%) and 296 (82.0%), respectively, at follow-up. The target of achieving ≥ 70% fidelity of implementation of essential elements in three schools was achieved. Coverage of relationships and sex education topics was much higher in intervention schools than in control schools. The intervention was acceptable to 80% of students. Interviews with staff indicated strong acceptability. Data linkage was feasible, but there were no exact matches for births or abortions in our cohort. Measures performed well. Poor test–retest reliability on some sexual behaviour measures reflected that this was a cohort of developing adolescents. Qualitative research confirmed the appropriateness of the intervention and theory of change, but suggested some refinements. Limitations The optimisation school underwent repeated changes in leadership, which undermined its participation. Moderator analyses were not conducted as these would be very underpowered. Conclusion Our findings suggest that this intervention has met prespecified criteria for progression to a Phase III trial. Future work Declining prevalence of teenage pregnancy suggests that the primary outcome in a full trial could be replaced by a more comprehensive measure of sexual health. Any future Phase III trial should have a longer lead-in from randomisation to intervention commencement. Trial registration Current Controlled Trials ISRCTN12524938. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 1. See the NIHR Journals Library website for further project information.
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Connolly, Paul, Sarah Miller, Frank Kee, Seaneen Sloan, Aideen Gildea, Emma McIntosh, Nicole Boyer, and Martin Bland. "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." Public Health Research 6, no. 4 (March 2018): 1–108. http://dx.doi.org/10.3310/phr06040.
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Background There 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 outcomes To 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. Design A 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 participants The intervention schools delivered ROE to their Year 5 children (aged 8–9 years) as a whole class. Intervention ROE 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. Results Although 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. Conclusions These 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 registration Current Controlled Trials ISRCTN07540423. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 4. See the NIHR Journals Library website for further project information.
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Davis, Jaimie, Katie Nikah, Fiona Asigbee, Matthew Landry, Sarvenaz Vandyousefi, Amy Hoover, Matthew Jeans, et al. "TX Sprouts: A School-Based Cluster Randomized Gardening, Nutrition, and Cooking Intervention: Effects on Obesity, Blood Pressure and Diet." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1296. http://dx.doi.org/10.1093/cdn/nzaa059_013.
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Abstract Objectives To assess the effects of a one-year school-based gardening, nutrition, and cooking cluster randomized controlled trial, called TX Sprouts, on dietary intake, obesity markers, and blood pressure. Methods Sixteen schools were randomly assigned to either the TX Sprouts intervention (n = 8 school) or to delayed intervention (n = 8 schools). The intervention arm received: formation/training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly during school hours; and nine parent lessons. The delayed intervention received the same protocol one year later. Primary child outcomes were measured at baseline and after one school year included: changes in dietary intake (fruit and vegetables servings via screener), height, weight, waist circumference, body composition, and blood pressure. Ten multiple imputations and generalized linear mixed models with schools as the random cluster were used to assess differences in changes in primary outcomes between intervention and control groups. Results Of the 4239 eligible students, 3135 (74%) of students consented and completed baseline clinical measures and child surveys. Participants were 47.4% male and average age was 9.2 years. Approximately 64% were Hispanic, and 69% were economically disadvantaged with attendance to TX Sprouts lessons was 95% of the intervention children. Ninety-one % of children completed both pre and post measures. Intervention group compared to control group resulted in increases, mean change (SE), in vegetable intake [+0.33(0.13) vs. 0.03(0.11) serv/d; P = 0.003]. There was a significant race/ethnicity by sex interaction (P = 0.01) for diastolic blood pressure, with Hispanic males in the intervention group compared to Hispanic males in the control group having reductions in diastolic blood pressure [−2.5(1.0) vs. +0.8(1.10) Hg/mm; P = 0.021). There was no effect of the intervention on any of the obesity parameters. Conclusions The TX Sprouts intervention targets the school nutrition environment, and may provide a sustainable approach to increase vegetable intake and reduce blood pressure in low-income, primarily Hispanic children. Funding Sources NIH/NHLBI (1R01HL123865, 2015-2020), Whole Kids Foundation, Home Depot, Sprouts Healthy Communities Foundation.
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Jovanovic, Veljko, Snezana Smederevac, and Snezana Tovilovic. "Influence of environmental factors on intellectual efficiency of pre-school children." Zbornik Instituta za pedagoska istrazivanja 41, no. 2 (2009): 511–25. http://dx.doi.org/10.2298/zipi0902511j.
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The basic goal of this research was to study the influence of environmental factors on intellectual efficiency of pre-school children. Research participants were 149 children (52 Roma, 48 non-Roma children of average socioeconomic status and 49 children of low socioeconomic status), of the average age of 81 months. Data were collected during maturity evaluation for school in primary schools in Sabac and Sremska Mitrovica. Children's intellectual abilities were assessed by the School Maturity Test, and the data on socioeconomic status and educational climate were obtained from parents, by administering the Questionnaire for collecting data about the child and the family and Interview with the parent. Results of covariance analysis indicated that the quality of stimulation, parental ambitions and financial status of the family have the biggest effect on intellectual achievement of children. Poorer cognitive efficiency is demonstrated by children who grow up in poverty and non-stimulative environment, and whose parents have low ambitions regarding their child's education. When these variables are controlled, there are no differences between groups in either of cognitive functions. The abilities of visual and motor coordination and attention proved out to be the most sensitive to the influences of environmental factors. The results indicate that environmental factors have a pervasive effect, since, besides the influence on manipulative abilities, they also determine achievement on tests used to estimate verbal abilities.
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Stallard, Paul, Elena Skryabina, Gordon Taylor, Rob Anderson, Obioha C. Ukoumunne, Harry Daniels, Rhiannon Phillips, and Neil Simpson. "A cluster randomised controlled trial comparing the effectiveness and cost-effectiveness of a school-based cognitive–behavioural therapy programme (FRIENDS) in the reduction of anxiety and improvement in mood in children aged 9/10 years." Public Health Research 3, no. 14 (November 2015): 1–88. http://dx.doi.org/10.3310/phr03140.
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BackgroundAnxiety in children is common, impairs everyday functioning and increases the risk of severe mental health disorders in adulthood, yet few children with anxiety are identified and referred for treatment.ObjectiveTo investigate the clinical effectiveness and cost-effectiveness of a universal school-based preventative programme (FRIENDS) in reducing symptoms of anxiety and low mood.DesignCluster randomised controlled trial. Schools (n = 41) were randomly assigned after recruitment on a 1 : 1 : 1 basis to health-led FRIENDS, school-led FRIENDS and usual school provision.SettingPrimary schools in three local education authorities in the south-west of England.ParticipantsChildren (n = 1362) aged 9–10 years attending school and participating in personal, social and health education (PSHE).InterventionsThe FRIENDS programme is a cognitive–behavioural therapy programme that develops skills to counter the cognitive, emotional and behavioural aspects of anxiety. The FRIENDS programme was led by either a trained member of the school or a health leader external to the school and was delivered over 9 consecutive weeks. The comparison group received usual school PSHE lessons. Interventions were delivered in the academic year September 2011–July 2012.Main outcome measuresClinical effectiveness assessed by child report of symptoms of anxiety (Revised Child Anxiety and Depression Scale, RCADS); cost-effectiveness based on RCADS and quality-adjusted life-years (Child Health Utility 9 Dimensions, CHU-9D) between baseline and 6 months; process evaluation, evaluation of reach and attrition and qualitative feedback from children, school staff and parents.ResultsAt 12 months there was a difference in the adjusted mean RCADS scores for health-led FRIENDS compared with school-led FRIENDS [–3.91, 95% confidence interval (CI) –6.48 to –1.35] and for health-led FRIENDS compared with usual school provision (–2.66, 95% CI –5.22 to –0.09). At 24 months we were able to assess only 43.6% of our cohort. There were few differences in baseline characteristics between completers and non-completers. Child-reported anxiety in all three groups had reduced by 24 months and there were no longer any group effects. There were no between-group effects for any parent- or child-completed secondary outcomes at 12 or 24 months. The cost of the FRIENDS programme was £52–56 per child. We found no evidence that the FRIENDS programme was cost-effective over a 6-month period; however, our subgroup for the economic analysis differed significantly from our main trial cohort.ConclusionsAlthough greater reductions in anxiety were noted at 12 months when the FRIENDS programme was delivered by health leaders, these additional benefits were not maintained at 24 months. Children’s anxiety levels improved irrespective of the intervention that they received. Our economic evaluation and 24-month assessment had significant shortcomings. However, the universal delivery of specific anxiety prevention programmes will result in additional costs that may be beyond the finances available to most schools. Future work should identify the active ingredients and potential moderators of universal anxiety programmes to determine whether programme length can be reduced, short-term effectiveness maintained and cost-effectiveness improved. At present, our results find limited evidence to support the universal provision of specific anxiety prevention programmes in UK primary schools.Trial registrationCurrent Controlled Trials ISRCTN23563048.FundingThe National Institute for Health Research Public Health Research programme.
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Schwartz, Christine, Jenny Lou Barican, Donna Yung, Yufei Zheng, and Charlotte Waddell. "Six decades of preventing and treating childhood anxiety disorders: a systematic review and meta-analysis to inform policy and practice." Evidence Based Mental Health 22, no. 3 (July 17, 2019): 103–10. http://dx.doi.org/10.1136/ebmental-2019-300096.
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QuestionAnxiety disorders are the most prevalent childhood mental disorders. They also start early and persist, causing high individual and collective costs. To inform policy and practice, we therefore asked: What is the best available research evidence on preventing and treating these disorders?MethodsWe sought randomised controlled trials (RCTs) evaluating interventions addressing anxiety problems in young people. We identified RCTs by searching CINAHL, ERIC, MEDLINE, PsycINFO and Web of Science. Thirty-three RCTs met inclusion criteria—evaluating 8 prevention programmes, 12 psychosocial treatments and 7 pharmacological treatments. We then conducted meta-analyses by intervention type.FindingsFor prevention, the cognitive-behavioural therapy (CBT) programme Coping and Promoting Strength stood out for reducing anxiety diagnoses. For psychosocial treatment, 9 CBT interventions also reduced diagnoses: Cool Kids; Cool Little Kids Plus Social Skills; Coping Cat; Coping Koala; One-Session Treatment; Parent Education Program; Skills for Academic and Social Success; Strongest Families and Timid to Tiger. Successful CBT interventions were used with children ranging from pre-schoolers to teens in homes, communities/schools and clinics. For pharmacological treatment, selective-serotonergic-reuptake-inhibitors (SSRIs) significantly improved symptoms. Fluoxetine stood out for also reducing post-test diagnoses, but caused adverse events. Meta-analyses indicated strongest effects for CBT (Log OR=0.95; 95% CI, 0.69 to 1.21) and SSRI treatments (1.57; 1.09 to 2.06).ConclusionsCBT is effective for preventing and treating childhood anxiety—across a range of ages and formats. Fluoxetine is also an effective treatment but side effects must be managed. CBT prevention and treatment interventions should be made widely available, adding fluoxetine in severe cases.
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Cherewick, Megan, Sarah Lebu, Christine Su, and Ronald E. Dahl. "An Intervention to Enhance Social, Emotional, and Identity Learning for Very Young Adolescents and Support Gender Equity: Protocol for a Pragmatic Randomized Controlled Trial." JMIR Research Protocols 9, no. 12 (December 31, 2020): e23071. http://dx.doi.org/10.2196/23071.
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Background The onset of puberty is a pivotal period of human development that is associated with significant changes in cognitive, social, emotional, psychological, and behavioral processes that shape identity formation. Very early adolescence provides a critical opportunity to shape identity formation around gender norms, attitudes, and beliefs before inequitable gender norms are amplified during and after puberty. Objective The aim of the Discover Learning Project is to integrate strategic insights from developmental science to promote positive transformation in social, emotional, and gender identity learning among 10- to 11-year-olds in Tanzania. Through a pragmatic randomized controlled trial, the intervention scaffolds the development of critical social and emotional mindsets and skills (curiosity, generosity, persistence, purpose, growth mindset, and teamwork) delivered by conducting 18 after-school, technology-driven, experiential learning sessions in small, mixed-gender groups. Methods The Discover Learning Intervention is a 3-arm randomized controlled trial that will be delivered to 579 participants selected from four public primary schools in Temeke District, Dar es Salaam, Tanzania. Randomization will be done at the individual level into 3 treatment groups receiving incremental intervention components. The treatment components include Discover Learning content curated into child-friendly videos, facilitated discussions, and a parent-child workbook, to be implemented over two phases, each 6 weeks long. A baseline survey will be administered to participants and their parents prior to the intervention. The process will be observed systematically, and data will be collected using surveys, in-depth interviews, observations, and focus group discussions with adolescents, parents, teachers, and facilitators conducted prior, during, and after each implementation phase. Results This study builds on formative and pilot studies conducted with the target population to inform the design of the intervention. The results will generate new evidence that will inform strategies for achieving scale in Tanzania and provide insights for replication of similar programs that are invested in gender-transformative interventions in peri-urban, low-resource settings. Conclusions The Discover Learning Intervention makes an important contribution to the field of adolescent developmental science as an intervention designed for very young adolescents in a low-resource setting. Trial Registration ClinicalTrials.gov NCT04458077; https://clinicaltrials.gov/ct2/show/NCT04458077 International Registered Report Identifier (IRRID) DERR1-10.2196/23071
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Sotos-Prieto, Mercedes, Gloria Santos-Beneit, Stuart Pocock, Juliana Redondo, Valentín Fuster, and José L. Peñalvo. "Parental and self-reported dietary and physical activity habits in pre-school children and their socio-economic determinants." Public Health Nutrition 18, no. 2 (April 3, 2014): 275–85. http://dx.doi.org/10.1017/s1368980014000330.
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AbstractObjectiveTo assess the agreement between self-reported and parent-reported dietary and physical activity habits in children; and to evaluate the socio-economic determinants of healthier habits (Mediterranean diet and physical activity) among children.DesignCross-sectional analysis of children recruited to a cluster-randomized controlled trial (Program SI!). Information about children’s and parents’ dietary and physical activity habits was obtained through validated questionnaires (Program SI! questionnaires, Kidmed, Krece Plus and Predimed scores).SettingTwenty-four schools in Madrid, Spain.SubjectsChildren (n 2062) aged 3–5 years and their parents (n 1949).ResultsThere was positive agreement between parental- and self-reporting for three of the six children’s habits examined. Parents’ dietary and physical activity patterns were associated with those of their children. The main determinants of higher scores in children were higher parental age, the mother’s scores, Spanish origin and higher awareness of human health (P<0·005). Children from parents with a low educational level had lower odds for scoring positively on items such as using olive oil (OR=0·23; 95 % CI 0·13, 0·41) and not skipping breakfast (OR=0·36; 95 % CI 0·23, 0·55), but higher odds for meeting the recommendations for consuming pulses (OR=1·71; 95 % CI 1·14, 2·55). Other habits being influenced by parental socio-economic status included the consumption of vegetables, fish, nuts, avoidance of fast food, and consumption of bakery products for breakfast.ConclusionsChildren’s habits may be influenced by their parents’ health awareness and other socio-economic characteristics. These findings suggest that intervention strategies, even in very young children, should also target parents in order to achieve maximum success.
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Sutherland, Rachel, Alison Brown, Nicole Nathan, Serene Yoong, Lisa Janssen, Amelia Chooi, Nayerra Hudson, et al. "A Multicomponent mHealth-Based Intervention (SWAP IT) to Decrease the Consumption of Discretionary Foods Packed in School Lunchboxes: Type I Effectiveness–Implementation Hybrid Cluster Randomized Controlled Trial." Journal of Medical Internet Research 23, no. 6 (June 24, 2021): e25256. http://dx.doi.org/10.2196/25256.
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Background There is significant opportunity to improve the nutritional quality of foods packed in children’s school lunchboxes. Interventions that are effective and scalable targeting the school and home environment are therefore warranted. Objective This study aimed to assess the effectiveness of a multicomponent, mobile health–based intervention, SWAP IT, in reducing the energy contribution of discretionary (ie, less healthy) foods and drinks packed for children to consume at school. Methods A type I effectiveness–implementation hybrid cluster randomized controlled trial was conducted in 32 primary schools located across 3 local health districts in New South Wales, Australia, to compare the effects of a 6-month intervention targeting foods packed in children’s lunchboxes with those of a usual care control. Primary schools were eligible if they were not participating in other nutrition studies and used the required school communication app. The Behaviour Change Wheel was used to co-design the multicomponent SWAP IT intervention, which consisted of the following: school lunchbox nutrition guidelines, curriculum lessons, information pushed to parents digitally via an existing school communication app, and additional parent resources to address common barriers to packing healthy lunchboxes. The primary outcome, mean energy (kilojoules) content of discretionary lunchbox foods and drinks packed in lunchboxes, was measured via observation using a validated school food checklist at baseline (May 2019) and at 6-month follow-up (October 2019). Additional secondary outcomes included mean lunchbox energy from discretionary foods consumed, mean total lunchbox energy packed and consumed, mean energy content of core lunchbox foods packed and consumed, and percentage of lunchbox energy from discretionary and core foods, all of which were also measured via observation using a validated school food checklist. Measures of school engagement, consumption of discretionary foods outside of school hours, and lunchbox cost were also collected at baseline and at 6-month follow-up. Data were analyzed via hierarchical linear regression models, with controlling for clustering, socioeconomic status, and remoteness. Results A total of 3022 (3022/7212, 41.90%) students consented to participate in the evaluation (mean age 7.8 years; 1487/3022, 49.22% girls). There were significant reductions between the intervention and control groups in the primary trial outcome, mean energy (kilojoules) content of discretionary foods packed in lunchboxes (–117.26 kJ; 95% CI –195.59 to –39.83; P=.003). Relative to the control, the intervention also significantly reduced secondary outcomes regarding the mean total lunchbox energy (kilojoules) packed (–88.38 kJ; 95% CI –172.84 to –3.92; P=.04) and consumed (–117.17 kJ; 95% CI –233.72 to –0.62; P=.05). There was no significant difference between groups in measures of student engagement, consumption of discretionary foods outside of school hours, or cost of foods packed in children’s lunchboxes. Conclusions The SWAP IT intervention was effective in reducing the energy content of foods packed for and consumed by primary school–aged children at school. Dissemination of the SWAP IT program at a population level has the potential to influence a significant proportion of primary school–aged children, impacting weight status and associated health care costs. Trial Registration Australian Clinical Trials Registry ACTRN12618001731280; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376191&isReview=true International Registered Report Identifier (IRRID) RR2-10.1186/s12889-019-7725-x
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Ford, Tamsin, Rachel Hayes, Sarah Byford, Vanessa Edwards, Malcolm Fletcher, Stuart Logan, Brahm Norwich, et al. "Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT." Public Health Research 7, no. 6 (March 2019): 1–150. http://dx.doi.org/10.3310/phr07060.
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BackgroundPoor mental health in childhood is common, persistent and associated with a range of adverse outcomes that include persistent psychopathology, as well as risk-taking behaviour, criminality and educational failure, all of which may also compromise health. There is a growing policy focus on children’s mental health and the role of schools in particular in addressing this.ObjectivesTo evaluate whether or not the Incredible Years®(IY) Teacher Classroom Management (TCM) training improved children’s mental health, behaviour, educational attainment and enjoyment of school, improved teachers’ mental health and relationship with work, and was cost-effective in relation to potential improvements.DesignA two-arm, pragmatic, parallel-group, superiority, cluster randomised controlled trial.SettingA total of 80 UK schools (clusters) were recruited in three distinct cohorts between 2012 and 2014 and randomised to TCM (intervention) or teaching as usual [(TAU) control] with follow-ups at 9, 18 and 30 months. Schools and teachers were not masked to allocation.ParticipantsEighty schools (n = 2075 children) were randomised: 40 (n = 1037 children) to TCM and 40 (n = 1038 children) to TAU.InterventionsTCM was delivered to teachers in six whole-day sessions, spread over 6 months. The explicit goals of TCM are to enhance classroom management skills and improve teacher–student relationships.Main outcome measuresThe primary planned outcome was the teacher-reported Strengths and Difficulties Questionnaire Total Difficulties (SDQ-TD) score. Random-effects linear regression and marginal logistic regression models using generalized estimating equations were used to analyse outcomes.ResultsThe intervention reduced the SDQ-TD score at 9 months [adjusted mean difference (AMD) –1.0, 95% confidence interval (CI) –1.9 to –0.1;p = 0.03] but there was little evidence of effects at 18 months (AMD –0.1, 95% CI –1.5 to 1.2;p = 0.85) and 30 months (AMD –0.7, 95% CI –1.9 to 0.4;p = 0.23). Planned subgroup analyses suggested that TCM is more effective than TAU for children with poor mental health. Cost-effectiveness analysis using the SDQ-TD suggested that the probability of TCM being cost-effective compared with TAU was associated with some uncertainty (range of 40% to 80% depending on the willingness to pay for a unit improvement in SDQ-TD score). In terms of quality-adjusted life-years (QALYs), there was evidence to suggest that TCM was cost-effective compared with TAU at the National Institute for Health and Care Excellence thresholds of £20,000–30,000 per QALY at 9- and 18-month follow-up, but not at 30-month follow-up. There was evidence of reduced disruptive behaviour (p = 0.04) and reductions in inattention and overactivity (p = 0.02) at the 30-month follow-up. Despite no main effect on educational attainment, subgroup analysis indicated that the intervention’s effect differed between those who did and those who did not have poor mental health for both literacy (interactionp = 0.04) and numeracy (interactionp = 0.03). Independent blind observations and qualitative feedback from teachers suggested that teachers’ behaviour in the classroom changed as a result of attending TCM training.LimitationsTeachers were not masked to allocation and attrition was marked for parent-reported data.ConclusionsOur findings provide tentative evidence that TCM may be an effective universal child mental health intervention in the short term, particularly for primary school children who are identified as struggling, and it may be a cost-effective intervention in the short term.Future workFurther research should explore TCM as a whole-school approach by training all school staff and should evaluate the impact of TCM on academic progress in a more thorough and systematic manner.Trial registrationCurrent Controlled Trials ISRCTN84130388.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. 7, No. 6. See the NIHR Journals Library website for further project information. Funding was also provided by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (NIHR CLAHRC South West Peninsula).