Longer-term effects of school-based counselling in UK primary schools

Ozone concentration, physical activity, and emotional and behavioral problems in children and adolescents

BACKGROUND

No prior study has examined the mutual association of long-term outdoor ozone (O3) concentration and physical activity (PA) with emotional and behavioral problems (EBPs) in children and adolescents. This study aims to investigate the association between long-term outdoor O3 concentration and the risk of EBPs in children and adolescents and further explore whether increased PA levels modify this association.

METHODS

Data were obtained from the 2020 wave follow-up examination of an ongoing prospective cohort study (COHERENCE project) in Guangzhou, China. A total of 419,033 children aged 6-17-year-old were included. Annual average outdoor O3 concentrations were obtained from the China High Air Pollutants (CHAP) dataset based on participants' residential addresses. PA levels were identified using the International Physical Activity Questionnaire Short Form (IPAQ). EBPs were assessed by the Chinese Parent-Report Strengths and Difficulties Questionnaire (SDQ-P).

RESULTS

Each interquartile range (IQR) increase in outdoor O3 concentration was associated with an increased odds ratio (OR) for abnormal emotional problems (OR: 1.024, 95% CI: 1.010-1.038), conduct problems (OR: 1.015, 95% CI: 1.002-1.029), peer relationship problems (OR: 1.029, 95% CI: 1.006-1.052), prosocial behavior (OR: 1.023, 95% CI: 1.012-1.034), total difficulties (OR: 1.024, 95% CI: 1.010-1.038), and internalizing behavior (OR: 1.039, 95% CI: 1.026-1.053), in fully adjusted models. The highest OR for abnormal EBPs was observed in children with low PA levels, in combination with high O3 concentration.

CONCLUSION

This study identified that long-term outdoor O3 concentration is associated with an increased risk of EBPs in children and adolescents, with higher PA levels attenuating these risks.

Selective and indicated UK school-based mental health interventions: a systematic review and narrative synthesis

BACKGROUND

Mental health disorders amongst children and young people pose a significant burden, with a growing emphasis on early intervention. A notable gap exists between the prevalence of these disorders and sufficiently early treatment, emphasising the need for effective preventive measures.

AIMS

This review aims to comprehensively assess and narratively synthesise both quantitative and qualitative literature on secondary preventative (indicated and selective) school-based mental health interventions in the UK.

METHOD

All empirical studies published since 2010, which reported on UK secondary preventative school-based interventions were eligible. Eligible studies were identified by searching the following electronic databases: PsycINFO (Ovid), MEDLINE (Ovid), Scopus (Elsevier), EMBASE (Elsevier), ERIC (EBSCO), and Web of Science (Clarivate). Database searches yielded 3269 results, with 26 articles meeting inclusion criteria. These articles covered 22 unique studies encompassing various study designs. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality, and study findings were synthesised using a single narrative synthesis ('storytelling') approach.

RESULTS

Three central themes emerged: (1) Outcomes for children and young people; (2) acceptability and preferences; and (3) practical considerations. The majority of included studies demonstrated high quality. Studies revealed diverse perspectives on the strengths, limitations, barriers, and facilitators of school-based interventions.

CONCLUSIONS

School-based interventions hold promise in promoting positive mental health amongst young people, emphasising the pivotal role of educational settings in addressing these challenges. Despite encouraging outcomes, this review highlights the need for further research to better understand intervention effectiveness, implementation barriers, and cost-effectiveness; to facilitate the development of tailored and impactful strategies for supporting young people's mental health.

PRISMA/PROSPERO STATEMENT

This systematic review was conducted following Cochrane methodology PRISMA guidelines. The review was registered with PROSPERO in June 2023 (CRD42023431966).

Mental Health in Pre-Adolescents with Cerebral Palsy: Exploring the Strengths and Difficulties Questionnaire as a Screening Tool in a Follow-Up Study including Multi-Informants

There is a high prevalence of mental health problems in children with Cerebral Palsy (CP). Still, knowledge regarding the trajectory of mental health problems throughout childhood and differences according to informants is lacking. There is also a need for more knowledge regarding the validity of mental health screening tools. In the present study, we assessed changes in parent-rated mental health problems in a cohort of 36 children with CP from school-starting age to pre-adolescence and differences in mental health problems according to informants. Further, we assessed the validity of the Strengths and Difficulties Questionnaire (SDQ) for psychiatric disorders. The study cohort was assessed using the SDQ and a child psychiatric diagnostic instrument at school-starting age and at pre-adolescence. Mean parental SDQ scores increased significantly for emotional, hyperactivity and total problems. Self-reported impact of mental health problems was significantly lower than parent-reported impact, and parents and pre-adolescents reported significantly higher mean scores than teachers for emotional problems, conduct problems and total problem scores. Validated against psychiatric disorders, the SDQ was satisfactory for screening children with CP for risk of psychiatric disorders at pre-adolescence. We recommend that mental health screening be integrated into the regular follow-up for children with CP.