Out-of-School-Time Academic Programs to Improve School Achievement: A Community Guide Health Equity Systematic Review

Expanded In-School Instructional Time and the Advancement of Health Equity: A Community Guide Systematic Review

Expanded in-school instructional time (EISIT) may reduce racial/ethnic educational achievement gaps, leading to improved employment, and decreased social and health risks. When targeted to low-income and racial/ethnic minority populations, EISIT may thus promote health equity. Community Guide systematic review methods were used to search for qualified studies (through February 2015, 11 included studies) and summarize evidence of the effectiveness of EISIT on educational outcomes. Compared with schools with no time change, schools with expanded days improved students' test scores by a median of 0.05 standard deviation units (range, 0.0-0.25). Two studies found that schools with expanded day and year improved students' standardized test scores (0.04 and 0.15 standard deviation units). Remaining studies were inconclusive. Given the small effect sizes and a lack of information about the use of added time, there is insufficient evidence to determine the effectiveness of EISIT on academic achievement and thus health equity.

Common Elements of Practice, Process and Implementation in Out-of-School-Time Academic Interventions for At-risk Children: a Systematic Review

Academic achievement is a strong preventive factor against marginalization. Children at risk of academic failure and drop out can benefit from out-of-school-time academic (OSTA) interventions. Wide-scaled implementation and sustainment of effective interventions remain a struggle across education, welfare, and health. The need for approaches to increase implementability, effectiveness, and efficiency of interventions is pressing. Advancements in the field of education and mental health suggest identifying and studying discrete elements that are common across interventions for the purpose of hypothesis generation, intervention optimization, design improvement, and implementation. This review identified OSTA interventions for primary school children at risk of academic failure. Common elements methodology was used to code practice elements (n = 62), process elements (n = 49), and implementation elements (n = 36) in 30 effective and six ineffective OSTA interventions in matrices. Based on frequency counts, common practice, process, and implementation elements across the interventions were identified, and given frequency count values (FV) reflecting how often elements were included in effective studies as opposed to in ineffective studies. The five common practice elements with the highest FVs were homework support, training in positive parental school involvement, positive reinforcement, structured tutoring, and psychoeducation. The most common process element was regular support to intervention receiver, and the most common implementation element was quality monitoring. Common combinations of elements were also identified and given FVs. Results from this review can inform efforts to design or optimize OSTA interventions, and inform education, implementation, and practice to improve academic achievement for children at risk.

Use of Licensed Vocational Nurses in California Schools: A Descriptive Study

The demand for schools to provide complex health-care services for students with chronic conditions has induced districts to hire licensed vocational nurses (LVNs). Questions remain about how overlapping responsibilities and skills of nursing staff works to facilitate care. The purpose of this mixed-methods descriptive study was to examine the use of LVNs to identify factors related to the supports and impediments to school nurse (SN) practice. The sample consisted of members of the California School Nurse Organization, and methodologies consisted of an online survey and one-on-one interviews. LVNs perform duties within their scope of practice, allowing SNs time for activities related to the Framework for 21st Century School Nursing Practice^TM, confirming appropriate use, and alignment with National Association of School Nurses guidance on the utilization of LVNs. Identified areas of concern included role definition and orientation and supervision of the LVN. Insights into best practices for the effective addition of the LVN to the team are provided.

Linking studies to assess the life expectancy associated with eighth grade school achievement

Extensive evidence indicates the causal association of school outcomes and long-term health. We combined the findings of two studies by Chetty and colleagues to estimate the life expectancy associated with achievement scores in the eighth grade. We linked the dependent variable of the first study and the independent variable of the second study. The first study (of students in Tennessee) found a positive correlation between school achievement scores in eighth grade and income at age 25–27. Controlling for family background, a one percentile increase in eighth grade test score was associated with an increase of $148 (95% CI: $125, $172) in 2009 $U.S. in mean yearly wages at ages 25–27 years. Based on estimated mean annual income growth of 3.35%, $148 would increase 1.59 fold to $235 (CI: $199, $273) in 14 years, at age 40—$251 (CI: $213, $292) in 2012 $U.S. adjusted for inflation. The second study (of the U.S. population) found that a one percentile household income ($1500 in 2012 $U.S.) was associated with one month life expectancy at age 40. We calculate that an increase in income at age 40 attributable to one percentile increase in eighth grade test scores, i.e., $251, would increase life expectancy by 17% (i.e., $251/$1500) (CI: 14%, 19%) of one month per percentile eighth grade test score. Estimates of long-term health outcomes associated with educational outcomes can be made with caution. Applicability of findings from the Tennessee to the U.S. population is discussed.

Knowledge translation in child welfare-improving educational outcomes for children at risk: study protocol for a hybrid randomized controlled pragmatic trial

BACKGROUND

In Norway, a disproportionately high number of children receiving Child Welfare Services (CWS) struggle academically and drop out of school. Academic attainment is one of the strongest protective factors against societal marginalization. The present study is part of a knowledge translation project in collaboration with local CWS with the aim to develop, implement, and evaluate Enhanced Academic Support (EAS) for primary school children in CWS.

METHODS/DESIGN

The study is a mixed-methods hybrid type 2 randomized, controlled pragmatic trial. The participants are approximately 120 children whose families receive support measures from three child welfare agencies in and around Oslo, Norway, and practitioners from these agencies. Families are randomly assigned to either the EAS condition or "business as usual" support. Primary outcomes are math and reading skills, parental involvement in school, and intervention fidelity. Questionnaires and academic tests are administered at baseline, post-intervention (after 6 months), and at follow-up (after 12 months). Implementation drivers are assessed before and after the trial period, and intervention fidelity is monitored during the trial through checklists and structured telephone interviews. Semi-structured interviews and focus groups are conducted after the trial.

DISCUSSION

This hybrid study has two implications. (1) The effects of providing EAS to children in child welfare will be investigated. The study also explores how each core component of the intervention and the use of specific adaptations, implementation drivers, and other important child-level covariates moderate the overall effects. The results can provide valuable knowledge about how to deliver precise and effective academic support to increase academic skills and prevent dropout. In turn, this can promote academic completion and well-being, outcomes that are beneficial for both children and society at large. (2) The study also evaluates the feasibility of applying an Integrated Knowledge Translation model designed to develop, implement, and evaluate research-supported practice in health, care, and welfare services in less time than is usually the case. If deemed successful, this model will provide an efficient collaborative approach to translate the best available evidence into effective evidence-based practice, applicable in effectiveness research and quality improvement efforts.

TRIAL REGISTRATION

ISRCTN, ISRCTN38968073 . Registered on 18 September 2017. https://doi.org/10.1186/ISRCTN38968073 .

Out-of-School-Time Academic Programs Are Recommended to Improve Academic Achievement and Health Equity

The Community Preventive Services Task Force makes several recommendations for academically at-risk students: reading-focused out-of-school-time academic programs are recommended on the basis of strong evidence of effectiveness in improving the reading achievement of students in grade levels K-3. Mathematics-focused out-of-school-time academic programs are recommended on the basis of sufficient evidence of effectiveness in improving mathematics achievement. General out-of-school-time academic programs that do not focus on one specific subject are recommended on the basis of sufficient evidence of effectiveness in improving the reading and mathematics achievement. Out-of-school-time academic programs with minimal academic content have insufficient evidence to determine the effectiveness of these programs. Because academic achievement is linked with long-term health, and because out-of-school-time academic programs are commonly implemented in racial and ethnic and minority or low-income communities, these programs are likely to improve health equity.