Is there a "school effect" on pupil outcomes? A review of multilevel studies

Patterns of intra-cluster correlation coefficients in school-based cluster randomised controlled trials of interventions for improving social-emotional functioning outcomes in pupils: a secondary data analysis of five UK-based studies

BACKGROUND

The cluster randomised trial (CRT) design is increasingly used to evaluate the impact of school-based interventions for improving social-emotional functioning outcomes in pupils. Good knowledge is required on plausible values of the intra-cluster correlation coefficient (ICC) of the outcome to calculate the required sample size in such studies. Using data from five school-based CRTs in the UK, we estimate, and describe patterns in, ICCs for social-emotional functioning outcomes.

METHODS

Mixed effects linear regression models were fitted to estimate the ICC and variance components. Estimates for baseline data were obtained by fitting "null" models that had no predictor variables; estimates at follow-up were adjusted for trial arm status.

RESULTS

Five hundred and twenty-nine (529) ICCs were estimated. Variation across clusters in the outcomes was present at the school, year group and classroom levels. Overall, the ICCs were not markedly different between the primary and secondary school settings. Most of the school- and classroom-level ICCs were less than 0.04 for pupil-reported outcomes and less than 0.035 for parent-reported outcomes; a notable exception for pupil-reported outcomes was for outcomes that reflect a common experience shared by children, such as school climate, where the ICCs were as large as 0.1. The ICCs for teacher-reported outcomes (up to 0.1 at the school level and 0.2 at the classroom level) were larger than for pupil- and parent-reported outcomes. In the CRT that allocated schools to trial arms and only sampled one classroom from each school, the nominal school-level ICCs for teacher-reported outcomes took values up to 0.25. ICCs for teacher-reported measures of internalising behaviour problems and pro-social behaviour were larger than for externalising behaviour problems.

CONCLUSIONS

When randomising school clusters, sub-sampling of lower-level clusters such as classrooms should be accounted for in the sample size calculation. Teacher-reported ICCs are likely to be greater than those for pupil- and parent-reported outcomes as teachers will often provide data for many or all pupils in a given school or classroom. Differences across reporter type and across outcomes need to be considered when specifying plausible values of the ICC to calculate sample size.

TRIAL REGISTRATION

STARS study (ISRCTN84130388); KiVa study (ISRCTN23999021); PACES study (ISRCTN23563048); PROMISE study (ISRCTN19083628); MYRIAD study (ISRCTN86619085).

Parents' Educational Background and Child's Learned Skills Are More Predictive for a Positive School Career than Earlier Parenting Behavior or Child's Mental Health-Results from an 18-Year Longitudinal Observation Study

Background/Objectives: Developmental research has shown that mental health and functioning is determined by social background and child and family characteristics. Until now, there have been few longitudinal studies which considered several aspects at the same time and observed children's development over ten or more years. Methods: The aim of this 18-year-longitudinal study is to find out to which degree different child, family, and socioeconomic factors during early childhood (4 years of age) are associated with educational and professional outcomes in young adulthood (22 years of age). Of the initial sample of 280 participating families, 225 could again be investigated with standardized interviews and questionnaires at the 18 years follow-up (retention rate: 80%). Results: Educational degree of the parents was predictive of the child's school success (β = -0.267, p < 0.001, in regression analysis). Maternal mental health (β = -0.005, p = 0.953), parenting behavior (β = -021, p = 0.782), and early child mental health problems (β = 0.071, p = 0.551) only had a low impact. The child's sex did not predict school success. Better early learned skills (i.e., crystalline intelligence), but not cognitive skills, as measured by the child-specific intelligence test K-ABC, made children more likely to achieve good school-leaving grades (β = -0.240, p = 0.008). Children's early mental health problems had no relevant impact on school degree (d = 0.00, p = 0.934/d = 0.02, p = 0.52 3) or professional status (d = 0.04, p = 0.157/d = -0.02, p = 0.299) at age 22. Conclusions: Besides the not-changeable parental education level, (learnable) competency aspects may be more predictive of a child's educational success until young adulthood than earlier mental health problems in parents and children. This is good news as it supports the idea that mental health deficits can be compensated for through learning and competency training.

Using Non-Violent Discipline Tools: Evidence Suggesting the Importance of Attunement

Training in non-violent discipline is important to prevent violence against children and ensure that their caregivers remain a safe base for them. This paper aims to deepen understanding of non-violent discipline by exploring attunement as a mechanism in the effectiveness of non-violent discipline tools. Attunement describes the sensitive responsiveness of caregivers towards their children and has been found to be central to the formation of secure attachment bonds and development of self-regulation. It includes understanding or being "in tune with" the child's needs and signals, matching these with appropriate responses. The objective of this paper is to explore attunement in relation to non-violent discipline. Peer-reviewed systematic reviews previously included in a systematic overview of evidence on non-violent discipline options were screened for information relevant to attunement. All reviews were published in English between 1999 and 2018 and offered evidence on at least one non-violent discipline tool. Although no reviews explicitly addressed attunement, evidence was found suggesting its importance in the use and effectiveness of discipline methods. Research directly investigating attunement in discipline is needed.

Problematic familial alcohol use and adolescent outcomes: Do associations differ by parental education?

Aim: To investigate the associations between problematic familial alcohol use and adolescent subjective health, binge drinking, relationships with parents, school performance, and future orientation, and to study whether these associations differ in relation to parental education. Methods: Cross-sectional data from the Stockholm School Survey (SSS) collected among students in the 9th and 11th grades in 2018 and in 2020 were used (n = 19,415). Subjective health, parent-youth relationships, and school performance were coded as continuous variables; binge drinking and future orientation were coded as binary variables. Familial drinking included three categories: problematic; don't know/missing; and not problematic. Parental university education distinguished between adolescents with two, one, or no university-educated parent(s). Control variables included gender, grade, family structure, migration background, parental unemployment, and survey year. Linear and binary logistic regression analyses were performed. Results: Problematic familial alcohol use was associated with worsened subjective health, a higher likelihood of engaging in binge drinking, worse relationships with parents, and a higher likelihood of having a pessimistic future orientation, even when adjusting for all control variables. Having less than two university-educated parents was associated with a higher likelihood of reporting problematic familial alcohol use. Parental university education moderated the association between problematic familial alcohol use and binge drinking as this relationship was stronger for adolescents with no and one university-educated parent(s). Conclusions: Adolescents with problematic familial alcohol use fared worse with regards to all studied outcomes, except for school performance. Parental university education only moderated the association between problematic familial alcohol use and binge drinking. However, since problematic familial alcohol use was more common among adolescents with less than two university-educated parents, we argue that at the group level, this category may be more negatively affected by alcohol abuse in the family. Policy interventions could benefit from having a socioeconomic perspective on how children are affected by alcohol's harms to others.

School collective efficacy and gambling: A multilevel study of 11th grade students in Stockholm

The aim of the present study was to investigate variations between schools when it comes to gambling and risk gambling, and, in particular, to analyse the links between school collective efficacy and student gambling and risk gambling. The data consists of official register information on schools as well as survey data collected in 2016 among 1,061 teachers and 5,191 students in 46 Stockholm upper secondary schools. School collective efficacy was operationalized on the basis of teacher responses, which were aggregated to the school level. Gambling and risk gambling were based on students' self-reports. Two-level binary logistic regression analyses were performed. The results show that there is between-school variation in gambling and in all the study's indicators of risk gambling. Both gambling and risk gambling were more commonly reported by students attending schools with weak collective efficacy, even when adjusting for student- and school-level sociodemographic characteristics. The findings suggest that conditions at school may counteract students' engagement in gambling and risk gambling.

Intracluster correlation coefficients from school-based cluster randomized trials of interventions for improving health outcomes in pupils

BACKGROUND AND OBJECTIVES

To summarize intracluster correlation coefficient (ICC) estimates for pupil health outcomes from school-based cluster randomized trials (CRTs) across world regions and describe their relationship with study design characteristics and context.

METHODS

School-based CRTs reporting ICCs for pupil health outcomes were identified through a literature search of MEDLINE (via Ovid). ICC estimates were summarized both overall and for different categories of study characteristics.

RESULTS

Two hundred and forty-six articles reporting ICC estimates were identified. The median (interquartile range) ICC was 0.031 (0.011 to 0.08) at the school level (N = 210) and 0.063 (0.024 to 0.1) at the class level (N = 46). The distribution of ICCs at the school level was well described by the beta and exponential distributions. Besides larger ICCs in definitive trials than feasibility studies, there were no clear associations between study characteristics and ICC estimates.

CONCLUSION

The distribution of school-level ICCs worldwide was similar to previous summaries from studies in the United States. The description of the distribution of ICCs will help to inform sample size calculations and assess their sensitivity when designing future school-based CRTs of health interventions.

Teaching away from school: do school digital support influence teachers' well-being during Covid-19 emergency?

The Covid-19 pandemic coerced the closure of most schools around the world and forced teachers and students to change teaching and learning methods. Emergency Remote Teaching (ERT) generated consequences to teachers and students in terms of learning outcomes and personal well-being. This study focuses on teachers' individual and working environment well-being in ERT conditions and intends to explore which factors related to the provision of digital equipment and the implementation of digital strategies by schools explain the school effect on both typologies of well-being during the Covid-19 emergency. To do so, data collected in the Responses to Educational Disruption Survey (REDS) across three countries were used, and a two-step analysis was conducted. A first step involves the use of linear mixed effect models to assess the school effect on teachers individual and working environment well-being. In the second step Regression Trees (RT) are used to investigate which factors and policies related to digital tools explained the identified school effects. The results show that schools and countries played a role in determining teachers perceived well-being during the Covid-19 disruption, in particular the school level explains more than 7% of the work environment well-being and 8% of individual one. In the second step of the analysis results show that a high positive effect on school environment well-being is observed when the school's activity is not influenced by policies limiting the use of online tools and when teacher's readiness for remote teaching, like the development of technical skills and the provision of internet access and digital devices, is met. To the best of our knowledge, this is the first study that evaluates the impact of digital tactics and instruments provided by schools on teachers' well-being on a large scale.

Fear of Covid-19 and perceived academic safety: the buffering role of personal resources

Purpose

The study investigates the moderating effect of personal resources, including optimism and resilience, on the link between fear of Covid-19 and perceptions of academic safety among university students in Ghana.

Design/methodology/approach

A total of 618 students took part in the research by completing an online self-reported questionnaire. The respondents were chosen using a simple random sample method. The data was processed and analysed using IBM SPSS version 24 and SEM-PLS, respectively.

Findings

Results reveal fear of Covid-19 positively influence students' perception of academic safety. Furthermore, both resilience and optimism mitigate the impact of fear of Covid-19 on students' perceptions of academic safety.

Originality/value

This is the first study to examine personal resources as a moderator between fear of Covid-19 and students' perceptions of academic safety. Practical and theoretical implications are added to the text.

Alcohol norms and alcohol intake among high school students

AIMS

To analyse whether parental alcohol norms were associated with the alcohol intake of high school students and whether this association persisted across different levels of alcohol intake in school and trustful communication with parents.

METHODS

This was a cross-sectional study among 70,544 high school students (mean age 18 years) participating in the Danish National Youth Study 2014. We examined the associations between parental alcohol norms and individual alcohol intake as the number of drinks at the most recent school party and the frequency of binge drinking in the last 30 days using negative binomial regression. We then performed joint analyses of parental alcohol norms and alcohol intake at school level, and parental alcohol norms and trustful communication with parents.

RESULTS

The mean intake of alcohol at the most recent school party was 9.9 units of alcohol for boys and 7.6 units of alcohol for girls. A total of 36.2% of boys and 24.7% of girls were binge drinking frequently (more than four occasions in the last month). Lenient parental alcohol norms and a low level of trustful communication with parents were associated with a higher intake at the most recent school party and with the frequency of binge drinking. Joint analyses showed that these associations persisted across different levels of school level alcohol intake and levels of trustful communication with parents.

CONCLUSIONS

Among high school students, parental alcohol norms were strongly associated with alcohol intake and consistently so across different levels of school level alcohol intake and level of trustful communication with parents. This indicates that the role of parents in preventing excessive drinking is important, even in older adolescents.

Longitudinal changes in quality of life and psychosocial problems of primary school children in a deprived urban neighborhood over the course of a school-based integrated approach

The municipality of Amsterdam implemented a 2-year school-based integrated approach in schools in a deprived neighborhood. The integrated approach targeted the domains of education, health and poverty and the children's school, neighborhood and home environment by involving various agencies and actors. In this study, changes in children's quality of life and psychosocial problems over the course of the integrated approach were examined and evaluated. A dynamic cohort design was used. At five measurement occasions (T1-T5) during 2 years, children from four consecutive grades in five schools filled out a questionnaire (total n = 614). In children between 7 and 13 years, quality of life was measured with the KIDSCREEN-10. In children between 9 and 13 years, psychosocial problems were measured with the Strengths and Difficulties Questionnaire. Generalized estimating equations were applied. Time, sex, age, socio-economic status, ethnic background, grade, and school were included as independent variables. Quality of life was higher from the first follow-up during the approach (T2) until the end of the approach (T4) compared to at the start of the approach (T1). At T5, several months after the approach ended, scores returned back to baseline. Likewise, a reduction in children's psychosocial problems was detected at the end of the approach (T4) compared to at the start of the approach (T1). However, both before and after that time point, no improvements were detected. This study shows that integrated approaches can be beneficial for children's quality of life and psychosocial health, but continued investments may be needed to maintain established improvements.Trial registration NTR6571 (NL6395), August 4 2017 retrospectively registered.

School Connectedness and E-cigarette Susceptibility/ Ever Use in Texas 6th-Grade Students

Objectives: We examined the association between school connectedness (SC) and e-cigarette susceptibility/ ever use in a diverse sample of Texas 6^th graders, with a secondary aim to explore the association stratified by gender and classroom setting (in-person vs remote). Methods: A cross-sectional analysis was conducted of CATCH My Breath baseline data, representing 985 6^th -graders from 21 public schools. SC was based on National Longitudinal Study of Adolescent Health measures; e-cigarette susceptibility/ever use was based on the FDA's definition of "at-risk" for long-term use. We conducted multi-level logistic regression analyses.Results: Over half the sample was Hispanic (57.6%), with 36.2% reporting susceptibility/ever use. Lower SC was associated with increased odds of e-cigarette susceptibility/ever use (low SC: aOR: 5.17, 95% CI: 3.54, 7.55; medium SC: aOR: 2.15, 95% CI: 1.44, 2.91; high SC= referent). The association held across gender groups, with low SC girls reporting the highest odds of susceptibility/ever use (aOR: 7.83, 95% CI: 4.51, 13.61). Low SC in- person and remote students were 6 and 4 times, respectively, more likely to report susceptibility/ever use as high SC students (p<.05). Conclusion: SC protected against e-cigarette susceptibility/ever use in this sample.

Party, Academic, or Prepped for College? School Norm Profiles and Adolescent Well-being using National Data

The current study examined how schoolwide norms came together into distinct profiles and how norm profile membership was linked to adolescent well-being. Using school-level (N = 786) and student-level data (N = 174,587 12th grade students; 52% female; 64% White, 13% Latino, 12% Black, 12% other) from Monitoring the Future (MTF), we identified four distinct school profiles-average, academic, prepped-for-college, party-that had unique patterns of shared norms. Compared with average schools, academic schools (high academics and low substance use and social integration norms) were most advantageous for students, prepped-for-college schools (high academics, substance use, and social integration norms) had both benefits and drawbacks, and party schools (low academics and high substance use and social integration norms) were most detrimental.

E-cigarette school policy and staff training: Knowledge and school policy experiences with e-cigarette products among a national sample of US middle and high school staff

Background

As youth e-cigarette use has surged in the last several years, teachers and school administrators have reported challenges addressing student use of emerging e-cigarette products on school property. While federal policy prohibits smoking in U.S. schools that receive federal funding, school e-cigarette bans only exist where states or localities have acted. Little is known about school staff experiences with implementing these relatively new policies; this study examines associations between school e-cigarette policies and trainings on school staff awareness and intervention on student e-cigarette use.

Methods

A national convenience sample of 1,526 U.S. middle- and high-school teachers and administrators was surveyed in November-December 2018. Among respondents who provided their job title and indicated that they worked in a school rather than a district (n = 1,480, response rate = 97.0%), separate logistic regressions examine associations of school policies and policy training with e-cigarette awareness and intervention on student e-cigarette use.

Results

Despite being the most popular e-cigarette at the time, fewer than half (47.5%) of respondents identified an image of a JUUL device as an e-cigarette. However, respondents reporting the presence of e-cigarette policies in their schools had higher odds of recognizing e-cigarettes (OR = 3.85, p<0.01), including photo recognition of JUUL (OR = 1.90, p<0.001). Respondents reporting e-cigarette policies also had higher odds of reporting intervention on student e-cigarette use (communicating with students about e-cigarette avoidance: OR = 2.32, p<0.001; reporting students had been caught using e-cigarettes at school: OR = 1.54, p<0.05). Among respondents reporting a school e-cigarette policy, those trained on the policy had higher odds of JUUL photo recognition (OR = 1.54, p<0.01). Respondents trained on e-cigarette policies also had higher odds of reporting intervention (communicating: OR = 3.89, p<0.001; students caught using e-cigarettes: OR = 2.71, p<0.001).

Conclusions

As new tobacco products enter the market, school policies may be important tools to raise school personnel awareness of and intervention on emerging e-cigarette product use. However, policy adoption alone is not sufficient; policy training may further aid in recognition and intervention upon student use of e-cigarettes at school.

Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: a scoping review

OBJECTIVES

To synthesise the evidence on the role of compositional or contextual characteristics of schools in the association between students' socioeconomic position and their health in primary and secondary education in developed economies.

DESIGN

Scoping review. We included studies examining the role of at least one school or class characteristic on students' health inequalities and was published since 1 January 2000, in English or German. We searched PubMed/Medline, Web of Science and Education Resources Information Center. We provided a narrative synthesis and an overview of findings. School characteristics were grouped into five broad categories: school composition, school climate, school policies and organisation, food environment and facilities.

RESULTS

Of 8520 records identified, 26 studies were included. Twelve studies found a moderating and 3 a mediating effect. The strongest evidence came from studies examining the moderating effect of school composition, that is, the negative impact of a low individual socioeconomic position on mental health and well-being was aggravated by a low average socioeconomic position of schools. Evidence concerning the role of school climate, school stratification (eg, performance base tracking) and sponsorship, food environment and sport facilities and equipment was generally weak or very weak and mostly based on singular findings. Overall, favourable meso-level characteristics mitigated the negative impact of low individual socioeconomic position on health outcomes.

CONCLUSIONS

School characteristics affect health inequalities in children and adolescents to some degree, but future research is necessary to strengthen the existing evidence and address under-represented aspects in school characteristics and health outcomes.

Problematic familial alcohol use and heavy episodic drinking among upper secondary students: a moderator analysis of teacher-rated school ethos

Objective

Building on findings reported in a previous publication, the objective of this study is to explore if teacher-rated indicators of school ethos modify the association between problematic familial alcohol use and heavy episodic drinking among upper secondary students. Data were based on combined information from two separate surveys conducted in 2016 among 4709 students and 1061 teachers in 46 Stockholm upper secondary schools, with linked school-level information from administrative registers. Multilevel binary logistic regression analyses were performed.

Results

Problematic familial alcohol use was associated with an increased likelihood of heavy episodic drinking among upper secondary students (OR 1.36, 95% CI 1.12–1.65). Cross-level interactions revealed that the association was weaker among students attending schools with higher levels of teacher-rated ethos. This was true for overall school ethos (OR 0.79, 95% CI 0.65–0.97) and for four of five studied sub-dimensions of ethos: staff stability (OR 0.78, 95% CI 0.65–0.95); teacher morale (OR 0.79, 95% CI 0.65–0.97); student focus (OR 0.80, 95% CI 0.65–0.97); and academic atmosphere (OR 0.79, 95% CI 0.65–0.96). The sub-dimension “structure and order for dealing with unwanted behaviour” did however not moderate the association between problematic familial alcohol use and heavy episodic drinking (OR 0.95, 95% CI 0.77–1.18).

Teacher-Rated School Leadership and Adolescent Gambling: A Study of Upper Secondary Schools in Stockholm, Sweden

So-called “effective schools” are characterised by properties such as a strong and purposeful school leadership and a favourable school ethos. In a previous study we showed that a school’s degree of teacher-rated ethos was inversely associated with student gambling and risk gambling. Building on these findings, the current study aims to examine the associations that teachers’ ratings of the school leadership share with gambling and risk gambling among students in the second grade of upper secondary school in Stockholm (age 17–18 years). Data were drawn from the Stockholm School Survey and the Stockholm Teacher Survey with information from 5191 students and 1061 teachers in 46 upper secondary schools. School-level information from administrative registers was also linked to the data. The statistical method was two-level binary logistic regression analysis. Teachers’ average ratings of the school leadership were inversely associated with both gambling (OR 0.96, 95% CI 0.93–0.998, p = 0.039) and risk gambling (OR 0.94, 95% CI 0.89–0.99, p = 0.031) among upper secondary students, whilst adjusting for sociodemographic characteristics at the student and the school level. The findings lend further support to the hypothesis that characteristics of effective schools may reduce students’ inclination to engage in gambling and risk gambling behaviours.

Adolescent mental health difficulties and educational attainment: findings from the UK household longitudinal study

OBJECTIVE

This study examines whether there is an independent association between mental difficulties in adolescence and educational attainment at age 16.

DESIGN

Longitudinal study.

SETTING

Nationally representative data from the UK Household Longitudinal Study (UKHLS) were linked to the National Pupil Database for England.

PARTICIPANTS

Respondents (N=1100) to the UKHLS between 2009 and 2012 were linked to the National Pupil Database to investigate longitudinal associations between mental difficulties at ages 11-14 and educational attainment at age 16 (General Certificate of Secondary Education (GCSE)).

PRIMARY OUTCOME MEASURE

Not gaining five or more GCSE qualifications at age 16, including English and maths at grade A*-C.

RESULTS

An atypical total mental health difficulty score measured using the Strengths and Difficulties Questionnaire at ages 11-14 predicted low levels of educational attainment at age 16 (OR: 3.11 (95% CI: (2.11 to 4.57)). Controlling for prior attainment and family sociodemographic factors, happiness with school (/work) and parental health, school engagement and relationship with the child partially attenuated the association, which was significant in the fully adjusted model (2.05, 95% CI (1.15 to 3.68)). The association was maintained in the fully adjusted model for males only (OR: 2.77 (95% CI (1.24 to 6.16)) but not for females. Hyperactivity disorder strongly predicted lower attainment for males (OR: 2.17 (95% CI: (1.11 to 4.23)) and females (OR: 2.85 (95% CI (1.30 to 6.23)).

CONCLUSION

Mental difficulties at ages 11-14 were independently linked to educational success at age 16, highlighting an important pathway through which health in adolescence can determine young people's life chances.

Job strain and sense of coherence: Associations with stress-related outcomes among teachers

Background: Teachers constitute an occupational group experiencing high levels of stress and with high sick-leave rates. Therefore, examining potentially protective factors is important. While prior research has mainly focused on the link between teachers’ own experiences of their work environment and stress-related outcomes, it is also possible that colleagues’ perception of the work environment and their possibilities for dealing with work-related stress contribute to influencing individual teachers’ stress. Aim: The aim of this study was to investigate how teachers’ reports of high job strain (i.e. high demands and low control) and sense of coherence (SOC), as well as the concentration of colleagues reporting high strain and high SOC, were associated with perceived stress and depressed mood. Methods: The data were derived from the Stockholm Teacher Survey, with information from two cross-sectional web surveys performed in 2014 and in 2016 (N=2732 teachers in 205 school units). Two-level random intercept linear regression models were performed. Results: High job strain at the individual level was associated with higher levels of perceived stress and depressed mood, but less so for individuals with high SOC. Furthermore, a greater proportion of colleagues reporting high SOC was associated with lower levels of perceived stress and depressed mood at the individual level. Conclusions: High SOC may be protective against work-related stress among teachers. Additionally, the proportion of colleagues reporting high SOC was related to less individual stress, suggesting a protective effect of school-level collective SOC.

Multilevel Twin Models: Geographical Region as a Third Level Variable

The classical twin model can be reparametrized as an equivalent multilevel model. The multilevel parameterization has underexplored advantages, such as the possibility to include higher-level clustering variables in which lower levels are nested. When this higher-level clustering is not modeled, its variance is captured by the common environmental variance component. In this paper we illustrate the application of a 3-level multilevel model to twin data by analyzing the regional clustering of 7-year-old children’s height in the Netherlands. Our findings show that 1.8%, of the phenotypic variance in children’s height is attributable to regional clustering, which is 7% of the variance explained by between-family or common environmental components. Since regional clustering may represent ancestry, we also investigate the effect of region after correcting for genetic principal components, in a subsample of participants with genome-wide SNP data. After correction, region no longer explained variation in height. Our results suggest that the phenotypic variance explained by region might represent ancestry effects on height.

Implementation of a Dutch school-based integrated approach targeting education, health and poverty-a process evaluation

This study provides an evaluation of the implementation of a school-based integrated approach to improve academic outcomes by targeting children’s education, health, and poverty. A two-year municipal subsidy program was provided to four primary schools in a deprived urban neighborhood in Amsterdam. Schools were put in charge of the implementation and coordination of the program. The municipality and district authorities provided assistance. This study evaluated whether the program functioned as integrated approach, i.e., whether it targeted multiple domains and environments by involving various agencies and actors, and what factors facilitated or hampered this. It also yielded an overview of the initiatives implemented and the facilitators and barriers of successful implementation of initiatives. Principals’ perceptions served as the main input for this study. We thematically analyzed seven written customized plans for spending the subsidy (one to two per school), 15 transcripts of interviews with the principals (three to four per school) and the minutes of 16 meetings between principals, policy officers, and researchers. According to the principals, the schools had made great progress in the education domain and in improving the school’s pedagogical climate, but in the health and poverty domains less progress had been made. Apart from the municipality, relatively few external agencies and actors had been actively involved in the program, and progress in other environments than the school was hardly achieved. This study shows that functioning of the program as integrated approach was facilitated by connections between initiatives, and that hired, well-trusted third parties may be crucial to establish these connections.

Lay summary

This study evaluated whether a two-year municipal program to improve academic outcomes by targeting children’s education, health, and poverty, provided to primary schools in a deprived urban neighborhood, functioned as intended, and if so why, or if not, why not. The program was intended to function as integrated approach. This means that it was supposed to target the mentioned domains, the school, home, and neighborhood environment, and to involve various agencies and actors, such as school staff, policy officers, parents, children, and external organizations. The school principals could implement multiple, self-chosen, initiatives. According to the principals, on whose perceptions this evaluation study was primarily based, both teaching and the school climate improved during the program. However, improvements in children’s health and poverty levels, and outside the school environment in general, were more difficult to achieve. In addition, the program involved mainly school staff and policy officers. The program thus functioned as an integrated approach, but only to a limited extent. The functioning of the program as integrated approach was facilitated by involving hired third parties to stimulate interconnection of initiatives, i.e., initiatives serving the same goals, involving multiple agencies and actors, and/or being implemented in the same location.

How Can Bullying Victimisation Lead to Lower Academic Achievement? A Systematic Review and Meta-Analysis of the Mediating Role of Cognitive-Motivational Factors

Bullying involvement may have an adverse effect on children’s educational outcomes, particularly academic achievement. However, the underlying mechanisms and factors behind this association are not well-understood. Previous meta-analyses have not investigated mediation factors between bullying and academic achievement. This meta-analysis examines the mediation effect of cognitive-motivational factors on the relationship between peer victimization and academic achievement. A systematic search was performed using specific search terms and search engines to identify relevant studies that were selected according to specific criteria resulting in 11 studies encompassing a sample total of 257,247 children (10 years and younger) and adolescents (11 years and older) (48–59% female). Some studies were longitudinal and some cross sectional and the assessment for each factor was performed by various methods (self, peer, teacher, school and mixed reports). Children involved in bullying behaviour were less likely to be academically engaged (k = 4) (OR = 0.571, 95% CI [0.43, 0.77], p = 0.000), to be less motivated (k = 7) (OR = 0.82, 95% CI [0.69, 0.97], p = 0.021), to have lower self-esteem (k = 1) (OR = 0.12, 95% CI [0.07, 0.20], p = 0.000) and lower academic achievement (k = 14) (OR = 0.62, 95% CI [0.49, 0.79], p = 0.000). Bullying involvement was also significantly related to overall cognitive-motivational factors (k = 17, OR = 0.67, 95% CI [0.59, 0.76], p = 0.000). Cognitive-motivational factors, taken together, mediated the association between bullying victimisation and academic achievement (k = 8, OR = 0.74, 95% CI (0.72, 0.77), p = 0.000). Bullying victimisation was negatively related to cognitive-motivational factors, which, in turn, was associated with poorer academic achievement. These findings were moderated by the design of the studies, assessment methods for the bullying reports, mediators and outcomes, country, age of children in the sample and/or types of bullying. The findings are of relevance for practitioners, parents, and schools, and can be used to guide bullying interventions. Interventions should focus on improving internal and external motivational factors including components of positive reinforcement, encouragement, and programs for enhancing academic engagement and achievement amongst children and adolescents.

Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: protocol for a scoping review

INTRODUCTION

Childhood and adolescence are crucial life stages for health trajectories and the development of health inequalities in later life. The relevance of schools for health and well-being of children and adolescents has long been recognised, and there is some research regarding the association of contextual and compositional characteristics of schools and classes with health, health behaviour and well-being in this population. Little is known about the role of meso-level characteristics in relation to health inequalities. The aim of this scoping review is to retrieve and synthesise evidence about the mediating or moderating role of compositional or contextual characteristics of schools for the association between students' socioeconomic position and health in primary and secondary education.

METHODS AND ANALYSIS

We will conduct a systematic search of electronic databases in PubMed/Medline, Web of Science and Education Resources Information Center. Studies must meet the following inclusion criteria: (1) The population must be students attending primary or secondary schools in developed economies. (2) The outcomes must include at least one indicator for individual health, health behaviour or well-being. (3) The study must include at least one contextual or compositional characteristic of the school context and one individual determinant of socioeconomic position. (4) The study must also examine the mediating or moderating role of the contextual or compositional characteristic of the school context for the associations between socioeconomic position and health, health behaviour or well-being. (5) The study must be published since 1 January 2000 in English or German language. We will provide a narrative synthesis of findings.

ETHICS AND DISSEMINATION

We will not collect primary data and only include secondary data derived from previously published studies. Therefore, ethical approval is not required. We intend to publish our findings in an international peer-reviewed journal and to present them at national and international conferences.

Effects of Four-Day School Weeks on Physical Education Exposure and Childhood Obesity

BACKGROUND

Use of 4-day school weeks (FDSWs) as a cost-saving strategy has increased substantially as many US school districts face funding declines. However, the impacts of FDSWs on physical activity exposure and related outcomes are unknown. This study examined physical education (PE) exposure and childhood obesity prevalence in 4- versus 5-day Oregon schools; the authors hypothesized lower PE exposure and higher obesity in FDSW schools, given reduced school environment exposure.

METHODS

The authors utilized existing data from Oregon to compare 4- versus 5-day models: t tests compared mean school-level factors (PE exposure, time in school, enrollment, and demographics) and complex samples weighted t tests compared mean child-level obesity data for a state representative sample of first to third graders (N = 4625).

RESULTS

Enrollment, time in school, and student-teacher ratio were significantly lower in FDSW schools. FDSW schools provided significantly more PE, both in minutes (120 vs 101 min/wk in 4- vs 5-d schools, P < .01) and relative to total time in school (6.9% vs 5.0%, P < .0001). Obesity prevalence did not differ significantly between school models.

CONCLUSION

Greater PE exposure in FDSW schools was observed, and it remains unknown whether differences in PE exposure contributed to obesity prevalence in this sample of students. Efforts to better understand how FDSWs impact physical activity, obesity risk, and related factors are needed.

Academic Well-Being and Structural Characteristics of Peer Networks in School

Peer networks at school and students' position in these networks can influence their academic well-being. We study here individual students' network position (isolation, popularity, social activity) and peer network structures at the school level (centralization, density, clustering, school connectedness) and their relations to students' academic well-being (school burnout, SB; schoolwork engagement, SE). Classroom surveys for 14-16-year-olds (N = 11,015) were conducted in six European cities (SILNE survey). Students were asked to nominate up to five schoolmates with whom they preferred to do schoolwork. SB and SE correlated negatively (-0.32; p < 0.0001). Students had on average 3.4 incoming (popularity; range 0-5) and 3.4 outgoing (social activity; 0-5) social ties. Percentage of isolated students was 1.4. Students' network position was associated weakly with academic well-being-popular students had less SB and higher SE, and socially active students had higher SE. School-level peer networks showed high clustering and school connectedness, but low density and low centralization. Clustering was associated with higher SB. Low centralization and high school connectedness protected from SB. Dense networks supported SE as did high average school connectedness. Correlations between these network indicators and academic well-being were, however, low. Our study showed that both students' network position and network characteristics at the school level can influence adolescents' academic well-being.

The Role of Academic Achievement in the Relationship between School Ethos and Adolescent Distress and Aggression: A Study of Ninth Grade Students in the Segregated School Landscape of Stockholm

Equitable access to high-quality schools is important for student achievement. However, the increasing attention placed on adolescent mental health promotion suggests that school contextual factors and school achievement may also play an important role for students’ psychological well-being. This study examined the relationships between school ethos, academic achievement, psychological distress and aggressive behaviour among Swedish students, further considering the role of school sociodemographic composition. Analyses were based on two separate data collections in Stockholm, one among teachers (n = 2089) and the other among students aged 15–16 (n = 9776; 49.7% girls). Using multilevel structural equation modelling, the relations between teachers’ reports of school ethos and students’ reports of achievement, psychological distress and aggressive behaviour were tested. Analyses showed a positive relationship between a school’s ethos and average academic achievement. At the school level, higher academic achievement was in turn associated with less psychological distress among students, providing an indirect pathway between school ethos and psychological distress. At the individual level, students with higher academic achievement reported less psychological distress and aggressive behaviour. These findings indicate that schools’ value-based policies and practices can play a role for students’ academic performance, and through this, for their psychological well-being.

School and town factors associated with risky alcohol consumption among Catalan adolescents

Risky alcohol consumption among adolescents has health and social consequences. Evidence identifying the school context that determines alcohol consumption among rural and urban adolescents is lacking. This study aimed to describe the contextual school and town factors determining risky alcohol consumption among rural and urban 10th-grade adolescents (15-17 years old) from Catalonia (northeastern Spain). The study had a cross-sectional design. Cluster sampling with the class as the sampling unit was used, and a total of 1268 10th-grade adolescents from Catalonia nested in 26 high schools participated in the study. A computerized and self-administrated questionnaire was used to collect individual variables. Contextual variables were collected from the Catalan police registers, geocoded sources, and governmental internet databases, and by aggregation of answers from the self-administrated questionnaire. The prevalence of risky alcohol consumption was calculated, and a multilevel Poisson regression analysis with robust variance was conducted with data from adolescents nested within high schools. The results show that risky alcohol consumption is higher among rural adolescents (59.3%) than among urban youth (51.1%) (p < 0.005). Positive expectancies, drunkenness of siblings and friends, and most of the variables indicating accessibility are associated with risky alcohol consumption at the individual level. At the contextual level, the sports center rate and the high school's percentage of risky student alcohol consumption are strongly associated with individual risky alcohol consumption. The town environment (rural or urban), the unemployment rate, and the number of pubs and nightclubs lost their significance after adjustment by the individual and mediating variables. In conclusion, individual factors, such as the influence of drinking patterns of siblings and friends, and more alcohol access opportunities, are associated with adolescents' risky alcohol consumption. The associated contextual factors are the sports center rate and the percentage of risky classmate alcohol consumers. Interventions targeting adolescents should focus at community and high school levels, trying to reduce adolescents' accessibility to alcohol.

School Ethos and Recurring Sickness Absence: A Multilevel Study of Ninth-Grade Students in Stockholm

School absence has been identified as a severe problem in Sweden, both at the individual level and for society as a whole. Despite the multitude and complexity of reasons behind school absence, health-related problems are likely to be one important determinant. This indicates that knowledge about factors that may contribute to preventing health-related absence among students is relevant. The aim was to investigate whether a higher level of teacher-reported school ethos was associated with less recurring sickness absence among students. Data from four cross-sectional surveys performed in 2014 and 2016 were combined. The Stockholm School Survey was carried out among 9482 ninth-grade students (ages 15-16 years) in 150 school units, and the Stockholm Teacher Survey was performed among 2090 teachers in the same units. School ethos was operationalised by an index of 12 teacher-reported items that was aggregated to the school-level. Recurring student sickness absence was captured by self-reports and defined as absence on >10 occasions during the current school year. Two-level logistic regressions were performed. The results show that about 9.5% of the students reported recurring sickness absence. Students attending schools with higher levels of teacher-rated school ethos were less likely to reporting recurring sickness absence than those attending schools with lower levels of ethos, even when adjusting for potential confounders (OR 0.79, 95% CI 0.65-0.97). In conclusion, recurring sickness absence was less common among students attending schools with higher levels of teacher-rated ethos. The findings suggest that schools may contribute to promoting student health.

The Role of Primary School Composition in the Trajectories of Internalising and Externalising Problems across Childhood and Adolescence

There is little research on the role of school and its composition in explaining individual children’s psychological outcomes. This study examined for the first time the role of several primary-school compositional characteristics, and their interactions with individual level characteristics, in the development of two such outcomes, internalising and externalising problems, at ages 7, 11 and 14 years in 4794 children in England participating in the Millennium Cohort Study. Using hierarchical (multilevel) linear models, we found that, even after adjusting for individual and family characteristics, children in schools with higher proportions of pupils eligible for free school meals had more externalising problems. In general, children with special educational needs, lower academic performance, more distressed mothers, and those in non-intact families had more internalising and externalising problems. Our results underline the importance of targeting schools with less affluent overall intakes, but also highlight the key role of individual and family characteristics in the development of their pupils’ psychological functioning.

Overall and work-related well-being of teachers in socially disadvantaged schools: a population-based study of French teachers

OBJECTIVES

As a human service profession, teaching presents specific risk factors that could be intensified in socially disadvantaged schools and, ultimately, impact the service quality. The aim of the present study was to evaluate the association between school socioeconomic status and teachers' well-being.

DESIGN

Population-based postal survey 'Teachers' Quality of Life' (MGEN Foundation for Public Health/French Ministry of Education; 2013). To categorise the school socioeconomic status, we used the 'Education Priority Area (EPA)' administrative classification, which is chiefly based on the proportion of underprivileged students and is available for primary and lower secondary state schools.

PARTICIPANTS

In-service French teachers randomly selected from among the teaching staff administrative list of the French Ministry of Education after stratification by sex, age and type of school.

OUTCOME MEASURES

Indicators of well-being at work included a question on job satisfaction, job difficulty evolution and the Maslach Burnout Inventory. The short version of the WHO Quality of Life questionnaire was used to evaluate overall well-being. Among primary and lower secondary school teachers, we evaluated cross-sectional associations between school EPA status and indicators of well-being, using logistic or linear regressions stratified by school level and adjusted for sociodemographic and work-related characteristics.

RESULTS

In the adjusted models, there was no significant difference in work-related well-being between teachers in EPA and non-EPA schools, both in primary school (n=154 vs n=788) and in lower secondary school (n=113 vs n=452). Regarding overall well-being, the only significant differences were seen among primary school teachers, with teachers in EPA schools reporting a worse perception of physical health and living environment than teachers in non-EPA schools.

CONCLUSION

Using a representative sample of French teachers, we did not observe substantial differences in work-related well-being between teachers in EPA and non-EPA schools.

School-level electronic cigarette use prevalence and student-level tobacco use intention and behaviours

Prevalent electronic cigarette (e-cigarette) use in schools may undermine tobacco denormalisation, and thus increase tobacco use in students. We investigated the associations of school-level e-cigarette use prevalence with student-level intention and behaviours related to e-cigarettes, cigarettes, and other tobacco products. In a 2014-15 school-based cross-sectional survey of 41035 secondary school students (grade 7–12; age 11–18 years) in Hong Kong, information was collected on the use of e-cigarettes, cigarettes, and non-cigarette tobacco products (NCTPs), susceptibility to e-cigarette and cigarette use, intention to quit cigarette smoking, and sociodemographic characteristics. The adjusted odds ratio (AOR) of e-cigarette use susceptibility in relation to high (vs low) school-level e-cigarette use prevalence was 1.40 (95% CI 1.05–1.87) in never e-cigarette users. The AORs of cigarette smoking susceptibility in relation to medium and high (vs low) school-level e-cigarette use prevalence were 1.24 (1.01–1.52) and 1.34 (1.02–1.75), respectively, in never cigarette smokers. School-level e-cigarette use prevalence was associated with ever and past 30-day cigarette smoking, but not with intention to quit (in past 30-day cigarette smokers) or past 30-day NCTP use. The findings highlight the importance of strictly banning e-cigarettes in schools, and add to the evidence that prevalent e-cigarette use in adolescents may increase cigarette smoking prevalence.

School effectiveness and students' future orientation: A multilevel analysis of upper secondary schools in Stockholm, Sweden

INTRODUCTION

Future orientation (FO) refers to individuals' beliefs and feelings about their future. Earlier research has primarily investigated correlates of FO at the individual and family level, but it seems likely that FO is also shaped by other central agents or institutions, such as the school. Earlier studies have found positive associations between "school effectiveness" and student performance, and negative associations in relation to e.g., bullying, delinquency, and health risk behaviors. The current study investigated three teacher-reported features of school effectiveness - school leadership, teacher cooperation and consensus, and school ethos - and their links with student-reported FO.

METHODS

Survey data were collected in 2016 among 5131 students (aged 17-18 years) and 1061 teachers in 46 upper secondary schools in Stockholm, Sweden, and merged with school-level register data. Two-level binary logistic regression analyses were performed.

RESULTS

The analyses showed that higher teacher ratings of school leadership and school ethos were associated with a greater likelihood of reporting an optimistic FO among students. Teacher cooperation and consensus was however not associated with students' FO.

CONCLUSION

The findings indicate that the school environment contributes to shaping students' beliefs about their future. Thus, enhancing features of school effectiveness may be a way of promoting a positive development and brighter objective future prospects for the young, via pathways such as good student-teacher relations and academic motivation and achievement.

Well-Being and Academic Achievement: Differences Between Schools From 2002 to 2010 in the Helsinki Metropolitan Area

BACKGROUND

We studied school-level differences in academic achievement and well-being from 2002 to 2010 in the Helsinki Metropolitan Area, as well as the connection between academic achievement, well-being, and socioeconomic composition.

METHODS

The School Health Promotion Study covered 109 schools and 78% of schoolchildren (N = 100,413; aged 14 to 16 years). Depression was measured with the modified Beck Depression Scale and academic achievement with the grade-point average. Trajectory analysis identified groups of schools that were as heterogeneous over time as possible.

RESULTS

Six school trajectories differing in academic achievement and 3 in well-being were observed. Differences between the trajectories persisted over time. Academic achievement and well-being were related: schools on a poor achievement trajectory were more often on a low-well-being trajectory. The poor socioeconomic composition of students was more common in low-academic achievement and well-being trajectories.

CONCLUSIONS

Academic achievement and well-being differed between schools and are closely related to each other and to the school's socioeconomic composition. Differences between the schools did not increase over time. Educational policies aimed at reducing differences should address both academic achievement and well-being.

School- and class-level variation in self-harm, suicide ideation and suicide attempts in Danish high schools

Aim: Strong associations have been found between being exposed to self-harm in family and friends and own self-harm in adolescence. Therefore, self-harm and suicide behaviour might tend to cluster within school and school classes. The aim of this study was to describe the prevalence, frequency and type of self-harm, suicide ideation and suicide attempts within Danish high schools and to test whether self-harm and suicide behaviour cluster in schools and school classes. Methods: Data came from the Danish National Youth Study 2014, a national survey. The respective study included 66,284 high-school students nested in 117 schools and 3146 school classes. The prevalence and clustering of self-harm behaviour, ever and within the last year, type of self-harm (e.g. cutting, burning, scratching and hitting) and suicide ideation and suicide attempts were investigated. Multi-level logistic regression was applied to quantify clustering among participants within the same class and school. Results: In total, 12,960 (20%) reported self-harm ever and 5706 (8.6%) within the last year. Prevalence was higher among girls than boys. Among girls, cutting (15%) and scratching (13%) was the most common type of self-harm, whereas among boys, hitting (6.7%) was most prevalent. The degree of clustering of self-harm and suicide behaviour was low, with school-level intra-class correlation coefficients (ICC) ranging from 0.8–1.8% and school class level ICC’s from 4.3–6.8%. Conclusions: This study shows that self-harm was common, especially in girls. The degree of clustering of self-harm and suicide behaviour in school and school classes was low.

Is being a "small fish in a big pond" bad for students´ psychosomatic health? A multilevel study on the role of class-level school performance

Background

Features of schools and classes are closely related to students´ health and wellbeing. However, class composition (e.g. in terms of school performance) has rarely been examined in relation to students´ health and wellbeing. This study focuses on the so called Big-Fish-Little-Pond-Effect (BFLPE), by investigating whether the level of high-performing students in classroom is negatively associated with psychosomatic complaints of students who perceive themselves as poor performers.

Methods

Data were derived from the German sample of the WHO-Collaborative “Health Behaviour in School-aged Children (HBSC)” study 2013/2014. The sample included 5226 11-, 13- and 15-year-old students. Individual perceived school performance (PSP) was included (very good/good vs. average/below average PSP) at the individual student-level. At the class-level, school performance in class was generated by aggregating the share (in percentage) of students who report a very good/good PSP to the class-level, indicating the percentage of students with good/very good PSP in classroom. Using multilevel regression models, the association between class-level school performance (in percentage of students with very good/good PSP) and individual psychosomatic complaints were analyzed, stratified by students´ individual PSP.

Results

Students who report average/below average PSP showed higher likelihoods of psychosomatic complaints (Odds Ratio: 1.75; 95% Confidence Interval: 1.52–2.03) compared to counterparts with very good/good PSP. The aggregated class-level PSP was not significantly associated with psychosomatic complaints. However, in line with the BFLPE, results further revealed that students with average/below average PSP, who attend classes with a higher percentage of students who report very good/good PSP, had higher likelihoods of psychosomatic complaints (Odds Ratio: 1.91; 95% Confidence Interval: 1.01–4.01) compared to classmates with very good/good PSP.

Conclusions

This study revealed that class composition in terms of PSP was differentially associated with students´ psychosomatic complaints, depending on their individual PSP. Findings highlight the vulnerability of students with poor PSP placed in classes with a higher percentage of students with good PSP. Results of this study therefore indicate a need for initiatives for low performing students from teachers and school staff in class.

School poverty and the risk of attempted suicide among adolescents

PURPOSE

Existing theory and empirical work suggest that impoverished school contexts may increase the risk of mental health problems such as suicide. This study tests this hypothesis by investigating the longitudinal association between school income and attempted suicide among American adolescents.

METHODS

Logistic regression models were used to estimate the association between school income and suicidal attempts among all adolescents and among those with suicidal thoughts, respectively. Data come from the National Longitudinal Survey of Adolescent Health, a nationally representative sample of American adolescents across 132 middle and high schools (N = 12,920).

RESULTS

Among all adolescents, the prevalence of attempted suicide was higher in low-income schools compared to middle-income schools for boys but not girls. Among those with suicidal thoughts, the prevalence of attempted suicide was also higher in low-income schools compared to middle- and high-income schools for boys only. Differences between middle- and high-income schools were not observed, suggesting that school income may only impact attempted suicide when high levels of deprivation are present. These significant associations persisted after adjusting for established risk factors such as prior suicidal attempts.

CONCLUSION

Highly impoverished school contexts may increase the risk of attempted suicide for boys. Future research exploring the mechanisms underlying this association may help inform the development of more effective suicide-prevention interventions.

The PATHS curriculum for promoting social and emotional well-being among children aged 7–9 years: a cluster RCT

Background

Universal social and emotional learning interventions can produce significant practical improvements in children’s social skills and other outcomes. However, the UK evidence base remains limited.

Objectives

To investigate the implementation, impact and cost-effectiveness of the Promoting Alternative THinking Strategies (PATHS) curriculum.

Design

Cluster randomised controlled trial. Primary schools (n = 45) were randomly assigned to implement PATHS or to continue with their usual provision for 2 years.

Setting

Primary schools in seven local authorities in Greater Manchester.

Participants

Children (n = 5218) in Years 3–5 (aged 7–9 years) attending participating schools.

Intervention

PATHS aims to promote children’s social skills via a taught curriculum, which is delivered by the class teacher, generalisation activities and techniques, and supplementary materials for parents. Schools in the usual provision group delivered the Social and Emotional Aspects of Learning programme and related interventions.

Main outcome measures

Children’s social skills (primary outcome, assessed by the Social Skills Improvement System); pro-social behaviour and mental health difficulties (Strengths and Difficulties Questionnaire); psychological well-being, perceptions of peer and social support, and school environment (Kidscreen-27); exclusions, attendance and attainment (National Pupil Database records); and quality-adjusted life-years (QALYs) (Child Health Utility 9 Dimensions). A comprehensive implementation and process evaluation was undertaken, involving usual provision surveys, structured observations of PATHS lessons, interviews with school staff and parents, and focus groups with children.

Results

There was tentative evidence (at ap-value of  < 0.10) that PATHS led to very small improvements in children’s social skills, perceptions of peer and social support, and reductions in exclusions immediately following implementation. A very small but statistically significant improvement in children’s psychological well-being [d = 0.12, 95% confidence interval (CI) –0.02 to 0.25;p < 0.05) was also found. No lasting improvements in any outcomes were observed at 12- or 24-month post-intervention follow-up. PATHS was implemented well, but not at the recommended frequency; our qualitative analysis revealed that this was primarily due to competing priorities and pressure to focus on the core academic curriculum. Higher levels of implementation quality and participant responsiveness were associated with significant improvements in psychological well-being. Finally, the mean incremental cost of PATHS compared with usual provision was determined to be £29.93 per child. Mean incremental QALYs were positive and statistically significant (adjusted mean 0.0019, 95% CI 0.0009 to 0.0029;p < 0.05), and the incremental net benefit of introducing PATHS was determined to be £7.64. The probability of cost-effectiveness in our base-case scenario was 88%.

Limitations

Moderate attrition through the course of the main trial, and significant attrition thereafter (although this was mitigated by the use of multiple imputation of missing data); suboptimal frequency of delivery of PATHS lessons.

Conclusions

The impact of PATHS was modest and limited, although that which was observed may still represent value for money. Future work should examine the possibility of further modifications to the intervention to improve goodness of fit with the English school context without compromising its efficacy, and identify whether or not particular subgroups benefit differentially from PATHS.

Trial registration

Current Controlled Trials ISRCTN85087674 (the study protocol can be found at:www.journalslibrary.nihr.ac.uk/programmes/phr/10300601/#/).

Funding

This 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. 10. See the NIHR Journals Library website for further project information.

Are the Benefits of Economic Resources for Socioemotional Functioning Shared across Racial/Ethnic Groups?

Growth in economic disparities, economic segregation, and racial/ethnic diversity have occurred in tandem in the U.S., leading to essential questions concerning whether the benefits of economic resources are shared across diverse groups. Analyzing a sample of eighth grade early adolescents (age 14 years) drawn from the nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (N = 7625; 59% White, 12% Black, 19% Hispanic, 7% Asian, 2% Native American, and 2% multiracial; 47% female), lagged regression models assessed links between family, neighborhood, and school income and adolescent emotional and behavioral functioning. The results found that family income was associated with heightened emotional and behavioral functioning, and school income with improved behavioral functioning for White adolescents, whereas no benefits emerged for Black or Hispanic youth. In contrast, mixed associations emerged between income and early adolescent functioning for Asian and American Indian youth, with predominantly negative links appearing for multiracial youth. These patterns highlight diversity in the potential benefits and costs of economic resources, and suggest the need to better specify mechanisms through which economic disparities affect youth from varied backgrounds.

Does an uneven sample size distribution across settings matter in cross-classified multilevel modeling? Results of a simulation study

BACKGROUND

Recent advances in multilevel modeling allow for modeling non-hierarchical levels (e.g., youth in non-nested schools and neighborhoods) using cross-classified multilevel models (CCMM). Current practice is to cluster samples from one context (e.g., schools) and utilize the observations however they are distributed from the second context (e.g., neighborhoods). However, it is unknown whether an uneven distribution of sample size across these contexts leads to incorrect estimates of random effects in CCMMs.

METHODS

Using the school and neighborhood data structure in Add Health, we examined the effect of neighborhood sample size imbalance on the estimation of variance parameters in models predicting BMI. We differentially assigned students from a given school to neighborhoods within that school's catchment area using three scenarios of (im)balance. 1000 random datasets were simulated for each of five combinations of school- and neighborhood-level variance and imbalance scenarios, for a total of 15,000 simulated data sets. For each simulation, we calculated 95% CIs for the variance parameters to determine whether the true simulated variance fell within the interval.

RESULTS

Across all simulations, the "true" school and neighborhood variance parameters were estimated 93-96% of the time. Only 5% of models failed to capture neighborhood variance; 6% failed to capture school variance.

CONCLUSIONS

These results suggest that there is no systematic bias in the ability of CCMM to capture the true variance parameters regardless of the distribution of students across neighborhoods. Ongoing efforts to use CCMM are warranted and can proceed without concern for the sample imbalance across contexts.

Parent Education and Substance Use among Latin-American Early Adolescents

Objective

To examine the relationship between parent education, at individual- and school-level, and substance use behaviors (smoking, alcohol drinking, binge drinking, and illicit drug use) among young adolescents from Argentina and Mexico.

Methods

A cross-sectional, school-based survey of middle-school early adolescents from Mexico (N=10,123) and Argentina (N=3,172) queried substance use.

Results

After adjusting for age, sex and individual-level parent education, students from Mexican schools with lower parent education had higher likelihood of current smoking and drug use than those from schools with higher parent education. In Argentina, lower parent education at school-level was positively associated with all outcomes.

Conclusion

Disadvantageous contextual school characteristics contributes to substance use among early adolescents in Mexico and Argentina.

Family dysfunction and anxiety in adolescents: A moderated mediation model of self-esteem and perceived school stress

This 18-month longitudinal study examined a moderated mediation model addressing the psychosocial mechanisms that account for the association between family dysfunction and anxiety. A sample of 847 Chinese early adolescents (M age = 12.96 years, SD = 0.67) completed questionnaires assessing family dysfunction, self-esteem, perceived school stress, and anxiety on three occasions at 6-month intervals. After gender and socioeconomic status were included as covariates, the results revealed that family dysfunction was significantly associated with adolescents' anxiety. Moreover, self-esteem partially mediated the relation between family dysfunction and anxiety, and perceived school stress moderated the mediation process in the family dysfunction to anxiety path and in the self-esteem to anxiety path. The findings suggested that both social contextual factors (e.g., family dysfunction and school stress) and self-system factors (e.g., low self-esteem) are risk factors for increased anxiety levels in adolescents. Limitations and practical applications of the study were discussed.

The Effects of Satisfaction of Basic Psychological Needs at School on Children's Prosocial Behavior and Antisocial Behavior: The Mediating Role of School Satisfaction

Grounded in Basic Psychological Need Theory, we examined the direct effects of the satisfaction of three basic psychological needs at school (i.e., satisfaction of autonomy needs at school, satisfaction of relatedness needs at school, and satisfaction of competence needs at school) on prosocial behavior and antisocial behavior as well as the mediation effects of school satisfaction on the relations between the satisfaction of three basic psychological needs at school and prosocial behavior as well as antisocial behavior. We employed a sample of 801 Chinese children (429 males; Mage = 9.47) in a three-wave longitudinal study, with each wave occurring 6 months apart. Direct and indirect effects were estimated by Structural Equation Modeling. Results indicated that: (1) Satisfaction of relatedness needs at school and competence needs at school, but not satisfaction of autonomy needs at school, displayed direct effects on prosocial behavior. Also, satisfaction of relatedness needs at school, but not satisfaction of autonomy needs at school or competence needs at school, displayed direct effects on antisocial behavior. (2) Both satisfaction of relatedness needs at school and competence needs at school displayed indirect effects on prosocial behavior and antisocial behavior via school satisfaction as a mediator. However, satisfaction of autonomy needs at school failed to have indirect effects on prosocial behavior or antisocial behavior via school satisfaction. These findings suggest differential predictors of children's prosocial and antisocial behavior, supporting the separability of the two constructs. The findings also suggest developmental differences in need satisfaction, with the satisfaction of autonomy needs playing a relatively less important role in school-age children. We also discussed limitations and practical applications of the study.

Perceived class climate and school-aged children's life satisfaction: The role of the learning environment in classrooms

The aim of this study is to examine the impact of class-level class climate on school-aged children's life satisfaction. Data was derived from the German National Educational Panel Study (NEPS) using sixth grade school-aged children (n = 4,764, 483 classes). Class climate includes indicators of teachers' care and monitoring, demands, interaction, autonomy, as well as school-aged children's attitudes towards schoolwork at the class- and individual-level. Results showed that individual perceived class climate in terms of teachers' care and monitoring and autonomy was positively related to life satisfaction, whereas school-related demands were related to lower life satisfaction. Besides teachers' care and monitoring at class-level, indicators of class climate were not associated with school-aged children's life satisfaction, while the individual perceived class climate is more important for life satisfaction.

Favourable Perceptions of Electronic Cigarettes Relative to Cigarettes and the Associations with Susceptibility to Electronic Cigarette Use in Hong Kong Chinese Adolescents

We investigated favourable perceptions of electronic cigarettes (ECs) relative to cigarettes and their associations with EC use susceptibility in adolescents. Hong Kong Chinese Secondary 1-6 (U.S. grade 7-12) students (n = 40,202) were surveyed in 2014/2015 on EC use, cigarette smoking, favourable perceptions of ECs relative to cigarettes, EC use susceptibility, family smoking, and socio-demographic characteristics. Cox regression yielded adjusted prevalence ratios (APRs) of EC use susceptibility in never users, excluding those unaware of ECs. In all students, 8.9% were ever EC users, 47.2% reported favourable perceptions of ECs relative to cigarettes, such as less likely to cause accidents (25.2%) and less harmful to users (24.5%), and 28.9% did not know ECs. Among never EC users who were aware of ECs (n = 24,663), EC use susceptibility was associated with each of the favourable perceptions, especially greater attractiveness (APR 2.84, 95% CI 2.53-3.19), and better parental (2.75, 2.41-3.15) and school acceptability (2.56, 2.15-3.05). An increased number of favourable perceptions of ECs relative to cigarettes was associated more strongly with the susceptibility (p for trend < 0.001). Our findings inform strategies to reduce unwarranted favourable perceptions and prevent adolescent EC use.

School Collective Efficacy and Bullying Behaviour: A Multilevel Study

As with other forms of violent behaviour, bullying is the result of multiple influences acting on different societal levels. Yet the majority of studies on bullying focus primarily on the characteristics of individual bullies and bullied. Fewer studies have explored how the characteristics of central contexts in young people’s lives are related to bullying behaviour over and above the influence of individual-level characteristics. This study explores how teacher-rated school collective efficacy is related to student-reported bullying behaviour (traditional and cyberbullying victimization and perpetration). A central focus is to explore if school collective efficacy is related similarly to both traditional bullying and cyberbullying. Analyses are based on combined information from two independent data collections conducted in 2016 among 11th grade students (n = 6067) and teachers (n = 1251) in 58 upper secondary schools in Stockholm. The statistical method used is multilevel modelling, estimating two-level binary logistic regression models. The results demonstrate statistically significant between-school differences in all outcomes, except traditional bullying perpetration. Strong school collective efficacy is related to less traditional bullying perpetration and less cyberbullying victimization and perpetration, indicating that collective norm regulation and school social cohesion may contribute to reducing the occurrence of bullying.

School Context and American Indian Substance Use

The present study extends prior research exploring the role of school contextual factors in predicting individual adolescent substance use by examining how a school's racial composition is associated with American Indian adolescent tobacco and marijuana use. Using a subsample of 523 American Indian students from the restricted use Add Health data, we consider both individual and school contextual factors across 99 schools. Our results suggest that a school's racial composition is associated with individual tobacco and marijuana use among American Indian youth, but in different ways depending upon the substance. Our findings illustrate the importance of extending research on the correlates of substance use for racial and ethnic minorities beyond studies examining African-Americans and/or Hispanics.