Socioeconomic status, mental wellbeing and transition to secondary school: Analysis of the School Health Research Network/Health Behaviour in School-aged Children survey in Wales

Screen time among kindergarten children in the Australian Capital Territory (including a comparison of First Nations and non-Indigenous children)

BACKGROUND

Australian First Nations children have poorer outcomes across a range of health measures. High levels of screen time are associated with a range of adverse health outcomes. Gaps remain in our knowledge on the association between screen time and health outcomes for different demographic groups, including First Nations children. We aimed to describe the screen time behaviours of First Nations and non-Indigenous kindergarten children in the Australian Capital Territory (ACT) and identify any associated disparities in key health outcomes.

METHODS

5,516 children participated in the cross-sectional population-based ACT Kindergarten Health Check (KHC) survey, including 146 First Nations children. The association between screen time of more than two hours per day and health outcomes (body mass index, respiratory health, development and wellbeing) was assessed for both First Nations and non-Indigenous cohorts using comparative statistics.

RESULTS

Non-Indigenous children who had an average of more than two hours of screen time per day were 1.5 (95% CI, 1.3-1.7) times more likely to be overweight/obese, 1.2 (95% CI, 1.0-1.4) times more likely to have had a wheeze/whistle in their chest in the 12 months before the KHC, 1.5 (95% CI, 1.3-1.7) times more likely to have developmental concerns and 1.5 (95% CI, 1.3-1.8) times more likely to have reduced wellbeing measures compared to non-Indigenous children with screen time of two hours or less per day. None of these associations were statistically significant amongst First Nations children.

CONCLUSIONS

Screen time of more than two hours per day is associated adverse health outcomes in non-Indigenous children, including overweight/obesity, respiratory problems, developmental concerns, and reduced wellbeing. Further analysis is required to enable a more robust assessment of the effect of screen time on health outcomes for First Nations children.

Adolescents' Wellbeing at School: What Helps and What Hinders From Feeling Safe and Satisfied?

Objectives

The aim of this qualitative study was to identify the main factors that help and hinder adolescents' wellbeing at school using their perspectives and experiences.

Methods

We used data from 45 adolescents in the first year of high school in Slovakia (mean age = 14.98; 22.2% boys). We obtained the data using 11 semi-structured group interviews conducted in 2020/2021. Participants were selected from three types of high school with regard to graduation system. Data was analysed using consensual qualitative research and thematic analysis.

Results

We identified three main themes of factors contributing to their wellbeing at school: 1. School (atmosphere and organisation of life at school, physical environment, threats and the ability of school to deal with issues); 2. Relationships (with peers and teachers, and teachers' behaviour towards them); 3. Myself (own perceived obstacles and resilience resources).

Conclusion

The organisation of life at school, surroundings, threats and dealing with issues importantly affect adolescents' wellbeing. Therefore, adjustment of physical environment and interpersonal competences of teachers, supporting of resilience resources of adolescents should be targets for interventions and prevention programmes at schools.

The Social and Emotional Education and Development intervention to address wellbeing in primary school age children: the SEED cluster RCT

Background

Stronger social and emotional well-being during primary school is positively associated with the health and educational outcomes of young people. However, there is little evidence on which programmes are the most effective for improving social and emotional well-being.

Objective

The objective was to rigorously evaluate the Social and Emotional Education and Development (SEED) intervention process for improving pupils' social and emotional well-being.

Design

This was a stratified cluster randomised controlled trial with embedded process and economic evaluations. Thirty-eight primary schools were randomly assigned to the SEED intervention or to the control group. Hierarchical regression analysis allowing for clustering at school learning community level was conducted in R (statistical package).

Setting

The SEED intervention is a whole-school intervention; it involved all school staff and two cohorts of pupils, one starting at 4 or 5 years of age and the second starting at 8 or 9 years of age, across all 38 schools.

Participants

A total of 2639 pupils in Scotland.

Intervention

The SEED intervention used an iterative process that involved three components to facilitate selection and implementation of school-based actions: (1) questionnaire completion, (2) benchmarked feedback to all staff and (3) reflective discussions (all staff and an educational psychologist).

Main outcome measure

The primary outcome was pupils' Strengths and Difficulties Questionnaire-Total Difficulties Score when pupils were 4 years older than at baseline.

Results

The primary outcome, pupils' Strengths and Difficulties Questionnaire-Total Difficulties Score at follow-up 3, showed improvements for intervention arm pupils, compared with those in the control arm [relative risk -1.30 (95% confidence interval -1.87 to -0.73), standardised effect size -0.27 (95% confidence interval -0.39 to -0.15)]. There was no evidence of intervention effects according to deprivation: the results were significant for both affluent and deprived pupils. Subgroup analysis showed that all effect sizes were larger for the older cohort, particularly boys [relative risk -2.36 (95% confidence interval -3.62 to -1.11), standardised effect size -0.42 (95% confidence interval -0.64 to -0.20)]. Although there was no statistically significant difference in incremental cost and quality-adjusted life-years, the probability that the intervention is cost-effective at a willingness-to-pay threshold of £20,000 per quality-adjusted life-year was high, at 88%. Particularly valued mechanisms of the SEED intervention were its provision of time to reflect on and discuss social and emotional well-being and its contribution to a culture of evaluating practice.

Limitations

It was a challenge to retain schools over five waves of data collection.

Conclusions

This trial demonstrated that the SEED intervention is an acceptable, cost-effective way to modestly improve pupil well-being and improve school climate, particularly for older boys and those with greater levels of psychological difficulties. It was beneficial during the transition from primary to secondary school, but this diminished after 6 years. The SEED intervention can be implemented alongside existing systems for addressing pupil well-being and can be complementary to other interventions.

Future work

Assess whether or not the SEED intervention has a beneficial impact on academic attainment, is transferable to other countries and other organisational settings, would be strengthened by adding core training elements to the intervention process and is transferable to secondary schools. Understand the gender differences illustrated by the outcomes of this trial. Conduct further statistical research on how to handle missing data in longitudinal studies of complex social interventions.

Trial registration

This trial is registered as ISRCTN51707384.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 10/3006/13) and is published in full in Public Health Research; Vol. 12, No. 6. See the NIHR Funding and Awards website for further award information.

Association between sports participation and resilience in school-attending students: a cross-sectional study

Aim

This research sought to identify the association between sports participation and resilience in children and adolescents as a means to enhance mental health.

Methods

A comprehensive survey was carried out, encompassing primary, middle, and high school students from chosen educational institutions. The analytical sample comprised 67,281 students of school age. Sports participation and resilience were evaluated using validated assessment tools, while relevant covariates, such as sex and school grade, were assessed through self-reported questionnaires. Generalized Linear Models were applied to ascertain the association between sports participation and resilience for the entire sample, and separately for subgroups divided by gender or school grade, after controlling for covariates.

Results

Among the 67,281 school students, males constituted 51.9% of the sample. Approximately 47.1% of the entire sample reported no sports participation, and the average resilience score was 24.7. The regression model analysis revealed that, in the entire sample, increased in sports participation was linked to higher resilience scores (odds ratio [OR] for 1-3 times per month: 1.20, 95%CI: 1.16-1.24; OR for 1-2 times per week: 1.38, 95%CI: 1.33-1.43; OR for 3 times or more per week: 1.72, 95%CI: 1.65-1.79). Analyses stratified by gender and school grade indicated that sports participation was consistently associated with greater resilience.

Conclusion

This study provides cross-sectional evidence supporting the positive association between sports participation and the resilience of children and adolescents, underscoring the potential of encouraging sports participation as a strategy for promoting mental health resilience. The findings presented herein should be subject to further confirmation or refutation in future research endeavors.

Learning loss and psychosocial issues among Thai students amidst the COVID-19 pandemic: the perspectives of teachers in the online classroom

BACKGROUND

The COVID-19 pandemic has had a broad influence on health and society across the globe, especially on the education sector as its educators have had to continue the provision of teaching and learning opportunities to their students online in the midst of pandemic. This has led to learning loss and psychological health issues among students, which is now being recognized worldwide. This study aims to explore the perceptions, perspectives, and experiences of teachers with regards to learning loss and psychological health issues among students during the COVID-19 pandemic in Thailand.

METHODS

Descriptive qualitative research was employed to gain a richer understanding of this interesting phenomenon. The experiences of twelve primary and secondary teachers were looked into by dividing them into several focus groups and interviewing them through video conferencing. All interviews were recorded, transcribed and analyzed through the use of content analysis.

RESULTS

The findings that include the perceptions, perspectives, and experiences among teachers focused on three main themes, which are teaching and Learning during the COVID-19 pandemic, learning loss caused by the COVID-19 pandemic, and support to deal with the psychosocial issues during the COVID-19 pandemic. These are then divided into fifteen sub themes.

CONCLUSIONS

Through these findings, this study is able to provide an understanding of the perceptions, perspectives, and experiences of teachers regarding learning loss and psychosocial issues among students during the COVID-19 pandemic in Thailand. It also highlights the psychological issues that were met, the social and family support offered, ways how learning loss among students could have been prevented in the midst of the pandemic, and finally suggests what the education administrators and healthcare or public health sector administrators can do to enhance the quality of education and resilience skills of the students during and after the pandemic.

A Systematic Review of School Transition Interventions to Improve Mental Health and Wellbeing Outcomes in Children and Young People

Normative transitions between educational settings can be important life events for young people, having the potential to influence mental health trajectories across the life course. Interventions to target transitions have been used to support children and young people as they transition between school settings, but there is limited synthesis of their effects. Seven databases were searched to identify studies of universal interventions focused on supporting mental health and wellbeing across three main types of educational transition: preschool to elementary school; school to school (including elementary to middle; middle to high and other combinations depending on country); and high school to post-compulsory education. Effect directions for behavioural, psychological/emotional and social measures of mental health were extracted for each study and synthesized using effect direction plot methodology. Searches identified 6494 records for screening. This resulted in 34 papers being included in the review, consisting of 24 different interventions. Social outcomes appeared more amenable to intervention than behavioural outcomes, with mixed findings for psychological measures of mental health. Intervention characteristics shifted based on the age of young person involved in the transition, with greater focus on parenting and school environment during the early transitions, and more focus on social support for the transition to post-compulsory education. A broad range of interventions were identified for supporting mental health and wellbeing across the three types of educational transition with mixed impact and diverse methodologies. More research is needed to identify transferable intervention mechanisms that may hold across different contexts and settings. PROSPERO registration number: CRD42020176336.

Safety Risks of Primary and Secondary Schools in China: A Systematic Analysis Using AHP–EWM Method

Owing to the frequent accidents in primary and secondary schools (PSS) in China in the past decades, a systematic analysis of indicators influencing safety risks in PSS is critical to identifying preventive measures. A two-hierarchy structure of indicators was identified by analyzing various cases, intensive interviews, and related previous literature. A combination of the analytic hierarchy process and the entropy weight method was developed to synthetically assess the primary and secondary risk indicators through a case study of Ma Shan School in China. The results are as follows: (1) the primary risk indicators, namely, natural disasters, public health, facility safety, accidental injury, public security, school bullying, and individual health constitute the evaluation framework of the safety risks in PSS. (2) Public health risks and accidental injury risks are the most critical factors that should be prioritized. In addition to providing academic implications, several managerial implications are proposed for these stakeholders to reduce the safety risks in PSS.

Mental health and life satisfaction among 10-11-year-olds in Wales, before and one year after onset of the COVID-19 pandemic

BACKGROUND

In many countries, including in the United Kingdom (UK), COVID-19 social distancing measures placed substantial restrictions on children's lives in 2020 and 2021, including closure of schools and limitations on play. Many children faced milestones such as transition to secondary school having missed several months of face-to-face schooling in the previous academic years.

METHODS

This paper examines change in mental health difficulties, life satisfaction, school connectedness, and feelings about transition to secondary school among 10-11-year-olds in Wales, UK, using data from repeat cross-sectional surveys before and after the onset of the COVID-19 pandemic. Participants were 4032 10-11-year-old schoolchildren. The first cohort completed a school-based survey in 2019 (prior to introduction of social distancing measures), and the second in 2021 (following full return to school after two rounds of school closure).

RESULTS

The percentage of children reporting elevated emotional difficulties rose from 17% in 2019 to 27% in 2021 (Odds Ratio = 1.65; 95%CI = 1.23 to 2.20). There was no evidence of increased behavioural difficulties (OR = 1.04; 95%CI = 0.73 to 1.46). There was a tendency toward declines in life satisfaction in all analyses, but this intersected the null (OR = 0.86; 95%CI = 0.70 to 1.07). Children reported a high degree of school connectedness before and after the pandemic, with no evidence of change in ratings of teacher relationships, pupil relationships or pupil involvement in school life. There was no evidence of impacts of the pandemic on children's feelings about the transition to secondary school, with feelings becoming more positive as transition neared. Most findings were robust to a range of sensitivity analyses.

CONCLUSIONS

Supporting children's emotional recovery from the COVID-19 pandemic is a public health priority requiring urgent and effective action at multiple levels of society. Maintaining connectedness to school through the pandemic may have played a role in preventing a steeper increase in child mental health difficulties.

Using Latent Class Analysis to Explore Complex Associations Between Socioeconomic Status and Adolescent Health and Well-Being

PURPOSE

Research demonstrates a strong socioeconomic gradient in health and well-being. However, many studies rely on unidimensional measures of socioeconomic status (SES) (e.g. educational qualifications, household income), and there is often a more limited consideration of how facets of SES combine to impact well-being. This paper develops a multidimensional measure of SES, drawing on family and school-level factors, to provide more nuanced understandings of socioeconomic patterns in adolescent substance use and mental well-being.

METHODS

Data from the Student Health and Wellbeing Survey from Wales, UK was employed. The sample compromised 22,372 students and we used latent class analysis to identify distinct groups using three measures of SES. These classes were then used to estimate mental well-being, internalizing symptoms, and substance use.

RESULTS

The five-class solution offered the best fit. Findings indicated distinct classes of families as follows: "nonworking," "deprived working families," "affluent families in deprived schools," "lower affluence," and "higher affluence." There was a clear relationship among the classes and mental well-being, internalizing symptoms, smoking, and cannabis use; alcohol was the exception to this.

CONCLUSIONS

The identification of these classes led to a fuller understanding of the health and well-being effects of SES, showing clearer patterning in health behaviors that often is not captured in research. The implications for adolescent health and well-being are discussed, including considerations for future research.

Socio-Economic Status, Mental Health Difficulties and Feelings about Transition to Secondary School among 10-11 Year Olds in Wales: Multi-Level Analysis of a Cross Sectional Survey

Transition between primary and secondary school represents an important milestone in young people's development. While most young people look forward to this transition, it is a source of anxiety for many. Drawing on a nationally representative survey of 2218 children in 73 schools in Wales, this study aimed to understand the extent to which 10-11 year old children worried about and/or looked forward to their imminent transition to secondary school, the things they worried about and/or looked forward to, and how feelings about transition differed by socioeconomic status, as well as by emotional and behavioural difficulties. About a third of children reported being quite or very worried about transition to secondary school, while approximately two-thirds reported looking forward to it quite a bit or very much. These items were only moderately correlated, with many children both looking forward to and worrying about transition, or neither. Major sources of worry about transition centred around bullying and impact on existing friendships, while forming new friendships or joining existing friends in their new school were key things children looked forward to. Children from poorer backgrounds, attending poorer schools and reporting more emotional difficulties were significantly more likely to report worries about transition. Children from poorer families, and children reporting more emotional difficulties and behavioural difficulties, were less likely to look forward to transition. Interventions to support children in transition to secondary school need to be sensitive to the needs of children from poorer backgrounds and children with mental health difficulties.

Pupil Mental Health, Concerns and Expectations About Secondary School as Predictors of Adjustment Across the Transition to Secondary School: A Longitudinal Multi-informant Study

The transition from primary to secondary schooling is challenging and involves a degree of apprehension. The extent to which pre-existing mental health difficulties, as well as pupil, parent, and teacher concerns and expectations about secondary school predict adaptation to secondary school, is unclear. In a three-wave, prospective longitudinal study, we examined associations between pre-transition concerns and expectations about moving to secondary school with mental health difficulties and demographic factors. We then evaluated whether these constructs predicted multiple indicators of adaptive pupil functioning at the end of the first year of secondary school (academic attainment, classmate behaviour rating, school liking and loneliness at school). We found children’s concerns reduced across the transition period. Concurrent associations were identified between both concerns about secondary school and lower parent and teacher expectations that children would settle in well at secondary school, with mental health difficulties and special educational needs. Investigating associations with multiple indicators of adaptive functioning at secondary school, multivariable regression analyses controlling for a range of baseline factors (e.g. special educational needs), found children’s concerns about secondary school to be specifically associated with loneliness. In contrast, children’s mental health difficulties and both parent and teacher expectations of how well children would settle into secondary school were associated with a wider range of indicators of adaptive functioning at secondary school. When examining all predictors simultaneously, primary school teacher expectations showed longitudinal association with a wide range of indicators of successful transition. These findings suggest that assessing primary school teacher expectations may be useful for monitoring and supporting pupils through this transition period and could usefully inform school-based interventions to support transition and mental health.

A bio-ecological framing of evidence on the determinants of adolescent mental health - A scoping review of the international Health Behaviour in School-Aged Children (HBSC) study 1983-2020

This paper extracts, organises and summarises findings on adolescent mental health from a major international population study of young people using a scoping review methodology and applying a bio-ecological framework. Population data has been collected from more than 1.5 million adolescents over 37 years by the Health Behaviour in School-Aged Children: WHO Cross-National (HBSC) Study. The paper reviews the contribution that this long standing study has made to our understanding of the individual, developmental, social, economic, cultural determinants of adolescent mental health by organising the findings of 104 empirical papers that met inclusion criteria, into individual, microsystem, mesosystem and macrosystem levels of the framework. Of these selected papers, 68 were based on national data and the other 36 were based on international data, from varying numbers of countries. Each paper was allocated to a system level in the bio-ecological framework according to the level of its primary focus. The majority (51 papers) investigate individual level determinants. A further 28 concentrate primarily on the microsystem level, 6 on the mesosystem level, and 29 on the macrosystem level. The paper identifies where there is evidence on the determinants of mental health, summarises what we have learned, and highlights research gaps. Implications for the future development of this population health study are discussed in terms of how it may continue to illuminate our understanding of adolescent mental health in a changing world and where new directions are required.