A Longitudinal Evaluation of the Positive Action Program in a Low-Income, Racially Diverse, Rural County: Effects on Self-Esteem, School Hassles, Aggression, and Internalizing Symptoms

Whole-school interventions promoting student commitment to school to prevent substance use and violence, and improve educational attainment: a systematic review

Background

Whole-school interventions modify the school environment to promote health. A subset of these interventions promotes student commitment to school to prevent substance (tobacco, alcohol, other drugs) use and/or violence. A previous review identified the theory of human functioning and school organisation as a comprehensive theory of such interventions, and found evidence that these interventions reduce substance use and/or violence.

Objectives

The objectives were to search for, appraise and synthesise evidence to address the following questions: (1) What whole-school interventions promoting student commitment to school to prevent substance use and/or violence have been evaluated, what intervention subtypes are apparent and how closely do these align with the theory of human functioning and school organisation? (2) What factors relating to setting, population and intervention affect implementation? (3) What are the effects on student substance use, violence and educational attainment? (4) What is the cost-effectiveness of such interventions? (5) Are intervention effects mediated by student commitment to school or moderated by setting or population?

Data sources

A total of 56 information sources were searched (in January 2020), then an updated search of 48 of these was carried out (in May 2021). Reference lists were also searched and experts were contacted.

Review methods

Eligible studies were process/outcome evaluations of whole-school interventions to reduce student violence or substance use among students aged 5-18 years attending schools, via actions aligning with the theory of human functioning and school organisation: modifying teaching to increase engagement, enhancing student-staff relationships, revising school policies, encouraging volunteering or increasing parental involvement. Data extraction and quality assessments used existing tools. Theory and process reports were synthesised qualitatively. Outcome and economic data were synthesised narratively; outcome data were meta-analysed.

Results

Searches retrieved 63 eligible reports on 27 studies of 22 interventions. We identified four intervention subtypes focused on student participation in school-wide decisions, improving staff-student relationships, increasing engagement in learning and involving parents. The theories of change of most intervention subtypes aligned closely with the theory of human functioning and school organisation, and informed refinement of an intervention theory of change. Theories of change for interventions increasing learning engagement did not align with this theory, aiming instead to increase school commitment primarily via social skills curricula. Factors influencing the implementation included whether or not interventions were tailorable, workable and well explained. Interventions with action groups comprising staff/students, etc. and providing local data were well implemented. Implementation was also affected by whether or not schools accepted the need for change and staff had the resources for delivery. Meta-analyses suggest small, but significant, intervention effects in preventing violence victimisation and perpetration, and substance use. There was sparse and inconsistent evidence of moderation and some evidence of mediation by student commitment to school. Two economic evaluations suggested that there is the potential for the interventions to be cost-effective.

Limitations

The quality of the studies was variable and the economic synthesis was limited to two studies.

Conclusions

Whole-school interventions aiming to promote student commitment to school share similar theories of change and factors affecting implementation. They have the potential to contribute to preventing violence and substance use among young people. Future trials should aim to optimise intervention effectiveness by better theorisation, and assess implementation and effect moderators and mediators.

Study registration

This study is registered as PROSPERO CRD42019154334.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/151/05) and is published in full in Public Health Research; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.

Body image construction and mental health levels among college students: a data survey of Chinese university students

Background

With the rapid changes in body image construction brought about by the upgrading of consumption in China, trend-seeking college students are faced with mental health problems brought about by the pursuit of the "ideal body type," which cannot be ignored. This study aims to explore the relationship between body image construction and mental health among college students. This study utilized data from the Survey on Physical Activity and Mental Health of College Students. A total of 1,192 students were randomly selected as the survey sample, and 1,044 valid samples were obtained. The mean age of the respondents was 19.34 years.

Methods

First, we categorized body image constructs into three categories based on the differences between subjective and objective body image: high acceptance, low acceptance, and consistency. Second, to ensure analytical rigor and minimize potential confounders, we used a generalized propensity score weighting model. Finally, we used a causal mediation framework to investigate the potential causal mechanisms between the independent variable (perceived body image bias) and the dependent variable (mental health) in order to better understand the "net effect."

Results

(1) There is a significant correlation between college students' body image perceptual bias and mental health, i.e., the higher the individual's acceptance of his/her own body image, the higher the level of mental health, and vice versa. (2) Students in humanities and social sciences are more likely to have increased psychological burden due to poor negative body image. (3) In the mediation analysis, although the causal mediating effect of physical exercise was not significant, family and peer support in physical exercise played an important mediating role, especially the influence of peers was more significant.

Conclusion

The construction of body image is a double-edged sword that can either promote positive individual development or lead to self-depreciation. Creating a positive climate for physical activity has a positive impact on college students' mental health compared to participation in physical activity behaviors. While improving students' media literacy on college campuses, it is important to enhance adaptive guidance to promote their physical and mental health and personal development.

The moderating effects of school resources on the impact of a school-based intervention on the social information-processing skills of third graders in rural China

Using a school-based intervention, Let's Be Friends (LBF), designed to promote the social information-processing (SIP) skills of third-grade children in rural China, the specific aim of this study was to assess the moderating effects of school characteristics on program outcomes. We systematically tested the moderating effects of six school-resource variables (i.e., student-teacher ratio, school size, number of library books per student, number of computers per 100 students, percentage of teachers with middle- and high-level titles, and percentage of teachers with high-level title or "backbone" recognition) on outcomes in a controlled trial of LBF program. School resources (i.e., small school size, low student-teacher ratio, and more teachers with high-level title or backbone) were associated with SIP skill acquisition, reduced aggressive behavior, and higher cognitive concentration. School contextual characteristics condition the impact of social-emotional education programs in Chinese rural primary schools.

When Does Rejection Trigger Aggression? A Test of the Multimotive Model

Research has sought to identify the conditions under which rejection leads to retaliation. The Multimotive Model (MMM) proposes that there are three primary behavioral responses to rejection: prosocial (e.g., befriending others), asocial (e.g., withdrawal), and antisocial behavior (e.g., aggression toward others). In this study, we conducted the first full test of the MMM as well as expanded the model. Based on research linking aggression and “perceived groupness,” construal items were added assessing whether the rejection was perceived as extending beyond the individual to one's peers. We also included self-harm behavioral responses as this outcome was not sufficiently captured by existing antisocial or asocial operationalizations. This expanded model was then tested with two high school student samples (Ns of 231 and 374) who reported experiencing aggressive rejection (i.e., experienced physical, verbal, relational, or cyber aggression from peers). The MMM was compared to a saturated model separately in each of the two datasets using structural equation modeling. Results indicate that the saturated model provides a better fit for the data than the MMM across all models examined (all p < 0.001). In part, this is due to certain paths having different associations than hypothesized. For example, perceiving the rejection as carrying a higher cost was predicted to promote prosocial behavior, where instead it predicted asocial responses. Perceived groupness was the strongest predictor of antisocial responses. Self-harm outcomes were significantly and consistently associated with higher perceived costs across the models. These results and others will be discussed in the context of how we can better encourage prosocial and discourage antisocial and self-harm responses to social rejection, including bullying.

A longitudinal study of the impact of school delinquency on self-worth development among Black American adolescents

Previous research found adolescents with low self-worth often utilize delinquency as a method of "self-enhancing" as proposed by Kaplan, which suggests the effects of delinquency can be both enhancing and damaging to adolescents' later reports of self-worth. We tested Kaplan's self-enhancing thesis to determine the extent to which different levels of self-worth in early adolescents foretell long-term levels of self-worth associated with delinquency among adolescents placed at-risk. Data from a sample of 982 primarily Black American (95%) adolescents living in high-poverty neighborhoods were analyzed using global and behavioral self-worth measures collected annually between the ages of 12-17, with school delinquency as the self-enhancing mechanism. Gender (45% female, 55% male) and baseline self-worth measures were included in the model. We found empirical support for the positive effects of school delinquency consistent with self-enhancing theories, although with younger female participants only. Specifically, engaging in delinquent behaviors at age 12 had a positive effect on a females' behavioral self-worth. There were, however, differential effects for males. Although delinquency increased self-worth among females in the short-term, long-term effects were negative, as greater school delinquency resulted in lower self-worth at age 17. Additional gender results and implications for findings are discussed.

Protective and Risk Factors for Adolescent Substance Use in Spain: Self-Esteem and Other Indicators of Personal Well-Being and Ill-Being

Although self-esteem has traditionally been considered as an important correlate of psychosocial adjustment, some empirical studies have found a positive relationship between some domains of self-esteem and drug use among adolescents. The present study analyzes self-esteem and other adjustment personal indicators as protective or risk factors for substance use. Participants were 644 Spanish adolescents aged 12–17 years. Substance use (cigarettes, alcohol, marijuana, and other illicit drugs), multidimensional self-esteem (academic, social, emotional, family, and physical), and other indicators of adolescents’ well-being and ill-being (psychological problems, behavior problems, and parenting) were measured. We observed, on the one hand, that substance use had a significant negative relationship with academic, family, and physical self-esteem. On the other hand, we also observed a significant positive relationship between drug use and social self-esteem. However, this significant relationship disappeared after statistically controlling for sex and age, using both partial correlation analyses and covariance analysis. Interestingly, beyond the importance of each factor related to drugs, prevention science should first of all be able to identify whether the main psychological variables (e.g., social or physical self-esteem) are risk or protective factors for drug use.

How can adolescent aggression be reduced? A multi-level meta-analysis

Aggressive behaviour among adolescents has significant social and economic costs. Numerous attempts have been made to intervene to reduce aggression in adolescents. However, little is known about what factors enhance or diminish intervention effectiveness. The present systematic review and meta-analysis, therefore, seeks to quantify the effectiveness of interventions to reduce aggressive behaviour in adolescents and to identify when and for whom such interventions work best. Sixteen databases were searched for randomised controlled trials that assessed interventions to reduce aggression among adolescents. After screening 9795 records, 95 studies were included. A multi-level meta-analysis found a significant overall small-to-medium effect size (d = 0.28; 95% CI [0.17, 0.39]). More effective interventions were of shorter duration, were conducted in the Middle East, were targeted at adolescents with higher levels of risk, and were facilitated by intervention professionals. Potentially active ingredients were classified using the Behaviour Change Technique Taxonomy. Behavioural practice and problem solving were components of more effective interventions targeted at the general population. Overall the findings indicate that psychosocial interventions are effective in reducing adolescent aggression. Future trials need to assess the effect of individual techniques and their combination to identify the key components that can reduce aggression in adolescents.

Mechanisms of Change in the Prevention of Depression: An Indicated School-Based Prevention Trial at the Transition to High School

OBJECTIVE

Depression represents a major public health concern, and prevalence increases significantly during adolescence. The high school transition may exacerbate the risk of depression for youth with pre-existing vulnerability. The High School Transition Program (HSTP) is a brief, skills-based intervention that has demonstrated efficacy in preventing depression in adolescents. The current study aimed to evaluate the theorized mechanisms of change of the HSTP intervention by testing a multiple mediation model including school attachment (SA) and self-esteem (SE) as two mediators of treatment outcomes.

METHOD

Students (N= 497; 61.5% girls) with elevated depressive symptoms, identified for the intervention program via an eighth-grade screening, were randomized to a brief intervention (n = 247) or the HSTP (n = 233) from 2003 to 2008. Participants completed measures at five time points. The first assessment occurred at the start of the second semester of eighth grade and the last assessment occurred at the end of ninth grade. A multiple mediation model tested whether SA and SE contributed to changes in depression for youth in the HSTP.

RESULTS

The mediation model, including contemporaneously assessed SE and SA, was not supported. There was evidence of sequential mediation, such that students who participated in the HSTP intervention reported higher SA, which in turn predicted improved SE, and in turn contributed to amelioration of depressive symptoms.

CONCLUSION

The HSTP intervention ameliorated depressive symptoms by targeting factors specific to the school transition (ie, SA). Results suggest youth at risk for depression may benefit from prevention efforts that enhance students' capacity to effectively manage identified environmental stressors, such as school transitions.

CLINICAL TRIAL REGISTRATION INFORMATION

Middle School to High School Transition Project: Depression and Substance Abuse Prevention; https://clinicaltrials.gov/; NCT00071513.

Conciencia de las capacidades personales y rendimiento académico en la implementación de un programa psicoeducativo

La mejora de la experiencia educativa de los menores y el desarrollo de competencias personales reducen el riesgo de trabajo infantil. En este estudio valoramos el impacto de una intervención psicoeducativa para la prevención del trabajo infantil en dos barrios de la periferia de Lima. Con un diseño pretest-postest, evaluamos los cambios en la autoestima, la autoeficacia, las habilidades sociales, la asistencia a la escuela y el rendimiento académico de 48 alumnos de entre 8 y 13 años (M=10.38, DE=1.22). Los resultados mostraron una mejora en la autoestima percibida y un descenso en la autoeficacia social y el auto-informe de habilidades sociales. La evaluación cualitativa de la percepción de los cambios por parte de los estudiantes, los padres y los docentes mostró mejoras en el desarrollo socio-afectivo de los participantes. La evaluación del programa sugiere la existencia de un proceso de toma de conciencia de las capacidades personales por parte de los participantes, junto con pequeñas mejoras en el ámbito académico que pueden repercutir indirectamente en el riesgo del trabajo infantil.

Socio-affective and cognitive predictors of social adaptation in vulnerable contexts

People living in vulnerable environments face a harder set of challenges adapting to their context. Nevertheless, an important number of them adapt successfully. However, which cognitive and socio-affective variables are specifically related to these variations in social adaptation in vulnerable contexts has not been fully understood nor directly addressed. Here we evaluated socio-affective variables (anxious attachment style, internal locus of control, self-esteem and stress) and cognitive variables (fluid intelligence, crystallized intelligence, working memory, numeracy, probabilistic reasoning and logical reasoning) to explain variations in social adaptation in a sample of 232 adults living in vulnerable contexts (M = 42.3, SD = 14.9, equal amount of men and women). Our results show that an important amount of variance in social adaptation can be explained by socio-affective variables, principally by self-esteem, while cognitive variables also contributed significantly. As far as we know, this is one of the first steps towards understanding the role of cognitive and socio-affective features on social adaptation. In the long run, this area of research could play an important role on the assignation of resources to ease people's integration into society. Our data and R analysis scripts can be found at: https://osf.io/egxy5/.

Individual-level factors related to better mental health outcomes following child maltreatment among adolescents

Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above.

Scaling Up a Multifaceted Violence Prevention Package: County-Level Impact of the North Carolina Youth Violence Prevention Center

OBJECTIVE

Multifaceted approaches to youth-violence prevention package evidence-based programs into initiatives that yield large-scale impact. This study assessed the impact of a package of evidence-based violence prevention programs, implemented as part of the North Carolina Youth Violence Prevention Center, on county-level violence indicators.

METHOD

Using growth-curve modeling, the target county was compared to all other counties in North Carolina and a comparison county.

RESULTS

Results reveal downward trends on several county-level indicators (i.e., undisciplined/delinquent complaints, total delinquent complaints, juvenile arrests-aggravated assaults, and short-term suspensions) throughout the intervention period. However, statistical tests were unable to confirm that intervention-period scores on youth-violence indicators were significantly different than expected scores given the relationship between pretest and intervention-period scores in other North Carolina counties.

CONCLUSIONS

Although additional administrative data points are needed to support the hypotheses, this study provides preliminary evidence of the effectiveness of North Carolina Youth Violence Prevention Center interventions.