School-based prevention of depression: a 2-year follow-up of a randomized controlled trial of the beyondblue schools research initiative.
ABSTRACT To investigate the effectiveness of a universal intervention designed to reduce depressive symptoms experienced by adolescents at high school. The results from annual assessments during the 3-year intervention and a 2-year follow-up are reported.
Twenty-five pairs of secondary schools matched on socio-economic status were randomly assigned to either an intervention or a comparison group (n = 5,633 year 8 students, mean age = 13.1 years, SD = .5). The intervention used a comprehensive classroom curriculum program, enhancements to school climate, improvements in care pathways, and community forums. A range of measures completed by students and teachers was used to assess changes in depressive symptoms, risk and protective factors relevant to depression, and the quality of the school environment.
Changes in the levels of depressive symptoms and in the levels of risk and protective factors experienced by students in the two groups did not differ significantly over the 5 years of the study. Statistically significant differences in the ratings of school climate across this time were found only for teacher-rated assessments.
There was little evidence that a multicomponent universal intervention delivered over a 3-year period reduced levels of depressive symptoms among participating students. Implementing universal interventions to improve student mental health is difficult in school settings that commonly have a crowded agenda of educational and health-related programs. Successful implementation will require programs which are perceived by teachers and students as relevant to educational and learning goals, and which can be effectively delivered in conjunction with other school programs.
SourceAvailable from: Theodora Pouliou[Show abstract] [Hide abstract]
ABSTRACT: Background Healthy children achieve better educational outcomes which, in turn, are associated with improved health later in life. The World Health Organization’s Health Promoting Schools (HPS) framework is a holistic approach to promoting health and educational attainment in school. The effectiveness of this approach has not yet been rigorously reviewed. Methods We searched 20 health, education and social science databases, and trials registries and relevant websites in 2011 and 2013. We included cluster randomised controlled trials. Participants were children and young people aged four to 18 years attending schools/colleges. HPS interventions had to include the following three elements: input into the curriculum; changes to the school’s ethos or environment; and engagement with families and/or local communities. Two reviewers identified relevant trials, extracted data and assessed risk of bias. We grouped studies according to the health topic(s) targeted. Where data permitted, we performed random-effects meta-analyses. Results We identified 67 eligible trials tackling a range of health issues. Few studies included any academic/attendance outcomes. We found positive average intervention effects for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small. On average across studies, we found little evidence of effectiveness for zBMI (BMI, standardized for age and gender), and no evidence for fat intake, alcohol use, drug use, mental health, violence and bullying others. It was not possible to meta-analyse data on other health outcomes due to lack of data. Methodological limitations were identified including reliance on self-reported data, lack of long-term follow-up, and high attrition rates. Conclusion This Cochrane review has found the WHO HPS framework is effective at improving some aspects of student health. The effects are small but potentially important at a population level.BMC Public Health 02/2015; 15:130. DOI:10.1186/s12889-015-1360-y · 2.32 Impact Factor
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ABSTRACT: Adolescence is a developmental period characterised by vulnerability to psychopathology. Previous research has often confused treatment and prevention, and has cited effect sizes in selective or indicated samples as evidence for preventive efficacy without regard to the course of ‘healthy’ participants over time. The present review clarifies the definition of a prevention effect, and reviews universal, school-based prevention studies. It was found that of 36 included studies, 16.7%, 0%, and 21.4% demonstrated a true prevention effect for depression, anxiety, and disordered eating, respectively. No conclusions regarding a ‘gold standard’ approach could be drawn. Future directions for prevention research are discussed.11/2014; DOI:10.1016/j.mhp.2014.11.002
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ABSTRACT: Background The present study evaluates the long-term effects of a universal prevention approach for depression in children. It looks into the 2- and 3-year follow-ups of previously reported postintervention and 1-year outcomes. Method One hundred and eighty-nine 3rd grade (8–9 years old) children participated in a five-session, school-based, universal prevention program designed to encourage social skills and peer support. The study was conducted from 2006 to 2009 in two public schools in Miyazaki, the south main island of Japan. ResultsDepressive symptoms decreased significantly from the pre to the postintervention periods, and this effect was maintained. Furthermore, children in the prevention group showed significantly lower depression than the normative sample. Conclusions This study reveals the beneficial long-term effects of a universal approach.Child and Adolescent Mental Health 05/2013; 18(2). DOI:10.1111/j.1475-3588.2012.00665.x · 0.95 Impact Factor