M Tobro’s research while affiliated with Cancer Research UK Oxford Centre and other places

The aim of this study was to evaluate the effect of an intervention with a universal program (single-tier) in one group, and the combination of this universal program and a selected + indicated measure (multi-tier) in another group. Interventions were designed to enhance the psychosocial environment to reduce loneliness and mental health problems. 17 upper secondary schools in Norway were randomly assigned with six, six, and five schools in the single-tier, multi-tier and control group respectively. An overall increase in mental health problems and loneliness was found in all groups at follow-up. Compared to girls in the control group, girls in the multitier group had a significantly lower increase in mental health problems. Due to small effects, we take caution in interpreting findings.

Background: Drop out from upper secondary school represents a risk for the future health and wellbeing of young people. Strengthening of psychosocial aspects of the learning environment may be an effective strategy to promote completion of upper secondary school. This paper is a study protocol of a school based cluster randomized controlled trial (RCT) evaluating two school-based interventions, namely the Dream School Program (DSP) and the Mental Health Support Team (MHST). The interventions aim to improve psychosocial learning environments and subsequently school achievements and decrease drop-out and absence. Methods/design: The COMPLETE RCT is aimed at youth in upper secondary school, grade 1 (age 15-16 years), and examines the effect of the combination of the DSP and the MHST; and the DSP only, compared with a comparison group on the following primary outcomes: student completion, presence, average grade, and self-reported mental health. Seventeen upper secondary schools from four counties in Norway were randomized to one of the three arms: 1) DSP and MHST; 2) DSP; and 3) comparison (offered DSP intervention in 2018/2019). The study will evaluate the interventions based on information from two cohorts of students (cohort 1 (C1) and cohort 2 (C2)). For C1, data was collected at baseline (August 2016), and at first follow-up seven months later. Second follow-up will be collected 19 months after baseline. For C2, data was collected at baseline (August 2017), and first and second follow-up will be collected similarly to that of C2 seven and 19 months respectively after baseline. Process evaluations based on focus groups, interviews and observation will be conducted twice (first completed spring 2017). Discussion: The COMPLETE trial is a large study that can provide useful knowledge about what interventions might effectively improve completion of upper secondary school. Its thorough process evaluation will provide critical information about barriers and points of improvement for optimizing intervention implementation. Findings can guide school development in the perspective of improving psychosocial learning environments and subsequent completion of upper secondary schooling. Trial registration: The trial was retrospectively registered in the ClinicalTrials.gov register on December 22.2017: NCT03382080 .