Academic Stress Interventions in High Schools: A Systematic Literature Review.

The experience of academic stress is common during high school and can have significant negative consequences for students' educational achievement and wellbeing. High school students frequently report heightened levels of school-related distress, particularly as they approach high-stakes assessments. Programs designed to reduce or prevent academic stress are needed, and their delivery in school settings is ideal to improve treatment access. The current review aimed to examine the effectiveness of high school-based programs in reducing or preventing academic stress. A systematic search returned 31 eligible studies across 13 countries. Programs were categorised according to intervention type, format, and facilitator. Results showed that the methodological quality of most studies was poor, and many used an inactive control group. As predicted by theories of academic stress, the strongest evidence was for programs grounded in cognitive-behavioural therapy (CBT). There was evidence that both universal and targeted approaches can be beneficial. The unique implementation issues for these two formats are discussed. Most programs were delivered by psychologists and were generally effective, but almost all of these were CBT programs. A smaller proportion of programs delivered by teachers were effective. Therefore, future studies should evaluate the implementation success of programs to improve the rate of effective delivery by school staff. Overall, the field will benefit from more randomised controlled trials with comparisons to active control groups, larger sample sizes and longer-term follow-ups.

Improving Children's Lifestyle and Quality of Life through Synchronous Online Education: The Nutritional Adventures School-Based Program.

The early introduction of effective nutritional educational programs is pivotal for instilling sustainable healthy behaviors. The present work aims to present a best practice example of a nutrition and overall lifestyle school-based training program, the Nutritional Adventures ("Diatrofoperipeteies"). Conducted during 2020-2022 in Greek primary schools, this synchronous, online educational initiative included two 1-school-hour activities with a nutrition instructor. Additionally, schools were randomly assigned to supplementary "at-home" supported-by-parents or "in-class" supported-by-educators educational activities. In total, n = 12,451 students of 84 primary schools participated. Parent-completed questionnaires were selected in the recruitment and post-intervention phase (40% participation rate); overall, the working sample was n = 1487 students. In the post-intervention phase, a significant increase in Mediterranean diet adherence was observed (KIDMED score: mean increment = 0.25 units; p < 0.001), particularly fruit and vegetable consumption. Time spent on physical activity increased, while screen time decreased. Students' total quality of life significantly improved (PedsQL; mean increment = 1.35 units; p < 0.001), including on all of its subscales (physical, emotional, social, and school function). Supplementary educational activities that were supported by educators rather than parents yielded a more favorable impact on students' lifestyle and quality of life. The Nutritional Adventures program can be regarded as a successful initiative in primary schools, yielding immediate advantages that extend beyond promoting healthy dietary habits.

Co-design and Development of Implementation Strategies: Enhancing the PAX Good Behaviour Game in Australian Schools.

Effective implementation strategies are important for take-up of programs in schools. However, to date, few implementation strategies have been co-designed with teachers and support staff (including principals) in Australia. The aim of this study was to iteratively co-design multiple implementation strategies to enhance the delivery of mental health prevention program, PAX Good Behaviour Game, in New South Wales primary schools. The secondary aim was to evaluate the acceptability of the implementation strategies from the perspective of school staff. Twenty-nine educational staff (including principals) informed the co-design of the implementation strategies across three phases. Phase 1 involved a rapid review of the literature and stakeholder meetings to agree upon potential evidence-based strategies. Phase 2 involved focus group discussions with educational staff to co-design implementation strategies. Phase 3 involved semi-structured interviews with school staff to assess strategy acceptability after implementation at 6-months post-baseline. Data were analysed using deductive, framework analysis. The final co-designed intervention included nine implementation strategies accessible through a toolkit delivered to the school's leadership team. These strategies were deemed acceptable in school settings that experienced periods of both face-to-face and remote learning due to the changing COVID-19 situation in 2021. This paper contributes to the implementation literature by transparently reporting how educational staff-informed implementation strategies were iteratively co-designed. This will provide a roadmap for other researchers to co-design implementation strategies to further support the delivery of evidence-based prevention programs in schools.

The impact of dentists' availability in delivering dental care in Florida Elementary Schools.

OBJECTIVE: This study evaluates the dentists' availability to deliver preventive dental care to children in schools and the impact of school-based programs on access. METHODS: The study population included Florida elementary-school children, differentiated by dental insurance (Medicaid, CHIP, private, or none). We considered the implementation of school-based programs using optimization modeling to (re)allocate the dentists' caseload to schools to meet demand for preventive care under resource constraints. We considered multiple settings for school-based program implementation: (i) school prioritization; and (ii) dentists' participation in public insurance. Statistical inference was used to identify communities to improve access and reduce disparities. RESULTS: School-based programs reduced unmet demand (3%-12%), being more efficient if prioritizing schools in communities targeted to improve access. The access improvement varied by insurance status and geography. Uninsured urban children benefited most from school-based programs, with 15%-75% unmet need reduction. The percentage of urban communities targeted to improve access decreased by 12% against no-school program. Such percentage remained large for suburban (15%-100%) and rural (50%-100%) communities. Disparity in access for public-insured vs. private-insured children persisted under school-based programs (32%-84% identified communities). CONCLUSION: School-based programs improve dental care access; the improvement was however different by insurance status, with uninsured children benefiting the most. Accounting to the dentists' availability in prioritizing schools resulted in effective resource allocation to school-based programs. Access disparities between public and private-insured children did not improve; school-based programs shifted resources from public-insured to uninsured. School-based programs are effective in addressing access barriers to those children experiencing them most.

Social features in internet-based programs to prevent alcohol consumption among adolescents: a scoping review.

Alcohol consumption among adolescents is a social and public health issue. School-based programs are needed to prevent the onset of alcohol consumption during adolescence. Information and communication technologies offer new promising approaches to deliver preventive programs to these populations. The most traditional, successful programs use group dynamics within the classroom. However, the usefulness of social interaction features (SIF) within internet-based interventions remains unclear. The current scoping review aims to identify and evaluate the effectiveness of online and mobile psychosocial preventive interventions that use SIF, and that target adolescents. Web of Science, Scopus and Google Scholar were electronically searched for all articles published between January 2011 and December 2020. Articles reporting on school-based, web-based interventions for adolescents to prevent alcohol consumption and that encouraged any kind of interaction between users ('social interactions') were eligible for inclusion. Fourteen articles were included in the review. These articles assessed eight preventive programs. Six programs showed positive results on outcome variables. In two of them, it was possible to determine that their success was partially due to the SIF. SIF seem to be useful to enhance the receptivity and usefulness of web-based prevention programs, but the current evidence of their effectiveness is scarce. More evidence is required to assess the effectiveness of these features and to improve programs having the objective of preventing the consumption of alcohol among young people.

Alcohol consumption among adolescents is a social and public health issue. School-based programs are needed to prevent the onset of alcohol consumption during adolescence. Information and communication technologies offer new promising approaches to deliver preventive programs to these populations. The most traditional, successful programs use group dynamics within the classroom. However, the usefulness of social interaction features (SIF) within internet-based interventions remains unclear. The current scoping review aims to identify and evaluate the effectiveness of online and mobile psychosocial preventive interventions that use SIF and target adolescents. Thus, we conducted a scoping review with the aim to identify online and mobile psychosocial preventive interventions that use SIF to reduce adolescent drinking behavior. Our literature review identified eight different programs. Six of them showed positive results on outcome variables. However, only in two of these programs was it possible to determine that their success was partially due to the SIF. SIF seem to be useful to enhance the receptivity and usefulness of web-based prevention programs, but more evidence with appropriate research methods is required to assess these social features' effectiveness to improve web-based prevention programs for young people.

Be YOU!: A Collaborative Effort to Address Minority Stress for LGBTQ+ Youth in School Settings.

LGBTQ youth often experience unsafe school climates and are at greater risk for compromised mental health relative to their heterosexual and cisgender peers. The psychological mediation model posits that these health inequities are produced by minority stress, which operates through several key mechanisms: rumination, emotion regulation, and coping. Efforts towards designing social services that might address these mechanisms, and thus improve LGBTQ youth wellbeing, are limited. Informed by empirical research and therapeutic practices, Be YOU! was conceived as a school-based empowerment program that provides LGBTQ youth with an accessible, safe space where they build skills to reduce rumination and promote emotion regulation and coping strategies for dealing with minority stressors. Developed collaboratively between a local LGBTQ youth center, a local school-based community organization, and university researchers, the Be YOU! partnership effectively circumvented barriers to accessing social services for LGBTQ youth. Findings from the pilot program evaluation showed that youth participation was associated with increased emotion regulation and decreased rumination. The practical impact on and positive feedback from LGBTQ youth suggest that there are measurable benefits and long-term promise in strategic multi-sector partnerships that address social services needs of LGBTQ youth and strengthen their ability to navigate minority stress.

Promoting educator social emotional competence, well-being, and student-educator relationships: A pilot study.

Educator mental health and well-being have received increased attention in response to the additional stress experienced during the coronavirus pandemic. Cultivating mental health and well-being can be facilitated by enhancing adult social emotional competencies. However, relatively limited research has explored how prevention programs promoting social emotional competencies have enhanced educator well-being and related attributes of self-care, efficacy, and skillful interactions with students. In this pilot study, we implemented and evaluated an innovative prevention program called Resilience in Schools and Educators (RISE) in eight Colorado schools with 53 educators. RISE builds knowledge and skills that promote educator social-emotional competencies, trauma responsivity, cultural responsivity, resilience, and well-being. The first study aim was to explore the fidelity and feasibility of the RISE program implemented in a school-based context. The second study aim was to explore whether RISE is associated with increases in educators' self-reported social emotional competencies, well-being, self-care practices, self-efficacy, and quality of interactions with students. As compared to field standards, facilitators reported high levels of fidelity and feasibility of RISE. Educators' pre- and post- self-report measures indicate significant improvements in social emotional competencies (emotional awareness, emotional clarity, non-reactivity, nonjudging), self-care practices, well-being, and student-educator conflict, with effect sizes indicating small to medium impacts. No findings emerged for self-efficacy or perceived closeness of student-teacher relationships. Theoretical and practical implications are discussed.

[Evaluation of the effectiveness of a school-based alcohol and cannabis prevention programme among adolescents.] / Evaluación de la eficacia de un programa de prevención escolar del consumo de alcohol y cannabis entre adolescentes.

OBJECTIVE: Alcohol and cannabis consumption in young people aged 14 to 18 years show high and stable prevalence and incidence. The Instituto de Adicciones de Madrid Salud (IAMS) within its prevention strategy aimed at adolescents and young people in Madrid, implements an universal 3-sessions school-based prevention program. To evaluate the effectiveness of a program aimed at alcohol and cannabis from the Theory of Planned Behavior (TPB, Ajzen, 1991), we analysed the changes in consumption and intention of consumption, attitudes and subjective norm as well as in the risk perception. METHODS: Quasi-experimental design. Participants: Over 1,529 students belonging to 12 high schools in Madrid (M=15.36 years, DT=1.13, range: 13-18, 51.8% boys) Experimental group: N=790, intervention period October-December 2018. Control group: N=469. The Student's t test was used for the repeated means test. When the difference between the means was significant, the effect size was calculated using Cohen's d index. RESULTS: Alcohol: consumption (t=2.08, p<0.05, d=0.07), intention (t=3.01, p<0.01, d=0.12), risk perception (t=-502, p<0.001, d=0.20), attitudes (t=5.77, p<0.001, d=0.21), subjective norm (t=2.17, p<0.05, d=0.08). Cannabis: intention (t=2.98, p<0.01, d=0.11), risk perception (t=-3.99, p<0.001, d=0.14), attitudes (t=6.19, p<0.001, d=0.23). CONCLUSIONS: Students who received the intervention reduced the favourable attitudes and intention of alcohol and cannabis consumption and alcohol consumption, and increased the risk perception on both substances, with significant differences, but low effect sizes. Related to control group and regarding cannabis there were no significant differences. The program has been shown to be potentially effective, but would benefit from a review for fit to its theoretical framework.

OBJETIVO: El consumo de alcohol y cannabis entre jóvenes de 14 a 18 años muestra alta y mantenida prevalencia e incidencia. El Instituto de Adicciones de Madrid Salud (IAMS) dentro de su estrategia de prevención dirigida a adolescentes, desarrolla un programa de prevención universal de tres sesiones en ámbito educativo. Con el fin de evaluar la eficacia de dicho programa dirigido al consumo de alcohol y cannabis desde la Teoría de la Acción Planeada (TAP, Ajzen, 1991), se analizaron los cambios en el consumo e intención de consumo, actitudes y norma subjetiva, así como en la percepción de riesgo. METODOS: Diseño cuasi-experimental pretest-postest con grupo control equiparado. Participantes: 1.529 estudiantes distribuidos en 12 centros educativos de Madrid, (M=15,36 años, DT=1,13; rango: 13-18; 51,8% chicos). Grupo experimental: N=790 recibió la intervención en octubre-diciembre de 2018. Grupo control: N=469. Para el contraste de medias repetidas se utilizó el test t de Student. Cuando la diferencia entre las medias fue significativa, se calculó el tamaño del efecto mediante el índice d de Cohen. RESULTADOS: Alcohol: consumo (t=2,08, p<0,05, d=0,07), intención (t=3,01, p<0,01, d=0,12), percepción de riesgo (t=-502, p<0,001, d=0,20), actitudes (t=5,77, p<0,001, d=0,21), norma subjetiva (t=2,17, p<0,05, d=0,08). Cannabis: intención (t=2,98, p<0,01, d=0,11), percepción de riesgo (t=-3,99, p<0,001, d=0,14), actitudes (t=6,19, p<0,001, d=0,23). CONCLUSIONES: Los adolescentes que recibieron la intervención, redujeron las actitudes favorables e intención de consumo de alcohol y cannabis y el consumo de alcohol, y aumentaron la percepción de riesgo sobre ambas sustancias, con diferencias significativas, pero tamaños de efecto bajos. En relación al grupo control y respecto a cannabis no se encuentran diferencias significativas. El programa ha mostrado ser potencialmente eficaz, pero se beneficiaría de una revisión para un mejor ajuste a su marco teórico.

"I am Learning to Protect Myself with Mika:" A Teacher-based Child Sexual Abuse Prevention Program in Turkey.

This study aimed to explore the effectiveness of a teacher-based child sexual abuse prevention program entitled "I am learning to protect myself with Mika." The sample consisted of 290 children, their parents, and their classroom teachers. The participants were randomly assigned to intervention (n = 137) or wait-list comparison groups (n = 153) by classroom. The age of the children ranged from 46 to 71 months (M = 58.99, SD = 6.64). The prevention program was a 5-week program that consisted of five modules, including emotional awareness, good touch-bad touch, and body safety rules. To investigate the effectiveness of the prevention program, a latent Markov analysis was conducted. A three-class solution was identified as the best model: Status-1 (self-protecting group), Status-2 (risky secret keepers), and Status-3 (risk group). Following the intervention, members of the two at-risk groups (Statuses 2 and 3) were more likely to move into the Status-1 group than were those participants who had not received the intervention (wait-list comparison). Self-protection skills were analyzed using a 2 × 2 ANOVA with repeated measures. The increase in self-protection skills was greater for participants in the intervention group than for those in the wait-list comparison group from pre-test to post-test. Two-month follow-up analysis showed that gain in knowledge and skills was maintained. This program should be considered as a potential approach to meeting the need for child sexual abuse preventive efforts in Turkish preschool curriculum.

A Field Test of Opportunities for Teen Dating Violence Disclosure in School-Based Relationship Education Programs.

School-based relationship education programs offer an opportunity to identify youth who are experiencing teen dating violence (TDV), support their safety, and connect them with individualized services or referrals. However, no research has tested the feasibility or accuracy of approaches to create opportunities for TDV disclosure in the context of school-based programs. The current study presents the results of a field test comparing three tools used to provide opportunities for TDV disclosure (two questionnaire-style tools and one universal education discussion guide). High school students from two federally funded healthy marriage and relationship education (HMRE) program sites (N = 648) were offered the three tools in random order over the course of the HMRE program, which lasted between 3 weeks and 3 months and took place during the school day. Onsite qualitative interviews with HMRE program staff and their local domestic violence program partners assessed how service providers saw the tools and the process of implementing them. Latent class models examined the accuracy of the tools in identifying TDV. Sensitivities of the tools were low and specificities were high; the questionnaire-style tools tended to have higher sensitivities and fewer classification errors than the universal education tool. Several three-item combinations from across the tools performed better than any intact tool, suggesting that shorter assessments may be effective, provided they include items on sexual coercion and physical violence. Qualitative findings suggested that implementation of TDV assessment and universal education in school settings is a viable strategy, provided programs are able to gain support from school staff, adapt to tight time constraints, and plan procedures for protecting student privacy and confidentiality.

Prevention of eating disorders-Efficacy and cost-benefit of a school-based program ("MaiStep") in a randomized controlled trial (RCT).

OBJECTIVE: Given the severity of eating disorders, effective and easily implementable prevention programs which reduce incidence rates and in addition have health-economic benefits are essential. The majority of research on prevention programs focuses on questionnaire-based efficacy or the reduction of eating disorder symptoms while neglecting the health-economic perspective. By contrast, the present study focuses on both an efficacy analysis considering diagnostic criteria (DSM-5) and on evaluating the cost-benefit of a universal prevention program for eating disorders ("MaiStep"). METHOD: A three-arm randomized controlled trial with baseline, posttreatment and 12-month follow-up was conducted with 1,654 adolescents (M = 13.35, SD = 0.76), comprising two intervention groups (MaiStep delivered by psychologists or teachers, IG-T) and an active control group (ACG). The primary outcome was DSM-5 eating disorder diagnosis measured with the SIAB-S. Furthermore, the costs of the prevention program and the savings in health care costs were calculated. RESULTS: A significant difference in eating disorder diagnosis was found between the IG-T and the ACG for posttreatment (χ2 (1= 7.352, p = .007), Relative Risk (RR) = .53 and 12-month follow-up (χ2 (1= 5.203, p = .023), RR = .61. MaiStep proved to be cost-effective (tcbr  = 6.75), saving about 560,000 € (standardized per 1,000 students = 601,388.19 €). DISCUSSION: Universal prevention can both reduce incidence rates of eating disorders and be cost-beneficial for health care systems. Future research should analyze prevention programs regarding efficacy and cost-benefit to enable comparability and derive guidelines for political decision-makers. TRIAL REGISTRATION NUMBER: MaiStep is registered at the German Clinical Trials Register (DRKS00005050).

Effective Components of School-Based Prevention Programs for Child Abuse: A Meta-Analytic Review.

School-based programs seem promising for child abuse prevention. However, research mainly focused on sexual child abuse and knowledge is lacking on how individual program components contribute to the effectiveness of school-based prevention programs for any form of child abuse. This study aimed to examine the overall effect of these school-based programs on (a) children's child abuse-related knowledge and (b) self-protection skills by conducting two three-level meta-analyses. Furthermore, moderator analyses were performed to identify how program components and delivery techniques were associated with effectiveness. A literature search yielded 34 studies (158 effect sizes; N = 11,798) examining knowledge of child abuse and 22 studies (99 effect sizes; N = 7804) examining self-protection skills. A significant overall effect was found of school-based programs on both knowledge (d = 0.572, 95% CI [0.408, 0.737], p < 0.001) and self-protection skills (d = 0.528, 95% CI [0.262, 0.794], p < 0.001). The results of the first meta-analysis on children's child abuse knowledge suggest that program effects were larger in programs addressing social-emotional skills of children (d = 0.909 for programs with this component versus d = 0.489 for programs without this component) and self-blame (d = 0.776 versus d = 0.412), and when puppets (d = 1.096 versus d = 0.500) and games or quizzes (d = 0.966 versus d = 0.494) were used. The second meta-analysis on children's self-protections skills revealed that no individual components or techniques were associated with increased effectiveness. Several other study and program characteristics did moderate the overall effects and are discussed. In general, school-based prevention programs show positive effects on both knowledge and self-protection skills, and the results imply that program effectiveness can be improved by implementing specific components and techniques.

Long-term effect of one-time nutritional education in school on nutritional knowledge of early school-aged children.

BACKGROUND: In the group of school-aged children nutritional education (NE) enables an early development of healthy eating habits, which can be transferred to the adult life. OBJECTIVE: The aim of the study was to assess the long-term effect of a one-time nutritional education, including also culinary workshops, on the level of nutritional knowledge (NK) of early school-aged children as well as to analyse the nutritional content of the children's books. MATERIAL AND METHODS: The study was conducted among second- and third-grade pupils from a primary school in Warsaw (n=76). The level of NK was determined using the same, self-administrated questionnaire at each of the three stages of the study. RESULTS: The level of NK was assumed as very good in 47% of respondents before the education, in 91% immediately after the education, and in 74% six months after it. Out of all 23.0 points (max.) on average 18.1 points were obtained at the first stage, 21.1 points at the second stage and 19.7 points at the third stage (p<0.001). Immediately after the NE and six months after it the level of NK increased significantly (comparing to the first stage) especially on these topics: the daily water requirements and the recommendations on physical activity (p<0.001 for both questions). CONCLUSIONS: The results of the study confirmed the effectiveness of a one-time nutritional education on the level of nutritional knowledge. Moreover, results show that in the research group nutritional knowledge about importance of physical activity, adequate nutrition, eating varicoloured vegetables and fruits, screen time limits and distinguishing between healthy and unhealthy products was satisfactory, even at the baseline, but in the main source of fats in a diet, the role of milk products, the effect of having too little water in a diet and the sugar content in food children's knowledge was not enough.

A quasi-experimental examination of how changes in school-level intramurals are associated with physical activity among a sample of Canadian secondary school students from the COMPASS study.

INTRODUCTION: Intramurals in schools may encourage physical activity among youth. Schools are continuously making changes to these intramurals, yet it is not well understood how these changes impact youth physical activity. The main objective of this research was to examine if changes in the number of intramurals were associated with youth physical activity over time with a secondary objective to explore the association between sport participation and physical activity among youth over time. METHODS: This study used three years of linked longitudinal school- and student-level data from Ontario schools in year 5 (Y5: 2016-2017), year 6 (Y6: 2017-2018) and year 7 (Y7: 2018-2019) of the COMPASS study. Data on intramurals from 55 schools were collected from the School Programs and Policies questionnaire to determine intramural changes that were made from Y5 to Y6. Using the COMPASS Student Questionnaire, baseline demographics were collected and data on physical activity and sport participation were measured at Y5, Y6 and Y7 on 4417 students. Hierarchical linear mixed regression models were used to estimate how changes in intramurals were associated with youth physical activity over time. RESULTS: Changes in school-specific intramurals were not significantly associated with physical activity over time. Intramural, varsity and community sport participation were all positively and significantly associated with youth physical activity among female and males. CONCLUSIONS: Intramural, varsity and community sport participation are important opportunities for youth physical activity. Schools should offer a variety of intramural and varsity sports to encourage physical activity. Although adding intramurals may not be effective at increasing youth physical activity, they may be effective when used in combination with other strategies to increase physical activity.

Responsible Behavior with Younger Children: Examining the Feasibility of a Classroom-Based Program to Prevent Child Sexual Abuse Perpetration by Adolescents.

Child sexual abuse (CSA) is a preventable public health problem typically addressed with either after-the-fact interventions or prevention programs focused on teaching children to protect themselves and report abuse. Such responses do little to prevent CSA victimization, leading to calls for prevention efforts targeting individuals most at risk of perpetrating CSA. These individuals include young adolescents, who are prone to making mistakes and bad decisions when it comes to their sexual behaviors. To begin to address this call to action, we developed Responsible Behavior with Younger Children (RBYC), a universal school-based prevention program to provide sixth and seventh grade students (and their parents and educators) with the knowledge, skills, and tools to prevent engaging younger children in sexual behaviors. School-based CSA prevention interventions are often met with feasibility and acceptability concerns including that (a) people at risk of offending are impervious to prevention efforts, (b) schools do not have the resources to take on additional programs, and (c) the content is too sensitive for educators, parents, and students. The goal of this article is to describe how the RBYC program was developed to address these concerns. We also summarize data on the feasibility of the RBYC program obtained from focus groups with educators, parents, and students during the development of the program and interviews with educators after a pilot randomized controlled trial (RCT). Feedback received during program development and after the pilot RCT suggests that RBYC is relevant, salient, palatable, and feasible for implementation in middle schools.

Preliminary Results of the Planet Nutrition Program on Obesity Parameters in Mexican Schoolchildren: Pilot Single-School Randomized Controlled Trial.

School-based obesity prevention programs are key to promoting healthy habits. The aim of this study was to evaluate the effect of the Planet Nutrition program on BMI z-score and other parameters compared to a control group of Mexican schoolchildren after 9 weeks of intervention. The effect of the summer holidays on the BMI z-score was also evaluated at 23 weeks. A pilot randomized controlled trial design was used and 41 schoolchildren were randomized (21 intervention group and 20 control). The program included 18 nutrition education sessions, 20 physical activity classes and six brochures for parents. At 9 weeks, no significant differences were found between the intervention and control groups in the change in BMI z-score (-0.11, 95% CI -0.23, 0.01). Significant differences were observed in some secondary outcomes: body fat percentage (-1.72, 95% CI -3.42, -0.02), waist circumference (-3.45, 95% CI -5.55, -1.36), physical activity (0.44, 95% CI 0.01, 0.88) and nutrition knowledge (1.15, 95% CI 0.27, 2.03). Summer holidays negatively affected the BMI z-score in both groups, reducing the difference observed between groups at 9 weeks (-0.07, 95% CI -0.22, 0.07). The Planet Nutrition program showed favorable effects in some obesity and lifestyle parameters in the short term.

Preventing Sexual Violence in Adolescence: Comparison of a Scientist-Practitioner Program and a Practitioner Program Using a Cluster-Randomized Design.

Numerous school-based prevention programs have been developed by scientists and practitioners to address sexual violence in adolescence. However, such programs struggle with two major challenges. First, the effectiveness of many well-established practitioner programs has not been rigorously evaluated. Second, effective scientific programs may be hard to implement into everyday school practice. Combining the knowledge of scientists and practitioners in a scientist-practitioner program could be a helpful compromise. The aim of the present study is to evaluate the effects of a scientist-practitioner program and a practitioner program using a cluster-randomized experimental design. Twenty-seven school classes were randomly assigned to either one of two programs or a control group. Outcome variables (knowledge, attitudes, behavior, and iatrogenic effects) were assessed at pretest, posttest, and a 6-month follow-up for 453 adolescents (55% female, Mage = 14.18). Short-term effects were found in both programs regarding general knowledge, knowledge of professional help, and victim-blaming attitudes. Long-term effects were found in both programs regarding general knowledge and knowledge of professional help and, in the practitioner program, in a reduction of victimization. No other effects were found on attitudes and behavior. No iatrogenic effects in the form of increased anxiety were found. Both the scientist-practitioner and the practitioner program show promise for the prevention of sexual violence in adolescence; in particular, the practitioner program may be a more cost-effective method.

The Prevention of Anxiety and Depression in Early Childhood.

Recent statistics suggest that anxiety and depressive symptoms and disorders can occur earlier in life than previously thought, and appear to be on the increase. The burden that is associated with internalizing symptoms is large, with children's social, emotional, and cognitive development negatively impacted. Research suggests that early intervention and prevention is vital for adaptive development, and this review set out to explore the literature regarding social-emotional learning programs for children of preschool age that aim to prevent and reduce symptoms of anxiety and depression. The review focused on interventions that could be delivered universally in the school context to children aged 4-6 years or their parents. Only six programs were identified that met these criteria. The results of this review suggest that intervention and prevention efforts in early childhood are needed and can be effective in terms of reducing the burden associated with internalizing symptoms in childhood, at least in the short term. This appears to be the case particularly when parents are actively involved in the intervention, too. However, more rigorous research is needed that involves larger randomized controlled trials with multiple reporters and consistent administration of assessments across the samples.

Physical Activity Habits and Well-Being among 6-Year-Old Children: The "Improving Umbrian Kids' Healthy Lifestyle", an Uncontrolled Pilot Study Project.

There is evidence that promoting physical activity programs and decreasing sedentary behavior is a potential strategy for improving health-outcomes, peer relationships and social/emotional well-being in at-risk youth. The World Health Organization recommends enhancing physical education and school-based programs with multi-component and evidence-based assessment methodology. In Umbria (Italy) an uncontrolled pilot study project referred to as "Improving Umbrian kids' healthy lifestyle" was implemented as a systemic school-based intervention directed at 6-year-old primary school children. The intervention applied a consolidated assessment methodology developed by the C.U.R.I.A.Mo. and Eurobis projects that inserted two hours per week of physical education activity into the school curriculum, structured and supervised by specialists with Exercise and Sport Science degrees, for eight months (from October to June) of the school year. We measured anthropometric values (BMI, waist circumference, waist-to-height ratio index) with objective tools. Moreover, we evaluated physical performance variables (speed, strength, and flexibility) using standard tests. Additionally, self-report measures (measured physical activity during the week, sedentary habits, and psychological well-being) were assessed using validated questionnaires. We observed a significant decrease in waist to height ratio, and improvements in physical performance values and self-report questionnaire measures. Our study suggests that the promotion of physical activity in the school setting is likely to result in physically, mentally, and psycho-socially healthier primary-school-age children.

Roadmap for Effective School-Based Practices to Support Expectant and Parenting Youth: Lessons from the New Heights Program in Washington, DC.

INTRODUCTION: New Heights is a voluntary school-based program that provides a well-defined system of supports for expectant and parenting students in Washington, DC, and was found to be effective at improving educational outcomes. This study explores the program elements and practices that, when used together, improved academic outcomes for New Heights participants and define a possible roadmap for service providers interested in replicating the program's success. METHODS: The study team collected data through site visits, key informant interviews, staff surveys, program observations, case files, and program materials. RESULTS: The core design and implementation elements of the New Heights program are (1) placing a trained staff member in the school to provide advocacy, case management, education, and in-kind incentives; (2) bringing community-based service providers into the school; (3) giving trained staff autonomy and a strong grounding in local context; and (4) using a highly collaborative process to hire and support school-based coordinators. DISCUSSION: Staff and funders interested in improving outcomes for young parents in school could use the experience of New Heights and the key practices that were critical to its success as a guide: (1) ensure that the program is well defined but can be tailored to the needs of schools and students, (2) engage community partners to bring services to participants, (3) hire and train the right staff who are committed to "do whatever it takes," (4) actively cultivate a culture of collaboration among program staff, and (5) develop buy-in with school staff and illustrate program value.