Longitudinal pathways between emotional difficulties and school absenteeism in middle childhood: Evidence from developmental cascades.

Emotional difficulties are associated with both authorized and unauthorized school absence, but there has been little longitudinal research and the temporal nature of these associations remains unclear. This study presents three-wave random-intercepts panel models of longitudinal reciprocal relationships between teacher-reported emotional difficulties and authorized and unauthorized school absence in 2,542 English children aged 6 to 9 years old at baseline, who were followed-up annually. Minor differences in the stability effects were observed between genders but only for the authorized absence model. Across all time points, children with greater emotional difficulties had more absences, and vice versa (authorized: ρ = .23-.29, p < .01; unauthorized: ρ = .28, p < .01). At the within-person level, concurrent associations showed that emotional difficulties were associated with greater authorized (ß = .15-.17, p < .01) absence at Time 3 only, but with less unauthorized (ß = -.08-.13, p < .05) absence at Times 1 and 2. In cross-lagged pathways, neither authorized nor unauthorized absence predicted later emotional difficulties, and emotional difficulties did not predict later authorized absence at any time point. However, greater emotional difficulties were associated with fewer unauthorized absences across time (ß = -13-.22, p < .001). The implications of these findings are discussed.

"We want it to be a culture": children and young people's perceptions of what underpins and undermines education-based wellbeing provision.

BACKGROUND: Provision that aims to promote the social, emotional, and mental wellbeing of children and young people (including their mental health) is increasingly implemented in education settings. As researchers, policymakers, and practitioners explore the complexities of promotion and prevention provision in practice, it is critical that we include and amplify children and young people's perspectives. In the current study, we explore children and young people's perceptions of the values, conditions, and foundations that underpin effective social, emotional, and mental wellbeing provision. METHODS: We engaged in remote focus groups with 49 children and young people aged 6-17 years across diverse settings and backgrounds, using a storybook in which participants constructed wellbeing provision for a fictional setting. ANALYSIS: Using reflexive thematic analysis, we constructed six main themes presenting participants' perceptions: (1) recognising and facilitating the setting as a caring social community; (2) enabling wellbeing to be a central setting priority; (3) facilitating strong relationships with staff who understand and care about wellbeing; (4) engaging children and young people as active partners; (5) adapting to collective and individual needs; and (6) being discreet and sensitive to vulnerability. CONCLUSIONS: Our analysis presents a vision from children and young people of an integrated systems approach to wellbeing provision, with a relational, participatory culture in which wellbeing and student needs are prioritised. However, our participants identified a range of tensions that risk undermining efforts to promote wellbeing. Achieving children and young people's vision for an integrated culture of wellbeing will require critical reflection and change to address the current challenges faced by education settings, systems, and staff.

A randomised controlled trial of the Nextdoor Kind Challenge: a study protocol.

BACKGROUND: Community interventions are often promoted as a way of reducing loneliness and social isolation in our neighbourhoods. However, those community interventions are rarely examined within rigorous study designs. One strategy that holds the potential to reduce loneliness and can promote health and wellbeing is doing acts of kindness. The current study involves evaluating the impact of kindness acts on loneliness in community-dwelling individuals using an online social networking platform. METHODS: This study is made up of three randomised controlled trials conducted in three countries. Each randomised controlled trial has two arms (intervention vs waitlist control) and is designed to compare the effectiveness of the KIND challenge, which involves doing at least one act of kindness per week within a four-week period. This study will recruit users of an online community, be randomised online, and will be conducted using online assessments. We will first explore the effects of the intervention on the primary outcome of loneliness, followed by secondary outcomes, social isolation, neighbour relationship quality and contact, mental health symptoms, stress, quality of life, and positive affect. Further, we will assess the feasibility, acceptability, and safety of the KIND Challenge. DISCUSSION: This study, designed to evaluate the impact of kindness on the community, will be the first large scale randomised control trial conducted across three countries, Australia, UK, and USA. It will examine the potential of community-led interventions to reduce loneliness, improve social isolation, and promote neighbourhood cohesion, health, and wellbeing, which is especially crucial during the COVID-19 public health crisis. TRIAL REGISTRATION: Clinical Trials Registry. NCT04398472 . Registered 21st May 2020.

Game On-Complier Average Causal Effect Estimation Reveals Sleeper Effects on Academic Attainment in a Randomized Trial of the Good Behavior Game.

To examine the efficacy of the Good Behavior Game (GBG) in improving children's reading attainment, and the extent to which this varies as a function of cumulative intervention intensity (dosage) and timing of outcome measurement. A 2-year cluster-randomized controlled trial was conducted. Seventy-seven primary schools from three regions in England were randomly assigned to intervention and control groups. Children (N = 3084) aged 67 at baseline were the target cohort. The GBG is an interdependent group-contingency behavior management strategy used by teachers in elementary schools. Reading attainment was assessed via national teacher assessment scores at baseline, and the Hodder Group Reading Test at post-test and 1-year post-intervention follow-up. Dosage was assessed using a bespoke online GBG scoreboard system. Multi-level intent-to-treat (ITT) and complier average causal effect (CACE) estimation were utilized. At post-test, no effects of the GBG on children's reading attainment were found in either the ITT or CACE models. At 1-year follow-up, results remained null in the ITT model, but a significant intervention effect was found among moderate compliers (Δ = 0.10) in the CACE model. The GBG can produce measurable improvements in children's academic attainment, but these effects may take time to become apparent and are contingent upon implementation dosage falling within an optimal range. The project was supported by funding from the Education Endowment Foundation and the National Institute for Health Research. ISRCTN: 64152096.

'It's scary starting a new school': Children and young people's perspectives on wellbeing support during educational transitions.

BACKGROUND: Children and young people experience various transitions throughout their education. Theory and evidence highlight that these can be complex, and poor experiences of transitions can be associated with worsened outcomes, necessitating a need to develop and implement wellbeing support. However, children and young people's views are lacking in the literature, and studies tend to focus on specific transitions rather than on what matters for wellbeing during transitions generally. AIMS: We explore children and young people's own perceptions of what would support wellbeing during educational transitions. SAMPLE: We engaged with 49 children and young people aged 6-17 years, using purposeful maximum variation sampling to facilitate engagement of a diverse sample across a variety of education setting types. METHODS: We undertook focus groups, using creative methods centred around a storybook, asking participants to make decisions as headteachers about wellbeing provision in a fictional setting. Data were analysed using reflexive thematic analysis. ANALYSIS: We constructed four themes: (1) helping children and young people understand what to expect; (2) developing and sustaining relationships and support; (3) being responsive to individual needs and vulnerabilities; and (4) managing loss and providing a sense of closure. CONCLUSIONS: Our analysis highlights a desire among children and young people for a considered, supportive approach that recognizes their individual needs and their connection to educational communities. The study makes a methodological and conceptual contribution, demonstrating the value of adopting a multifocussed lens to researching and supporting transitions.

A Global Longitudinal Study Examining Social Restrictions Severity on Loneliness, Social Anxiety, and Depression.

Purpose: Social restrictions and government-mandated lockdowns implemented worldwide to kerb the SARS-CoV-2 virus disrupted our social interactions, behaviours, and routines. While many studies have examined how the pandemic influenced loneliness and poor mental health, such as depression, almost none have focussed on social anxiety. Further, how the change in social restrictions affected change in mental-health and well-being has not yet been explored. Methods: This is a longitudinal cohort study in community dwellers who were surveyed across three timepoints in the first six months of the pandemic. We measured loneliness, social anxiety, depression, and social restrictions severity that were objectively coded in a sample from Australia, United States, and United Kingdom (n = 1562) at each time point. Longitudinal data were analysed using a multivariate latent growth curve model. Results: Loneliness reduced, depression marginally reduced, and social anxiety symptoms increased as social restrictions eased. Specific demographic factors (e.g., younger age, unemployment, lower wealth, and living alone) all influenced loneliness, depression, and social anxiety at baseline. No demographic factors influenced changes for loneliness; we found that those aged over 25 years reduced faster on depression, while those younger than 25 years and unemployed increased faster on social anxiety over time. Conclusion: We found evidence that easing social restrictions brought about additional burden to people who experienced higher social anxiety symptoms. As country-mandated lockdown and social restrictions eased, people are more likely report higher social anxiety as they readjust into their social environment. Mental health practitioners are likely to see higher levels of social anxiety in vulnerable communities even as social restrictions ease.

Treatment effect modifiers in a randomized trial of the good behavior game during middle childhood.

Objective: Two key treatment effect modifiers-implementation variability and participant cumulative risk status-are examined as predictors of disruptive behavior outcomes in the context of a large cluster randomized controlled trial of a universal, school-based behavior management intervention. The core components of the Good Behavior Game (GBG) are classroom rules, team membership, monitoring behavior, and positive reinforcement. Children work in teams to win the game, which is played alongside a normal classroom activity, during which their teacher monitors infractions to classroom rules. Teams with four or fewer infractions at the end of the game win and are rewarded. Method: Seventy-seven English primary schools (N = 3,084 children, aged 6-7) were randomly assigned to deliver the GBG or continue their usual practice over 2 years. Results: Intent-to-treat analysis found no discernible impact of the intervention on children's disruptive behavior. Additionally, subgroup analyses revealed no differential gains among children at low, moderate or high levels of cumulative risk exposure (CRE). However, complier average causal effect estimation (CACE) using dosage as a compliance marker identified a large, statistically significant intervention effect (d = -1.35) among compliers (>1,030 min of cumulative intervention exposure). Furthermore, this compliance effect varied by participant CRE, such that children at high and low levels of exposure experienced significantly greater and lesser reductions in disruptive behavior, respectively. Conclusions: These findings highlight the importance of optimizing implementation and demonstrate the utility of CRE as a theoretically informed approach to subgroup moderator analysis. Implications are discussed and study strengths and limitations are noted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Prevalence and Social Inequality in Youth Loneliness in the UK.

Using data from the English arm of the Health Behaviour in School-aged Children (HBSC) study, we examined the prevalence of loneliness for school-aged adolescents and how it is linked to social inequalities. The HBSC study collects data from 11-, 13-, and 15-year-olds, and is repeated every four years, allowing the exploration of prevalence rates of loneliness pre COVID-19 pandemic for comparison. We also explored whether loneliness was associated with socio-economic status (SES) and linked to academic attainment and health complaints. The total sample was 14,077 from 156 schools in England. Findings revealed a stable prevalence rate of 8.2% for loneliness from 2006 to 2014. We also found, across all survey years, (1) those aged 15 years were significantly lonelier than younger peers, (2) those who reported lower SES were lonelier than their more well-off peers, and (3) higher loneliness was associated with being '"below average" academically and reporting more health complaints. Conclusions: These prevalence data enable researchers, policymakers, and others to make comparisons with prevalence rates during the COVID-19 pandemic to explore whether there have been increases in loneliness among school-aged adolescents. Loneliness was consistently related to social inequalities, suggesting that targeted interventions that include whole systems changes are needed.

Cost-Effectiveness of a School-Based Social and Emotional Learning Intervention: Evidence from a Cluster-Randomised Controlled Trial of the Promoting Alternative Thinking Strategies Curriculum.

BACKGROUND: School-based social and emotional learning interventions can improve wellbeing and educational attainment in childhood. However, there is no evidence on their effects on health-related quality of life (HRQoL) or on their cost effectiveness. OBJECTIVE: Our objective was to evaluate the cost effectiveness of the Promoting Alternative Thinking Strategies (PATHS) curriculum. METHODS: A prospective economic evaluation was conducted alongside a cluster-randomised controlled trial of the PATHS curriculum implemented in the Greater Manchester area of England. In total, 23 schools (n = 2676 children) were randomised to receive PATHS, and 22 schools (n = 2542 children) were randomised to continue with usual practice. A UK health service perspective and a 2-year time horizon were used. HRQoL data were collected prospectively from all children in the trial via the Child Health Utility Nine-Dimension questionnaire. Micro-costing was undertaken to estimate the intervention costs. Missing data were imputed using multiple imputation. RESULTS: The mean incremental cost of the PATHS curriculum compared with usual practice was £32.01 per child, and mean incremental quality-adjusted life-years (QALYs) were positive (0.0019; 95% confidence interval [CI] 0.0009-0.0029). Assuming a willingness-to-pay threshold of £20,000 per QALY, the expected incremental net benefit of introducing the PATHS curriculum was £5.56 per child (95% CI - 14.68 to 25.81), and the probability of cost effectiveness was 84%. However, this probability fell to 0% when intervention costs included teacher's salary costs. CONCLUSION: The PATHS curriculum has the potential to be cost effective at standard UK willingness-to-pay thresholds. However, the sensitivity of the cost-effectiveness estimates to key assumptions means decision makers should seek further information before allocating scarce public resources. TRIAL REGISTRATION NUMBER: ISRCTN85087674.