Feasibility, acceptability, and appropriability of a national whole-school program for reducing school violence and improving school coexistence.

Introduction: The increase in school violence following the COVID-19 pandemic underscores the need for schools to adopt a multilevel whole-school approach. This study examines a national program designed by the Chilean Ministry of Education, in collaboration with universities, as part of the Ministry's Educational Reactivation Plan, aimed at improving school climate management across Chile. Methods: The "Learning to Live Together Program" (LLT) was implemented across all 16 regions of Chile, focusing on establishing school climate networks, providing direct intensive university technical assistance, and enhancing professional development and training. The feasibility, acceptability, and appropriability of the LLT program were assessed through a survey distributed to 1,561 staff members from 783 schools. Participants responded to a comprehensive set of instruments measuring acceptability, appropriability, feasibility, attitudes toward implementation, fidelity, and initial perceived results. Results: The results indicate high initial adoption rates and significant improvements in the assessed dimensions. The enhancement of school climate practices and strengthening school collaboration networks were of considerable relevance. Discussion: These findings support the efficacy of the multilevel whole-school approach as a viable strategy for Latin American countries, providing critical data for educational and governmental decision-making. Furthermore, this study provides evidence that these outcomes may be applicable to the implementation of similar policies in different contexts and countries.

Capturing the whole-school food environment in primary schools.

OBJECTIVE: The school food environment (SFE) is an ideal setting for encouraging healthy dietary behaviour. We aimed to develop an instrument to assess whole-SFE, test the instrument in the school setting and demonstrate its use to make food environment recommendations. DESIGN: SFE literature and UK school food guidance were searched to inform instrument items. The instrument consisted of (i) an observation proforma capturing canteen areas systems, food presentation and monitoring of food intake and (ii) a questionnaire assessing food policies, provision and activities. The instrument was tested in schools and used to develop SFE recommendations. Descriptive analyses enabled narrative discussion. SETTING: Primary schools. PARTICIPANTS: An observation was undertaken at schools in urban and rural geographical regions of Northern Ireland of varying socio-economic status (n 18). School senior management completed the questionnaire with input from school caterers (n 16). RESULTS: The instrument captured desired detail and potential instrument modifications were identified. SFE varied. Differences existed between food policies and how policies were implemented and monitored. At many schools, there was scope to enhance physical eating environments (n 12, 67 %) and food presentation (n 15, 83 %); emphasise healthy eating through food activities (n 7, 78 %) and increase parental engagement in school food (n 9, 56 %). CONCLUSIONS: The developed instrument can measure whole-SFE in primary schools and also enabled identification of recommendations to enhance SFE. Further assessment and adaptation of the instrument are required to enable future use as a research tool or for self-assessment use by schools.

The Use and Effectiveness of the Whole School Approach in School-Based Interventions Addressing Gender-Based Violence in Sub-Saharan Africa: A Systematic Review.

Adolescents and young people in sub-Saharan Africa (SSA) experience high rates of gender-based violence (GBV). The whole school approach (WSA) is an established benchmark of effective school-based interventions to address this issue. We conducted a systematic review of peer-reviewed literature using PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library, Clinicaltrials.gov, and Google Scholar (1) to determine the characteristics, measured outcomes, and effectiveness of school-based GBV interventions and (2) to examine each papers' alignment with WSA and methodological quality. We developed a comprehensive intervention characteristics form for data extraction and analyzed the selected studies' quality using the modified Methodological Quality Rating Scale. To measure alignment with WSA implementation standards, we expanded the application of the WSA by creating the Whole School Approach Rating Scale (WSARS) for assessing school-based GBV interventions. Most interventions (n = 14/16) we reviewed effectively addressed at least one of the three outcomes of interest (i.e., sexual violence, physical violence, and GBV-related knowledge/attitudes). Over half (n = 9/16) of the studies were rated high on the WSARS. However, we observed no significant differences in effectiveness between studies rated high and those rated low on the WSARS. Our results indicate that school-based GBV interventions could be an effective and sustainable strategy for addressing GBV in and around schools.

"There's been a huge change": Educator experiences of a whole-school SLP-led project to address developmental language disorder in three Australian secondary schools.

PURPOSE: Developmental Language Disorder (DLD) remains prevalent for secondary school students and continues to compromise educational, social and vocational outcomes within and beyond school. Community-based approaches to service provision are needed to use speech-language pathology resources effectively in realising benefits for this student population. Our article focusses on educator experiences of a whole-school project facilitated by a speech-language pathologist (SLP) to address DLD in secondary school settings. METHOD: Twenty-one educators were interviewed across three schools to understand their perceptions and experiences of the project and their view(s) of what assisted or compromised early implementation. Data were analysed inductively to develop key themes. RESULT: Educators reported gaining increased knowledge and awareness of DLD, which supported a reframing of their perceptions of student behaviour and learning issues. They identified the project provided them with ready skills and tools to change their practice, realised learning benefits for all the students they taught, aligned with broader school initiatives, and overcame potential challenges to supporting project implementation. CONCLUSION: Overall, the educators found the project and implementation of strategies doable, acceptable, important, and sustainable. We explore the features of project design that appeared to contribute to educators' positive experience of the project. This knowledge will be helpful for SLPs using innovative service approaches in classroom settings.

Integrating mental health into climate change education to inspire climate action while safeguarding mental health.

Climate change is the greatest threat humanity faces, and puts at risk the mental health and wellbeing of children and young people. Climate change education must equip children and young people with the knowledge, skills and resilience to live in an uncertain future, sustainably take relevant climate action and work in climate careers. As attention on climate change education grows, this is a critical moment for the mental health community to ensure mental health and wellbeing considerations are embedded. Critically, appropriate integration of mental health can enable these very necessary goals of equipping children and young people to live and work in a future where climate change looms large. This paper explores why promoting good mental health and wellbeing and building psychological resilience can help achieve climate change education outcomes, and why not doing so risks harming children and young people's mental health. It also explores how integrating discussions about emotions, mental health, and coping strategies within climate change education can be a route into wider discussions about mental health, to support children and young people in the context of rising mental health needs. Learning from an existing approach to promoting good mental health and wellbeing in schools (the 'whole school approach') provides the opportunity to explore one avenue through which such an integrated approach could be implemented in practice. Identifying appropriate mechanisms to integrate mental health into climate change education will require co-design and research with educators and young people, and addressing systemic barriers facing the schools sector.

Assessing the Impacts of Creating Active Schools on Organisational Culture for Physical Activity.

BACKGROUND: National and international guidance recommends whole-school approaches to physical activity, but there are few studies assessing their effectiveness, especially at an organisational level. This study assesses the impact of the Creating Active School's (CAS) programme on organisational changes to physical activity provision. METHODS: In-school CAS leads completed a 77-item questionnaire assessing school-level organisational change. The questionnaire comprised 19 domains aligned with the CAS framework and COM-B model of behaviour change. Wilcoxon Signed Rank Tests assessed the pre-to-nine-month change. RESULTS: >70% of schools (n = 53) pre-CAS had inadequate whole-school physical activity provision. After nine months (n = 32), CAS had a significant positive effect on organisational physical activity. The positive change was observed for: whole-school culture and ethos, teachers and wider school staff, academic lessons, physical education (PE) lessons, commute to/from school and stakeholder behaviour. CONCLUSIONS: This study provides preliminary evidence that CAS is a viable model to facilitate system-level change for physical activity in schools located within deprived areas of a multi-ethnic city. To confirm the results, future studies are required which adopt controlled designs combined with a holistic understanding of implementation determinants and underlying mechanisms.

Exploring the acceptability and feasibility of a whole school approach to physical activity in UK primary schools: a qualitative approach.

BACKGROUND: UK Children generally fail to meet physical activity (PA) recommendations. Whole school approaches (WSA) have the potential to impact large numbers of children due to their ubiquitous nature for school wide implementation, however there is limited knowledge regarding primary school PA WSA implementation in the UK. This study aimed to investigate the acceptability and feasibility of a PA WSA in the UK.  METHODS: Semi structured interviews explored research aims with participants. A qualitative description approach was adopted and data were analysed using thematic analysis to draw codes and themes from the data. RESULTS: Thirteen primary school senior leadership team (SLT) and Physical Education (PE) leads were interviewed. A PA WSA was found acceptable by all participants. Implementation, however, was questioned when other significant mechanisms were not in place. A PA WSA aided prioritisation and planning of PA provision, providing a holistic overview of all key areas of PE, school-sport and PA (PESSPA). Due to the high acceptability but dependent feasibility of a PA WSA, it is recommended that PA WSAs align with whole-school health policy and improvement plans to advance implementation. Future research, however, is needed to explore how this method is best implemented as additional interventions may also be required to promote the prioritisation of the PA agenda due to the importance of SLT backing for implementation being paramount, as results highlight. CONCLUSIONS: PA WSAs aid awareness, understanding and planning of school wide PESSPA provision, however their implementation in complex. Having SLT support and an appropriately resourced PE lead maximised the impact and utility of a PA WSA.

Feasibility of using health and wellbeing data for school planning: the SHINE pilot in Scotland.

Child and adolescent mental health and wellbeing (MHWB) have received greater attention in recent years due to increases in mental ill health and reports of decreasing subjective wellbeing. The School Health and Wellbeing Improvement Research Network (SHINE) was established to create a national infrastructure to support Scottish schools to collect and use health and wellbeing (HWB) data to inform school improvement action planning. This study aimed to evaluate a pilot of SHINE's provision of school-level HWB data reports from the Health Behaviour in School-aged Children survey and their impact on school action planning. Using a qualitative case study design, we collected data in four local authorities across Scotland via pupil and school staff focus groups (n = 23 groups), and from interviews with senior leaders, school SHINE Leads, other relevant school-level stakeholders, local authority (LA) HWB and data leads (n = 30 interviews). Data analysis was supported using Normalisation Process Theory as a guiding framework. Implementation was at an early stage. Participants indicated that the data reports were an accessible and valuable source of local information to support the improvement agenda. SHINE's expertise supported the lack of research capacity and strengthened HWB data literacy skills in schools. At the point of interview, data reports had not been shared widely within the school community, but there was some limited use of the reports to inform action planning around HWB. Through close working and further engagement with schools, SHINE has the potential to support them to deliver national commitments to improving HWB.

Scottish schools are required to support young people's health and wellbeing (HWB). Schools must demonstrate a robust framework of self-evaluation to understand pupils' HWB needs and find ways to support them. The School Health and Wellbeing Improvement Research Network (SHINE) was set up to support Scottish schools to better understand the HWB needs of pupils and make more effective use of HWB data. In SHINE's initial pilot phase, schools were given reports of findings from a survey of some of their pupils. This study asked schools and local authorities what they thought of these reports and whether they had used them to inform school improvement. Schools were enthusiastic about receiving reports with their own school's data. They liked the format and content of the reports. However, at the time of interview, only a few schools had used the reports to make changes within the school. Some limitations of the data reports were identified. They believed however that SHINE's expertise was valuable and were enthusiastic about the potential of network membership. SHINE will continue to develop in response to this study's feedback.

Shaping Physical Activity through Facilitating Student Agency in Secondary Schools in the Netherlands.

Schools can enable students' capability for lifelong physical activity (PA) by providing a physical, social and pedagogical context fostering students' agency. This entails allowing them to develop their autonomy and ability to shape PAs according to what they value. This paper explores whether, and, if so, how, school practices provide the conditions for developing and employing PA-related student agency. We followed a multiple case study design, partnering with six secondary schools in the Netherlands. We based our qualitative content analysis on the schools' policy documents and transcripts of interviews and focus groups with school management, teaching staff and supporting sports professionals. First, we analysed the space provided for PA-related student agency using the whole-of-school framework. Next, we used a social practice theory perspective to understand how each school practice allows for student agency. Results suggest that schools offer sufficient and varied PA opportunities but have not embedded deliberation with students on their meaningfulness and transfer to other contexts in their practices. We conclude that for schools to promote lifelong PA for students, there is a need for a pedagogical approach involving students' perspectives, participation and reflections, enabling them to transfer PAs to other (future) life settings.

The Italian School Psychologists' Role: A Qualitative Study about Professional Practices and Representations.

School psychologists' relevance has been broadly affirmed. However, there is no shared definition of their professional role, and more efforts are needed to promote an organisational and whole-school approach. The present study aims to investigate practices and representations of Italian school psychologists, advance knowledge of the status and development of school psychology, and learn more about the approaches currently adopted in schools. A qualitative method was used and 11 focus groups with a total of 86 participants were carried out. Ad hoc instruments were defined. The results highlighted that school psychologists are more focused on building one-on-one relationships, whereas relationships with the organisation as a whole appear to be more difficult. However, participants reported a wide range of activities, targeted to both the individual and the organisation. Moreover, efforts to strengthen the relationships with school principals and the entire school community were described. Specific needs emerged and the necessity to better define the school psychologists' role was reported by the participants. More efforts are needed to promote an organisational approach among Italian school psychologists and specific training should be offered.

Are Perceptions of Health Dependant on Social Class? Studying Soft Power and Symbolic Violence in a Health Promotion Program among Young Men at Vocational Schools.

Health behaviour among young people has a social gradient, and tends to be skewed in terms of gender as well. Young men in vocational educational settings are an example where the inequality in health is apparent. Addressing this problem requires an understanding of health behaviour and its determinants in the target group in order to be able to develop interventions that can address the problem. The aim of the paper is to investigate to what extent a multicomponent intervention based on the Whole School Approach, targeting the risk behaviours, smoking, eating and physical activity that have an impact on health behaviour among male students in a disadvantaged educational setting. The paper uses self-reported longitudinal data on risk behaviours from the "Gearing up the Body" 1-year intervention program that was implemented among students at a Danish vocational school. For the analysis, we created a score model to categorise students and behaviour. Analyses suggest that interventions had only a modest impact and what evidence there is shows that the interventions reduced the health behaviour scores by 0.03 points. More specifically, we find that symbolic violence reduces the health behaviour score of the healthy types by 0.20 points, whereas soft power increases the health behaviour of the unhealthy type by 0.05 points. An explanation for the disappointing results of the "Gearing up the Body" program is tension between different understanding of what is "right" and "wrong" health behaviour. We find that the ideas of soft power and symbolic violence can contribute to a better understanding of why health and health behaviour is understood differently among vocational students. Thus, the finding demonstrates that one needs to apply a participatory approach rather than a normative approach addressing the health behaviour of disadvantaged individuals.

Considerations for Individual-Level Versus Whole-School Physical Activity Interventions: Stakeholder Perspectives.

Strategies to address declining physical activity levels among children and adolescents have focused on 'individual-level' approaches which often fail to demonstrate impact. Recent attention has been on an alternative 'whole-school' approach to increasing physical activity that involves promoting physical activity throughout all aspects of the school environment. There is, however, a lack of evidence on how whole-school physical activity approaches could be implemented in the UK. This qualitative study explored perspectives of key stakeholders on potential reasons for the lack of impact of individual-level school-based interventions on children's physical activity, and key considerations for adopting a whole-school approach. Nineteen semi-structured interviews were conducted with a range of stakeholders involved in the implementation of physical activity programmes in UK schools. Data were analysed using an inductive approach. Respondents suggested that individual-level school-based interventions to increase physical activity often failed to consult end users in the design and were typically implemented in environments unsupportive of long-term change. They subsequently outlined specific barriers and key facilitators for the adoption and implementation of whole-school approaches in UK settings and recommended a shift in research foci towards building an evidence base around educational outcomes and whole-school implementation insights.

Food environment intervention improves food knowledge, wellbeing and dietary habits in primary school children: Project Daire, a randomised-controlled, factorial design cluster trial.

BACKGROUND: Evidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children's health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions. METHODS: Daire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) 'Nourish', ii) 'Engage', iii) 'Nourish' and 'Engage' and iv) Control (Delayed). 'Nourish' was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. 'Engage' was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured. RESULTS: Fifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6-7 years and n = 458 aged 10-11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6-7 and 10-11 year old pupils) who received the 'Nourish' intervention compared with those that did not (adjusted difference in mean = - 0.82; 95% CI -1.46, - 0.17; P < 0.02). No statistically significant difference in Health-Related Quality of Life was observed. The 'Nourish' intervention also produced some changes in school-based dietary behaviour, which were most apparent in the 10-11 year old pupils. The 'Nourish' intervention also produced improvements in understanding of food labels (adjusted difference in mean = 0.15; 95% CI 0.05, 0.25; P < 0.01) and knowledge of vegetables in season (adjusted difference in mean = 0.29; 95% CI 0.01,0.56; P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed. CONCLUSIONS: Improvements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the 'Nourish' whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted. TRIAL REGISTRATION: National Institute of Health (NIH) U.S. National Library of Medicine Clinical Trials.gov (ID: NCT04277312 ).

Comprehensive Prevention of Campus Sexual Violence: Expanding Who Is Invited to the Table.

There are calls for sexual violence prevention to be more comprehensive and align with a socio-ecological approach. However, there is lack of models with specificity on how to engage additional stakeholders. Whole School Approach (WSA) frameworks have been used to address health promotion and bullying prevention and can be a useful model for guiding campus sexual violence prevention work. WSA models situate violence as a community issue and one where all community members have a role to play in prevention. Rather than focusing on addressing individual behavior, WSA frameworks address the role of the larger school environment in serving as a protective factor against violence, abuse, and harassment. A review of the literature on WSA frameworks in other disciplines reveals a number of potential ways to translate key elements of WSA models to the field of campus sexual violence prevention. In particular, mechanisms can be applied to expand the role of students, faculty, staff, parents/significant adults, institutional leadership, and the larger community.

UPRIGHT, a resilience-based intervention to promote mental well-being in schools: study rationale and methodology for a European randomized controlled trial.

BACKGROUND: Adolescence is crucial period for laying the foundations for healthy development and mental well-being. The increasing prevalence of mental disorders amongst adolescents makes promotion of mental well-being and prevention interventions at schools important. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is designed as a whole school approach (school community, students and families) to promote a culture of mental well-being and prevent mental disorders by enhancing resilience capacities. The present article aims at describing the rationale, conceptual framework, as well as methodology of implementation and evaluation of the UPRIGHT intervention. METHODS: UPRIGHT project is a research and innovation project funded by the European Union's Horizon 2020 Research and Innovation programme under grant agreement No. 754919 (Duration: 48 months). The theoretical framework has been developed by an innovative and multidisciplinary approach using a co-creation process inside the UPRIGHT Consortium (involving seven institutions from Spain, Italy, Poland, Norway, Denmark, and Iceland). Resulted is the UPRIGHT programme with 18 skills related to 4 components: Mindfulness, Coping, Efficacy and Social and Emotional Learning. Among the five Pan-European regions, 34 schools have been currently involved (17 control; 17 intervention) and around 6000 adolescents and their families are foreseen to participate along a 3-year period of evaluation. Effectiveness of the intervention will be evaluated as a randomized controlled trial including quantitative and qualitative analysis in the five Pan-European regions representative of the cultural and socioeconomic diversity. The cost-effectiveness assessment will be performed by simulation modelling methods. DISCUSSION: We expect a short- to medium-term improvement of mental well-being in adolescents by enhancing resilience capacities. The study may provide robust evidence on intrapersonal, familiar and social environmental resilience factors promoting positive mental well-being. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03951376 . Registered 15 May 2019.

The influence of contextual factors on implementation fidelity in a whole school approach to prevention of violence against women.

ISSUE ADDRESSED: Implementation fidelity relates to the degree of adherence to implementation protocols and content and helps to guide replication of evidence-based programs. In settings-based research, notions of fidelity have been applied more often to delivery of education content rather than whole of setting change. The aims of this paper were firstly, to analyse how contextual factors influenced implementation of a whole school program on respectful relationships education, and secondly given the findings, discuss whether a more flexible approach to implementation fidelity may have yielded increased school engagement. METHODS: The project was conducted in 19 secondary schools in Victoria in 2015. This paper reports on focus groups and interviews which were conducted with 81 school staff and 28 staff from the lead agency, community agency partners, and departmental staff to understand the contextual factors influencing implementation. RESULTS: The program followed a traditional implementation fidelity approach of considering core elements and some minor scope for adaption which engaged some regions and schools but not others. CONCLUSION: An alternative notion of implementation fidelity, "fidelity to function," may have permitted increased flexibility to tailor the intervention components to suit different school and community contexts and potentially, increasing both the reach and impact of the program. SO WHAT?: Understanding how to apply notions of fidelity to guide whole of setting change are important considerations if programs are to be replicated to have wider reach and greater impact and effectiveness.

Short-term effects of the "Together at School" intervention program on children's socio-emotional skills: a cluster randomized controlled trial.

BACKGROUND: Together at School is a universal intervention program designed to promote socio-emotional skills among primary-school children. It is based on a whole school approach, and implemented in school classes by teachers. The aim of the present study is to examine the short-term effects of the intervention program in improving socio-emotional skills and reducing psychological problems among boys and girls. We also examine whether these effects depend on grade level (Grades 1 to 3) and intervention dosage. METHODS: This cluster randomized controlled trial design included 79 Finnish primary schools (40 intervention and 39 control) with 3 704 children. The outcome measures were the Strengths and Difficulties Questionnaire (SDQ) and the Multisource Assessment of Social Competence Scale (MASCS) with teachers as raters. The intervention dosage was indicated by the frequencies six central tools were used by the teachers. The data was collected at baseline and 6 months later. Intervention effects were analyzed using multilevel modeling. RESULTS: When analyzed across all grades no intervention effect was observed in improving children's socio-emotional skills or in reducing their psychological problems at 6-month follow-up. Among third (compared to first) graders the intervention decreased psychological problems. Stratified analyses by gender showed that this effect was significant only among boys and that among them the intervention also improved third graders' cooperation skills. Among girls the intervention effects were not moderated by grade. Implementing the intervention with intended intensity (i.e. a high enough dosage) had a significant positive effect on cooperation skills. When analyzed separately among genders, this effect was significant only in girls. CONCLUSIONS: These first, short-term results of the Together at School intervention program did not show any main effects on children's socio-emotional skills or psychological problems. This lack of effects may be due to the relatively short follow-up period given the universal, whole school-based approach of the program. The results suggest that the grade level where the intervention is started might be a factor in the program's effectiveness. Moreover, the results also suggest that for this type of intervention program to be effective, it needs to be delivered with a high enough dosage. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02178332 ; Date of registration: 03-April-2014.

Combating school bullying through developmental guidance for positive youth development and promoting harmonious school culture.

Bullying and violence, which can bring detrimental effects, are situations which young people have to face in their process of development. Though school bullying has been a spreading and explicit problem in Hong Kong schools, most of the programs or guidelines dealing with the problem lack citywide, recognized initiatives and the effectiveness of these programs is unknown due to the lack of evaluation. The present paper discusses preventing school bullying from a developmental guidance perspective, using the positive youth development paradigm and promoting the values of harmony and forgiveness at the whole-school level to cultivate a harmonious school culture as a way of combating school bullying.