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A pilot whole-school intervention to increase students’ social inclusion and engagement, and reduce substance use Bonell C, Sorhaindo A, Strange V, Wiggins M, Allen E, Fletcher A, Oakley A, Bond L, Flay B, Patton G, Rhodes T. Overview.

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A pilot whole-school intervention to increase students’ social inclusion and engagement, and reduce substance use

Bonell C, Sorhaindo A, Strange V, Wiggins M, Allen E, Fletcher A, Oakley A, Bond L, Flay B, Patton G, Rhodes T.

overview
Overview
  • Review evidence on young people’s substance use, related harms and existing interventions.
  • Review international evidence on how whole-school interventions to increase students’ social inclusion and engagement can reduce substance use.
  • Report on evaluation of English pilot of the Healthy School Ethos intervention
  • Discuss implications for research and policy
substance use and related harms
Substance use and related harms
  • Young people’s smoking, alcohol and illicit drug use are among the highest in Europe and key priorities in the 2007 Chief Medical Officer’s report and government policy.
  • Substance use is greatest among socially disadvantaged young people.
  • Early, frequent use strongly predicts later harmful use associated with increased chronic disease.
existing interventions
Existing interventions
  • Curriculum-based education focused on knowledge about alcohol, drugs and tobacco and skills to resist their use are now common in English schools.
  • Systematic reviews report such interventions have small and non-sustained effects.
complementary approaches are required
Complementary approaches are required
  • Lack of engagement or connection to school is a risk factor for substance use and schools exert independent effects on substance use among their students.
  • Studies suggest these might be mediated by inter-school differences in student inclusion and engagement.
  • Pathways involve substances as identity markers for disengaged or insecure students and self-medication for anxious students.
aban aya
Aban Aya
  • The US ‘Aban Aya’ project aimed to increase social inclusion by ‘rebuilding the village’ via various whole-school actions led locally by a staff/student committee and via an emotional/social skills curriculum.
  • 3 arms: 1) whole-school and curriculum elements; 2) curriculum-only; and 3) no intervention.
  • Primary analysis comparing the two intervention with the no-intervention arm, reported a 34% reduction in boys’ substance use (P<0.05) and other benefits.
aban aya7
Aban Aya
  • Secondary analysis reported intervention with whole-school and curriculum elements was more effective than curriculum-only in reducing a composite behavioural risk measure.
  • No process evaluation of implementation, acceptability etc.
gatehouse
Gatehouse
  • This aimed via a similar range of actions to promote students’ security, positive self-regard and communication with staff/other students.
  • It reported reductions in a range of measures of substance use and other risk behaviours.
  • Process evaluation reported that inputs (survey, action team, external facilitator) functioned synergistically.
  • Specific actions varied between schools but were generally well completed.
  • Implementation was facilitated by supportive management and broad participation.
limitations in existing evidence
Limitations in existing evidence
  • Need to know more about how implementation varies and is influenced by schools’ baseline social climate or ‘ethos’.
  •  English schools experience pressures relating to government-set attainment targets, local league tables of attainment and regular external inspections – do they have time for this?
  •  Fostering a positive school environment is required within the National Healthy Schools Programme but there is no evidence-based guidance on how to achieve this.
our aims
Our aims
  • To pilot ‘Healthy School Ethos’ (HSE) in 2007/08 in order to examine:

 (1) whether this was feasible and acceptable in English schools;

 (2) awareness of the intervention throughout the school;

 (3) the influence of schools’ baseline ethos on implementation.

intervention objective and inputs
Intervention objective and inputs

To enable locally determined actions over one academic year 2007/08 to increase students’ security, positive self-regard and communication with staff and students.

  •  External facilitator with head-teacher experience.
  •  Guidance manual.
  •  Survey of students in years 8 and 10 to inform priorities.
  •  10 hours’ training for 20 staff per school on inclusive classroom management.
  •  £4000 core plus £5000 responsive funding per school.
intervention process
Intervention process
  • Staff-student action-teams to meet 10 times through the year.
  •  Determine priorities for action and ensure delivery.
  •  Some pre-set actions: develop agreed rules for appropriate conduct; review policies on bullying and feedback to students; one-to-one pastoral care; events and displays.
  •  Other actions locally decided as long as fit overall aims.
evaluation design
Evaluation design
  •  Two pairs of schools matched on Ofsted rating and proportions of Black/minority ethnic students and students receiving free meals.
  •  One from each pair randomly allocated to intervention and comparison (usual practice).
  •  Drop out of one intervention school led to swap so RCT compromised but our focus was on process not outcomes.
evaluation methods
Evaluation methods
  •  Pre- and post-intervention surveys of year-7 students (age 11/12).
  •  In-depth interviews in intervention schools with: 2 head-teachers; 1 external facilitators and 2 trainers; 11 action-team members (7 staff, 4 students); 4 staff participating in training; 8 students participating in other intervention actions; and 34 other students.
  •  Unstructured observations of various meetings.
results woodbridge
Results - Woodbridge
  • Community school of intake 210 per year.
  •  21% of students receive free school meals and 45% are of Black or other ‘minority’ ethnicity.
  •  Most teaching is in mixed-ability groups.
  •  ‘Satisfactory’ Ofsted rating.
  •  Baseline ethos - individual learning, enjoyment of school and preparation for life, increasing attention to academic attainment.
hillside
Hillside
  •  Foundation school of intake 190 per year.
  •  7% of students receiving free meals and 3.5% of Black/‘minority’ ethnicity.
  •  Students are streamed by ability from year-7.
  •  ‘Good’ Ofsted rating.
  •  Baseline ethos - academic attainment, student contribution to school life, increasing attention to inclusion of less academic students.
inputs facilitator and manual
Inputs - Facilitator and manual
  • Facilitator crucial in providing fresh perspective and structure.
  •  Head-teacher experience not essential other than for school recruitment.
  •  No-one read the manual except where facilitator used certain sections to make worksheets.
  •  Name made initial marketing of project more difficult.
need survey
Need survey
  •  Need survey was feasible and focus on year-8 and -10 students was useful.
  •  Woodbridge students generally more negative.
  •  Almost 1/3 in both schools reported feeling lonely, that few teachers praised them when they did good work, or that students didn’t contribute to planning in the school.
need survey19
Need survey
  • Main priority at Woodbridge was tackling bullying and violence.
  • At Hillside it was making the rules fairer.
  •  Results increased priority for security in Woodbridge and supported priority for Hillside revising reward scheme to engage disaffected students.
training
Training
  •  Provided by large consultancy who sub-contracted to a freelancer.
  •  Communication weak.
  •  Training insufficiently focused on practical strategies.
  •  Inter-session peer observations not properly facilitated.
  •  Less experienced staff still benefited.
action teams
Action teams
  • Both involved requisite staff and students and met 10 times.
  •  Hillside involved more students but drawn from school council.
  •  Woodbridge better at involving disaffected students.
  •  Facilitator and chairs encouraged broad participation.
  •  Student inputs viewed as critically important.
  •  Raised profile through school and brought individual benefits.
quote student action team member hillside
Quote - student, action-team member, Hillside
  • It changed how I felt about the teachers around me at school… It changed school because of the atmosphere that I now feel because the teachers, I now know what goes on behind the scenes…and how much hard work they actually put into all of this... And I think that, kind of, made me appreciate the things that they did more.
pre set actions
Pre-set actions
  • Generally less acceptable than locally determined actions.
  •  Requirement to introduce named pastoral care, revise bullying and other policies and hold events to celebrate ethos took no account of existing practices and plans.
  •  Generally done tokenistically.
  •  Exception was student/staff collaboration to revise school rules - in both schools done with broad consultation and great enthusiasm.
quote student action team member woodbridge
Quote - student action-team member, Woodbridge
  •  You feel like you’re a part of something and because you have a say in it as well… I was speaking to some younger students, they felt so happy about it, especially year-seven students, they said, “I can’t believe this is happening and we’re having a say in the rules…” And they think, if I make the rules, then I shouldn’t go against my own rules.
locally determined actions woodbridge
Locally determined actions - Woodbridge
  •  Safe space and student mediators with student management group – from responsive funding.
  •  Work with charity to develop strategies to combat bullying – slowed by problems with first charity.
  •  Motivational work targeting disaffected year-10 students – some misgivings about targeting but did appear to re-engage these boys.
  •  Delivery driven by senior staff leading.
quote student woodbridge
Quote - student, Woodbridge
  •  It was just a group of young Black boys, and was, like, why is it just us? Why? You know what I mean? Like, are we the only ones failing in this school? Like, we know that’s not the case. But then when we got involved with [motivational leader] and met [him] then we understood why. We learnt a lot… Before, when I had problems I used to come into school, and I used to let my outside problems affect me in school but whereas when the Healthy Ethos Project was introduced … I could, like, talk to my teachers ‘cause it helped me build relationships with my teachers. And teachers would work with me, and help me get my learning…
locally determined actions hillside
Locally determined actions - Hillside
  • Safe space and student mediators – building on existing prefect system but improving training, equipment and representation.
  •  Reviewing the rewards policy – little progress because led by relatively junior staff-member and went against grain of rewarding academic achievement.
  •  Electronic communication boards with student editorial group – funded responsively after initial querying fit with aims.
quote facilitator
Quote - facilitator

We had one of the heads of year working on it. But she didn’t have the seniority to bring about the, kind of, changes that were needed.

I – Was that the main reason then?

Well, yeah, because there was a certain reluctance to engage in a debate about who should be rewarded and what for. Was it going to be rewards for – they had a, sort of, very much a traditional format about, you know, the high achievers were being rewarded.

awareness of project
Awareness of project
  • High – 67% recognised ‘a project to make the school better’ and 60% recognised ‘Healthy School Ethos’.
  • 66% aware of revisions to rules even higher, and approval of rules was higher in intervention schools.
acceptability
Acceptability
  • Interviews suggested all components were acceptable and some very popular indeed.
  •  Interviews suggested many staff and students who had participated in some actions or not at all had only sketchy idea of the overall project.
  •  Suggested improvements included: better name; more student input; more time; fewer pre-set and more locally determined actions.
conclusions feasibility awareness and acceptability
Conclusions - feasibility, awareness and acceptability
  • The intervention was feasible in 2 English schools despite their strong focus on targets, inspections and league tables.
  •  Both schools implemented a broadly similar range of actions.
  •  The project was known about but not always fully understood by staff and students.
  •  Student participation was popular and may be a key mechanism of action.
conclusions factors influencing success
Conclusions – factors influencing success

Actions were more successful when they:

  •  Fitted local priorities.
  •  Built on some aspects of existing ethos.
  •  Were led by senior staff.
conclusions factors influencing success33
Conclusions – factors influencing success

Actions were less successful where they:

  •  Took no account of existing practice.
  •  Were not clearly specified.
  •  Were led by junior staff with insufficient support.
  •  Went too directly/quickly against the grain.
study limitations
Study limitations
  •  Only 2 schools but diverse and likely to be representative in terms of external pressures faced.
  •  We didn’t interview everyone but we did have broader informal discussions which appear to confirm our results.
  • We didn’t aim to assess outcomes since our sample and time-period was limited.
implications for research and policy
Implications for research and policy
  •  Move to a full trial of this intervention combined with social/emotional skills curriculum.
  •  Refocus training on enabling teachers to integrate social/emotional learning into the mainstream curriculum.
  •  If the intervention proves effective then use it as a basis for schools to promote positive ethos as part of the National Healthy Schools Programme.
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