Examining subgroup effects by socioeconomic status of public health interventions targeting multiple risk behaviour in adolescence

Multiple risk behaviour (MRB) refers to two or more risk behaviours such as smoking, drinking alcohol, poor diet and unsafe sex. Such behaviours are known to co-occur in adolescence. It is unknown whether MRB interventions are equally effective for young people of low and high socioeconomic status (SES). There is a need to examine these effects to determine whether MRB interventions have the potential to narrow or widen inequalities. Two Cochrane systematic reviews that examined interventions to reduce adolescent MRB were screened to identify universal interventions that reported SES. Study authors were contacted, and outcome data stratified by SES and intervention status were requested. Risk behaviour outcomes alcohol use, smoking, drug use, unsafe sex, overweight/obesity, sedentarism, peer violence and dating violence were examined in random effects meta-analyses and subgroup analyses conducted to explore differences between high SES and low SES adolescents. Of 49 studies reporting universal interventions, only 16 also reported having measured SES. Of these 16 studies, four study authors provided data sufficient for subgroup analysis. There was no evidence of subgroup differences for any of the outcomes. For alcohol use, the direction of effect was the same for both the high SES group (RR 1.26, 95% CI: 0.96, 1.65, p = 0.09) and low SES group (RR 1.14, 95% CI: 0.98, 1.32, p = 0.08). The direction of effect was different for smoking behaviour in favour of the low SES group (RR 0.83, 95% CI: 0.66, 1.03, p = 0.09) versus the high SES group (RR 1.16, 95% CI: 0.82, 1.63, p = 0.39). For drug use, the direction of effect was the same for both the high SES group (RR 1.29, 95% CI: 0.97, 1.73, p = 0.08) and the low SES group (RR 1.28, 95% CI: 0.84, 1.96, p = 0.25). The majority of studies identified did not report having measured SES. There was no evidence of subgroup difference for all outcomes analysed among the four included studies. There is a need for routine reporting of demographic information within studies so that stronger evidence of effect by SES can be demonstrated and that interventions can be evaluated for their impact on health inequalities.https://doi.org/10.1186/s12889-018-6042-

Success for some: An evaluation of a Success for All program

Results from an evaluation of a 3-year Success for All program applied under difficult circum-stances show positive effects for the kindergarten component but a mix of nonsignificant, positive, and negative results for other early elementary grades. Large negative effects were found for achievement ratings of students’performance in Years 2 and 3 for all cohorts. Previous evaluations have reported results for a limited range of outcome measures and used a narrow range of outcome measures. Future evaluations of Success for All programs should assess attainment of the stated goal of the program—to get all students reading at grade level by Grade 3. This attempt to implement the program in a difficult school implies that the program may not be effective wherever and whenever attempted. One of our nation’s most pressing social problems is the prevalence of early school failure, especially in urban public schools. According to the National Assessment of Educational Progress, the average reading profi-ciency score for 9-year-old students in disadvantaged urban areas lagged far behind other groups (U.S. Department of Education 1995). In some cities, large percentages of first graders become official failures when they are not promoted to the second grade; 25 % of first graders were retained i

School size and school disorder

"July 1985."; Includes bibliographical references (p. 42-44)

Gender differences in effects of teen courts on delinquency: A theory-guided evaluation

Teen Court (TC) is an innovative juvenile diversion program that has spread rapidly across the United States in recent years. Despite its popularity, rigorous research on TC effectiveness is lacking. This study used data from a recent randomized trial of the effectiveness of TCs to examine gender differences and mediators anticipated by labeling theory. The study found gender differences in the effect of TC on delinquency. TC was found to increase delinquency for males and to have no effect for females. Implications related to the findings are discussed.

School-based prevention of problem behaviors: A meta-analysis

This study examines the features of effective school-based prevention of crime, substance use, dropout͞nonattendance, and other conduct problems. It summarizes, using meta-analytic techniques, results from 165 studies of school-based prevention activities that ranged from individual counseling or behavior modification programs through efforts to change the way schools are managed. The results highlight several inadequacies in the existing research for guiding policy and practice, the most notable of which is that many popular school-based prevention approaches have not been well studied to date. The study shows, however, that school-based prevention practices appear to be effective in reducing alcohol and drug use, dropout and nonattendance, and other conduct problems. The size of the average effect for each of the four outcomes was small and there was considerable heterogeneity across studies in the magnitude of effects, even within program type after adjusting for measured method and population differences. Non-cognitive-behavioral counseling, social work, and other therapeutic interventions show consistently negative effects, whereas self-control or social competency promotion instruction that makes use of cognitive-behavioral and behavioral instructional methods show consistently positive effects. Also effective are noninstructional cognitive-behavioral and behavioral methods programs. Environmentally focused interventions appear to be particularly effective for reducing delinquency and drug use. KEY WORDS: prevention; drug use; problem behavior; delinquency; quantitative review