A pilot wholeschool intervention to increase students social inclusion and engagement, and reduce su

1

• 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.

2
Overview

• Review evidence on young peoples 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

3
Substance use and related harms

• Young peoples smoking, alcohol and illicit drug
  use are among the highest in Europe and key
  priorities in the 2007 Chief Medical Officers
  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.

4
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.

5
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.

6
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 (Plt0.05) and
  other benefits.

7
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.

8
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.

9
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.

10
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.

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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.

12
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.

13
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.

14
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.

15
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.

16
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.

17
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.

18
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 didnt contribute
  to planning in the school.

19
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.

20
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.

21
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.

22
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 scenesand 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.

23
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.

24
Quote - student action-team member, Woodbridge

•  You feel like youre 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 cant believe this is happening and
  were having a say in the rules And they think,
  if I make the rules, then I shouldnt go against
  my own rules.

25
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.

26
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 thats 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

27
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.

28
Quote - facilitator

• We had one of the heads of year working on it.
  But she didnt 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.

29
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.

30
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.

31
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.

32
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.

33
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.

34
Study limitations

•  Only 2 schools but diverse and likely to be
  representative in terms of external pressures
  faced.
•  We didnt interview everyone but we did have
  broader informal discussions which appear to
  confirm our results.
•  We didnt aim to assess outcomes since our
  sample and time-period was limited.

35
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.