How much is enough?

There have now been many controlled studies of preventive mental health interventions for young people. For these studies to be useful, practitioners need to know whether the effects shown for a particular intervention are modest, moderate, or large.

Emily Tanner-Smith and colleagues summarised more than 400 mean effect size estimates from 74 meta-analyses that synthesised findings from many trials. All the trials were of programmes aimed at preventing problematic behaviour or emotional problems for young people aged 5-18. The results, published in Prevention Science, indicate that, with few exceptions, the median average effect sizes on various outcomes fell within the range of +0.07 to +0.16. The authors advise that these indicate the level of improvement that has been achieved to date and can serve as a benchmark for assessing the value of new findings.

The report also points out that prevention programmes yielded larger effects on knowledge than on actual behaviour. Providing information to increase knowledge (e.g., about the risks of drug use) is an important component of many programmes, but knowledge does not always correlate strongly with actual behaviour.

Source: Empirically Based Mean Effect Size Distributions for Universal Prevention Programs Targeting School-Aged Youth: A Review of Meta-Analyses (August 2018) Prevention Science

Does the KiVa anti-bullying programme work?

A study in Prevention Science evaluates the effectiveness of the KiVa anti-bullying programme in Italy through a randomised controlled trial of students in grades 4 and 6 (equivalent to Years 5 and 7). The sample involved 2,042 students across 13 schools that were randomly assigned to intervention (KiVa) or control (usual school provision) conditions. The Italian school system is divided into primary school (grades 1–5), middle school (grades 6–8), and secondary school (grades 9–14), so only schools which had both primary and middle schools were included.

KiVa is a research-based anti-bullying programme developed by the University of Turku, Finland. It is a schoolwide intervention that is focused on the bystanders’ reactions to a bullying situation, which assist and reinforce the bully, and aims to change their attitudes and behaviours.

Researchers Annalaura Nocentini and Ersilia Menesini considered different outcomes (bullying, victimisation, pro-bullying attitudes, pro-victim attitudes, empathy toward victims), analyses, and estimates of effectiveness in order to compare the Italian results with those from other countries. Multilevel models showed significant results for KiVa for all outcomes and analyses in grade 4. In grade 6, KiVa also reduced bullying, victimisation, and pro-bullying attitudes, but the effects were smaller as compared to grade 4, although still significant. The results also showed that the odds of being a victim were 1.93 times higher for a control student than for a KiVa student in grade 4. Overall, their findings provide evidence of the effectiveness of the programme in Italy.

Source: KiVa Anti-Bullying Program in Italy: Evidence of Effectiveness in a Randomized Control Trial (2016), Prevention Science, 17(8)

Which schools abandon interventions?

A new study published in Prevention Science looks at which schools persevere with interventions and which abandon them.

Led by Kent McIntosh from the University of Oregon, the researchers looked at 5,331 schools during five years of implementing schoolwide positive behavioural interventions and supports (SWPBIS) – a school-wide behaviour management program. The extent to which a school was implementing the program was measured using three surveys completed by the schools each year. Analysing this data, the researchers identified four different kinds of schools:

  • Sustainers (29% of schools) had a high likelihood of meeting the fidelity criterion across all years of implementation.
  • Slow Starters (13%) had an inconsistent pattern of reaching the fidelity criterion across the first three years of implementation that then increased to nearly the level of the Sustainers in the fourth and fifth years.
  • Late Abandoners (24%) were more likely than not to reach the fidelity criterion in the first three years of implementation, but then were very unlikely to reach the criterion in the fourth and fifth years.
  • Rapid Abandoners (34%) had a high probability of reaching the fidelity criterion in the first year, but dropped off rapidly and remained low in subsequent years.

Schools were more likely to abandon if they were middle or high schools, smaller, and had fewer schools locally that were already using SWPBIS. The researchers suggest that their results highlight the importance of supporting those schools implementing programs, particularly in Year 1 (when Rapid Abandoners are already struggling) and Year 3 (when Late Abandoners are more likely to quit).

Source: Identifying and Predicting Distinct Patterns of Implementation in a School-Wide Behavior Support Framework (2016), Prevention Science