School ethos A relevant concept for schoolbased health
School ethos: A relevant concept for school-based health promotion research? Sherri Bisset *Ph. D (Cand) Public Health, Université de Montréal
Outline 1) School ethos : definitions, relevance, utility 2) School ethos : evidence as an independent factor on health outcomes 3) School ethos : interplay with health promotion programs 4) School ethos : a theoretical approach with evidence for an independent effect on student health
1) School ethos : definitions, relevance, utility
School ethos: definitions & relevance n n School climate is a general term that refers to the feel, atmosphere, tone, ideology, or milieu of a school. An open school climate is one in which teacher and principal behaviour is supportive, genuine, and engaged. A closed climate is characterized by lack of authenticity and disengaged behaviour. Empirical evidence has linked school climate with achievement; n the more healthy the school climate, the more committed, loyal, and satisfied the teachers are. n more open the climate of the school, the less alienated students tend to be.
School ethos: utility n Limitations of “school ethos” n Vague, inconsistently defined and variously operationalised n Under theorized and vulnerable to the same criticisms as social capital, social support, social cohesion… n Strengths of “school ethos” n Conceptualises the school as a dynamic and interactive social context that is; n more or less health promoting (i. e. Can have an independent effect on health behaviours) n will ‘interfere’ with health promotion planning
2) School ethos : evidence as an independent factor on health outcomes
School ethos - an independent factor on health outcomes n “Current strategies (i. e. focussing on individual characteristics, such as knowledge and attitudes) to improve teenage health are not having the desired effects. . . interventions aiming to promote a positive school ethos might provide an effective complement to existing interventions” n Bonell, C. , Fletcher, A. , Mc. Cambridge, J. (2007) Improving school ethos may reduce substance
School ethos - an independent factor on health outcomes n Observational studies; n School effects on pupils drug, alcohol, and tobacco use. School effects on smoking uptake. n Effects remain after controlling for individual, family and neighborhood factors. n Experimental studies; n School and community partnerships to plan and review programs and policies n improve sense of belonging and perceived social support
3) School ethos : interplay with health promotion programs
School ethos - interplay with health promotion programs The school climate arises from routine organizational practices that are important to an organization's members. n The school climate is created by the interpersonal dynamics, perceptions, attitudes and behaviours of its members. n A health promotion program imposes changes among school personnel with respect to some of their regular activities and routines. n
School ethos - interplay with health promotion programs The school climate arises from routine organizational practices that are important to an organization's members n An organisational climate is created by the interpersonal dynamics, perceptions, attitudes and behaviours of its members n A health promotion program imposes changes among school personnel with respect to some of their regular activities n
School ethos - interplay with health promotion programs n n n “whether or not a study addresses diet and activity may be less important than how the intervention addresses diet and activity” (Doak et a. , 2006; pg. 126). How schools go about promoting health has more bearing on the health of students than the presence of a specific program (Stewart-Brown, 2006). Programs with “stakeholders in the decision making regarding the potential strategies to be implemented” are more likely to create a supportive environment for sustained action and positive impact (Summerbell, Waters, Edmunds, Kelly, Brown, & Campbell, 2007)
4) School ethos : a theoretical approach with evidence for an independent effect on student health
“School culture as an influencing factor on youth substance use” Sherri Bisset*, Wolfgang Markham**, Paul Aveyard*** *Université de Montréal, Canada; **University of Warwick, United Kingdom; ***University of Birmingham, United Kingdom
Study Objective n To determine if a novel school-level measure of school performance is associated with the prevalence of substance use, after controlling for the composition of pupil risk factors in the school.
Theoretical proposition n Schools optimize pupil functioning through the provision of an appropriate balance of support and control (i. e. support and control are not normative but adjust to needs of pupils) n n Support, facilitates the acquisition of knowledge and skills Control refers to the processes used to ensure pupils’ behaviour is acceptable
Definition (1) n Appropriate support; n n schools perform better than would be expected on academic success, given the socio-demographics of the pupil composition Appropriate control; n schools perform better than would be expected on the rate of truancy, given the socio-demographics of the pupil composition
Definitions (2) n Schools where both academic success and truancy rates are better than expected given the socio-demographic pupil composition provide value-added education n n These schools are categorized as authoritative Schools where both academic success and truancy rates are worse than expected given the socio-demographic pupil composition provide value-denuded education n These schools are categorized as laissez-faire
Findings n Substance use varied among the 166 schools n n n early alcohol initiation (χ2=31. 5, df=1, p< 0. 001) heavy alcohol consumption (χ2=47. 11, df=1, p<0. 001) regular illicit drug use (χ2=35. 2, df=1, p<0. 001) Substance use was significantly associated with value-added education n Little association was found between substance use and ‘raw’ school truancy and academic achievement n
Findings (1) n Value-added education was associated with reduced risk of early alcohol initiation n n Odds Ratio (95% confidence interval) of 0. 87 (0. 78 -0. 95) Estimated prevalence of early alcohol initiation according to the median value-added score Laissez-faire schools Year 7 23. 3% Indeterminate schools 20. 2% Value-added 13. 7%
Findings (2) n Value-added education was associated with reduced risk of heavy alcohol consumption n n Odds Ratio (95% confidence interval) of 0. 91 (0. 85 -0. 96) Estimated prevalence of heavy alcohol consumption according to the median value-added score; Laissez-faire schools Indeterminate schools Authoritative schools Year 7 7. 8% 7. 1% 5. 6% Year 9 14. 6% 13. 5% 10. 8% Year 11 27. 7% 25. 9% 21. 4%
Findings (3) n Value-added education was associated with reduced risk of use of illicit drugs n n Odds Ratio (95% confidence interval) of 0. 90 (0. 82 -0. 98) Estimated prevalence of use of illicit drugs according to the median value-added score; Laissez-faire schools Indeterminate schools Authoritative schools Year 7 1. 7% 1. 5% 1. 2% Year 9 5. 1% 4. 6% 3. 6% Year 11 15. 0% 13. 8% 11. 0%
Conclusions n n n School ethos is a concept which attempts to account for and measure the social dynamics in the school. Recent research recognizes these interpersonal and professional dynamics as having an importance influence on the effectiveness of a health promotion program. Health promotion researchers have incorporated educational and parental theories to understand how the school ethos may independently influence students health behaviours.
Slides prepared in anticipation of some specific queries…
Study Design and Methodology n Cross-sectional self-reported survey of alcohol and drug consumption n West Midlands Young People’s Lifestyle Survey 1995/1996 (WMYPLS) Data were collected across 15 West Midlands English school districts and included 25, 789 grade 7, 9 and 11 pupils from 166 UK secondary schools. Analysis used two-level logistic modelling to relate schools providing value-added education with pupils' substance use. n Model adjusted for individual level confounders; gender, grade, ethnicity, housing tenure, eligibility for free school meal, drinking with parents, neighbourhood deprivation
Background; n n n Markham WA, Aveyard P. A new theory of health promoting schools based on human functioning, school organisation and pedagogic practice. Social Science & Medicine 2003; 56(6): 1209 -20. Aveyard P, Markham WA, Lancashire E, Almond J, Griffiths R, Cheng KK. Is interschool variation in smoking uptake and cessation due to differences in pupil composition? A cohort study. Health & Place 2005; 11(1): 55 -65. Aveyard P, Markham WA, Cheng KK. A methodological and substantive review of the evidence that schools cause pupils to smoke. Social Science & Medicine 2004; 58(11): 2253 -65. Markham WA, Aveyard P, Thomas H, Charlton A, Lopez ML, De Vries H. What determines future smoking intentions of 12 - to 13 -year-old UK African-Caribbean, Indian, Pakistani and white young people? Health Education Research 2004; 19(1): 1528. Aveyard P, Markham WA, Lancashire E, Bullock A, Macarthur C, Cheng KK, et al. The influence of school culture on smoking among pupils. Social Science & Medicine 2004; 58(9): 1767 -80. Aveyard P, Markham WA, Almond J, Lancashire E, Cheng KK. The risk of smoking in relation to engagement with a school-based smoking intervention. Social Science & Medicine 2003; 56(4): 869 -82.
Table 1. Sample Characteristics Year 7 Early initiation to Heavy alcohol use consumption Use of illicit drugs n=8, 037 n=25, 360 n=24, 771 8037 (100%) 8125 (32. 0%) 7786 (31. 4%) Year 9 - 9346 (36. 9%) 9164 (37. 0%) Year 11 - 7889 (31. 1%) 7821 (31. 6%) Male 12698 (50. 1%) 12353 (49. 9%) Female 12523 (49. 4%) 12283 (49. 6%) White 21324 (84. 1%) 20892 (84. 3%) Indian 1493 (5. 9%) 1441 (5. 8%) Most deprived* 1122 (14. 0%) 4140 (16. 3%) 4099 (16. 5%) Fairly deprived 1329 (16. 5%) 4289 (16. 9%) 4240 (17. 1%) Middle 1294 (16. 1%) 4371 (17. 2%) 4311 (17. 4%) Fairly affluent 1340 (16. 7%) 4359 (17. 2%) 4260 (17. 2%) Most affluence 1526 (19. 0%) 4489 (17. 7%) 4310 (17. 4%) * Townsand score
Table 2. Substance use within sample Year 7 Early initiation to alcohol use Heavy alcohol consumption Use of illicit drugs n=8, 037 n=25, 360 n=24, 771 21. 2% (1701) 7. 4% (8125) 1. 4% (110) Year 9 - 13. 9% (9346) 4. 5% (414) Year 11 - 26. 6% (7889) 13. 7% (1071) Girls 17. 2% (689) 19. 6% (2494) 7. 8% (960) Boys 25. 0% (999) 11. 8% (1479) 5. 1% (622) Most deprived* 22. 5% (252) 15. 2% (628) 5. 7% (235) Fairly deprived 24. 7% (328) 15. 4% (660) 6. 0% (254) Middle 24. 7% (319) 16. 3% (711) 6. 2% (269) Fairly Affluent 19. 2% (257) 15. 6% (681) 6. 7% (284) Most Affluent 15. 6% (238) 13. 3% (599) 5. 9% (254) * According to Townsand score
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