What do we know about preventing drug-related harm through social developmental intervention with children and young people

This chapter examines the evidence for the effectiveness of interventions aiming to reduce drug-related harm by improving conditions for healthy develeopment in the earliest years through adolescence. Of the interventions beginning prior to birth, there is efficacy evidence that family home visitation is a feasible strategy for implementation with disadvataged families and can reduce risk factors for early developmental deficits and thereby improve childhood development outcomes. There is efficacy evidence for strategies such as parent education and school preparation through the pre-school age period. Some of the strongest evidence for efficacy in reducing developmental pathways to drug-related harm comes from interventions delivered through the early school years to improve educational environments. Of the interventions targeting the high school age period, school drug education has been the most commonly evaluated. The evidence suggests that short term reduction in both drug use and progression to frequent drug use may be achievable through this strategy, but the prospects for longer-term and population-level behaviour change is still unclear. In overview, a range of prevention strategies have been developed and evaluated. Most of the exisiting evidence is restricted to efficacy studies and there are future challenges to progress evaluation through to studies of effectiveness. In general, prevention programmes appear more successful where they maintain intervention activities over a number of years and incorporate more than one strategy. Much of the existing research has been based in North America and evaluates discrete programmes. Future research should test effects in other countries, in different social contexts and seek to better understand the interrelated effects of combining interventions within the community. Developmental prevention programmes target different age periods and social settings, hence communities have the challenge of coordinating a mixture of programmes that address the local conditions that adversely influence child and youth development. There are opportunities in this work to coordinate prevention activities using funding from different jurisdictions (e.g., crime prevention, health promotion, mental health, education, substance abuse prevention).

The nature of children's social interactions at school

Interpersonal interactions are important for emotional and psychological wellbeing. One attempt to systematically assess social interactions among gifted children was presented by Manor-Bullock et al. (1995) in their Social Interaction Questionnaire (SIQ). However, no psychometric properties of this scale or the nature of the factors that form students' social interactions have been reported. The aim of this study to ascertain the underlying factor structure of students' social interactions on scores on the SIQ and to compare the responses of children attending a regular school to those in Manor-Bullock et al.'s cohort of gifted children. Two independent factors emerged from the data: social/popular and confident/studious with internal reliability of {alpha} = 0.82 and {alpha} = 0.60 respectively. There were no gender differences on these factors in the current data. Chi square analyses revealed concordance between gifted and regular-school children on seven of 16 comparable items. Discussion of the items demonstrating an association is presented. Confirmation of the current factor structure is necessary and a matched comparison with gifted children is recommended.

What are grade 5 and 6 children buying from school canteens and what do parents and teachers think about it?

Objective: The foods sold in school canteens have a significant role to play in ensuring children consume a healthy balance of nutritious foods. However, no research to date has described the foods that Australian children are purchasing at school canteens, or the perceptions held about school canteens by students, teachers and parents.
Design: An exploratory cross-sectional survey was used to obtain information from students, parents and teachers through self completion questionnaires.
Subjects: There were 384 children aged nine to 12 years, 404 parents and 41 teachers involved.
Settings: The study was conducted in 12 primary schools in Victoria, Australia.
Main outcome measures: Types of foods purchased at school canteens, school canteen usage, parents' and teachers' perceptions of the role of the school and canteen in influencing children's eating habits.
Results: More than 50% of the children surveyed used the school canteen at least once per week. Children identified preference for unhealthy alternatives and availability as key barriers to choosing healthy foods at the canteen and suggested increased availability, advertisements and cost reductions as aids to purchasing healthy foods. Teachers placed more importance on the role of the canteen than parents did.
Statistical analyses: Frequencies, cross-tabulation analyses and chi square tests were undertaken using the SPSS 11 computer program.
Conclusions: These Victorian primary school children and their teachers, and to a lesser extent parents, had a clear understanding of healthy foods. Children and teachers identified barriers that prevent school canteens
from providing healthy foods. There is likely to be strong support from these stakeholders for novel health promoting policies.

Children's physical activity levels during school recess : a quasi-experimental intervention study

Background : Recess provides a daily opportunity for children to engage in moderate-to-vigorous (MVPA) and vigorous physical activity (VPA). Limited research has investigated the effects of recess-based interventions on physical activity using large sample sizes whilst investigating variables that may influence the intervention effect. The aim of the study was to investigate the short-term effects of a playground markings and physical structures intervention on recess physical activity. A secondary aim was to investigate the effects of covariates on the intervention.

Methods : 150 boys and 147 girls were randomly selected from 26 elementary schools to wear uni-axial accelerometers that quantified physical activity every 5 seconds during recess. Fifteen schools located in deprived areas in one large urban city in England received funding through a national initiative to redesign the playground environment. Eleven schools served as matched socioeconomic controls. Data were collected at baseline and 6-weeks following playground intervention. Recess MVPA and VPA levels adjusted for pupil- and school-level covariates (baseline physical activity, age, gender, recess length, body mass index) were analysed using multilevel analyses.

Results : Positive but non-significant intervention effects were found for MVPA and VPA when confounding variables were added to the model. Gender was a significant predictor of recess physical activity, with boys engaging in more MVPA and VPA than girls. Significant interactions for MVPA revealed that the intervention effect was stronger for younger elementary aged school children compared to older children, and the intervention effect increased as daily recess duration increased.

Conclusion : The playground redesign intervention resulted in small but non-significant increases in children's recess physical activity when school and pupil level variables were added to the analyses. Changing the playground environment produced a stronger intervention effect for younger children, and longer daily recess duration enabled children to engage in more MVPA following the intervention. This study concludes that the process of increasing recess physical activity is complex when school and pupil-level covariates are considered, though they should be taken into account when investigating the effects of playground intervention studies on children's physical activity during recess.

A study of the effectiveness of music appreciation TV programs for young children in Hong Kong

This paper provides a preliminary report of a small-scale research examining the effectiveness of a series of Music Appreciation segments of “Pre-school: Learn to Fly”—a locally designed and produced early childhood TV program in Hong Kong. Four aspects of young children’s musical development were studied: 1) musical exposure; 2) attention span; 3) response to music; and 4) musical memory. The findings enrich local understanding of early childhood music education and media, and provide more information for the production of the next series from late 2004.

The subjective wellbeing of high-school students : validating the personal wellbeing index—school children

The Personal Wellbeing Index—School Children (PWI-SC) is designed as a parallel form of the adult PWI-A, to measure subjective wellbeing. This study examines the psychometric properties of the PWI-SC. Data from 351 students, aged between 12 and 20 years, were collected by two independent studies over the years 2005–2006. Using the combined data, the results indicate good psychometric properties for the PWI-SC. It is also found that females have higher SWB but that both genders show an age-related decline in SWB from early to mid adolescence. Notably, School satisfaction meets the criteria for a new domain for the PWI-SC and should be considered for inclusion in a future revision of the scale. The use of the PWI-SC in schools can provide important information for the development of educational policy.

Early peer play interactions of resilient children living in disadvantaged communities

Resilience for children is positive adaptation and a capacity to thrive despite challenging circumstances. Children demonstrating resilience are seen to have strong cognitive skills and have developed positive peer relationships. The ‘Supporting Resilience’ project is exploring the conditions and characteristics of resilience of young children and their families who live in rural, regional and metropolitan communities that are economically and socially disadvantaged. The aim of this paper was to report on pretend play and social competence within the early years’ cohort of the ‘Supporting Resilience’ project. Twenty-six children aged 4–6 years who were identified as resilient by their preschool teacher were involved in the study. Results obtained from the Child Initiated Pretend Play Assessment and the Penn Interactive Peer Play Scale when the children were at pre-school found significant relationships between object substitution and social interaction (r = .414, p < .05). Children who could elaborate play with unstructured objects were less likely to be socially disconnected (r = –.49, p < .05). There was no significant difference between geographical locations for play ability. Significant difference for social competence was found between geographical locations. By situating play as individual development within a socio-cultural environment the relationship between children's pretend play ability and social peer play interactions are considered within early childhood development and resilience literature.

Is a change in mode of travel to school associated with a change in overall physical activity levels in children? Longitudinal results from the SPEEDY study

Background
Children who use active modes of travel (walking or cycling) to school are more physically active than those who use passive (motorised) modes. However, less is known on whether a change in mode of travel to school is associated with a change in children’s physical activity levels. The purpose of this analysis was to investigate the association between change in mode of travel to school and change in overall physical activity levels in children.

Methods
Data from 812 9–10 year old British children (59% girls) who participated in the SPEEDY study were analysed. During the summer terms of 2007 and 2008 participants completed a questionnaire and wore an accelerometer for at least three days. Two-level multiple linear regression models were used to explore the association between change in usual mode of travel to school and change in objectively measured time spent in MVPA.

Results
Compared to children whose reported mode of travel did not change, a change from a passive to an active mode of travel was associated with an increase in daily minutes spent in MVPA (boys: beta 11.59, 95% CI 0.94 to 22.24; girls: beta 11.92, 95% CI 5.00 to 18.84). This increase represented 12% of boys’ and 13% of girls’ total daily time spent in MVPA at follow-up.

Conclusion
This analysis provides further evidence that promoting active travel to school may have a role in contributing to increasing physical activity levels in children.

An observational assessment of physical activity levels and social behaviour during elementary school recess

Objective: The purpose of the present study was to assess children’s physical activity, social play behaviour, activity type and social interactions during elementary school recess using a pre-validated systematic observation system.

Design: Cross-sectional.

Setting: Two elementary schools located in Merseyside, England.

Method: Fifty-six elementary school children (27 boys, 29 girls) were systematically observed during recess over a three-month period using a standardized physical activity observation instrument.

Results: The results revealed the boys were engaged in significantly higher levels of physical activity during recess than girls. The boys were also involved in more sport-specific activities and participated in larger group sizes. Positive associations between physical activity and availability of equipment during recess were also reported.

Conclusion: This study has confirmed recess as a valuable opportunity for elementary school children to increase their levels of physical activity. However, further studies with larger sample sizes need to identify and explore the relationship between physical activity (PA) and availability of equipment.

A school-based education programme to reduce salt intake in children and their families (School-EduSalt): protocol of a cluster randomised controlled trial

The current salt intake is very high for children as well as adults in China. A reduction in salt intake is one of the most cost-effective measures to curb the rapidly growing disease burden attributed to blood pressure and cardiovascular disease in the Chinese population. A lower salt diet starting from childhood has the potential to prevent the development of such conditions. The School-EduSalt (School-based Education Programme to Reduce Salt) study aims to determine whether an education programme targeted at school children can lower salt intake in children and their families.

Review of guidelines for children's vision screenings

The aim of children's vision screenings is to detect visual problems that are common in this age category through valid and reliable tests. Nevertheless, the cost effectiveness of paediatric vision screenings, the nature of the tests included in the screening batteries and the ideal screening age has been the cause of much debate in Australia and worldwide. Therefore, the purpose of this review is to report on the current practice of children's vision screenings in Australia and other countries, as well as to evaluate the evidence for and against the provision of such screenings. This was undertaken through a detailed investigation of peer-reviewed publications on this topic. The current review demonstrates that there is no agreed vision screening protocol for children in Australia. This appears to be a result of the lack of strong evidence supporting the benefit of such screenings. While amblyopia, strabismus and, to a lesser extent refractive error, are targeted by many screening programs during pre-school and at school entry, there is less agreement regarding the value of screening for other visual conditions, such as binocular vision disorders, ocular health problems and refractive errors that are less likely to reduce distance visual acuity. In addition, in Australia, little agreement exists in the frequency and coverage of screening programs between states and territories and the screening programs that are offered are ad hoc and poorly documented. Australian children stand to benefit from improved cohesion and communication between jurisdictions and health professionals to enable an equitable provision of validated vision screening services that have the best chance of early detection and intervention for a range of paediatric visual problems.

Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents

INTRODUCTION AND AIMS: Alcohol misuse and depressed mood are common during early adolescence, and comorbidity of these conditions in adulthood is associated with poorer health and social outcomes, yet little research has examined the co-occurrence of these problems at early adolescence. This study assessed risky and protective characteristics of pre-teens with concurrent depressed mood/early alcohol use in a large school-based sample. DESIGN AND METHODS: School children aged 10-14 years (n = 7289) from late primary and early secondary school classes in government, Catholic and independent sectors participated with parental consent in the cross-sectional Healthy Neighbourhoods Study. Key measures included depressed mood, recent alcohol use, school mobility, family relationship quality, school engagement and coping style. Multinomial logistic regression analyses were used to identify school and family-related factors that distinguished those with co-occurring drinking and depressive symptoms from those with either single condition. Gender and school-level interactions for each factor were evaluated. RESULTS: Co-occurring conditions were reported by 5.7% of students [confidence interval (CI)95 5.19, 6.19]. Recent drinkers were more likely than non-drinkers to have symptoms consistent with depression (odds ratio 1.80; CI95 1.58, 2.03). Low school commitment was associated with co-occurring drinking/depressive symptoms (odds ratio 2.86; CI95 2.25, 3.65 compared with null condition). This association appeared to be weaker in the presence of adaptive stress-coping skills (odds ratio 0.18; CI95 0.14, 0.23). CONCLUSIONS: We have identified factors that distinguish pre-teens with very early co-occurrence of drinking and depressed mood, and protective factors with potential utility for school-based prevention programmes targeting these conditions. [Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev 2015].

School based education programme to reduce salt intake in children and their families (School-EduSalt): cluster randomised controlled trial

Objective To determine whether an education programme targeted at schoolchildren could lower salt intake in children and their families. Design Cluster randomised controlled trial, with schools randomly assigned to either the intervention or control group. Setting 28 primary schools in urban Changzhi, northern China. Participants 279 children in grade 5 of primary school, with mean age of 10.1; 553 adult family members (mean age 43.8). Intervention Children in the intervention group were educated on the harmful effects of salt and how to reduce salt intake within the schools' usual health education lessons. Children then delivered the salt reduction message to their families. The intervention lasted for one school term (about 3.5 months). Main outcome measures The primary outcome was the difference between the groups in the change in salt intake (as measured by 24 hour urinary sodium excretion) from baseline to the end of the trial. The secondary outcome was the difference between the two groups in the change in blood pressure. Results At baseline, the mean salt intake in children was 7.3 (SE 0.3) g/day in the intervention group and 6.8 (SE 0.3) g/day in the control group. In adult family members the salt intakes were 12.6 (SE 0.4) and 11.3 (SE 0.4) g/day, respectively. During the study there was a reduction in salt intake in the intervention group, whereas in the control group salt intake increased. The mean effect on salt intake for intervention versus control group was -1.9 g/day (95% confidence interval -2.6 to -1.3 g/day; P<0.001) in children and -2.9 g/day (-3.7 to -2.2 g/ day; P<0.001) in adults. The mean effect on systolic blood pressure was -0.8 mm Hg (-3.0 to 1.5 mm Hg; P=0.51) in children and -2.3 mm Hg (-4.5 to -0.04 mm Hg; P<0.05) in adults. Conclusions An education programme delivered to primary school children as part of the usual curriculum is effective in lowering salt intake in children and their families. This offers a novel and important approach to reducing salt intake in a population in which most of the salt in the diet is added by consumers.

Two of everything: developing functional thinking in the primary grades through children's literature

Traditionally algebra has been regarded as the domain of the secondary school years in Australia and many other countries. Non-mathematics teachers, parents and students often narrowly regard algebra as the manipulation of symbols adhering to tightly prescribed rules (Serow, Callingham & Muir, 2013). It is now recognised, however, that foundational ideas associated with algebraic thinking can, and should be, included in mathematics curricula in the pre-school and primary years (Bobis, Mulligan & Lowrie, 2009). This stance is reflected in the Australian Curriculum: Mathematics (Australian Curriculum Assessment & Reporting Authority, 2012) which extends key algebraic ideas to patterns and generalisations, and acknowledges that number and algebra are developed together as each enriches the study of the other. This article explores the concept of functional thinking and demonstrates how the story, ‘Two of Everything’ (Hong, 1993) is employed as a springboard for developing functional thinking with students from the early years through to upper primary schooling.