Preventing Stress among High School Students in Denmark through the Multicomponent Healthy High School Intervention: The Effectiveness at First Follow-Up

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Abstract

Stress is a widespread phenomenon and young people especially are experiencing high levels of stress. School-related factors are the most frequently self-reported stressors among adolescents, but few interventions have targeted the school environment. This study evaluated the effectiveness of the Healthy High School (HHS) intervention on stress at a 9-month follow-up. The study included 5201 first-year high school students (~16 years) in Denmark. Participating schools were randomized into the HHS intervention (N = 15) or control group (N = 15). Baseline measurements were conducted in August 2016 and the follow-up was conducted in May 2017. The intervention was designed to promote well-being (primary outcome) by focusing on physical activity, meals, sleep, sense of security, and stress (secondary outcomes). The intervention comprised: structural initiatives at the school level; a teaching material; peer-led innovation workshops; and a smartphone app. The 10-item Perceived Stress Scale was used to measure stress. Intervention effects on perceived stress were estimated using an intention-to-treat approach with multiple imputations of missing data and multilevel general linear regression modelling. A total of 4577 students answered the baseline questionnaire. No statistically significant difference was found in stress between students at intervention and control schools at the follow-up (mean score: 16.7 versus 16.7, adjusted b = 0.42, 95% CI: −0.16;1.00). The HHS Study is one of the first large randomized controlled trials targeting school environmental stressors. Potential implementation failures and the failures of the program theory are discussed.
OriginalsprogEngelsk
Artikelnummer1754
TidsskriftInternational Journal of Environmental Research and Public Health
Vol/bind20
Udgave nummer3
Antal sider16
ISSN1661-7827
DOI
StatusUdgivet - 18. jan. 2023

Bibliografisk note

Funding Information:
This research was funded by TrygFonden, grant number 30035 and Nordea-Fonden, grant number 02-2015-1364.

Publisher Copyright:
© 2023 by the authors.

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