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Personal Development: A Review of the School-Based Evidence for the Efficacy of Teaching Personal Development in Post-Primary Schools Alissa A. Lange Queen’s University, Belfast CCEA 29 Clarendon Road Clarendon Dock Belfast BT1 3BG Telephone: (028) 9026 1200 Textphone: (028) 9024 2063 Fax: (028) 9026 1234 E-mail: [email protected] Contents 1. Executive Summary 4 2. Introduction 5 3. Social Emotional Learning (SEL) / Personal Social Education (PSE) 10 3.1 Literature reviews 10 3.2 Selected specific programmes 13 4. Mental Health Promotion 16 4.1 Literature reviews 16 4.2 Selected specific programmes 19 5. Substance Abuse and Violence Prevention 21 5.1 Literature reviews 21 5.2 Selected specific programmes 24 6. Sexual Health Promotion 27 6.1 Literature reviews 27 6.2 Selected specific programmes 28 7. Other Programmes Promoting Health 30 7.1 Literature reviews 30 7.2 Selected specific programmes 32 8. Benefits of Teaching Personal Development: Summary 34 8.1 School Outcomes 34 8.2 Social Emotional Outcomes 36 8.3 Health Related Outcomes 37 9. What Makes Programmes Work? 40 10. Conclusion 44 11. Further Information 46 12. References 49 2 Key Words Used in This Document Below is a brief glossary of some specialized terms used in this review. cognitive – the mental processes of perceiving, thinking, and remembering. meta-analysis – the use of statistical techniques in a systematic review to integrate the results of included studies. A meta-analysis can show the strength of an effect of interventions. For example, for all studies on drug abuse prevention included a review, a meta-analysis would tell on average how effective they are on preventing drug use. meta-cognitive skills – skills which involve thinking about thinking. The ability to self-monitor learning is well-developed in skilful learners (Shepard, 2001). prosocial behaviour–behaviour intended to help or benefit another person, group or society. The underlying goal or motive that initiates and drives the behaviour rather than the actual outcome of the behaviour is what makes the behaviour prosocial. SEL – Social Emotional Learning is the process of acquiring the skills to recognize and manage emotions, develop caring and concern for others, make responsible decisions, establish positive relationships, and handle challenging situations effectively (http://www.casel.org). school ecology - all concrete environmental aspects of a school, both in and outside of the classroom, which are closely connected to curriculum and instruction, and can influence teaching effectiveness and development of students. universal approaches – universal approaches to interventions are those aimed at whole classes or groups. These can be contrasted with programmes which only target at-risk populations, or those who have existing problems or conditions. 3 1. EXECUTIVE SUMMARY Research has shown multiple benefits of teaching Personal Development in post-primary schools. Positive outcomes for students have been identified for programmes aiming to teach moral development, social skills, caring, coping skills, personal health and safety, sexual health and conflict resolution skills, and prevent substance abuse, violence, and problem behaviour. The benefits were either reported by students or staff (e.g., classroom participation), or observed or measured by researchers (e.g., attendance records, pre- and post-tests of sexual health knowledge). Some of the benefits found for students include the following: School-based improvements in Attendance School commitment School behaviour Standardized test scores Exam marks Personal competency or social emotional improvements in Self-esteem Conflict resolution skills Assertiveness Coping skills Social problem solving skills Health outcomes including Decreased depression Decreases in substance abuse Increase in knowledge about drugs Decreased smoking Decreases in risky sexual behaviours Healthier eating habits 4 The positive changes in knowledge, behaviour and attitudes mentioned above are dependent upon a number of factors. The following factors all impact on the effectiveness of PD programmes: Teaching style and classroom environment The physical environment and the general atmosphere in the school Quality and length of implementation Resources and training Organizational structure and leadership Specific methodological themes emerged from the literature that characterized successful programmes. The following recommended strategies were reported for teaching topics corresponding to those found in the revised Northern Ireland curriculum: Knowledge alone is not enough, although important information and facts must also be included Participatory, interactive teaching methods should be used Generally, developing positive skills and competencies is more effective than directly trying to reduce negative behaviours Programmes involving multiple domains (school, home, community) are generally more successful than those involving the classroom alone Longer term programmes tend to be more successful than short-term projects The school and classroom environment are key A holistic approach, involving the whole school is better than one limited to the classroom The quality of implementation is crucial; fully implemented programmes are more likely to succeed than partially delivered programmes Carefully planned, theory- and research-based programmes shown to be effective will be more likely to produce benefits than those not based on theory and research, or those without evidence of effectiveness A broad review of relevant literature and practice would suggest that using appropriate teaching and learning approaches with sufficient support and training, teachers can productively implement the PD curriculum in Northern Ireland. Teachers have the opportunity to help students develop skills which can improve well-being, social interactions and school behaviour and performance while they are in school, and promote success in later life. 5 2. INTRODUCTION New elements of the Personal Development curriculum will become statutory for Key Stage 3 in 2007 in Northern Ireland. To support the revised curriculum, CCEA commissioned this document to compile research-based evidence demonstrating the benefits of PD teaching to students between the ages of 11-16, focusing on ages 11-14. Teaching Personal Development requires a different approach to classroom management, involving more interactive and conversational methods. These approaches might challenge existing power or authority structures within the classroom where active learning approaches are not so widely used. Some of the topics explored in PD may be controversial and sensitive to students and teachers alike, such as the consequences of early sexual activity. In addition, teachers may feel a tension between requirements in basic skills teaching and broader personal development goals (Stipek & Byler, 1997). Although teaching Personal Development may require changes, there is an abundance of research showing that schools will be most successful in their educational goals when they include academic, social and emotional learning (Berkowitz & Bier, 2004; Elias, Zins, Weissberg, Frey, Greenberg, Haynes, Kessler, Schwab-Stone & Shriver, 1997; McCarthy, 1998; Wang, Haertel & Walberg, 1997), or character education (Berkowitz & Bier, 2004). In fact, social emotional or psychological aptitudes may be the most important factors influencing school performance (Wang, Haertel & Walberg, 1993). In addition to academic outcomes, teaching the skills and information found in the Personal Development curriculum also can help both prevent risky behaviours and promote positive behaviours (Catalano, Berglund, Ryan, Lonczak & Hawkins, 2004). In other words, helping a child to develop positive social, emotional, critical thinking skills not only decreases the chances that they will engage in problem behaviours (e.g., cigarette smoking), but it also increases the chances they will engage in beneficial and healthy behaviours (e.g., healthier eating & improved exam scores). This report summarizes existing research which illustrates positive outcomes of teaching aspects of the revised Personal Development curriculum to post-primary students. The curriculum encompasses a wide range of concepts and competencies. Programmes in this review include those aimed at improving social emotional skills and moral development (Section 3), promoting mental health (Section 4), decreasing rates of substance abuse and violent behaviours (Section 5), reducing risky sexual behaviours (Section 6), and improving other aspects of health (Section 6 7). Section 8 summarizes the benefits found in the review, while Section 9 details the recurring themes in the literature leading to effective instruction. Each section begins by discussing existing literature reviews in an area relevant to the Personal Development strand. Reviews synthesize multiple programmes that have similar aims in order to determine best practice and common outcomes. The second part of each section highlights some specific programmes which have been properly evaluated and have shown to be effective in schools with the target population. Inclusion Criteria Studies included in this review were limited to those relevant to students aged 11-16, although some overlap with other age and year groups was common. Programmes were also limited to teacher-delivered programmes (except where noted), because this is and will be the primary method of delivery of the PD curriculum in Northern Ireland. Only universal programmes - those taught to whole classes, not to specifically at-risk groups were discussed. This requirement was used for a number of reasons. First, universal instruction is and will be the method of delivery in schools in Northern Ireland for the PD materials. Second, universal programmes focused on controversial behaviours (e.g., drug use), which target the general school population appear to be more successful than those aimed at at-risk youth because they are less stigmatising. Third, what works well with a few students appears to work well with most. Fourth, targeting specific individuals with arbitrary cut-offs (e.g., what categorizes someone as being at-risk for developing a drug problem?) can lead to students with problems not receiving adequate help, because they just miss a cut-off (Weare & Gray, 2003). Finally, studies which try to target risk groups are problematic because for some areas, such as drug use, the list of risk-factors is incredibly long (Morgan, 2001). It should be noted that while there are some excellent studies included from the UK and Ireland, many well-documented, well-designed studies have been conducted in the United States. However, the convergence of evidence from multiple studies across countries is growing, and would suggest that programmes would be worth implementing or adapting for use in the UK (Weare & Gray, 2003). While there are extensive case studies and anecdotal evidence supporting the teaching of social emotional development, this paper focused primarily on peer-reviewed research studies and 7 critical reviews or meta-analyses of peer-reviewed studies. These are the most rigorously tested and reliable findings. There are most likely other well-evaluated studies that were not included, and excellent programmes which have not yet been evaluated. Non-inclusion does not necessarily mean that these programmes are weak or non-effective. Due to budget restrictions, this review could not be exhaustive or systematic in nature. Rather, the aim was to locate wellstructured and evaluated programmes showing the effects of teaching elements covered in the PD curriculum in Northern Ireland. Finally, it should be mentioned that research in teaching social emotional competencies, coping skills, drug refusal skills, etc., is referred to by many different names in the literature depending on the specific type of programme, the part of the world it is conducted, and on the researcher’s or school’s perspective. The Personal Development curriculum falls under the umbrella of Personal Social Education (PSE) in Northern Ireland, but other nomenclature includes Social Emotional Learning (SEL), Social Physical Health Education (SPHE), Sexual Health Education (SHE), Personal Social Health Education (PSHE), positive youth development, moral education, character education, etc. 8 3. SOCIAL EMOTIONAL LEARNING (SEL)/ PERSONAL SOCIAL EDUCATION (PSE) 3.1 SEL/PSE: Literature Reviews There are multiple and seemingly diverse aspects of the PD curriculum (e.g., substance abuse prevention, social and emotional health, sexual education, relationships, moral education). However, research has shown that teaching methods and aims which are most effective in one domain, tend to be applicable to other seemingly unrelated areas. The most effective drug abuse prevention programmes teach some of the same skills and abilities (social, emotional, mental health, relationship skills, etc.) as those promoting mental health or sexual health (Greenberg, Weissberg, O’Brien, Zins, Fredericks, Resnik & Elias, 2003; Morgan, 2001). There is an abundance of evidence supporting various academic benefits of teaching Personal Development in schools. Research shows that students who engage in positive relationships and social interactions tend to achieve above average academically (Osterman, 2000). Emotional and social competence are widely recognised as important for educational achievement (e.g., Elias, et al., 1997). Zins, Weissberg, Wang and Walberg (2004) reviewed academic outcomes related to teaching social emotional health, and multiple outcomes are evident ranging from increased attachment to school to improved exam scores. Some programmes discussed in Zins, et al. (2004) are highlighted in this paper in Section 3.2 & 4.2. School-based positive youth development programmes also have been shown to have positive academic and non-academic effects. Positive youth development programmes were characterized by Catalano, et al. (2004) as encouraging one or more of the following constructs: promoting social, emotional, cognitive, behavioural and moral competence, and school bonding; fostering self-efficacy, self-determination, spirituality, clear and positive identity, belief in the future, resilience and prosocial norms, provides recognition for positive behaviour and opportunities for prosocial involvement. Programmes reviewed by Catalano, et al. (2004) showed positive outcomes such as better health behaviours, greater assertiveness, problem solving, increased social skills, among others. Four of the school-based programmes highlighted in this review are detailed below: Growing Healthy (Section 7.2), Life Skills Training, PATHS project (Section 3.2), and Project ALERT (Section 5.2). 9 Elias, et al. (1997) described the following ‘essential characteristics of effective SEL programming’: Carefully planned, theory- and research-based Teach skills that are applicable to every day life Address emotional and social dimensions of learning Coordinated, integrated, unified programming linked to academic outcomes Address key implementation issues, such as classroom environment Include more than one domain, such as home and community Design should include continuous improvement, evaluation and dissemination of findings. Longer, multi-year programmes are more likely to be helpful than short-term lessons (Lantieri & Patti, 1996). Moral Education Research has shown that caring psychologically safe supportive and cooperative learning environments which promote sharing and social and emotional learning can result in benefits for students. These include improved social emotional skills, better academic outcomes (Schaps, Battistich & Solomon, 2004), improved cognitive problem-solving skills, more prosocial conflict resolution techniques, lower rates of drug use and delinquency (Solomon, Watson, Dellucchi, Schaps & Battistich, 1998), increased sense of community and commitment to school (Battistick, Solomon, Watson & Schaps, 1997), and increased student engagement and attachment to school (Osterman, 2000). Engagement and attachment to school have been identified as important in influencing academic performance (Osterman, 2000; Berkowitz & Bier, 2004) and in preventing risky behaviours (Hawkins, Catalano & Miller, 1992). Students who describe their classrooms as including a caring teacher and students who help each other were more likely to participate in class and to finish homework (Murdock, 1999). Some of these studies began with younger students, but most involved students up to at least age 12. In a review of developing values, attitudes and personal qualities, Halstead & Taylor (2000) report that teaching caring in schools leads to longer-term caring of adolescents (Chaskin & Rauner, 1995), and that providing positive caring adult role models is important in children learning caring behaviours. A project designed specifically to help children become more caring by thinking about prosocial norms and values is The Child Development Project (Schaps, Battistich & Solomon, 2004). Details of this project can be found below in Section 3.2. 10 Research has shown that prosocial behaviour is linked to academic performance (e.g., Haynes, Ben-Avie, & Ensign, 2003; Pasi, 2001; Wentzel, 1993). Wentzel (1993) found that students’ GPAs (overall rating representing marks received from school exams) were predicted by prosocial and antisocial behaviour. That is, students that engaged more often in behaviours such as sharing, cooperation, helping others, are more likely to score higher on exams. Solomon, Watson, and Battistich (2001) reviewed the research on teaching moral development in schools. Projects either focus on direct or indirect methods. Direct approaches teach morals and values directly, such as courage, respect, honesty, etc. Indirect approaches encourage students to become more active democrats, critically thinking about morality, in order to develop into principled and caring community members. Both methods have shown benefits. For direct approaches, improvements for students in the target age range include teacher-reported improvements in ethical conduct and increased understanding of moral concepts (Leming, Henrick-Smith & Antis, 1997). For indirect approaches, benefits include improvements in moral reasoning (Higgins, 1980; Higgins, Power & Kohlberg, 1984), increase in school values, increases in norms for integrating people from different backgrounds and norms for attendance (Reimer & Power, 1980; Higgins, Power & Kohlberg, 1984), improved teacher-assessed sociability, teacher- and student-reported social skills (Trianes Torres, Munos Sanches, Sanchez Sanchez, 1995). Two programmes, a direct (Heartwood) and an indirect (Just Community) programme, are highlighted below in Section 3.2. 3.2 SEL/PSE: Selected Specific Programmes Heartwood This direct approach to moral education involves teaching 7 ‘universal’ ethical values: courage, loyalty, justice, respect, hope, honesty, and love. The programme uses multicultural stories to demonstrate the various values, and develop students understanding and commitment to each. Outcomes for students in late elementary school (ages 9-12) included increased understanding of principles and improved teacher-rated ethical conduct, although no differences were found in ethical sensibility (Leming, Henrick-Smith & Antis, 1997). 11 Just Communities The norms and moral atmosphere of a school, as well as moral discussions and active student involvement were the target of this programme. Teachers act as facilitators by encouraging roletaking, focussing on issues of fairness and morality and highlighting or discussing moral reasoning. This programme was developed based on theories of child moral development and has been implemented multiple countries, including the USA, Hungary and Germany. The programme resulted in improvements in moral reasoning for participants (Higgins, 1980; Higgins, Power & Kohlberg, 1984), increases in school values, positive changes in norms for integrating people from different backgrounds and norms for attendance (Reimer & Power, 1980), increased likelihood of participants seeing their peers and themselves as making prosocial choices (Higgins, Power & Kohlberg, 1984). PATHS The PATHS curriculum was developed 20 years ago to provide a comprehensive curriculum to teach social and emotional development (Greenberg, Kusche & Riggs, 2004) and prevent disruptive acting out behaviours. While PATHS starts with younger pupils, the programme can be run with students up to age 12. Based on existing theories of child development, PATHS seeks to develop basic emotional literacy, peer relations and problem solving. The programme has been extensively evaluated on emotional, behavioural and academic outcomes. Specific outcomes include increases in students’ scores on cognitive skills tests, ability to plan ahead and solve complex tasks, cognitive flexibility and low impulsivity with non-verbal tasks. The Child Development Project in California Although the CDP begins with younger children, it is implemented with students up to age 12. The programmes has been thoroughly developed and evaluated, including following students for years after the intervention. Caring psychologically safe learning environments which promote sharing and SEL can result in improvements to students’ social emotional skills and to academic outcomes. The programme was conceived to create a more caring learning environment to help students develop more prosocial, supportive and friendly behaviour and more caring attitudes and behaviours. 12 Results showed that students in the programme demonstrated more prosocial classroom behaviour, were more likely to take everyone’s needs into account when dealing with hypothetical conflicts, and showed increased problem solving and conflict resolution skills (Battistich, Solomon, Watson, Solomon & Schaps, 1989; Solomon, Watson, Dellucchi, Schaps & Battistich, 1998). Seattle Social Development Project Although aimed at younger children at the beginning of the intervention, the SSDP runs until age 12. This programme also has been designed based on sound developmental and evidencebased principals, and has been rigorously evaluated. Based in low-income areas with high rates of violence, the SSDP has components aimed at training teachers in classroom management, teaching parents about ways to recognize positive behaviour and look for opportunities for positive involvement of children in school and family, and teaching students social interaction skills. The developers assert that the training will lead to increased bonding to school and family and decrease in negative behaviours. Abbott, O’Donnell, Hawkins, Hill, Kosterman and Catalano (1998) showed that students aged 1012 involved in the project demonstrated stronger bonding to school, which is related to academic performance (Osterman, 2000; Berkowitz & Bier, 2004). Another study showed that compared to control students not in the programme, girls aged 11-12 showed more classroom participation and more commitment to school (O’Donnell, Hawkins, Catalano, Abbott & Day, 1995). Boys in this study reported improved social skills, school work, commitment to school, and had better achievement test scores and exam marks. Better academic performance of students in the SSDP project compared to controls was found to exist even at age 18 (Hawkins, Catalano, Kosterman, Abbott & Hill, 1999). Life Skills for Health Promotion An Ireland-based programme, Life Skills for Health Promotion, is aimed at promoting seven key skills: communication, relationship building, assertiveness, maintaining self-esteem, skills for maintaining physical well-being, stress management and time management. The programme is aimed at post-primary students. 13 Programme participants demonstrated more responsible behaviour in relation to alcohol, although there was no impact on smoking rates or use of illegal substances. Other improvements include improved adjustment to school. There was also a more marked effect for girls compared with boys in these areas (Nic Gabhainn & Kelleher, 2000; Nic Gabhainn & Kelleher, 1995), with girls in later years benefiting from exposure to the programme more than boys. 14 4 MENTAL HEALTH PROMOTION 4.1 Mental Health Promotion: Literature Reviews There is a high rate of psychological distress and other emotional, behavioural and developmental problems in young people (International Union for Health Promotion and Education, 2000). Depression in particular is on the increase for young people in Northern Ireland (Department of Health, Social Services and Public Safety, 1999; Investing for Health, 2003). Poor mental health in children such as depression, anxiety and behavioural problems is a risk factor for poor school outcomes, poor physical health, and poor social skills (Mental Health Foundation, 1999). Classroom-based efforts can be successful in decreasing the likelihood of mental illness and promoting healthy coping skills. School-based mental health promotion efforts are most successful when taught as a part of coordinated efforts to teach social emotional learning (Greenberg, et al., 2003). A review of selected successful school-based mental health promotion programmes was conducted for the Scottish Executive (Mentality, 2002). Programme topics reviewed included Health Promoting Schools, anti-bullying, body image, suicide prevention, prevention of depression, coping with transitions, participation in school, and substance abuse prevention programmes. A number of benefits for school-age population were mentioned, such as reducing body dissatisfaction and decreasing levels of depression compared to control students. Details of specific programmes from this review (Health Promoting Schools review; Everybody’s Different Program) can be found in Section 7.1. Wells, Barlow and Stewart-Brown (2003) reviewed universal approaches to mental health promotion in schools. Programmes in the review which included students between the ages of 11-16 resulted in decreases in student violence in school (O’Donnell, Stueve & San Doval, 1998), absenteeism and drop out rates, and improvements in self-concept, school marks (Felner, Brand, Adan, Mulhall, Flowers & Sartain, 1993; Felner, Ginter & Primavera, 1982), social self-concept, academic self-concept (Eitan, Amir, Rich, 1992), problem-solving and social problem-solving skills (Snow, Gilchrist, Schilling, Schinke & Kelso, 1986). Greenberg, Domitrovich, and Bumbarger (2001) investigated prevention programmes designed to reduce symptoms or risk of mental disorders in school-age children. The review clearly describes multiple programmes organized by type that have empirical evidence to support their use. Three programmes relevant to the KS3 age group are described in this paper in Section 3.2 (PATHS; 15 CDP; SSDP) and one is described later in this Section (Improving Social Awareness – Social Problem Solving: ISA-SPS). Coping Projects promoting mental health may measure both direct health benefits and improvements in skills which are linked to mental or social health. For example, lack of problem-solving skills or conflict resolution skills is linked to problems in relationships and to poor mental health (Wells, et al., 2003), as these skills are vital elements of psychological health and adjustment (Hinde, 1979). A more positive coping strategy has been liked to improvements in motivation for learning, classroom behaviour and acquiring meta-cognitive skills (Boekaerts, 1996; Dweck & Sorich, 1999). Cunningham, Brandon and Frydenberg (2002) found that teaching coping skills to early adolescents led to improved coping efficacy and fewer depressive attributions. Programmes aimed at helping students deal with school changes include elements teaching coping skills, problem solving skills (Coping with Junior High curriculum) and social competence and social problem solving skills (Improving Social Awareness – Social Problem Solving: ISASPS). These programmes led to improvements in self-reported ability to cope with school transition, teacher reports of behaviour, problem-solving and social problem-solving (BrueneButler, Hampson, Elias, Clabby & Schuyler, 1997; Elias, Gara, Schuyler, Branden-Muller & Sayette, 1991; Snow, Gilchrist, Schilling, Schinke & Kelso, 1986). Details of a specific transition programme, STEP can be found in Section 4.2 Conflict Resolution Teaching conflict resolution as a part of existing curriculum has been shown to have benefits to students’ ability to resolve conflicts and other school-related outcomes (Johnson & Johnson, 1995; Stevahn, 2004). Weissberg, Caplan & Benetto (1988) evaluated a project designed to enhance social-problem solving, involving students learning and applying an ordered approach to dealing with difficult situations. Students in the project compared to those not trained produced more cooperative solutions to hypothetical problems, selected more assertive and cooperative strategies for solving conflict between people andhad higher teacher-ratings of adjustment. Powell, Muir-McClain & Halasyamani (1995) reviewed 9 conflict resolution and peer mediation programmes and reported improved student attitudes towards violence, decreases in referrals to 16 the principal for behaviour problems, decreases in both in- and out-of-school suspensions for the target group and for the whole school and reduced absenteeism. Details of one successful conflict resolution programme in the UK, Leap Confronting Conflict, can be found in Section 4.2. In their review, Johnson & Johnson (1996) found that teaching conflict resolution and peer mediation appear to have positive affects on school climate, increase student psychological health and self-esteem, decrease behaviour problems and even improve academic performance. Students that learn these skills seemed able to retain the skills for months after the programme ends, apply the skills to conflict situations and to spontaneously apply the skills to situations outside of the class and school. The authors note that the key to success of teaching conflict resolution is to practice the skill and not just learn about it. It is also important to promote a cooperative view of conflict resolution as opposed to individualistic or competitive. Ingredients for Success There are a number of factors identified by literature reviews which make school-based universal mental health programmes successful. A recurring theme across programmes is that teaching ideas alone is not enough to cause changes (e.g., Browne, Gafni, Roberts, Byrne & Majumdar, 2004; Moon, Mullee, Rogers, Thompson, Speller, & Roderick, 1999; Greenberg, et al., 2003). This is evident in the evaluation by Clarke, Hawkins, Murphy and Sheeber (1993), which showed that a project teaching about depression and the causes and symptoms did not result in changes in depressive symptoms or knowledge about seeking treatment. Longer term interventions tend to work better than shorter ones, programmes that start earlier in education are more likely to be successful (Browne, et al., 2004; Greenberg, Domitrovich & Bumbarger, 2001). The most successful mental health promotion projects emphasized healthy behaviours, as opposed to trying to preventing negative behaviours (Wells, et al., 2003; Greenberg, Domitrovich & Bumbarger, 2001). Programmes which try to address multiple domains, including school environments and institutions, in addition to individuals, tend to show more positive outcomes (Browne, et al., 2004; Greenberg, Domitrovich & Bumbarger, 2001). Programmes for school-age children should focus on the school ecology and climate (Greenberg, et al., 2001). Teachers should have proper training to enable them to fully deliver programmes (Han & Weiss, 2005). 4.2 Mental Health Promotion: Selected Specific Programmes 17 STEP (transitions, school bonding) STEP helps students who are transitioning from elementary school (primary school) to middle school (KS3), and from middle school (KS3) to high school (KS4). The programme aims to change the school environment and help with school transitions by improving bonding to prosocial adults and peers. Teachers receive training to improve their academic and social emotional counselling skills, and students’ opportunities are increased to be rewarded for academic success. Positive outcomes of the STEP programme included better adjustment to changes in school, improved academic progress (Felner, et al., 1993), reductions in stress, anxiety and depression, fewer absences and drop-outs and higher school marks compared to peers not in the programme (Felner & Adan, 1988; ; Felner, et al., 1982; Felner, et al., 1993). Leap Confronting Conflict Through active group work and peer medication, the Leap project aims to help students and staff become more aware of conflict issues, work with diversity, work in teams and learn negotiation skills. The programme was evaluated in one school in England and was found to have had the following positive impacts (Inman & Turner, 2001): Positive change in school culture and ethos Significant reduction of high-level conflict, with bullying less likely to result in physical violence Staff less threatened by conflicts and more confident in dealing with them Greater self-confidence among young people to take responsibility for their behaviour and achievement Decrease in number of permanent exclusions since start of the project General improvement in GCSE exam results each year since the start of project 18 5. SUBSTANCE ABUSE AND VIOLENCE PREVENTION 5.1 Substance Abuse and Violence Prevention: Literature Reviews Substance Abuse Prevention Primary prevention programs and character or social emotional education programs share many of the same goals (Berkowitz & Bier, 2004). Drug and substance abuse prevention and mental health promotion efforts and are most successful when taught as a part of coordinated efforts to teach social emotional learning (Greenberg, et al., 2003; Morgan, 2001). Watkins (1995b) found that in schools where alcohol education is taught as PSE, the drinking rates are lower than when it is taught in science class. A widely used drug abuse prevention programme in Ireland, ‘On My Own Two Feet’, is detailed in Section 5.2. In a meta-analysis of school-based prevention programmes aimed at reducing problem behaviours, Wilson, Gottfredson and Najaka (2001) found that programmes taught in schools could be effective in reducing alcohol and drug use. In addition, they found that those programmes which focused on social emotional learning positively impacted school behaviours, including dropout and attendance rates. Details of one programme mentioned in this review, Life Skills Training (LST) & another from the review by Catalano, et al. (2004), Project ALERT, can be found in Section 5.2. The US Department of Health and Human Services (2002) summarized model prevention programmes which aim to improve overall social and behavioural functioning, among other objectives, that also lead to improved academic achievement. Four programmes were relevant to students in KS3 (Across Ages: school & community-based; Leadership & Resiliency Program: school & community-based; PATHS: school-based; Project ACHIEVE: school-based). Specific positive outcomes included increased school marks, improved attendance (Across Ages; Leadership & Resiliency Program), decreased suspensions, improved attitudes towards school, decreased alcohol and tobacco use (Across Ages), graduation rates, increased sense of school bonding, increased knowledge of and negative attitudes towards substance abuse and violence (Leadership & Resiliency Program), better reading, math and language test scores, significant 19 improvement in students’ abilities to tolerate frustration and willingness to use effective conflict resolution strategies (Project ACHIEVE), improved problem-solving skills, cognitive flexibility, scores on cognitive skills test (PATHS), fewer reported behaviour problems (Leadership & Resiliency Program; Project ACHIEVE). Details of one of the school-based programmes, PATHS, can be found in Section 3.2. Reviews of cigarette smoking prevention programmes found that smoking was reduced in socialskills development programmes much more than traditional knowledge-only programmes or developmental/social norms orientation programmes (Bruvold, 1993; Lantz, Jacobson, Warner, Wasserman, Pollack, Berson & Ahlstrom, 2000). Other programmes not specifically aimed at reducing smoking, but with more broad social skills development goals also resulted in reduced tobacco use (Botvin, Baker, Dusenbury, Tortu & Botvin, 1990; Moon, et al., 1999) Violence Prevention Universal programmes aimed at violence prevention in schools can be useful in helping prevent situational violence and relationship violence. They particularly can be helpful for violence which can arise out of normal difficult developmental situations, such as school transitions or the onset of adolescence (Farrell, Meyer, Kung & Sullivan, 2001). These programmes are aimed typically at increasing protective factors in students’ lives by teaching helpful skills, such as social skills. However, there are not many well-implemented and thoroughly evaluated programmes in the literature. There is evidence that social and emotional or youth development programmes can help to reduce violent behaviours (e.g., Greenberg, Kusche & Riggs, 2004). A programme specifically aimed at violence prevention, RIPP, can be found in Section 5.2. A review of school-based problem behaviour prevention programmes showed that programmes can indeed be successful in reducing alcohol and drug use, drop out, non-attendance and other difficult or problem behaviours (Wilson, Gottfredson & Najaka, 2001). The method of delivery was crucial in predicting whether a positive outcome was found. Programmes were more likely to be successful when they were based on solid learning theories and used cognitive behavioural and behavioural modelling methods. Some of the more effective methods were self-control or social competency promotion instruction using cognitive behavioural instructional methods. Neither traditional instructional or individual counselling methods using non-cognitive behavioural methods had any effects on behaviour (Wilson, Gottfredson & Najaka, 2001). 20 Ingredients for Success In both substance abuse and violence and other problem behaviour prevention programmes, didactic, knowledge-based programmes appear to have little or no effect on behaviour (Klepp, Oygard, Tell Grethe & Vellar Odd, 1994; Moon, et al., 1999; Tobler, Roona, Ochshorn, Marchall, Streke & Stackpole, 2000; Morgan, 2001; Thomas, et al., 1999; Wilson, Gottfredson & Najaka, 2001). Although Tobler & Stratton, (1997) note that the key facts must also be included. According to a large meta-analysis of drug prevention programmes, those which are interactive are the most likely to cause decrease in drug and substance abuse (Tobler, et al., 2000). Interactive methods of teaching about drugs provide contact and communication opportunities to talk about ideas and to hone drug refusal skills. These methods also involve feedback and an opportunity to practice skills in a safe environment. Three types of interactive drug prevention programmes identified by Tobler, et al. (2000) were social influences, comprehensive life skills and system-wide change. Research has shown that teaching students the consequences of taking drugs, such as the DARE programme in the United States, is much less effective than teaching students the emotional and social skills to make wise decisions and think for themselves (Morgan, 2001). Students appear to respond negatively or not at all to programmes that threaten dangerous longterm consequences to their lives (Morgan, 2001). Several studies have found that simply expelling students for using drugs in schools does nothing to reduce drug use (Munro & Midford, 2001; Pentz, Dwyer, MacKinnon, Flay, Hansen, Wang, & Johnson, 1989b). Reppucci, Woolard and Fried (1999) noted that programmes designed to deal with large social problems must address multiple levels, such as the individuals, families, schools and the community. Many studies report that for prevention programmes to maximize effectiveness, they need to involve more than just the classroom (Reppucci, Woolard & Fried, 1999; Moon, et al., 1999). Programmes will be more likely to be successful when they are fully implemented, than those that are partially delivered (Kam, Greenberg & Walls, 2003). Drug prevention programmes which are successful include teaching elements of personal development, including life skills such as communication, assertiveness, social/relationships, coping and goal-setting. These are central to the self-awareness, personal health and relationships streams of the Personal Development curriculum in Northern Ireland. 5.2 Substance Abuse and Violence Prevention: Selected Specific Programmes 21 On My Own Two Feet An Irish social influence-type programme, On My Own Two Feet teaches social skills to resist social pressure in addition to standard drug information. The programme is age-appropriate, implemented nationally and uses various types of interactive methods, including role play. The programme has received very positive feedback from both teachers and students (Morgan, 2001). It has been found to lead to more negative attitudes and expectations towards drugs than students in control groups (Morgan, Morrow, Sheehan & Lillis, 1996). Although this study did not find a difference in actual substance use compared to the control group, this was a pilot study and further evaluations are expected. Life Skills Training (LST) A three-year study by Botvin, et al. (1990) found positive effects of a Life Skills Training (LST) programme aimed at prevention. The programme teaches drug resistance skills to enable students to deal with peers and media pressure to use legal and illegal substances. Also included are personal self-management skills which help students learn how to examine their self-image and its effects on behaviour, set goals and keep track of personal progress, identify everyday decisions and how they may be influenced by others, analyze problem situations and consider the consequences of each alternative solution before making decisions, reduce stress and anxiety and look at personal challenges in a positive light. Finally, the programme teaches general social skills. These teach students the skills to overcome shyness, communicate effectively and avoid misunderstandings, initiate and carry out conversations, handle social requests, utilize both verbal and nonverbal assertiveness skills to make or refuse requests and recognize that they have choices other than aggression or passivity when faced with difficult situations. For those programs that exhibited a minimum standard of quality of implementation, there was a significant inverse relationship between how well the programmes were implemented and amount of cigarette smoking, drinking frequency, frequency of getting drunk and cannabis use. Project ALERT A recent evaluation demonstrated multiple positive benefits of participation in Project ALERT with a cohort of middle school (KS3) students (Ellickson, McCaffrey, Ghosh-Dastidar & Longshore, 22 2003). This positive youth development programme was reviewed in Catalano, et al., (2004), and is based on the combination of 3 concepts: the cognitive factors that influence behaviour, the social norms and the influence of significant others on young people’s behaviours and importance of self-efficacy. Compared to control students not in the programme, the students in the programme showed curbed cigarette and cannabis smoking behaviours and reductions in alcohol misuse. RIPP RIPP is a universal violence prevention programme for 11-12 year old students. The programme is delivered by a prevention specialist, although it seems likely that aspects of the curriculum could be taught by teachers. Elements include those found in social-emotional programmes, such as knowledge, attitudes and skills that promote non-violence, positive communication and achievement. Students are instructed in the use of a social-cognitive problem-solving model and specific skills for preventing violence (e.g., avoiding potentially violent situations, talking things through; see Meyer & Farrell, 1998; Meyer, Farrell, Northup, Kung & Plybon, 2000). Three basic techniques are used including repetition of behaviours and mental rehearsal of problem-solving methods, experiential learning techniques and traditional instructional methods. Early sessions focus on team building and acquiring knowledge, while later sessions focus on critical thinking and skill building. Results showed that RIPP participants: had fewer disciplinary violations for violent offences fewer in-school suspensions at post-test compared with the control group also fewer suspensions than the control group at a 12-month follow-up for boys, but not for girls those who started with higher levels of problem behaviour benefited to a greater degree than those that started with lower levels (Farrell, Meyer & White, 2001) 23 6. SEXUAL HEALTH 6.1 Sexual Health: Literature Reviews The UK currently has the highest rates of teenage pregnancy in Europe, and the sexual health of young people in terms of sexually transmitted infections is rapidly declining (Select Committee on Health, 2003). An analysis of the National Child Development Study (NCDS) in the UK found that parents under the age of 22 were less likely to have performed well in school and to have completed their education with qualifications (Kiernan, 1995). However, research has shown that properly implemented, sexual education programmes can be effective in reducing risky behaviours and increasing positive behaviours (e.g., Mellanby, Phelps, Crichton & Tripp, 1995). Kirby (2002) reviewed sex education programs and found a number of benefits of some of the more comprehensive programs. Effects of sexual and STD/HIV education programs on contraceptive use consistently find increase in contraceptive use. STD/HIV education that promotes abstinence, but also covers condoms or contraception do not increase sexual activity, can lead to some delay the initiation of sex, reduce its frequency and reduce the number of partners. Abstinence-only programmes have not shown reliable significant effects on delaying the onset of sexual intercourse, although methodological problems make it difficult to draw conclusions (Fullerton, 2004; Kirby, 2002). Two sexual education programmes, SHARE and APAUSE, are reviewed in Section 6.2. Cowie, Boardman, Dawkins, & Jennifer (2004) report that good communication skills, self-esteem and an ability to understand and control feelings are all important in healthy sexual behaviours. Consequently, programmes which teach these elements are more likely to be successful. Sexual education literature (Cowie, et al., 2004; DfES, 2001; Fullerton, 2004; Kirby, 2002) has outlined the following characteristics of programmes which are associated with positive results: Deliver and consistently reinforce clear prevention messages about abstinence, condom use and other forms of contraception Include behavioural goals, teaching methods and materials that are appropriate to the age, sexual experience and culture of the students Use theoretical models and methods shown to be effective in reducing other risky behaviours Provide basic, accurate information about the risks of sexual activity and about ways to avoid intercourse or methods of protection against HIV/STI and pregnancy Include activities that address social pressures related to sexual behaviours 24 Provide modelling and practice of communication. Include examples of, and rehearse (e.g., role play), communication, negotiation and refusal skills Use teaching methods that involve students and have them personalize the information Last a sufficient amount of time to cover a range of activities If applicable, select teachers or peer leaders who support the programme Involve pupils own assessment of their needs 6.2 Sexual Health: Selected Specific Programmes SHARE The effectiveness of a Scottish sex education programme, SHARE, aimed at 13-15 year olds was reviewed by Abraham, Henderson & Der (2004). The programme aimed to decrease the incidence of unsafe sex by encouraging students to delay sexual intercourse until they were sure they were ready and to always use a condom. The programme also aimed to improve the quality of sexual and romantic relationships. The 10-lesson programme used videos, discussions and covered topics such as conception, contraception and condom use. Students in the programme had significantly higher scores on the belief that there are alternatives to sexual intercourse in romantic/sexual relationships, intentions to resist unwanted sexual activities and intentions to discuss condoms with sexual partners. SHARE recipients were also less likely to agree that condom use would reduce sexual enjoyment. However, effect sizes were not significantly different from those of conventional sexual education programmes. A preliminary study on the effects of SHARE also showed that pupils in the intervention arm were more knowledgeable than those in the control arm (Wight, Henderson, Raab, Abraham, Buston, Scott & Hart, 2000; Wight, Raab, Henderson, Abraham, Buston, Hart & Scott, 2002). APAUSE APAUSE is a programme run in the UK aimed at improving sexual health in teenagers (Kay, Tripp, Mellanby, Hinde & Hull, 2002; Mellanby, Phelps, Crichton & Tripp, 1995). The programme emphasizes knowledge as well as elements of self-development. Subjects covered included puberty, reproduction, contraception and negotiation in relationships, including training in assertiveness skills. The emphasis on avoidance of risks was taught by involving students in role play and group work. While it used a programme team including a doctor teaching some lessons, 25 training and support was also provided for the schools' own teachers (and for a few sessions, peer leaders) to deliver parts of the intervention. Compared to control students not participating in the programme, students participating in APAUSE were: more likely to have correct knowledge of sex, contraception and sexually transmitted diseases less likely to report that intercourse should be part of relationships for those under age 16 more tolerant of the behaviour of others less likely to be sexually active those that were sexually active were less likely to have unprotected sex more likely to approve of their "sex education" 26 7. OTHER PROGRAMMES PROMOTING HEALTH 7.1 Other Programmes Promoting Health: Literature Reviews Health Promoting Schools In a review of health promoting schools, Lister-Sharp, Chapman, Stewart-Brown & Sowden (1999) found that they can usefully change health-related behaviour and improve health. Some positive outcomes included injury prevention, healthy eating and cardiovascular health, mental health, positive attitudes and behaviours. Fewer evaluations showed positive effects of preventing substance abuse or high-risk sexual behaviour. However, programmes on these two topics have been reviewed and researched intensively, and are covered in Sections 4 & 5 of this review. An evaluation of a healthy schools initiative in Ireland was conducted by Morgan (1997). The programme covered personal hygiene, nutrition, relationships, legal and illegal drugs, growth and development, environmental health and safety and first aid. Skills targeted included communication skills, maintaining physical well-being, building self-esteem, assertiveness, decision making skills, skills involved in relationships and study skills. Results showed that teachers rated the programme and the training highly, and compared to students not in the programme, participants in the programme reported more optimistic views of their future, were less likely to predict they would be smokers as adults and had less favourable attitudes and beliefs towards alcohol and smoking. Accidents/Safety Reviews of school-based accident prevention programmes showed that some practices can be effective in preventing or promoting certain behaviours. In a review of projects promoting safety policies and education aimed at preventing accidents, Doswell, Towner, Simpson & Jarvis (1996) found pedestrian education aimed at the child & parent to be successful in reducing accidents. However, these were not necessarily school-based. In a synthesis of reviews of school-based accident prevention programmes, Lister-Sharp, Chapman, Stewart-Brown & Sowden (1999) found some burn prevention programmes increased 27 knowledge about burns, educational interventions had positive effects on increasing bicycle helmet use and a road safety programme improved driver and pedestrian behaviour. One comprehensive school-based health promotion programme that has accident prevention as one of its many aims, has been shown to have impacts on reducing accidents. This programme, Growing Healthy, is reviewed below in Section 7.2. A health and safety information programme, Life Skills-Learning for Living Programme (Oxford Evaluation Team, 2003), led to improvements in knowledge and confidence in dealing with emergencies. The programme teaches children about safety through interacting with the environment and spotting possible hazards. The programme is not school-based, but rather it is a self-contained site with various sets representing rooms of the house and other locations which might present safety hazards. Although this was not school-based, a lesson from this study is that the interactive, hands-on method of teaching children about health and safety appeared to be effective, as opposed to lecture-style instruction. Nutrition Proper eating habits are included in the aims of the Healthy Schools initiatives in the UK and are included in the Northern Ireland Personal Development curriculum. Few literature reviews of programmes aimed at improving healthy eating in schools could be located, but one such programme which showed positive effects on eating habits and attitudes was Growing Healthy (reviewed in Section 7.2). Eating disorders can be usefully addressed in a PSE scheme. Stewart (1998) found benefits of an eating disorder prevention programme in terms of increased knowledge about eating problems and less deterioration in eating behaviours compared to a control group. The programme aimed among other objectives to promote healthy relationships, improve personal identity, and encourage resilience to peer pressures. These are all related to the personal development scheme. Characteristics of the programme, as with programmes in other areas of personal development, are again interactive, with elements of role-play. They are not simply informational in nature. A programme hoping to improve the body image of adolescents, Everybody’s Different Program (O’Dea & Abraham, 1999) focused on self-esteem and body image. Body dissatisfaction in young people was successfully reduced and weight control behaviours in girls were altered. 28 7.2 Other Programmes Promoting Health: Selected Specific Programmes Healthy Schools Programme: Example A study evaluating a health promoting school showed positive effects on behaviours and attitudes (Moon, et al., 1999). The curriculum mainly focused on teaching about healthy lifestyles, including information about diet, smoking exercise, drugs and sex education. The results of this UK study showed benefits in terms of pupils’ health-related knowledge and attitudes, reducing smoking and reducing drug use. The benefits were most pronounced in older girls. Growing Healthy Growing Healthy is a comprehensive multi-year health education program as opposed to a single-topic curriculum (reviewed in Catalano, et al., 2004). The comprehensive program incorporates ten content areas, mental and emotional health, family life and health, growth and development, nutrition, personal health, substance use and abuse, disease control and prevention, safety and first aid, consumer health community and environmental health management. The programme starts at early primary school, but does continue up to 6th Grade (age 12). The skills taught include goal setting, decision making, creative thinking, empathy, selfawareness, problem solving, effective communication, coping with stress, critical thinking, coping with emotions, interpersonal relationship skills. Some positive outcomes of the programme include the following: Better personal health management knowledge and attitudes Better health practices Decreases in cigarette smoking Improved attitudes and knowledge about smoking 29 8. BENEFITS OF TEACHING PD: SUMMARY This section summarizes the benefits found for post-secondary students in this review of teaching the various aspects of the PD curriculum. Examples are given for each benefit, but not all examples are included. 8.1 School Outcomes Attitudes Improved attitudes towards school/teachers Prevention programmes, SEL programmes (U.S. Department of Health and Human Services, 2002; Zins, Weissberg, Wang & Walberg, 2004) Increased attachment and commitment to school SEL programmes, programmes designed to promote caring, supportive, cooperative learning environment (Hawkins, Smith, Catalano, 2004; Battistick, Solomon, Watson & Schaps, 1997; Osterman, 2000) Behaviour General improvements in behaviour Prevention programmes (U.S. Department of Health and Human Services, 2002); SEL programmes (Zins, Weissberg, Wang & Walberg, 2004) Improved attendance Prevention of problem behaviours (Wilson, et al., 2001) STEP programme (Felner, Ginter & Primavera, 1982); Conflict resolution programmes (Powell, Muir-McClain & Halasyamani, 1995) Increased participation Programmes designed to promote caring, supportive, cooperative learning environment (Murdock, 1999); SSDP (O’Donnell, et al., 1998) Reduced suspensions 30 Conflict resolution programmes (Powell, Muir-McClain & Halasyamani, 1995) Less dropout Prevention of problem behaviours (Wilson, et al., 2001); STEP programme (Felner, Ginter & Primavera, 1982) More ethical conduct and increased understanding of moral concepts Direct moral education programmes (Leming, Henrick-Smith & Antis, 1997) Less violent behaviour Conflict resolution programmes (O’Donnell, Stueve & San Doval, 1998); ADD OTHERS Decreases in negative or aggressive behaviour Mental health promotion (Wells, Barlow & Stewart-Brown, 2003); STEP (Felner, Ginter & Primavera, 1982); PATHS (Greenberg, Kusche & Riggs, 2004); prevention of problem behaviours (Wilson, et al., 2001) Performance Improved academic achievement SEL programmes (Zins, Weissberg, Wang & Walberg, 2004); Prevention programmes using SEL methods (U.S. Department of Health and Human Services, 2002) More homework completed Programmes designed to promote caring, supportive, cooperative learning environment (Murdock, 1999) Improved exam scores, school marks Prevention programmes using SEL methods (U.S. Department of Health and Human Services, 2002) SEL programmes (Zins, Weissberg, Wang & Walberg, 2004); STEP programme (Felner, Ginter & Primavera, 1982); Leap Confronting Conflict (Inman & Turner, 2001) Increased achievement test scores SSDP (Abbott, et al., 1998) Improved non-verbal reasoning and cognitive test scores 31 PATHS (Greenberg, Kusche & Riggs, 2004) 8.2 Social Emotional Outcomes Improved self-esteem & self-concept STEP (Felner, Ginter & Primavera, 1982); Mental health promotion programmes (Wells, Barlow & Stewart-Brown, 2003) Increased confidence in dealing with conflict Leap Confronting Conflict (Inman & Turner, 2001) More sociability, increased social skills Indirect moral development programmes (Trianes Torres, et al., 1995) Improved negotiation skills Universal mental health promotion programmes (Wells, Barlow & Stewart-Brown, 2003) Improved problem-solving skills Universal mental health promotion programmes (Wells, Barlow & Stewart-Brown, 2003); WHICH? (Snow, et al., 1986) Improved conflict resolution skills Conflict resolution and peer mediation programmes (Johnson & Johnson, 1995; Stevahn, 2004) Increased prosocial problem solving or improvements in moral reasoning Child Development Project (Solomon, Watson, Delucchi, Schaps & Battistich, 1998); (Snow, et al., 1986); PATHS (Greenberg, Kusche & Riggs, 2004); Improving Social Awareness – Social Problem Solving: ISA-SPS (Bruene-Butler, Hampson, Elias, Clabby & Schuyler, 1997); indirect moral development programmes (Higgins, 1980; Higgins, Power & Kohlberg, 1984) 8.3 Health Related Outcomes Mental health Reducing depression or depressive attributes 32 (Cunningham, et al., 2002); STEP (Felner, Ginter & Primavera, 1982); PATHS (Greenberg, Kusche & Riggs, 2004) Reduced anxiety STEP (Felner, Ginter & Primavera, 1982); PATHS (Greenberg, Kusche & Riggs, 2004) Improved coping skills Teaching coping skills (Cunningham, et al., 2002) Coping with Junior High curriculum (Snow, Gilchrist, Schilling, Schinke & Kelso, 1986); Improving Social Awareness – Social Problem Solving: ISA-SPS (Bruene-Butler, Hampson, Elias, Clabby & Schuyler, 1997) Smoking Less favourable attitudes towards smoking Healthy schools programme (Morgan, 1997) Reducing smoking behaviour Life Skills programme (Botvin, 1990); health promoting schools (Moon, et al., 1999); Social-skills based smoking-prevention programmes (Bruvold, 1993); Growing Healthy (Catalano, Berglund, Ryan, Lonczak & Hawkins, 2004) Drugs Decrease in drug use Healthy schools promoting programmes (Moon, et al., 1999); substance abuse prevention programmes (Botvin, et al., 1990; Tobler, et al., 2000); prevention of problem behaviours (Wilson, et al., 2001) Drinking Less favourable attitudes towards drinking Healthy schools programme (Morgan, 1997) Decrease in frequency of drinking Substance abuse prevention programmes (Tobler, et al., 2000); Life Skills programme (Botvin, et al., 1990); Prevention of problem or risky behaviours (Thomas, et al., 1999; Wilson, et al., 2001); Healthy schools programmes (Nic Gabhainn & Kelleher, 2000) 33 Sexual health Knowledge about sex and relationships Sexual health promoting programmes (Fullerton, 2004); SHARE (Wight et al., 2002); APAUSE (Mellanby, Phelps, Crichton & Tripp, 1995) Increased social and personal skills, Some impact on quality of relationships SHARE (Wight, et al., 2002) Do not increase sexual activity Sexual health programmes (Kirby, 2002) Increase in contraceptive use Effect of sex and STD/HIV education programs on contraceptive use (Kirby, 2002) Delay in onset of sexual activity Teaching sex education combined with contraceptive services (Kirby, 2002) Reduce frequency of sex Sex education programmes (Kirby, 2002); APAUSE (Mellanby, Phelps, Crichton & Tripp, 1995) Reduce the number of partners, less likely to believe that intercourse should be part of relationships for under 16s and more tolerant of the behaviour of others APAUSE (Mellanby, Phelps, Crichton & Tripp, 1995) Eating habits Less deterioration in eating habits Eating disorder prevention programmes (Stewart, 1995) More knowledge about eating disorders Eating disorder prevention programmes (Stewart, 1995); Growing Healthy (Catalano, Berglund, Ryan, Lonczak & Hawkins, 2004) Better eating habits Growing Healthy (Catalano, Berglund, Ryan, Lonczak & Hawkins, 2004) 34 Reduced body dissatisfaction Everybody’s Different Program (O’Dea & Abraham, 1999) Positive changes in weight control behaviours Everybody’s Different Program (O’Dea & Abraham, 1999) Healthier attitudes, knowledge and practices Growing Healthy (Catalano, Berglund, Ryan, Lonczak & Hawkins, 2004) Decreased accidents, increased knowledge about safety Lifeskills-Learning for Living (Oxford Evaluation Team, 2003) Pedestrian safety programmes (Doswell, et al., 1996) Road safety, burns, bicycle helmet use programmes (Lister-Sharp, et al., 1999) 35 9. WHAT MAKES PROGRAMMES WORK? This section summarizes common themes found in the literature that characterize successful programmes, and which correspond to those found in the revised PD curriculum in Northern Ireland. There are aspects of teaching some topics (e.g., sexual education) which are not covered here, as they were specific only to that area. Topic-specific themes can be found in their respective sections of this review. Teaching knowledge alone is not enough Knowledge only programmes are much less effective than those which use other methods, such as role-play (Klepp, et al., 1994; Tobler, et al., 2000) This is true for general SEL or character education programmes (Zins, Weissberg, Wang & Walberg, 2004), mental health promoting programmes (e.g., Clarke, Hawkins, Murphy & Sheeber, 1993; Browne, et al., 2004), sexual health and substance and violence prevention programmes (Thomas, et al., 1999; Browne et al., 2000; Moon, et al., 1999; Tobler, et al., 2000; Morgan, 2001) and eating issues (Stewart, 1998). However, the important information and/or facts should also be present (Tobler & Stratton, 1997) Involving interactive learning Interactive learning helps engage students and allow them to practice newly acquired skills (Tobler, et al., 2000; Elias, 1990; Weare & Gray, 2003; Morgan, 2001) Examples are group work and role-play (e.g., in sex education, Fullerton, 2004) Practicing skills that are taught is crucial in some areas, such as conflict resolution programmes (Johnson & Johnson, 1996; Weare & Gray, 2003; Zins, Weissberg, Wang & Walberg, 2004) A change in structure of classroom may be required, such as with Circle Time (Mosley, 1996) Developing protective skills is often better than trying to reduce risky behaviours 36 Developing coping, social skills which help students to make healthy choices against peer pressure will be better than telling students to stop doing drugs (Morgan, 2001) Most successful mental health promotion projects emphasized healthy behaviours, as opposed to preventing illness (Wells, et al., 2003) This is true for sexual health programmes too: interventions that improve self-esteem, ability to communicate and develop social and emotional skills all help students make healthy sexual decisions (Cowie, et al., 2004) 37 Involving multiple domains More successful substance abuse prevention, violence prevention, sexual health promoting, SEL, and mental health promoting programmes involve home and/or community as well as school (Morgan, 2001; Greenberg, et al., 2001; Berkowitz & Bier, 2004; Zins, et. al, 2004; Dowswell, et al., 1996; Repucci, Woolard & Fried, 1999) Although some programmes can be successful in one domain (e.g., Project ALERT). Longer term programmes are more successful than short intensive ones Multi-year programs are more likely to foster enduring benefits (Greenberg, et al., 2001; Wells, et al., 2003; Weare & Gray; Lantieri & Patti, 1996) This is true for substance abuse prevention, mental health promotion, and others (Greenberg, Domitrovich & Bumbarger, 2001; Wells, et al., 2003) Classroom and school environment is key (Weare & Gray, 2003) A positive teacher-student relationship helps improve social emotional skills, academic performance, and classroom behaviour (Grossman & Tierney, 1998) Classrooms where students feel safe to talk about sensitive issues will lead to more sharing and to more attachment to school (Greenberg, et al., 2003) Attachment to school/family is important in predicting outcomes such as academic success (Zins, et al., 2004), and preventing risky behaviours (Hawkins, Catalano & Miller, 1992) Use a holistic approach (Weare & Gray, 2003), provide teacher support and training, have good leadership Focus should be not just on teachers, rather whole school should be integrated and have elements working together (Elias, et al., 1997; Cowie, et al., 2004) 38 Most successful mental health promotion programmes used a whole-school approach (Wells, et al., 2003) Leadership of principal is crucial (Berkowitz & Bier, 2004; Greenberg, et al., 1995) Quality of Implementation Partially implemented programmes are less likely to have the desired effect (Berkowitz & Bier, 2004; Han & Weiss, 2005; Kam, Greenberg & Walls, 2003; Tobler, et al., 2000) In order to be properly implemented, teachers should have good support and training (Berkowitz & Bier, 2004; Han & Weiss, 2005; Weare & Gray, 2003). Programmes which were well-structured, with manuals, etc., were more successful (Catalano, et al., 2002; Elias, et al., 1997) Carefully planned, theory and research-based lessons work better (Elias, et al., 1997; Farrell, Meyer, Kung, and Sullivan, 2001; Cowie, et al., 2004) Lessons should target the age and experience of the audience (Cowie, et al., 2004) 39 10. Conclusion Teaching the Personal Development strand of the Learning for Life and Work curriculum can help students gain valuable life skills, learn more about themselves, develop positive self-esteem and self-efficacy, understand and resist peer pressure, be able to deal better with conflict, and become better informed about risky behaviours. These skills provide students with the tools they need to make good decisions, engage in healthier behaviours and perform better academically. In this review, Section 3: SEL/PSE covered programmes teaching the full spectrum of topics included in the Self-Awareness component of the PD curriculum, as well as selected elements of the Personal Health and Relationships components. Section 4: Mental Health Promotion covered particular elements of all three segments. Section 5: Substance Abuse and Violence Prevention discussed topics clearly related to this topic from the curriculum, including investigating effects of legal and illegal substances, promoting personal safety (Personal Health component) and elements of healthy relationships (Relationships component). However, effective programmes in this section also covered elements of developing the self (Self-Awareness component), understanding changes on the mind, body and behaviour (Personal Health component), and conflict resolution (Relationships component). Programmes mentioned in Section 6: Sexual Health Promotion, covered topics in the Relationships component. However, as with Section 5, many successful programmes also targeted elements of the Self-Awareness component, such as exploring a sense of self and developing self-esteem. They also covered elements of the Personal Health component, including exploring the development of the whole person, understanding and managing change, and promoting personal safety. Finally, Section 7: Other Programmes Promoting Health covered topics across the curriculum, including some not covered elsewhere, such as strategies to avoid accidents (Personal Health component). While there are a number of benefits evident for promoting and teaching positive youth development in schools, the method of delivery is also crucial. A number of key themes emerged from the literature describing teaching practices, school and teaching environments and other intervention qualities that characterize the most successful programmes. Schools and teachers would need to evaluate the current personal development programmes, school atmosphere, and available resources to determine how to give the revised PD curriculum the best chances of producing positive results. 40 The revised PD curriculum in Northern Ireland is based in part on the idea that different types of risks can be reduced by teaching similar skills. This means it is both possible and economical to target multiple negative outcomes by teaching similar skills, such as social and coping skills (Greenberg, Domitrovich & Bumbarger, 2001). The revised curriculum also acknowledges that a linked set of strategies, based on theory and research, is more likely to be successful than any one program component in promoting academics and encouraging positive development (Greenberg, Domitrovich & Bumbarger, 2001). The PD curriculum is a comprehensive, researchbased programme with the potential, if implemented properly, to positively impact the health and development of post-secondary students in Northern Ireland. 41 11. Further Information Websites CASEL Organization focusing on SEL in schools http://www.casel.org Drug Education and Prevention Information Service (DEPIS), UK http://www.info.doh.gov.uk/doh/depisusers.nsf/Main?readForm Scottish Health Promoting Schools Unit (SHPSU) www.healthpromotingschools.co.uk www.healthyliving.gov.uk SAMHSA Model Programs Effective substance abuse and mental health programs for every community http://modelprograms.samhsa.gov APAUSE Adolescent sexual health promotion programme in the UK http://www.programmes.ex.ac.uk/apause/index.htm Conflict Resolution in Schools Programme http://www.crispuk.org Life Skills Training (LST) Programme http://www.lifeskillstraining.com Project ACHIEVE http://www.projectachieve.info Growing Healthy http://www.nche.org/growinghealthy.htm 42 Books Building Academic Success on Social and Emotional Learning J. Zins, R. P. Weissberg, M. C. Wang & H. J. Walberg 2004 New York: Teachers College Press Handbook of Research on Teaching Edited by V. Richardson Teaching and schooling effects on moral/prosocial development (Chapter) D. Solomon, M. S. Watson & V. Battistich. 2001 Washington DC: American Educational Research Association. The Health Promoting School: Policy, Research and Practice S. Denman 2002 London ; New York: Routledge Falmer Emotional Health and Wellbeing H. Cowie, C. Boardman, J. Dawkins & D. Jennifer 2004 PLACE: Sage Publications Other Publications Drug use prevention: Overview of research M. Morgan 2001 Dublin: The Stationary Office. 43 Opportunities for Drug and Alcohol Education in the School Curriculum N. Sinclair, S. Noor, V. Evans. 2001 London: Alcohol Concern/Drugscope Peer Mediation in the UK: A Guide for Schools W. Baginsky 2004 London: NSPCC Life Skills Education for Children and Adolescents in Schools: Introduction and Guidelines to Facilitate the Development and Implementation of Life Skills Programmes 1993a Geneva: World Health Organization (WHO) Teenage pregnancy and parenthood: A review of reviews (Evidence Briefing) C. Swann, K. Bowe, G. McCormick & M. Kosmin 2003 London: Health Development Agency 44 12. References Abraham, C., Henderson, M. & Der, G. (2004) Cognitive impact of a research-based school sexeducation programme. Psychology and Health, 19, 689–703. Abbott, R. D., O’Donnell, J., Hawkins, J. D., Hill, K. G., Kosterman, R. & Catalano, R. F. (1998). Changing teaching practices to promote achievement and bonding to school. American Journal of Orthopsychiatry, 68, 542-552. Battistich,V., Solomon, D., Watson, M. & Schaps, E. (1997). Caring school communities. Educational Psychologist, 32, 137–151. Battistich,V., Solomon, D., Watson, M., Solomon, J. & Schaps, E. (1989). 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