School-based wellbeing programs benefits from multiple voices

 

 Health and wellbeing education can be an important addition to a school curriculum. But for these programs to be effective, they must be delivered in a way that works for everyone, including students, instructors, and school administrators. A new study from University of Illinois evaluates the implementation of two prevention programs, using a mixed-methods approach with input from multiple sources.

“Soliciting diverse perspectives is important. The more we can listen to everyone who's involved, the better we can learn what can be done to improve the programs. And we really need to include the youth voice, because they're the experts of their own experience,” says Jacinda K. Dariotis, professor in the Department of Human Development and Family Studies and director of the Family Resiliency Center, both part of the College of Agricultural, Consumer and Environmental Sciences at the U of I. Dariotis is lead author on the paper, published in Prevention Science.

The study was conducted in three urban public schools in low-income neighborhoods. Participants were ninth-grade students, the majority of whom (84%) self-identified as Black. The students volunteered for the study and were randomly assigned to either a mindfulness or a health education class. The programs were delivered in 30-minute sessions four times a week for 10 weeks.

To evaluate program implementation, the researchers asked instructors to note student attendance and engagement, as well as their own adherence to the program. Some class sessions were videotaped and rated by independent observers. Finally, students discussed their experiences in focus groups after program conclusion.

Dariotis and her colleagues identified four themes that had a positive impact on delivery. For example, it is essential that instructors are attentive and engaging. A variety of activities are needed to hold attention, including more student involvement. There needs to be sufficient time for program delivery. Student preferences should also be considered in program scheduling.

“One of our key takeaways is that students’ relationship with the instructor really matters, because that builds connection,” Dariotis says. “We also found that active learning is important, including physical activity and opportunities to help and train other students.”

The researchers measured program fidelity, which addresses how closely instructors adhere to a program protocol, through instructor self-reports and observer notes. Instructors sometimes deviated from protocol due to environmental circumstances and interruptions, but that’s not necessarily a bad thing, Dariotis points out. Some flexibility in program delivery can help to accommodate student and school needs.

Several barriers to implementation also emerged from the study, including insufficient time, behavior management issues, and environmental disruptions in the school environment.

“These are very low-resource schools in disadvantaged neighborhoods. When you’re trying to provide preventive programs like these, there are so many distractions that make implementation difficult. The more we can do to bring greater predictability and reduce distractions, the better chances of success,” Dariotis says.

Schools need to balance limited time and many different demands, but listening to youth perspectives and learning about their challenges can help to increase participation.

“It’s important to bring in youth input and perceptions early on to ensure the programs can be designed and implemented in ways that meet the needs of the students, as well as the teachers and the schools,” Dariotis states.

“These types of programs can be provided in any school or afterschool program wanting to invest in low cost, highly scalable, and sustainable programs that can make a difference,” she concludes. 

The paper, “Implementing Adolescent Wellbeing and Health Programs in Schools: Insights from a Mixed Methods and Multiple Informant Study,” is published in Prevention Science [DOI: https://doi.org/10.1007/s11121-022-01481-2]. Authors include Jacinda Dariotis, Keren Mabisi, Rachel Jackson-Gordon, Nan Yang, Emma Jane Rose, Tamar Mendelson, and Diana Fishbein. This work was supported by the National Center for Complementary and Integrative Health (grant number: R61AT009856. 

Early morning university classes correlate with poor sleep and academic performance

 Digital data from university students in Singapore suggest they could be getting better grades if their classes started later. The findings, from tens of thousands of students, were published by Duke-NUS Medical School researchers and colleagues in the journal Nature Human Behaviour.

Research in recent years has shown that postponing the start time of high schools improves the amount of sleep that students get and reduces their sleepiness during school hours. But findings are mixed about whether this has a positive impact on grades.

To determine the impact specifically on university students, Associate Professor Joshua Gooley, from Duke-NUS’ Neuroscience & Behavioural Disorders Programme and colleagues used student Wi-Fi connection data, log-ins to university digital learning platforms, and activity data from special sensing watches to conduct large-scale monitoring of class attendance and sleep behaviour of tens of thousands of university students.

“We implemented new methods that allow large-scale monitoring of class attendance and sleep behaviour by analysing students’ classroom Wi-Fi connection data and their interactions with digital learning platforms,” said Dr Yeo Sing Chen, first author of the study and a Duke-NUS PhD graduate.

From the data, the researchers found that early class start times were associated with lower attendance, with many students regularly sleeping past the start of such classes. When students did attend an early class, they lost about an hour of sleep. Morning classes on more days of the week were also associated with a lower grade point average.

“If the goal of formal education is to position our students to succeed in the classroom and workforce, why are we forcing many university students into the bad decision of either skipping morning class to sleep more or attending class while sleep-deprived?” asked Assoc Prof Gooley. “The take-home message from our study is that universities should reconsider mandatory early morning classes.”

The researchers drew insights using the Wi-Fi connection logs of 23,391 students to find out if early morning classes were associated with lower attendance. They then compared the data with six weeks of watch-derived activity data from a subset of 181 students to determine if the students were sleeping instead of attending early morning classes.

They also analysed activity data with the day and night patterns of digital learning platform logins of 39,458 students to determine if early morning classes were associated with waking up earlier and getting less sleep. Finally, they studied the grades of 33,818 students and the number of morning classes these students were taking to determine if it impacted their grade point average.

The team is now investigating differences between class attendance, sleep, wellbeing and academic performance between early birds and night owls. “We expect to find that evening-type students will be at a learning disadvantage in early morning classes and have lower class attendance, shorter sleep, poorer mental health and lower grades compared with their peers,” said Assoc Prof Gooley.

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JOURNAL

Nature Human Behaviour

DOI

10.1038/s41562-023-01531-x 

Economically (Dis)advantaged Students’ College Attendance Under Mandatory College and Career Readiness Assessments

In 2015, Wisconsin began mandating the ACT college entrance exam and the WorkKeys career readiness assessment. With population-level data and several quasi-experimental designs, This study assesses how this policy affected college attendance. 

The authors estimate a positive policy effect for middle/high-income students, no effect for low-income students, and greater effects at high schools that had lower ACT participation before the policy. The authors further find little evidence that being deemed college-ready by one’s ACT scores or career-ready by one’s WorkKeys scores affects college attendance probabilities. Pragmatically, the findings highlight the policy’s excellence and equity consequences, which are complex given that the policy has principally helped advantaged students. Theoretically, the findings shed light on students’ (dis)inclinations to update educational beliefs in light of new signals.

Teacher Performance Pay, Coaching, and Long-Run Student Outcomes

 This paper examines the effects of a comprehensive performance pay program for teachers implemented in high-need schools on students’ longer-run educational, criminal justice, and economic self-sufficiency outcomes. Using linked administrative data from a Southern state, the authors leverage the quasi-randomness of the timing of program adoption across schools to identify causal effects of the school reform. The program improved educational attainment and reduced both criminal activity and dependence on government assistance in early adulthood.

Attracting and Retaining Highly Effective Educators in Hard-to-Staff Schools

 Efforts to attract and retain effective educators in high poverty public schools have had limited success. Dallas ISD addressed this challenge by using information produced by its evaluation and compensation reforms as the basis for effectiveness-adjusted payments that provided large compensating differentials to attract and retain effective teachers in its lowest achievement schools. The Accelerating Campus Excellence (ACE) program offers salary supplements to educators with records of high performance who are willing to work in the most educationally disadvantaged schools. 

This study documents that ACE resulted in immediate and sustained increases in student achievement, providing strong evidence that the multi-measure evaluation system identifies effective educators who foster the development of cognitive skills. The improvements at ACE schools were dramatic, bringing average achievement in the previously lowest performing schools close to the district average. When ACE stipends are largely eliminated, a substantial fraction of highly effective teachers leaves, and test scores fall. This highlights the central importance of the performance-based incentives to attract and retain effective educators in previously low-achievement schools.

For stressed-out grad students, mindfulness makes big difference

 

 While recent studies and polls indicate the nation is in the midst of a mental health crisis, the situation in academia is even more grim: Within the high-stress, high-pressure, often socially isolated world of advanced education, graduate students experience depression and anxiety at six times the rate of the general population.  

Normalizing mindfulness practices within the graduate student experience may be an answer, according to a three-year study conducted by University of Wisconsin–Madison researchers. Their results showed that regular, sustained mindfulness activities can play an important role in improving engineering graduate student emotional well-being.  

The research team, which includes UW–Madison engineering and Center for Healthy Minds researchers, published details of the National Science Foundation-funded study in the March 23, 2023 edition of the journal PLOS ONE. 

"Because of the state of graduate student mental health nationally, there's a tangible need for a concrete intervention like this," says Susan Hagness, a professor of electrical and computer engineering and one of the study's co-authors. "How do we help our students develop resiliency and a really robust toolbox, both professional and personal, to flourish in an environment where there's inevitably going to be stress? We're getting the word out that investing in self-care is important, and it's normal." 

Cultivated through practices such as meditation, yoga or prayer, mindfulness centers around being in the present moment in an open, non-judgmental, curious, accepting way. In recent years, corporate giants like Google, Intel, Nike, General Mills, Target and others have included mindfulness in employee development activities to reduce employee stress and burnout, and enhance their focus, creativity, job satisfaction and wellness.  

The UW–Madison research included two studies involving a total of 215 participants across six academic semesters at UW–Madison (and the final four semesters concurrently at the University of Virginia). In the study, engineering graduate student cohorts participated in an hour-long, instructor-led mindfulness training program once a week for eight weeks. This "Mindful Engineer" curriculum was based on an existing Center for Healthy Minds training, "Cultivating Well-Being in the Workplace," and drew on neuroscience-derived concepts described in The Emotional Life of Your Brain, a book co-authored by center founder Richard Davidson, a professor of psychology and psychiatry at UW–Madison.  

Each weekly session built on the previous weeks' content; students learned about the brain's neuroplasticity and how it can be trained to change responses to emotions. They explored the six dimensions of emotional style (attention, self-awareness, resilience, outlook, social intuition and sensitivity to context) and learned strategies for creating and maintaining healthy mental and emotional habits. The graduate students also received training in mindfulness meditation and other contemplative practices, cognitive skills and techniques, and each session included time for meditation and cognitive exercises. 

In post-training surveys, students reported significantly improved emotional well-being, a more positive outlook, fewer negative emotions and increased mindfulness. Over the same period, the control groups (which received training at a later date) noted steady or decreased well-being. Mindfulness participants also reported they were better able to manage stress and anxiety, deal positively with setbacks, work more effectively with colleagues and focus on their research.  

"What was beautiful is that we saw a really consistent pattern of results across all of the cohorts we did this study with," says Pelin Kesebir, an honorary fellow with the Center for Healthy Minds and a study co-author. 

Somewhat surprisingly, the researchers also found that engineering graduate students were open to mindfulness training and were not only highly satisfied with it, but also enjoyed the opportunity to connect with other graduate students. 

"In the literature, there's evidence that engineers are less likely to seek treatment for mental health issues — so our team wondered if engineers would engage with this," says Wendy Crone, a professor of engineering physics and mechanical engineering and a study co-author. "The answer is that they did, and we had great cohorts throughout the project." 

The researchers say they'd like mindfulness training to be integrated into the graduate student experience in the future. In the meantime, they recommend the Healthy Minds Program app, which offers podcast-style lessons and seated and active meditations. 

And while the researchers focused on engineering graduate students, they note that adopting a mindfulness practice can be a positive step for anyone.  

"Modest investments of your time can result in really significant benefits to your overall well-being," says Hagness. "Small investments in self-care can have long-term rewards." 

Rates of autism climb to new highs in the U.S., with California setting record numbers

New federal studies coauthored by autism experts at Rutgers found that more children have been diagnosed with autism than at any time since monitoring began more than two decades ago.

 

According to the U.S. Centers for Disease Control and Prevention (CDC), about 4 percent of 8-year-old boys and 1 percent of 8-year-old girls, have autism in the U.S. These estimates are the highest since the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network was created in 2000.

 

Biennial studies from the ADDM Network, which analyzed data from 2020, were coauthored by Walter Zahorodny, director of the New Jersey Autism Study at the Rutgers New Jersey Medical School and Josephine Shenouda, a Rutgers epidemiologist.

 

The first study, the CDC’s 2020 autism prevalence report, found that California set new records, diagnosing 45 percent more boys with autism than any other state in the network. Nearly 7 percent of all 8-year-old boys in the San Diego region are estimated to have autism spectrum disorder (ASD), according to the report.

 

In New Jersey, the combined rate of 8-year-old boys and girls with ASD was 28.7 per 1,000 children (2.9 percent), the third-highest behind Minnesota (3 percent) and California (4.5 percent).

 

Maryland recorded the lowest rate (2.3 percent) across the 11 states in the network (which includes Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah and Wisconsin).

 

“For California in particular, the data are surprising and represent the highest autism prevalence estimates from a region by an epidemiologic study,” Zahorodny said.

 

There may be several reasons for the disparity between California’s numbers and the rest of the country, he said. For one, California’s figures were drawn from an area in metro San Diego that is leading national efforts to diagnose autism as early as possible, translating into more accurate – and higher – numbers than other states.

 

State-funded centers also provide evaluations and service coordination for children with disabilities and their families. Other states may be undercounting because they don’t have as many diagnostic resources, he said.

 

“The true rate may not be substantially different between California and other ADDM states, including New Jersey,” Zahorodny said. “What’s different is that California implemented some wide-ranging screening and intervention programs, which may have resulted in a higher estimated prevalence than elsewhere in the network.”

 

California also outpaced all other states in the 2018 study, recording an overall prevalence of 38.9 per 1,000 children. The state was not included in the 2016 study.

 

Zahorodny said other states should consider expanding screening programs to echo what California has done.  “Consistent universal screening of young children coordinated through multiple pediatric practices may be the way to make a difference in autism detection and intervention,” he said. 

 

A companion 2020 report, which estimated early identification of autism in 4-year-old children, found similar patterns and trends. Total prevalence in this age group increased 26 percent compared with 2018 results – to 2.1 percent of children. But the rates varied widely and were 265 percent higher in California than in Utah, the state with the lowest prevalence.

 

More difficult to ascertain is why ASD prevalence continues to climb. While there are known risk factors for autism, including age of parents, multiple-gestation birth, prematurity, C-section delivery and care in the intensive care unit after delivery, these perinatal factors have remained relatively stable even as the rate of ASD has continued to surge.

 

A common misconception is that better awareness and more availability of services is largely responsible for the rise, but Zahorodny said this was “impossible” because the scope and breadth of increase has been extensive across all subtypes of ASD, from mild to severe and across all demographic groups.

 

“This is not just a phenomenon of becoming more sensitive to subtly impaired kids,” he said.

 

Among other highlights from the reports:

 

• For the first time among 8-year-old children, the prevalence of ASD was lower among white children than among other racial and ethnic groups, reversing the direction of racial and ethnic differences in ASD prevalence observed in the past.
• Black 8-year-old children with ASD were more likely than white children with ASD to have a co-occurring intellectual disability.
• Over the past two decades, ASD prevalence estimates of 8-year-old children from the ADDM Network have increased sharply, from 0.6 percent in 2000 to 2.2 percent 2018.
• Among 4-year-olds, ASD prevalence in 2020 ranged from 1.2 percent of children in Utah to 4.6 percent in California, with an overall prevalence of 2.1 percent.

 

“Once considered a rare disorder, these figures suggest that autism may be one of the most common disabilities,” Zahorodny said. “The trouble is we don't understand what the primary drivers of the increase are.”