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

Author

Listed:
  • Camilla Thørring Bonnesen

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

  • Lau Caspar Thygesen

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

  • Naja Hulvej Rod

    (Section of Epidemiology, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark)

  • Mette Toftager

    (Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark)

  • Katrine Rich Madsen

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

  • Marie Pil Jensen

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

  • Johanne Aviaja Rosing

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

  • Stine Kjær Wehner

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

  • Pernille Due

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

  • Rikke Fredenslund Krølner

    (National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark)

Abstract

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

Suggested Citation

  • Camilla Thørring Bonnesen & Lau Caspar Thygesen & Naja Hulvej Rod & Mette Toftager & Katrine Rich Madsen & Marie Pil Jensen & Johanne Aviaja Rosing & Stine Kjær Wehner & Pernille Due & Rikke Fredenslu, 2023. "Preventing Stress among High School Students in Denmark through the Multicomponent Healthy High School Intervention—The Effectiveness at First Follow-Up," IJERPH, MDPI, vol. 20(3), pages 1-16, January.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:1754-:d:1039628
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    References listed on IDEAS

    as
    1. Anda, Diane de & Baroni, Sergio & Boskin, Lori & Buchwald, Lisa & Morgan, Jan & Ow, Jeanee & Gold, Julie Siegel & Weiss, Robert, 2000. "Stress, stressors and coping among high school students," Children and Youth Services Review, Elsevier, vol. 22(6), pages 441-463, June.
    2. Clare A. O'Connor & Judith Dyson & Fiona Cowdell & Roger Watson, 2018. "Do universal school‐based mental health promotion programmes improve the mental health and emotional wellbeing of young people? A literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(3-4), pages 412-426, February.
    3. Viveca Östberg & Stephanie Plenty & Sara B. Låftman & Bitte Modin & Petra Lindfors, 2018. "School Demands and Coping Resources−Associations with Multiple Measures of Stress in Mid-Adolescent Girls and Boys," IJERPH, MDPI, vol. 15(10), pages 1-11, September.
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