Sherri Bisset

School culture as an influencing factor on youth substance use

Objective: To determine whether value-added education is associated with lower risk of substance use among adolescents: early initiation of alcohol use (regular monthly alcohol consumption in grade 7), heavy alcohol use (>10 units per week) and regular illicit drug use. Design: Cross-sectional self-reported survey of alcohol and drug use. Analysis used two-level logistic modelling to relate schools providing value-added education with pupils’ substance use. The value-added education measure was derived from educational and parenting theories proposing that schools providing appropriate support and control enhance pupil functioning. It was operationalised by comparing observed and expected examination success and truancy rates among schools. Expected examination success and truancy rates were based on schools’ sociodemographic profiles. Participants: Data were collected across 15 West Midlands English school districts and included 25 789 pupils in grades 7, 9 and 11 from 166 UK secondary schools. Results: Value-added education was associated with reduced risk of early alcohol initiation (OR (95% CI) 0.87 (0.78 to 0.95)) heavy alcohol consumption (OR 0.91 (0.85 to 0.96)) and illicit drug use (OR 0.90 (0.82 to 0.98)) after adjusting for gender, grade, ethnicity, housing tenure, eligibility for free school meal, drinking with parents and neighbourhood deprivation. Conclusions: The prevalence of substance use in school is influenced by the school culture. Understanding the mechanism through which the school can add value to the educational experience of pupils may lead to effective prevention programmes.

Predicting academic and cognitive outcomes from weight status trajectories during childhood.

Objective:To identify childhood body mass index (BMI) trajectories and to describe their association with subsequent academic and cognitive outcomes.Study design:Prospective cohort: Height and weight measured annually from 4 to 7 years. A mixture of regressions approach grouped children into BMI trajectories (n=1959 children; n=5754 BMI measures). Academic outcomes included teacher-rated progress and achievement. Cognitive outcomes measured by Kaufman’s Assessment Battery for Children. Academic and cognitive outcomes were regressed according to BMI trajectories, controlling for family and individual covariates. Subjects drawn from Quebec Longitudinal Study of Child Development (Canada), a 1998 birth cohort (n=2120).Results:Four clusters of BMI trajectories emerged: two healthy weight groups, one overweight group and one low weight group. Relative to healthy weight, belonging to the overweight or low weight clusters was negatively associated with cognitive and academic outcomes. With the exception of the low weight cluster, this relationship was insignificant in the adjusted model.Conclusions:Results suggest that during childhood being overweight does not increase risk for poor educational outcomes. Instead, being underweight may the increase risk for poorer cognitive outcomes. Further group-based trajectory modeling (GBTM) for BMI development over time is needed to confirm results.

Association of body mass index and dietary restraint with changes in eating behaviour throughout late childhood and early adolescence: a 5-year study

OBJECTIVES To describe patterns of dietary behaviours specific to low quality snacking, fruit and vegetable, and fast food consumption during the transition from childhood to adolescence and to examine how these behaviours are associated with tendencies towards dietary restraint and the occurrence of overweight and obesity in mid-adolescence. DESIGN A 5-year follow-up of self-reported eating. Hierarchical linear modelling was utilised to explore the relationship between dietary changes and body mass index (BMI) and dietary restraint while controlling for physical activity and smoking. SETTING The sample was derived from students participating in the Quebec Heart Health Demonstration Project, and represents rural, suburban and inner city youths. SUBJECTS A sample of 561 girls and 627 boys in the fourth, sixth, seventh and ninth grades. RESULTS Overall the sample was characterised by a decrease in fruit and vegetable consumption and increase in low quality snacking, and a decrease in fast food consumption over the 5-year follow-up. Dietary restraint and BMI were found to be associated with dietary behaviour. Lower than average dietary restraint was associated with a lower frequency of fast food consumption and greater increase in low quality snacking over the 5-year period. Higher than average dietary restraint was associated with lesser frequency of low quality snacking at baseline. Having a BMI in the obese range was associated with more frequent fast food consumption in the fourth grade and a more rapid drop in fast food consumption across the 5-year period. CONCLUSIONS Dietary behaviours are associated with the psychological construct dietary restraint and with weight status in this population of adolescents.

Exploring the Intervention-Context Interface: A Case from a School-Based Nutrition Intervention.

It has been acknowledged for several decades that programs interact with context. The nature of this interactivity, and how it defines a program, has not been adequately addressed. We view this lacuna as a function of the dominant theoretical perspectives guiding knowledge of program operations. We propose the actor-network theory (ANT) and its conceptual apparatus, the sociotechnical network, as suitable for guiding the acquisition of general knowledge on program operations. We tested this proposition with an instrumental case study of health professional practices during the implementation of a nutrition program into an elementary school setting. Data collection and analysis were guided by the ANT. Data were derived from semistructured interviews completed with six health professionals (nutritionists). Analysis procedures focused on the nutritionists’ collective representation of the microprocesses by which they aimed to build a sociotechnical network of alliances with educational stakeholders. Findings identified nutritionists as preoccupied with three overarching goals during the implementation of the nutrition program, whereby goals were found to take form interactively with the interests of the program participants (primarily students) and stakeholders (primarily teachers). Nutritionists strategically translated program components as a means of negotiating with participants and stakeholders. The findings of this study support the theoretical proposition that program implementation is a process of expanding a sociotechnical network. Beyond simply reaffirming that programs do indeed adapt to context, we interpret this adaptation through the lens of a social theory that suggests why and how adaptation is an inevitable component of program implementation.

There Is More to Methodology than Method

There is much more to evaluation than collecting, analyzing, and interpreting scientific data in order to compare the outcomes of vious treatments. For the past 40 years, method-related discussions in the field of program evaluation have evolved to include models and reflections on the complex and multiple roles associated with the practice of evaluation. In fact, for Shadish, Cook, & Leviton, (1991), the knowledge basis which pertains to the practice of evaluation must consider issues related to the evaluator’s roles as well as to the design of evaluation. Thus, evaluation practice requires both the methodological and technical competencies for systematic inquiry, in addition to a whole set of interpersonal and negotiation skills, identified by Brown (1995) as ranging from pedagogical to political. Conceiving evaluation as a practice, as we do in this collection of essays, is based upon the premise that evaluators are more than good and rigorous scientists, implementing empirical inquiry devices to study programs and interventions. While there is clearly more to the evaluator’s role than data-related activities, how do these two aspects of practice which are inherently part of program evaluation, come together and build knowledge of evaluation practice? To address this question, we propose revisiting the teleological, epistemological and ontological foundations upon which evaluation roles are defined. Consistent with the orientation of this book, we define evaluators’ roles vis-avis a program as framed by one’s evaluation practice. We suggest that evaluation practice does not however simply represent a repertoire of roles from which the evaluator may (more or less) arbitrarily choose from in order to define themselves and their evaluation activities (i.e. their methodological tool kit). In this chapter we argue that the evaluator’s role vis-a-vis programs stakeholders and the approach taken to identify, describe, and measure a program and its effects, form an evaluator’s practice, which is consistent and coherent across the contexts of their work. We will also argue that a practice, like a paradigm, constitutes an organized rationality (Crozier & Friedberg, 1977) common to groups of individuals that allow

School Social Fragmentation, Economic Deprivation and Social Cohesion and Adolescent Physical Inactivity: A Longitudinal Study

Objectives To examine the independent influence of school economic deprivation, social fragmentation, and social cohesion on the likelihood of participating in no physical activity among students. Methods Data are from a large-scale longitudinal study of schools based in disadvantaged communities in Quebec, Canada. Questionnaires were administered every year between 2002 and 2008 among n = 14,924 students aged 12 to 18 from a sample of 70 schools. Cross-sectional and longitudinal analyses were conducted. Multilevel modeling was utilized to account for the clustering of students within schools. Schools were categorized as being low, moderate or high economic deprivation, social fragmentation and social cohesion. Those who indicated that they do no participate in any physical activity during the week were identified as being physically inactive. Results In baseline multilevel cross-sectional analyses, adolescents attending schools in the highest (compared to the lowest) levels of socioeconomic deprivation and social fragmentation were more likely to be physically inactive (OR = 1.33, 95% CI = 1.03, 1.72; and OR = 1.24, 95% CI = 0.98, 1.56, respectively). Conversely, students attending schools with the highest cohesion were less likely to be physically inactive (OR = 0.78, 95% CI = 0.61, 0.99). In longitudinal analysis, physically active students who attended schools with the highest social fragmentation were more likely to become physically inactive over two years (OR = 1.65, 95% CI = 1.09, 2.51). Conclusion The school socioeconomic environment appears to be an important contextual influence on participation in no physical activity among adolescents. Following adolescents beyond two years is necessary to determine if these environments have a lasting effect on physical activity behavior.

Traditional and Alternative Community Food Security Interventions in Montréal, Québec: Different Practices, Different People

Food insecurity is steadily increasing in developed countries. Traditional interventions adopted to tackle food insecurity, like food banks, address the urgent need for food. By contrast, alternative interventions, such as community gardens and kitchens, are oriented towards social integration and the development of mutual aid networks. The objective of this paper is to examine whether the populations served by traditional and alternative interventions in food security differ according to measures of vulnerability. We studied newly registered participants to food security interventions. Participants were selected from a random sample of food security community organizations in a two-stage cluster sampling frame. The categorizing variable was participation in a community organization providing either traditional interventions or alternative interventions. Seven measures of vulnerability were used: food security; perceived health; civic participation; perceived social support of the primary network, social isolation, income and education. Regression multilevel models were used to assess associations. 711 participants in traditional interventions and 113 in alternative interventions were enrolled in the study. Between group differences were found with respect to food insecurity, health status perception, civic participation, education and income, but not with respect to social isolation or perceived social support from primary social network. Traditional and alternative food security interventions seem to reach different populations. Participants in traditional interventions were found to have less access to resources, compared to those in alternative interventions. Thus, new participants in traditional interventions may have higher levers of vulnerability than those in alternative interventions.

Short-Term Effects of Traditional and Alternative Community Interventions to Address Food Insecurity

Background Despite the effects of food insecurity on health are well documented, clear governmental policies to face food insecurity do not exist in western countries. In Canada, interventions to face food insecurity are developed at the community level and can be categorized into two basic strategies: those providing an immediate response to the need for food, defined “traditional” and those targeting the improvement of participants’ social cohesion, capabilities and management of their own nutrition, defined “alternative”. Objective The objective of this study was to evaluate the effects of food insecurity interventions on food security status and perceived health of participants. Design This was a longitudinal multilevel study implemented in Montreal, Quebec, Canada. Participants were recruited in a two-stage cluster sampling frame. Clustering units were community organizations working on food insecurity; units of analysis were participants in community food security interventions. A total of 450 participants were interviewed at the beginning and after 9 months of participation in traditional or alternative food security interventions. Food security and perceived health were investigated as dependent variables. Differences overtime were assessed through multilevel regression models. Results Participants in traditional interventions lowered their food insecurity at follow-up. Decreases among participants in alternative interventions were not statistically significant. Participants in traditional interventions also improved physical (B coefficient 3.00, CI 95% 0.42–5.59) and mental health (B coefficient 6.25, CI 95% 4.15–8.35). Conclusions Our results challenge the widely held view suggesting the ineffectiveness of traditional interventions in the short term. Although effects may be intervention-dependent, food banks decreased food insecurity and, in so doing, positively affected perceived health. Although study findings demonstrate that food banks offer short term reprise from the effects of food insecurity, the question as to whether food banks are the most appropriate solution to food insecurity still needs to be addressed.