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ObjectivesTo investigate whether intergroup contact in addition to education is more effective than education alone in reducing stigma of mental illness in adolescents.DesignA pragmatic cluster randomised controlled trial compared education alone with education plus contact. Blocking was used to randomly stratify classes within schools to condition. Random allocation was concealed, generated by a computer algorithm, and undertaken after pretest. Data was collected at pretest and 2-week follow-up. Analyses use an intention-to-treat basis.SettingSecondary schools in Birmingham, UK.ParticipantsThe parents and guardians of all students in year 8 (age 12–13 years) were approached to take part.InterventionsA 1-day educational programme in each school led by mental health professional staff. Students in the ‘contact’ condition received an interactive session with a young person with lived experience of mental illness.OutcomesThe primary outcome was students’ attitudinal stigma of mental illness. Secondary outcomes included knowledge-based stigma, mental health literacy, emotional well-being and resilience, and help-seeking attitudes.ResultsParticipants were recruited between 1 May 2011 and 30 April 2012. 769 participants completed the pretest and were randomised to condition. 657 (85%) provided follow-up data. At 2-week follow-up, attitudinal stigma improved in both conditions with no significant effect of condition (95% CI −0.40 to 0.22, p=0.5, d=0.01). Significant improvements were found in the education-alone condition compared with the contact and education condition for the secondary outcomes of knowledge-based stigma, mental health literacy, emotional well-being and resilience, and help-seeking attitudes.ConclusionsContact was found to reduce the impact of the intervention for a number of outcomes. Caution is advised before employing intergroup contact with younger student age groups. The education intervention appeared to be successful in reducing stigma, promoting mental health knowledge, and increasing mental health literacy, as well as improving emotional well-being and resilience. A larger trial is needed to confirm these results.Trial registration numberISRCTN07406026; Results.

BackgroundIn cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use.MethodsData were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels.ResultsAt baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use.ConclusionsThis is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required.

This article provides two illustrations of some of the factors that can influence findings from pre-and post-test research designs in evaluation studies, including regression to the mean (RTM), maturation, history and test effects. The first illustration involves a re-analysis of data from a study by Marsden (2004), in which pre-test scores are plotted against gain scores to demonstrate RTM effects. The second illustration is a methodological review of single group, pre-and post-test research designs (pre-experiments) that evaluate causal relationships between intervention and outcome. Re-analysis of Marsden's prior data shows that learners with higher baseline scores consistently made smaller gains than those with lower baseline scores, demonstrating that RTM is clearly observable in single group, pre-post test designs. Our review found that 13% of the sample of 490 articles were evaluation studies. Of these evaluation studies, about half used an experimental design. However, a quarter used a single group, pre-post test design, and researchers using these designs did not mention possible RTM effects in their explanations, although other explanatory factors were mentioned. We conclude by describing how using experimental or quasi-experimental designs would have enabled researchers to explain their findings more accurately, and to draw more useful implications for pedagogy.

BackgroundYouth comprise 40% of the world’s unemployed, a status associated with adverse wellbeing and social, health, and economic costs. This systematic review and meta-analysis review synthesises the literature on the effectiveness of interventions targeting young people not in employment, education, or training (NEET).MethodsRandomised and quasi-randomised trials with a concurrent or counterfactual control group and baseline equivalence are included. Cochrane collaboration tools are used to assess quality, and a narrative synthesis was undertaken. The primary outcome is employment; secondary outcomes were health, earnings, welfare receipt, and education.ResultsEighteen trials are included (9 experimental and 9 quasi-experimental), sample sizes range from 32 to 54,923. Interventions include social skills, vocational, or educational classroom-based training, counselling or one-to-one support, internships, placements, on-the-job or occupational training, financial incentives, case management, and individual support. Meta-analysis of three high-quality trials demonstrates a 4% (CI 0.0–0.7) difference between intervention and control groups on employment. Evidence for other outcomes lacks consistency; however, more intensive programmes increase employment and wages over the longer term.ConclusionsThere is some evidence that intensive multi-component interventions effectively decrease unemployment amongst NEETs. The quality of current evidence is limited, leaving policy makers under-served when designing and implementing new programmes, and a vulnerable population neglected.Systematic review registrationPROSPERO CRD42014007535Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0394-2) contains supplementary material, which is available to authorized users.