The relationship between school-based smoking policies and prevention programs on smoking behavior among grade 12 students in Prince Edward Island: A multilevel analysis

Murnaghan, Donna; Sihvonen, Marja; Leatherdale, Scott T.; Kekki, Pertti

doi:10.1016/j.ypmed.2007.01.003

Cited by 37 publications

(50 citation statements)

References 33 publications

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“…However, students who reported that the rules about smoking are clear reduced their likelihood of smoking on school grounds. This finding is consistent with Murnaghan et al [17], who reported that school policies were effective only when students perceived them to be clear. It is logical that a policy must be communicated clearly for the desired behavior to occur.…”

Section: Discussionsupporting

confidence: 91%

“…In Canada, 14% of youth aged 15-19 were current smokers in 2009, which is unchanged from 2008 [3]. Similarly, in the United States, 20% of youth in grades 9 through 12 were current smokers in 2009, unchanged from 2007 [4] and in the United Kingdom, 22% of youth aged [16][17][18][19] were current smokers in 2007, up slightly from 21% in 2006 [5]. Although smoking rates in many developed countries have reached historical lows, the rate of decline has slowed substantially, and preventive efforts are still needed.…”

Section: Introductionmentioning

confidence: 99%

“…It remains unclear how school policies impact adolescent smoking as literature examining the effectiveness of school policies on student smoking is mixed [10,[15][16][17][18][19][20][21][22]. Most studies have focused upon smoking status and not all studies include measures of enforcement despite the evidence that to be effective, policies should be strongly enforced (OR = 0.34-0.86, R 2 = -0.77) [16,18,22].…”

Section: Introductionmentioning

confidence: 99%

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Do students’ perceptions of school smoking policies influence where students smoke?: Canada’s Youth Smoking Survey

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Do students’ perceptions of school smoking policies influence where students smoke?: Canada’s Youth Smoking Survey

Watts

Lovato

Card

et al. 2010

Cancer Causes Control

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“…72,75 Of the other studies: 82 both drew on National Education Longitudinal Study (NELS) data, but the latter used data from more follow-ups. Ishibashi 83 and Murnaghan et al 84 both drew on data from the School Health Action Planning and Evaluation System (SHAPES) study, but used different waves to examine different outcomes.…”

Section: Adjustments For Appropriate Covariatesmentioning

confidence: 99%

Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis

Bonell

Jamal

Harden

et al. 2013

Public Health Research

160

192

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BackgroundIn contrast to curriculum-based health education interventions in schools, the school environment approach promotes health by modifying schools' physical/social environment. This systematic review reports on the health effects of the school environment and processes by which these might occur. It includes theories, intervention outcome and process evaluations, quantitative studies and qualitative studies.Research questionsResearch question (RQ)1: What theories are used to inform school environment interventions or explain school-level health influences? What testable hypotheses are suggested? RQ2: What are the effects on student health/inequalities of school environment interventions addressing organisation/management; teaching/pastoral care/discipline; and the physical environment? What are the costs? RQ3: How feasible/acceptable and context dependent are such interventions? RQ4: What are the effects on student health/inequalities of school-level measures of organisation/management; teaching/pastoral care/discipline; and the physical environment? RQ5: Through what processes might such influences occur?Data sourcesA total of 16 databases were searched between 30 July 2010 and 23 September 2010 to identify relevant studies, including the British Educational Index, the Cumulative Index to Nursing and Allied Health Literature, the Health Management Information Consortium, EMBASE, MEDLINE and PsycINFO. In addition, references of included studies were checked and authors contacted.Review methodsIn stage 1, we mapped references concerning how the school environment affects health and consulted stakeholders to identify stage 2 priorities. In stage 2, we undertook five reviews corresponding to our RQs.ResultsStage 1: A total of 82,775 references were retrieved and 1144 were descriptively mapped. Stage 2: A total of 24 theories were identified (RQ1). The human functioning and school organisation, social capital and social development theories were judged most useful. Ten outcome evaluations were included (RQ2). Four US randomised controlled trials (RCTs) and one UK quasi-experimental study examined interventions building school community/relationships. Studies reported benefits for some, but not all outcomes (e.g. aggression, conflict resolution, emotional health). Two US RCTs assessed interventions empowering students to contribute to modifying food/physical activity environments, reporting benefits for physical activity but not for diet. Three UK quasi-experimental evaluations examined playground improvements, reporting mixed findings, with benefits being greater for younger children and longer break times. Six process evaluations (RQ3) reported positively. One study suggested that implementation was facilitated when this built on existing ethos and when senior staff were supportive. We reviewed 42 multilevel studies, confining narrative synthesis to 10 that appropriately adjusted for confounders. Four UK/US reports suggested that schools with higher value-added attainment/attendance had lower rates of substance use and fighting. Three reports from different countries examined school policies on smoking/alcohol, with mixed results. One US study found that schools with more unobservable/unsupervised places reported increased substance use. Another US study reported that school size, age structure and staffing ratio did not correlate with student drinking. Twenty-one qualitative reports from different countries (RQ5) suggested that disengagement, lack of safety and lack of participation in decisions may predispose students to engage in health risks.LimitationsWe found no evidence regarding health inequalities or cost, and could not undertake meta-analysis.ConclusionsThere is non-definitive evidence for the feasibility and effectiveness of school environment interventions involving community/relationship building, empowering student participation in modifying schools' food/physical activity environments, and playground improvements. Multilevel studies suggest that schools that add value educationally may promote student health. Qualitative studies suggest pathways underlying these effects. This evidence lends broad support to theories of social development, social capital and human functioning and school organisation. Further trials to examine the effects of school environment modifications on student health are recommended.FundingThe National Institute for Health Research Public Health Research programme.

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“…Since students (level 1) are nested within schools (level 2), a series of multi-level logistic regression analyses were performed in order to understand the student-and schoollevel factors associated with being overweight within this hierarchical data structure. Consistent with other multilevel studies Murnaghan et al 2007), a three-step modelling procedure was used.…”

Section: Analysesmentioning

confidence: 99%

The association between overweight and opportunity structures in the built environment: a multi-level analysis among elementary school youth in the PLAY-ON study

Leatherdale

Pouliou²,

Church

et al. 2010

Int J Public Health

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The relationship between school-based smoking policies and prevention programs on smoking behavior among grade 12 students in Prince Edward Island: A multilevel analysis

Cited by 37 publications

References 33 publications

Do students’ perceptions of school smoking policies influence where students smoke?: Canada’s Youth Smoking Survey

Do students’ perceptions of school smoking policies influence where students smoke?: Canada’s Youth Smoking Survey

Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis

The association between overweight and opportunity structures in the built environment: a multi-level analysis among elementary school youth in the PLAY-ON study

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