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. 2019 Apr;40(2):151-170.
doi: 10.1007/s10935-018-0530-y.

A School-Based Program to Promote Well-Being in Preadolescents: Results From a Cluster Quasi-Experimental Controlled Study

Elias Allara  1   2 , Franca Beccaria  3 , Roberta Molinar  4   3 , Laura Marinaro  5 , Antonella Ermacora  3 , Alessandro Coppo  4 , Fabrizio Faggiano  4 ; Diario della Salute Evaluation Support Team
Collaborators, Affiliations

A School-Based Program to Promote Well-Being in Preadolescents: Results From a Cluster Quasi-Experimental Controlled Study

Elias Allara et al. J Prim Prev. 2019 Apr.

Abstract

Diario della Salute [My Health Diary] is a school-based program designed to enhance the subjective well-being and health of 12- to 13-year-old students. We hypothesized that providing students with the social and emotional skills to fulfill their potential and deal with common developmental tasks of adolescence (e.g., onset of puberty, identity development, increased responsibilities and academic demands) would result in improved well-being and health. The program comprises five standardized interactive lessons concerning common psychosocial and health issues in adolescence, and two narrative booklets addressed to both students and their parents. We evaluated the effectiveness of the program in terms of the students' subjective well-being, aggressive behavior, and health behavior. Using a quasi-experimental study design, schools in the intervention group implemented the full program and those in the comparison group received their regular curriculum. We administered measures of the study's objectives both before and after program implementation. Statistical analyses accounted for within-school clustering, potential socioeconomic and demographic confounding, and pre-implementation levels of these measures. We sampled 62 schools and allocated 2630 students to either an intervention or comparison group. Sociodemographic characteristics and baseline outcomes were balanced across study groups. Unexpectedly, respondents in the intervention group had 0.38 greater mean adjusted score of the WHO/Europe Health Behaviour in School-Aged Children Symptom Checklist instrument than respondents in the comparison group, indicating a reduction in subjective well-being. We did not observe any program effects on aggressive and health behaviors. The apparent reduction in subjective well-being reflected by an increased perception of psychosomatic complaints is suggestive of either increased emotional competence or, potentially, iatrogenic program effects. While greater emotional competence is positively associated with well-being over the course of life, the program in its present form should not be disseminated due to the possibility of adverse unintended effects.

Keywords: Adolescence; Effectiveness; Health promotion; Prevention; Quasi-experimental study; School-based program; Well-being.

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Conflict of interest statement

Conflict of Interest

The authors declare that they have no conflict of interest. The group of authors which evaluated the Diario della Salute program (Elias Allara, Fabrizio Faggiano, Laura Marinaro, and the members of the Diario della Salute Evaluation Support Team) did not contribute to program development and implementation, which was carried out by a separate group of authors (Franca Beccaria, Roberta Molinar, and Antonella Ermacora).

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Study flowchart. aOne class dropped out after administration of the baseline survey
See this image and copyright information in PMC

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