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

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 and Rikke Fredenslund Krølner
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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

IJERPH, 2023, vol. 20, issue 3, 1-16

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.

Keywords: school-based intervention; high school; stress; effectiveness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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