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Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study.

ABSTRACT: BACKGROUND:School drop-out is a problem all over the world with adverse life-course consequences. The aim of this paper is to study how internalising and externalising problems in the 10th grade are associated with non-completion of upper secondary school, and to examine the mediating role of grade points in the 10th grade across general academic and vocational tracks in upper secondary school. We also study the impact of health behaviour. METHODS:Population-based health surveys were linked with Norwegian registries on education and sociodemographic factors (n?=?10 931). Mental health was assessed by the self-report Strengths and Difficulties Questionnaire. Logistic regression was used to analyse the relations between mental health and health behaviour in 10th grade and non-completion of upper secondary school. The mediating effect of grade points was studied by causal mediation analysis. RESULTS:Adolescents not completing upper secondary school reported more externalising problems and girls more internalising problems in the 10th grade, after adjustments. Smoking and physical inactivity increased the odds of non-completion of upper secondary school. Causal mediation analyses showed that a reduction in externalising problems of 10 percentage points led to lower rates of non-completion of 4-5 percentage points, and about three-quarters of this total effect was mediated by grades. For internalising problems the total effect was significant only for girls (1 percentage point), and the mediated effect of grades was about 30%. The effect of mental health problems on school dropout was mainly the same in both vocational and general tracks. CONCLUSIONS:Assuming a causal relationship from mental health problems to school performance, this study suggests that externalising problems impair educational attainment. A reduction of such problems may improve school performance, reduce school drop-out and reduce the adverse life-course consequences.

SUBMITTER: Sagatun A

PROVIDER: S-EPMC3905670 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study.

Sagatun Ase A Heyerdahl Sonja S Wentzel-Larsen Tore T Lien Lars L

BMC public health 20140109

<h4>Background</h4>School drop-out is a problem all over the world with adverse life-course consequences. The aim of this paper is to study how internalising and externalising problems in the 10th grade are associated with non-completion of upper secondary school, and to examine the mediating role of grade points in the 10th grade across general academic and vocational tracks in upper secondary school. We also study the impact of health behaviour.<h4>Methods</h4>Population-based health surveys w ...[more]

PMID: 24406098

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Project description:Background:While previous research has evidently and extensively acknowledged socioeconomic gradients in children's education, we know very little about the determinants of socioeconomic-related inequality in children's education at the population level in Sweden. Therefore, we aimed: (i) to assess the extent of income inequality in upper secondary school completion in Sweden; (ii) to examine the contribution of mental health and other determinants to income inequality; and (iii) to explore gender differences in the magnitude and determinants of the inequalities. Method:We utilised data from a population-based cohort available in Umeå SIMSAM Lab, linked with several national registries in Sweden. The dataset includes all children who were born in Sweden in 1991 and completed or not completed their upper secondary education in 2010, n = 116,812 (56,612 girls and 60,200 boys). We analysed the data using a Wagstaff-type decomposition method. Results:The results first show substantial income-related inequality in upper secondary school incompletion concentrated among the poor in the Swedish setting. Second, these inequalities were in turn to a large degree explained jointly by parental, family and child factors; primarily parents' income and education, number of siblings and child's poor mental health. Third, these inferences remained when boys and girls were considered separately, although the determinants explained a greater share of the inequalities in boys than in girls. Conclusion:Our results highlighted substantial income-related inequality in upper secondary school incompletion concentrated among the poor in the Swedish setting. Apart from family level characteristics, which explained a large portion of the inequalities, mental health problems appeared to be of particular importance as they represent a central target for both increasing the population average in upper secondary school completion and for reducing the gap in income-related inequalities in Sweden.

Project description:Drop out from upper secondary school represents a risk for the future health and wellbeing of young people. Strengthening of psychosocial aspects of the learning environment may be an effective strategy to promote completion of upper secondary school. This paper is a study protocol of a school based cluster randomized controlled trial (RCT) evaluating two school-based interventions, namely the Dream School Program (DSP) and the Mental Health Support Team (MHST). The interventions aim to improve psychosocial learning environments and subsequently school achievements and decrease drop-out and absence.The COMPLETE RCT is aimed at youth in upper secondary school, grade 1 (age 15-16 years), and examines the effect of the combination of the DSP and the MHST; and the DSP only, compared with a comparison group on the following primary outcomes: student completion, presence, average grade, and self-reported mental health. Seventeen upper secondary schools from four counties in Norway were randomized to one of the three arms: 1) DSP and MHST; 2) DSP; and 3) comparison (offered DSP intervention in 2018/2019). The study will evaluate the interventions based on information from two cohorts of students (cohort 1 (C1) and cohort 2 (C2)). For C1, data was collected at baseline (August 2016), and at first follow-up seven months later. Second follow-up will be collected 19 months after baseline. For C2, data was collected at baseline (August 2017), and first and second follow-up will be collected similarly to that of C2 seven and 19 months respectively after baseline. Process evaluations based on focus groups, interviews and observation will be conducted twice (first completed spring 2017).The COMPLETE trial is a large study that can provide useful knowledge about what interventions might effectively improve completion of upper secondary school. Its thorough process evaluation will provide critical information about barriers and points of improvement for optimizing intervention implementation. Findings can guide school development in the perspective of improving psychosocial learning environments and subsequent completion of upper secondary schooling.The trial was retrospectively registered in the ClinicalTrials.gov register on December 22.2017: NCT03382080 .

Project description:BackgroundEvidence has not been conclusive on whether adolescent overweight is associated with mental health, possibly caused by indirect, yet untested associations. Therefore, the purpose of this study was to examine the association between overweight or obesity and mental health problems among adolescents, and to determine whether victimization plays a mediating role in these associations.MethodsSelf-reported data on mental health and victimization and objectively measured Body Mass Index data were used, using three cohorts (2010-2011 until 2012-2013) and an interval between the measurement waves of two years later. We performed a multi-level mediation analysis with a two-level structure to incorporate the clustering of the measurements within individuals. The study population consisted of 13,740 secondary school students, 13-14 years old at the first measurement moment, in Amsterdam, the Netherlands.ResultsCompared to their normal-weight peers, adolescents with overweight or obesity reported psychosocial problems and suicidal thoughts more often. Victimization was a significant mediator in the relationship between having overweight, and psychosocial problems (indirect effect OR: 2.3; 95% CI 1.5, 3.7 and direct effect OR: 1.4; 95% CI 1.2, 1.7) or suicidal thoughts (indirect effect OR: 2.1; 95% CI 1.4, 3.2 and direct effect OR: 1.3; 95% CI 1.1, 1.5). The associations between obesity, and psychosocial problems (indirect OR: 6.2; 95% CI 2.8, 14.7 and direct effect OR: 1.4; 95% CI 1.0, 2.0), or suicidal thoughts (indirect OR: 4.5; 95% CI 2.3, 9.1 and direct effect OR: 1.5; 95% CI 1.1, 2.0) were even stronger.ConclusionsOverweight and obesity were significantly associated with mental health problems in adolescents, and victimization played a mediating role in this association. Victimization and mental health should be integrated into prevention programs that address healthy weight development. Moreover, overweight should be given more attention in programs to prevent victimization and promote adolescent mental health.

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Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study.

Publications

Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study.

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