Evidence for the Effectiveness of a National School-Based Mental Health Program in Chile
Evidence for the Effectiveness of a National School-Based Mental Health Program in Chile
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DOI：
10.1016/j.jaac.2015.07.005
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发表时间：
2015-10-01
影响因子：
13.3
通讯作者：
Murphy, J. Michael
中科院分区：
文献类型：
--
作者：
Guzman, Javier;Kessler, Ronald C.;Murphy, J. Michael
目标：生活技能 (SFL) 是世界上最大的以学校为基础的心理健康项目，在过去十年中为智利超过 1,000,000 名学生进行筛查和提供服务。这是该计划的首次外部评估。 方法：2010 年智利 8,372 所接受公共资助的小学中，五分之一 (1,637 所)选择参加 SFL。每年，这些学校的所有一年级和三年级学生都会接受经过验证的教师和家长完成的心理社会功能测量（教师课堂适应观察重新修订版 [TOCA-RE.] 和智利儿科症状检查表 [PSC-CL]）的筛查。一年级时被确定为 TOCA-RR 存在风险的学生将在二年级接受为期 10 次的标准化预防性干预。本文探讨了参加研讨会与 TOCA-RR 和 PSC-CL 分数变化、出勤率以及三至四年级升职之间的关系。结果：总共 16.4% 的学生被确定为有风险。托卡-RR。在控制非随机选择暴露和失访后，发现参加研讨会的次数与行为和学术成果的改善之间存在统计学上的显着关系。参加最多 (7-10) 次课程与参加较少 (0-6) 次课程之间的差异的效果大小范围为 0.08 至 0.16 个标准差。 结论：这项研究提供的经验证据表明，上学初期的大规模心理健康干预与行为和学业成绩的改善显着相关。未来的研究需要对该计划进行更严格的实验评估，检查长期效果，并调查治疗反应异质性的可能预测因素。
Objective: Skills for Life (SFL) is the largest school-based mental health program in the world, screening and providing services to more than 1,000,000 students in Chile over the past decade. This is the first external evaluation of the program.Method: Of the 8,372 primary schools in Chile in 2010 that received public funding, one-fifth (1,637) elected to participate in SFL. Each year, all first- and third-grade students in these schools are screened with validated teacher- and parent-completed measures of psychosocial functioning (the Teacher Observation of Classroom Adaptation Re-Revised [TOCA-RE.] and the Pediatric Symptom Checklist Chile [PSC-CL]). Students identified as being at risk on the TOCA-RR in first grade are referred to a standardized 10-session preventive intervention in second grade. This article explores the relationships between workshop participation and changes in TOCA-RR and PSC-CL scores, attendance, and promotion from third to fourth grades.Results: In all, 16.4% of students were identified as being at-risk on the. TOCA-RR. Statistically significant 'relationships were found between the number of workshop sessions attended and improvements in behavioral and academic outcomes after controlling for nonrandom selection into exposure and loss to follow-up. Effect sizes for the difference between attending most (7-10) versus fewer (0-6) sessions ranged from 0.08 to 0.16 standard deviations.Conclusion: This study provides empirical evidence that a large-scale mental health intervention early in schooling is significantly associated with improved behavioral and academic outcomes. Future research is needed to implement more rigorous experimental evaluation of the program, to examine longer-term effects, and to investigate possible predictors of heterogeneity of treatment response.