Assessment of Exposure to High-Performing Schools and Risk of Adolescent Substance Use: A Natural Experiment.
Assessment of Exposure to High-Performing Schools and Risk of Adolescent Substance Use: A Natural Experiment.
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DOI：
10.1001/jamapediatrics.2018.3074
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发表时间：
2018-12-01
期刊：
影响因子：
26.1
通讯作者：
Wong MD
中科院分区：
文献类型：
--
作者：
Dudovitz RN;Chung PJ;Reber S;Kennedy D;Tucker JS;Shoptaw S;Dosanjh KK;Wong MD
尽管学校环境被认为会影响健康行为，但缺乏评估因果关系的实验数据，而且学校环境的哪些方面对青少年健康最为重要尚不清楚。
为了检验就读于高绩效学校是否会减少青少年的危险健康行为。
我们利用入学抽签（模拟随机分配）来评估学校环境对青少年健康的因果效应。我们对1270名申请洛杉矶低收入少数族裔社区高绩效公立特许学校的学生进行了调查。我们从八年级末/九年级初到十一年级末对抽签“获胜者”（干预组）和“失败者”（对照组）进行了跟踪。意向性治疗（ITT）和工具变量（IV）技术评估了抽签“获胜”以及就读高绩效学校对健康行为的影响，以及这种影响是否因性别而异。
洛杉矶的特许公立高中和非特许公立高中。
申请洛杉矶5所公立特许学校之一的学生，这些学校大多数入学学生经济条件不利，学校的学业成绩在洛杉矶县公立高中排名前三分之一，申请人数比可提供的学位至少多50人，并且他们采用入学抽签的方式。
主要结果是30天内使用大麻和高风险使用大麻的情况。其他健康结果包括30天内饮酒、酗酒、曾经打架、曾经有性行为以及过去一年的违法行为。我们还研究了潜在的中间因素（学习时间、旷课、转学、学校文化、学校秩序、教师支持以及学生社交网络中使用毒品的同龄人比例）。
意向性治疗分析显示，抽签“获胜者”（n = 694）报告的大麻滥用情况比抽签“失败者”（n = 576）少，使用毒品的同龄人也更少，学习时间更多，旷课更少，教师支持更多，学校更有序，转学情况更少（所有p < 0.05）。分层分析表明，对男孩的影响更为一致，早在九年级就注意到了治疗效果。
这项自然实验提供的证据表明，学校环境可以改善低收入少数族裔青少年的危险行为。
Although school environments are thought to influence health behaviors, experimental data assessing causality are lacking, and which aspects of school environments may be most important for adolescent health are unknown. To test whether exposure to high-performing schools reduces risky adolescent health behaviors. We used admission lotteries—which mimic random assignment—to estimate the causal effect of school environments on adolescent health. We surveyed 1270 students who applied to high-performing public charter schools in low-income minority communities in Los Angeles. We followed lottery “winners” (Intervention) and “losers” (Control) from the end of 8th grade/beginning of 9th grade through the end of 11th grade. Intent-to-Treat (ITT) and Instrumental Variables (IV) techniques estimate the effects of “winning” the lottery and attending high-performing schools on health behaviors and whether effects varied by gender. Charter and non-charter public high schools in Los Angeles. Students applying to one of the 5 public charter schools in Los Angeles where the majority enrolled were economically disadvantaged, the school’s academic performance ranked in the top tertile of LA County public high schools, there were at least 50 more applicants than seats available, and they used an admissions lottery. Primary outcomes were 30-day marijuana use and high-risk marijuana use. Additional health outcomes included 30-day alcohol use, alcohol misuse, ever being in a fight, ever having sex and past year delinquency. We also examined potential intermediate factors (time studying, truancy, school mobility, school culture, school order, teacher support, and proportion of substance using peers in students’ social networks). Intent-to-treat analysis showed that lottery “winners” (n=694) reported less marijuana misuse than loterry “losers” (n=576), as well as fewer substance using peers, more time studying, less truancy, greater teacher support, more orderly schools, and less school mobility(all p<0.05). Stratified analyses suggest more consistent effects for boys with treatment effects noted as early as 9th grade. This natural experiment provides evidence that school environments can improve risky behaviors for low-income minority adolescents.
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影响因子：
10.7
作者：
Fryer, Roland G., Jr.;Katz, Lawrence F.
通讯作者：
Katz, Lawrence F.
影响因子：
8.2
作者：
Dobbie, Will;Fryer, Roland G., Jr.
通讯作者：
Fryer, Roland G., Jr.
影响因子：
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作者：
Flay, BR;Graumlich, S;Holliday, MY
通讯作者：
Holliday, MY
影响因子：
7.6
作者：
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通讯作者：
Jacobson, Kristen C.
影响因子：
2.2
作者：
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通讯作者：
Giles, Wayne