My Life - I Decide: A Health Promoting School Intervention to Promote Physical and Mental Health and Well-being Among Danish 10th Grade Students.
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 500
- 试验地点
- 1
- 主要终点
- Social-emotional competence
研究概览
简要总结
Background
The proportion of young people experiencing poor mental health and well-being is increasing, placing this group at high risk of not completing secondary education. Educational attainment and health status are strongly correlated, underscoring the need for interventions to address this development. Approximately half of Danish 10th grade students report feeling tired of school, while one in four report pressure and low academic confidence. Schools represent a unique setting for health promotion by enhancing social and emotional competencies, emphasizing the necessity of positioning the school as a health-promoting environment for 10th grade students.
In one Danish local community, a teaching component focused on life-skills for 10th grade students has been developed and tested over several years. Positive outcomes have been reported, although the experiences also revealed a need for organizational and structural changes to support implementation and enhance impact. Research supports such approaches, recommending whole-school interventions that emphasize health-promoting structures both within the school and in the broader community.
The My Life Initiative
My Life - I Decide is a health-promoting school intervention targeted at 10th grade students in Denmark. The purpose of the My Life research project is to develop and evaluate the processes, effects, and scalability of a health-promoting school intervention aimed at improving physical and positive mental health and school well-being among 10th grade students.
The intervention is based on a health-promoting school approach and incorporates teaching inspired by outdoor-based learning, the life psychological method, action learning, and continuous evaluation and implementation of health-promoting actions at class, school, and community levels.
The health and well-being curriculum consists of 28 lessons delivered over 8-10 weeks. The program focuses on ten life-skills designed to strengthen self.efficacy, social, emotional, and health-related competencies and school well-being. Lessons are delivered by a local community health consultant in close collaboration with one or more 10th grade teachers. This organizational structure has been well-received, as it injects new energy into teaching, strengthens cooperation between schools and local communities, and builds teacher capacity.
Implementation of health-promoting actions at the school and community levels is facilitated through an evidence-based, system-oriented co-creation process. This process involves representatives from schools (teachers, students, and leadership), local community health consultants and coordinators, and civil society actors. The aim is to create health-promoting environments that support students' physical and positive mental health and school well-being through structural and organizational changes.
Collaboration and Research Design
Collaborators include Steno Diabetes Center Copenhagen, the Intersectoral Prevention Laboratory, and ten local communities in the West and South regions. This formalized practice and research collaboration aims to further develop the initiative in a pilot study, followed by an evaluation of its effectiveness using a controlled waitlist design. The project will generate knowledge on how, and under which circumstances, the initiative produces the desired effects, and whether national implementation is feasible.
The intervention project runs for 1.5 years, with research examining impact through a controlled waitlist design involving approximately 26 classes and 500 students. Intervention classes will implement the initiative in 2025/2026, while waitlist classes will implement it in 2026/2027.
Impact will be tracked through electronic student questionnaires administered at three time points: baseline (start of the school year), mid-point (before Christmas), and follow-up (before summer break). A process evaluation will assess implementation, contextual adaptation, and mechanisms of change using interviews, focus groups, observations, and surveys.
Data will be analyzed and reported in scientific articles, with findings addressing the overall research objectives and refining a logic model for the initiative to support implementation in other schools.
详细描述
Background
Low mental health and well-being increase the risk of not completing secondary education. Almost every tenth young person in Denmark reports low mental health and well-being, and from 1984-2018, mental health, well-being, and self-reported health have decreased among 15-year-olds. Data from the Danish Health Behavior in School Children Survey 2018 reported that among 15-year-old students, 11% of boys and 20% of girls had low positive mental health measured by the Warwick-Edinburgh Mental Well-Being Scale. Altogether, these factors call for mental health and well-being interventions among young people, as indicated by the priority areas posed in the common Health Agreement between the Capital Region, local communities, and general practice in Denmark.
In Denmark, students who are not ready to attend secondary education have the option to attend 10th grade before embarking on the next steps in life. However, almost half of 10th grade students have been found to be tired of school, and every fourth student felt pressured by the amount of work in school. In addition, students attending municipal 10th grade schools report lower professional self-confidence compared to students at voluntary boarding schools (efterskole), making municipal 10th grade students in need of support to ensure educational readiness and attainment to progress into secondary education.
Improving health among youth has been shown to have positive effects on educational attainment. Positive mental health among adolescents has been associated with educational attainment in adulthood. Health literacy can be seen as an indicator of later health behavior among youth, as higher health literacy scores among Vocational Education and Training students are associated with lower odds of unhealthy behaviors. Mental health promotion initiatives show strong evidence for using the school setting to strengthen positive mental health, including self-efficacy, mental well-being, and social and emotional skills. Targeting 10th grade students therefore has the potential to increase both positive mental health and educational attainment and progression into secondary education.
Students attending 10th grade expect personal and social development in the form of new life-skills, maturity, extroversion, inclusive class communities, and a varied school day with new forms of learning, activities, and movement. This setting therefore presents an ideal opportunity for health promotion initiatives. The Health Promoting Schools (HPS) framework further advocates for using a whole-school approach, ensuring that different socioecological levels are targeted. Nonetheless, implementing whole-school interventions like the HPS remains challenging, often due to tokenistic rather than authentic implementation. Increasing authentic implementation requires interventions sensitive to school contexts, ensuring that teachers experience interventions as acceptable and feasible. However, knowledge remains limited on how and why school-based interventions work or do not work, underlining the need for research investigating both processes and outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 15 Years 至 19 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Enrolled into a 10th grade class in participating schools
排除标准
- •Ability to read and understand Danish
研究组 & 干预措施
Intervention Schools
The My Life intervention consisting of the four phases of preparation, planning, the health education program and anchoring will be delivered at intervention schools.
干预措施: The My Life intervention (Behavioral)
Control Schools
No intervention will be applied, but according to the wait-list design, the My Life intervention will be implemented in the control schools after follow-up.
结局指标
主要结局
Social-emotional competence
时间窗: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.
Measured using an index developed for fifth-ninth grade students by Nielsen et al. 2015. Item scores are combined into a single index score ranging from 0 to 9, with higher scores indicating stronger social-emotional competence.
Self-efficacy
时间窗: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.
Measured using the validated Self-Efficacy Scale from the Danish cont-ribution to the Health Behaviour in School-aged Children (HBSC) survey. Items are combined into a single total scale score ranging from 2 to 10, with higher scores indicating higher self-efficacy.
Mental well-being
时间窗: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.
Measured using the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), validated in a Danish population (50). Items are summed to create a single total score ranging from 7 to 35, with higher scores reflecting better mental well-being.
Physical health (health literacy)
时间窗: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.
Physical Health was measured using health literacy as both an indicator and determinant of health. We used the validated Danish version of the Health Literacy for School-aged Children (HLSAC) instrument covering five aspects: theoretical knowledge, practical knowledge, critical thinking, self-awareness, and citizenship. The HLSAC is a validated 10-item instrument assessing health literacy among children and adolescents. Each item is rated on a 4-point Likert scale (1 = Not at all true, 4 = Absolutely true). Items are summed to create a single total score ranging from 10 to 40, with higher scores indicating higher health literacy.
Positive student interpersonal relations
时间窗: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.
Measured using a five-item student support scale from the HBSC study. Items are summed to create a single total score ranging from 5 to 25, with higher scores indicating stronger perceived support from peers.
Positive student-teacher relations
时间窗: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.
Measured using a three-item teacher relatedness scale from the HBSC study. Items are summed to create a single total score ranging from 3 to 15, with higher scores indicating greater perceived support from teachers. Both the student support and teacher relatedness scales have demonstrated adequate validity and reliability in samples of 13- and 15-year-old students.
School connectedness
时间窗: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.
Measured using a three-item connectedness scale from the HBSC study. The Items are summed to create a single total score ranging from 3 to 15, with higher scores reflecting stronger connectedness to school. The scale has previously shown adequate reliability in a sample of 10- to 12-year-old students.
次要结局
- Physical activity(Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.)
- Social media use(Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.)
- Food literacy(Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.)
- Smoking(Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months after baseline.)
- Nicotine use(Time Frame: Baseline data will be collected at the earliest 1-2 weeks after class formation and prior to the health education program; mid-intervention (Time 1) approximately 2-3 months after baseline; and follow-up (Time 2) approximately 7-8 months afte)
研究者
Charlotte Demant Klinker
Senior Researcher and Research Group Leader
Steno Diabetes Center Copenhagen