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American Academy of Pediatrics
Review Article

The Effect of the School Environment on the Emotional Health of Adolescents: A Systematic Review

Judi Kidger, Ricardo Araya, Jenny Donovan and David Gunnell
Pediatrics May 2012, 129 (5) 925-949; DOI: https://doi.org/10.1542/peds.2011-2248
Judi Kidger
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Ricardo Araya
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Jenny Donovan
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David Gunnell
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Abstract

BACKGROUND AND OBJECTIVES: The evidence base for the importance of the school environment for adolescent emotional health has never been systematically reviewed. We aimed to synthesize the evidence for the effect on adolescent emotional health of (1) interventions targeting the school environment and (2) the school environment in cohort studies.

METHODS: Searches of Medline, Embase, PsychINFO, CINAHL, ERIC, the Social Citation Index, and the gray literature were conducted. Criteria for inclusion were (1) cohort or controlled trial designs, (2) participants aged 11 to 18 years, (3) emotional health outcomes, and (4) school environment exposure or intervention. Relevant studies were retrieved and data extracted by 2 independent reviewers.

RESULTS: Nine papers reporting 5 controlled trials were reviewed, along with 30 cohort papers reporting 23 studies. Two nonrandomized trials found some evidence that a supportive school environment improved student emotional health, but 3 randomized controlled trials did not. Six (20%) cohort papers examined school-level factors but found no effect. There was some evidence that individual perceptions of school connectedness and teacher support predict future emotional health. Multilevel studies showed school effects were smaller than individual-level effects. Methodological shortcomings were common.

CONCLUSIONS: There is limited evidence that the school environment has a major influence on adolescent mental health, although student perceptions of teacher support and school connectedness are associated with better emotional health. More studies measuring school-level factors are needed. Randomized controlled trials evaluating 1 or 2 environmental components may have more success in establishing effective and feasible interventions compared with complex whole-school programs.

  • adolescence
  • school environment
  • emotional health
  • depression
  • mental health
  • Abbreviations:
    CI —
    confidence interval
    OR —
    odds ratio
    RCT —
    randomized controlled trial
    SEAL —
    Social and Emotional Aspects of Learning
    STEP —
    School Transitional Environment Project
    • Accepted December 22, 2011.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 129, Issue 5
    1 May 2012
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    The Effect of the School Environment on the Emotional Health of Adolescents: A Systematic Review
    Judi Kidger, Ricardo Araya, Jenny Donovan, David Gunnell
    Pediatrics May 2012, 129 (5) 925-949; DOI: 10.1542/peds.2011-2248

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    The Effect of the School Environment on the Emotional Health of Adolescents: A Systematic Review
    Judi Kidger, Ricardo Araya, Jenny Donovan, David Gunnell
    Pediatrics May 2012, 129 (5) 925-949; DOI: 10.1542/peds.2011-2248
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