School climate
Conditions
Interventions
1. The intervention is a multicomponent whole-school programme aimed at improving school climate and adolescent mental health. It is implemented collaboratively with students and school staff under th
active involvement in improving the school environment through participatory activities. The individual approach aims to facilitate appropriate support for students experiencing difficulties by linki
views, and share information, the following activities may be implemented under the support of the coordinator as needed: - Establishment of mechanisms to collect students'
opinions and suggestions - School-wide surveys to gather students'
views - Communication of activities and progress - Dissemination of information through posters and other materials - Presentations at school assemblies and other events
(Continued) 4. Opportu
participation will be encouraged as needed to support the implementation of activities described in secti
Sponsors
Tokyo Metropolitan Institute of Medical Science
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Participants will be first-year students in Japanese public junior high schools and senior high schools. As this study implements the intervention at the school level, participating schools will first be recruited. Eligibility criteria for schools are public junior high schools or public senior high schools. Randomisation Once candidate schools are identified, allocation to intervention or control groups will be conducted using a computer-generated random sequence. Stratified randomisation will be applied to balance school characteristics (e.g., school type and region). The allocation ratio will be 1:1. Randomisation will be conducted by a researcher who is not involved in the implementation of the intervention or outcome assessment, and the allocation will be communicated to the participating schools. Allocation concealment is not applicable in this study, as it is a whole-school intervention implemented at the school level. Schools and teaching staff need to be aware of the allocation in order to implement the intervention. However, after allocation at the school level, an approximately one-year embedding phase will be conducted to allow schools to understand and fully implement the intervention. Outcome evaluation will be conducted using data from all first-year students newly enrolled in the following academic year who were not exposed to the intervention during the embedding phase. This design ensures that participants included in the evaluation are not exposed to the intervention at the time of allocation and are assessed without being influenced by allocation status. This type of embedding phase is essential for implementing complex whole-school interventions (Shinde et al., 2018). Shinde et al., Lancet, 2019;392(10163):2465-77
Exclusion criteria
Exclusion criteria: None.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Adolescents' perceived school climate will be assessed using the Japanese version of the Beyond Blue School Climate Questionnaire (BBSCQ) (Shinde et al., 2019; Sasaki et al., in preparation). The response scale of the BBSCQ will be modified from a two-point to a six-point scale. The primary outcomes will be the BBSCQ total score and its subscale scores at the end of the eight-month intervention. Follow-up assessments at 12 and 20 months after the intervention will also be conducted and used as follow-up outcomes. Shinde et al., Lancet, 2019;392(10163):2465-77 | — |
Secondary
| Measure | Time frame |
|---|---|
| We will assess well-being, depressive symptoms, loneliness, problematic internet use, bullying victimisation, interpersonal trust, anger management, and the number of trusted adults at school using a self-report questionnaire. Data on school absenteeism (number of days absent) will be obtained from participating schools. For school absenteeism, the outcome will be the total number of days absent during the intervention period, while all other outcomes will be assessed using scores at the end of the eight-month intervention. The same assessments will also be conducted at 12 and 20 months after the intervention, and scores at each time point will be treated as secondary outcomes. Well-being and depressive symptoms will be assessed using the WHO-5 (Awata et al., 2007) and the Short Mood and Feelings Questionnaire (SMFQ) (Angold et al., 1995). Loneliness will be assessed using a single SMFQ item ("I felt lonely"). Problematic internet use will be assessed using the CIUS (Meerkerk et al., 2009). Bullying victimisation will be assessed using an adapted version of the OBVQ-R (Gaete et al., 2021). Interpersonal trust will be assessed using a single item ("Most people can be trusted") (Tsomokos et al., 2024). Anger management will be assessed using a single SDQ item ("I get very angry and often lose my temper.") (Goodman, 1997). The number of trusted adults at school will be assessed using a single item ("There are adults at school I can talk to easily"). School absenteeism will be treated as an exploratory outcome. In addition, fidelity assessments will be conducted to evaluate the extent to which interventions are implemented according to the current protocol. Awata et al., Int Psychogeriatr, 2007;19:77-88 Angold et al., Int J Methods Psychiatr Res, 1995;5:237-49 Meerkerk et al., Cyberpsychol Behav, 2009;12(1):1-6 Gaete et al., Front Psychol 2021;12:578661 Tsomokos et al., Nat Ment Health, 2024;2:328-36 Goodman R., J Child | — |
Countries
Japan
Contacts
Public ContactSatoshi Yamaguchi
Tokyo Metropolitan Institute of Medical Science Research Center for Social Science & Medicine
Outcome results
None listed