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    • Alternatively the notion of peer contagion effects Cohen Pri

    2018-11-07

    Alternatively, the notion of peer contagion effects (Cohen & Prinstein, 2006; Dishion & Tipsord, 2011) and social mimicry (Moffitt, 1993) place emphasis on the compositional elements of the school environment using socialisation processes to explain similarity in behaviours. Peer contagion effects suggests that students influence each other׳s behaviours and emotions, such that deviant behaviours and emotional problems are transmitted from one student to another. The transmission of behaviours is an unintended consequence of social relationships (Cohen & Prinstein, 2006; Dishion & Tipsord, 2011). A related but distinct (S)-Crizotinib is that of social mimicry, which argues that behaviours are explained through the desire for social acceptance and esteem (Moffitt, 1993). A number of school factors have repeatedly been shown to protect against unhealthy behaviour and poor mental health, particularly school connectedness or more broadly aspects of the school ‘culture’ and ethos (Bonell et al., 2013a, 2013b; Viner et al., 2012). Several systematic reviews of school based interventions show the potential for schools to influence a wide range of student health and behavioural outcomes, including nutrition and activity, substance use, sexual health behaviours, and violence related outcomes (Bonell et al., 2013b; Fletcher, Bonell, & Hargreaves, 2008; Foxcroft & Tsertsvadze, 2011; Langford et al., 2014; Sellström & Bremberg, 2006). School based interventions that address the school environment are effective at changing student health behaviours (Fletcher et al., 2008; Foxcroft & Tsertsvadze, 2011; Langford et al., 2014). Higher ICCs for specific behaviours could suggest that school-level interventions are more effective in changing those behaviours, as a higher proportion of variance at the school-level suggests that the outcome is predicted by characteristics of the school as well as characteristics of the student. Although, this is only true if the ICC is not a reflection of selection effects into schools (Macintyre et al., 2002). A serious limitation of the current literature on the effectiveness of school level interventions is a reliance on evidence from the US (Bonell et al., 2013a; Fletcher et al., 2008; Foxcroft & Tsertsvadze, 2011). There is a clear need for interventions from other countries to contribute to the evidence on school-based interventions. In Haplotype paper we use data from the 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD) (Hibell et al., 2009) to provide plausible country-specific estimates of ICCs for a range of adolescent health outcomes in 21 European countries. We test the proportion of variance at the school level in several key health outcomes, including substance use (licit and illicit) and psychosocial wellbeing (depressive mood, self-esteem), where the data are available. We also compare the estimates across countries to determine the extent of differences among countries.
    Methods
    Results Table 1 breaks down the number of observations for every possible clustering unit. There were between 36 (Denmark) and 531 (Portugal) schools per country, with an average of between 5.92 (Portugal) and 119.62 (Cyprus) students observed within each school. Across all included countries the Cronbach׳s alpha value for the CES-D was 0.82, with an average inter-item correlation of 0.43. The Cronbach׳s alpha value for self esteem was 0.82, with an average inter-item correlation of 0.31. The country level prevalence and means of outcomes are shown in Table 2, which also indicates where countries did not provide data on an outcome. On average across all countries 60% of students had ever tried alcohol, 19% had on at least 6 occasions in the last 30 days, and 43% had drank 5 or more drinks on a single occasion in the last 30 days, 27% had ever tried a cigarette, 17% smoked at least one cigarette per day over the last 30 days, and 9% had ever tried cannabis, ecstasy or inhalants. The depressive mood scale ranged from 0 to 18 with a mean of 5.11 (SD=3.89). Country level mean depressive mood scores ranged from 3.65 in Iceland to 6.30 in Armenia. The self-esteem scale ranged from 0 to 30 with a mean of 19.54 (SD=5.15). Country level mean self-esteem scores ranged from 17.07 in Slovakia through to 21.31 in Iceland.