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The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health Prepared for: Smith Anniversary Conference Improving the Odds
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The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Dec 26, 2015

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Page 1: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

The Power of Schools to Improve Outcomes for Teens

Robert Wm. Blum, MD, MPH, PhDWilliam H. Gates Sr. Professor and Chair

Department of Population, Family and Reproductive Health

Johns Hopkins Bloomberg School of Public Health

Prepared for:

Smith Anniversary Conference

University of Arizona

21 October 2008

Improving the Odds

Page 2: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Young people who are connected to school not

only do better academically but are less involved with

every risk behavior studied.

Page 3: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Methods

n The National Longitudinal Study of Adolescent Health

s A stratified random sample of 80 high schools with primary feeder schools

s N=134 schools (127 participated in school survey)

s N=71,515 students in 7th through 12th grade

s N=127 school administrator surveys

The Sample

Page 4: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Add-Health Sample Add-Health Sample DesignDesign 129 Schools

(79%)90,118(75.6%)

• Saturation• High income African American• Twins• Disability

N=15,243

In-SchoolSample(1994)

In-HomeSamples(1995)

Special

CoreIn-school survey &

school rosters

Wave 1(1994-5)

TeenN=14,738

Wave 2(1996)

TeenN=12,105(79.5%)

ParentN=10,471(86.5%)

Young AdultsN=15,197

Wave 3(2001-2)

AdultsWave 4(2007-8)

PartnersN=1507

Page 5: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Methods

n Ethnicitys Black 15.0%s Latino 12.2%s White 72.8%

n Genders Female 51.8%s Male 49.2%

The Sample (continued)

Page 6: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Substance Use

-0.5

0

0.5

1

1.5

Not at All Very Little Somewhat Quite a Bit A Lot

AlcoholCigarettesMarijuana

Levels of connectedness

Students who feel connected to school are less likely to use substances

Frequency of Use:

Lev

el o

f S

ub

sta

nce

Use

(S

D U

nit

s)

Page 7: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Emotional Distress

-0.5

0

0.5

1

1.5

Not at All Very Little Somewhat Quite a Bit A Lot

EmotionalDistress

Suicide

Students who feel connected to school experience less emotional distress

Levels of connectedness

Lev

el o

f E

mo

tio

nal

Dis

tres

s (

SD

Un

its)

Page 8: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Violence or Deviant Behavior

-0.5

0

0.5

1

Not at All Very Little Somewhat Quite a Bit A Lot

DeviantBehavior

Violence

Students who feel connected to school engage In less violent or deviant behavior

Levels of connectedness

Lev

el o

f V

iole

nce

or

De

via

nt

Beh

avio

r (S

D U

nit

s)

Page 9: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Pregnancy

12

14

16

18

20

22

24

Not at All Very Little Somewhat Quite a Bit A Lot

Students who feel connected to school are less likely to become pregnant

Levels of connectedness

Per

cent

eve

r P

regn

ant

Page 10: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Research Questions

n What contributes to teens feeling connected to school?

n Why do some adolescents feel attached to school and others don’t?

n What school characteristics predict connectedness?

n What impact do friendships have on a young person feeling connectedness to school?

Page 11: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Methods

n Size 42 to 5422 (average=642)

n Public 82.7%n Class size 10 to 39 (average=23)

n Locations Rural 18.6%s Suburban 59.6%s Urban 21.8%

School Characteristics

Page 12: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Methods

Master’s degree 42%

1st year teachers 9%

Teacher Characteristics

Page 13: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

n Out of school suspension for smoking

n Out of school suspension for cheating

n 10 item scale (alpha=.78) for disciplinary policy of school for:

ScalesDiscipline Policies

Possessing alcoholDrinking alcoholPossessing an illegal substanceUsing an illegal substance

Destroying school propertyVerbally abusing a teacherFightingInjuring a teacherInjuring another studentCarrying a weapon

Page 14: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

n Getting along with teachersn Getting along with other studentsn Paying attention in schooln Getting homework done

ScalesClassroom Management8 items: alpha = .83

Page 15: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

n I feel close to people at this schooln I am happy to be at this schooln I feel like I am part of this schooln The teachers at this school treat

students fairlyn I feel safe in this school

Scales

School Connectedness

Page 16: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

n School size mattered…classroom size did not

n School type is not associated with connectedness

…public, private, parochialn Location of school is not associated

with connectedness…urban, suburban, rural

ResultsFactors Associated with School Connectedness

THE SCHOOL

Page 17: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

n No single school policy was associated with connectedness …

n … A climate of harsh discipline is associated with lower school connectedness

n The directionality of the relationship cannot be deduced from the present study

ResultsFactors Associated with School Connectedness

SCHOOL POLICIES

Page 18: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

n Teacher experience was not associated with connectedness.

n Having a master’s degree was not associated with connectedness.

ResultsFactors Associated with School Connectedness

TEACHERS

Page 19: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

The single strongest association with

connectedness was school climate

ResultsFactors Associated with School Connectedness

SCHOOL CLIMATE & CLASSROOM MANAGEMENT

Page 20: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Initiated Cigarette Use Predicted Percent at Three Levels of

Teacher Support

16.5

14.3

12.2

5.33.8

2.80

2

4

6

8

10

12

14

16

18

None to Occasional None to Regular

- 1 s.d.Mean+ 1 s.d.

Multinomial logit models adjusted for social belonging, race/ethnicity, income, gender, family structure, emotional distress, relationship with parents, hx of peer suicide, hx of family suicide

Page 21: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Initiated Getting DrunkPredicted Percent Three Levels of

Teacher Support

0

2

4

6

8

10

12

14

16

18

None to Occasional None to Regular

- 1 s.d.Mean+ 1 s.d.6.2

11.3

9.5

4.53.2

13.4

Multinomial logit models adjusted for social belonging, race/ethnicity, income, gender, family structure, emotional distress, relationship with parents, hx of peer suicide, hx of family suicide

Page 22: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Initiated Marijuana Use Predicted Percent at Three Levels of

Teacher Support

0

2

4

6

8

10

12

14

16

18

None to Occasional None to Regular

- 1 s.d.Mean+ 1 s.d.

4.4

6.34.7

3.4 2.6

8.3

Multinomial logit models adjusted for social belonging, race/ethnicity, income, gender, family structure, emotional distress, relationship with parents, hx of peer suicide, hx of family suicide

Page 23: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Seriously Considered or Attempted Suicide

Predicted Percent at Three Levels of Teacher Support

0

2

4

6

8

10

12

14

16

18

None to Ideation None to Attempt

- 1 s.d.Mean+ 1 s.d.

2.2

5.0 4.5

1.7 1.3

5.5

Multinomial logit models adjusted for social belonging, race/ethnicity, income, gender, family structure, emotional distress, relationship with parents, hx of peer suicide, hx of family suicide

Page 24: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Initiated Violence Predicted Percent at Three Levels of

Teacher Support

0

2

4

6

8

10

12

14

16

18

- 1 s.d.Mean+ 1 s.d.7.5

6.04.7

Multinomial logit models adjusted for social belonging, race/ethnicity, income, gender, family structure, emotional distress, relationship with parents, hx of peer suicide, hx of family suicide

Page 25: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Family Engagement and School leaving: what are the effects over time?

Page 26: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

CONCEPTUAL MODEL

Wave 1Early Adolescence:Ages 12-14

Wave 2Early to Middle Adolescence: Ages 13-16

Wave 3Emerging Adulthood:Ages 18-21

Family Closeness

Parental Behavioral Control

Skipping School Dropping out of School

Page 27: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Measures: ParentingFamily closeness in early adolescence

5-item measure of youth report that s/he has fun with family; family pays attention to youth; cares for youth; understands youth; how much youth felt like leaving home (α = .76)

Response categories: 1 = not at all; 5 = very much

Mean= 4.2 (.02)

Page 28: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Measures: ParentingParental behavioral control in early adolescence

Seven items measuring whether or not youth decides: what wears; who hangs out with; TV amount & programs watch; time home on weekends; time to bed during week; what eats.

Response categories: 0 = no; 1 = yes. Reverse coded.

Page 29: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Measures: ParentingParental behavioral control

3 Classes:

37% “High” - Parent decides many things

(reference group)

30% “Moderate” – Parent decides curfews and inside activities (eat, TV programs, time to bed)

32% “Low” – Parent decides curfews

Page 30: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

HOW WERE FAMILY CLOSENESS AND PARENTAL BEHAVIORAL CONTROL OPERATIONALIZED

My Family Cares for Me

Parent decides what child eats, who child hangs with and what child wears

Parent decides what TV programs child watches and time child goes to bed on week-night

Parent decides amount of TV child watches and what time child comes home on weekend

My Family Pays Attention to Me

I Have Fun with My Family

My Family Understands MeFamily Closeness

Parental Behavioral

Control

.42***

.72***

.72***

.78***

.57***

.46***

.43***

.11**

Page 31: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

Measures: Youth OutcomesSchool engagement

Time 1 & Time 2: Skipped school past year

Time 3: Highest education completed 10 years or less

Proportion youth skipping school:

14% (T1) & 18% (T2)

Proportion youth dropping out: 7%

Page 32: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

0

0.5

1

1.5

2

2.5

3

3.5

+1 SD 0 -1 SD

Od

ds

of

Sc

ho

ol

Dro

po

ut

Family Closeness

Odds of School Dropout by Family Closeness and Skipping School during Early

Adolescence

No Early Skipping School

Early School Leaving

Page 33: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

SCHOOL DROPOUT: MALE

Family ClosenessAges 12-14

Parental Behavioral Control

Ages 12-14

Skipped School in the Past Year

Ages 13-16

School DropoutAges 18-21

-.10*

-.01 (.05)

.16***

.01 (.003)

.06

Page 34: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

SCHOOL DROPOUT: FEMALE

Family ClosenessAges 12-14

Parental Behavioral Control

Ages 12-14

Skipped School in the Past Year

Ages 13-16

School DropoutAges 18-21

-.19***

-.08 (-.12**)

.21***

.10 (.01)

.004

Page 35: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

ConclusionThe present report suggests that

school climate and adult

connections as well as

family connectedness may

impact

health as well as educational outcomes.

Page 36: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

1. Be a model of respectful, cooperative, positive behavior in your everyday interactions.

2. Participate in school events.

3. Show interest. Be involved in your child’s academic activities.

4. Maintain regular contact with your

child’s teacher.

ParentsTen Strategies that Foster Connections to School

Page 37: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

5. Monitor your child’s homework completion and work with him or her on homework assignments that involve family participation.

6. Be present when things go wrong.

7. Meet your child’s friend, and their parents.

ParentsTen Strategies that Foster Connections to School

Page 38: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

8. Ask school leaders what you can do to support them.

9. Volunteer at school.

10. Nominate effective school leaders for local awards.

ParentsTen Strategies that Foster Connections to School

Page 39: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

1. Help students get to know each other’s (and your) strengths.

2. Involve students in planning, problem solving, identifying issues and assessing curriculum in the classroom.

3. Promote cooperation over competition. Post everyone’s best work. Offer opportunities for the class to work together to help everyone achieve their level of excellence.

TeachersTen Strategies that Foster Connections to School

Page 40: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

4. Build a strong relationship with each student.

5. Convey attentiveness to students and excitement about learning through nonverbal gestures.

6. Involve all students in chores and responsibilities in the classroom.

7. Integrate concepts of discipline and respect for classmates through instruction.

TeachersTen Strategies that Foster Connections to School

Page 41: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

8. Give students more say in what they will learn.

9. Involve students in developing the criteria by which their work will be assessed and provide guidelines so they clearly understand what’s expected of them.

10. Use first person plural (we, us, let’s) when presenting classroom activities.

TeachersTen Strategies that Foster Connections to School

Page 42: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

1. Brainstorm with students, faculty, staff and parents simple changes that could make school a more pleasant place to be.

2. Create policies that are based on student, family and neighborhood strengths and assets.

3. Turn mistakes into learning opportunities rather than failures meriting punishment.

AdministratorsTen Strategies that Foster Connections to School

Page 43: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

4. Acknowledge and honor accomplishments and all types of competencies (such as helpfulness, good citizenship, most improved performance, volunteerism, participation in decision making, and cessation of negative behavior).

5. Set high standards and challenge students to meet them.

6. Reinforce explicit expectations for positive behavior and academic success.

AdministratorsTen Strategies that Foster Connections to School

Page 44: The Power of Schools to Improve Outcomes for Teens Robert Wm. Blum, MD, MPH, PhD William H. Gates Sr. Professor and Chair Department of Population, Family.

7. Encourage highly interactive teaching strategies.

8. Create a welcoming environment for all who come to the school.

9. Invite family and community members to take active and regular roles in the daily operation of the school.

10. Create a common vision of success and keep it visible.

AdministratorsTen Strategies that Foster Connections to School