title: Does school ethos explain the relationship between value-added education and teenage substance use? A cohort study.
abstract: Previous studies found lower substance use in schools achieving better examination and truancy results than expected, given their pupil populations (high value-added schools). This study examines whether these findings are replicated in West Scotland and whether school ethos indicators focussing on pupils' perceptions of schooling (environment, involvement, engagement and teacher-pupil relations) mediate the associations. Teenagers from forty-one schools (S2, aged 13, n = 2268; S4, aged 15, n = 2096) previously surveyed in primary school (aged 11, n = 2482) were surveyed in the late 1990s. School value-added scores were derived from standardised residuals of two regression equations separately predicting from pupils' socio-demographic characteristics (1) proportions of pupils passing five Scottish Standard Grade Examinations, and (2) half-day truancy loss. Outcomes were current smoking, monthly drinking, ever illicit drug use. Random effects logistic regression models adjusted for potential pupil-level confounders were used to assess (1) associations between substance use and school-level value-added scores and (2) whether these associations were mediated by pupils' perceptions of schooling or other school-level factors (school roll, religious denomination and mean aggregated school-level ethos scores). Against expectations, value-added education was positively associated with smoking (Odds Ratios [95% confidence intervals] for one standard deviation increase in value-added scores were 1.28 [1.02-1.61] in S2 and 1.13 [1.00-1.27] in S4) and positively but weakly and non-significantly associated with drinking and drug use. Engagement and positive teacher-pupil relations were strongly and negatively associated with all substance use outcomes at both ages. Other school-level factors appeared weakly and largely non-significantly related to substance use. Value-added scores were unrelated to school ethos measures and no ethos measure mediated associations between value-added education and substance use. We conclude that substance use in Scotland is more likely in high value-added schools, among disengaged students and those with poorer student-teacher relationships. Understanding the underpinning mechanisms is a potentially important public health concern.
authors.affiliation: School of Health and Social Studies, University of Warwick, Coventry CV4 7AL, UK. Wolfgang.Markham@warwick.ac.uk
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Markham
authors.forename: Robert
authors.initials: R
authors.lastname: Young
authors.forename: Helen
authors.initials: H
authors.lastname: Sweeting
authors.forename: Patrick
authors.initials: P
authors.lastname: West
authors.forename: Paul
authors.initials: P
authors.lastname: Aveyard
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D004522:Educational Status; D006266:Health Education / Q000941:ethics*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D015995:Prevalence; D025341:Principal Component Analysis; D012307:Risk Factors; D012572:School Health Services / Q000941:ethics*; D012574:Schools / Q000941:ethics*; D012606:Scotland / Q000453:epidemiology; D013334:Students; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires