title: Replication of a whole school ethos-changing intervention: different context, similar effects, additional insights.
abstract: BACKGROUND
  Whole school, ethos-changing interventions reduce risk behaviours in middle adolescence, more than curriculum-based approaches. Effects on older ages are not known. We set out to replicate one of these interventions, Australia's Gatehouse Project, in a rural Canadian high school.
  
  
  METHODS
  A guided, whole school change process sought to make students feel more safe, connected, and valued by: changes in teaching practices, orientation processes, professional development of staff, recognition and reward mechanisms, elevating student voice, and strategies to involve greater proactivity and participation. We conducted risk behaviour surveys in grades 10 to 12 before the intervention and 2 years afterwards, and social network analyses with the staff. Changes in health and health risk behaviours were assessed using chi-square. Interactions between the intervention and gender and between the intervention and school engagement were assessed using interaction terms in logistic regression models. Changes in the density of relationships among staff were tested with methods analogous to paired t-tests.
  
  
  RESULTS
  Like Gatehouse, there was no statistically significant reduction in depressive symptoms or bullying, though the trend was in that direction. Among girls, there was a statistically significant decrease in low school engagement (45% relative reduction), and decreases in drinking (46% relative reduction), unprotected sex (61% relative reduction) and poor health (relative reduction of 73%). The reduction in drinking matched the national trend. Reductions in unprotected sex and poor health went against the national trend. We found no statistically significant changes for boys. The effects coincided with statistically significant increases in the densities of staff networks, indicating that part of the mechanism may be through relationships at school.
  
  
  CONCLUSIONS
  A non-specific, risk protective intervention in the social environment of the school had a significant impact on a cluster of risk behaviours for girls. Results were remarkably like reports from similar school environment interventions elsewhere, albeit with different behaviours being affected. It may be that this type of intervention activates change processes that interact highly with context, impacting different risks differently, according to the prevalence, salience and distribution of the risk and the interconnectivity of relationships between staff and students. This requires further exploration.
authors.affiliation: O'Brien Institute of Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4N6, Canada. penny.hawe@sydney.edu.au.|The Australian Prevention Partnership Centre and Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, 2006, Australia. penny.hawe@sydney.edu.au.
authors.forename: Penelope
authors.initials: P
authors.lastname: Hawe
authors.affiliation: Centre for Excellence in Intervention and Prevention Science, 15-30 Pelham Street, Carlton, VIC, 3053, Australia. lyndalbond@ceips.org.au.
authors.forename: Lyndal
authors.initials: L
authors.lastname: Bond
authors.affiliation: The Ability Hub, 3rd Floor, 3820-24th Ave NW, Calgary, AB, T3B 2X9, Canada. lghali@theabilityhub.org.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Ghali
authors.affiliation: O'Brien Institute of Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4N6, Canada. perryr@ucalgary.ca.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Perry
authors.affiliation: Department of Public Health Sciences, Queens University, Carruthers Hall, Office 203, 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, Canada. davisonc@queensu.ca.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Davison
authors.affiliation: Alberta Health Services, Centre 15, 1509 Centre Street SW, Calgary, AB, T2G 2E6, Canada. David.Casey@albertahealthservices.ca.
authors.forename: David M
authors.initials: DM
authors.lastname: Casey
authors.affiliation: Faculty of Education and Arts, Melbourne Campus (St Patricks), Australian Catholic University, Mary Glowrey Building, 115 Victoria Parade, Fitzroy, VIC, 3065, Australia. Helen.Butler@acu.edu.au.
authors.forename: Helen
authors.initials: H
authors.lastname: Butler
authors.affiliation: Department of Marketing and Management, Macquarie University, Sydney, NSW, 2109, Australia. Cynthia.Webster@mq.edu.au.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Webster
authors.affiliation: Brooks Composite High School, Box 849, 650 - 4th Avenue, Brooks, AB, T1R 0Z4, Canada. Bert.Scholz@grasslands.ab.ca.
authors.forename: Bert
authors.initials: B
authors.lastname: Scholz
mesh_terms: D000293:Adolescent; D058445:Bullying; D002170:Canada / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D040242:Risk Reduction Behavior; D012424:Rural Population; D012572:School Health Services; D011795:Surveys and Questionnaires