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Moving Policy Upstream to Advance Adolescent Flourishing Rapid Evidence Review:Appendices

September 30, 2019

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Rapid Evidence Review Appendix 1: Key Definitions

Table of Contents

Rapid Evidence Review Appendix 1: Key Definitions .......................................................................................................................................................3

Rapid Evidence Review Appendix 2: Methods .................................................................................................................................................................10

Rapid Evidence Review Appendix 3: Narrative Summary of Findings ........................................................................................................................20

Rapid Evidence Review Appendix 4: Findings by Outcome ..........................................................................................................................................31

Rapid Evidence Review Appendix 5: Evidence Tables ....................................................................................................................................................54

Rapid Evidence Review Appendix 6: Excluded Reviews ..............................................................................................................................................124

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Rapid Evidence Review Appendix 1: Key Definitions

Moving Policy Upstream to Advance Adolescent Flourishing

Rapid Evidence Review Appendix 1: Key Definitions

D. Dougherty, N. LeBlanc, P. Armstrong, E. Cope, and the AcademyHealth & ACT for Health Team

With support from Well Being Trust

September 30, 2019

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Rapid Evidence Review Appendix 1: Key Definitions

Key Definitions

Active School Travel/Transport. Non-motorized personal mobility (e.g., walking, cycling) to and from school.1

Cognitive Autonomy. Cognitive autonomy includes the ability to assess one’s thinking process and to make logical deductions, express one’s stance, create and consider different alternative and their outcomes, conduct validating comparisons, and self-evaluative and self-reflection skills. Thus, cognitive autonomy and self-efficacy tap complimentary self-beliefs and thinking skills that are integral to decision making processes.2

Cognitive Behavioral Therapy (CBT). The key focus of CBT is on how individuals perceive and interpret meaning in their daily lives and often involves working to modify unhelpful or dysfunctional thoughts and behaviors through a variety of methods.3

Community. Communities are aggregates of people who form a loosely cohesive association within a residential space or district; they represent a subpopulation of a larger unit such as a city, or they can be indigenous and ethnic groups that may not reside in immediate residential proximity but possess a common community identity.4

Community Coalitions. Community coalitions are one strategy in the wider range of community‐based co‐operative programs that involve community members in programs to improve population health (e.g. community‐based participatory research, lay community health workers, advisory boards that include community members). Specifically, community coalitions are conglomerates of citizen groups, public and private organizations, and professions that are characterized by representation from multiple community sectors in bottom‐up planning and decision-making. They operate through partnerships and emphasize using local assets and resources to build community capacity. The focus of a community coalition may vary depending on the sectors of the community involved (e.g. education, public safety, public health).4

Community Infrastructure. The physical places and spaces where people can come together, formally or informally, to interact and par-ticipate in the social life of the community.5

Contemplative Education. Contemplative education is “a set of practices that may foster particular forms of awareness in students, forms conducive to the conscious motivation and regulation of learning, and also to freedom and transcendence in life more generally.”6 Exam-ples include Transcendental Meditation and Mindfulness.

Emotion Regulation (ER). Processes by which individuals respond to, manage, and modify emotional experiences in order to achieve individual goals and meet environmental demands.7

Emotional wellbeing. Emotional well-being involves the presence of positive emotions and satisfaction with life.8 In the early 2000s, Keyes measured emotional wellbeing as answers to how often during the past month teens ages 12 through 17 felt: happy; interested in life; and satisfied.9,10

Exergames. Also known as active (video) games, exergames allow players to perform physical activity over the course of play.11

Flourishing. According to a New Zealand Mental Health Foundation, flourishing as defined in international literature is a state where people experience positive emotions, positive psychological functioning and positive social functioning.12 Keyes posits that a spectrum from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through moderate mental health, through languishing, for 12-17-year-old U.S. adolescents in an early 2000s nationally representative survey.9 Flourishing required an average score of 5 or 6 across items in the domains of emotional, psychological, and social wellbeing. Another definition of flourishing through languishing can be found in the U.S. federally-supported National Survey of Children’s Health (NSCH), via responses to 3 items from parents of 6-17 year-olds.14,15 The items used by Keyes and the NSCH can be found in Appendix 2 of this document.

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Rapid Evidence Review Appendix 1: Key Definitions

Health Promoting Schools. The World Health Organization (WHO) Health Promoting Schools framework is based on an eco- holistic model, recognizing the physical, social, mental, emotional, and environmental dimensions of health and well-being. Three domains rec-ognize different levels of influence upon health - moving from the individual, to the school environment, to the wider community context - and emphasize the need to act upon all three levels in order to successfully influence health.16

Heritage-based interventions. Designing, modifying, and/or delivering historic places or assets as a key element of an activity that has an observed impact on people.17

Intangible Asset. As defined by the What Works Well Being Centre, intangible asset means things like traditional or cultural customs, practice, skills or knowledge.18

Gendered health programs.• Gender-neutral health programs. Health programs that did not incorporate any gender-focused aims or tailored interventions.19

• Gender-sensitive programs. Health programs that recognize the specific needs of their targeted gender in response to socialized gender roles, specifically tailoring program information to that target gender.19

• Gender-transformative programs. Health programs that aim to rework maladaptive gender roles and promote gender equitable relationships.19

Languishing. Languishing is the absence of positive mental health. Languishing individuals are those who are stuck in life, feel empty, and lack interest and engagement. Keyes defined languishing for teens ages 12 through 17 as an average score of 1 or 2 across items in the domains of emotional, psychological, and social wellbeing.9

Life Skills Training. Typically focused on teaching social resistance skills or a set of general life skills either alone or in combination.20

Loneliness.• Emotional loneliness describes the absence or loss of meaningful relationships that meet a deeply felt need to be recognized and ‘be-

long.’21

• Existential loneliness refers to an experience of feeling entirely separate from other people, often when confronted with traumatic experiences or mortality.21

• Social loneliness refers to the perceived lack of quantity as well as quality of relationships.21

Mental health promotion. Actions to create living conditions and environments that support mental health and allow people to adapt and maintain healthy lifestyles.22

Mindfulness. “Paying attention in a particular way: on purpose, in the present moment, nonjudgmentally,”23 or, “self-regulation of atten-tion to the conscious awareness of one’s immediate experiences while adopting an attitude of curiosity, openness, and acceptance.”24

Mindfulness-Based Stress Reduction. An 8-week group intervention that meets once per week for 2.5 h and has one all-day session towards the sixth week. Each session has specific formal mindfulness exercises (e.g., body scan, walking meditation) and encourages informal mindfulness practices outside of session, by bringing mindfulness to daily activities (e.g., showering, eating). Beyond the three mechanisms outlined above (focused attention, decentering, and emotion regulation), specific mechanisms of MBSR also include mindful-ness and self-compassion.25

Moderate mental health. In the flourishing through languishing continuum, individuals who are neither flourishing nor languishing are considered to have moderate mental health.8 Keyes defined moderate mental health for teens ages 12 through 17 as an average score of 3 or 4 across items in the domains of emotional, psychological, and social wellbeing.9

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Rapid Evidence Review Appendix 1: Key Definitions

Moving to Opportunity for Fair Housing Experiment. The MTO experiment randomized participants living in public housing or private assisted housing at baseline into experimental and control groups and provided a housing voucher for experimental group participants to move to neighborhoods with less than 10% of the population below the poverty line.26 The study took place between 1994 and 1997, in five U.S. cities (Boston, MA; Baltimore, MD; Chicago, IL; Los Angeles, CA; New York, NY).

Positive Psychology. The study of the conditions and processes that contribute to the flourishing or optimal functioning of people, groups, and institutions. It has four main categories of focus: positive emotions and their effects on psychological and physical functioning, positive individual traits and their protective role in different physical and psychological disorders, positive interpersonal relationships, and positive institutions.27

Positive Youth Development. PYD programs build skills, assets, and competencies; foster youth agency; build healthy relationships; strengthen the environment; and transform systems to prepare youth for successful adulthood.28

Preventive interventions. Preventive interventions are based on modifying risk exposure and strengthening the coping mechanisms of the individual. Effective interventions require identifying causal risk factors and can target both generic risk factors and disease-specific fac-tors. Most preventive intervention will likely involve a combination of strategies for reducing exposure to risk factors, enhancing protective factors, and targeting putative mediating causal mechanisms such as cognitive schemas. Primary preventive interventions in mental health are those targeting risk factors and promoting mental health in individuals without a clinically diagnosable mental disorder.29

Psychological wellbeing. Psychological well-being comprises aspects of individuals’ psychological functioning (e.g., autonomy and a sense of personal growth).8 The four theoretical domains of psychological wellbeing measured for teens ages 12 through 17 in a U.S. nationally representative survey were environmental mastery, positive relations with others, personal growth, and autonomy.8

Resilience. Most definitions of resilience have the same underlying recognition of the presence of adaptation/coping in response to risk/adversity/challenges. In other words, resilience develops in response to challenges, not in their absence, and the person (or system) can become stronger than before.30 Psychological resilience refers to a person’s capacity to adapt to the challenges of life and maintain mental health despite exposure to adversity.31

School climate. School climate is broadly defined as the values, relationships, practices, and structures that contribute to students’ experi-ences at school and encompasses members’ feelings of physical and emotional safety and the quality of their interpersonal relationships.32

Self-efficacy. Self-efficacy is the belief in one’s capability to organize and execute the courses of action required to produce given attain-ments. Self-efficacy is a key construct within several popular health psychology theories including social cognitive theory, protection motivation theory, transtheoretical model, health action process approach, and perceived behavioral control.33

Self-regulation. A psychological construct which encompasses a range of important competencies, including the capacity for control-ling one’s emotions, the ability to have positive interactions with others, the capacity for avoiding inappropriate or aggressive actions, and the ability to carry out self-directed learning. Cognitive processes contributing to SR are often referred to as executive functions, and they include the ability to direct or focus attention, shift perspective, and adapt flexibly to changes (cognitive flexibility); retain information (working memory); and inhibit automatic or impulsive responses to achieve a goal, such as problem-solving (impulse control).34

Social and Emotional Learning. Social and emotional competence is the ability to understand, manage, and express the social and emo-tional aspects of one’s life in ways that enable the successful management of life in ways that enable the successful management of life tasks such as learning, forming relationships, solving everyday problems, and adapting to the complex demands of growth and development. It includes self-awareness, control of impulsivity, working cooperatively, and caring about oneself and others. Social and emotional learning is the process through which children and adults develop the skills, attitudes, and values necessary to acquire social and emotional compe-tence.35

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Rapid Evidence Review Appendix 1: Key Definitions

Social isolation. The state in which the individual or group expresses a need or desire for contact with others but is unable to make that contact.36

Social wellbeing. Social well-being indicates how well an individual functions in their social life as a member of a larger society (e.g., social integration and social contribution.8 The four theoretical domains of social wellbeing measured for teens ages 12 through 17 in an early 2000s U.S. nationally representative survey were social contribution, social integration (sense of belongingness), social actualization (feel-ing that society is becoming a better place), social acceptance (feeling that people are basically good), and social coherence (feeling that the way our society works makes sense).9

Structural determinants. “All social and political mechanisms that generate … stratification and social class divisions in society and that define individual socioeconomic position within hierarchies of power, prestige and access to resources.” The structural determinants cause and operate through intermediary determinants of health—housing, physical work environment, social support, stress, nutrition and physical activity—to shape health outcomes.37

Youth Participatory Action Research (YPAR). YPAR includes three key principles. First, YPAR is inquiry based; topics of investigation are grounded in youths’ lived experiences and concerns. Second, it is participatory; youth are collaborators in the methodological and pedagogical process. Finally, it is transformative; the purpose of YPAR is to actively intervene in order to change knowledge and prac-tices to improve the lives of youth and their communities. Consistent with these principles, Ozer and Douglas (2015) have identified key processes in YPAR. Youth and adults share power during an iterative process that includes developing an integrated research and action agenda; training in, and application of, research and advocacy methods; practicing and discussing strategic thinking about how to create social change; and building alliances with stakeholders.38

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Endnotes

1. Pang B, Kubacki K, Rundle-Thiele S. Promoting active travel to school: A systematic review. BMC Public Health [Internet]. 2017 Aug 5 [cited 2019 July 26]; 17(1):638. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28779756

2. Margalit D, Ben-Ari A. The Effect of Wilderness Therapy on Adolescents’ Cognitive Autonomy and Self-Efficacy: Results of a Non-Randomized Trial. Child & Youth Care Forum [Internet]. 2014 Apr [cited 2019 Aug 15]; 43(2):181-194. Available from: https://link.springer.com/article/10.1007/s10566-013-9234-x

3. Soulakova B, Kasal A, Butzer B, Winkler P. Meta-Review on the Effective-ness of Classroom-Based Psychological Interventions Aimed at Improving Student Mental Health and Well-Being, and Preventing Mental Illness. The Journal of Primary Prevention [Internet]. 2019 May 28 [cited 2019 Aug 6]; 40(3):255-278. Available from: https://link.springer.com/article/10.1007%2Fs10935-019-00552-5

4. Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner-Brown J, Krause LK. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database of Sys-tematic Reviews [Internet]. 2015 Jun 15 [cited 2019 July 26]. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009905.pub2/full

5. Bagnall A, South J, Di Martino S. 2018, Mar. A systematic review of inter-ventions to boost social relations through improvements in community infrastructure (places and spaces). London: What Works Centre for Wellbe-ing. Available from: https://whatworkswellbeing.org/product/places-spaces-people-and-wellbeing/

6. Waters L, Barsky A, Ridd A, Allen K. Contemplative Education: A Sys-tematic, Evidence-Based Review of the effect of Meditation Interventions in Schools. Educational Psychology Review [Internet]. 2015 Mar [cited 2019 July 26]; 27(1):103-134. Available from: https://link.springer.com/article/10.1007/s10648-014-9258-2

7. Thomas RA. Emotion Regulation: A Theme in Search of Definition. Mono-graphs of the Society for Research in Child Development [Internet]. 1994 Feb [cited 2019 Aug 2]; 59(2-3):25-52. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-5834.1994.tb01276.x Cited By: Morrish L, Rickard N, Chin TC, Vella-Brodrick DA. Emotion Regulation in Ado-lescent Well-Being and Positive Education. Journal of Happiness Studies [Internet]. 2018 June [cited 2019 July 26]; 19(5):1543-1564. Available from: https://link.springer.com/article/10.1007/s10902-017-9881-y

8. Perugini MLL, de la Iglesia G, Solano, AC, Keyes CLM. 2017. The Mental Health Continuum–Short Form (MHC–SF) in the Argentinean context: Confirmatory factor analysis and measurement Invariance. Europe’s Journal of Psychology 13(1), 93–108, doi:10.5964/ejop.v13i1.1163

9. Keyes CLM. Mental health in adolescence: Is America’s youth flourishing? American Journal of Orthopsychiatry [Internet]. 2006 July [cited 2019 June 24]; 76(3):395-402. https://www.ncbi.nlm.nih.gov/pubmed/16981819

10. Keyes CLM. 2005, January. The subjective well-being of America’s Youth: Toward a Comprehensive Assessment. Adolescent & Family Health 4(1):3- 11.

11. Joronen K, Aikasalo A, Suvitie A. Nonphysical effects of exergames on child and adolescent well-being: A comprehensive systematic review. Scandinavian Journal of Caring Sciences [Internet]. 2017 Sep [cited 2019 July 26]; 31(3):449-461. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27862145

12. Mental Health Foundation of New Zealand. Undated. Flourishing, Positive Mental Health and Wellbeing: How can they be increased? https://www.mentalhealth.org.nz/assets/Flourishing/Flourishing-and-Positive-Mental-Health-Dec-2010.pdf

13. Westerhof GJ and Keyes CLM. 2010. Mental Illness and Mental Health: The Two Continua Model Across the Lifespan. J Adult Dev 17:110–119 DOI 10.1007/s10804-009-9082-y

14. The Child & Adolescent Health Measurement Initiative. 2017. 2016 Na-tional Survey of Children’s Health. Available from: http://www.childhealth-data.org/browse/survey/ results?q=4621&r=1&g=609.

15. Bethell CD, Gombojav N, and Whitaker RC. 2019. Family resilience and connection promote flourishing among us children, even amid adversity.Health Affairs 38(5):729-737. doi: 10.1377/hlthaff.2018.05425.

16. Langford R, Bonell CP, Jones HE, Pouliou T, Murphy SM, Waters E, Komro KA, Gibbs LF, Magnus D, Campbell R. The WHO Health Promotion Schools Framework for Improving the Health and Well-Being of Students and their Academic Achievement. Cochrane Database of Systematic Reviews [Internet]. 2014 [cited 2019 Aug 7]; 4:CD008958. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008958.pub2/epdf/full

17. Pennington A, Jones R, Bagnall AM, South J, Corcoran R. Heritage and Wellbeing: The Impact of Historic Places and Assets on Community Well-being - A Scoping Review [Internet]. London (UK): What Works Centre for Wellbeing, Community Wellbeing Evidence Programme. 2019 March [cited 2019 Aug 16]. Available from: https://whatworkswellbeing.org/product/heritage-and-wellbeing-full-scoping-review/

18. How Can Intangible Assets Enhance Wellbeing or Reduce Loneliness? Evidence Call [Internet]. London (UK): What Works Centre for Wellbeing; 2019 July 8 [cited 2019 Aug 7]. Available from: https://whatworkswellbeing.org/call-for-evidence/how-can-intangible-assets-enhance-wellbeing-and-reduce-loneliness-evidence-call/

19. Gwyther K, Swann R, Cassey K, Purcell R, Rice SM. Developing Young Men’s Wellbeing Through Community and School-based Programs: A Systematic Review. PLoS ONE [Internet]. 2019 May 20 [cited 2019 Aug 1]; 14(5):e0216955. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216955

20. Sancassiani F, Pintus E, Holte A, Paulus P, Moro MF, Cossu G, et al. Enhanc-ing the Emotional and Social Skills of the Youth to Promote their Wellbeing and Positive Development: A Systematic Review of Universal School-based Randomized Controlled Trials. Clinical Practice and Epidemiology in Men-tal Health [Internet]. 2015 Feb 26 [cited 2019 July 26]; 11(Suppl 1 M2):21-40. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25834626

21. Mansfield L, Daykin N, Meads C, Tomlinson A, Gray K, Lane J, Victor C. A Conceptual Review of Loneliness Across the Adult Life Course (16+ Years): Synthesis of Qualitative Studies. What Works Centre for Wellbeing [Inter-net]. 2019 July. Available from: https://whatworkswellbeing.org/product/loneliness-conceptual-review/

22. O’Reilly M, Svirydzenka N, Adams S, Dogra N. Review of mental health promotion interventions in schools. Social Psychiatry and Psychiatric Epidemiology [Internet]. 2018 July [cited 2019 July 26]; 53(7):647-662. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29752493

23. Kabat-Zinn J. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New York City (NY): Hachette Books. 1994. 278 p.

24. Bishop S, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, et al. Mindfulness: A Proposed Operational Definition. Clinical Psychology: Sci-ence and Practice [Internet]. 2004 September [cited 2019 Aug 7]; 11(3):230-241. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1093/clipsy.bph077

25. Zoogman S, Goldberg SB, Hoyt WT, Miller L. Mindfulness Interventions with Youth: A Meta-Analysis. Mindfulness [Internet]. 2015 Apr [cited 2019 July 26]; 6(2):290-302. Available from: https://link.springer.com/ar-ticle/10.1007/s12671-013-0260-4

26. Antonakis CL, Coulton CJ, Kaestner R, Lauria M, Porter DE, Colabianchi N. Built Environment Exposures of Adults in the Moving to Opportunity Experiment. Housing Studies [Internet]. 2019 Jun 25 [cited 2019 Aug 7]; (ePub ahead of print). Available from: https://www.tandfonline.com/doi/abs/10.1080/02673037.2019.1630560

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27. Banos, Online Positive Interventions to Promote Well-being and Resilience in the Adolescent Population: A Narrative Review. Frontiers in Psychiatry [Internet]. 2017 Jan 30 [cited 2019 July 26]; 8:10. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28194117

28. Catalano RF, Skinner ML, Alvarado G, Kapungu C, Reavley N, Patton GC, et al.Positive Youth Development Programs in Low- and Middle-Income Countries: A Conceptual Framework and Systematic Review of Efficacy. Journal of Adolescent Health [Internet]. 2019 July [cited 2019 July 26]; 65(1):15-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31010725

29. Arango C, Diaz-Caneja CM, McGorry PD, Rapoport J, Sommer IE, Vorst-man JA, et al. Preventive strategies for mental health. Lancet Psychiatry [Internet]. 2018 July [cited 2019 July 26]; 5(7):591-604. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29773478

30. Khanlou N, Wray R. A Whole Community Approach Toward Child and Youth Resilience Promotion: A Review of Resilience Literature. Interna-tional Journal of Mental Health and Addiction [Internet]. 2014 Jan 15 [cited 2019 Aug 7]; 12:64-79. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913859/pdf/11469_2013_Article_9470.pdf

31. Masten AS. 2018. Resilience Theory and Research on Children and Fami-lies: Past, Present, and Promise. Journal of Family Theory & Review 10:1. https://onlinelibrary.wiley.com/doi/abs/10.1111/jftr.12255

32. Trach J, Lee M, Hymel S. A Social-Ecological Approach to Addressing Emotional and Behavioral Problems in Schools: Focusing on Group Pro-cesses and Social Dynamics. Journal of Emotional and Behavioral Disorders [Internet]. 2018 [cited 2019 Aug 2]; 26(1):11-20. https://journals.sagepub.com/doi/pdf/10.1177/1063426617742346

33. Ashford S, Edmunds J, French DP. What is the best way to change self-efficacy to promote lifestyle and recreational physical activity? A systematic review with meta-analysis. British Journal of Health Psychology [Internet]. 2010 Dec 24 [cited 2019 Aug 16]; 15(2):265-288. Available from: https://onlinelibrary.wiley.com/doi/full/10.1348/135910709X461752

34. Pandey A, Hale D, Das S, Goddings AL, Blakemore SJ, Viner RM. Effective-ness of universal self-regulation-based interventions in children and adoles-cents: A systematic review and meta-analysis. JAMA Pediatrics [Internet]. 2018 Jun 1 [cited 2019 July 26]; 172(6):566-575. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29710097

35. Elias MJ, Zins JE, Weissberg RP, Frey KS, Greenberg MT, Haynes NM, et al. Promoting Social and Emotional Learning: Guidelines for Educators. Alexandria (VA): ASCD. 1997. 164 pp.

36. Carpenito, L.J. (1992). Nursing diagnosis: Application to clinical practice (4th ed). Philadelphia: P.J. Lippincott.

37. Solar O, Irwin A. A Conceptual Framework for Action on the Social Determinants of Health: Social Determinants of Health Discussion Paper 2 (Policy and Practice) [Internet]. Geneva: World Health Organization; 2010 [cited 2019 Aug 7]. Available from: http://nccdh.ca/resources/entry/a-conceptual-framework

38. Anyon et al. 2018. A Systematic Review of Youth Participatory Action Research (YPAR) in the United States: Methodologies, Youth Outcomes, and Future Directions.Health Education & Behavior 45(6) 865–878,citing Rodriguez and Brown, 2009; and Ozer and Douglas, 2015.

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Rapid Evidence Review Appendix 2: Methods

Moving Policy Upstream to Advance Adolescent Flourishing

Rapid Evidence Review Appendix 2: Methods

D. Dougherty, N. LeBlanc, P. Armstrong, E. Cope, and the AcademyHealth & ACT for Health Team

With support from Well Being Trust

September 30, 2019

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Rapid Evidence Review Appendix 2: Methods

Rapid Evidence Review Methods

Overview

The purpose of this Rapid Evidence Review (RER) is to identify interventions and strategies for enhancing the psychological, social, and emotional well-being of high-school-aged teens.1 The project is supported by Well Being Trust, as a component of their development of an overarching framework and strategy for enhancing the psychological, social, emotional, and spiritual wellbeing of the U.S. population. Consistent with the AcademyHealth approach to conducting Rapid Evidence Reviews, we leverage existing systematic reviews of inter-ventions, strategies, and policies, identified by searching for outcomes conceptually related to the definition of psychological, social, and emotional wellbeing, as defined initially by Keyes2 and expanded on through ACT for Health’s previous scoping reviews.3,4

In identifying systematic reviews, we followed PRISMA’s definition of a systematic review as “a review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant research, and to collect and analyze data from the studies that are included in the review.”5

To guide our work, we developed a Rapid Evidence Review Protocol specific to this project, which was reviewed in draft by 2 Key Expert Reviewers6 and members of the project’s National Expert Panel.7

Concepts

What is Teen Psychological, Social, and Emotional Wellbeing?

There is no single set of definitions of psychological, social, and emotional wellbeing applied to interventions for teens, but a brief history of recent work suggests an emerging convergence.

In the early 2000s, Keyes and colleagues constructed a measure of subjective (psychological, social, and emotional [PSEWB]) wellbeing for 12-18 year-olds based on measures of adult psychological, social, and emotional wellbeing, and using items from the Child Development Supplement—II (CDS-II) in a nationally representative survey (see items in Box 1).2,8 Keyes and colleagues aimed in part to see if previous-ly identified dimensions of adult subjective wellbeing applied to younger people.9 Purpose in life and self-acceptance were not measured in the CDS-II because self-esteem, a closely related measure of self-acceptance, was already part of the CDS, and purpose in life did not seem to be a pertinent question for pre-high school youth, and they wanted to obtain measures on all youth between the ages of 12 and 18. Keyes used scores from the measure to assess teens on a scale from flourishing to languishing. “Flourishing” required an average score of 5 or 6 across the items. “Languishing” required an average score of 1 or 2 across the items. Moderate mental health required an average score of 3 or 4 across the items. The work by Keyes also contributed to an emerging movement to add rigorous measures of children’s positive health and wellbeing to government reports.10

Similar approaches to conceptualizing teen flourishing include the characterization of outcomes of Positive Youth Development (PYD) as the 5 C’s: Confidence, Character, Caring, Competence, and Contribution.11 However, the framing of positive youth development and simi-lar concepts like resilience is changing along the lines of a Relational Developmental Systems metatheory.12,13 Further, continuing work on the PYD model is resulting in proposed additions to the 5 Cs, such as critical consciousness of socioeconomics,14 and calls to consider the potential downsides of some 5 C components (e.g., “caring too much”).15 The federally sponsored National Survey of Children’s Health also reports its own metrics of flourishing and languishing for 12-17 year-olds, as reported by parents rather than teens themselves. The 3 items in the measure are meant to capture “curiosity and discovery about learning; resilience; and self-regulation,” by using the following 3 items (1) child shows interest and curiosity in learning new things, (2) child works to finish tasks he or she starts, and (3) child stays calm and in control when faced with a challenge. If the adolescent’s parent or guardian answers “definitely true” to 0-1 flourishing items, the adolescent is classified as “languishing.”16

A recently developed survey – Youth THRIVETM –measures 5 groups of protective and promotive factors–youth resilience, social connec-tions, knowledge of adolescent development, concrete support in times of need, and cognitive and social-emotional competence–using 66 adolescent self-report items.17 The primary purpose of the survey is to provide baseline and progress data for youth-serving organizations (e.g., child welfare, juvenile justice), although the developers say it can be used with any teen population. The factors and subfactors include most of those used as positive outcomes in the systematic reviews included in this RER. Youth THRIVETM does not measure some of the

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Rapid Evidence Review Appendix 2: Methods

outcomes in the RER, such as symptoms related to psychiatric disorders (depression, anxiety, internalizing symptoms, externalizing symp-toms, stress), suicidal thoughts, gender ideology, and stigma related to mental illness.

Conceptually, this RER uses the Keyes conceptual framework of flourishing defined as high levels, and languishing as low levels, of psycho-logical, social, and emotional wellbeing. However, the systematic reviews and large-scale studies use their own terminology for outcomes (and interventions), which we adhere to rather than try to force the labels into any particular framework.

Search Strategy

Figure 1 shows the Boolean search term strategy used for this review. Given the wide variation in database search capabilities, we modified searches as appropriate for the databases utilized in this review. Searches began by filtering for review method and publication or posting data (Column 1). Next, target populations (Column 2), using grouped keywords and the Boolean “OR” operator, were added, followed by grouped keywords for measured outcomes (Column 3). In order to obtain reviews of studies of interventions, strategies, or policies at various ecological levels, we used terms commonly employed in their discussion or implementation, terms from our ecological framework, terms related to specific settings, and the phrase “AND (universal)” (Column 4).

Box 1. Items in Keyes’ Measurement of Psychological, Social, and Emotional Wellbeing in 12-18-year olds: Child Development Supplement-II (CDS-II) Included in the Panel Survey of Income Dynamics, 2002-3

Emotional well-being

Three items that asked youth how often during the past month they had felt: (1) happy(2) interested in life(3) satisfied

Psychological wellbeing

Four of the six theoretical dimensions of psychological well-being, and the survey items measuring them were: 1. Environmental mastery: “how often did you feel good at managing the responsibilities of your daily life”?2. Positive relations with others: “how often did you feel that you have warm and trusting relationships with other kids?”3. Personal growth: “how often did you feel that you have experiences that challenge you to grow or become a better person?”, and 4. Autonomy: “how often did you feel confident to think or express your own ideas and opinions?”

Social wellbeing

Five dimensions of social well-being were measured in the CDS-II. 1. Social contribution: “How often did you feel that you had something important to contribute to society?” 2. Social integration: “how often did you feel that you belonged to a community like a social group, your school, or your neighborhood?” 3. Social actualization: “how often did you feel that our society is becoming a better place?” 4. Social acceptance: “how often did you feel that people are basically good?” 5. Social coherence: “how often did you feel that the way our society works made sense to you?”

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Rapid Evidence Review Appendix 2: Methods

Figure 1. Search terms used for this Rapid Evidence Review

Column 1.Systematic

Review; Publication/

Posting Dates

AND Column 2. Population AND

Column 3.Outcomes

ANDColumn 4.

Intervention Indicator

Systematic review Adolescen* Flourish* (Interven* OR policy OR strategy* OR program OR training OR cur-ricular OR initiative)

Scoping review Youth Languish* (School OR education OR parent OR family OR nation* OR fed-eral OR state OR community OR neighborhood OR employment OR workplace OR “social environ-ment” OR “school climate”)

Rapid review Teen* (Psychological OR emotional OR social OR mental) AND (wellbeing OR well-being)

Universal

Review High school students

(Psychological OR (positive AND mental) OR social OR emotional) AND health

Year (2014-2019) Secondary school students

Positive youth development

(Stress OR anger OR fear OR hostil-ity OR loneliness OR internalizing OR externalizing OR intolerance OR racism OR ((racial OR ethnic) AND (discrimina-tion OR prejudice)) OR stigma OR bias OR (suicidal AND thoughts)

(Fulfilment OR “sense of meaning” OR purpose OR “sense of purpose” OR hope* OR “belief in the future” OR balance OR (life AND satisfaction) OR “quality of life”)

(Resilien* OR grit)

(self-efficacy OR self-confidence OR self-perception OR identity OR self-image OR self-esteem)

(Pro-social or “social participation” OR “social competence” OR “social skills” OR “social well-being” OR empath* OR attachment OR connectedness OR engagement OR “positive relationships” OR forgiveness OR respect)

(Social AND (isolation OR avoidance))

(Violence OR bullying OR victimization)

(“Emotional competence” OR “emotion-al skills” OR “emotion regulation” OR (positive AND affect) OR mindfulness)

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Rapid Evidence Review Appendix 2: Methods

We searched for universal, population-based, interventions for both practical and scientific reasons. The practical considerations stem from our use of a “review of reviews” approach. Once they have identified their target population, review authors typically provide limited additional details about the characteristics of target populations in included studies. In addition, to our knowledge, no well-being or other deliberate intervention has been applied universally to the entire teen population of the world, so no study is population-based in its most comprehensive definition.

Scientifically, one can justify 13-18 year-olds as a distinct population, at least within high income countries.18 Reasons include: (1) the seemingly universal nature of distinct neuro-developmental changes;19,20 (2) the apparently universal exposure to common social environ-ments or determinants of health, such as widespread public misunderstanding of the nature of adolescence;21 (3) the common experi-ence of intense academic and other pressures; (4) legal status of most 13-18 year-olds as minors, and so, limited in their capacity to act autonomously; and (5) the substantial percentages of teens experiencing psychological distress without identified modifiable risk factors that would allow a targeted approach to interventions.22,23,24,25 In addition, population-based, universal interventions may provide more opportunities to trade reactive, deficit-oriented strategies for those that are proactive, empowering, and strengths-based,26 and may be able to provide a broad-based “foundation for well-being and effective functioning.”27 This RER did not search for reviews or studies of inter-ventions, policies, or strategies focused on distinct subpopulations of adolescents at risk for languishing, and especially not teen subpopula-tions with diagnosed mental disorders, even though they too may benefit from universal well-being interventions.28 We do include in our evidence tables additional characteristics of teens if they are provided by review authors. We hope that future work can analyze and build on our broad-based evidence base to enable targeting within universalism.29

Also due to practical and theoretical considerations (e.g., size of search fields in databases), we did not include a list of interventions, strategies, or policies as search terms (e.g., mindfulness interventions) in our initial searches. However, when we learned of new or newly popular types of interventions, strategies, or policies seemingly related to enhancing PSEWB ,we conducted rapid searches of key databases

Figure 1. Search terms used for this Rapid Evidence Review (cont’d)

Column 1.Systematic

Review; Publication/

Posting Dates

AND Column 2. Population AND

Column 3.Outcomes

ANDColumn 4.

Intervention Indicator

(“Moral competence” OR “Moral skills” OR “behavioral competence” OR “behavioral skills” OR (“non-cognitive” AND (competence OR skills))

(Coping OR help-seeking OR ((mental AND health) AND awareness))

(Identity AND (exploration OR commit-ment))

(Belonging OR autonomy OR indepen-dence OR functioning)

(Growth AND mindset)

((Collective AND efficacy) OR (collective AND well-being))

Friendship OR (neighbor* AND relation*)

((Social AND wellbeing) OR (social AND capital) OR (social AND inclusion) OR (community AND resilience))

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(e.g., PubMed, Google Scholar, What Works Wellbeing Centre) to find systematic reviews that focused on specific interventions and teen psychological, social, or emotional wellbeing outcomes. Examples of such topics include: school climate; loneliness-focused interventions; social media; digital mental health; racism; racial- or ethnic-discrimination interventions; nature (blue or green space). However, for the most part, our RER search can be considered an outcomes-based search strategy.

Inclusion/Exclusion Process and Reliability Checks

Figure 2 details the procedure, derived from PRISMA Statement,5 through which articles found during our search were selected for inclu-sion in this rapid review.

The task of performing initial searches was split by database among three team members, who then screened for relevant titles. After initial screening for titles, another team member would rescreen the same search results and the two team members then resolved any discrepan-cies.

After developing a shortlist of agreed-upon titles, full-paper assessment was conducted by one team member and any recommendations for inclusion into, or exclusion from, the final RER report were checked by a second team member. Differences were resolved by group discussion. Rationales for exclusion included one or more of the following; failure to assess psychological, social, and emotional wellbeing (PSEWB) outcomes; failure to include any high-school-aged teen (13-18 years of age) samples; lack of PSEWB intervention or program; lack of a universal intervention; and failure to qualify as a systematic review. When assessing whether a review was teen-focused, if a study included participants older or younger than our desired demographic we considered that study to be teen-focused if either of the following two conditions were met: 1) more than 50% of the sample population fell within our desired age range, or, 2) the mean age of the sample population was within our desired age range. This careful evaluation of teen-focused studies occasionally led us to exclude an entire review because of a lack of PSEWB findings for our focus age group.

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Rapid Evidence Review Appendix 2: Methods

Figure 2. Rapid Evidence Review article selection process

3,497 records published after 2014 identified during initial search of PubMed, Health Evidence, Campbell Collabora-tion, Blueprints for Healthy Youth Development, What Works Clearinghouse, What Works Centre for Wellbeing, Cochrane Collaboration, and Google Scholar.

3,406 records excluded after review of title (or abstract if title failed to provide sufficient information) because they were du-plicates or failed to meet inclusion criteria. 18 records included after discovery through databases alerts (e.g., Google Alerts) and title screening.

109 records were retained. The full text of these records was retrieved and assessed.

43 records were excluded after examination of the full articles.

• Not a systematic review n=19• No intervention/program n=2• Adolescents excluded n=9• No Psychological, Social, or Emotional Well-Being

outcomes n=10• Not a universal intervention n=3

The full papers for 66 records published between January 2014 and end of July 2019 were further examined and 34 of these were excluded if:

• They were published between January 2014 and December 2017, unless they focused on interventions for which there was no SR published in 2018 or 2019 OR

• On closer examination they did not meet criteria for the RER (see previous box)

• We were unable to obtain a copy of the Systematic Review

34 full SRs were retained.

Subsequently, due to the retention of such a large number (66) of SRs, we decided to exclude any systematic reviews published prior to January 2018, unless they covered a topic for which we had not identified a SR published in 2018 and 2019. For example, when we found that no reviews identified through our searches covered the effects of parenting interventions for parents of teens, we added the systematic review by Yap et al. published by 2016 that we had identified in the previous ACT for Health scoping reviews.

Further, when we found that no reviews identified through our searches covered the effects of income supplementation, we added studies with findings for teen PSEWB from the large randomized trials known as Moving to Opportunity and the Great Smoky Mountains experiment.

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Our focus is on interventions delivered to teens when they are high-school-aged. For example, we did not include studies such as the large-scale community-level-intervention “Communities That Care” (CTC) study. The CTC intervention occurred while the teens were in grades 5 through 8, and appears to have measured PSEWB outcomes only at the end of grade 8.30 Substance use and delinquency were the main outcomes of interest for CTC.

Reviews that were excluded from the final RER report at any stage of assessment, along with accompanying rationale, are listed in Appendix 6.

Analysis: Evidence Tables

Retained full review papers were then synthesized in tabular format. These Evidence Tables can be found in Appendix 5 and note the fol-lowing components of a review:

1. Focus of the Reviewa. All age/developmental groups included in the review.b. Age/developmental groups included that are relevant to high-school-aged teens (ages 13-18).c. Intervention type, name, and definition – overall. d. Intervention type, name, and definition – examined for 13-18-year-olds or equivalent (specified by study, and included in a “Teen

Table” at the end of the Evidence Table, if information was available).31

e. Outcomes examined overall (including all, but highlighting PSEWB outcomes).f. Outcomes examined for 13-18-year-olds or equivalent (and included in the Teen Table) g. Outcomes examined regarding social/built environments and/or people surrounding 13-18-year-olds (specified by study if necessary

and for whom/what it is measured). h. Settings for the intervention/program, Country(ies)/State(s)/Region(s)/Locality(ies) for the intervention/program, and ecological

level of the intervention/program (e.g., national, community/neighborhood, school, family, work, recreation, OST).

2. Systematic Review Methodsa. Date range for the review.b. Databases searched for the review.c. Review inclusion criteria (focusing on study methodology). d. Review exclusion criteria (focusing on study methodology).e. Guidance used to structure the review (e.g., PRISMA, GRADE).

3. Relevant Findingsa. Number of studies included in the reviewb. High level findings (e.g., for all ages/developmental groups, especially if data on teens specifically was not included).c. Adolescent-specific findings (related to 13-18-year-olds or similar).

4. Systematic Review Limitationsa. Limitations noted by the review author.b. Limitations noted by AcademyHealth (if any).

If a systematic review did not report findings separately for our targeted age group, but did provide sufficiently detailed information about included studies by age or similar relevant characteristic (e.g., study took place in high school), we added an additional table at the end of our evidence tables, noting the teen studies and their findings.

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Rapid Evidence Review Appendix 2: Methods

Endnotes

1. Approximately 13- through 18-years-old.

2. Keyes CLM. Mental health in adolescence: Is America’s youth flourishing? American Journal of Orthopsychiatry [Internet]. 2006 July [cited 2019 June 24]; 76(3):395-402. https://www.ncbi.nlm.nih.gov/pubmed/16981819

3. Dougherty D and Wittenberg RL. (2017, June). Promoting adolescent social and emotional well-being: Can a culture of health approach help? Poster presented at the AcademyHealth Annual Research Meeting, Child Health Services Research Interest Group pre-conference. New Orleans, LA.

4. ACT for Health. (2018, June). ACT for Health Scoping Review. (Unpub-lished evidence tables for 22 reviews of non-school-based interventions to promote high-school-aged psychological, social, and emotional well-being).

5. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med [Internet]. 2009 [cited 2019 Aug 19]; 6(7):e1000097. Available from: https://doi.org/10.1371/journal.pmed.1000097

6. Eric Fein, MD, UCLadA; and Anthony James, PhD, Miami University of Ohio.

7. NEP members are: Johanna Bergan, Youth MOVE National; Christina D. Bethell, PhD, Professor, Bloomberg School of Public Health; Director, Child and Adolescent Health Measurement Initiative (CAHMI), Johns Hopkins University; Anne Collier, M.A., Executive Director of the Net Safety Collab-orative; Angela Diaz, MD., Director of the Adolescent Health Center, Icahn School of Medicine, Mount Sinai; Nadine Gracia, MD, MSCE., Executive Vice President and Chief Operating Officer of Trust for America’s Health; Vicki Harrison, MSW., Program Director of the Center for Youth Mental Health and Wellbeing, Stanford University; Corey Keyes, PhD., Founder of Simply Flourishing, Emory University; Michelle Kim Leff, MD, MBA, CAPT, USPHS, NIDA Technology Development Coordinator, IRP Chief of Staff, National Institute of Drug Abuse, National Institute of Health, Balti-more, MD; Matt Soeth, M.E.d., Founder of #ICANHELP, Teacher College of San Joaquin; Shawn Sprecker, Strategy Consultant and Data Privacy Expert, #ICANHELP; Qi Wang, PhD, Director of the Culture and Social Cognition Lab, Cornell University.

8. Keyes CLM. 2005, January. The subjective well-being of America’s Youth: Toward a Comprehensive Assessment. Adolescent & Family Health 4(1):3-11.

9. The items were adapted from the Midlife in the United States (MIUS) study of adults. The items were administered for the first time to youth ages 12-18 in the CDS-II of the Panel Study of Income Dynamics. Respondents were asked how often in the past month they had the specified feeling.

10. Moore KA and Lippman L. 2005. Letter from the Editor. Adolescent & Fam-ily Health 4(1): 1.

11. https://fyi.extension.wisc.edu/wi4hvolunteers/files/2017/09/1-5-Cs-Hand-out-Lerner-2007.pdf

12. Lerner RM, Brindis CD, Batanova M, and Blum RW. 2018. Adolescent health development: A relational developmental systems perspective. In N. Halfon et al. (eds.), Handbook of Life Course Health Development. https://link.springer.com/content/pdf/10.1007%2F978-3-319-47143-3.pdf

13. RDS is characterized by a process-relational paradigm that focuses on process (systematic changes in the developmental system), becoming (moving from potential to actuality), holism (the meanings of entities and events depend on context), relational analysis (assessment of the mutu-ally influential relations within the developmental system), and the use of multiple perspectives and explanatory forms. The developing organism is seen as: inherently active, self-creating, self-organizing, self-regulating, non-linear/complex, and adaptive. The nature of natural developmental changes during adolescence makes teens more likely to have and be aware of these characteristics.

14. Tyler CP, Geldhof GJ, Black KL, Bowers EP. Critical Reflection and Positive Youth Development among White and Black Adolescents: Is Understand-ing Inequality Connected to Thriving? Journal of Youth and Adolescence [Internet]. 2019 Aug 4 [cited 2019 Sep 27]: 1-15. Available from: https://link.springer.com/article/10.1007/s10964-019-01092-1

15. Geldhof GJ, Larsen T, Urke H, Holsen I, Lewis H, Tyler CP. Indicators of Positive Youth Development Can Be Maladaptive: The Example Case of Caring. Journal of Adolescence [Internet]. 2019 Feb [cited 2019 Sep 27]; 71:1-9. Available from: https://www.sciencedirect.com/science/article/pii/S0140197118302069.

16. The Child & Adolescent Health Measurement Initiative. 2016 Na-tional Survey of Children’s Health [Internet]. 2017 [cited 2019 Sep 27]. Available from: http://www.childhealthdata.org/browse/survey/results?q=4621&r=1&g=609.

17. Center for the Study of Social Policy. Youth THRIVE Survey User’s Manual. Washington DC: CSSP.

18. The World Bank Group. How does the World Bank classify countries? [Internet]. 2019 [cited 2019 Sep 27]. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/378834-how-does-the-world-bank-classify-countries

19. Jernigan TL & Brown SA. Introduction. Developmental Cognitive Neuro-science [Internet]. 2018 Aug [cited 2019 Sep 27]; 32:1-3. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29496476

20. Dahl RE, Allen NB, Wilbrecht L, Suleiman AB. Importance of Investing in Adolescene from a Developmental Science Perspective. Nature [Internet]. 2018 Feb 21 [cited 2019 Sep 27]; 554(7693):441-450. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29469094

21. Frameworks Institute. Adolescent Development Page [Internet]. Washing-ton (DC): Frameworks Institute; 2016 [Updated 2018 Dec 17; cited 2019 June 27]. Available from: https://www.frameworksinstitute.org/adolescence.html

22. Bethune, S. APA Stress in AmericaTM Survey: Generation Z Stressed About Issues in the News but Least Likely to Vote [Internet]. Washington (DC): APA Stress in AmericaTM Press Room; 2018 Oct 30 [cited 2019 June 27]. Available from: https://www.apa.org/news/press/releases/2018/10/genera-tion-z-stressed

23. Horowitz JM and Graf N. Most U.S. Teens See Anxiety and Depression as a Major Problem Among Their Peers [Internet]. Washington (DC): Pew Research Center; 2019 Feb 20 [cited 2019 June 27]. Available from: https://www.pewsocialtrends.org/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers/

24. Graf N. A majority of U.S. teens fear a shooting could happen at their school and most parents share their concern [Internet]. Washington (DC): Pew Research Center; 2018 Apr 18 [cited 2019 June 27]. Available from: https://www.pewresearch.org/fact-tank/2018/04/18/a-majority-of-u-s-teens-fear-a-shooting-could-happen-at-their-school-and-most-parents-share-their-concern/

25. Forrest CB, Simpson L, Clancy C. Child health services research: Chal-lenges and opportunities. JAMA [Internet]. 1997 Jun 11 [cited 2019 June 27]; 277(22): 1787-1793. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9178792

26. Herrenkohl TI. Cross-System Collaboration and Engagement of the Public Health Model to Promote the Well-Being of Children and Families. Journal of the Society for Social Work and Research [Internet]. 2019 July 9 [cited 2019 July 18]; Ahead of Print. Available from: https://www.journals.uchi-cago.edu/doi/abs/10.1086/704958

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27. World Health Organization, Department of Mental Health and Substance Abuse. Promoting Mental Health: Concepts, Emerging Evidence, Practice [Internet]. Geneva (CH): Marketing and Dissemination, World Health Organization; 2004 [cited 2019 June 27]. Available from: https://www.who.int/mental_health/evidence/en/promoting_mhh.pdf

28. Greenberg MT & Abenavoli R. 2017. Universal Interventions: Fully Explor-ing Their Impacts and Potential to Produce Population-Level Impacts. Journal of Research on Educational Effectiveness [Internet]. 2017 [cited 2019 July 18]; 10(1): 40-67. Available from: https://www.tandfonline.com/doi/abs/10.1080/19345747.2016.1246632

29. Powell JA, Menendian S, Ake W. Targeted Universalism: Policy & Practice [Internet]. Berkeley (CA): University of California, Berkeley, Haas Institute for a Fair and Inclusive Society; 2019 May [cited 2019 June 27]. Available from: https://www.socalgrantmakers.org/sites/default/files/resources/tar-geted_universalism_primer.pdf

30. According to the Communities That Care website: By the end of Grade 8, panel youths from CTC communities reported higher levels than controls of all the protective factors that support positive youth development identified in the social development strategy. Social skills, interaction with prosocial peers, school recognition for prosocial involvement, and community oppor-tunities for prosocial involvement were significantly improved among CTC panel youth. https://www.communitiesthatcare.net/research-results/.

31. If supporting information was available in the review, or through the review’s supplementary materials, we created a supplemental table of studies focused on adolescents, high-schools, or secondary schools following the aforementioned criteria for teen-focused studies. These tables were added at the end of the Evidence Table for any review for which it was necessary to understand the impacts of interventions on high-school-based teens specifi-cally and for which the information was available in the publication under review. These “Teen Tables” listed the review publication’s first author; the teen ages in the group or similar; the specific intervention assessed; study findings; and, as relevant, any notes relevant to understanding the study findings.

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Moving Policy Upstream to Advance Adolescent Flourishing

Rapid Evidence Review Appendix 3: Narrative Summary of Findings

D. Dougherty, N. LeBlanc, P. Armstrong, E. Cope, and the AcademyHealth & ACT for Health Team

With support from Well Being Trust

September 30, 2019

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Narrative Summary of Findings

Findings from the Rapid Evidence Review

The Rapid Evidence Review found that reviews related to teen wellbeing include studies at the national, community, including school, interpersonal, and individual-teen levels, but not the global or cultural level (Figure 1 in Summary of Findings).

Few systematic reviews address levels other than the individual teen level (in which efforts are made directly with teens themselves). A few studies at the national/community, school, interpersonal, and individual level also measured effects at the community and school levels (community wellbeing), findings that can suggest potential moderators of effects on teen flourishing.

Effects on community well being of national, community, school, and interpersonal level strategies

Different approaches have been tried, or occurred naturally, at the combined national-community level, community and school levels, interpersonal, and multiple levels of our socio-ecological framework. The combined national/community level intervention “Moving to Opportunity” (MTO) housing assistance experiment in 5 U.S. cities,1 resulted in improved community environments (e.g., better food choices; decreased neighborhood-level percent poverty; less intense development; fewer gangs; more exposure to nature), but diverse im-pacts on families (e.g., more housing discrimination in the new neighborhoods). Efforts in the U.K. to improve community environments had multiple positive effects on neighborhoods (e.g., more green and blue space; social cohesion, neighborhood pride) although not all effects were positive.

School-level teen wellbeing strategies attempt to change high school environments so that they function better for all stakeholders. For example, a review of mindfulness training for elementary and high school teachers improved educators’ psychological distress and psycho-logical wellbeing, but not classroom climate or teaching practices. An intervention with teen participants also measured effects on commu-nity wellbeing. A review of “youth inquiry” approaches (e.g., youth participation in research) found changes at the exosystem (school, city, state level policy adoption), meso-system (research benefits); and microsystem levels (practitioner growth; peer group norms).

Effects on teen flourishing indicators of national, community, school, and interpersonal level strategies

National/community level intervention effects on teens. We found relatively few large studies or reviews have tested the teen wellbeing effects of efforts to change the environments within which teens live (national/community, community, community/school, interpersonal). Most of the interventions at these levels had a broader focus than solely enhancing wellbeing of teen participants. Further, the MTO ex-periment’s teen results appear to depend on a number of factors, such as the age at which adolescents move, their gender, and characteris-tics of the new neighborhood and city. In the MTO experiment, psychological distress was reduced for girls in 4 out of 5 cities, and did not change among boys in any city.

Community level intervention effects on teens. A natural experiment that occurred halfway through the Great Smoky Mountains child mental health epidemiological study had mixed effects on teen wellbeing. A new American Indian-run casino began sharing its profits with tribal families, increasing their monthly incomes. The Great Smoky Mountains income supplement reduced oppositional defiant disorder and conduct disorder symptoms but not anxiety and depression symptoms.

Observers of both studies suggest that more careful attention to teen developmental factors in connection with change processes during the interventions could result in more positive results. For example, researchers suggest that moving teenage boys after age 13 may be too disruptive and teen boys may be more likely than girls to return to their old neighborhoods rather than seek new friends.

School- level intervention effects on teens. Many school districts are being pressured to change school start times for teens, based on new research showing that teen sleep cycles are natural and not easily modifiable, but have not been factored into decisions about school start times. A few studies, mostly small and in single schools, have been included in reviews. Earlier school start times in these studies found mixed but largely positive effects, improving school-night sleep duration and some mental health measures. A mindfulness based whole-school mental health promotion intervention resulted in moderate reductions in low-grade depressive symptoms.

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Interpersonal-level intervention effects on teens. Interpersonal interventions involve efforts to change family or peer behavior and relationships. The one existing review relevant to helping parents of teens found only 3 studies, with a mix of positive (reduced depressive symptoms) and no impact.

Efforts to change teens’ attitudes, feelings, and behavior by intervening with the teens themselves

Interventions that aim to change teens’ attitudes, feelings, and behavior by intervening with the teens themselves are by far the most com-mon approach to enhancing teen flourishing. Their findings are summarized by strategy type or strategy component in Table 1. For a va-riety of reasons, the summaries in Table 1 should not be used as a definitive guide to which individual-teen-level evidence-based strategies should proceed to widespread implementation.2 For example, the same strategies may be described using a variety of labels by different reviewers and over time. Some of the reported findings rely on one to a few studies identified as teen-relevant within broader reviews, while others come from composite effect sizes from multiple studies.

The broadest reviews were of universal resilience-focused interventions, universal school-based mental health promotion strategies, and universal school-based mental health interventions in the context of Multi-tiered Systems of Supports (MTSS). The focus on resilience-based interventions is from a 2017 review and suggests little reason to have confidence in the effectiveness of this intervention type, except for internalizing symptoms. Recent observers have noted that attempts to make individual people more resilient can be wrongheaded, when the ecological focus should be on changing potentially harmful environments. Universal school-based mental health promotion strategies reviewed found positive outcomes for anger, sigma, and suicidal ideation, and the review of the school-based interventions in the MTSS context found mixed effects on depressive symptoms.

Skeen et al. recently estimated the effectiveness of specific components of universal adolescent mental health programs on 4 broad outcome groupings, including 2 types that we include in this RER (positive mental health promotion outcomes; anxiety and depression symptoms). Skeen reports that positive mental health promotion outcomes have been positively affected by specific components (alcohol and drug education, emotional regulation, interpersonal skills, and skills to resist peer pressure), although the effect sizes varied consider-ably, and some components worked better for some outcomes than others. Skeen et al. also questioned why the alcohol and drug education strategies worked for positive mental health. Some of the same components that were effective for positive mental health were also effective for anxiety and depression symptoms (emotional regulation and interpersonal skills), but others (conflict resolution, goal setting, problem-solving) were effective for anxiety and depression symptom reduction but not for positive mental health promotion outcomes. Skeen et al. differentiated between face-to-face and digital or digital-and-combined mechanisms for delivery.

A few interventions can be considered “digital.” They varied in effectiveness. BiteBack (an online positive mental health intervention) was effective for improving total symptom scores, but not life satisfaction. E-health4U improved mental health; mass media digital platforms reduced stigma among teens, but mobile apps and phone-based multimedia messages were not able to reduce depressive symptoms.

Multiple reviews, with multiple outcomes, measured the strategies of exercise, yoga, mindfulness, mentoring (separately and under the umbrella of social and emotional skills development), and social and emotional skills development, broadly defined. Both positive and no impacts were found for each of these types.

Several less-studied strategies showed at least one positive impact on psychological, social, and emotional wellbeing. These include creative activities, community sports participation, suicide prevention, and youth-led community development programs.

Only single reviews covered interventions to improve young males’ wellbeing, video interventions, and interventions to increase interac-tions with nature. All had mixed effects.

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Findings for subpopulations of teens

As noted previously, a limitation of the review of reviews approach is the paucity of consistent and useful information about teen and other subpopulations. However, some reviews and studies focused on subpopulations. For example, Catalano focused on low- and middle-income countries, and Gwyther focused on interventions and outcomes for males. Some reviews provided information about the nature of the studies they included on gender, race, socioeconomic status, urbanicity/rurality, geography, school type, school location, and achieve-ment levels.3

Limitations and Implications for the Future

This RER and the reviews and studies included have limitations. As explained in Appendix 2 (Methods), the RER limited its searches to universal, population-based, interventions and did not look for targeted interventions to advance flourishing for teens at potentially higher risk of languishing.4 In addition, the findings presented in summary tables should be interpreted carefully and not taken as indicators of relative effectiveness. The tables include a mix of high-level findings from systematic reviews, often covering relatively broad age ranges; and findings from original research studies included in broader reviews but focused on teens and/or psychological, social, and emotional wellbeing outcomes.

Across reviews, terminology for adolescent and other populations, interventions, and outcomes is used inconsistently; we followed the way reviewers and study authors labeled populations, interventions, and outcomes.

Since our search strategy was primarily outcome-based, it is possible we may have missed some reviews that gave more weight to interven-tion keywords.

Our analytic focus on reviews published in 2018 and 2019, while reasonable because of recent conceptual advances and methodological improvements in both study and review processes, may have missed older reviews with relevant outcomes or interventions.

The nature of the reviews precluded conduct of a meta-analysis of findings for teens.

An important limitation beyond our control is the nature of the evidence. Almost every systematic review notes methodological challenges in their included studies (see Evidence Tables in Appendix 5). Many of the studies included in reviews suffer from threats to both internal and external validity, because of small sample sizes and single-site implementation. The use of home-grown metrics rather than validated instruments is an issue noted in several reviews. Funding for psychological and social science interventions, and for research focused on teens and/or wellbeing outcomes, is traditionally very limited, relative to medical research on adults. Those wishing to evaluate such inter-ventions may not have sufficient resources to conduct rigorous research. Further, there may be community resistance to spending resourc-es on evaluation versus expanding programming, and resistance to randomization or other strong experimental and quasi-experimental designs.

A possible limitation from the U.S. perspective may be the fact that most of the systematic reviews are from non-U.S. entities and authors. Twelve reviews were led by U.S.-based authors. Nine reviews were from the U.K. Other countries included: Australia (3), Canada (2), Czech Republic (2), Spain (2), Ireland (1), Malaysia (1), South Africa (1), The Netherlands (1).

Implications for the Future

Intervention types at socio-environmental levels beyond the individual teen level received little rigorous study or systematic review atten-tion for their impacts on teens. These include global and cultural changes, national and/or community-level policy changes (e.g., family housing assistance, family income supplementation), community infrastructure improvements, whole school and whole school/whole community/whole child approaches (e.g., social and emotional learning as a coherent multi-level strategy, school climate), and expansion of access to nature (i.e., blue and green space).

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

In addition, newer cross-cutting approaches to teen flourishing interventions, and newer sources of teen stress, are missing from the scien-tific literature, due in part perhaps to the lag times between issue identification, innovation development or adaptation of existing promis-ing strategies, scientific evaluation of interventions, and availability of studies for systematic review. For example, Relational Developmen-tal Systems Theory is a relatively new way to conceptualize approaches to adolescent development.5,6 Yeager and colleagues noted a more pervasive failure of interventions aimed at teens, and recommended that strategy designers more carefully think through how strategies can appeal to teens and lead to a more robust evidence base.7

Contemporary sources of teen stress without reviews include systemic racism;8 aspects of social media;9 climate change;10 peers’ mental health;10,11 mass shootings;12 academic and economic pressure.13 These have been topics of discussion but have not been specifically ad-dressed with adapted or new interventions. On the positive side, recent examples of teen-generated civic engagement may be worth further study to understand whether they enhance flourishing.14

Recent methodological guidance may help future study leads and systematic reviewers provide a more rigorous evidence base. For ex-ample, Reavley and Sawyer’s recent publication for UNICEF focuses on remedies for a variety of flaws within adolescent-focused research, including how ages/developmental stages are grouped.15

Subsequent analyses could go beyond program labels and examine effectiveness using program components, theories of change, and the extent to which interventions that include teens are tailored to adolescence using the most recent science. Skeen and colleagues recently published an evidence review of teen-focused interventions by component, for use by the WHO and the United Nations for their upcom-ing initiative, Helping Adolescents Thrive.16 Yeager recently noted that social and emotional learning interventions for teens often fail because many were “simply aged-up versions of childhood programs—for instance, they communicate the same message, but now the character doing the talking has a skateboard and a chain wallet. Such programs often fail to capture adolescents’ attention, both in what they say and how they say it.”17

Conclusion

A variety of interventions, strategies, and policies, at different levels of social and environmental influence, can make positive changes to-ward enhancing teens’ psychological, social, and emotional wellbeing. If well implemented at a population level, and possibly combined to address multiple levels, strategies could help to get teens, their communities, schools, and families, on a path toward positive mental health and flourishing and away from a current path to increasing “languishing.” However, there is enough uncertainty in the data to warrant additional and more rigorous evaluation of any program or policy intervention. Future evaluations should carefully measure the impacts of universal programs and strategies on teens at varying risk of psychological distress, in preparation for potential future targeting.

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Table 1. Summary of teen-level findings from the rapid evidence review, by strategy. Bolded entries indicate the findings are from methodologically more robust reviews

Socio-Environmental Level and Strategy

(Review OR Study)18

Outcomes with Positive Impact

(Strategy Subtype)

Outcomes with No Effect, Inconclusive, or Negative Effect

(Strategy Subtype)

National/community-level interventions

1 Housing assistance (Nguyen, 2016) Psychological distress (girls only) Psychological distress (Chicago par-ticipants: null findings; boys in other locations: detrimental effects)

Community-level interventions

2 Income supplementation (Costello, 2003)

Oppositional defiant disorder and con-duct disorder symptoms

Depression and anxiety symptoms

School-level interventions

3 Later school start times (Berger, 2018; Marx, 2017)

Depressive symptoms; sleep duration; other mental health (prosocial, emo-tional symptoms, peer relationships, total difficulties); composite mental health

Mental health (inconclusive due to study design flaws); conduct prob-lems; feeling accepted by other stu-dents; feeling accepted by adults

4 Whole school approach focused on mental health promotion (Enns, 2016)

Social and emotional competence19,20

Interpersonal-level interventions

5 Parenting interventions to prevent teen internalizing symptoms (Yap, 2018)

Depressive symptoms or diagnosis Internalizing symptoms

Multi-level interventions

6 “MindMatters” (multi-tier involv-ing school personnel and students) (O’Reilly, 2018)

Emotional and/or social competence

7 “Up” (school-based mental health promotion) (O’Reilly, 2018)

Emotional and/or social competence

8 Violence reduction and gender equali-ty-focused intervention with training for school counselors and parent involve-ment (Catalano, 2019)

Favorable attitudes toward domestic violence (declined)

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Socio-Environmental Level and Strategy

(Review OR Study)18

Outcomes with Positive Impact

(Strategy Subtype)

Outcomes with No Effect, Inconclusive, or Negative Effect

(Strategy Subtype)

Individual teen-level interventions

Broad groupings of strategies

9 Universal resilience-focused interven-tions (various types) (Dray, 2017)

Internalizing symptoms (cognitive behavioral therapy-based)

Anxiety/anxiety and stress; depressive symptoms; externalizing problems/be-haviors; psychological distress

10 Universal school-based mental health promotion (O’Connor, 2018)

Anger/anger control (life-skills training); stigma (anti-stigma program); stress (stress management program); suicidal ideation (Suicide prevention and de-pression awareness program)

11 Universal ‘Tier 1” school-based mental health interventions in the context of multi-tiered systems of support (MTSS) (Arora, 2019)

Depressive symptoms Depressive symptoms

Specific programs or program components

12 Alcohol and drug education (Skeen, 2019)

Positive mental health promotion (face to face interventions only)

13 Anxiety reduction interventions (Feiss, 2019)

Anxiety/stress

14 BiteBack and BiteBack School (online positive mental health) (Banos, 2017)

Total symptom score Life satisfaction

15 Body image interventions (Soulakova, 2019)

Body image

16 Cognitive behavioral therapy-based (Soulakova, 2019)

Anxiety/stress

17 Community sports participation (Barry, 2018)

Community engagement21

18 Conflict resolution components of universal adolescent mental health preventive interventions (Skeen, 2019)

Anxiety and depression symptoms (face to face components only)

19 E-health4U (Banos, 2017) Mental health

20 Emotional regulation components of universal mental health prevention strategies (Skeen, 2019)

Anxiety and depression symptoms; positive mental health promotion

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Socio-Environmental Level and Strategy

(Review OR Study)18

Outcomes with Positive Impact

(Strategy Subtype)

Outcomes with No Effect, Inconclusive, or Negative Effect

(Strategy Subtype)

21 Exercise22 (includes Tai Chi, which could also be considered medita-tion) (Mansfield, 2018; Pandey, 2018; Rodriguez-Ayllon, 2019)

Anxiety/stress (to 50-80% of heart rate; tai chi [versus gymnastics]); depressive symptoms; imbalance (emotional, psychological); psycho-logical distress (aerobics and hip-hop groups had lower psychological distress than body conditioning and ice-skating groups); feelings (aerobics only); positive wellbeing (volleyball: effects varied based on extent to which the sport met students’ psycho-logical needs; aerobics and hip-hop rated positive wellbeing higher than body conditioning and ice-skating groups); self-esteem (aerobic exercise: girls only; greater improvements for resistance training than for aerobics); process self-regulation (personal and social responsibility model exercise interventions)

Stress ( tai chi [cen-style]); body image; happiness (tai chi [versus gymnastics]); mental health/mental health status (CrossFit); psychological wellbeing (high-intensity interval train-ing ); self-esteem (active video game program)

22 Goal-setting components of universal adolescent mental health prevention interventions (Skeen, 2019)

Anxiety and depression symptoms (face to face only)

23 Interpersonal skills components of universal mental health preventive programs (Skeen, 2019)

Anxiety and depression symptoms; positive mental health promotion

24 Life skills education (Nasheeda, 2019) Emotional adjustment; empathy; self-esteem

Social adjustment

25 Life skills for mental health (Catalano, 2019)

Self-esteem

26 Mental health awareness (Salerno, 2016)

Stigma (1 out of 3 studies found im-provements in attitudes)

Stigma (2 out of 3 studies found no improvement in attitudes); help-seek-ing (grades 5-12 combined); mental health literacy (knowledge)

27 Mentoring23 (also see row 38 for posi-tive youth development interventions) (Barry, 2018; Raposa, 2019)

Emotional difficulties and behaviors; multiple outcomes (school engage-ment, social skills, perceived social support, relationship quality)24

28 Mindulness based interventions (Dun-ning, 2019; Skeen, 2019)

Anxiety/stress;25 depressive symp-toms;25 anxiety and depressive symptoms (face to face only); stress; mindfulness;25 resilience

Negative behavior;25 attention; 25 executive functions; 25 social behavior25

29 Mobile app self-report on mood, stress, daily activities, and coping strategies (Punukullo, 2019)

Depressive symptoms26

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Socio-Environmental Level and Strategy

(Review OR Study)18

Outcomes with Positive Impact

(Strategy Subtype)

Outcomes with No Effect, Inconclusive, or Negative Effect

(Strategy Subtype)

30 Mobile phone-based multimedia mes-sages (cognitive behavioral therapy-based texts) (Punukullo, 2019)

Depressive symptoms

31 Nature interactions (Tillman, 2018) Stress;27 emotional wellbeing;27 mental health/mental health status; resilience28

Emotional wellbeing;27 mental health/mental health status; resil-ience;29 self-esteem30

32 Penn Resiliency Program - Finnish derivative (Bastounis, 2016)

Anxiety and depressive symptoms Depressive symptoms; explanatory style; anxiety (control group did better)

33 Preparation for adulthood strategies (Burrus, 2018)

Healthy relationships; parent-child communication; adolescent develop-ment

34 Problem-solving components of universal adolescent mental health prevention interventions (Skeen, 2019)

Anxiety and depression symptoms (digital and combined only)

35 Programs to develop young men’s wellbeing (Gwyther, 2019)

Depressive symptoms; negative affect; cognitive autonomy; emotional intelli-gence (multiple studies); help-seeking; interest in diversity of contact; mental health/mental health status; optimism; psychological wellbeing (gender sensitive programs); quality of life (enjoyment and satisfaction); reshaped perceptions about being a man; self-efficacy (male only programs and mixed gender programs); self-esteem; self-reflection

36 Self-regulation/Emotional regula-tion techniques (Pandey, 2018; Van Genugtsen, 2016)

Connectedness Student (success skills program); self-esteem

Externalizing problems/behaviors; internalizing symptoms

37 Skills to resist peer pressure as a com-ponent of universal adolescent mental health prevention programs (Skeen, 2019)

Positive mental health (aggregate)

38 Social and emotional skills develop-ment (multiple intervention types) (Barry, 2018; Taylor, 2017)

Communication and facilitation skills (through mentoring); life satisfaction/life is worthwhile (multi-component so-cial action interventions were the de-livery mechanism for social-emotional skills); coping skills; positive youth development outcomes;31 relationship skills

Negative affect (through mentoring ); motivation to change; positive outlook

39 Stress reduction interventions (Feiss, 2019)

Stress: targeted interventions found to be better than universal

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Socio-Environmental Level and Strategy

(Review OR Study)18

Outcomes with Positive Impact

(Strategy Subtype)

Outcomes with No Effect, Inconclusive, or Negative Effect

(Strategy Subtype)

40 Suicide prevention (O’Connor, 2018) Suicide knowledge; suicidal ideation; suicide prevention; help-seeking be-havior and ability to identify support

Attitudes and behaviors

41 The Council for Boys and Young Men (UK)32 (Gwyther, 2019)

Self-efficacy (school and future) Identity distress; masculine ideology

42 Video interventions (Janouskova, 2017) Stigma; help-seeking Stigma; help-seeking

43 Yoga (Pandey, 2018) Tension-anxiety; total mood distur-bance; body image

Self-regulation (mindful yoga)

44 Youth-led community development program (Pennington, 2018)

Self-esteem

Outcomes in bold come from relatively rigorous reviews or studies.

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Rapid Evidence Review Appendix 3: Narrative Summary of Findings

Endnotes

1. In the late 1990s, MTO randomly supplied Federal housing assistance vouchers to volunteer families to new, higher-rent neighborhoods; some of the families had teenaged children, and the impact of the moves on teens’ selected mental health measures was included in the extensive data collec-tion effort of the initiative.

2. All outcomes come from systematic reviews. However, some outcomes are based on reviewers’ syntheses, sometimes for all populations included in the review, and sometimes for teens included in our focus population of 13-18-year-olds, or high-school-aged teens. Some other outcomes come from just one or a few studies included in the review and focused on high-school-aged teen group findings for psychological, social, and emotional wellbeing outcomes, and not other outcomes that may have been reported in the review. Additional details can be found in Appendix 6 (Evidence Tables).

3. See, for example, evidence tables for Kennedy, Mansfield, Marx, Nasheeda, Pandey, Raposa, Salerno, and Taylor (Appendix 5).

4. See Appendix 2.

5. Lerner RM, Brindis CD, Batanova M, et al. 2018. Adolescent health devel-opment: A relational developmental systems perspective. In N. Halfon et al. Handbook of Life Course Development. DOI 10.1007/978-3-319-47143-3_6.

6. O’Neil M., Volmert A, Pineau MG. 2019, July. Reframing Developmental Relationships: A Frameworks MessageMemo. Washington DC: Frameworks Institute.

7. Yeager DS, Dahl RE, Dweck CS. 2018. Why Interventions to Influence Ado-lescent Behavior Often Fail but Could Succeed. Perspect Psychol Sci. 2018 Jan; 13(1): 101–122.

8. Smedley, BD 2019. Multilevel interventions to undo the health consequenc-es of racism: The need for comprehensive approaches. Cultural Diversity and Ethnic Minority Psychology, Vol 25(1):123-125. https://psycnet.apa.org/doiLanding?doi=10.1037%2Fcdp0000263.

9. Anderson M & Jiang J. Teens, Friendships, and Online Groups [Internet]. Pew Research Center; 2018 Nov 28 [cited 2019 Sep 27]. Available from: https://www.pewinternet.org/2018/11/28/teens-friendships-and-online-groups/

10. American Psychological Association. Stress in America: Generation Z [Internet]. American Psychological Association; 2018 Oct [cited 2019 Sep 27]. Available from: https://www.apa.org/news/press/releases/stress/2018/infographics

11. Horowitz JM & Graf N. Most U.S. Teens See Anxiety and Depression as a Major Problem Among Their Peers [Internet]. Pew Research Center; 2019 Feb 20 [cited 2019 Sep 27]. Available from: https://www.pewsocialtrends.org/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers/

12. Graf, N. A Majority of U.S. Teens Fear a Shooting Could Happen at Their School, and Most Parents Share Their Concern [Internet]. Pew Research Center; 2018 Apr 18 [cited 2019 Sep 27]. Available from: https://www.pe-wresearch.org/fact-tank/2018/04/18/a-majority-of-u-s-teens-fear-a-shoot-ing-could-happen-at-their-school-and-most-parents-share-their-concern/

13. Livingston G & Barroso A. For U.S. Teens Today, Summer Means More Schooling and Less Leisure Time Than in the Past [Internet]. Pew Research Center; 2019 Aug 13 [cited 2019 Sep 27]. Available from: https://www.pewresearch.org/fact-tank/2019/08/13/for-u-s-teens-today-summer-means-more-schooling-and-less-leisure-time-than-in-the-past/

14. Examples include Black Lives Matter, climate activism, March for Our Lives, and the organization Youth MOVE National.

15. Reavley NJ & Sawyer SM. Improving the Methodological Quality of Research in Adolescent Well-being [Internet]. UNICEF Office of Research –Innocenti; 2017 Mar [cited 2019 Sep 27]. Available from: https://www.unicef-irc.org/publications/pdf/IRB_2017_03_Adol01.pdf

16. Skeen S, Laurenzi CA, Gordon SL, du Toit S, Tomlinson M, Dua T, et al. Adolescent Mental Health Program Components and Behavior Risk Reduction: A Meta-analysis. Pediatrics [Internet]. 2019 Jul 1 [cited 2019 July 26]; (Epub ahead of print). Available from: https://www.ncbi.nlm.nih.gov/pubmed/31262779Skeen S,

17. Yeager DS. Social and Emotional Learning Programs for Adolescents. The Future of Children [Internet]. 2017 [cited 2019 July 26]; 27(1):31-52. Available from: https://labs.la.utexas.edu/adrg/files/2013/12/5-Adolescence-Yeager-2.pdf

18. Full citations can be found in Appendix 5, Evidence Tables.

19. Positive outcomes compared to whole-school approach focused on pre-venting mental illness.

20. Ages 6-18 combined.

21. Characterized as social and emotional by Barry, 2018.

22. Note that different forms of exercise have different effects, according to reviews.

23. Mentoring programs varied. For example, the program with positive effect on emotional difficulties and behaviors was residential plus 9 months of mentoring, categorized as social and emotional skills development.

24. Note that mentoring with these outcomes was intergenerational and one-on-one.

25. Most study participants were older than 12, but the ages ranged from 4.7 to 17.4.

26. Reviewers attributed improvement in symptoms to participation in the research study rather than increased emotional self-awareness as a result of the mobile app.

27. Findings not available by age. Children and adolescent (18 and younger) interventions and outcomes combined.

28. 3 out of 5 interventions showed positive effects. Children and teens com-bined.

29. 2 out of 5 interventions showed positive effects. Children and teens com-bined.

30. 10 of 13 findings were not statistically significant.

31. Combined effect size reported. Outcomes not specific to adolescents, but demographics, including child age group, were not associated with the combined effect size.

32. The Council intervention aimed to encourage solidarity amongst young men, question maladaptive stereotypes, and recognize strengths and collec-tive responsibilities.

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Rapid Evidence Review Appendix 4: Findings by Outcome

Moving Policy Upstream to Advance Adolescent Flourishing

Rapid Evidence Review Appendix 4: Findings by Outcome

D. Dougherty, N. LeBlanc, P. Armstrong, E. Cope, and the AcademyHealth & ACT for Health Team

With support from Well Being Trust

September 30, 2019

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Rapid Evidence Review Appendix 4: Findings by Outcome

Summary of Findings by Outcome

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Rapid Evidence Review Appendix 4: Findings by Outcome

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8 ty

pes o

f com

mun

ity

infra

stru

ctur

e in

terv

entio

ns (e

.g.,

com

mun

ity h

ubs;

chan

ges t

o ne

ighb

orho

od d

esig

n; g

reen

and

bl

ue sp

ace)

Bagn

all,

2018

Al

l age

gro

ups;

10

stud

ies i

nclu

ded

child

ren

and/

or

adol

esce

nts

Mod

erat

e ev

iden

ce o

f pos

itive

effe

cts o

n co

mm

unity

w

ellb

eing

out

com

es.

By in

terv

entio

n ty

pes:

For c

omm

unity

hub

s int

erve

ntio

ns:

-Soc

ial c

ohes

ion;

-S

ocia

l cap

ital;

-Tru

st b

etw

een

peop

le;

-Wid

er so

cial n

etw

orks

Fo

r cha

nges

to n

eigh

borh

ood

desig

n:

-Sen

se o

f bel

ongi

ng;

-Sen

se o

f prid

e Fo

r gre

en a

nd b

lue

spac

e:

- Soc

ial i

nter

actio

ns;

- Soc

ial n

etw

orks

Bo

ndin

g an

d br

idgi

ng so

cial c

apita

l

Teen

-Lev

el O

utco

mes

Psyc

holo

gica

l dist

ress

M

ovin

g to

Opp

ortu

nity

Ng

uyen

, 201

62 Ad

oles

cent

s age

d 12

to

19

year

s in

fam

ilies

offe

red

hous

ing

vouc

hers

ve

rsus

thos

e re

mai

ning

in p

ublic

ho

usin

g

Chica

go p

artic

ipan

ts e

xper

ienc

ed n

ull t

reat

men

t effe

cts.

Ou

tsid

e Ch

icago

, boy

s exp

erie

nced

det

rimen

tal e

ffect

s, w

here

as g

irls e

xper

ienc

ed b

enef

icia

l effe

cts.

Psyc

hiat

ric sy

mpt

om le

vels

(for a

nxie

ty,

depr

essio

n, o

ppos

ition

al d

efia

nt d

isord

er, c

ondu

ct

diso

rder

)

Grea

t Sm

oky

Mou

ntai

ns S

tudy

Q

uasi-

Expe

rimen

t4 Co

stel

lo, 2

003

Teen

s 13-

17 a

t tim

e of

inte

rven

tion.

Af

ter t

he ca

sino

open

ing,

leve

ls of

sym

ptom

s for

op

posit

iona

l def

iant

diso

rder

and

cond

uct d

isord

er

amon

g th

e ex

-poo

r fel

l to

thos

e of

the

neve

r-poo

r

Page 34: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

34

Rapid Evidence Review Appendix 4: Findings by Outcome

| 4

W

ellb

eing

Out

com

e, b

y So

cio-e

nviro

nmen

tal

Deve

lopm

ent I

nter

vent

ion

Leve

l and

Out

com

e M

easu

rem

ent L

evel

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

child

ren,

whi

le le

vels

amon

g th

ose

who

wer

e pe

rsist

ently

poo

r rem

aine

d hi

gh (o

dds r

atio

, 1.5

0; 9

5%

conf

iden

ce in

terv

al, 1

.08-

2.09

; and

odd

s rat

io, 0

.91;

95

% co

nfid

ence

inte

rval

, 0.7

7-1.

07, r

espe

ctiv

ely)

. An

xiety

and

dep

ress

ion

sym

ptom

s wer

e un

affe

cted

.

Scho

ol-L

evel

Inte

rven

tions

Scho

ol-L

evel

Out

com

es

Clas

sroo

m cl

imat

e

Min

dful

ness

-bas

ed in

terv

entio

ns

for t

each

ers

Klin

gbei

l, 20

18

Te

ache

rs in

gra

des

K-12

; Fi

ndin

gs n

ot

repo

rted

sepa

rate

ly

for s

econ

dary

sc

hool

s

Not s

igni

fican

t

Psyc

holo

gica

l dist

ress

St

atist

ically

sign

ifica

nt e

ffect

s.

Psyc

holo

gica

l wel

lbei

ng o

f tea

cher

s Sm

all t

o m

ediu

m e

ffect

(g=.

431,

95%

CI

.254

, .60

8)

Teac

hing

pra

ctice

s No

t sig

nific

ant

Teen

-Lev

el O

utco

mes

Depr

essiv

e sy

mpt

oms

Late

r sch

ool s

tart

tim

es (2

in

terv

entio

n st

udie

s)

Berg

er, 2

0185

High

scho

ols

Inhe

rent

des

ign

draw

back

s in

the

stud

ies p

reve

nt

auth

ors f

rom

conc

ludi

ng th

at d

elay

ing

a hi

gh sc

hool

’s st

art t

ime

will

caus

e st

uden

ts’ m

enta

l hea

lth to

im

prov

e.

Repo

rted

resu

lts fo

r pre

-pos

t stu

dies

: Lon

ger s

leep

du

ratio

ns (3

0 m

inut

es a

nd 2

5 m

inut

es) a

nd si

gnifi

cant

ly

low

er le

vels

of d

epre

ssiv

e sy

mpt

oms;

depr

essiv

e sy

mpt

oms w

ere

inve

rsel

y co

rrel

ated

with

slee

p du

ratio

n.

Univ

ersa

l sch

ool-b

ased

men

tal

heal

th p

rom

otio

n (m

indf

ulne

ss)

prog

ram

; 1 st

udy)

O’Co

nnor

, 201

8 12

-16-

year

old

s M

oder

ate

redu

ctio

n in

low

-gra

de d

epre

ssiv

e sy

mpt

oms

at 3

-mon

th fo

llow

-up

Page 35: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

35

Rapid Evidence Review Appendix 4: Findings by Outcome

| 5

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

Late

r sch

ool s

tart

tim

es (1

stud

y)

Mar

x, 2

0176

13-1

9-ye

ar-o

lds

over

all;

Grad

es 9

-12

for t

his s

tudy

Stud

ents

in th

e tw

o la

ter s

tart

tim

es (7

:25

and

8:30

a.

m.)

repo

rted

less

dep

ress

ion

than

stud

ents

in th

e ea

rlies

t sta

rt ti

me

(7:1

5).

No si

gnifi

cant

diff

eren

ce b

etw

een

8:30

a.m

. and

7:2

5 st

art t

imes

.

Othe

r men

tal h

ealth

La

ter s

choo

l sta

rt ti

me

(1 st

udy)

Be

rger

, 201

85

High

scho

ols

Inhe

rent

des

ign

draw

back

s in

the

stud

ies p

reve

nt

auth

ors f

rom

conc

ludi

ng th

at d

elay

ing

a hi

gh sc

hool

’s st

art t

ime

will

caus

e st

uden

ts’ m

enta

l hea

lth to

im

prov

e.

Repo

rted

resu

lts fo

r int

erve

ntio

n ve

rsus

com

paris

on

scho

ols:

Pr

osoc

ial

Pr

osoc

ial b

ehav

ior,

emot

iona

l sym

ptom

s, pe

erre

latio

nshi

p pr

oble

ms,

tota

l diff

iculti

es:

All

impr

oved

Cond

uct p

robl

ems:

no im

prov

emen

t.

Com

posit

e m

enta

l hea

lth (G

HQ-1

2): i

mpr

oved

Tim

e in

bed

on

both

scho

ol n

ight

s and

non

-sch

ool

nigh

ts: i

ncre

ased

.

Slee

p du

ratio

n (s

choo

l nig

ht)

Late

r sch

ool s

tart

tim

es: f

rom

9

a.m

. to

10 a

.m. (

1 st

udy)

13-1

9-ye

ar-o

lds

over

all;

Grad

es 9

-12

for t

his s

tudy

Over

all,

revi

ew su

gges

ts la

ter s

choo

l sta

rt ti

mes

hav

e po

tent

ial b

enef

its b

ut p

oint

to th

e ne

ed fo

r hig

her

qual

ity p

rimar

y st

udie

s. Sl

eep

dura

tion:

stat

istica

lly si

gnifi

cant

mea

n di

ffere

nce

of 0

.49

hour

s (CI

0.2

4, 0

.74)

Socia

l out

com

es

Late

r sch

ool s

tart

tim

es (1

stud

y)

13-1

9-ye

ar-o

lds

over

all;

Grad

es 9

-12

for t

his s

tudy

Feel

ing

acce

pted

by

othe

r stu

dent

s: no

effe

ct

Feel

ing

acce

pted

by

adul

ts: n

o ef

fect

Socia

l/soc

ial a

nd e

mot

iona

l com

pete

nce

Who

le S

choo

l App

roac

h Fo

cuse

d on

Men

tal H

ealth

Pro

mot

ion

Enns

, 201

6 6-

18A

who

le sc

hool

app

roac

h fo

cusin

g on

men

tal h

ealth

pr

omot

ion

is ef

fect

ive

in p

rom

otin

g ch

ild a

nd y

outh

m

enta

l hea

lth

Page 36: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

36

Rapid Evidence Review Appendix 4: Findings by Outcome

| 6

W

ellb

eing

Out

com

e, b

y So

cio-e

nviro

nmen

tal

Deve

lopm

ent I

nter

vent

ion

Leve

l and

Out

com

e M

easu

rem

ent L

evel

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

Inte

rper

sona

l-Lev

el In

terv

entio

ns (I

nter

vent

ions

with

Fam

ily, P

eers

, Cow

orke

rs)

Inte

rper

sona

l-Lev

el O

utco

mes

None

ava

ilabl

e.

Teen

-Lev

el O

utco

mes

Depr

essiv

e sy

mpt

oms o

r dia

gnos

is Pa

rent

ing

inte

rven

tions

to p

reve

nt

child

inte

rnal

izing

pro

blem

s Ya

p, 2

0167

Birt

h to

age

18

(3 st

udie

s foc

used

on

ado

lesc

ents

>12

-18

)

Two

stud

ies f

ocus

ed o

n re

ducin

g te

en d

epre

ssiv

e sy

mpt

oms f

ound

a sm

all b

ut si

gnifi

cant

effe

ct

(com

bine

d ef

fect

size

-0.1

19, C

I -0.

217,

-0,0

20, p

=

0.01

9).

Inte

rnal

izing

sym

ptom

s Pa

rent

ing

inte

rven

tions

to p

reve

nt

child

inte

rnal

izing

pro

blem

s Ya

p, 2

0167

Birt

h to

age

18

(3 st

udie

s foc

used

on

ado

lesc

ents

>12

-18

)

No e

ffect

.

Mul

ti-Le

vel I

nter

vent

ions

Teen

-Lev

el O

utco

mes

Emot

iona

l and

/or s

ocia

l com

pete

nce

“U

p” (s

choo

l-bas

ed m

ulti-

leve

l8 m

enta

l hea

lth p

rom

otio

n) (1

st

udy)

O’Re

illy,

201

8 11

-15

year

s old

(G

rade

s 5-9

) in

Denm

ark

Stat

istica

lly si

gnifi

cant

incr

ease

in %

of c

hild

ren

repo

rtin

g hi

gh so

cial a

nd e

mot

iona

l com

pete

nce

pre-

post

Min

dMat

ters

(mul

ti-tie

r[sch

ool

pers

onne

l and

child

ren)

pro

gram

en

cour

agin

g re

spec

t, to

lera

nce,

re

silie

nce,

com

mun

icatio

n,

prob

lem

-sol

ving

) (1

stud

y)

O’Re

illy,

201

8

10-1

5 ye

ars o

ld

Min

imal

impr

ovem

ent

Favo

rabl

e at

titud

es to

war

d do

mes

tic v

iole

nce

Mul

ti-co

mpo

nent

aim

ed a

t Ca

tala

no, 2

019

High

scho

ol

Redu

ced

Page 37: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

37

Rapid Evidence Review Appendix 4: Findings by Outcome

| 7

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

viol

ence

redu

ctio

n an

d ge

nder

eq

ualit

y, in

cludi

ng tr

aini

ng fo

r sc

hool

coun

selo

rs a

nd p

aren

t-in

volv

emen

t fac

ilita

tion

(1 st

udy)

Stud

ents

in Ir

an

Indi

vidu

al T

een-

Leve

l Int

erve

ntio

ns

Com

mun

ity-L

evel

Out

com

es

Socio

-env

ironm

enta

l out

com

es fo

r adu

lts, p

eers

, or

gani

zatio

ns, a

nd/o

r ins

titut

ions

9 Yo

uth

inqu

iry (e

.g.,

Yout

h Pa

rtici

pato

ry A

ctio

n Re

sear

ch)

Kenn

edy,

201

9 Yo

uth,

age

un

spec

ified

57

.1%

of i

nclu

ded

stud

ies s

how

ed p

ositi

ve ch

ange

s, in

cludi

ng:

M

icros

yste

m le

vel:

prac

titio

ner g

row

th; p

eer

grou

p no

rms

M

eso-

syst

em le

vel:

prog

ram

dev

elop

men

t or

impr

ovem

ent;

rese

arch

ben

efits

Exos

yste

m le

vel:

scho

ol, c

ity, s

tate

leve

l pol

icyad

optio

n

Stud

ies m

ore

likel

y to

repo

rt im

prov

emen

ts:

us

ed a

dvoc

acy

stra

tegi

es;

ta

rget

ed d

ecisi

on-m

aker

s;

conv

ened

for a

long

er d

urat

ion.

Indi

vidu

al T

een-

Leve

l Out

com

es: R

educ

tion

in P

sych

olog

ical D

istre

ss

Ange

r/an

ger c

ontr

ol/a

ggre

ssio

n Un

iver

sal s

choo

l-bas

ed m

enta

l he

alth

pro

mot

ion

(life

skill

s tr

aini

ng)

O’Co

nnor

, 201

8 14

-16

year

s old

Redu

ced

ange

r, im

prov

ed a

nger

cont

rol

Digi

tal a

lcoho

l and

dru

g ab

use

com

pone

nts o

f uni

vers

al

prev

entiv

e m

enta

l hea

lth p

rogr

ams

Skee

n, 2

018

10-1

9Ag

gres

sion

redu

ced

Anxio

us a

nd/o

r Dep

ress

ive

Sym

ptom

atol

ogy

Face

to fa

ce m

indf

ulne

ss,10

in

terp

erso

nal s

kills

, em

otio

nal

regu

latio

n, co

nflic

t res

olut

ion,

and

Skee

n, 2

018

10-1

9Re

duce

d an

xious

and

dep

ress

ive

sym

ptom

atol

ogy

Page 38: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

38

Rapid Evidence Review Appendix 4: Findings by Outcome

| 8

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

digi

tal a

nd co

mbi

ned

prob

lem

-so

lvin

g pr

ogra

m co

mpo

nent

s of

univ

ersa

l pre

vent

ive

men

tal h

ealth

pr

ogra

ms

Finn

ish d

eriv

ativ

e of

the

Penn

Re

silie

ncy

Prog

ram

(cog

nitiv

e-be

havi

oral

dep

ress

ion

prev

entio

n pr

ogra

m) (

2 st

udie

s)11

Bast

ouni

s, 20

1612

Ov

eral

l inc

lude

d st

udie

s: 8

-17.

M

ean

ages

in 2

st

udie

s: 1

3 an

d 14

ye

ars o

f age

No e

ffect

s on

depr

essiv

e sy

mpt

oms f

or te

ens.

Cont

rol c

ondi

tions

had

bet

ter a

nxie

ty o

utco

mes

acr

oss

all s

tudi

es/a

ll ag

e gr

oups

.

Anxie

ty/s

tres

s M

indf

ulne

ss-b

ased

inte

rven

tions

Du

nnin

g, 2

019

Mea

n ag

es fr

om 4

.7

to 1

7.4;

mos

t wer

e ol

der t

han

12.

For R

CTs w

ith a

ctiv

e co

ntro

l con

ditio

ns: m

ean

effe

ct

size

0.18

.

(Yo)

Pie

nso,

Sie

nto,

Act

uo13

Ca

tala

no, 2

019

13-1

5-ye

ar-o

lds i

n Lo

w- a

nd M

iddl

e-In

com

e Co

untr

ies

(LM

IC)

Effe

ct o

n an

xiety

was

stat

istica

lly si

gnifi

cant

but

not

co

nsid

ered

clin

ically

mea

ning

ful.

Anxie

ty re

duct

ion

inte

rven

tions

Fe

iss, 2

019

11-1

8-ye

ar-o

lds

A hi

gher

dos

e w

as a

ssoc

iate

d w

ith a

gre

ater

redu

ctio

n.

FRIE

NDS

prog

ram

(Cog

nitiv

e Be

havi

oral

The

rapy

[CBT

]-bas

ed)

Soul

akov

a, 2

019

(3)

8-15

-yea

r old

sNo

effe

ct w

hen

low

qua

lity

stud

ies w

ere

rem

oved

from

th

e an

alys

is

Exer

cise

to 5

0-80

% o

f max

imum

he

art r

ate

Rodr

igue

z-Ay

llon,

20

19

13-1

6-ye

ar-o

lds

Posit

ive

effe

ct.

Tai C

hi (v

ersu

s gym

nast

ics [1

st

udy]

) Ro

drig

uez-

Ayllo

n,

2019

13

-16-

year

-old

sSi

gnifi

cant

redu

ctio

n

Anxie

ty/a

nxie

ty a

nd st

ress

Un

iver

sal r

esili

ence

-focu

sed

inte

rven

tions

Dr

ay, 2

017

11-1

8-ye

ar-o

lds

No e

ffect

Page 39: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

39

Rapid Evidence Review Appendix 4: Findings by Outcome

| 9

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

Depr

essio

n/De

pres

sive

sym

ptom

s14

Varie

d “T

ier 1

” (un

iver

sal)

scho

ol-

base

d m

enta

l hea

lth i

nter

vent

ions

(3

stud

ies)

in co

ntex

t of m

ulti-

tiere

d sy

stem

s of s

uppo

rt [M

TSS]

) (3

stud

ies)

Aror

a, 2

019

14-2

0 ye

ars o

f age

2 st

udie

s had

pos

itive

effe

cts;

1 ha

d ne

gativ

e ef

fect

s

Sele

cted

mal

e-on

ly g

ende

r-ne

utra

l sc

hool

and

com

mun

ity-b

ased

pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

(8

stud

ies)

Gwyt

her,

2019

M

ean

ages

15

and

15.5

yea

rs o

f age

Po

sitiv

e ef

fect

Min

dful

ness

-bas

ed in

terv

entio

ns

(33

stud

ies)

Du

nnin

g, 2

019

Mea

n ag

es fr

om 4

.7

to 1

7.4;

mos

t wer

e ol

der t

han

12.

For R

CTs w

ith a

ctiv

e co

ntro

l con

ditio

ns: M

ean

effe

ct

size

0.47

.

Mob

ile a

pp se

lf-re

port

on

moo

d,

stre

ss, d

aily

act

iviti

es, a

nd co

ping

st

rate

gies

. (1

stud

y)

Punu

kullo

, 201

9 Ov

eral

l 10-

19-y

ear-

olds

. St

udy:

14-

24 y

ears

ol

d

Incr

ease

d em

otio

nal s

elf-a

war

enes

s (ES

A) w

as

pred

ictiv

e of

a d

ecre

ase

in d

epre

ssiv

e sy

mpt

oms;

how

ever

, the

inte

rven

tion

was

not

caus

ally

resp

onsib

le

itsel

f for

the

decr

ease

in d

epre

ssiv

e sy

mpt

oms.

Inte

rven

tion

grou

p sh

owed

sign

ifica

nt in

crea

ses i

n ES

A w

ith m

ediu

m to

larg

e sig

nific

ant m

ain

effe

cts f

or ti

me,

fo

r dep

ress

ion,

anx

iety

, and

stre

ss. A

naly

sis su

gges

ted

that

par

ticip

atio

n in

RCT

itse

lf en

hanc

ed m

enta

l he

alth

care

and

impr

oved

MH

outc

omes

.

Mob

ile p

hone

-bas

ed m

ultim

edia

m

essa

ges (

CBT-

base

d te

xts,

vide

o m

essa

ges,

cart

oons

) (1

stud

y)

Punu

kullo

, 201

9 Ov

eral

l, 10

-19-

year

-ol

ds.

No si

gnifi

cant

effe

ct o

f CBT

-bas

ed p

rogr

am o

ver c

ontr

ol.

Both

pro

gram

s dem

onst

rate

d sm

all i

mpr

ovem

ents

in

depr

essio

n sc

ore

imm

edia

tely

afte

r the

inte

rven

tion

follo

wed

by

a w

orse

ning

of s

core

s at 1

2-m

onth

follo

w-

up.

Page 40: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

40

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

0

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

13-1

7-ye

ar-o

lds

Aero

bic e

xerc

ise;

Resis

tanc

e ex

ercis

e; v

ersu

s co

mbi

ned

aero

bic a

nd re

sista

nce

(1 st

udy)

Rodr

igue

z-Ay

llon,

20

19

14-1

8-ye

ar-o

lds

Posit

ive

effe

ct fo

r res

istan

ce g

roup

Exer

cise

to 5

0-80

% o

f max

imum

he

art r

ate

(2 st

udie

s)

Rodr

igue

z-Ay

llon,

20

19

13-1

6-ye

ar-o

lds

Posit

ive

effe

ct

Depr

essiv

e sy

mpt

oms

Univ

ersa

l res

ilien

ce-fo

cuse

d in

terv

entio

ns

Dray

, 201

7 11

-18

No e

ffect

Emot

iona

l diff

iculti

es a

nd b

ehav

iors

M

ento

ring

(resid

entia

l plu

s 9

mon

ths o

f men

torin

g) (c

ateg

orize

d as

socia

l and

em

otio

nal s

kills

de

velo

pmen

t) (1

stud

y15)

Barr

y, 2

018

Youn

g pe

ople

di

spla

ying

ant

isocia

l be

havi

or; n

on-

spec

ified

age

rang

e

Redu

ced

Exte

rnal

izing

pro

blem

s/be

havi

ors

Self-

regu

latio

n te

chni

ques

Va

n Ge

nugt

sen,

20

16

Adol

esce

nts o

nly

No e

ffect

Univ

ersa

l res

ilien

ce-fo

cuse

d in

terv

entio

ns

Dray

, 201

7 11

-18

No e

ffect

Iden

tity

dist

ress

Th

e Co

uncil

Gw

ythe

r, 20

19

Mea

n ag

es 1

5 an

d 15

.5 y

ears

No

effe

cts (

posit

ive

or n

egat

ive)

Imba

lanc

e (e

mot

iona

l, ps

ycho

logi

cal)

Exer

cise

to 5

0-80

% o

f max

imum

he

art r

ate

(2 st

udie

s)

Rodr

igue

z-Ay

llon,

20

19

13-1

6-ye

ar-o

lds

Posit

ive

effe

ct

Inte

rnal

izing

sym

ptom

s (in

clude

s dep

ress

ive

and

Univ

ersa

l Res

ilien

ce F

ocus

ed

Inte

rven

tions

(inc

lude

s cog

nitiv

e-Dr

ay, 2

017

11-1

8 ye

ars o

f age

Si

gnifi

cant

ove

rall

inte

rven

tion

effe

ct

Page 41: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

41

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

1

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

anxie

ty sy

mpt

oms)

be

havi

oral

-ther

apy-

base

d)

Self-

regu

latio

n te

chni

ques

Va

n Ge

nugt

sen,

20

16

Adol

esce

nts o

nly

Smal

l to

med

ium

effe

ct o

n in

tern

alizi

ng b

ehav

ior

Mas

culin

e id

eolo

gy

The

Coun

cil

Gwyt

her,

2019

M

ean

ages

15

and

15.5

yea

rs

No e

ffect

s (po

sitiv

e or

neg

ativ

e)

Nega

tive

affe

ct

Sele

cted

mix

ed g

ende

r, ge

nder

-ne

utra

l sch

ool-

and

com

mun

ity-

base

d pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

Gwyt

her,

2019

M

ean

ages

15

and

15.5

Po

sitiv

e ch

ange

s, m

ostly

in m

ales

Socia

l and

em

otio

nal s

kills

de

velo

pmen

t: M

ento

ring

(resid

entia

l plu

s 9 m

onth

s of

men

torin

g) (1

stud

y15)

Barr

y, 2

018

Youn

g pe

ople

di

spla

ying

ant

isocia

l be

havi

or; n

on-

spec

ified

age

rang

e

Redu

ced

nega

tive

emot

ions

Nega

tive

beha

vior

M

indf

ulne

ss-b

ased

inte

rven

tions

Du

nnin

g, 2

019

Mea

n ag

es fr

om 4

.7

to 1

7.4;

mos

t wer

e ol

der t

han

12.

For R

CTs w

ith a

ctiv

e co

ntro

l con

ditio

ns:

Not a

stat

istica

lly si

gnifi

cant

effe

ct.

Psyc

holo

gica

l dist

ress

Un

iver

sal r

esili

ence

-focu

sed

inte

rven

tions

Dr

ay, 2

017

11-1

8No

effe

ct

Aero

bics

, hip

-hop

, bod

y co

nditi

onin

g, ic

e sk

atin

g (1

stud

y)

Man

sfie

ld, 2

018

17-2

2Ae

robi

cs a

nd h

ip-h

op g

roup

s had

low

er p

sych

olog

ical

dist

ress

than

bod

y co

nditi

onin

g an

d ice

-ska

ting

grou

ps

Stig

ma

Univ

ersa

l sch

ool-b

ased

men

tal

heal

th p

rom

otio

n (m

enta

l hea

lth

anti-

stig

ma

prog

ram

; 1 st

udy)

O’Co

nnor

, 201

8 13

-15

year

s old

Posit

ive

chan

ges i

n st

uden

ts’ b

elie

fs a

nd a

ttitu

des

tow

ard

peop

le w

ith m

enta

l illn

ess

Mas

s Med

ia D

igita

l pla

tform

s (1

revi

ew, w

ith 2

2 RC

Ts)

Das,

2017

16

11-1

9, 1

5-24

-yea

r-ol

d Di

scrim

inat

ion

agai

nst m

enta

lly il

l: SM

D: -

.85

to -.

17

Page 42: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

42

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

2

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

Urba

n lo

w-in

com

e yo

uth

Prej

udice

aga

inst

men

tally

ill:

SMD:

-2.

94 to

2.4

0

Vide

o in

terv

entio

ns (v

ario

us ty

pes)

Ja

nous

kova

, 201

7 Yo

ung

peop

le; 4

of

23 st

udie

s wer

e co

nduc

ted

with

se

cond

ary

scho

ol

stud

ents

Find

ings

wer

e m

ixed

, dep

endi

ng o

n ty

pe o

f in

terv

entio

n, o

utco

me

mea

sure

s, an

d le

ngth

of f

ollo

w-

up p

erio

d. 2

stud

ies h

ad n

o sig

nific

ant i

mpa

ct; 1

stud

y ha

d po

sitiv

e fin

ding

s; an

d 1

had

both

pos

itive

and

ne

gativ

e fin

ding

s.

Men

tal h

ealth

aw

aren

ess (

2 RC

Ts

and

1 So

lom

on 4

gro

ups d

esig

n w

ith o

nly

hig

h sc

hool

pop

ulat

ions

)

Sale

rno,

201

6 Ov

eral

l, gr

ades

5

thro

ugh

12.

Som

e st

udie

s with

hi

gh sc

hool

po

pula

tion

1 ou

t of 3

stud

ies f

ound

impr

ovem

ents

in a

ttitu

des

Stre

ss (p

erce

ived

) St

ress

redu

ctio

n in

terv

entio

ns

Feiss

, 201

9 11

-18

year

s of a

geTa

rget

ed in

terv

entio

ns w

ere

bett

er th

an u

nive

rsal

Tai C

hi (C

en-s

tyle

) (1

stud

y)

Rodr

igue

z-Ay

llon,

20

19

11-1

6 ye

ars o

f age

No e

ffect

Min

dful

ness

-Bas

ed In

terv

entio

ns

(1)

Soul

akov

a, 2

019

(3)

8-15

yea

rs o

ldSi

gnifi

cant

effe

ct, b

ut sm

alle

r tha

n fo

r som

e ot

her

mea

sure

s

Univ

ersa

l sch

ool-b

ased

men

tal

heal

th p

rom

otio

n (s

tres

s m

anag

emen

t pro

gram

; 2

min

dful

ness

pro

gram

s; 1

stud

y ea

ch)

O’Co

nnor

, 201

8 12

-14

year

s old

(s

tres

s m

anag

emen

t)

12-1

6 ye

ars o

ld

(min

dful

ness

)

15-1

8-ye

ar o

lds

(min

dful

ness

)

Stre

ss m

anag

emen

t pro

gram

: Red

uced

stre

ss

Min

dful

ness

(12-

15-y

ear-o

lds a

nd 1

5-18

-yea

r old

s):

Redu

ced

stre

ss

Inte

ract

ions

with

nat

ure

Tillm

an, 2

018

Child

ren

and

teen

ager

s, 18

or

Find

ings

not

ava

ilabl

e by

age

.

Page 43: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

43

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

3

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

youn

ger,

mos

tly

early

ado

lesc

ents

(n

ot d

efin

ed)

Over

all,

with

rem

oval

of l

ow-q

ualit

y pa

pers

, 4 o

f 5

findi

ngs w

ere

signi

fican

tly p

ositi

ve.

Suici

de-re

late

d Un

iver

sal s

choo

l-bas

ed m

enta

l he

alth

pro

mot

ion

(sui

cide

prev

entio

n an

d de

pres

sion

awar

enes

s; 1

stud

y)

O’Co

nnor

, 201

8 14

-18-

year

old

sRe

duce

d su

icida

l ide

atio

n Im

prov

ed a

bilit

y to

iden

tify

supp

ort

Incr

ease

in h

elp-

seek

ing

beha

vior

s

Scho

ol-b

ased

suici

de p

reve

ntio

n pr

ogra

ms

Das,

2017

16

11-1

9, a

nd 1

5-24

,ye

ars o

f age

In

crea

sed

shor

t-ter

m k

now

ledg

e of

suici

de

Incr

ease

d kn

owle

dge

of su

icide

pre

vent

ion

No e

ffect

on

suici

de-re

late

d at

titud

es o

r beh

avio

rs

Tens

ion-

anxie

ty sc

ale

Krip

alu

yoga

(1 st

udy)

Pa

ndey

, 201

8 Gr

ades

11

and

12

Decr

ease

d re

lativ

e to

cont

rol

Tota

l moo

d di

stur

banc

e Kr

ipal

u yo

ga (1

stud

y)

Pand

ey, 2

018

Grad

es 1

1 an

d 12

De

crea

sed

rela

tive

to co

ntro

l

Tota

l sym

ptom

scor

es17

Bi

teBa

ck a

nd B

iteBa

ck S

choo

l Ba

nos,

2017

12

-18

year

s of a

geSi

gnifi

cant

dec

reas

e

Indi

vidu

al T

een-

Leve

l Out

com

es: P

ositi

vely

-Fra

med

Out

com

es

Posit

ive

men

tal h

ealth

out

com

e (a

ggre

gate

) Di

gita

l pla

tform

inte

rven

tions

(8

revi

ews)

Da

s, 20

1716

NA

Pe

rson

plu

s env

ironm

ent:

SMD:

.27,

95%

CI:

.16

to .3

7 (s

tatis

tical

ly si

gnifi

cant

) En

viro

nmen

t onl

y: S

MD:

.38,

95%

CI .

15 to

.60

(sta

tistic

ally

sign

ifica

nt)

Mul

tiple

out

com

es: S

choo

l: sc

hool

eng

agem

ent

(e.g

., sc

hool

conn

ecte

dnes

s, at

tend

ance

, sch

ool

likin

g); S

ocia

l: so

cial s

kills

(e.g

., co

oper

atio

n,

empa

thy,

turn

-taki

ng),

perc

eive

d so

cial s

uppo

rt,

rela

tions

hip

qual

ity (e

.g.,

perc

eptio

ns o

f re

latio

nshi

p qu

ality

with

teac

hers

, par

ents

, pee

rs)

Yout

h m

ento

ring

prog

ram

s (on

e-on

-one

, int

erge

nera

tiona

l) Ra

posa

, 201

9 9-

16-y

ear-o

lds;

mea

n ag

e of

12.

Ove

rall

effe

ct si

ze a

cros

s out

com

es a

nd p

rogr

ams:

He

dges

g 0

.21.

Pr

ogra

ms w

ith b

ette

r out

com

es h

ad th

e fo

llow

ing

char

acte

ristic

s:

High

er p

erce

ntag

e of

mal

e m

ente

es.

Hi

gher

per

cent

age

of m

ale

men

tors

.

Page 44: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

44

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

4

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

Hi

gher

per

cent

age

of m

ale

men

tors

who

wor

ked

in

the

help

ing

prof

essio

ns.

Prog

ram

s with

smal

ler e

ffect

s had

the

follo

win

g ch

arac

teris

tic:

Pr

ogra

ms s

pecif

ying

long

er m

eetin

g du

ratio

nsM

any

othe

r var

iabl

es w

ere

mea

sure

d as

pot

entia

l m

oder

ator

s of e

ffect

s, bu

t sho

wed

no

impa

ct o

n fin

ding

s.

Atte

ntio

n M

indf

ulne

ss-b

ased

inte

rven

tions

Du

nnin

g, 2

019

Mea

n ag

es fr

om 4

.7

to 1

7.4;

mos

t wer

e ol

der t

han

12.

For R

CTs w

ith a

ctiv

e co

ntro

l con

ditio

ns:

Not a

stat

istica

lly si

gnifi

cant

effe

ct.

Body

imag

e Ae

robi

c exe

rcise

Re

sista

nce

exer

cise

Com

bine

d ae

robi

c and

resis

tanc

e (1

stud

y)

Rodr

igue

z-Ay

llon,

20

19

14-1

8-ye

ar-o

lds

No d

iffer

ence

bet

wee

n ex

perim

enta

l and

cont

rol

Body

imag

e in

terv

entio

ns

Soul

akov

a, 2

019

(3)

14-1

6 ye

ars o

ldNo

effe

cts.

(Effe

cts w

ere

foun

d fo

r you

nger

ado

lesc

ents

)

Body

imag

e: tr

ait b

ody

surv

eilla

nce

(neg

ativ

e ou

tcom

e)

Yoga

(1 st

udy)

Ro

drig

uez-

Ayllo

n,

2019

13

-17

Sign

ifica

nt m

oder

ate

decr

ease

s, in

vers

ely

rela

ted

to

chan

ge i

n ph

ysica

l sel

f-wor

th

Cogn

itive

aut

onom

y Se

lect

ed m

ale-

only

gen

der-

neut

ral

scho

ol a

nd co

mm

unity

-bas

ed

prog

ram

s to

deve

lop

youn

g m

en’s

wel

lbei

ng

Gwyt

her,

2019

M

ean

ages

15

and

15.5

yea

rs o

f age

Po

sitiv

e ef

fect

Com

mun

icatio

n an

d fa

cilita

tion

skill

s So

cial a

nd e

mot

iona

l ski

lls

deve

lopm

ent:

Men

torin

g (re

siden

tial;

peer

-led)

(1 st

udy)

Barr

y, 2

018

15-2

5-ye

ar-o

lds

Posit

ive

effe

ct

Com

mun

ity e

ngag

emen

t So

cial a

nd e

mot

iona

l ski

lls

deve

lopm

ent:

Yout

h co

mm

unity

Ba

rry,

201

8 8-

18-y

ear-o

lds,

prim

arily

mal

e fro

mPo

sitiv

e im

pact

on

com

mun

ity e

ngag

emen

t

Page 45: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

45

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

5

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

spor

ts in

terv

entio

n (1

stu

dy)

blac

k an

d et

hnic

min

ority

gro

ups

recr

uite

d fro

m

inne

r-city

Lond

on

scho

ols

Conn

ecte

dnes

s St

uden

t Suc

cess

Ski

lls (E

mot

iona

l Re

gula

tion)

(1 st

udy)

Pa

ndey

, 201

8 12

-15

year

s old

Ef

fect

on

fem

ales

Copi

ng sk

ills/

Copi

ng a

nd re

silie

nce

Socia

l and

em

otio

nal s

kills

de

velo

pmen

t: M

ento

ring

(resid

entia

l; pe

er-le

d) (

1 st

udy)

Barr

y, 2

018

15-2

5-ye

ar-o

lds

Posit

ive

effe

ct fo

r cop

ing

skill

s

Univ

ersa

l sch

ool-b

ased

men

tal

heal

th p

rom

otio

n (s

tres

s m

anag

emen

t pro

gram

; SEL

pr

ogra

m; 1

stud

y ea

ch)

O’Co

nnor

, 201

8 12

-14

year

s old

(s

tres

s m

anag

emen

t; SE

L)

Stre

ss m

anag

emen

t: Im

prov

ed co

ping

stra

tegi

es,

incr

ease

d us

e of

rela

xatio

n st

rate

gies

SEL:

Effe

ctiv

e co

ping

stra

tegi

es

Emot

iona

l int

ellig

ence

/em

otio

nal a

ttent

ion

and

clarit

y/em

otio

nal c

ompe

tenc

e/em

otio

nal

adju

stm

ent/

emot

iona

l aw

aren

ess

Sele

cted

mal

e-on

ly g

ende

r-ne

utra

l sc

hool

and

com

mun

ity-b

ased

pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

(8 st

udie

s)

Gwyt

her,

2019

M

ean

ages

15

and

15.5

yea

rs o

f age

Po

sitiv

e ef

fect

Sele

cted

mix

ed g

ende

r, ge

nder

-ne

utra

l sch

ool-

and

com

mun

ity-

base

d pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

(18

stud

ies)

Gwyt

her,

2019

M

ean

ages

15

and

15.5

Po

sitiv

e ch

ange

s, m

ostly

in m

ales

Life

skill

s edu

catio

n (1

stud

y)

Nash

eeda

, 201

9 15

-17-

year

-old

sEm

otio

nal a

djus

tmen

t im

prov

ed

Univ

ersa

l sch

ool-b

ased

men

tal

heal

th p

rom

otio

n (m

indf

ulne

ss; 1

st

udy)

O’Co

nnor

, 201

8 15

-18-

year

old

sPo

sitiv

e ch

ange

s in

stud

ents

’ bel

iefs

and

att

itude

s to

war

d pe

ople

with

men

tal i

llnes

s

Emot

iona

l wel

l-bei

ng

Inte

ract

ions

with

nat

ure

Tillm

ann,

201

8 Ch

ildre

n an

d te

enag

ers,

18 y

ears

Fi

ndin

gs n

ot a

vaila

ble

by a

ge g

roup

.

Page 46: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

46

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

6

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

old

and

youn

ger

With

rem

oval

of l

ow-q

ualit

y pa

pers

, onl

y 10

out

of 2

3 fin

ding

s ide

ntifi

ed a

sign

ifica

nt p

ositi

ve re

latio

nshi

p.

Empa

thy

Life

skill

s edu

catio

n (1

stud

y)

Nash

eeda

, 201

9 15

-17-

year

-old

sIm

prov

ed

Exec

utiv

e fu

nctio

ns

Min

dful

ness

-bas

ed in

terv

entio

ns

Dunn

ing,

201

9 M

ean

ages

from

4.7

to

17.

4; m

ost w

ere

olde

r tha

n 12

.

For R

CTs w

ith a

ctiv

e co

ntro

l con

ditio

ns:

Not a

stat

istica

lly si

gnifi

cant

effe

ct.

Expl

anat

ory

styl

e Fi

nnish

der

ivat

ive

of th

e Pe

nn

Resil

ienc

y Pr

ogra

m (c

ogni

tive-

beha

vior

al d

epre

ssio

n pr

even

tion

prog

ram

) (2

stud

ies)

18

Bast

ouni

s, 20

1619

Ov

eral

l inc

lude

d st

udie

s: 8

-17.

M

ean

ages

in 2

st

udie

s: 1

3 an

d 14

ye

ars o

f age

No e

ffect

on

expl

anat

ory

styl

e fo

r all

stud

ies/

all a

ge

grou

ps.

Feel

ings

Hi

gh-in

tens

ity in

terv

al tr

aini

ng

with

aer

obics

v co

ntro

l and

co

mbi

ned

v co

ntro

l (1

stud

y)

Rodr

igue

z-Ay

llon,

20

19

14-1

6 ye

ars o

ldFe

elin

gs im

prov

ed si

gnifi

cant

ly o

nly

in th

e ae

robi

c gro

up

Happ

ines

s Ta

i Chi

v g

ymna

stics

Ro

drig

uez-

Ayllo

n,

2019

13

-16

No e

ffect

of e

xper

imen

tal g

roup

Help

-see

king

(lik

elih

ood

of se

ekin

g, in

crea

sed

unde

rsta

ndin

g of

how

for s

elf a

nd o

ther

s)

Sele

cted

mal

e-on

ly g

ende

r-se

nsiti

ve co

mm

unity

- and

scho

ol-

base

d pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

Gwyt

her,

2019

M

ean

ages

of 1

5 an

d 15

.5

Posit

ive

Vide

o in

terv

entio

n (d

ocum

enta

ry

inte

rven

tion

with

edu

catio

n; 1

st

udy)

Jano

usko

va, 2

017

Youn

g pe

ople

; 4 o

f 23

stud

ies w

ere

cond

ucte

d w

ith

seco

ndar

y sc

hool

st

uden

ts

Mixe

d fin

ding

s for

atti

tude

s tow

ard

help

-see

king

. No

sign

ifica

nt e

ffect

on

help

-see

king

beh

avio

r.

Men

tal h

ealth

aw

aren

ess (

1 RC

T an

d 1

Solo

mon

4 g

roup

s des

ign

with

onl

y h

igh

scho

ol p

opul

atio

ns

Sale

rno,

201

6 Ov

eral

l, gr

ades

5

thro

ugh

12.

Som

e st

udie

s with

Neith

er st

udy

foun

d im

prov

emen

ts in

hel

p-se

ekin

g.

Page 47: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

47

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

7

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

mea

sure

d he

lp-s

eeki

ng)

high

scho

ol

popu

latio

n

Inte

rest

in d

iver

sity

of co

ntac

t Se

lect

ed m

ixed

gen

der,

gend

er-

neut

ral s

choo

l- an

d co

mm

unity

-ba

sed

prog

ram

s to

deve

lop

youn

g m

en’s

wel

lbei

ng

Gwyt

her,

2019

M

ean

ages

15

and

15.5

In

crea

sed,

mos

tly in

mal

es

Life

satis

fact

ion/

sens

e th

at li

fe is

wor

thw

hile

So

cial a

nd e

mot

iona

l ski

lls

deve

lopm

ent:

Socia

l act

ion

inte

rven

tions

(mul

ti-co

mpo

nent

) (2

RCT

stud

ies)

Barr

y, 2

018

14-2

5-ye

ar-o

lds,

mos

tly fr

omdi

sadv

anta

ged

area

s

Posit

ive

effe

cts o

n lif

e sa

tisfa

ctio

n an

d lif

e se

en a

s w

orth

whi

le

Bite

Back

and

Bite

Back

Sch

ool

(Onl

ine

posit

ive

psyc

holo

gy

inte

rven

tions

)

Bano

s, 20

17

12-1

8-ye

ar-o

lds

No im

prov

emen

t in

life

satis

fact

ion

scor

es.

Men

tal h

ealth

lite

racy

(kno

wle

dge)

M

enta

l hea

lth a

war

enes

s (2

RCTs

an

d 1

Solo

mon

4 g

roup

s des

ign

with

onl

y h

igh

scho

ol p

opul

atio

ns)

Sale

rno,

201

6 Ov

eral

l, gr

ades

5

thro

ugh

12.

Som

e st

udie

s with

hi

gh sc

hool

po

pula

tion

All 3

stud

ies f

ound

impr

ovem

ents

in k

now

ledg

e of

sp

ecifi

c diso

rder

s or m

enta

l hea

lth li

tera

cy g

ener

ally

.

Men

tal h

ealth

/men

tal h

ealth

stat

us

Sele

cted

Mixe

d Ge

nder

, Gen

der-

Neut

ral S

choo

l- an

d co

mm

unity

-ba

sed

prog

ram

s to

deve

lop

youn

g m

en’s

wel

lbei

ng

Gwyt

her,

2019

M

ean

ages

15

and

15.5

Po

sitiv

e ch

ange

s, m

ostly

in m

ales

Cros

sFit

exer

cise

(1 st

udy)

Ro

drig

uez-

Ayllo

n,

2019

15

.4 m

ean

age

No si

gnifi

cant

effe

cts f

or fu

ll st

udy

sam

ple

Inte

ract

ions

with

nat

ure

Tillm

an, 2

018

Child

ren

and

teen

ager

s, 18

yea

rs

old

and

youn

ger,

mos

t ear

ly

adol

esce

nts

Find

ings

not

ava

ilabl

e by

age

gro

up.

Over

all:

with

rem

oval

of l

ow-q

ualit

y pa

pers

, 8 o

ut o

f 12

findi

ngs i

dent

ified

a si

gnifi

cant

pos

itive

rela

tions

hip.

Page 48: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

48

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

8

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

E-he

alth

4U

Bano

s, 20

17

3rd

and

4th

year

of

seco

ndar

y sc

hool

M

inor

impr

ovem

ent.

Min

dful

ness

M

indf

ulne

ss-b

ased

inte

rven

tions

Du

nnin

g, 2

019

Mea

n ag

es fr

om 4

.7

to 1

7.4;

mos

t wer

e ol

der t

han

12.

For R

CTs w

ith a

ctiv

e co

ntro

ls:

Mea

n ef

fect

size

0.4

2 (C

I .16

to .6

7].

Larg

er e

ffect

size

s wer

e as

socia

ted

with

old

er a

ges.

Mot

ivat

ion

to ch

ange

So

cial a

nd e

mot

iona

l ski

lls

deve

lopm

ent:

Men

torin

g (re

siden

tial p

lus 9

mon

ths o

f m

ento

ring)

(1

stud

y20)

Barr

y, 2

018

Youn

g pe

ople

di

spla

ying

ant

isocia

l be

havi

or; n

on-

spec

ified

age

rang

e

No d

iffer

ence

Optim

ism

Sele

cted

mix

ed g

ende

r, ge

nder

-ne

utra

l sch

ool-

and

com

mun

ity-

base

d pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

Gwyt

her,

2019

M

ean

ages

15

and

15.5

Po

sitiv

e ch

ange

s, m

ostly

in m

ales

Posit

ive

men

tal h

ealth

pro

mot

ion

outc

omes

Co

mpo

nent

s of u

nive

rsal

ad

oles

cent

men

tal h

ealth

in

terv

entio

ns

Al

coho

l and

dru

g ed

ucat

ion

Em

otio

nal r

egul

atio

n

Inte

rper

sona

l ski

lls

Sk

ills t

o re

sist p

eer

pres

sure

Skee

n, 2

019

10-1

9 Po

sitiv

e im

pact

Posit

ive

wel

lbei

ng

Volle

ybal

l (1

stud

y)

Man

sfie

ld, 2

018

13-1

8-ye

ar-o

ld

fem

ales

Ef

fect

s dep

ende

d on

ext

ent t

o w

hich

the

spor

t met

st

uden

ts’ p

sych

olog

ical n

eeds

Aero

bics

, hip

-hop

, bod

y co

nditi

onin

g, ic

e sk

atin

g

Man

sfie

ld, 2

018

17

-22-

year

-old

s Ae

robi

cs a

nd h

ip-h

op ra

ted

posit

ive

wel

lbei

ng h

ighe

r th

an b

ody

cond

ition

ing

and

ice-s

katin

g gr

oup;

Posit

ive

outlo

ok

Socia

l and

em

otio

nal s

kills

Ba

rry,

201

8 Yo

ung

peop

le

No d

iffer

ence

Page 49: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

49

Rapid Evidence Review Appendix 4: Findings by Outcome

| 1

9

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

deve

lopm

ent:

Men

torin

g (re

siden

tial p

lus 9

mon

ths o

f m

ento

ring)

(1 st

udy21

)

disp

layi

ng a

ntiso

cial

beha

vior

; non

-sp

ecifi

ed a

ge ra

nge

Posit

ive

yout

h de

velo

pmen

t out

com

es (g

roup

ed a

s so

cial a

nd e

mot

iona

l ski

lls; a

ttitu

des t

owar

d se

lf,

othe

rs a

nd sc

hool

; pos

itive

socia

l beh

avio

r; em

otio

nal d

istre

ss; a

cade

mic

perfo

rman

ce;

cond

uct p

robl

ems;

subs

tanc

e us

e; a

nd a

dditi

onal

ou

tcom

es in

som

e st

udie

s [e.

g., h

igh

scho

ol

grad

uatio

n; re

latio

nshi

ps])

Scho

ol-b

ased

Soc

ial a

nd E

mot

iona

l Le

arni

ng In

terv

entio

ns fo

r Pos

itive

Yo

uth

Deve

lopm

ent

Tayl

or, 2

01722

23

K-12

; ado

lesc

ent

deve

lopm

enta

l st

age

defin

ed a

sag

es 1

4-18

/gra

des

9-12

Posit

ive

com

bine

d ef

fect

size

24 .1

8* (C

I .05

-.31)

was

st

atist

ically

sign

ifica

nt.

Outc

omes

for i

ndiv

idua

l out

com

es a

re n

ot a

vaila

ble

for

adol

esce

nts.

Acro

ss a

ll st

udie

s, tw

o va

riabl

es e

mer

ged

as si

gnifi

cant

pr

edict

ors:

--Hig

her t

otal

sam

ple

attr

ition

(low

er e

ffect

ive

size)

. --P

artic

ipan

t age

was

initi

ally

neg

ativ

ely

rela

ted

to

posit

ive

effe

ct si

ze, b

ut w

hen

a m

eta-

regr

essio

n of

the

two

pred

ictor

s (at

triti

on a

nd a

ge) w

as co

nduc

ted,

the

age

diffe

renc

e w

as n

ot si

gnifi

cant

. Ot

her d

emog

raph

ics (%

whi

te st

uden

ts, %

bla

ck

stud

ents

, % fe

mal

e, sc

hool

com

mun

ity lo

catio

n,

dom

estic

or i

nter

natio

nal s

tudy

) wer

e no

t ass

ocia

ted

with

the

com

bine

d ef

fect

size

.

Prep

arat

ion

for a

dulth

ood

Varie

ty o

f int

erve

ntio

ns

Burr

us, 2

018

Adol

esce

nts

inclu

ding

mid

dle

scho

ol

Impr

ovem

ents

in:

Heal

thy

rela

tions

hips

Pa

rent

-chi

ld co

mm

unica

tion

Adol

esce

nt d

evel

opm

ent

Psyc

holo

gica

l wel

lbei

ng

Gend

er-s

ensit

ive

Com

mun

ity- a

nd

scho

ol-b

ased

pro

gram

s to

deve

lop

youn

g m

en’s

wel

lbei

ng

Gwyt

her,

2019

M

ean

ages

of 1

5 an

d 15

.5

Posit

ive

High

-inte

nsity

inte

rval

trai

ning

(H

IIT) (

Exer

cise-

base

d in

terv

entio

ns) (

1 st

udy)

Pand

ey, 2

018

Grad

es 9

and

10

No st

atist

ically

sig

nific

ant e

ffect

Qua

lity

of li

fe -

enjo

ymen

t and

satis

fact

ion

Gend

er-s

ensit

ive co

mm

unity

- and

sc

hool

-bas

ed p

rogr

ams t

o de

velo

p Gw

ythe

r, 20

19

Mea

n ag

es o

f 15

and

15.5

Po

sitiv

e

Page 50: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

50

Rapid Evidence Review Appendix 4: Findings by Outcome

| 2

0

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

youn

g m

en’s

wel

lbei

ng

Resh

aped

per

cept

ions

abo

ut “b

eing

a m

an”

Com

mun

ity- a

nd sc

hool

-bas

ed

prog

ram

s to

deve

lop

youn

g m

en’s

wel

lbei

ng

Gwyt

her,

2019

M

ean

ages

of 1

5 an

d 15

.5

Posit

ive

effe

cts (

base

d on

par

ticip

ant c

omm

ents

)

Rela

tions

hip

skill

s So

cial a

nd e

mot

iona

l ski

lls

deve

lopm

ent:

Men

torin

g (re

siden

tial;

peer

-led)

(1 st

udy)

Barr

y, 2

018

15-2

5-ye

ar-o

lds

Posit

ive

effe

ct

Resil

ienc

e M

indf

ulne

ss-B

ased

Inte

rven

tions

(1

) So

ulak

ova,

201

9 Gr

ades

1-1

2 Si

gnifi

cant

, alth

ough

smal

ler t

han

for o

ther

mea

sure

s.

Inte

ract

ions

with

nat

ure

Tillm

an, 2

019

Child

ren

and

teen

ager

s, 18

and

yo

unge

r, m

ostly

ea

rly a

dole

scen

ts

(not

def

ined

)

Find

ings

not

repo

rted

by

age

grou

p.

Over

all,

3 ou

t of 5

find

ings

wer

e po

sitiv

e an

d sig

nific

ant.

Self-

effic

acy25

Th

e Co

uncil

26; S

elec

ted

mal

e-on

ly

gend

er-n

eutr

al p

rogr

ams t

o de

velo

p yo

ung

men

’s w

ellb

eing

Gwyt

her,

2019

M

ean

ages

15

and

15.5

Si

gnifi

cant

pos

itive

effe

cts f

or sc

hool

self-

effic

acy

and

futu

re se

lf-ef

ficac

y (m

ales

onl

y)

Sele

cted

mix

ed g

ende

r, ge

nder

-ne

utra

l sch

ool-

and

com

mun

ity-

base

d pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

Gwyt

her,

2019

M

ean

ages

15

and

15.5

Po

sitiv

e ch

ange

s, m

ostly

in m

ales

Self-

effic

acy:

socia

l Yo

ga (1

stud

y)

Rodr

igue

z-Ay

llon,

20

19

11-1

6-ye

ar-o

lds

Sign

ifica

nt in

crea

se

Self-

este

em/s

elf-c

onfid

ence

/sel

f-im

age/

self-

wor

th

Life

Skill

s for

Men

tal H

ealth

Ca

tala

no, 2

019

(94,

with

2 fo

r te

ens w

ithou

t hi

gh ri

sk o

r ex

istin

g

14-1

6-ye

ar-o

lds

Impr

oved

self-

este

em

Page 51: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

51

Rapid Evidence Review Appendix 4: Findings by Outcome

| 2

1

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

prob

lem

s)

Sele

cted

mal

e-on

ly g

ende

r-se

nsiti

ve C

omm

unity

- and

scho

ol-

base

d pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

Gwyt

her,

2019

M

ean

ages

of 1

5 an

d 15

.5

Posit

ive

effe

cts

Life

skill

s edu

catio

n (4

stud

ies)

Na

shee

da, 2

019

Varie

d, a

ll hi

gh

scho

ol st

uden

ts

Self-

este

em, s

elf-i

mag

e, a

nd co

nfid

ence

impr

oved

Aero

bic e

xerc

ise to

ach

ieve

60-

80%

m

axim

um h

eart

rate

(1)

Rodr

igue

z-Ay

llon,

20

19

13-1

9 ye

ars o

ld

Posit

ive

effe

ct (a

ll fe

mal

es)

Aero

bic e

xerc

ise

Resis

tanc

e ex

ercis

e Co

mbi

ned

aero

bic a

nd re

sista

nce

(1 st

udy)

Rodr

igue

z-Ay

llon,

20

19

14-1

8-ye

ar-o

lds

All g

roup

s im

prov

ed o

n gl

obal

self-

este

em, w

ith g

reat

er

chan

ges i

n th

e re

sista

nce

grou

p.

Activ

e vi

deo

gam

e pr

ogra

m (1

st

udy)

Ro

drig

uez-

Ayllo

n,

2019

15

-19-

year

-old

s No

effe

cts

Socia

l and

em

otio

nal s

kills

de

velo

pmen

t: M

ento

ring

(resid

entia

l; pe

er-le

d)

Barr

y, 2

018

15-2

5-ye

ar-o

lds

Posit

ive

effe

ct fo

r con

fiden

ce

Yout

h-le

d co

mm

unity

de

velo

pmen

t pro

gram

(1

qual

itativ

e st

udy)

Penn

ingt

on, 2

018

Not s

pecif

ied

May

hav

e ha

d an

effe

ct

Inte

ract

ions

with

nat

ure

Ti

llman

, 201

8 Ch

ildre

n an

d te

enag

ers,

18 a

nd

youn

ger,

mos

t ear

ly

adol

esce

nts (

not

defin

ed)

Find

ings

not

ava

ilabl

e by

age

gro

up.

Over

all,

10 o

ut o

f 13

findi

ngs w

ere

non-

signi

fican

t.

Page 52: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

52

Rapid Evidence Review Appendix 4: Findings by Outcome

| 2

2

Wel

lbei

ng O

utco

me,

by

Socio

-env

ironm

enta

l De

velo

pmen

t Int

erve

ntio

n Le

vel a

nd O

utco

me

Mea

sure

men

t Lev

el

Inte

rven

tion

Type

/ Sp

ecifi

c Int

erve

ntio

n Re

view

or M

ajor

St

udy

(Mos

t Re

cent

Firs

t)

Age

or O

ther

Gro

up

in R

evie

wed

Stu

dies

Ev

iden

ce S

umm

ary

(inclu

ding

not

able

subg

roup

di

ffere

nces

, if n

oted

by

revi

ewer

)

Com

mun

ity-b

ased

crea

tive

activ

ities

Da

s, 20

1716

11

-19,

and

15-

24,

year

-old

s In

crea

sed

self-

conf

iden

ce

Incr

ease

d se

lf-es

teem

Self-

regu

latio

n te

chni

ques

Va

n Ge

nugt

sen,

20

16

Adol

esce

nts o

nly

Smal

l to

med

ium

effe

ct o

n se

lf-es

teem

Self-

refle

ctio

n Co

mm

unity

- and

scho

ol-b

ased

pr

ogra

ms t

o de

velo

p yo

ung

men

’s w

ellb

eing

Gwyt

her,

2019

M

ean

ages

15

and

15.5

yea

rs

Posit

ive

effe

cts (

base

d on

par

ticip

ant c

omm

ents

)

Self-

Regu

latio

n/em

otio

n re

gula

tion

Univ

ersa

l sch

ool-b

ased

men

tal

heal

th p

rom

otio

n (m

indf

ulne

ss

prog

ram

; 1 st

udy)

O’Co

nnor

, 201

8 15

-18

yea

rs o

ld

Impr

oved

em

otio

n re

gula

tion

Min

dful

Yog

a (M

indf

ulne

ss/Y

oga

inte

rven

tions

) (1

stud

y)

Pand

ey, 2

018

Gr

ades

9-1

2

No e

ffect

Pers

onal

& S

ocia

l Res

pons

ibili

ty

mod

el (E

xerc

ise-b

ased

in

terv

entio

ns)

Pand

ey, 2

018

Stud

ents

from

3

publ

ic sc

hool

s (m

ean

age

of 1

3.6

year

s)

Posit

ive

effe

ct o

n pr

oces

s sel

f-reg

ulat

ion

Socia

l adj

ustm

ent

Life

skill

s edu

catio

n Na

shee

da, 2

019

15-1

7-ye

ar-o

lds

No im

prov

emen

t

Socia

l beh

avio

r M

indf

ulne

ss-b

ased

inte

rven

tions

Du

nnin

g, 2

019

Mea

n ag

es fr

om 4

.7

to 1

7.4;

mos

t wer

e ol

der t

han

12.

For R

CTs w

ith a

ctiv

e co

ntro

l con

ditio

ns: N

ot a

st

atist

ically

sign

ifica

nt e

ffect

.

Page 53: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

53

Rapid Evidence Review Appendix 4: Findings by Outcome

Endnotes

1. Note that the intervention itself did not comprise efforts to change the out-comes listed in these rows. Rather, the outcomes were measured post-hoc to examine whether the new neighborhoods (requiring higher rent payments) actually had more health-promoting environments.

2. For details on all Moving to Opportunity’ citations, see the single Evidence Table, Moving to Opportunity.

3. There are no reviews per se of the Moving to Opportunity’s experiment’s effects on teen mental health. The citations are for individual studies using aspects of the MTO database. All citations are summarized on the Moving to Opportunity Evidence Table in Appendix 5.

4. Halfway through the Great Smoky Mountains study, an American Indian tribe opened a casino and began sharing proceeds with families in the tribe. The Great Smoky Mountains study was originally an epidemiological study of the incidence and progression of mental health problems among children in a defined geographic area (American Indians and others).

5. We included only the intervention studies included in the review.

6. This 2017 review is included because of differences between Marx, 2017, and Berger. Marx, 2017, is a Cochrane Collaboration review with more rigorous study inclusion criteria than the Berger et al. (2018) review. Berger et al. included studies of associations as well as interventions; Marx et al. included only interventions (RCTs, quasi-experiments, controlled before and after, interrupted time series). However, Berger et al. focused more on psychological outcomes than did Marx et al. We only reported findings from intervention studies from the Berger et al review; both reviews come to the same conclusion that more primary research, of higher quality, is needed, before conclusions can be drawn.

7. Note that Yap subsequently (2019) reported on the medium-term effects of a tailored web-based parenting intervention tested in a randomized con-trolled trial. The RCT showed some success Yap MBH, Cardamone-Breen MC, Rapee RM, Lawrence KA, Mackinnon AJ, Mahtani S, Jorm AF. 2019. Medium-Term Effects of a Tailored Web-Based Parenting Intervention to Reduce Adolescent Risk of Depression and Anxiety: 12-Month Findings From a Randomized Controlled Trial J Med Internet Res 2019;21(8):e13628 DOI: 10.2196/13628 PMID: 31418422. https://www.jmir.org/2019/8/e13628/

8. Parent involvement, staff skills training, activities for children/adolescents.

9. See Anyon et al. for youth outcomes.

10. The highest positive effect size was for the Mindfulness component of inter-ventions (-0.219).

11. Also see Explanatory Style.

12. Kept Bastounis (2016) as a key document for its inclusion of the Penn Resiliency Program. We could identify no subsequent reviews of the Penn Resiliency Program, but the Program is still active, according to its website. See https://ppc.sas.upenn.edu/services/penn-resilience-training.

13. Think, Feel, Act.

14. Also see anxiety and depressive symptomatology, internalizing symptoms and total symptom score outcomes.

15. Study was the one of strongest quality, among 3 mentoring studies with young people at risk of criminality

16. We report on the Das 2017 “overview of reviews” only for Digital Platform interventions, Community-based Creative activities, and school-based suicide prevention interventions because we could find no subsequent sys-tematic reviews of these intervention types. Further, most of the interven-tions included in Das et al. 2017 are focused on treatment or prevention of disorders.

17. Also see internalizing symptoms, anxiety symptoms, and depression symp-toms

18. Also see anxiety and depression symptoms.

19. We kept Bastounis (2016) as a key document for its inclusion of the Penn Resiliency Program. We could identify no subsequent reviews of the Penn Resiliency Program, but the Program is still active, according to its website. See https://ppc.sas.upenn.edu/services/penn-resilience-training.

20. Study was the one of strongest quality, among 3 mentoring studies with young people at risk of criminality

21. Study was the one of strongest quality, among 3 mentoring studies with young people at risk of criminality

22. We kept this 2017 review in the RER because it appears to be the most re-cent systematic review that enabled analysis of SEL interventions by adoles-cent/teen age. The review by Barry. et al. (2018) included SEL; however, the review focused only on interventions implemented in the United Kingdom. Taylor et al. (2017) included both U.S. and international interventions.

23. Note that authors of this review included two (Taylor and Weissberg) employed at the Center for Academic, Social, and Emotional Learning (CASEL).

24. According to the authors, “in order to examine the effectiveness of SEL interventions across demographic groups, it was necessary to collapse the outcome categories into a single intervention level ES to obtain sufficient sample sizes.” Only 11% of 82 interventions focused on adolescents ages 14-18/grades 9-12.

25. Also see Skeen effects of programs with self-efficacy components

26. The Council intervention aimed to encourage solidarity amongst young men, question maladaptive stereotypes, and recognize strengths and collec-tive responsibilities.

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54

Rapid Evidence Review Appendix 5: Evidence Tables

Moving Policy Upstream to Advance Adolescent Flourishing

Rapid Evidence Review Appendix 5: Evidence Tables

D. Dougherty, N. LeBlanc, P. Armstrong, E. Cope, and the AcademyHealth & ACT for Health Team

With support from Well Being Trust

September 30, 2019

Page 55: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

55

Rapid Evidence Review Appendix 5: Evidence Tables

Evidence Tables by Article Reviewed

1. A

rora

PG

, Co

llins

TA

, Dar

t E

H, H

erna

ndez

S, F

ette

rman

H, D

oll

B. M

ulti

-tie

red

Sys

tem

s o

f S

upp

ort

fo

r S

cho

ol-

Bas

ed M

enta

l Hea

lth:

A S

yste

mat

ic R

evie

w o

f D

epre

ssio

n In

terv

enti

ons

. S

cho

ol M

enta

l Hea

lth

[Int

erne

t]. 2

019

June

[ci

ted

201

9 A

ug 1

3]; 1

1(2)

:240

-264

. Ava

ilab

le f

rom

: htt

ps:

//lin

k.sp

ring

er.c

om

/art

icle

/10.

1007

%2F

s123

10-0

19-0

9314

-4FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

Sch

ool-a

ged

yout

h ag

es 6

to 2

1 ye

ars.

Da

te ra

nge

for r

evie

w: 1

990-

2017

# of

stud

ies i

nclu

ded:

119

As

not

ed b

y au

thor

: Rev

iew

onl

y da

tes b

ack

until

199

0. D

ecisi

on to

con

duct

a sy

stem

atic

revi

ew in

stea

d of

a m

eta-

anal

ysis

resu

lted

in

a le

ss fo

rmal

ass

essm

ent o

f the

se p

rogr

ams

whe

n re

cent

met

a-an

alys

es h

ave

dem

onst

rate

d th

at th

ese

type

s of i

nter

venti

ons a

re e

ffecti

ve.

Incl

udes

uni

vers

al,

sele

cted

, and

targ

eted

in

terv

entio

ns. E

ssen

tially

ar

gues

for t

arge

ted

with

in

univ

ersa

lism

.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens a

ges 1

3-18

—sp

ecify

by

stud

y if

auth

or d

oesn

’t ag

greg

ate

by re

leva

nt a

ge g

roup

: 11-

14

(Cha

plin

et a

l., 2

006)

, 11-

17 (C

onne

ll &

Dish

ion,

201

7), 1

5-17

(Hai

ns e

t al.,

19

94),

11-1

3 (H

oyin

g &

Mel

nyk,

201

6), 1

3-14

(Hoy

ing

et a

l., 2

016)

, 15-

20 (L

e &

Gob

ert,

2015

), 14

-16

(Mel

nyk

et a

l., 2

015)

, 12-

15 (M

ende

lson

et a

l., 2

015)

, 11

-14

(Sib

ingo

et a

l., 2

016)

, 10-

14 (S

mok

owsk

i et a

l., 2

016)

.

Hi-L

evel

Fin

ding

s: 3

0 st

udie

s foc

used

on

Tier

1

prog

ram

s. 2

3 ou

t of t

he 3

0 st

udie

s yie

lded

pos

itive

re

sults

. Al

l thr

ee ti

ers c

onta

ined

pro

gram

s ide

ntifie

d as

eff

ectiv

e (7

7.5%

in T

ier 2

, 78.

9% in

Tie

r 3).

How

ever

, the

aut

hors

not

e th

at th

ere

are

a sw

ath

of im

plem

enta

tion

and

popu

latio

n iss

ues t

hat h

ave

yet t

o be

add

ress

ed, a

nd th

at so

lvin

g th

ese

issue

s is

criti

cal t

o de

liver

ing

an e

ffecti

ve M

TSS.

Inte

rven

tion

Type

/Nam

e/Df

—O

vera

ll: A

mul

ti-tie

red

syst

em o

f sup

port

(M

TSS)

invo

lves

the

deliv

ery

of e

vide

nce-

base

d se

rvic

es a

long

a c

ontin

uum

. U

nive

rsal

, or T

ier 1

, ser

vice

s are

impl

emen

ted

with

the

goal

of p

reve

nting

MH

conc

erns

whi

ch m

ight

serv

e as

a b

arrie

r to

acad

emic

ach

ieve

men

t. Ti

er 2

, or

sele

ctive

, ser

vice

s are

del

iver

ed w

ith th

e go

al o

f rem

edia

ting

stud

ents

at r

isk

for m

enta

l hea

lth c

once

rns,

whi

le T

ier 3

, or i

ndic

ated

or i

nten

sive,

serv

ices

ar

e im

plem

ente

d w

ith th

e go

al o

f tre

ating

you

th w

ith th

e hi

ghes

t lev

el o

f m

enta

l hea

lth n

eed.

Data

base

s sea

rche

d fo

r rev

iew

: Ps

ycIN

FO, E

RIC.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (s

peci

fy):

Penn

Res

ilien

cy P

rogr

am (C

hapl

in e

t al.,

200

6), F

amily

Res

ourc

e Ce

nter

(Con

nell

& D

ishio

n, 2

017)

, str

ess i

nter

venti

on (H

ains

et a

l., 1

994)

, CO

PE (H

oyin

g &

Mel

nyk,

201

6; H

oyin

g et

al.,

201

6; M

elny

k et

al.,

201

5),

Rest

orin

g th

e N

ative

Am

eric

an S

pirit

(Le

& G

ober

t, 20

15),

RAP

club

(M

ende

lson

et a

l., 2

015)

, Min

dful

ness

inte

rven

tion

(Sib

ingo

et a

l., 2

016)

, Po

sitive

Acti

on P

rogr

am (S

mok

owsk

i et a

l., 2

016)

.

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy:

Artic

les i

nclu

ded

in th

e re

view

m

ust d

escr

ibe

a pr

even

tion

or in

terv

entio

n st

udy

that

ta

rget

ed o

r disc

usse

d de

pres

sive

sym

ptom

s in

scho

ol-a

ged

yout

h ag

es 6

-21

in a

US

scho

ol se

tting

.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Pr

imar

ily a

nxie

ty a

nd d

epre

ssio

n sy

mpt

omol

ogy.

Re

view

exc

lusi

on c

riter

ia—

Focu

s on

stud

y m

etho

dolo

gy: A

rticl

es

wer

e ex

clud

ed fr

om th

e re

view

if

they

faile

d to

mee

t the

incl

usio

n cr

iteria

det

aile

d ab

ove.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent (

spec

ify)—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Dep

ress

ive

diso

rder

s and

dep

ress

ion

sym

ptom

olog

y (C

hapl

in e

t al.,

200

6; C

onne

ll &

Dish

ion,

201

7), a

nxie

ty/

depr

essio

n sy

mpt

omol

ogy

(Hai

ns, 1

994)

, wei

ght a

nd m

enta

l hea

lth (H

oyin

g &

Mel

nyk,

201

6; H

oyin

g et

al.,

201

6; M

elny

k et

al.,

201

5), s

uici

dalit

y (L

e &

Go

bert

, 201

5), t

raum

a (M

ende

lson

et a

l., 2

015)

, str

ess a

nd tr

aum

a (S

ibin

go e

t al

., 20

16),

emoti

onal

hea

lth (S

mok

owsk

i et a

l., 2

016)

.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): N

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity, I

nter

pers

onal

) – S

peci

fy o

utco

me

and

for w

hom

/wha

t it i

s mea

sure

d: N

/A

Setti

ng(s

): Sc

hool

sCo

untr

y(ie

s): U

.S.

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

: NA

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fam

ily, w

ork,

re

crea

tion,

OST

): Sc

hool

, Ind

ivid

ual

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56

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Chap

lin e

t al.,

200

611

-14

Penn

Res

ilien

cy P

rogr

amM

ixed

resu

lts o

n de

pres

sive

diso

rder

/sy

mpt

oms.

Pos

t-tes

t ES

of 0

.80.

Fou

nd

signi

fican

t int

erve

ntion

effe

cts o

n se

cond

ary

varia

bles

(e.g

., ho

pele

ssne

ss a

nd a

ttend

ance

).

From

Tab

le 1

onl

y th

e pr

imar

y fo

cus o

f eac

h in

terv

entio

n co

uld

be

glea

ned.

Conn

ell &

Dish

ion,

201

711

-17

Fam

ily R

esou

rce

Cent

erM

ixed

resu

lts o

n de

pres

sive

diso

rder

/sy

mpt

oms.

No

ES re

port

ed.

Hain

s, 1

994

15-1

7St

ress

inte

rven

tion

No

signi

fican

t res

ults

obs

erve

d on

anx

iety

/de

pres

sion

sym

ptom

s.

Hoyi

ng &

Mel

nyk,

201

611

-13

COPE

Positi

ve si

gnifi

cant

effe

ct o

bser

ved

on w

eigh

t an

d m

enta

l hea

lth (E

S =

0.22

).

Hoyi

ng e

t al.,

201

613

-14

COPE

Positi

ve si

gnifi

cant

effe

cts o

bser

ved

on w

eigh

t an

d m

enta

l hea

lth (E

S =

0.16

).

Le &

Gob

ert,

2015

15-2

0Re

stor

ing

the

Nati

ve A

mer

ican

Spi

ritPo

sitive

sign

ifica

nt e

ffect

obs

erve

d on

su

icid

ality

(No

ES p

rovi

ded)

.

Mel

nyk

et a

l., 2

015

14-1

6CO

PEPo

sitive

sign

ifica

nt e

ffect

s obs

erve

d on

wei

ght

and

men

tal h

ealth

(ES

= 2.

37).

Men

delso

n et

al.,

201

512

-15

RAP

club

Positi

ve si

gnifi

cant

effe

ct o

bser

ved

on tr

aum

a (E

S =

0.10

).

Sibi

ngo

et a

l., 2

016

11-1

4M

indf

ulne

ssPo

sitive

sign

ifica

nt e

ffect

s obs

erve

d on

stre

ss

and

trau

ma

(No

ES p

rovi

ded)

.

Smok

owsk

i et a

l., 2

016

10-1

4Po

sitive

Acti

on P

rogr

amN

o sig

nific

ant e

ffect

obs

erve

d on

em

otion

al

heal

th.

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57

Rapid Evidence Review Appendix 5: Evidence Tables

2. B

agna

ll A

, So

uth

J, D

i Mar

tino

S. 2

018,

Mar

. A s

yste

mat

ic r

evie

w o

f in

terv

enti

ons

to

bo

ost

so

cial

rel

atio

ns t

hro

ugh

imp

rove

men

ts in

co

mm

unit

y in

fras

truc

ture

(pla

ces

and

sp

aces

). Lo

ndo

n:  W

hat

Wo

rks

Cen

tre

for

Wel

lbei

ng. h

ttp

s://

wha

two

rksw

ellb

eing

.org

/pro

duc

t/p

lace

s-sp

aces

-peo

ple

-and

-wel

lbei

ng/

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

No

expl

icit

rang

e of

age

s/de

velo

pmen

tal g

roup

s, th

ough

focu

s was

for a

dults

(loo

sely

defi

ned

as a

ged

betw

een

16 a

nd 6

5).

Date

rang

e fo

r rev

iew

: 199

7-20

18#

of st

udie

s inc

lude

d: 5

1M

ost o

f the

evi

denc

e w

as o

f poo

r, or

poo

r to

mod

erat

e qu

ality

. The

bett

er-q

ualit

y ev

iden

ce

was

qua

litati

ve in

nat

ure,

and

mos

t of t

he

revi

ew’s

findi

ngs t

here

fore

com

e fr

om th

e th

emati

c sy

nthe

sis o

f qua

litati

ve e

vide

nce,

su

pple

men

ted

by q

uanti

tativ

e ev

iden

ce w

here

ap

plic

able

.

Revi

ew e

xclu

ded

stud

ies t

hat

incl

uded

onl

y ol

der a

dults

or o

nly

child

ren.

Onl

y 14

stud

ies w

ere

univ

ersa

l/op

en to

all.

15

stud

ies w

ere

of p

opul

ation

s in

“are

as o

f de

priv

ation

”; 7

stud

ies i

nclu

ded

raci

al a

nd e

thni

c m

inor

ity g

roup

s;

5 st

udie

s inc

lude

d ec

onom

ical

ly

disa

dvan

tage

d pe

ople

.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens a

ges 1

3-18

—sp

ecify

by

stud

y if

auth

or d

oesn

’t ag

greg

ate

by re

leva

nt a

ge g

roup

: (10

st

udie

s) (B

lake

and

Clo

utier

-Fish

er 2

009,

Dan

iels

et a

l. 20

09, G

omez

- Fel

icia

no

et a

l. 20

09, M

anga

du e

t al.

2016

, Ohm

er e

t al.

2009

, McL

ean

and

Rahd

er

2013

, Mor

ris a

nd O

’Brie

n 20

11, M

urra

y an

d De

vecc

hi 2

016,

Wel

ls et

al.

2012

, Zi

eff e

t al.

2016

).

Hi-L

evel

Fin

ding

s: M

ODE

RATE

evi

denc

e th

at

com

mun

ity h

ubs m

ay p

rom

ote

soci

al c

ohes

ion

thro

ugh

the

mix

ing

of d

iffer

ent s

ocia

l or a

ge/

gene

ratio

nal g

roup

s; in

crea

se so

cial

cap

ital a

nd

build

trus

t bet

wee

n pe

ople

in c

omm

uniti

es;

incr

ease

wid

er so

cial

net

wor

ks a

nd in

tera

ction

be

twee

n co

mm

unity

mem

bers

; and

incr

ease

in

divi

dual

s’ k

now

ledg

e or

skill

s.

MO

DERA

TE e

vide

nce

that

cha

nges

to

neig

hbou

rhoo

d de

sign

may

pos

itive

ly a

ffect

se

nse

of b

elon

ging

and

prid

e in

a c

omm

unity

.

MO

DERA

TE e

vide

nce

that

gre

en a

nd b

lue

spac

e in

terv

entio

ns th

at p

rovi

de th

e op

port

unity

to

parti

cipa

te in

acti

vitie

s or m

eetin

gs im

prov

e so

cial

inte

racti

ons,

incr

ease

soci

al n

etw

orks

, an

d bo

ndin

g an

d br

idgi

ng so

cial

cap

ital,

incr

ease

ph

ysic

al a

ctivi

ty a

nd h

ealth

y ea

ting,

and

impr

ove

com

mun

ity m

embe

rs’ s

kills

and

kno

wle

dge.

2 st

udie

s in

the

revi

ew sh

owed

no

impa

ct; b

oth

wer

e “t

op d

own

urba

n re

new

al p

roje

cts.”

The

revi

ew a

lso fo

und

evid

ence

from

qua

litati

ve

stud

ies t

hat p

lace

and

spac

e in

terv

entio

ns c

an

have

pot

entia

lly n

egati

ve e

ffect

s in

term

s of

som

e re

side

nts f

eelin

g ex

clud

ed, p

artic

ular

ly

in re

latio

n to

eve

nts t

hat t

arge

t or c

eleb

rate

pa

rticu

lar g

roup

s.

The

revi

ew fo

und

evid

ence

that

pla

ce a

nd

spac

e in

terv

entio

ns th

at p

rovi

de a

foca

l poi

nt

or a

targ

eted

gro

up a

ctivi

ty m

ay b

e us

eful

in (a

) pr

omoti

ng so

cial

coh

esio

n be

twee

n di

ffere

nt

grou

ps a

nd (b

) ove

rcom

ing

barr

iers

that

pre

vent

so

me

peop

le in

mar

gina

lised

gro

ups f

rom

taki

ng

part

in a

ctivi

ty.

The

qual

itativ

e sy

nthe

sis o

f pro

cess

out

com

es

iden

tified

som

e ke

y st

rate

gies

for s

ucce

ss

whe

n im

plem

entin

g co

mm

unity

infr

astr

uctu

re

chan

ges t

o pl

ace

or sp

ace,

whi

ch in

clud

ed:

acce

ssib

ility

; a c

omfo

rtab

le, f

riend

ly a

nd sa

fe

envi

ronm

ent;

invo

lvem

ent o

f com

mun

ity

mem

bers

in o

rgan

isatio

n an

d pl

anni

ng o

f co

mm

unity

infr

astr

uctu

re c

hang

es; i

nvol

vem

ent

of sk

illed

faci

litat

ors;

flex

ibili

ty; p

rovi

ding

a

foca

l poi

nt o

r rea

son

to in

tera

ct; a

void

ing

excl

usio

n; lo

okin

g at

long

er te

rm o

utco

mes

and

su

stai

nabi

lity;

and

invo

lvin

g vo

lunt

eers

.

Page 58: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

58

Rapid Evidence Review Appendix 5: Evidence Tables

Inte

rven

tion

Type

/Nam

e/Df

—O

vera

ll:

Com

mun

ity in

fras

truc

ture

: The

phy

sical

pla

ces a

nd sp

aces

whe

re p

eopl

e ca

n co

me

toge

ther

, for

mal

ly o

r inf

orm

ally,

to in

tera

ct a

nd p

artic

ipat

e in

the

soci

al

life

of th

e co

mm

unity

.Ei

ght i

nter

venti

on c

ateg

orie

s im

pacti

ng c

omm

unity

infr

astr

uctu

re:

com

mun

ity h

ubs;

eve

nts;

loca

l nei

ghbo

urho

od d

esig

n; g

reen

and

blu

e sp

ace;

pl

ace-

mak

ing;

alte

rnati

ve u

se o

f spa

ce; u

rban

rege

nera

tion;

and

com

mun

ity

deve

lopm

ent.

Data

base

s sea

rche

d fo

r rev

iew

: Ps

ycIn

fo, M

EDLI

NE,

CIN

AHL,

So

cial

Pol

icy

and

Prac

tice

(cov

ers

Soci

al C

are

Onl

ine

and

Idox

), So

cial

Sci

ence

s Cita

tion

Inde

x,

Acad

emic

Sea

rch

Com

plet

e,

Leisu

reTo

urism

, Hos

pita

lity

and

Tour

ism C

ompl

ete,

Ave

ry In

dex,

Gr

eenF

iles a

nd U

rban

Stu

dies

Ab

stra

cts.

Grey

lite

ratu

re a

lso se

arch

ed

thro

ugh

Ope

nSig

le.

Adol

esce

nt-S

peci

fic F

indi

ngs:

All

10 st

udie

s with

ad

oles

cent

s com

bine

d ad

oles

cent

s with

oth

er

popu

latio

ns; a

fter s

crub

bing

thro

ugh

indi

vidu

al

stud

ies n

one

of th

e in

divi

dual

stud

ies s

epar

ated

th

eir a

dole

scen

t-spe

cific

resu

lts e

ither

.

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18-y

ear-

olds

or e

quiv

alen

t (s

peci

fy):

NA

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es

that

incl

uded

any

inte

rven

tion

(form

al o

r inf

orm

al) w

hich

w

ere

desig

ned

to im

prov

e, o

r m

ake

bette

r or a

ltern

ative

use

of

, com

mun

ity in

fras

truc

ture

to

impr

ove

wel

lbei

ng. W

hile

fo

cus w

as g

iven

to st

udie

s tha

t in

clud

ed e

vide

nce

for a

dult

popu

latio

ns, c

hild

ren

and

adol

esce

nt fi

ndin

gs w

ere

also

in

clud

ed.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: So

cial

rela

tions

, com

mun

ity w

ellb

eing

or i

ndiv

idua

l wel

lbei

ng o

utco

mes

. Re

view

exc

lusi

on c

riter

ia—

Focu

s on

stud

y m

etho

dolo

gy:

Stud

ies t

hat f

ocus

ed o

n on

ly

olde

r adu

lt or

onl

y ch

ildre

n (a

s de

fined

by

the

stud

y au

thor

s)

wer

e ex

clud

ed. S

tudi

es th

at o

nly

prov

ided

des

crip

tive

info

rmati

on

or c

omm

enta

ry w

ere

excl

uded

.

Out

com

es e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r equ

ival

ent (

spec

ify)—

incl

ude

all

but h

ighl

ight

PSE

WB

outc

omes

: NA

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): W

WCW

Met

hods

Gui

de, P

RISM

A,

PRIS

MA-

Equi

ty g

uide

lines

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18-

year

-old

s (N

ation

, Com

mun

ity, I

nter

pers

onal

) – C

omm

unity

wel

lbei

ng,

soci

al re

latio

ns S

peci

fy o

utco

me

and

for w

hom

/wha

t it i

s mea

sure

d:

Setti

ng(s

): Co

untr

y(ie

s): M

ostly

USA

; UK,

Aus

tral

ia, T

urke

y, Sp

ain,

Sw

itzer

land

, Ger

man

ySt

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): M

ostly

urb

an

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fam

ily, w

ork,

re

crea

tion,

OST

): Co

mm

unity

/Nei

ghbo

rhoo

d

Page 59: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

59

Rapid Evidence Review Appendix 5: Evidence Tables

3. B

ano

s, O

nlin

e P

osi

tive

Inte

rven

tio

ns t

o P

rom

ote

Wel

l-b

eing

and

Res

ilien

ce in

the

Ad

ole

scen

t P

op

ulat

ion:

A N

arra

tive

Rev

iew

. Fro

ntie

rs in

Psy

chia

try

[Int

erne

t]. 2

017

Jan

30 [

cite

d 2

019

July

26]

; 8:

10. A

vaila

ble

fro

m: h

ttp

s://

ww

w.n

cbi.n

lm.n

ih.g

ov/

pub

med

/281

9411

7FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

mid

dle

or h

igh

scho

ol st

uden

tsDa

te ra

nge

for r

evie

w: 2

000-

2016

# of

stud

ies i

nclu

ded:

48

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens a

ges 1

3-18

—sp

ecify

by

stud

y if

auth

or d

oesn

’t ag

greg

ate

by re

leva

nt a

ge g

roup

: 12-

18

year

old

s (M

anic

avas

agar

et a

l., 2

014;

Bur

ckha

rdt e

t al.,

201

5), A

dole

scen

ts

(age

not

defi

ned)

(Red

zic e

t al.,

201

2; R

edzic

et a

l., 2

014)

, 3rd

and

4th

yea

r se

cond

ary

scho

ol st

uden

ts (B

anni

nk e

t al.,

201

4), a

dole

scen

t girl

s age

d 10

-14

(Fan

g &

Sch

inke

, 201

3).

Data

base

s sea

rche

d fo

r rev

iew

: ER

IC, P

sycI

NFO

, MED

LIN

E,

SCO

PUS,

Pro

Que

st S

ocio

logi

cal

Abst

ract

s, In

form

it, JS

TOR,

SAG

E,

and

Tayl

or a

nd F

ranc

is O

nlin

e.

Hi-L

evel

Fin

ding

s: In

gen

eral

all

stud

ies s

how

ed

positi

ve re

sults

, dec

reas

ing

anxi

ety

and

depr

essio

n sc

ores

, and

incr

easin

g w

ell-b

eing

.

As n

oted

by

auth

or: I

n th

is re

view

, no

syst

em

uses

mob

ile p

hone

reso

urce

s to

carr

y ou

t th

e in

terv

entio

ns a

nd n

urtu

re in

terp

erso

nal

rela

tions

hips

. How

ever

, sin

ce sm

artp

hone

s or

simila

r dev

ices

wer

e no

t con

sider

ed a

s key

wor

ds

it is

poss

ible

that

som

e sy

stem

s wer

e no

t de

tect

ed.

Inte

rven

tion

Type

/Nam

e/Df

—O

vera

ll: P

ositi

ve te

chno

logy

/inte

rnet

-bas

ed

positi

ve te

chno

logy

; pos

itive

inte

rven

tions

del

iver

ed o

ver t

he In

tern

et a

s eff

ectiv

e an

d su

stai

nabl

e he

alth

pro

moti

on to

ols;

all

stud

ies u

sed

a w

ebsit

e to

del

iver

the

PPIs

, one

stud

y al

so u

sed

soci

al n

etw

ork

(Fac

eboo

k) a

nd e

mai

l, an

d an

othe

r one

also

use

d te

xt m

essa

ges r

emin

ders

. PPI

s are

exe

rcise

s (e.

g.,

coun

ting

your

ble

ssin

gs, p

racti

cing

kin

dnes

s, e

xpre

ssin

g gr

atitu

de, u

sing

pers

onal

stre

ngth

s, e

tc.),

whi

ch h

ave

dem

onst

rate

d em

piric

ally

to in

crea

se

positi

ve e

moti

ons,

satis

facti

on w

ith li

fe, o

r oth

er p

ositi

ve st

ates

.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18-y

ear-

olds

or e

quiv

alen

t (s

peci

fy):

Bite

Bac

k pr

ogra

m (M

anic

avas

agar

et a

l., 2

014;

Bur

ckha

rdt e

t al.,

20

15),

InJo

y (R

edzic

et a

l., 2

012;

Red

zic e

t al.,

201

4), E

-hea

lth4U

th (B

anni

nk

et a

l., 2

014)

, Mot

her-D

augh

ter P

reve

ntion

Pro

gram

(Fan

g &

Sch

inke

, 201

3).

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es

that

wer

e in

clud

ed 1

) foc

used

on

pro

ving

the

effica

cy o

f an

onlin

e PP

I to

prom

ote

wel

l-bei

ng

and

resil

ienc

e in

ado

lesc

ent

popu

latio

n; 2

) wer

e pu

blish

ed

until

Apr

il 20

16; a

nd 3

) wer

e ra

ndom

ized

cont

rolle

d tr

ials

(RCT

s).

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: w

ell-b

eing

and

resil

ienc

e, a

nxie

ty a

nd d

epre

ssio

n sc

ores

Revi

ew e

xclu

sion

crit

eria

—Fo

cus

on st

udy

met

hodo

logy

: Stu

dies

th

at o

nly

invo

lved

prim

ary/

elem

enta

ry sc

hool

stud

ents

or

wer

e co

ncer

ned

with

topi

cs

such

as t

each

er w

ellb

eing

or

the

wor

k of

scho

ol c

ouns

ello

rs,

psyc

holo

gist

s, o

r psy

chia

trist

s w

ere

excl

uded

. Stu

dies

that

on

ly in

volv

ed c

onst

ruct

s suc

h as

ph

ysic

al sc

hool

env

ironm

ents

, cl

assr

oom

-leve

l clim

ates

, hom

e or

fam

ily e

nviro

nmen

ts, h

ealth

lit

erac

y, va

lues

or r

elig

ious

ed

ucati

on, a

nd p

hysic

al h

ealth

w

ere

also

exc

lude

d.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent (

spec

ify)—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: dep

ress

ion

sym

ptom

s, st

ress

, anx

iety

sy

mpt

oms,

tota

l sym

ptom

scor

es, w

ell-b

eing

(Man

icav

asag

ar e

t al.,

201

4;

Burc

khar

dt e

t al.,

201

5), c

opin

g an

d em

otion

regu

latio

n, d

epre

ssiv

e sy

mpt

oms,

eng

agem

ent (

Redz

ic e

t al.,

201

2), s

ocia

l and

lear

ning

dom

ains

, en

gage

men

t qua

lity

of in

terv

entio

n (h

elpf

ulne

ss, f

un, i

nter

estin

g) (R

edzic

et

al.,

2014

), he

alth

-rel

ated

qua

lity

of li

fe, c

ondo

m u

se d

urin

g in

terc

ours

e, d

rug

use,

men

tal h

ealth

stat

us (B

anni

nk e

t al.,

201

4), m

othe

r-dau

ghte

r clo

sene

ss,

mot

her-d

augh

ter c

omm

unic

ation

, mat

erna

l mon

itorin

g, p

aren

tal r

ules

aga

inst

su

bsta

nce

use,

self-

effica

cy, r

efus

al sk

ills,

inte

ntion

of u

sing

subs

tanc

es in

the

futu

re, d

epre

ssiv

e m

ood,

bod

y es

teem

, sub

stan

ce u

se n

orm

ative

bel

iefs

(Fan

g &

Sch

inke

, 201

3).

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Page 60: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

60

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity, I

nter

pers

onal

) – S

peci

fy o

utco

me

and

for w

hom

/wha

t it i

s mea

sure

d: N

/A

Setti

ng(s

): Sc

hool

-bas

ed, O

nlin

eCo

untr

y(ie

s): U

S, A

ustr

alia

, Net

herla

nds

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol, f

amily

, wor

k,

recr

eatio

n, O

ST):

Indi

vidu

al

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Man

icav

asag

ar e

t al.,

201

412

-18

year

s of a

geBi

te B

ack

prog

ram

Bite

Bac

k pa

rtici

pant

s with

hig

h le

vels

of

adhe

renc

e ha

d sig

nific

ant d

ecre

ases

in

depr

essio

n an

d st

ress

and

impr

ovem

ents

in w

ell-

bein

g w

hen

com

pare

d to

con

trol

gro

up. B

ite B

ack

parti

cipa

nts w

ho v

isite

d th

e sit

e m

ore

freq

uent

ly

had

signi

fican

t dec

reas

es in

dep

ress

ion

and

anxi

ety

and

impr

ovem

ents

in w

ell-b

eing

co

mpa

red

to c

ontr

ol g

roup

.

Burc

khar

dt e

t al.,

201

512

-18

year

s of a

geBi

te B

ack

prog

ram

(sch

ool)

Both

con

ditio

ns sa

w re

ducti

ons i

n de

pres

sion,

st

ress

, and

tota

l sym

ptom

scor

es w

ithou

t an

y sig

nific

ant d

iffer

ence

s or s

igni

fican

t im

prov

emen

ts in

life

satis

facti

on sc

ores

pos

t in

terv

entio

n.

Redz

ic e

t al.,

201

2Ad

oles

cent

s (ag

e no

t defi

ned)

InJo

yIn

Joy

show

ed g

ood

but s

mal

l effe

cts o

n co

ping

an

d em

otion

regu

latio

n, a

nd le

ss in

crea

ses i

n th

e pr

ogre

ssio

n of

dep

ress

ive

sym

ptom

s in

stud

ents

w

ith lo

w-r

isk o

f dep

ress

ion.

No

signi

fican

t effe

cts

on d

ecre

asin

g de

pres

sive

sym

ptom

s in

stud

ents

at

hig

h-ris

k of

dep

ress

ion.

Sig

nific

ant d

iffer

ence

s in

eng

agem

ent w

hen

com

pare

d to

con

trol

gro

up.

Redz

ic e

t al.,

201

4Ad

oles

cent

s (ag

e no

t defi

ned)

InJo

yRe

vise

d In

Joy

was

rate

d hi

gher

on

the

targ

eted

so

cial

lear

ning

dom

ains

and

as s

igni

fican

tly m

ore

enga

ging

(i.e

., he

lpfu

l, in

tere

sting

, fun

)

Bann

ink

et a

l., 2

014

3rd- a

nd 4

th-y

ear s

econ

dary

scho

ol

stud

ents

E-he

alth

4Uth

Com

pare

d to

the

cont

rol g

roup

, the

E-h

ealth

4Uth

in

terv

entio

n gr

oup

show

ed m

inor

pos

itive

resu

lts

in h

ealth

-rel

ated

qua

lity

of li

fe a

nd c

ondo

m

use

durin

g in

terc

ours

e am

ong

adol

esce

nts o

f Du

tch

ethn

icity

. E-h

ealth

4Uth

and

con

sulta

tion

inte

rven

tion

grou

p sh

owed

min

or p

ositi

ve re

sults

in

the

men

tal h

ealth

stat

us o

f ado

lesc

ents

, but

a

nega

tive

effec

t on

drug

use

in b

oys.

Fang

& S

chin

ke, 2

013

Adol

esce

nt g

irls a

ged

10-1

4M

othe

r-Dau

ghte

r Pre

venti

on P

rogr

amCo

mpa

red

to th

e co

ntro

l gro

up, i

nter

venti

on

girls

repo

rted

hig

her l

evel

s of m

othe

r-da

ught

er c

lose

ness

, gre

ater

mot

her-d

augh

ter

com

mun

icati

on, m

ore

mat

erna

l mon

itorin

g, a

nd

enha

nced

par

enta

l rul

es a

gain

st su

bsta

nce

use

at 2

yea

r fol

low

up.

Inte

rven

tion

arm

girl

s also

re

port

ed st

rong

er se

lf-effi

cacy

, gre

ater

refu

sal

skill

s, a

nd lo

wer

inte

ntion

of u

sing

subs

tanc

es

in th

e fu

ture

. Fur

ther

mor

e th

ey re

port

ed

signi

fican

tly fe

wer

inst

ance

s of u

sing

alco

hol,

mar

ijuan

a, a

nd p

resc

riptio

n dr

ugs f

or n

on-

med

ical

pur

pose

s.

Page 61: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

61

Rapid Evidence Review Appendix 5: Evidence Tables

4. B

arry

MM

, Cla

rke

AM

, Mo

rrea

le S

E, F

ield

CA

. A R

evie

w o

f th

e E

vid

ence

on

the

Eff

ects

of

Co

mm

unit

y-b

ased

Pro

gra

ms

on

Youn

g P

eop

le’s

So

cial

and

Em

oti

ona

l Ski

lls D

evel

op

men

t. A

do

lesc

ent

Res

earc

h R

evie

w

[Int

erne

t]. 2

018

Mar

ch [

cite

d 2

019

July

26]

; 3(1

):13-

27. A

vaila

ble

fro

m: h

ttp

s://

link.

spri

nger

.co

m/a

rtic

le/1

0.10

07/s

4089

4-01

7-00

55-2

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

You

th

aged

13-

19 y

ears

Da

te ra

nge

for r

evie

w: 2

004-

2014

# of

stud

ies i

nclu

ded:

14

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to

HS

aged

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gr

oup:

(see

tabl

e)

Hi-L

evel

Fin

ding

s: th

ere

are

a sm

all b

ut g

row

ing

num

ber o

f rob

ust s

tudi

es in

the

UK

prov

idin

g ev

iden

ce o

f the

effe

ctive

ness

of c

omm

unity

-ba

sed

prog

ram

s th

at d

evel

op y

oung

peo

ple’

s so

cial

and

em

otion

al s

kills

. The

qua

lity

of th

e da

ta c

olle

ction

met

hods

use

d fo

r ass

essi

ng

the

impa

ct o

f int

erve

ntion

s on

soc

ial a

nd

emoti

onal

wel

lbei

ng o

utco

mes

was

iden

tified

as

a m

etho

dolo

gica

l wea

knes

s. T

he e

vide

nce

from

inte

rven

tions

aim

ed a

t inc

reas

ing

soci

al

and

emoti

onal

ski

lls th

roug

h cr

eativ

e ar

ts a

nd

spor

ts-b

ased

acti

vitie

s in

the

UK

is c

urre

ntly

qu

ite li

mite

d du

e to

a la

ck o

f rob

ust s

tudy

de-

sign

s an

d po

or q

ualit

y an

alys

is.

As n

oted

by

auth

or: D

ue to

the

hete

roge

neity

of t

he e

valu

ation

st

udie

s id

entifi

ed, a

qua

ntita

tive

synt

hesi

s of t

he fi

ndin

gs fr

om

the

inte

rven

tion

stud

ies

revi

ewed

was

not

pos

sibl

e. T

here

fore

, th

e re

view

find

ings

are

bas

ed o

n a

narr

ative

synt

hesi

s, w

hich

do

es n

ot h

ave

the

stati

stica

l pow

er to

exa

min

e pr

ogra

m e

ffect

si

zes.

Wea

k st

udy

qual

ity.

Inte

rven

tion

Type

/Nam

e/Df

—O

vera

ll: S

ocia

l Ac

tion

inte

rven

tions

, You

th A

rts a

nd S

port

s in

terv

entio

ns, a

nd M

ento

ring

inte

rven

tions

Data

base

s sea

rche

d fo

r rev

iew

: EM

BASE

, Psy

cIN

FO, S

COPU

S,

Appl

ied

Soci

al S

cien

ce In

dex

and

Abst

ract

s, B

ritish

Edu

catio

n In

dex.

A to

tal o

f 24

educ

ation

dat

abas

es a

nd 8

pub

lic h

ealth

da

taba

ses w

ere

also

sear

ched

. Add

ition

al so

urce

s inc

lude

d go

ogle

Sch

olar

and

refe

renc

e lis

ts o

f rel

evan

t arti

cles

, boo

k ch

apte

rs, a

nd re

view

. Gre

y lit

erat

ure

data

base

s inc

ludi

ng Z

etoc

, ET

HOS,

Pro

Que

st a

nd G

oogl

e.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (sp

ecify

): (s

ee ta

ble)

Re

view

incl

usio

n cr

iteria

—Fo

cus o

n st

udy

met

hodo

logy

: St

udie

s inc

lude

d in

this

revi

ew m

ust i

nvol

ve in

terv

entio

ns th

at

1) a

ddre

ss o

ne o

r mor

e so

cial

and

em

otion

al sk

ills a

s out

lined

by

CAS

EL a

nd th

e Yo

ung

Foun

datio

n; 2

) are

impl

emen

ted

in a

co

mm

unity

-bas

ed se

tting

in th

e U

K; a

nd 3

) are

impl

emen

ted

as

a un

iver

sal i

nter

venti

on w

ith y

outh

in th

e ge

nera

l pop

ulati

on.

In a

dditi

on, p

rogr

ams h

ad to

em

ploy

a ra

ndom

ized

cont

rolle

d tr

ial (

RCT)

or q

uasi-

expe

rimen

tal d

esig

n (Q

ED) a

nd in

clud

e at

le

ast o

ne m

easu

re o

f a so

cial

or e

moti

onal

out

com

e.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut

high

light

PSE

WB

outc

omes

: cat

egor

ies o

f ou

tcom

es c

oded

into

: Em

otion

al S

kills

(ES)

; So

cial

Ski

lls (S

S); a

nd E

duca

tiona

l, He

alth

, and

So

cial

(EHS

) Out

com

es.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: In

terv

entio

n im

plem

ente

d w

ith y

outh

who

had

a d

iagn

osed

m

enta

l, be

havi

oral

, or p

hysic

al d

isord

er w

ere

not e

ligib

le fo

r in

clus

ion.

Oth

erw

ise, e

xclu

sion

from

the

revi

ew w

as b

ased

on

a fa

ilure

to m

eet t

he in

clus

ion

crite

ria d

etai

led

abov

e.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r eq

uiva

lent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht

PSEW

B ou

tcom

es: (

see

tabl

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

an

d/or

peo

ple

surr

ound

ing

13-1

8 ye

ar-o

lds

(Nati

on, C

omm

unity

, Int

erpe

rson

al) –

Spe

cify

ou

tcom

e an

d fo

r who

m/w

hat i

t is m

easu

red:

(s

ee ta

ble)

Setti

ng(s

): co

mm

unity

-bas

ed p

rogr

ams

Coun

try(

ies)

: UK

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er

coun

trie

s):

Leve

l (e.

g., n

ation

al, c

omm

unity

/ne

ighb

orho

od, s

choo

l, fa

mily

, wor

k, re

crea

tion,

O

ST):

Com

mun

ity

Page 62: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

62

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Boot

h, 2

014

15-1

7N

ation

al C

itize

n Se

rvic

eEm

otion

al S

kills

(ES)

: Sig

nific

ant i

mpr

ovem

ent i

n co

nfide

nce,

ha

ppin

ess,

life

satis

facti

on, r

ating

of “

life

is w

orth

whi

le”,

self-

repo

rted

anx

iety

, res

ilien

ce, s

elf-e

ffica

cy, a

nd p

robl

em-s

olvi

ng sk

ills.

So

cial

Ski

lls (S

S): S

igni

fican

t pos

itive

impa

ct o

n so

cial

trus

t, so

cial

ca

pita

l, atti

tude

to o

ther

s fro

m d

iffer

ence

bac

kgro

unds

, lea

ders

hip,

te

am w

ork,

soci

al c

ompe

tenc

e, c

omm

unic

ation

. Ed

ucati

onal

, Hea

lth, a

nd S

ocia

l out

com

es (E

HS):

Sign

ifica

nt p

ositi

ve

impa

ct o

n in

tere

st in

edu

catio

n, a

ttitu

de to

war

d so

cial

mix

ing

in lo

cal a

rea,

com

mun

ity a

war

enes

s, c

omm

unity

eng

agem

ent,

volu

ntee

ring,

inte

ntion

to v

ote,

edu

catio

n an

d ca

reer

asp

iratio

ns,

alco

hol a

nd sm

okin

g co

nsum

ption

.

Mod

erat

e qu

ality

ra

ting.

Kirk

man

, 201

614

-25

year

sVo

lunt

ary

Actio

n w

ithin

Ken

t, Yo

uth

Soci

al A

ction

Pr

ojec

tES

: Sig

nific

ant p

ositi

ve im

pact

on

ratin

g of

“lif

e is

wor

thw

hile

”, se

lf-re

port

ed a

nxie

ty, a

nd e

mpa

thy.

No

signi

fican

t im

pact

on

prob

lem

-so

lvin

g or

grit

.SS

: Sig

nific

ant p

ositi

ve im

pact

on

coop

erati

on, s

ense

of c

omm

unity

, an

d so

cial

trus

t.EH

S: S

igni

fican

t pos

itive

impa

ct o

n co

mm

unity

invo

lvem

ent a

nd

will

ingn

ess t

o vo

lunt

eer.

No

signi

fican

t im

pact

on

attitu

des t

owar

ds

educ

ation

.

Mod

erat

e qu

ality

ra

ting.

Kirk

man

, 201

616

-19

year

sEn

visio

nES

: Sig

nific

ant p

ositi

ve im

pact

on

satis

facti

on w

ith li

fe, r

ating

of “

life

is w

orth

whi

le”,

empa

thy,

prob

lem

-sol

ving

skill

s, a

nd g

rit.

SS: S

igni

fican

t pos

itive

impa

ct o

n co

oper

ation

and

sens

e of

co

mm

unity

. EH

S: S

igni

fican

t pos

itive

impa

ct o

n co

mm

unity

invo

lvem

ent,

attitu

des t

owar

ds e

duca

tion,

will

ingn

ess t

o vo

lunt

eer,

and

empl

oyab

ility

skill

s.

Mod

erat

e qu

ality

ra

ting.

The

RKT

Ltd.

, 201

58-

25 y

ears

Lond

on Y

outh

Ath

an 3

1 Pr

ogra

mES

: No

signi

fican

t im

pact

on

subj

ectiv

e w

ellb

eing

.W

eak

qual

ity

ratin

g.

Fam

ily K

ids a

nd Y

outh

, 201

511

-18

year

sYo

uth

Uni

ted,

You

th S

ocia

l Acti

on Jo

urne

y Fu

ndES

: Sig

nific

ant p

ositi

ve im

pact

of e

mpa

thy

and

crea

tivity

(fem

ales

), an

d re

silie

nce.

No

signi

fican

t im

pact

on

confi

denc

e, m

anag

ing

feel

ings

, pro

blem

-sol

ving

, wel

lbei

ng.

SS: S

igni

fican

t pos

itive

impa

ct o

n co

mm

unic

ation

. No

signi

fican

t im

pact

on

plan

ning

. EH

S: S

igni

fican

t pos

itive

impa

ct o

n co

mm

unity

eng

agem

ent.

Wea

k qu

ality

ra

ting.

Gora

rd, 2

016

13-1

4 ye

ars

Yout

h U

nite

d, Y

outh

Soc

ial A

ction

Tria

lsES

: Sig

nific

ant p

ositi

ve im

pact

on

confi

denc

e.

SS: S

igni

fican

t pos

itive

impa

ct o

n te

am w

ork

and

will

ingn

ess t

o he

lp

othe

r. EH

S: S

igni

fican

t pos

itive

impa

ct o

n pr

ofes

siona

l asp

iratio

n an

d ci

vic

enga

gem

ent.

Sign

ifica

nt n

egati

ve e

ffect

on

acad

emic

atta

inm

ent.

Mod

erat

e qu

ality

ra

ting.

Gree

nhou

se, 2

012

8-18

yea

rsGr

eenh

ouse

(com

mun

ity sp

orts

inte

rven

tion)

ES: S

igni

fican

t pos

itive

impa

ct o

n se

lf-co

nfide

nce,

cop

ing

skill

s,

happ

ines

s, a

nd m

otiva

tion.

No

signi

fican

t im

pact

on

self-

effica

cy.

SS: S

igni

fican

t pos

itive

impa

ct o

n so

cial

com

pete

nce

and

soci

al

rela

tions

hips

.EH

S: S

igni

fican

t pos

itive

impa

ct o

n co

mm

unity

eng

agem

ent.

No

signi

fican

t im

pact

on

heal

th sc

ore

and

acad

emic

ach

ieve

men

t.

Wea

k qu

ality

ra

ting.

Mea

de, 2

008

15-2

5 ye

ars

Getti

ng it

Toge

ther

ES: S

igni

fican

t pos

itive

impa

ct o

n co

nfide

nce

and

copi

ng sk

ills.

SS

: Sig

nific

ant p

ositi

ve im

pact

on

com

mun

icati

on a

nd fa

cilit

ation

sk

ills,

and

rela

tions

hips

skill

s.

Wea

k qu

ality

ra

ting.

Cent

re fo

r Ana

lysis

of Y

outh

Tra

nsiti

ons,

201

39-

13 y

ears

Confl

ict R

esol

ution

Unc

utSS

: Sig

nific

ant p

ositi

ve im

pact

on

confl

ict r

esol

ution

skill

s.

EHS:

Sig

nific

ant p

ositi

ve im

pact

on

attitu

des a

nd b

ehav

iors

in

rela

tion

to in

volv

emen

t in

knife

crim

e.

Wea

k qu

ality

ra

ting.

Shin

er, 2

004

15-1

9 ye

ars

Men

torin

g Pl

usES

: Sig

nific

ant p

ositi

ve im

pact

on

self-

confi

denc

e, d

ecisi

on-m

akin

g,

and

setti

ng g

oals.

No

signi

fican

t im

pact

on

self-

este

em.

SS: S

igni

fican

t pos

itive

impa

ct o

n so

cial

izatio

n. N

o sig

nific

ant i

mpa

ct

on re

latio

nshi

ps.

EHS:

Sig

nific

ant p

ositi

ve im

pact

on

excl

usio

n fr

om sc

hool

/tru

antin

g ra

tes.

No

signi

fican

t im

pact

on

subs

tanc

e m

isuse

or l

evel

s of

offen

ding

.

Wea

k qu

ality

ra

ting.

Page 63: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

63

Rapid Evidence Review Appendix 5: Evidence Tables

5. B

asto

unis

A, C

alla

gha

n P,

Ban

erje

e A

, Mic

hail

M. T

he e

ffec

tive

ness

of

the

Pen

n R

esili

ency

Pro

gra

mm

e (P

RP

) and

its

adap

ted

ver

sio

ns in

red

ucin

g d

epre

ssio

n an

d a

nxie

ty a

nd im

pro

ving

ex

pla

nato

ry s

tyle

: A s

yste

mat

ic r

evie

w a

nd m

eta-

anal

ysis

. Jo

urna

l of

Ad

ole

scen

ce [

Inte

rnet

]. 2

016

Oct

[ci

ted

201

9 Ju

ly 2

6]; 5

2:37

-48.

Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

7494

740

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

stud

ents

ag

ed 8

–17

year

sDa

te ra

nge

for r

evie

w: 1

974-

2015

# of

stud

ies i

nclu

ded:

9Se

vera

l lim

itatio

ns o

f the

cur

rent

met

a-an

alys

is sh

ould

be

ack

now

ledg

ed. F

irst,

the

limite

d nu

mbe

r of s

tudi

es

whi

ch m

et th

e in

clus

ion

crite

ria le

d to

und

erpo

wer

ed

anal

ysis

for t

he se

cond

ary

outc

omes

and

two

grou

ps

in su

bgro

up a

naly

ses.

Giv

en th

e sc

arci

ty o

f dat

a,

mea

n di

ffere

nces

for o

ne o

f the

seco

ndar

y ou

tcom

es

wer

e no

t agg

rega

ted.

Sec

ond,

this

met

a-an

alys

is as

sess

ed th

e eff

ectiv

enes

s of u

nive

rsal

PRP

and

its

deriv

ative

s onl

y at

pos

t-int

erve

ntion

, whe

reas

ther

e is

evid

ence

that

som

e eff

ects

of P

RP m

ay e

mer

ge la

ter

(Bru

nwas

ser e

t al.,

200

9, Q

uayl

e et

al.,

200

1). T

hird

, eff

ect s

izes (

ESs)

wer

e ob

tain

ed a

ssum

ing

norm

ality

of

outc

ome

data

dist

ributi

on, w

here

as in

som

e st

udie

s ou

tcom

e da

ta d

istrib

ution

was

pos

itive

ly sk

ewed

(C

hapl

in e

t al.,

200

6). T

his r

evie

w c

onfe

rs h

owev

er,

rese

arch

and

pra

ctica

l ben

efits

. Firs

t, th

is re

view

is

base

d on

a p

re-s

peci

fied

prot

ocol

. Sec

ond,

this

met

a-an

alys

is pr

ovid

es e

vide

nce

rega

rdin

g PR

P’s s

uita

bilit

y fo

r lar

ge sc

ale

roll-

out.

Third

, thi

s rev

iew

app

lied

rigid

qu

ality

crit

eria

, red

ucin

g th

e m

etho

dolo

gica

l div

ersit

y of

the

incl

uded

stud

ies.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens a

ges 1

3-18

—sp

ecify

by

stud

y if

auth

or

does

n’t a

ggre

gate

by

rele

vant

age

gro

up: K

indt

et a

l. (2

014)

: 13.

42, T

ak e

t al.

(201

5): 1

3.91

Hi-L

evel

Fin

ding

s: T

here

was

no

evid

ence

that

uni

vers

al

PRP

or it

s der

ivati

ves r

educ

e de

pres

sion

or a

nxie

ty a

nd

impr

ove

expl

anat

ory

styl

e at

pos

t-int

erve

ntion

; the

refo

re,

the

larg

e sc

ale

roll-

out o

f uni

vers

al P

RP –

in it

s cur

rent

fo

rm- c

anno

t be

reco

mm

ende

d.

Inte

rven

tion

Ove

rall:

Onl

y sc

hool

-bas

ed, u

nive

rsal

ap

plic

ation

s of P

RP1 an

d its

der

ivati

ves w

ere

incl

uded

in

this

revi

ew.

Data

base

s sea

rche

d fo

r rev

iew

: Coc

hran

e Ce

ntra

l Reg

ister

of

Con

trol

led

Tria

ls (C

ENTR

AL),

CIN

AHL

(Cum

ulati

ve In

dex

to N

ursin

g an

d Al

lied

Heal

th L

itera

ture

), EM

BASE

, MED

LIN

E (in

clud

ing

PubM

ed),

Psyc

INFO

, SCI

(Sci

ence

Cita

tion

Inde

x), S

cien

ce D

irect

, Sco

pus.

Onl

ine

data

base

s of g

rey

liter

atur

e, w

hich

wer

e se

arch

ed, w

ere:

Clin

ical

Tria

ls htt

p://

clin

ical

tria

ls.go

v, an

d IS

RCTN

Reg

ister

.

Adol

esce

nt-S

peci

fic F

indi

ngs:

In O

VK, g

reat

er m

otiva

tion

and

self-

repo

rted

pos

itive

atm

osph

ere

in th

e cl

assr

oom

pr

edic

ted

depr

essiv

e sy

mpt

oms r

educ

tion.

Inte

rven

tion

exam

ined

for 1

3-18

yea

r-ol

ds o

r eq

uiva

lent

(spe

cify

): O

VK, o

r ‘O

p Vo

lle K

rach

t2 , for

bo

th K

indt

et a

l. (2

014)

, Tak

et a

l. (2

015)

Revi

ew in

clus

ion

crite

ria: A

ll pu

blish

ed ra

ndom

ised

cont

rolle

d tr

ials

(RCT

s) a

nd c

lust

er R

CTs,

testi

ng th

e eff

ectiv

enes

s of t

he u

nive

rsal

app

licati

on o

f sch

ool-b

ased

PR

P or

any

of i

ts d

eriv

ative

s, ta

rgeti

ng d

epre

ssio

n an

d (o

r)

any

of th

e se

cond

ary

outc

omes

of i

nter

est,

com

pare

d w

ith

any

type

of c

ontr

ol c

ondi

tion

(acti

ve c

ontr

ol su

ch a

s hea

lth

man

agem

ent s

essio

ns, n

on-in

terv

entio

n su

ch a

s usu

al

lear

ning

sess

ions

and

wai

ting-

list)

, in

Engl

ish, w

ere

elig

ible

fo

r inc

lusio

n.

Out

com

es o

vera

ll—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: D

epre

ssio

n, a

nxie

ty.

Revi

ew e

xclu

sion

: Stu

dies

wer

e ex

clud

ed, i

f the

y w

ere

desc

ribin

g th

e ev

alua

tion

of ta

rget

ed (s

elec

tive

or

indi

cate

d) a

pplic

ation

s of P

RP a

nd it

s der

ivati

ves;

they

w

ere

not s

choo

l-bas

ed o

r wer

e no

t ass

essin

g an

y of

the

a pr

iori

sele

cted

out

com

es o

f int

eres

t. Le

ad a

utho

rs w

ere

cont

acte

d w

hen

ther

e w

ere

not e

noug

h de

tails

abo

ut

thei

r int

erve

ntion

s’ c

once

ptua

l fide

lity

with

PRP

. Afte

r tw

o un

succ

essf

ul c

onta

ct-a

ttem

pts,

the

stud

ies w

ere

excl

uded

. In

four

aut

hors

, who

wer

e co

ntac

ted,

two

of th

em d

id n

ot

resp

ond

and

thei

r stu

dies

wer

e ex

clud

ed.

Out

com

es fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (s

peci

fy)—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: De

pres

sion,

Clin

ical

dep

ress

ive

sym

ptom

s, O

VK-

spec

ific

varia

bles

. Anx

iety

, Hop

eles

snes

s, H

appi

ness

, Li

fe sa

tisfa

ction

, Opti

mis

m, C

opin

g, S

elf-e

ffica

cy,

Acad

emic

ach

ieve

men

t, He

alth

-risk

beh

avio

urs,

OVK

-sp

ecifi

c va

riabl

es

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A, C

ochr

ane

Hand

book

Out

com

es fo

r Soc

ial/

built

env

ironm

ents

and

/or

peo

ple

surr

ound

ing

13-1

8 ye

ar-o

lds (

Nati

on,

Com

mun

ity, I

nter

pers

onal

) – S

peci

fy o

utco

me

and

for w

hom

/wha

t it i

s mea

sure

d: N

/A

Setti

ng(s

): sc

hool

Co

untr

y(ie

s): A

ustr

alia

, the

Net

herla

nds,

and

U.S

.St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

co

untr

ies)

: N/A

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d,

scho

ol, f

amily

, wor

k, re

crea

tion,

OST

): sc

hool

Page 64: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

64

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RM

EA

N A

GE

GR

OU

P IN

STU

DY

INTE

RV

EN

TIO

NO

UTC

OM

EFI

ND

ING

S

Kind

t et a

l. (2

014)

13.4

2O

VKDe

pres

sion:

Clin

ical

dep

ress

ive

sym

ptom

s, O

VK-

spec

ific

varia

bles

No

firm

co

nclu

sions

can

be

dra

wn

abou

t th

e se

lecti

ve

pote

ntial

of t

he

OVK

dep

ress

ion

prev

entio

n pr

ogra

m. I

n its

cu

rren

t for

m, t

he

OVK

pro

gram

sh

ould

not

be

impl

emen

ted

on

a la

rge

scal

e in

th

e na

tura

l setti

ng

for n

on-h

igh-

risk

adol

esce

nts.

Tak

et a

l. (2

015)

13.9

1O

VKDe

pres

sion,

clin

ical

dep

ress

ive

sym

ptom

s: S

econ

dary

ou

tcom

es: A

nxie

ty, H

opel

essn

ess,

Hap

pine

ss, L

ife

satis

facti

on, O

ptim

ism, C

opin

g, S

elf-e

ffica

cy, A

cade

mic

ac

hiev

emen

t, He

alth

-risk

beh

avio

urs,

OVK

-spe

cific

va

riabl

es

OVK

was

not

eff

ectiv

e in

pr

even

ting

depr

essiv

e sy

mpt

oms a

cros

s th

e 2

year

follo

w-

up.

Page 65: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

65

Rapid Evidence Review Appendix 5: Evidence Tables

6. B

erg

er A

T, W

ido

me

R, T

roxe

l WM

. Sch

oo

l Sta

rt T

ime

and

Psy

cho

log

ical

Hea

lth

in A

do

lesc

ents

. Cur

rent

Sle

ep M

edic

ine

Rep

ort

s [I

nter

net]

. 201

8 Ju

n [c

ited

201

9 A

ug 2

3]; 4

(2):1

10-1

17. A

vaila

ble

fr

om

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/3

0349

805

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

stud

ents

in g

rade

K-1

2.

Date

rang

e fo

r rev

iew

: No

date

ra

nge

prov

ided

. #

of st

udie

s inc

lude

d: 8

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens

ages

13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

re

leva

nt a

ge g

roup

: Hig

h sc

hool

stud

ents

(Wah

lstro

m, 1

998;

W

ahlst

rom

, 200

2; M

artin

et a

l., 2

016)

, 10th

gra

de st

uden

ts (V

edaa

et

al.,

201

2), 8

th a

nd 9

th g

rade

stud

ents

(Per

kins

on-G

loor

et a

l.,

2013

), bo

ardi

ng sc

hool

stud

ents

(Boe

rger

s et a

l., 2

014;

Ow

ens e

t al

., 20

10),

seco

ndar

y sc

hool

stud

ents

(Cha

n et

al.,

201

7).

Hi-L

evel

Fin

ding

s:Al

l fou

r stu

dies

that

incl

uded

dep

ress

ion

and/

or a

nxie

ty a

s out

com

es fo

und

that

stud

ents

in

late

r sta

rting

scho

ols s

how

ed fe

wer

sym

ptom

s of

depr

essio

n th

an st

uden

ts in

ear

lier s

tarti

ng sc

hool

s.Tw

o st

udie

s use

d m

easu

res o

f pos

itive

or n

egati

ve

affec

t; ne

ither

find

ing

signi

fican

t ass

ocia

tions

be

twee

n su

ch m

easu

res a

nd la

ter s

choo

l sta

rt ti

mes

.In

the

maj

ority

of s

tudi

es re

view

ed, l

ater

scho

ol

star

t tim

es w

ere

asso

ciat

ed w

ith g

reat

er a

dole

scen

t ps

ycho

logi

cal h

ealth

. How

ever

, inh

eren

t des

ign

draw

back

s in

the

stud

ies p

reve

nt u

s fro

m c

oncl

udin

g th

at th

ese

asso

ciati

ons a

re c

ausa

l. Th

ere

are

a w

ide

rang

e of

pot

entia

l ben

efits

, bey

ond

men

tal

heal

th, t

hat l

ater

hig

h sc

hool

star

t tim

es o

ffer.

This

enco

urag

ing,

em

erge

nt li

tera

ture

on

dela

yed

star

t tim

es h

as le

d m

any

scho

ol d

istric

ts to

con

sider

ch

ange

s to

thei

r sta

rt ti

mes

.

As n

oted

by

auth

or: L

itera

ture

on

the

subj

ect i

s spa

rse,

and

al

l exi

sting

stud

ies r

evie

wed

had

sign

ifica

nt m

etho

dolo

gica

l lim

itatio

ns. N

one

of th

e lo

ng-t

erm

stud

ies i

denti

fied

incl

uded

a

conc

urre

ntly

mea

sure

d co

ntro

l gro

up, s

o ps

ycho

logi

cal

effec

ts o

f sch

ool s

tart

tim

e co

uld

not b

e se

para

ted

from

se

ason

al o

r sec

ular

var

iatio

n or

impa

ct o

f oth

er p

olic

ies a

nd

inte

rven

tions

on

sleep

and

psy

chol

ogic

al h

ealth

. The

rang

e of

ps

ycho

logi

cal o

utco

mes

that

hav

e be

en e

valu

ated

is in

cred

ibly

na

rrow

.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Lat

er sc

hool

star

t tim

e in

terv

entio

ns.

Data

base

s sea

rche

d fo

r rev

iew

: O

vid

Med

line,

Psy

cIN

FO, E

RIC

via

EBSC

Oho

st.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equi

vale

nt (s

peci

fy):

8:30

am v

s. 7

:30a

m o

r 7:1

5am

star

t tim

es

(Wah

lstro

m, 1

998)

, 8:4

0am

vs.

7:3

0am

(Wah

lstro

m, 2

002)

, 8:

00am

in D

ecem

ber v

s 8:3

0am

in M

arch

(Ow

ens e

t al.,

201

0),

9:30

am o

n M

onda

y an

d 8:

30am

on

Frid

ay v

s 8:3

0am

on

both

da

ys (V

edaa

et a

l., 2

012)

, 8:0

0am

vs.

7:4

0am

(Per

kins

on-G

loor

et

al.,

2013

), 8:

00am

in N

ovem

ber v

s. 8

:25a

m in

Mar

ch a

nd 8

:00a

m

in M

ay (B

oerg

ers e

t al.,

201

4), 1

:25p

m v

s 7:4

0am

(Mar

tin e

t al.,

20

16),

7:45

am a

t bas

elin

e an

d 8:

00am

at f

ollo

w-u

p vs

. 7:5

5am

at

base

line

and

follo

w-u

p (C

han

et a

l., 2

017)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es

mus

t be

peer

-rev

iew

ed, i

nclu

de

a K-

12 st

art ti

me

cont

rast

as

the

expo

sure

, and

incl

ude

a ps

ycho

logi

cally

rele

vant

mea

sure

as

an

outc

ome

to b

e in

clud

ed in

th

is re

view

.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Dep

ress

ion

and

anxi

ety

sym

ptom

s, p

ositi

ve o

r ne

gativ

e aff

ect,

and

beha

vior

al h

ealth

.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus

on st

udy

met

hodo

logy

: Rev

iew

s w

ere

excl

uded

bas

ed o

n a

failu

re to

m

eet t

he in

clus

ion

crite

ria d

etai

led

abov

e.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: D

epre

ssiv

e Sy

mpt

om S

core

(Sch

ool S

leep

Hab

its S

urve

y) (W

ahlst

rom

, 199

8;

Wah

lstro

m, 2

002;

Ow

ens e

t al.,

201

0; B

oerg

ers e

t al.,

201

4),

Positi

ve a

nd N

egati

ve A

ffect

Sch

edul

e (P

ANAS

) (Ve

daa

et a

l.,

2012

), Po

sitive

atti

tude

tow

ard

life

(Per

kins

on-G

loor

et a

l.,

2013

), De

tecti

on o

f Alc

ohol

and

Dru

g Pr

oble

ms i

n Ad

oles

cent

s,

Psyc

holo

gica

l Dist

ress

Inde

x of

the

Que

bec

Heal

th S

urve

y (ID

PESQ

) (M

artin

et a

l., 2

016)

, Gen

eral

Hea

lth Q

uesti

onna

ire

(GHQ

-12)

, Str

engt

hs a

nd D

ifficu

lties

Que

stion

naire

(SDQ

) (Ch

an

et a

l., 2

017)

.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e

.g.,

PRIS

MA,

GRA

DE):

Non

e pr

ovid

ed.

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity, I

nter

pers

onal

) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s mea

sure

d: N

/A

Setti

ng(s

): Sc

hool

sCo

untr

y(ie

s): C

anad

a, H

ong

Kong

, U.S

., Sw

itzer

land

, Nor

way

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

: M

inne

sota

, Rho

de Is

land

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fam

ily,

wor

k, re

crea

tion,

OST

): Sc

hool

Page 66: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

66

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Wah

lstro

m, 1

998

High

scho

ol st

uden

ts8:

30am

vs.

7:3

0am

or 7

:15a

m st

art ti

mes

High

scho

ol st

uden

ts a

t an

8:30

am st

art ti

me

had

signi

fican

tly

low

er d

epre

ssio

n sc

ore

than

7:1

5am

, non

-sig

nific

antly

low

er

than

7:3

0am

star

t tim

e st

uden

ts.

No

befo

re-a

fter d

ata.

No

adju

stm

ent f

or p

oten

tially

co

nfou

ndin

g va

riabl

es.

Wah

lstro

m, 2

002

High

scho

ol st

uden

ts8:

40am

vs.

7:3

0am

Stud

ents

at 8

:40a

m h

ad si

gnifi

cant

ly lo

wer

dep

ress

ion

scor

es

than

7:3

0am

star

t tim

e st

uden

ts.

Ow

ens,

201

0Bo

ardi

ng sc

hool

stud

ents

8:00

am in

Dec

embe

r vs 8

:30a

m in

Mar

chDe

pres

sion

scor

e an

d pe

rcen

t of s

tude

nts r

ating

self

“som

ewha

t unh

appy

” or

“som

ewha

t dep

ress

ed”

low

er in

M

arch

com

pare

d to

Dec

embe

r.

(Unc

ontr

olle

d be

fore

-afte

r st

udy)

Veda

a, 2

012

10th

gra

de st

uden

ts9:

30am

on

Mon

day

and

8:30

am o

n Fr

iday

vs 8

:30a

m

on b

oth

days

.De

laye

d sc

hool

star

t tim

e ha

d no

effe

ct o

n se

lf-re

port

ed

positi

ve o

r neg

ative

affe

ct.

Onl

y on

e da

y of

cha

nged

sc

hool

star

t tim

e pe

r wee

k.

Perk

inso

n-Gl

oor,

2013

8th a

nd 9

th g

rade

stud

ents

8:00

am v

s. 7

:40a

mN

o di

ffere

nces

in p

ositi

ve a

ttitu

de to

war

d lif

e in

mal

e or

fe

mal

e st

uden

ts.

Two-

item

mea

sure

of

positi

ve a

ttitu

de to

war

d lif

e m

ay n

ot b

e va

lid. V

ery

unba

lanc

ed c

ompa

rison

w

ith le

ss th

an 1

3% o

f st

uden

ts in

late

r-sta

rting

sc

hool

s.

Boer

gers

, 201

4Bo

ardi

ng sc

hool

stud

ents

8:00

am in

Nov

embe

r vs.

8:2

5am

in M

arch

and

8:0

0am

in

May

Depr

essio

n sc

ore

and

perc

ent o

f stu

dent

s rati

ng se

lf “s

omew

hat u

nhap

py”

or “s

omew

hat d

epre

ssed

” lo

wer

in

Mar

ch c

ompa

red

to N

ovem

ber.

(Unc

ontr

olle

d be

fore

-afte

r st

udy)

Tim

e 3

resu

lts a

re

not p

rese

nted

for v

aria

bles

ot

her t

han

sleep

dur

ation

.

Mar

tin, 2

016

High

scho

ol st

uden

ts1:

25pm

vs 7

:40a

mN

o sig

nific

ant d

iffer

ence

in a

lcoh

ol u

se b

etw

een

mor

ning

-sta

r an

d aft

erno

on-s

tart

stud

ents

. No

signi

fican

t diff

eren

ce in

ps

ycho

logi

cal d

istre

ss b

etw

een

mor

ning

-sta

rt a

nd a

ftern

oon-

star

t stu

dent

s.

Very

unu

sual

star

t tim

e.

Chan

, 201

7Se

cond

ary

stud

ents

7:45

am a

t bas

elin

e an

d 8:

00am

at f

ollo

w-u

p vs

. 7:

55am

at b

asel

ine

and

follo

w-u

pIm

prov

emen

t on

men

tal h

ealth

, pro

soci

al b

ehav

ior e

moti

onal

sy

mpt

oms,

hyp

erac

tive/

inatt

entio

n, p

eer r

elati

onsh

ip

prob

lem

s, to

tal d

ifficu

lties

in in

terv

entio

n sc

hool

com

pare

d to

co

mpa

rison

scho

ol.

Data

col

lecti

on a

t in

terv

entio

n an

d co

mpa

rison

scho

ols w

as a

ha

lf-ye

ar a

part

(pos

sible

se

ason

al e

ffect

s).

Page 67: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

67

Rapid Evidence Review Appendix 5: Evidence Tables

7. B

urru

s B

B, K

rieg

er K

, Rut

led

ge

R, R

abre

A, A

xels

on

S, M

iller

A, e

t al

. Bui

ldin

g b

rid

ges

to

a b

rig

hter

to

mo

rro

w: A

sys

tem

atic

evi

den

ce r

evie

w o

f in

terv

enti

ons

tha

t p

rep

ares

ad

ole

scen

ts f

or

adul

tho

od

. Am

eric

an J

our

nal o

f P

ublic

Hea

lth

[Int

erne

t]. 2

018

Feb

[ci

ted

201

9 Ju

ly 2

6]; 1

08(S

1):S

25-S

31. A

vaila

ble

fro

m: h

ttp

s://

ww

w.n

cbi.n

lm.n

ih.g

ov/

pub

med

/294

4356

1FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

10-

18Da

te ra

nge

for r

evie

w: 1

999-

2016

# of

stud

ies i

nclu

ded:

45

As n

oted

by

auth

or: T

he s

earc

h us

ed a

n ex

tens

ive

arra

y of

term

s an

d to

pics

to id

entif

y ad

ulth

ood

prep

arati

on to

pics

and

may

hav

e fa

iled

to p

ick

up

rele

vant

stu

dies

bec

ause

the

term

s di

d no

t fal

l w

ithin

the

spec

ified

sea

rch

crite

ria; S

ever

al o

f the

st

udie

s th

at m

et th

e in

clus

ion

crite

ria u

sed

quas

i-ex

perim

enta

l stu

dy d

esig

ns, h

ad u

nbal

ance

d ba

selin

e ch

arac

teris

tics

acro

ss tr

eatm

ent g

roup

s, h

ad h

igh

attriti

on ra

tes,

or h

ad u

nmea

sure

d co

nfou

ndin

g,

so th

ere

wer

e fe

wer

hig

h-qu

ality

stu

dies

on

whi

ch

to m

ake

confi

dent

con

clus

ions

; The

stu

dies

var

ied

exte

nsiv

ely

in th

e ex

tent

to w

hich

they

repo

rted

eff

ect s

ize, m

akin

g it

diffi

cult

to d

raw

con

clus

ions

ab

out t

he e

ffect

size

s ac

ross

the

broa

der g

roup

of

stud

ies.

Qua

lity

of e

vide

nce

varie

d: m

oder

ate-

qual

ity

(23

stud

ies)

, 7 h

igh-

qual

ity, 6

low

- qua

lity

Mos

t stu

dies

app

ear

to d

eal w

ith m

iddl

e sc

hool

pre

-ado

lesc

ents

(1

0-12

/13

year

old

s) o

r de

alt w

ith s

ubst

ance

us

e or

sex

ual h

ealth

(not

PS

EWB)

.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: (

see

tabl

e)

Hi-L

evel

Fin

ding

s: A

dole

scen

t dev

elop

men

t em

erge

d as

the

mos

t fre

quen

tly ta

rget

ed to

pic;

52.

8% o

f the

st

udie

s ta

rget

ed th

is to

pic.

Hea

lthy

life

skill

s w

as

the

seco

nd m

ost f

requ

ently

targ

eted

topi

c; 4

7.2%

of

stu

dies

incl

uded

pro

gram

ele

men

ts ta

rgeti

ng th

is

topi

c. 2

7 st

udie

s (7

5%) r

epor

ted

a si

gnifi

cant

effe

ct

on th

e sp

ecifi

ed a

dulth

ood

prep

arati

on b

ehav

iora

l ou

tcom

es, i

nclu

ding

hea

lthy

life

skill

s (n

= 2

), se

xual

ris

k be

havi

ors

(n =

6),

educ

ation

al a

nd c

aree

r suc

cess

(n

= 7

), he

alth

y re

latio

nshi

ps (n

= 4

), fin

anci

al li

tera

cy

(n =

1),

pare

nt–c

hild

com

mun

icati

on (n

= 6

), an

d ad

oles

cent

dev

elop

men

t (n

= 1)

. Beh

avio

ral o

utco

mes

sh

owin

g si

gnifi

cant

effe

cts

for r

isk

beha

vior

s in

clud

e al

coho

l, to

bacc

o, a

nd o

ther

dru

g us

e (n

= 9

) and

risk

y se

xual

beh

avio

rs (n

= 6

).

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Adu

lthoo

d pr

epar

a-tio

n tr

aini

ng fo

r ado

lesc

ents

that

focu

sed

on (1

) ado

lesc

ent

deve

lopm

ent,

(2) e

duca

tiona

l and

car

eer s

ucce

ss, (

3)

finan

cial

lite

racy

, (4)

hea

lthy

life

skill

s, (5

) hea

lthy

rela

tion-

ship

s, a

nd

(6) p

aren

t–ch

ild c

omm

unic

ation

. Out

com

e: B

ehav

iora

l ou

tcom

es in

clud

ing

(1) v

iole

nce

perp

etra

tion

and

victi

m-

izati

on, (

2) su

bsta

nce

use,

and

(3) r

isky

sex

ual b

ehav

iors

. O

ther

mea

sure

s w

ere

rela

ted

to jo

b sk

ills a

nd o

utco

mes

, ed

ucati

on sk

ills

and

outc

omes

, fina

ncia

l man

agem

ent,

and

pare

nt–c

hild

rela

tions

hip

and

com

mun

icati

on m

easu

res.

Data

base

s sea

rche

d fo

r rev

iew

: Pub

Med

, EB

SCO

Dis

cove

ry S

ervi

ce, E

duca

tion

Reso

urce

s In

form

ation

Cen

ter,

Web

of

Scie

nce,

Psy

cIN

FO

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

(see

tabl

e)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es e

ligib

le

for i

nclu

sion

mus

t (1)

be p

ublis

hed

in

Engl

ish

in a

n in

depe

nden

t, pe

er- r

e-vi

ewed

jour

nal;

(2) b

e co

nduc

ted

in

deve

lope

d, E

nglis

h sp

eaki

ng c

oun-

trie

s; (3

) hav

e im

plem

ente

d an

inte

rven

tion

that

add

ress

ed a

t lea

st

1 of

the

6 AP

S ar

eas,

del

iver

ed in

an

in-p

erso

n se

tting

; (4)

hav

e in

clud

ed

yout

hs a

t the

5th

- thr

ough

12t

h-gr

ade

leve

ls o

r age

d 10

to 1

8 ye

ars

at s

ome

poin

t dur

ing

inte

rven

tion

impl

emen

ta-

tion;

(5) h

ave

incl

uded

an

eval

uatio

n co

m-

pone

nt w

ith a

com

paris

on g

roup

and

ba

selin

e an

d fo

llow

-up

mea

sure

s; (6

) ha

ve in

clud

ed b

ehav

iora

l mea

sure

s as

out

com

es; a

nd (7

) hav

e re

port

ed

stati

stica

l sig

nific

ance

leve

ls fo

r the

be-

havi

oral

out

com

e m

easu

res.

Page 68: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

68

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Beh

avio

ral o

utco

mes

incl

udin

g (1

) vio

lenc

e pe

rpet

ratio

n an

d vi

ctim

izati

on, (

2) su

bsta

nce

use,

and

(3)

risky

sex

ual b

ehav

iors

. Oth

er m

easu

res

wer

e re

late

d to

jo

b sk

ills a

nd o

utco

mes

, edu

catio

n sk

ills

and

outc

omes

, fin

anci

al m

anag

emen

t, an

d pa

rent

–chi

ld re

latio

nshi

p an

d co

mm

unic

ation

mea

sure

s.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Stu

dies

wer

e ex

clud

ed if

th

ey fa

iled

to m

eet t

he in

clus

ion

crite

ria

deta

iled

abov

e.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

tabl

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Pr

imar

ily sc

hool

sCo

untr

y(ie

s): D

evel

oped

, Eng

lish-

spea

king

cou

ntrie

s St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s):

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fa

mily

, wor

k, re

crea

tion,

OST

): Sc

hool

, Fam

ily, I

ndiv

idua

l

TE

EN

SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Cam

pbel

l-Hei

der e

t al.,

200

912

-16

Teen

Clu

b pl

us P

ositi

ve A

dole

scen

t Life

Ski

lls (P

ALS)

Beca

use

of sm

all s

ampl

e siz

e (1

6), n

o sig

nific

ant fi

ndin

gs

wer

e ob

serv

ed.

Dono

hue

et a

l., 2

005

High

scho

ol st

uden

tsSu

mm

er B

usin

ess I

nstit

ute

(SBI

)Fi

nanc

ial m

anag

emen

t par

ticip

ants

dem

onst

rate

d sig

nific

antly

hig

her s

core

s in

finan

cial

man

agem

ent

skill

s (p<

0.00

1), a

nd a

bilit

y to

man

age

insu

ranc

e (p

<0.0

01) c

ompa

red

with

the

job

soci

al sk

ills

parti

cipa

nts.

Job

soci

al sk

ills p

artic

ipan

ts d

emon

stra

ted

signi

fican

tly h

ighe

r sco

res i

n jo

b in

terv

iew

ing

skill

s (p

<0.0

01),

abili

ty to

inte

ract

pro

fess

iona

lly w

ith o

ther

s at

wor

k (p

<0.0

01),

and

abili

ty to

take

initi

ative

at w

ork

(p<0

.001

), co

mpa

red

with

the

finan

cial

man

agem

ent

parti

cipa

nts.

Ferr

er-W

rede

r et a

l., 2

010

7th to

9th

gra

de st

uden

tsLS

T pl

us T

imeW

iseN

o dr

ug u

se d

iffer

ence

s bet

wee

n th

e gr

oups

. In

terv

entio

n gr

oup

had

high

er a

nxie

ty m

anag

emen

t sk

ills (

p=0.

051)

than

the

com

paris

on g

roup

.

Gree

son

et a

l., 2

015

17 y

ear o

lds

LST

of L

os A

ngel

esN

o sig

nific

ant d

iffer

ence

s bet

wee

n th

e co

ntro

l and

in

terv

entio

n gr

oups

.

Li e

t al.,

200

2Lo

w-in

com

e pa

rent

s and

thei

r 12-

16 y

ear

old

child

ren.

In

form

ed P

aren

ts a

nd C

hild

ren

Toge

ther

(im

PACT

)Pa

rent

s in

the

cont

rol g

roup

had

a lo

wer

con

cord

ance

be

twee

n th

eir u

nder

stan

ding

of t

heir

child

ren’

s be

havi

or a

nd th

eir c

hild

ren’

s rep

orte

d be

havi

or

(p<0

.05)

, whe

reas

the

pare

nts i

n th

e in

terv

entio

n di

d no

t.

Litr

owni

k et

al.,

200

0Pa

rent

s and

thei

r ado

lesc

ent c

hild

ren

Sem

bran

do S

alud

(Sow

ing

Heal

th)

Inte

rven

tion

fam

ilies

had

hig

her r

epor

ts o

f par

ent-c

hild

co

mm

unic

ation

(p<0

.05)

.

Mill

enky

et a

l., 2

014

High

scho

ol y

outh

who

hav

e dr

oppe

d ou

t of

hig

h sc

hool

Nati

onal

Gua

rd Y

outh

Cha

lleng

e Pr

ogra

m (N

GYCP

)In

terv

entio

n pa

rtici

pant

s wer

e m

ore

likel

y to

hav

e ob

tain

ed a

hig

h sc

hool

dip

lom

a or

GED

(p<0

.01)

; ear

ned

at le

ast s

ome

colle

ge c

redi

t (p<

0.01

); be

en e

mpl

oyed

fo

r a g

reat

er n

umbe

r of m

onth

s with

hig

her e

arni

ngs i

n th

e pa

st y

ear (

p<0.

01);

and

mor

e lik

ely

to b

e ov

erw

eigh

t (p

<0.0

5).

Mill

er e

t al.,

201

2Hi

gh sc

hool

mal

e at

hlet

esCo

achi

ng B

oys i

nto

Men

(CBI

M)

No

stati

stica

lly si

gnifi

cant

diff

eren

ces i

n pa

rtici

pant

s and

co

ntro

l in

datin

g vi

olen

ce p

erpe

trati

on o

r bys

tand

er

beha

vior

.

Tebe

s et a

l., 2

007

Mid

dle-

and

hig

h-sc

hool

age

d ad

oles

cent

s (m

ean

of 1

5 ye

ars)

Positi

ve Y

outh

Dev

elop

men

t Col

labo

ratio

n (P

YDC)

One

yea

r afte

r the

inte

rven

tion,

inte

rven

tion

parti

cipa

nts h

ad si

gnifi

cant

ly lo

wer

incr

ease

s in

use

of

alco

hol (

p=0.

029)

, mar

ijuan

a (p

<0.0

01),

othe

r dru

gs

(p<0

.001

), an

d an

y dr

ug (p

<0.0

01) t

han

the

cont

rol

grou

p.

Page 69: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

69

Rapid Evidence Review Appendix 5: Evidence Tables

Wan

g et

al.,

201

410

th g

rade

stud

ents

and

thei

r par

ents

Baha

rnia

n Fo

cus o

n O

lder

You

th (B

FOO

Y) p

lus C

arib

bean

In

form

ed P

aren

ts a

nd C

hild

ren

Toge

ther

(Cim

PACT

)At

six

mon

ths p

ost-i

nter

venti

ons B

FOO

Y pa

rtici

pant

s (in

al

l 3 c

ohor

ts) h

ad si

gnifi

cant

ly h

ighe

r con

dom

skill

s tha

n st

uden

ts in

the

stan

dard

hea

lth e

duca

tion

(p<0

.001

). Pa

rtici

pant

s in

the

BFO

OY

+ Ci

mPA

CT h

ad si

gnifi

cant

ly

high

er p

aren

t-ado

lesc

ent s

exua

l risk

com

mun

icati

on

than

par

ticip

ants

in th

e BF

OO

Y an

d st

anda

rd h

ealth

ed

ucati

on g

roup

s at 1

2 m

onth

s (p<

0.05

) and

18

mon

ths

(p<0

.05)

.

Wol

fe e

t al.,

200

314

-16

year

old

sYo

uth

Rela

tions

hips

Pro

ject

(YRP

)N

o sig

nific

ant d

iffer

ence

s in

beha

vior

al o

utco

mes

am

ong

the

inte

rven

tion

and

cont

rol g

roup

s in

the

final

sa

mpl

e. W

hile

not

stati

stica

lly si

gnifi

cant

, ove

r the

2

year

s of t

he st

udy,

inte

rven

tion

parti

cipa

nts w

ere

less

ph

ysic

ally

abu

sive

tow

ard

thei

r dati

ng p

artn

ers a

nd

repo

rted

less

vic

timiza

tion.

Wol

fe e

t al.,

200

9; W

olfe

et a

l., 2

012

14-1

5 ye

ar o

lds

Four

th R

The

inte

rven

tion

grou

p ha

d sig

nific

antly

low

er ra

tes

of p

hysic

al d

ating

vio

lenc

e th

an th

e co

ntro

l gro

up

(p=0

.05)

. Am

ong

a su

b sa

mpl

e of

196

9th

gra

de

stud

ents

, int

erve

ntion

par

ticip

ants

wer

e m

ore

than

tw

ice

as li

kely

to d

emon

stra

te n

egoti

ation

skill

s (p

<0.0

5), a

nd fo

ur ti

mes

mor

e lik

ely

to re

sist p

eer

pres

sure

(p<0

.05)

than

the

cont

rol p

artic

ipan

ts.

Page 70: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

70

Rapid Evidence Review Appendix 5: Evidence Tables

8. C

atal

ano

RF,

Ski

nner

ML,

Alv

arad

o G

, Kap

ung

u C

, Rea

vley

N, P

atto

n G

C, e

t al

. Po

siti

ve Y

out

h D

evel

op

men

t P

rog

ram

s in

Lo

w-

and

Mid

dle

-Inc

om

e C

oun

trie

s: A

Co

ncep

tual

Fra

mew

ork

and

S

yste

mat

ic R

evie

w o

f E

ffica

cy. J

our

nal o

f A

do

lesc

ent

Hea

lth

[Int

erne

t]. 2

019

July

[ci

ted

201

9 Ju

ly 2

6]; 6

5(1)

:15-

31. A

vaila

ble

fro

m: h

ttp

s://

ww

w.n

cbi.n

lm.n

ih.g

ov/

pub

med

/310

1072

5 FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

10-

29 y

ears

of a

geDa

te ra

nge

for r

evie

w: 1

990-

mid

201

6#

of st

udie

s inc

lude

d: 9

4 M

ost s

yste

mati

c re

view

s sta

rt w

ith a

sing

le o

utco

me

of in

tere

st o

r a re

latio

nshi

p be

twee

n a

clas

s of

inte

rven

tions

and

a si

ngle

out

com

e (e

.g.,

fam

ily-

orie

nted

pro

gram

s des

igne

d to

pre

vent

vio

lenc

e). F

or

this

revi

ew, t

he se

arch

term

s use

d to

iden

tify

diffe

rent

PY

D co

nstr

ucts

wer

e m

any

and

varie

d; a

larg

e de

velo

pmen

tal p

erio

d w

as c

over

ed (i

.e.,

child

hood

, ad

oles

cenc

e, a

nd y

oung

adu

lthoo

d); a

nd d

iver

se ty

pes

of in

terv

entio

ns a

cros

s a b

road

set o

f out

com

es w

ere

incl

uded

. As a

resu

lt of

this

inte

ntion

ally

bro

ad sc

ope,

a

larg

e nu

mbe

r of ti

tles w

ere

retr

ieve

d an

d sc

reen

ed.

The

num

ber a

nd c

ompl

exity

of t

he se

arch

term

s m

ay h

ave

resu

lted

in m

issin

g so

me

rele

vant

stud

ies.

Be

sides

the

limita

tions

enc

ount

ered

in c

ondu

cting

the

revi

ew it

self,

ther

e ar

e lim

itatio

ns in

the

inte

rpre

tatio

n of

resu

lts fo

undi

ng th

ese

eval

uatio

ns. I

n m

ost c

ases

, no

n-sig

nific

ant r

esul

ts w

ere

repo

rted

alo

ng w

ith

signi

fican

t one

s, b

ut it

is p

ossib

le th

at so

me

inte

nded

eff

ects

wer

e fo

und

to b

e no

t sig

nific

ant b

ut n

ot

repo

rted

, lea

ding

to a

n ov

erly

pos

itive

impr

essio

n of

th

e pr

ogra

m. P

rogr

am d

escr

iptio

ns a

re li

mite

d to

wha

t w

as a

vaila

ble

in re

port

s and

pub

licati

ons,

mak

ing

it im

poss

ible

to m

ake

stro

nger

stat

emen

ts a

bout

whi

ch

prog

ram

feat

ures

or c

hara

cter

istics

lead

to p

ositi

ve

resu

lts.

The

evid

ence

we

did

find

supp

orts

usin

g PY

D ap

proa

ches

with

vu

lner

able

or u

nder

serv

ed

popu

latio

ns to

redu

ce

disp

ariti

es in

ass

ets,

ag

ency

, con

trib

ution

, and

en

ablin

g en

viro

nmen

ts.

This

sugg

ests

that

w

hen

disp

ariti

es in

PYD

co

nstr

ucts

are

nar

row

ed,

disp

ariti

es in

pos

itive

yo

uth

outc

omes

such

as

inco

me

and

heal

th c

an a

lso

be re

duce

d.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: S

ee ta

ble

belo

w.

Hi-L

evel

Fin

ding

s: S

ixty

per

cent

of t

he 3

5 pr

ogra

ms

with

rigo

rous

eva

luati

ons d

emon

stra

ted

positi

ve e

ffect

s on

beh

avio

rs, i

nclu

ding

subs

tanc

e us

e an

d ris

ky se

xual

ac

tivity

, and

/or m

ore

dist

al d

evel

opm

enta

l out

com

es,

such

as e

mpl

oym

ent a

nd h

ealth

indi

cato

rs. T

here

is

prom

ising

evi

denc

e th

at P

YD p

rogr

ams c

an b

e eff

ectiv

e in

LM

ICs;

how

ever

, mor

e rig

orou

s exa

min

ation

with

long

-te

rm fo

llow

-up

is re

quire

d to

est

ablis

h if

thes

e pr

ogra

ms

offer

ben

efits

sim

ilar t

o th

ose

seen

in h

ighe

r inc

ome

coun

trie

s.

Inte

rven

tion

Ove

rall:

PYD

, or P

ositi

ve Y

outh

Dev

elop

men

t3Da

taba

ses s

earc

hed

for r

evie

w: S

copu

s an

d Pu

bMed

. For

the

gray

lite

ratu

re,

targ

eted

sear

ches

of k

now

ledg

e re

posit

ory

Web

site

s hos

ted

by

inte

rnati

onal

age

ncie

s ,in

clud

ing

the

U.K.

Dep

artm

ent f

or In

tern

ation

al

Deve

lopm

ent,

the

Uni

ted

Nati

ons,

the

Inte

r-Am

eric

an D

evel

opm

ent B

ank,

and

th

e W

orld

Ban

k.

Adol

esce

nt-S

peci

fic F

indi

ngs:

Sch

ool c

urric

ula

deliv

ered

in

wee

kly

sess

ions

by

trai

ned

scho

ol o

r pro

ject

staff

de

mon

stra

ted

som

e su

cces

s in

impr

ovin

g kn

owle

dge,

atti

tude

s, a

nd so

ft sk

ills.

The

se p

rogr

ams u

sual

ly

incl

uded

faci

litat

ed in

tera

ction

s and

acti

vitie

s to

supp

ort

peer

-to-p

eer i

nvol

vem

ent.

The

prog

ram

s with

rigo

rous

ev

alua

tions

, the

pro

gram

s tha

t int

entio

nally

targ

eted

se

vera

l rel

ated

pos

itive

you

th o

utco

mes

are

the

mos

t pr

omisi

ng fo

r lar

ger s

cale

impl

emen

tatio

ns. M

any

of

thes

e pr

ogra

ms e

ncou

rage

d yo

uth

enga

gem

ent i

n th

e im

plem

enta

tion

of th

e pr

ogra

m th

roug

h cr

eatin

g gr

oups

, pa

rtici

patin

g in

dec

ision

s abo

ut to

pics

and

acti

vitie

s w

ithin

the

prog

ram

s and

thro

ugh

prov

idin

g pe

er su

ppor

t. Di

rect

invo

lvem

ent o

f you

ng p

eopl

e in

dev

elop

ing

new

pr

ogra

ms w

as le

ss e

vide

nt, b

ut th

ere

is gr

owin

g ev

iden

ce

that

you

th in

volv

emen

t in

ever

y le

vel o

f dec

ision

-mak

ing

coul

d im

prov

e pr

ogra

m o

utco

mes

.

Inte

rven

tion

exam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

): Se

e ta

ble

belo

w.

Revi

ew in

clus

ion

crite

ria: (

1) b

e pu

blish

ed b

etw

een

1990

and

mid

-201

6;

(2) b

e w

ritten

in E

nglis

h, S

pani

sh, o

r Fr

ench

; (3)

incl

ude

an e

valu

ation

in a

n LM

IC; a

nd (4

)targ

et y

outh

bet

wee

n 10

an

d 29

yea

rs o

f age

. The

pro

gram

had

to

addr

ess m

ore

than

one

PYD

con

stru

ctor

ad

dres

s one

PYD

con

stru

ct a

cros

s m

ultip

le so

cial

izatio

n do

-mai

ns (e

.g.,

hom

e, sc

hool

, and

pee

rs).

Out

com

es o

vera

ll—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: I

mpr

ove

one

or m

ore

spec

ific

positi

ve y

outh

ou

tcom

es, s

uch

as e

duca

tion,

em

ploy

men

t, or

hea

lth.4

Revi

ew e

xclu

sion

: See

abo

ve.

Out

com

es fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (sp

ecify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: S

ee ta

ble

belo

w.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es fo

r Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): sc

hool

Coun

try(

ies)

: low

- and

mid

dle-

inco

me

coun

trie

s (LM

ICs)

St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): N

/ALe

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

scho

ol

Page 71: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

71

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RA

GE

GR

OU

P IN

STU

DY

INTE

RV

EN

TIO

NO

UTC

OM

EN

OTE

S

Jega

nnat

han

et a

l., 2

014

Seco

ndar

y sc

hool

Life

Ski

lls T

rain

ing

for S

uici

de P

reve

ntion

Bo

ys w

ith h

igh-

risk

beha

vior

impr

oved

on

rela

tions

hips

, pur

pose

in li

fe, a

nd li

fe sk

ills G

irls

impr

oved

rela

tions

hips

, hea

lth m

aint

enan

ce, a

nd

life

skill

s

Ekhti

ari e

t al.,

201

2Hi

gh S

choo

lVi

olen

ce P

reve

ntion

, Life

skill

s tra

inin

g: sp

ecifi

c to

do

mes

tic v

iole

nce

with

focu

s gro

ups f

or g

irls,

trai

ning

for

scho

ol c

ouns

elor

s in

prev

entio

n an

d fa

cilit

ating

par

ent

invo

lvem

ent

Redu

ced

favo

rabl

e atti

tude

s tow

ard

dom

estic

vi

olen

ce Im

prov

ed v

iole

nce

prev

entiv

e be

havi

ors,

co

mm

unic

ation

stra

tegi

es re

late

d to

dom

estic

vi

olen

ce a

mon

g gi

rls

Srik

ala

and

Kish

ore,

201

014

-16

year

-old

you

thLi

fe S

kills

for M

enta

l Hea

lth, L

ife sk

ills t

rain

ing

in sc

hool

Im

prov

ed se

lf-es

teem

, per

ceiv

ed c

opin

g, a

djus

tmen

t in

scho

ol a

nd w

ith te

ache

rs5 , a

nd p

roso

cial

beh

avio

r

Roth

eram

-Bor

us e

t al.,

201

213

-21

Voca

tiona

l tra

inin

g w

ith H

IV p

reve

ntion

for U

gand

an

yout

h Re

duce

d de

linqu

ent b

ehav

iors

and

impr

oved

em

ploy

men

t, qu

ality

of l

ife, a

nd so

cial

supp

ort

Amin

et a

l., 2

016

12-1

8 ye

ar o

ld g

irls i

n Ba

ngla

desh

PY

D-ba

sed

educ

ation

al su

ppor

t del

iver

ed in

four

ver

sions

: tu

torin

g, g

ende

r aw

aren

ess,

live

lihoo

d sk

ills,

and

co

mm

unity

eng

agem

ent.6

Redu

ced

child

mar

riage

, inc

reas

ed S

RH k

now

ledg

e.

Incr

ease

d sc

hool

atte

ndan

ce, p

rivat

e tu

tors

, ex

perie

nce

in w

orki

ng fo

r pay

(gen

der a

war

enes

s an

d liv

elih

oods

inte

rven

tions

),ind

icat

ors o

f soc

ial

free

dom

s and

redu

ced

hara

ssm

ent o

utsi

de

of h

ome(

gend

er a

war

enes

s and

edu

catio

n in

terv

entio

ns)

Aray

a et

al.,

201

313

-15

year

old

s10

gro

up se

ssio

ns c

over

ing

copi

ng w

ith th

ough

ts a

nd

emoti

ons a

nd p

robl

em-s

olvi

ng. B

oost

er se

ssio

ns a

t 2an

d 7

mon

ths a

fter l

ast s

essio

n

Ther

e w

as n

o ev

iden

ce o

f any

clin

ical

ly im

port

ant

impr

ovem

ent/

diffe

renc

e in

dep

ress

ive

sym

ptom

s.

Page 72: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

72

Rapid Evidence Review Appendix 5: Evidence Tables

9. D

ray

J, B

ow

man

J, C

amp

bel

l E, F

reun

d M

, Wo

lfend

en L

, Ho

dd

er R

K, e

t al

. Sys

tem

atic

Rev

iew

of

Uni

vers

al R

esili

ence

-Fo

cuse

d In

terv

enti

ons

Tar

get

ing

Chi

ld a

nd A

do

lesc

ent

Men

tal H

ealt

h in

the

S

cho

ol S

etti

ng. J

our

nal o

f th

e A

mer

ican

Aca

dem

y o

f C

hild

and

Ad

ole

scen

t P

sych

iatr

y [I

nter

net]

. 201

7 O

ct; 5

6(10

):813

-824

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

8942

803

FOC

US

OF

RE

VIE

WS

R M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

SY

STE

MAT

IC R

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

5-1

8 ye

ars

Date

rang

e fo

r rev

iew

: 199

5-20

15#

of st

udie

s inc

lude

d: 4

9

Insu

ffici

ent n

umbe

r of t

rials

in so

me

subg

roup

s,

thus

pre

clud

ing

com

pleti

on o

f all

met

a-an

alys

es

for s

ubgr

oups

spec

ified

a p

riori.

Num

ber o

f tria

ls re

porti

ng a

dequ

ate

data

for

met

a-an

alys

es v

arie

d by

out

com

e an

d su

bgro

up.

Rese

arch

sugg

ests

that

the

incl

usio

n of

4 o

r few

er

stud

ies i

n ra

ndom

effe

cts m

eta-

anal

ysis

may

re

sult

in im

prec

ise e

stim

ation

s of b

etw

een-

stud

y va

rianc

e.

Ri

sk o

f bia

s of i

nclu

ded

stud

ies w

as ra

ted

high

ov

eral

l due

to 2

key

met

hodo

logi

cal l

imita

tions

, na

mel

y, la

ck o

f blin

ding

of k

ey st

udy

pers

onne

l or

par

ticip

ants

, and

com

mon

use

of s

elf-r

epor

t ou

tcom

e m

easu

res.

Bec

ause

of t

he n

atur

e of

un

iver

sal,

scho

ol- b

ased

inte

rven

tion

tria

ls, su

ch

stud

y qu

aliti

es m

ay n

ot e

asily

be

mod

ified

to

redu

ce b

ias.

He

tero

gene

ity re

mai

ned

high

for t

he o

utco

mes

of

dep

ress

ive

sym

ptom

s and

anx

iety

sym

ptom

s.

It

was

not

pos

sible

to te

st w

heth

er th

e in

terv

entio

ns a

ffect

ed re

silie

nce

per s

e, a

s ver

y fe

w tr

ials

also

pro

vide

d a

mea

sure

of l

evel

s of t

he

resil

ienc

e pr

otec

tive

fact

ors t

arge

ted

with

in th

e in

terv

entio

ns.

Th

e qu

ality

of e

vide

nce

for a

ll m

enta

l hea

lth

prob

lem

out

com

es, e

xcep

t dep

ress

ive

sym

ptom

s,

was

dow

ngra

ded

to “

mod

erat

e” b

ecau

se

of m

etho

dolo

gica

l lim

itatio

ns; t

he q

ualit

y of

evi

denc

e fo

r dep

ress

ive

sym

ptom

s was

do

wng

rade

d to

“lo

w”

beca

use

of m

etho

dolo

gica

l lim

itatio

ns a

nd h

igh

prob

abili

ty o

f pub

licati

on

bias

bas

ed o

n vi

sual

insp

ectio

n of

the

funn

el p

lot.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: A

dole

scen

t Tria

ls (1

1-18

Ye

ars)

Hi-L

evel

Fin

ding

s: T

he m

ost p

rom

ise is

for u

sing

univ

ersa

l re

silie

nce-

focu

sed

inte

rven

tions

at l

east

for s

hort

-ter

m

redu

ction

s in

depr

essi

ve a

nd a

nxie

ty sy

mpt

oms f

or

child

ren

and

adol

esce

nts,

par

ticul

arly

if a

cog

nitiv

e-be

havi

oral

ther

apy

base

d ap

proa

ch is

use

d.

Inte

rven

tion

Ove

rall:

Incl

uded

tria

ls as

sess

ed in

terv

entio

ns

that

add

ress

ed a

t lea

st 3

inte

rnal

resil

ienc

e pr

otec

tive

fact

ors

(see

out

com

es).

Data

base

s sea

rche

d fo

r rev

iew

: Med

line,

Ps

ycIN

FO, E

RIC,

EM

BASE

, CIN

AHL,

and

the

Coch

rane

Cen

tral

Reg

ister

of C

ontr

olle

d Tr

ials

(CEN

TRAL

, The

Coc

hran

e Li

brar

y),

Goog

le S

chol

ar

Adol

esce

nt-S

peci

fic F

indi

ngs:

For

ado

lesc

ent t

rials,

met

a-an

alys

is w

as p

ossib

le fo

r 5 o

f 7 o

utco

mes

and

indi

cate

d a

sign

ifica

nt o

vera

ll in

terv

entio

n eff

ect f

or in

tern

aliz

ing

prob

lem

s onl

y. R

esul

ts o

f the

pre

sent

revi

ew su

gges

t so

me

bene

fit o

f int

erve

ning

bot

h in

chi

ldho

od (5

−10

year

s) a

nd in

ado

lesc

ence

(11−

18 y

ears

), de

pend

ing

on

the

men

tal h

ealth

out

com

e be

ing

targ

eted

.

Inte

rven

tion

exam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

): Se

e ab

ove.

Re

view

incl

usio

n cr

iteria

: Inc

lude

d st

udie

s wer

e ra

ndom

ized

cont

rolle

d tr

ials

(RCT

s), i

nclu

ding

clu

ster

rand

omize

d co

ntro

lled

tria

ls (C

RCTs

) tha

t com

pare

d a

univ

ersa

l, sc

hool

-bas

ed, r

esili

ence

-fo

cuse

d in

terv

entio

n to

a c

ontr

ol o

r an

alte

rnati

ve in

terv

entio

n

Out

com

es o

vera

ll—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: R

esili

ence

pro

tecti

ve fa

ctor

s: d

epre

ssiv

e sy

mpt

oms,

anx

iety

sym

ptom

s, h

yper

activ

ity, c

ondu

ct

prob

lem

s, in

tern

aliz

ing

prob

lem

s, e

xter

naliz

ing

prob

lem

s, o

r ge

nera

l psy

chol

ogic

al d

istre

ss.

Revi

ew e

xclu

sion

: Int

erve

ntion

s co

nduc

ted

in w

ar zo

nes w

ere

excl

uded

. O

ther

wise

, exc

lusio

n fr

om th

e re

view

w

as d

eter

min

ed b

y a

failu

re to

mee

t the

in

clus

ion

crite

ria d

etai

led

abov

e.

Out

com

es fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (sp

ecify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: D

epre

ssiv

e sy

mpt

oms,

anx

iety

sym

ptom

s, h

yper

activ

ity, c

ondu

ct

prob

lem

s, in

tern

aliz

ing

prob

lem

s, e

xter

naliz

ing

prob

lem

s,

gene

ral p

sych

olog

ical

dis

tres

s

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A, G

RADE

, Co

chra

ne H

andb

ook

Out

com

es fo

r Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): sc

hool

Coun

try(

ies)

: 16

tota

l, th

e la

rges

t con

trib

utor

s bei

ng fr

om th

e U.

S. a

nd A

ustr

alia

St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): N

/ALe

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

scho

ol

Page 73: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

73

Rapid Evidence Review Appendix 5: Evidence Tables

10. D

unni

ng D

L, G

riffi

ths

K, K

uyke

n W

, Cra

ne C

, Fo

ulke

s L,

Par

ker

J, D

alg

leis

h T.

The

Eff

ects

of

Min

dfu

lnes

s-B

ased

Inte

rven

tio

ns o

n C

og

niti

on

and

Men

tal H

ealt

h in

Chi

ldre

n an

d A

do

lesc

ents

A M

eta-

Ana

lysi

s o

f R

and

om

ized

Co

ntro

lled

Tri

als.

Jo

urna

l of

Chi

ld P

sych

olo

gy

and

Psy

chia

try

[Int

erne

t]. 2

018

Oct

22

[cit

ed 2

019

Aug

19]

; 60(

3):2

44-2

58. A

vaila

ble

fro

m: h

ttp

s://

onl

inel

ibra

ry.w

iley.

com

/do

i/fu

ll/10

.111

1/jc

pp

.129

80FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

You

th 1

8 ye

ars a

nd

youn

ger.

Date

rang

e fo

r rev

iew

: Inc

eptio

n of

da

taba

ses u

tilize

d –

Oct

201

7#

of st

udie

s inc

lude

d: 3

3

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: M

eta-

anal

ysis

aggr

egat

ed

sam

ples

with

the

aim

of c

aptu

ring

data

for y

outh

18

year

s and

yo

unge

r

Hi-L

evel

Fin

ding

s:

All R

CTs m

eta-

anal

ysis:

Acr

oss a

ll RC

Ts, t

hose

par

ticip

ants

re

ceiv

ing

an M

BI im

prov

ed si

gnifi

cant

ly m

ore

than

thos

e re

ceiv

ing

the

cont

rol c

ondi

tion

for t

he c

ateg

orie

s of

Min

dful

ness

and

Exe

cutiv

e Fu

nctio

ns. T

he re

lativ

e be

nefit

of

rece

ivin

g M

BIs f

or A

ttenti

on w

as n

ot si

gnifi

cant

. The

ca

tego

ries o

f Dep

ress

ion

and

Anxi

ety/

Stre

ss sh

owed

sig

nific

antly

gre

ater

redu

ction

s afte

r an

MBI

than

afte

r th

e co

ntro

l con

ditio

n. M

BIs d

id n

ot h

ave

a sig

nific

antly

gr

eate

r im

pact

on

chan

ging

Soc

ial B

ehav

ior.

How

ever

, th

e ca

tego

ry o

f Neg

ative

Beh

avio

r was

sign

ifica

nt, w

ith

MBI

reci

pien

ts sh

owin

g a

grea

ter r

educ

tion

in p

robl

ems

than

thos

e re

ceiv

ing

the

cont

rol c

ondi

tion.

For

stati

stica

lly

signi

fican

t res

ults

, effe

ct si

zes r

ange

d fr

om sm

all (

.19)

to

smal

l-to-

mod

erat

e (.3

0).

Indi

vidu

al, r

ando

m e

ffect

s met

a-re

gres

sions

show

ed

that

age

was

a si

gnifi

cant

mod

erat

or o

f im

prov

emen

ts

in E

xecu

tive

Func

tions

(Q =

5.6

0, p

= .0

18),

with

larg

er

effe

ct si

zes i

n fa

vor o

f the

MBI

ass

ocia

ted

with

old

er

age.

For

dur

ation

of M

BI, t

otal

trai

ning

hou

rs w

as a

sig

nific

ant m

oder

ator

of a

redu

ction

in N

egati

ve B

ehav

ior

(Q =

7.3

0, p

= .0

07),

with

larg

er e

ffect

size

s rel

ated

to

mor

e ho

urs o

f tra

inin

g. In

tere

stin

gly,

Risk

of b

ias s

core

ha

d no

sign

ifica

nt e

ffect

on

any

outc

ome

cate

gory

.

Activ

e Co

ntro

l RCT

s: D

ata

show

s tha

t tho

se c

ompl

eting

M

BIs i

mpr

oved

sign

ifica

ntly

mor

e th

an th

ose

in a

ctive

co

ntro

l int

erve

ntion

s for

Min

dful

ness

(ES=

0.4

2, C

I 0.1

6 to

0.

67) a

nd th

ere

was

also

a g

reat

er re

ducti

on in

pro

blem

s fo

llow

ing

an M

BI th

an fo

llow

ing

the

activ

e co

ntro

l co

nditi

on fo

r the

cat

egor

ies D

epre

ssio

n an

d An

xiet

y/St

ress

. Effe

ct si

zes f

or si

gnifi

cant

resu

lts ra

nged

from

smal

l (.1

8) to

smal

l-to-

mod

erat

e (.4

2). T

here

wer

e no

sign

ifica

nt

effec

ts o

n ch

ange

s in

mea

sure

s of S

ocia

l Beh

avio

r, N

egati

ve B

ehav

ior,

Exec

utive

Fun

ction

s, o

r Atte

ntion

.Ag

e sig

nific

antly

mod

erat

ed im

prov

emen

ts in

Neg

ative

Be

havi

or (Q

= 5

.27,

p =

.021

), w

ith la

rger

effe

ct

sizes

ass

ocia

ted

with

you

nger

age

. Risk

of b

ias s

core

sig

nific

antly

mod

erat

ed m

easu

res o

f Min

dful

ness

, w

ith la

rger

effe

ct si

zes r

elat

ed to

gre

ater

risk

of b

ias

(Q =

4.3

6, p

= .0

37).

Tota

l hou

rs o

f MBI

trai

ning

had

no

signi

fican

t effe

ct o

n an

y ou

tcom

e ca

tego

ry.

As n

oted

by

auth

or: W

hen

all R

CTs a

re in

clud

ed in

th

e an

alys

is, a

lmos

t all

of th

e ca

tego

ries s

uffer

from

he

tero

gene

ity. T

he p

rese

nce

of h

eter

ogen

eity

is

indi

cativ

e of

a la

ck o

f sim

ilarit

y be

twee

n th

e in

clud

ed

stud

ies,

in th

is ca

se p

erha

ps w

ith re

gard

s to

the

met

hodo

logy

use

d (e

.g.,

diffe

rent

con

trol

gro

ups)

. For

th

e 17

RCT

s with

acti

ve c

ontr

ol g

roup

s, h

eter

ogen

eity

is

less

of a

n iss

ue b

ut is

still

signi

fican

tly p

rese

nt in

bo

th o

f the

beh

avio

ral c

ateg

orie

s.Th

ere

was

also

evi

denc

e of

pub

licati

on b

ias i

n th

e su

b-ca

tego

ries o

f Neg

ative

Beh

avio

r and

Anx

iety

/St

ress

and

in a

dditi

on, f

or th

e RC

Ts w

ith a

ctive

con

trol

gr

oups

, in

the

Min

dful

ness

cat

egor

y. It

is im

port

ant t

o hi

ghlig

ht th

is as

it su

gges

ts th

at th

e st

udie

s inc

lude

d he

re, i

n th

e af

orem

entio

ned

cate

gorie

s at l

east

, ar

e sy

stem

atica

lly d

iffer

ent t

o un

publ

ished

stud

ies.

Sp

ecifi

cally

, the

re is

an

odds

ratio

of 2

.3 fo

r pre

ferr

ed

publ

icati

on o

f pos

itive

resu

lts (D

ubbe

n &

Bec

k-Bo

rnho

ldt,

2005

) sug

gesti

ng th

at th

ere

may

be

an

over

estim

ation

of t

he p

ositi

ve e

ffect

s of M

BIs.

Even

thou

gh R

CTs a

re th

e go

ld st

anda

rd re

sear

ch

desig

n, th

ere

are

still

rela

tivel

y fe

w m

indf

ulne

ss

stud

ies w

ith c

hild

ren/

adol

esce

nts t

hat a

dopt

them

, te

stify

ing

to h

ow e

arly

alo

ng th

e in

terv

entio

n de

velo

pmen

t tra

ject

ory

MBI

s for

you

th a

re.

Anot

her p

oten

tial i

ssue

is th

at m

any

stud

ies c

hoos

e to

test

new

MBI

pro

toco

ls ra

ther

than

run

repl

icati

on

stud

ies o

n es

tabl

ished

MBI

s.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

M

indf

ulne

ss-B

ased

Inte

rven

tions

(MBI

s): I

nter

venti

ons a

imed

at

aug

men

ting

min

dful

ness

(defi

ned

as in

tenti

onal

ly d

irecti

ng

atten

tion

to p

rese

nt e

xper

ienc

es w

ith a

n atti

tude

of c

urio

sity

and

acce

ptan

ce) t

hrou

gh tr

aini

ng. I

t is h

ypot

hesiz

ed th

at

the

enha

ncem

ent o

f pro

xim

al sk

ills t

rain

ed b

y M

BIs,

such

as

non

judg

men

tal a

ttenti

on c

ontr

ol, m

ay h

ave

dow

nstr

eam

eff

ects

on

mor

e di

stal

out

com

es su

ch a

s im

prov

ed b

ehav

ior o

r re

duce

d sy

mpt

oms o

f psy

chop

atho

logy

.

Data

base

s sea

rche

d fo

r rev

iew

: Pub

Med

, ER

IC, C

ochr

ane,

EM

BASE

, Psy

cIN

FO, W

eb

of S

cien

ce.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

abo

ve)

Page 74: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

74

Rapid Evidence Review Appendix 5: Evidence Tables

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

(See

abo

ve)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es w

ere

incl

uded

if

the

stud

y fu

lfille

d th

e fo

llow

ing

requ

irem

ents

: 1) D

esig

n m

ust c

ompa

re

the

effec

ts o

f min

dful

ness

aga

inst

a

cont

rol c

ondi

tion

and

parti

cipa

nts w

ere

rand

omly

ass

igne

d to

eith

er c

ondi

tion

(RCT

), 2)

Par

ticip

ants

of t

he st

udy

mus

t be

age

d 18

yea

rs o

r you

nger

, 3) t

he c

ore

of th

e m

indf

ulne

ss tr

aini

ng p

rogr

am

cons

isted

of t

he fo

llow

ing

esse

ntial

el

emen

ts: p

rese

nt m

omen

t foc

us a

nd

dece

nter

ing,

the

deve

lopm

ent o

f gre

ater

att

entio

nal a

nd b

ehav

iora

l sel

f-reg

ulati

on,

and

enga

gem

ent o

f the

par

ticip

ant

in su

stai

ned

min

dful

ness

med

itatio

n pr

actic

e, 4

) the

inte

rven

tion

mus

t also

be

del

iver

ed o

ver m

ore

than

one

sess

ion

by a

trai

ned

min

dful

ness

teac

her a

nd

min

dful

ness

pra

ctice

mus

t the

cen

tral

co

mpo

nent

of t

he in

terv

entio

n (r

athe

r th

an it

bei

ng c

ombi

ned

with

oth

er

activ

ities

like

min

dful

yog

a, m

indf

ul

colo

ring

or a

subc

ompo

nent

of a

noth

er

inte

rven

tion

like

Acce

ptan

ce C

omm

itmen

t Th

erap

y), a

nd 5

) the

out

com

e m

easu

res

mus

t pro

vide

qua

ntita

tive

data

from

w

hich

effe

ct si

zes c

ould

be

calc

ulat

ed.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Min

dful

ness

, soc

ial b

ehav

ior,

nega

tive

beha

vior

, de

pres

sion,

anx

iety

/str

ess,

exe

cutiv

e fu

nctio

ns, a

ttenti

on

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Exc

lusio

n w

as b

ased

on

a fa

ilure

to m

eet t

he in

clus

ion

crite

ria

deta

iled

abov

e.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

abov

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): N

ot d

efine

d, fa

ce to

face

inst

ructi

on b

y a

trai

ned

min

dful

ness

inst

ruct

orCo

untr

y(ie

s): N

ot d

efine

dSt

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s):

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fa

mily

, wor

k, re

crea

tion,

OST

): In

divi

dual

Page 75: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

75

Rapid Evidence Review Appendix 5: Evidence Tables

11. E

nns

J, H

olm

qvi

st M

, Wen

er P

, Hal

as G

, Ro

thne

y J,

Sch

ultz

A, e

t al

. Map

pin

g in

terv

enti

ons

tha

t p

rom

ote

men

tal h

ealt

h in

the

gen

eral

po

pul

atio

n: A

sco

pin

g r

evie

w o

f re

view

s. P

reve

ntiv

e M

edic

ine

[Int

erne

t]. 2

016

Jun

[cit

ed 2

019

July

26]

; 87:

70-8

0. A

vaila

ble

fro

m: h

ttp

s://

ww

w.n

cbi.n

lm.n

ih.g

ov/

pub

med

/268

9663

4 FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

You

th

Date

rang

e fo

r rev

iew

: 200

4-20

14#

of st

udie

s inc

lude

d: 3

9N

oted

by

auth

or:

Lim

itatio

ns o

f thi

s sco

ping

revi

ew in

clud

e:

The

poss

ibili

ty th

at so

me

rele

vant

pu

blic

ation

s may

not

hav

e be

en re

trie

ved

by th

e se

arch

stra

tegy

des

pite

the

use

of

syst

emati

c se

arch

met

hods

and

iter

ative

st

eps t

o m

inim

ize o

miss

ions

.

The

com

plex

ity o

f men

tal h

ealth

and

men

tal

wel

l-bei

ng c

once

pts,

and

the

over

lap

betw

een

prom

otion

and

pre

venti

on, w

ere

diffi

cult

to c

aptu

re in

a li

tera

ture

sear

ch, a

nd

as su

ch, t

he re

sults

of t

his s

tudy

may

not

be

trul

y co

mpr

ehen

sive.

Ther

e w

as in

evita

ble

subj

ectiv

ity in

cho

osin

g in

clus

ion

crite

ria a

nd c

onsid

erin

g w

heth

er

artic

les w

ere

rele

vant

for o

ur re

view

.

Beca

use

we

targ

eted

stud

ies i

n hi

gh-in

com

e co

untr

ies,

the

findi

ngs m

ay n

ot b

e ap

plic

able

to

low

- or m

iddl

e-in

com

e co

untr

ies

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: S

ee ta

ble

belo

w.

Hi-L

evel

Fin

ding

s: R

esea

rch

desc

ribin

g in

terv

entio

ns

to im

prov

e m

enta

l hea

lth o

r pre

vent

men

tal i

llnes

s ov

erw

helm

ingl

y fo

cuse

s on

trea

tmen

t of e

xisti

ng il

lnes

s or

, to

a le

sser

ext

ent,

on e

nhan

cing

resil

ienc

e. W

e be

lieve

th

at a

focu

s on

resil

ienc

e, w

hile

impo

rtan

t, sh

ould

not

di

stra

ct fr

om p

reve

ntion

effo

rts t

hat i

nvol

ve c

reati

ng

envi

ronm

ents

that

are

mor

e su

ppor

tive

of m

enta

l hea

lth.

The

impa

ct o

f pol

icy-

leve

l cha

nges

that

mea

ning

fully

ad

dres

s det

erm

inin

g fa

ctor

s lik

e cr

ime,

pov

erty

, soc

ial

excl

usio

n, a

nd in

equa

lity

need

s to

be st

udie

d. A

t pre

sent

, th

ere

is ve

ry li

ttle

in th

e ac

adem

ic li

tera

ture

that

spea

ks to

th

e im

pact

of t

hese

cha

nges

on

men

tal h

ealth

out

com

es

Inte

rven

tion

Ove

rall:

Fam

ily a

nd p

aren

ting

inte

rven

tions

, in

terv

entio

ns in

indi

geno

us p

opul

ation

s, in

terv

entio

ns in

the

wor

kpla

ce, i

nter

venti

ons i

n ol

der a

dults

, int

erve

ntion

s in

the

gene

ral p

ublic

Data

base

s sea

rche

d fo

r rev

iew

: Pub

Med

, Ps

ycIN

FO, S

copu

s, C

ochr

ane

CEN

TRAL

, CI

NAH

L an

d ER

Adol

esce

nt-S

peci

fic F

indi

ngs:

See

abo

ve.

Inte

rven

tion

exam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

): Se

e ta

ble

belo

w.

Revi

ew in

clus

ion

crite

ria: H

uman

subj

ects

in

Wes

tern

ized

coun

trie

s (Ca

nada

, U.S

.A.,

Euro

pe, U

.K.,

Aust

ralia

and

New

Zea

land

)Pu

blish

ed in

Eng

lish.

Dat

e ra

nge

July

20

04–J

uly

2014

. Res

earc

h ta

rgeti

ng th

e ge

nera

l pop

ulati

on w

here

no

illne

ss

or p

re-e

xisti

ng c

ondi

tion

is id

entifi

ed.

Met

hods

des

crib

e a

syst

emati

c re

view

, m

eta-

anal

ysis,

met

a-sy

nthe

sis, i

nteg

rativ

e an

alys

is, sc

opin

g re

view

, rap

id re

view

, or a

sy

stem

atic

appr

oach

to d

ata

colle

ction

Out

com

es o

vera

ll—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: I

n st

udie

s ass

essin

g ge

nera

l wel

l-bei

ng, t

he

outc

omes

of i

nter

est i

nclu

de m

easu

res o

f int

erac

tion

(soc

ial

skill

s), c

ogni

tive

abili

ties (

prob

lem

solv

ing

skill

s), e

moti

onal

m

atur

ity (c

opin

g ab

ility

and

resil

ienc

e), s

elf-p

erce

ption

(s

elf-e

stee

m, c

onfid

ence

), ac

adem

ic p

erfo

rman

ce, a

nd ri

sky

beha

vior

s (i.e

., al

coho

l or s

ubst

ance

abu

se)

Revi

ew e

xclu

sion

: Int

erve

ntion

s aim

ed

at tr

eatin

g a

spec

ific

popu

latio

n be

caus

e of

a p

re-e

xisti

ng c

ondi

tion

or il

lnes

s.

Artic

les t

hat d

id n

ot re

port

a ri

goro

us

met

hodo

logy

. Res

earc

h fo

cusin

g on

theo

ries o

r con

cept

s sup

porti

ng

polic

y de

velo

pmen

t, bu

t not

repo

rting

m

enta

l hea

lth-r

elat

ed o

utco

mes

. Re

sear

ch fo

cuse

d on

stud

y de

sign(

e.g.

, m

etho

dolo

gy o

r pro

toco

l pap

ers)

Out

com

es fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (sp

ecify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: S

ee ta

ble

belo

w.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): Ar

ksey

and

O’M

alle

y’s

scop

ing

revi

ew m

etho

dolo

gy (A

rkse

y an

d O

’Mal

ley,

2005

) and

Lev

ac e

t al.’s

m

etho

dolo

gy a

dvan

cem

ent (

Leva

c et

al.,

20

10) a

s gui

des f

or th

is sc

opin

g re

view

of

revi

ews.

Out

com

es fo

r Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): sc

hool

, cou

nsel

ing

cent

ers,

clin

ics,

hom

e, o

r via

the

inte

rnet

Coun

try(

ies)

: Wes

tern

ized

coun

trie

s (Ca

nada

, U.S

., Eu

rope

, U.

K., A

ustr

alia

, and

New

Zea

land

)St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): N

/ALe

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

scho

ol, c

omm

unity

, ind

ivid

ual

Page 76: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

76

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Cale

ar a

nd C

hrist

ense

n (2

010)

Child

ren/

adol

. Age

s 5-1

9CB

T, p

sych

oedu

catio

n, in

terp

erso

nal t

hera

pyIn

dica

ted

prog

ram

s, w

hich

targ

eted

stud

ents

ex

hibi

ting

elev

ated

leve

ls of

dep

ress

ion,

wer

e fo

und

to b

e th

e m

ost e

ffecti

ve. T

each

er p

rogr

am le

ader

s and

th

e em

ploy

men

t of a

ttenti

on c

ontr

ol c

ondi

tions

wer

e as

soci

ated

with

few

er si

gnifi

cant

effe

cts.

Carn

eval

e (2

013)

Adol

esce

nts

CBT

Resu

lts in

dica

ted

cogn

itive

–beh

avio

ral u

nive

rsal

pr

even

tion

inte

rven

tions

can

be

effec

tive

on

decr

easin

g de

pres

sive

sym

ptom

atol

ogy

in a

dole

scen

ts.

All r

evie

wed

stud

ies w

ere

cond

ucte

d in

the

scho

ol

envi

ronm

ent b

y pr

ofes

siona

ls an

d/or

scho

ol st

aff;

how

ever

, onl

y th

ree

of th

e pr

ogra

ms i

mpl

emen

ted

dem

onst

rate

d ad

optio

n an

d su

stai

nabi

lity

O’M

ara

and

Lind

(201

3)Ch

ildre

n/ad

oles

cent

s age

d 6–

18m

enta

l hea

lth p

rom

otion

, prim

ary

prev

entio

n of

men

tal

heal

th d

isord

ers

A w

hole

scho

ol a

ppro

ach

focu

sing

on m

enta

l hea

lth

prom

otion

rath

er th

an o

n m

enta

l illn

ess p

reve

ntion

is

effec

tive

in p

rom

oting

chi

ld a

nd y

outh

men

tal h

ealth

Beau

rega

rd (2

014)

Child

ren

aged

5-1

7cl

assr

oom

pro

gram

s with

a m

ajor

com

pone

nt o

f art

(v

isual

art

s, d

ram

a, m

usic

, dan

ce/m

ovem

ent)

Cultu

ral s

ensiti

vity

is n

eces

sary

bot

h in

inte

rven

tion

and

stud

y de

sign.

Ove

rall,

the

resu

lts in

dica

te th

at

prog

ram

mes

con

tain

ing

a m

ajor

com

pone

nt o

f cr

eativ

e ex

pres

sion

can

be b

enefi

cial

to c

hild

ren

but t

his n

eeds

to b

e co

nsid

ered

with

mod

erati

on.

On

one

hand

, sig

nific

ant i

mpr

ovem

ent w

as fo

und

in

hope

, cop

ing

and

resil

ienc

y, p

roso

cial

beh

avio

urs,

se

lf-es

teem

, im

pairm

ent,

emoti

onal

and

beh

avio

ural

pr

oble

ms (

espe

cial

ly a

ggre

ssiv

e be

havi

ours

), co

nstr

uctio

n of

mea

ning

and

PTS

D sc

ores

. On

the

othe

r han

d, so

me

stud

ies a

lso re

port

ed n

o sig

nific

ant

chan

ge in

pro

soci

al b

ehav

iour

s, se

lf-es

teem

, em

otion

al

and

beha

viou

ral p

robl

ems,

cop

ing

and

resil

ienc

y of

ad

oles

cent

boy

s and

PTS

D (fo

r a la

ck o

f a ta

rget

ed

inte

rven

tion)

.

Max

wel

l et a

l. (2

008)

Ag

ed 3

-18

psyc

hoed

ucati

on, C

BT, i

nter

pers

onal

psy

chot

hera

pyIn

scho

ols,

sust

aine

d br

oad-

base

d m

enta

l hea

lth

prom

otion

pro

gram

mes

com

bine

d w

ith m

ore

targ

eted

be

havi

oura

l and

cog

nitiv

e-be

havi

oura

l the

rapy

(C

BT) f

or th

ose

child

ren

with

iden

tifiab

le e

moti

onal

w

ellb

eing

and

men

tal h

ealth

nee

ds, o

ffer e

vide

nce

of a

dem

onst

rabl

y eff

ectiv

e ap

proa

ch. E

arly

and

brie

f in

terv

entio

n pr

ogra

mm

es w

hich

redu

ce w

aitin

g tim

es

for s

ervi

ces a

ppea

r pro

misi

ng a

ppro

ache

s and

seem

to

redu

ce th

e nu

mbe

r of s

essio

ns a

fam

ily re

quire

. Th

ere

is a

reas

onab

ly st

rong

evi

denc

e ba

se to

supp

ort

targ

eted

wor

k w

ith b

oth

pare

nts a

nd c

hild

ren.

Horo

witz

and

Gar

ber (

2006

)Ag

ed <

21CB

TBo

th se

lecti

ve a

nd in

dica

ted

prev

entio

n pr

ogra

ms

wer

e m

ore

effec

tive

than

uni

vers

al p

rogr

ams a

t fol

low

-up

, eve

n w

hen

the

2 st

udie

s with

col

lege

stud

ents

w

ere

excl

uded

.

Mer

ry a

nd S

penc

e (2

007)

Aged

5-1

9ps

ycho

educ

ation

, CBT

, int

erpe

rson

al p

sych

othe

rapy

Positi

ve re

sults

afte

r int

erve

ntion

and

at f

ollo

w-u

p ha

ve b

een

repo

rted

in a

num

ber o

f tar

gete

d st

udie

s,

alth

ough

an

attem

pt to

repl

icat

e fin

ding

s in

a sc

hool

an

d in

a p

rimar

y ca

re se

tting

wer

e un

succ

essf

ul. M

ost

stud

ies o

f uni

vers

al in

terv

entio

ns h

ave

show

n a

shor

t-te

rm e

ffect

that

did

not

per

sist a

t fol

low

-up.

Stice

et a

l. (2

009)

Child

ren

and

adol

esce

nts

CBT,

psy

choe

duca

tion

Larg

er e

ffect

s em

erge

d fo

r pro

gram

s tar

getin

g hi

gh-

risk

indi

vidu

als,

sam

ples

with

mor

e fe

mal

es, s

ampl

es

with

old

er a

dole

scen

ts, p

rogr

ams w

ith a

shor

ter

dura

tion

and

with

hom

ewor

k as

signm

ents

, and

pr

ogra

ms d

eliv

ered

by

prof

essio

nal i

nter

venti

onist

s.

Resu

lts su

gges

t tha

t dep

ress

ion

prev

entio

n eff

orts

pr

oduc

e a

high

er y

ield

if th

ey in

corp

orat

e fa

ctor

s as

soci

ated

with

larg

er in

terv

entio

n eff

ects

(e.g

., se

lecti

ve p

rogr

ams w

ith a

shor

ter d

urati

on th

at in

clud

e ho

mew

ork)

.

Page 77: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

77

Rapid Evidence Review Appendix 5: Evidence Tables

Chris

tens

en e

t al.

(201

0)Ag

ed 1

1-25

CBT,

exe

rcise

, psy

choe

duca

tion

The

effec

tiven

ess o

f 18

anxi

ety

and

26 d

epre

ssio

n st

udie

s add

ress

ing

prev

entio

n in

com

mun

ity

prog

ram

s wer

e id

entifi

ed u

sing

syst

emati

c re

view

m

etho

dolo

gy. A

nxie

ty a

nd d

epre

ssio

n sy

mpt

oms

wer

e re

duce

d in

~60

% o

f the

pro

gram

s. C

ogni

tive

beha

vior

al th

erap

y pr

ogra

ms w

ere

mor

e co

mm

on

than

oth

er in

terv

entio

ns a

nd w

ere

cons

isten

tly fo

und

to lo

wer

sym

ptom

s or p

reve

nt d

epre

ssio

n or

anx

iety

. Au

tom

ated

or c

ompu

teriz

ed in

terv

entio

ns sh

owed

pr

omise

, with

60%

of a

nxie

ty p

rogr

ams a

nd 8

3% o

f de

pres

sion

prog

ram

s yie

ldin

g su

cces

sful

out

com

es o

n at

leas

t one

mea

sure

.

Rich

ards

on e

t al.

(201

0)Ag

ed <

18co

mpu

teriz

ed C

BTAl

l stu

dies

repo

rted

redu

ction

s in

clin

ical

sym

ptom

s an

d al

so im

prov

emen

ts in

var

iabl

es su

ch a

s beh

avio

ur,

self-

este

em a

nd c

ogni

tions

. Sati

sfac

tion

with

tr

eatm

ent w

as m

oder

ate

to h

igh

from

bot

h ch

ildre

n an

d pa

rent

s, th

ough

leve

ls of

dro

p ou

t and

non

-co

mpl

etion

wer

e oft

en h

igh.

Mer

ry e

t al (

2011

)Ag

ed 5

-19

psyc

holo

gica

l and

edu

catio

nal s

trat

egie

s (e.

g. C

BTTh

ere

is so

me

evid

ence

from

this

revi

ew th

at ta

rget

ed

and

univ

ersa

l dep

ress

ion

prev

entio

n pr

ogra

mm

es m

ay

prev

ent t

he o

nset

of d

epre

ssiv

e di

sord

ers c

ompa

red

with

no

inte

rven

tion.

How

ever

, allo

catio

n co

ncea

lmen

t is

uncl

ear i

n m

ost s

tudi

es, a

nd th

ere

is he

tero

gene

ity

in th

e fin

ding

s. T

he p

ersis

tenc

e of

find

ings

sugg

ests

th

at th

is is

real

and

not

a p

lace

bo e

ffect

.

Burk

hard

t and

Bre

nnan

, 201

2Ag

ed 1

1-18

phys

ical

acti

vity

inte

rven

tions

usin

g re

crea

tiona

l dan

ceTh

ere

is so

me

evid

ence

to su

gges

t tha

t inv

olve

men

t in

danc

e m

ay h

ave

som

e po

sitive

out

com

es o

n ph

ysic

al

and

psyc

hoso

cial

wel

l-bei

ng.

Arbe

sman

et a

l., 2

013a

-Arb

esm

an e

t al.,

201

3bAg

ed 3

-21

prog

ram

s bui

ldin

g so

cial

skill

s, p

rom

oting

hea

lth/

prev

entin

g di

sord

ers,

and

focu

sed

on p

lay,

leisu

re o

r re

crea

tion

activ

ities

At th

e un

iver

sal l

evel

, str

ong

evid

ence

exi

sts f

or

the

effec

tiven

ess o

f occ

upati

on- a

nd a

ctivi

ty-b

ased

in

terv

entio

ns in

man

y ar

eas,

incl

udin

g pr

ogra

ms

that

focu

s on

soci

al–e

moti

onal

lear

ning

; sch

oolw

ide

bully

ing

prev

entio

n; a

nd a

fter-s

choo

l, pe

rfor

min

g ar

ts,

and

stre

ss m

anag

emen

t acti

vitie

s. A

t the

targ

eted

le

vel,

stro

ng e

vide

nce

indi

cate

s tha

t soc

ial a

nd li

fe

skill

s pro

gram

s are

effe

ctive

for c

hild

ren

who

are

ag

gres

sive,

hav

e be

en re

ject

ed, a

nd a

re te

enag

e m

othe

rs. T

he e

vide

nce

also

is st

rong

that

chi

ldre

n w

ith in

telle

ctua

l im

pairm

ents

, dev

elop

men

tal d

elay

s,

and

lear

ning

disa

biliti

es b

enefi

t fro

m so

cial

skill

s pr

ogra

mm

ing

and

play

, lei

sure

, and

recr

eatio

nal

activ

ities

. Add

ition

ally,

evi

denc

e of

the

effec

tiven

ess

of so

cial

skill

s pro

gram

s is s

tron

g fo

r chi

ldre

n re

quiri

ng

serv

ices

at t

he in

tens

ive

leve

l (e.

g., t

hose

with

auti

sm

spec

trum

diso

rder

, dia

gnos

ed m

enta

l illn

ess,

serio

us

beha

vior

diso

rder

s) to

impr

ove

soci

al b

ehav

ior a

nd

self-

man

agem

ent.

New

ton

and

Cilis

ka, 2

006a

-New

ton

and

Cilis

ka, 2

006b

Any

age

grou

p or

gen

der

soci

al le

arni

ng, C

BT a

nd p

sych

oedu

catio

n (r

eadi

ngs a

nd

refle

ction

, jou

rnal

ing,

inte

rnet

disc

ussio

n gr

oup)

No

robu

st e

vide

nce

exist

s on

the

impa

ct o

f Int

erne

t-ba

sed

prev

entio

n st

rate

gies

on

eatin

g di

sord

ered

sy

mpt

omat

olog

y an

d on

put

ative

fact

ors t

hat

cont

ribut

e to

eati

ng d

isord

er d

evel

opm

ent.

Page 78: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

78

Rapid Evidence Review Appendix 5: Evidence Tables

12. F

eiss

R, D

olin

ger

SB

, Mer

ritt

M, R

eich

e E

, Mar

tin

K, Y

anes

JA

, Tho

mas

CM

, Pan

gel

inan

M. A

Sys

tem

atic

Rev

iew

and

Met

a-A

naly

sis

of

Sch

oo

l-B

ased

Str

ess,

Anx

iety

, and

Dep

ress

ion

Pre

vent

ion

Pro

gra

ms

for

Ad

ole

scen

ts. J

our

nal o

f Yo

uth

and

Ad

ole

scen

ce [

Inte

rnet

]. 2

019

July

26

[cit

ed 2

019

Aug

1];

(ep

ub a

head

of

pri

nt).

Ava

ilab

le f

rom

: htt

ps:

//lin

k.sp

ring

er.c

om

/art

icle

/10.

1007

%2

Fs10

964-

019-

0108

5-0

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

Ado

lesc

ents

age

d 11

-18

year

sDa

te ra

nge

for r

evie

w: 1

990-

2018

# of

stud

ies i

nclu

ded:

42

As n

oted

by

auth

or: O

ver h

alf t

he st

udie

s (54

.8%

) ha

d a

high

risk

of b

ias d

ue to

lack

of a

dher

ence

to th

e in

terv

entio

n (e

.g.,

high

dro

p-ou

t, la

ck o

f atte

ndan

ce,

did

not p

rovi

de a

ttend

ance

info

rmati

on).

Also

, a h

igh

amou

nt o

f het

erog

enei

ty a

mon

g m

any

of th

e st

udie

s.Au

thor

is c

lear

to n

ote

that

man

y sc

hool

s, e

spec

ially

th

ose

in lo

wer

SES

or r

ural

are

as, m

ay n

ot b

e ca

pabl

e of

impl

emen

ting

such

pro

gram

s reg

ardl

ess o

f the

ir effi

cacy

.

Mix

of t

arge

ted

and

univ

ersa

l int

erve

ntion

s in

met

a-an

alys

is w

ere

sepa

rate

d fo

r com

paris

on.

(Cou

ld u

se to

add

ress

un

iver

sal-a

ppro

ach

conc

erns

)Al

l but

2 st

udie

s wer

e ra

ted

as h

igh

risk

for o

vera

ll bi

as,

larg

ely

due

to h

igh

risk

of

perf

orm

ance

bia

s sin

ce

blin

ding

par

ticip

ants

was

di

fficu

lt an

d se

lf-re

port

m

easu

res a

re c

omm

only

us

ed.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: P

oole

d m

eta-

anal

ysis,

cod

ed

into

eith

er m

iddl

e sc

hool

(MS)

or h

igh

scho

ol (H

S).

Hi-L

evel

Fin

ding

s: O

vera

ll, th

is st

udy

foun

d th

at p

rogr

ams

aim

ed a

t red

ucin

g de

pres

sion

and

/or a

nxie

ty d

isor

ders

in

ado

lesc

ents

are

gen

eral

ly e

ffecti

ve, h

owev

er, p

rogr

ams

for s

tres

s red

uctio

n ar

e no

t. Pr

ogra

m ty

pe in

fluen

ced

prog

ram

effi

cacy

for s

tres

s, a

nxie

ty, a

nd d

epre

ssio

n.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

All

but 7

pro

gram

s w

ere

trad

ition

al th

erap

y pr

ogra

ms (

e.g.

, CBT

-bas

ed, s

tres

s in

ocul

ation

)

Data

base

s sea

rche

d fo

r rev

iew

: Aca

dem

ic

Sear

ch P

rem

iere

, ERI

C, P

sycI

NFO

, and

Ps

ycAR

TICL

ES.

Adol

esce

nt-S

peci

fic F

indi

ngs:

St

ress

: Ove

rall,

stre

ss re

ducti

on in

terv

entio

ns d

id n

ot

redu

ce st

ress

sym

ptom

s com

pare

d to

con

trol

gro

ups.

Ta

rget

ed in

terv

entio

ns d

id sh

ow g

reat

er re

ducti

ons i

n st

ress

than

uni

vers

al p

rogr

ams.

Age

cou

ld n

ot b

e in

clud

ed

in a

step

wise

regr

essio

n as

non

e of

the

4 st

udie

s inc

lude

d M

S pa

rtici

pant

s.

Anxi

ety:

Anx

iety

redu

ction

inte

rven

tions

sign

ifica

ntly

re

duce

d an

xiet

y sy

mpt

oms c

ompa

red

to c

ontr

ol g

roup

s.

How

ever

no

diffe

renc

es in

anx

iety

sym

ptom

s wer

e ob

serv

ed a

t 3-6

mon

th fo

llow

-up

for t

he 6

stud

ies t

hat

incl

uded

follo

w-u

p da

ta. F

or u

nive

rsal

inte

rven

tions

hi

gher

dos

e w

as a

ssoc

iate

d w

ith a

gre

ater

redu

ction

in

anxi

ety.

De

pres

sion:

Dep

ress

ion

inte

rven

tions

sign

ifica

ntly

re

duce

d de

pres

sive

sym

ptom

s com

pare

d to

con

trol

gr

oups

, how

ever

in th

e 17

stud

ies i

nclu

ding

3-8

mon

th

follo

w-u

p no

diff

eren

ces w

ere

obse

rved

at f

ollo

w-

up. A

dditi

onal

ly, th

is re

ducti

on w

as m

oder

ated

by

a co

mbi

natio

n of

pro

gram

type

, dos

e, ra

ce, a

nd a

ge g

roup

.

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

Stre

ss in

ocul

ation

pro

gram

, Lea

rnin

g to

BRE

ATH

min

dful

ness

pro

gram

, tra

ditio

nal g

roup

ther

apy

met

hods

(e.g

., CB

T), a

ltern

ative

gro

up th

erap

y m

etho

ds (e

.g.,

med

itatio

n, h

olisti

c in

terv

entio

ns),

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es in

clud

ed

mus

t ass

ess a

scho

ol-b

ased

men

tal

heal

th p

rogr

am in

U.S

. mid

dle

and

high

sc

hool

setti

ngs a

imed

at r

educ

ing

stre

ss,

depr

essio

n/de

pres

sive

sym

ptom

s, a

nxie

ty,

or o

ther

inte

rnal

izing

men

tal h

ealth

-re

late

d pr

oble

ms.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Mea

sure

s of s

tres

s (4

of 4

2), a

nxie

ty (2

0 0f

42)

, and

de

pres

sion/

depr

essiv

e sy

mpt

oms (

38 o

f 42)

.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Rev

iew

s, e

pide

mio

logy

ar

ticle

s, n

on-p

eer r

evie

wed

arti

cles

, and

st

udie

s tha

t om

itted

bas

elin

e an

d/or

po

sttes

t sco

res w

ere

excl

uded

.

Page 79: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

79

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es:

Perc

eive

d St

ress

Sca

le (P

SS),

Stat

e-Tr

ait A

nxie

ty In

dex

(STA

I) su

bsca

les,

You

th S

elf-R

epor

t (YS

R) d

epre

ssio

n sc

ales

, Chi

ldre

n’s

Depr

essio

n In

vent

ory

(CDI

), Ce

nter

for E

pide

mio

logi

cal S

tudi

es

Depr

essio

n Sc

ale

(CES

-D),

Beha

vior

Ass

essm

ent S

yste

m fo

r Ch

ildre

n (B

ASC)

anx

iety

scal

es, B

rief S

ympt

om In

vent

ory

(BSI

) anx

iety

and

dep

ress

ion

scal

es, S

hort

Moo

d &

Fee

ling

ques

tionn

aire

(SM

FQ),

Moo

d an

d Fe

elin

g Q

uesti

onna

ire

(MFQ

), Re

vise

d Ch

ildre

n’s M

anife

st A

nxie

ty S

cale

(RCM

AS),

Scre

en fo

r Chi

ld A

nxie

ty R

elat

ed D

isord

ers (

SCAR

ED),

Reyn

olds

Ad

oles

cent

Dep

ress

ion

Scal

e (R

ADS)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Sc

hool

sCo

untr

y(ie

s): U

.SSt

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): N

/ALe

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Scho

ol, I

ndiv

idua

l

Page 80: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

80

Rapid Evidence Review Appendix 5: Evidence Tables

13. G

wyt

her

K, S

wan

n R

, Cas

sey

K, P

urce

ll R

, Ric

e S

M. D

evel

op

ing

Yo

ung

Men

’s W

ellb

eing

Thr

oug

h C

om

mun

ity

and

Sch

oo

l-b

ased

Pro

gra

ms:

A S

yste

mat

ic R

evie

w. P

LoS

ON

E [

Inte

rnet

]. 2

019

May

20

[ci

ted

201

9 A

ug 1

]; 1

4(5)

:e02

1695

5. A

vaila

ble

fro

m: h

ttp

s://

jour

nals

.plo

s.o

rg/p

loso

ne/a

rtic

le?i

d=

10.1

371/

jour

nal.p

one

.021

6955

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

you

ng m

ales

age

d 12

-25

year

s.Da

te ra

nge

for r

evie

w: F

irst y

ear o

f da

taba

se a

vaila

bilit

y –

2018

# of

stud

ies i

nclu

ded:

40

Hi-L

evel

Fin

ding

s: M

ale-

targ

eted

inte

rven

tions

may

be

mor

e be

nefic

ial f

or y

oung

men

7 than

gen

der-n

eutr

al

prog

ram

s; h

owev

er, n

one

of th

e st

udie

s inc

orpo

rate

d m

ascu

line-

spec

ific

theo

ry. 1

00%

of G

SP a

nd G

TPs

repo

rted

at l

east

one

pos

itive

effe

ct. 6

9% o

f GN

Ps

repo

rted

at l

east

one

pos

itive

effe

ct.

GTP:

Eac

h of

the

four

GTP

s rep

orte

d so

me

positi

ve

chan

ges i

n pa

rtici

pant

s pos

t-pro

gram

. The

Cou

ncil

was

th

e on

ly G

TP to

repo

rt q

uanti

tativ

e ou

tcom

es, w

ith

signi

fican

t pos

itive

inte

rven

tion

effec

ts o

bser

ved

for

scho

ol se

lf-effi

cacy

and

futu

re se

lf-effi

cacy

. For

the

Coun

cil,

no c

hang

es w

ere

foun

d fo

r mas

culin

e id

eolo

gy,

rela

tiona

l agg

ress

ion,

or i

denti

ty d

istr

ess.

Com

men

ts

from

par

ticip

ants

in th

e YM

I, TR

J, an

d RW

P su

gges

t the

pr

ogra

ms w

ere

effec

tive

for r

educ

ing

ange

r, in

crea

sing

se

lf-re

flecti

on, a

nd re

shap

ing

perc

eptio

n ab

out ‘

bein

g a

man

’. GS

P: A

ll 7

mal

e-sp

ecifi

c in

terv

entio

ns re

port

ed a

t lea

st 1

be

nefic

ial o

utco

me.

HEY

MAN

repo

rted

incr

ease

d qu

ality

of

life

enj

oym

ent a

nd sa

tisfa

ction

at p

ost-p

rogr

am,

ATLA

S re

port

ed in

crea

sed

psyc

holo

gica

l wel

lbei

ng

post

-pro

gram

, HBI

P pa

rtici

pant

s with

initi

al b

ody

diss

atisf

actio

n sh

owed

a si

gnifi

cant

redu

ction

in n

egati

ve

affec

t pos

t-pro

gram

(Sta

nfor

d an

d M

cCab

e’s b

ody

imag

e pr

ogra

m a

lso re

port

ed d

ecre

ased

neg

ative

affe

ct a

s wel

l as

incr

ease

d se

lf-es

teem

), Pa

rtici

pant

s in

the

OBB

C sa

w

signi

fican

t im

prov

emen

ts in

ove

rall

self-

este

em a

nd

acad

emic

self-

este

em, R

OC

and

Inco

link

foun

d po

sitive

ou

tcom

es fo

r hel

p-se

ekin

g ou

tcom

es (R

OC

parti

cipa

nts

repo

rted

incr

ease

d lik

elih

ood

to se

ek h

elp

post

-pro

gram

an

d ap

prox

imat

ely

80%

of p

artic

ipan

ts in

Inco

link

indi

cate

d in

crea

sed

unde

rsta

ndin

g of

how

to id

entif

y an

d se

ek h

elp

for p

robl

ems i

n th

emse

lves

and

oth

ers)

. GN

P: in

9 G

NPs

with

mal

e-on

ly sa

mpl

es, 8

repo

rted

po

sitiv

e eff

ects

for a

t lea

st o

ne o

utco

me.

Tw

o ou

tdoo

r ad

vent

ure

prog

ram

s rep

orte

d sig

nific

ant i

ncre

ase

in

self-

effica

cy a

nd c

ogni

tive

auto

nom

y, a

nd e

moti

onal

in

telli

genc

e, in

trap

erso

nal s

kills

, ada

ptab

ility

, and

m

ood.

1 sp

ortin

g pr

ogra

m (o

f 2) s

how

ed p

rom

ising

qu

alita

tive

resu

lts w

here

par

ticip

ants

repo

rted

incr

ease

d co

mpe

tenc

e. T

he o

ther

spor

ting

prog

ram

repo

rted

sig

nific

ant q

uanti

tativ

e in

terv

entio

n eff

ects

for r

educ

ed

depr

essi

ve sy

mpt

oms f

ollo

win

g th

e in

terv

entio

n. F

or

1 eH

ealth

inte

rven

tion

(of 2

), sig

nific

ant s

hort

-term

im

prov

emen

ts in

dep

ress

ive

sym

ptom

s and

a lo

ng te

rm

inte

rven

tion

effec

t for

self-

este

em w

ere

obse

rved

. In

the

othe

r, a

prev

enta

tive

effec

t in

dist

ress

sym

ptom

s (w

here

the

inte

rven

tion

grou

p ha

d a

non-

signi

fican

t de

crea

se in

dist

ress

and

the

cont

rol s

how

ed a

sign

ifica

nt

incr

ease

) was

obs

erve

d. O

ne m

indf

ulne

ss in

terv

entio

n re

port

ed si

gnifi

cant

redu

ction

s in

anxi

ety

sym

ptom

s and

ru

min

ation

. One

men

torin

g pr

ogra

m c

onve

yed

positi

ve

qual

itativ

e ou

tcom

es, w

ith p

artic

ipan

ts se

lf-re

porti

ng

decr

ease

d ag

gres

sion

and

incr

ease

d m

otiva

tion.

Th

e re

mai

ning

17

artic

les e

valu

ated

GN

Ps in

mix

ed-

gend

er sa

mpl

es. 7

pro

gram

s fou

nd p

ositi

ve c

hang

es

in m

ostly

mal

es. T

wo

psyc

hoed

ucati

onal

pro

gram

s im

prov

ed m

enta

l hea

lth, a

nd se

lf-effi

cacy

and

opti

mism

. O

ne m

indf

ulne

ss p

rogr

am a

nd o

ne c

omm

unity

serv

ice

prog

ram

repo

rted

redu

ced

nega

tive

affec

t. An

em

otion

al

inte

llige

nce

inte

rven

tion

repo

rted

incr

ease

d em

otion

al

atten

tion

and

clar

ity. A

cul

tura

lly-r

elev

ant e

Heal

th

prog

ram

repo

rted

incr

ease

d in

tere

st in

div

ersit

y of

co

ntac

t. O

ne sp

ort p

rogr

am in

crea

sed

asse

rtive

ness

.

As n

oted

by

auth

or: T

he h

eter

ogen

eity

of s

tudy

ch

arac

teris

tics p

reve

nted

a m

eta-

anal

ysis

or th

e as

sess

men

t of p

ublic

ation

bia

s. F

ew st

udie

s use

d m

eans

of a

ctua

lly m

easu

ring

mas

culin

e id

eolo

gy (t

he

auth

or st

ates

ther

e ar

e no

w a

t lea

st 1

6 va

lidat

ed

scal

es o

n th

e su

bjec

t). T

he m

ajor

ity o

f stu

dies

did

not

m

easu

re lo

ng-te

rm fo

llow

-up.

Thi

s patt

ern

of sh

ort-

term

, one

-off

inte

rven

tion

eval

uatio

n re

sults

in a

la

ck o

f effe

ct re

plic

ation

and

no

evid

ence

of p

rogr

am

enha

ncem

ent.

With

out r

epea

ting

eval

uatio

ns it

can

not

be d

eter

min

ed w

heth

er p

rogr

ams a

re re

liabl

y eff

ectiv

e.

This

artic

le d

id n

ot

prov

ide

indi

vidu

al st

udy

brea

k do

wn,

mak

ing

iden

tifyi

ng a

ge g

roup

s fo

r eac

h st

udy

diffi

cult

thou

gh it

app

ears

all

invo

lved

mal

es th

at w

ere

in o

ur ta

rget

dem

ogra

phic

(m

ean

and

med

ian

age

of

sam

ple

wer

e 15

and

15.

5 re

spec

tivel

y).

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: C

ould

not

det

erm

ine

age

of sa

mpl

e fo

r eac

h st

udy,

thou

gh th

e m

ean

and

med

ian

age

for a

ll st

udy

sam

ples

(8,2

90 p

artic

ipan

ts) a

t the

beg

inni

ng o

f in

terv

entio

n is

15 a

nd 1

5.5

resp

ectiv

ely.

Data

base

s sea

rche

d fo

r rev

iew

: MED

LIN

E,

Emba

se, P

sycI

NFO

, ERI

C, a

nd E

RAD.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Gen

der-T

rans

form

ative

Pr

ogra

ms (

GTP)

, Gen

der-S

ensiti

ve P

rogr

ams (

GSP)

, Gen

der-

Neu

tral

Pro

gram

s (GN

P).

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

GTP:

Roc

k an

d W

ater

Pro

gram

(RW

P), T

he C

ounc

il fo

r Boy

s and

Yo

ung

Men

(The

Cou

ncil)

, You

ng M

en In

itiati

ve (Y

MI),

The

Rite

Jo

urne

y (T

RJ).

GSP:

Acti

ve Te

en L

eade

rs A

void

ing

Scre

en T

ime

(ATL

AS),

Harn

essin

g EH

ealth

to e

nhan

ce Y

oung

men

’s M

enta

l hea

lth,

Activ

ity, a

nd N

utriti

on (H

EYM

AN),

Heal

thy

Body

Imag

e Pr

ogra

m (H

BIP)

, unn

amed

bod

y im

age

educ

ation

pro

gram

by

Stan

ford

and

McC

abe

(Sta

nfor

d &

McC

abe,

200

5), R

each

Out

Ce

ntra

l (RO

C), I

ncol

ink

Life

Ski

lls P

rogr

amm

e (IL

SP),

Out

war

d Bo

und

Brid

ging

Cou

rse

(OBB

C)GN

P: m

ento

ring

or c

omm

unity

serv

ice,

psy

choe

duca

tion,

ph

ysic

al a

ctivi

ty o

r spo

rt, e

Heal

th in

terv

entio

ns, o

utdo

or

adve

ntur

e pr

ogra

ms,

min

dful

ness

and

med

itatio

n pr

ogra

ms,

em

otion

al in

telli

genc

e in

terv

entio

ns, b

ody

imag

e pr

ogra

m.

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: A

rticl

es w

ere

incl

uded

if

they

eva

luat

ed a

n in

terv

entio

n or

pro

gram

w

ith a

gen

eral

or a

t-risk

8 sam

ple

of y

oung

m

en (m

ean

age

betw

een

12-2

5 ye

ars a

t be

ginn

ing

of in

terv

entio

n), a

nd m

easu

red

a ps

ycho

logi

cal,

psyc

hoso

cial

, mas

culin

ity, o

r ed

ucati

onal

out

com

e.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: GT

P: sc

hool

self-

effica

cy, f

utur

e se

lf-effi

cacy

, rel

ation

al

aggr

essio

n, id

entit

y di

stre

ss, a

nger

, sel

f-refl

ectio

n, p

erce

ption

s ab

out ‘

bein

g a

man

’. GS

P: q

ualit

y of

life

enj

oym

ent a

nd sa

tisfa

ction

, psy

chol

ogic

al

wel

lbei

ng, n

egati

ve a

ffect

, sel

f-est

eem

, aca

dem

ic se

lf-es

teem

, he

lp-s

eeki

ng o

utco

mes

. GN

P: se

lf-effi

cacy

and

cog

nitiv

e au

tono

my,

emoti

onal

in

telli

genc

e, in

trap

erso

nal s

kills

, ada

ptab

ility

, moo

d, se

nse

of c

ompe

tenc

e, d

epre

ssiv

e sy

mpt

oms,

self-

este

em, d

istre

ss

sym

ptom

s, a

nxie

ty sy

mpt

oms a

nd ru

min

ation

, agg

ress

ion,

m

otiva

tion,

men

tal h

ealth

, opti

mism

, neg

ative

affe

ct,

emoti

onal

atte

ntion

and

cla

rity,

ass

ertiv

enes

s, m

enta

l hea

lth

liter

acy,

men

tal h

ealth

pre

judi

ce.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Arti

cles

wer

e ex

clud

ed

if th

ey 1

) had

an

all-f

emal

e sa

mpl

e 2)

fo

cuse

d on

you

th o

ffend

ers,

clin

ical

or

out-p

atien

t sam

ples

3) w

ere

case

stud

ies 4

) us

ed b

iolo

gica

l, m

edic

al, o

r sup

plem

enta

ry

inte

rven

tions

5) a

sses

sed

outc

ome

varia

bles

rela

ted

to re

prod

uctiv

e he

alth

be

havi

ors,

par

tner

vio

lenc

e, su

bsta

nce

use,

phy

sical

hea

lth, s

mok

ing

and

prog

ram

fe

edba

ck o

nly.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

See

abov

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

GT

P: M

ascu

line

ideo

logy

GNP:

inte

rest

in d

iver

sity

of c

onta

ct

Page 81: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

81

Rapid Evidence Review Appendix 5: Evidence Tables

Setti

ng(s

): Se

cond

ary

scho

ol, c

omm

unity

, uni

vers

ity, o

nlin

e,

mix

edCo

untr

y(ie

s): M

ajor

ity O

ECD

coun

trie

s (sp

ecifi

cally

Aus

tral

ia

and

U.S.

)St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): N

/ALe

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Scho

ol, C

omm

unity

, Ind

ivid

ual

Adol

esce

nt-S

peci

fic F

indi

ngs:

(See

abo

ve)

Page 82: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

82

Rapid Evidence Review Appendix 5: Evidence Tables

14. J

ano

usko

va M

, Tus

kova

E, W

eiss

ova

A, T

ranc

ik P

, Pas

z J,

Eva

ns-L

acko

S, W

inkl

er P

. Can

vid

eo in

terv

enti

ons

be

used

to

eff

ecti

vely

des

tig

mat

ize

men

tal i

llnes

s am

ong

yo

ung

peo

ple

? A

sy

stem

atic

rev

iew

. Eur

op

ean

Psy

chia

try

[Int

erne

t]. 2

017

Mar

[ci

ted

201

9 Ju

ly 2

6]; 4

1:1-

9. A

vaila

ble

fro

m: h

ttp

s://

ww

w.n

cbi.n

lm.n

ih.g

ov/

pub

med

/280

4907

4FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

stud

ents

age

s 13-

25

year

s old

Date

rang

e fo

r rev

iew

: No

excl

usio

n ba

sed

on d

ate

of p

ublic

ation

# of

stud

ies i

nclu

ded:

23

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: S

econ

dary

scho

ol st

uden

ts

(13-

18 y

ears

old

) (Ch

an e

t al.,

200

9), S

econ

dary

scho

ol

stud

ents

(mea

n ag

e 14

.7 y

ears

old

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ters

et a

l., 1

998)

, Se

cond

ary

scho

ol st

uden

ts (1

3-17

yea

rs o

ld) (

Pint

o-Fo

ltz e

t al.,

20

11),

Seco

ndar

y sc

hool

stud

ents

(mea

n ag

e 15

.76

year

s old

) (S

apor

ito e

t al.,

201

1).

Hi-L

evel

Fin

ding

s:

Vide

o w

as fo

und

to b

e m

ore

effec

tive

than

oth

er

inte

rven

tions

(e.g

., fa

ce to

face

sim

ulati

on o

f ha

lluci

natio

ns).

Soci

al c

onta

ct d

eliv

ered

via

vid

eo

inte

rven

tion

achi

eved

sim

ilar e

ffect

to li

ve in

terv

entio

n.

Ove

rall,

vid

eo c

onsid

ered

pro

misi

ng.

Not

abl

e to

synt

hesiz

e da

ta m

eta-

anal

ytica

lly b

ecau

se

the

stud

ies s

how

ed su

bsta

ntial

het

erog

enei

ty in

term

s of

leng

th a

nd c

onte

nt o

f the

vid

eo in

terv

entio

ns, a

s w

ell a

s in

term

s of t

ools

to m

easu

re e

ffecti

vene

ss o

f th

ese

inte

rven

tions

. Inc

lusio

n of

stud

ies r

epor

ted

in

Engl

ish o

nly

mig

ht h

ave

had

furt

her l

imite

d re

sults

. Al

so, d

ata

extr

actio

n an

d qu

ality

ass

essm

ent w

as

perf

orm

ed b

y on

e au

thor

for e

ach

of th

e st

udie

s on

ly, so

aut

hors

wer

e no

t abl

e to

look

at p

ossib

le

disc

repa

ncie

s and

det

erm

ine

inte

r-rat

er re

liabi

lity.

Ho

wev

er, a

utho

rs in

volv

ed in

dat

a ex

trac

tion

and

qual

ity a

sses

smen

t sha

re a

com

mon

wor

kpla

ce a

nd

all a

mbi

guiti

es w

ere

disc

usse

d in

stan

tly a

mon

g th

em.

Non

e of

the

23 st

udie

s con

duct

ed in

a lo

w- o

r mid

dle-

inco

me

coun

try.

Al

l int

erve

ntion

s occ

urre

d in

scho

ols.

By A

H: R

isk o

f sel

ectio

n an

d att

rition

bia

s was

co

nsid

erab

le, e

xter

nal

valid

ity n

ot d

iscus

sed,

low

or

unr

ecor

ded

resp

onse

ra

tes

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Vid

eo in

terv

entio

ns

aim

ed a

t red

ucin

g sti

gma

tow

ards

peo

ple

with

men

tal

illne

sses

(gen

eral

ly a

s par

t of a

bro

ader

gro

up o

f mas

s med

ia

inte

rven

tions

, edu

catio

nal i

nter

venti

ons,

scho

ol-b

ased

in

terv

entio

ns, a

nd a

nti-s

tigm

a in

terv

entio

ns).

Data

base

s sea

rche

d fo

r rev

iew

: MED

LIN

E,

ERIC

, Aca

dem

ic S

earc

h Co

mpl

ete,

Co

chra

ne (t

rials)

, Coc

hran

e (r

evie

ws)

, Ope

n SI

GLE

(gre

y lit

erat

ure)

, Web

of K

now

ledg

e,

EMBA

SE, H

ealth

Man

agem

ent I

nfor

mati

on

Cons

ortiu

m, P

sycI

NFO

, Pro

Que

st,

Soci

al P

olic

y &

Pra

ctice

, and

Wor

ldCa

t di

sser

tatio

n.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18-y

ear-

olds

or

equ

ival

ent (

spec

ify):

Docu

men

tary

inte

rven

tion

(one

arm

: ed

ucati

on th

en d

ocum

enta

ry. S

econ

d ar

m: D

ocum

enta

ry th

en

educ

ation

) (Ch

an e

t al.,

200

9), E

duca

tion

inte

rven

tion

(Est

ers

et a

l., 1

998)

, Liv

e ta

lk in

terv

entio

n (w

ith e

duca

tion

+ di

rect

co

ntac

t) (P

into

-Fol

tz e

t al.,

201

1), D

ocum

enta

ry in

terv

entio

n (w

ith e

duca

tion)

(Sap

orito

et a

l., 2

011)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es in

clud

ed m

ust a

sses

s sc

hool

-bas

ed in

terv

entio

ns in

clud

ing

at

leas

t one

vid

eo-b

ased

com

pone

nt a

nd

focu

sed

on m

enta

l illn

ess o

r the

mes

clo

sely

co

nnec

ted

to m

enta

l hea

lth. S

tudi

es th

at

incl

uded

par

ticip

ants

old

er o

r you

nger

th

an th

e de

sired

age

rang

e (1

3-25

) wer

e in

clud

ed if

the

mea

n ag

e ra

nge

of th

e sa

mpl

e w

as w

ithin

the

desir

ed ra

nge.

The

in

terv

entio

n al

so h

ad to

aim

at r

educ

ing

stigm

a to

war

ds p

eopl

e w

ith m

enta

l illn

ess.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PS

EWB

outc

omes

: Cod

ed o

utco

mes

of i

ndiv

idua

l stu

dies

into

7

cate

gorie

s: k

now

ledg

e ab

out e

tiolo

gy, c

hara

cter

of p

eopl

e ha

ving

men

tal i

llnes

s, a

nd p

ossib

le tr

eatm

ent;

soci

al d

istan

ce;

repo

rted

em

otion

al re

actio

n; p

erce

ived

dan

gero

usne

ss;

com

bina

tion

of th

e ab

ove

men

tione

d di

men

sions

(gen

eral

atti

tude

s); a

ttitu

des t

owar

d he

lp se

ekin

g w

hile

hav

ing

men

tal

illne

ss; o

utco

mes

mea

surin

g ac

tual

beh

avio

ur to

war

d so

meo

ne

with

men

tal i

llnes

s.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Stu

dies

wer

e ex

clud

ed if

th

ey fa

iled

to m

eet t

he in

clus

ion

crite

ria

deta

iled

abov

e.

Out

com

es e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

abov

e)

Guid

ance

use

d to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18-

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Page 83: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

83

Rapid Evidence Review Appendix 5: Evidence Tables

Setti

ng(s

): Vi

deo

inte

rven

tions

wer

e on

ly d

eliv

ered

as p

art o

f ed

ucati

onal

inte

rven

tions

in sc

hool

setti

ngs

Coun

try(

ies)

: US,

Eur

ope,

Chi

na, A

ustr

alia

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er co

untr

ies)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Scho

olT

EE

N-S

PE

CIF

IC F

IND

ING

S

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Chan

et a

l., 2

009

Seco

ndar

y sc

hool

stud

ents

(13-

18 y

ears

ol

d)Do

cum

enta

ry in

terv

entio

n (o

ne a

rm: e

duca

tion

then

doc

umen

tary

. Sec

ond

arm

: Doc

umen

tary

then

ed

ucati

on)

In th

e ed

ucati

on-v

ideo

gro

up, t

here

wer

e sig

nific

antly

po

sitiv

e eff

ects

on

know

ledg

e ab

out e

tiolo

gy,

char

acte

r of p

eopl

e w

ith m

enta

l illn

ess a

nd p

ossi

ble

trea

tmen

t obs

erve

d at

pos

t-tes

t and

follo

w-u

p w

hen

com

pare

d to

the

educ

ation

con

trol

gro

up. T

here

wer

e al

so si

gnifi

cant

ly p

ositi

ve e

ffect

s obs

erve

d on

soci

al

dist

ance

at p

ost-t

est a

nd fo

llow

-up

whe

n co

mpa

red

to

the

educ

ation

-onl

y co

ntro

l gro

up. S

igni

fican

t pos

itive

eff

ects

on

gene

ral a

ttitu

des/

attrib

utes

tow

ards

peo

ple

with

men

tal i

llnes

s wer

e ob

serv

ed a

t pos

t-tes

t, bu

t no

t at f

ollo

w-u

p w

hen

com

pare

d to

the

educ

ation

-onl

y gr

oup.

In

the

vide

o-ed

ucati

on g

roup

, no

sign

ifica

nt e

ffect

s w

ere

obse

rved

on

know

ledg

e ab

out e

tiolo

gy,

char

acte

r of p

eopl

e w

ith m

enta

l illn

ess a

nd p

ossi

ble

trea

tmen

t obs

erve

d at

pos

t-tes

t or f

ollo

w-u

p w

hen

com

pare

d to

the

educ

ation

-onl

y co

ntro

l gro

up. T

here

w

as a

sign

ifica

ntly

pos

itive

effe

ct o

bser

ved

on so

cial

di

stan

ce a

t pos

t-tes

t whe

n co

mpa

red

to th

e co

ntro

l, bu

t thi

s effe

ct w

as lo

st a

t fol

low

-up.

No

signi

fican

t eff

ects

on

gene

ral a

ttitu

des/

attrib

utes

tow

ards

peo

ple

with

men

tal i

llnes

s wer

e ob

serv

ed a

t pos

t-tes

t or

follo

w-u

p w

hen

com

pare

d to

the

cont

rol g

roup

.

Este

rs e

t al.,

199

8Se

cond

ary

scho

ol st

uden

ts (m

ean

age

14.7

ye

ars o

ld)

Educ

ation

inte

rven

tion

Sign

ifica

ntly

pos

itive

effe

cts a

t pos

t-tes

t and

follo

w-u

p on

kno

wle

dge

abou

t etio

logy

, cha

ract

er o

f peo

ple

with

m

enta

l illn

ess a

nd p

ossi

ble

trea

tmen

t whe

n co

mpa

red

with

con

trol

. Sig

nific

antly

pos

itive

effe

cts a

t pos

t-tes

t an

d fo

llow

-up

on a

ttitu

des t

owar

ds h

elp-

seek

ing

whe

n co

mpa

red

with

con

trol

.

Pint

o-Fo

ltz e

t al.,

201

1Se

cond

ary

scho

ol st

uden

ts (1

3-17

yea

rs

old)

Live

talk

inte

rven

tion

(with

edu

catio

n +

dire

ct c

onta

ct)

No

sign

ifica

nt p

ositi

ve e

ffect

on

know

ledg

e ab

out

etiol

ogy,

cha

ract

er o

f peo

ple

with

men

tal i

llnes

s and

po

ssib

le tr

eatm

ent a

t pos

t-tes

t whe

n co

mpa

red

with

co

ntro

l but

sign

ifica

nt p

ositi

ve e

ffect

s wer

e fo

und

at

follo

w-u

p w

hen

com

pare

d to

con

trol

. No

repo

rted

sig

nific

ant p

ositi

ve e

ffect

on

repo

rted

em

otion

al

reac

tion

to m

enta

l illn

ess a

t pos

t-tes

t or f

ollo

w-u

p w

hen

com

pare

d to

con

trol

gro

up.

Auth

or in

dica

tes t

he la

ck

of st

atisti

cal s

igni

fican

ce

in o

utco

me

in “

repo

rted

em

otion

al re

actio

n to

m

enta

l illn

ess”

(in

the

indi

vidu

al st

udy

labe

led

as

“red

ucin

g m

enta

l illn

ess

stigm

a) w

as li

kely

due

to

a la

ck o

f pow

er to

det

ect

an e

ffect

. Sam

ple

size

to

adeq

uate

ly p

ower

the

stud

y w

as n

=100

0.

Sapo

rito

et a

l., 2

011

Seco

ndar

y sc

hool

stud

ents

(mea

n ag

e 15

.76

year

s old

)Do

cum

enta

ry in

terv

entio

n (w

ith e

duca

tion)

No

sign

ifica

nt p

ositi

ve e

ffect

on

know

ledg

e ab

out

etiol

ogy,

cha

ract

er o

f peo

ple

with

men

tal i

llnes

s an

d po

ssib

le tr

eatm

ent (

no fo

llow

-up

data

col

lect

ed)

whe

n co

mpa

red

to c

ontr

ol. S

igni

fican

t pos

itive

effe

cts

reco

rded

on

gene

ral a

ttitu

des/

attrib

utes

tow

ards

pe

ople

with

men

tal i

llnes

s at p

ost-t

est (

no fo

llow

-up

data

col

lect

ed) w

hen

com

pare

d to

con

trol

. Mix

ed

findi

ngs a

cros

s mea

sure

s of a

ttitu

des t

owar

ds h

elp-

seek

ing

acro

ss m

ultip

le m

easu

res (

two

signi

fican

t po

sitive

effe

cts,

one

non

-sig

nific

ant e

ffect

) whe

n co

mpa

red

to c

ontr

ol g

roup

at p

ost-t

est (

no fo

llow

-up

colle

cted

). N

o sig

nific

ant e

ffect

on

actu

al b

ehav

ior w

as

obse

rved

at p

ost-t

est (

no fo

llow

-up

data

col

lect

ed).

Page 84: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

84

Rapid Evidence Review Appendix 5: Evidence Tables

15. K

enne

dy

H, D

eCha

nts

J, B

end

er K

, Any

on

Y. M

ore

tha

n D

ata

Co

llect

ors

: A S

yste

mat

ic R

evie

w o

f th

e E

nvir

onm

enta

l Out

com

es o

f Yo

uth

Inq

uiry

Ap

pro

ache

s in

the

Uni

ted

Sta

tes.

Am

eric

an

Jour

nal o

f C

om

mun

ity

Psy

cho

log

y [I

nter

net]

. 201

9 M

ar 6

[ci

ted

201

9 A

ug 2

0]; 6

3(1-

2):2

08-2

26. A

vaila

ble

fro

m: h

ttp

s://

onl

inel

ibra

ry.w

iley.

com

/do

i/fu

ll/10

.100

2/aj

cp.1

2321

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

chi

ldre

n an

d yo

uth

25 y

ears

and

you

nger

, sta

ff an

d st

ruct

ures

invo

lved

in y

outh

in

quiry

.

Date

rang

e fo

r rev

iew

: 199

5-20

15#

of st

udie

s inc

lude

d: 3

6 do

cum

ente

d en

viro

nmen

tal

outc

omes

, rep

rese

nting

57.

1% o

f tot

al sa

mpl

e of

you

th

inqu

iry st

udie

s.

As n

oted

by

auth

or: T

his s

tudy

was

lim

ited

to

peer

-rev

iew

ed st

udie

s and

did

not

incl

ude

any

gray

lit

erat

ure

or b

ook

chap

ters

, exc

ludi

ng p

oten

tially

re

leva

nt w

ork

repo

rted

in n

on-p

eer r

evie

wed

sour

ces,

su

ch a

s rep

orts

on

agen

cy w

ebsit

es. T

he e

xclu

sion

of

othe

r diss

emin

ation

mec

hani

sms l

ikel

y re

sulte

d in

an

unde

rrep

ortin

g of

env

ironm

enta

l out

com

es a

ssoc

iate

d w

ith y

outh

inqu

iry a

ppro

ache

s. A

utho

rs d

id n

ot a

sses

s ris

k of

bia

s in

stud

ies i

nclu

ded

in re

view

. Giv

en th

e la

ck

of d

etai

led

info

rmati

on a

bout

ana

lytic

al a

ppro

ache

s in

man

y m

anus

crip

ts, a

utho

rs w

ere

only

abl

e to

gro

up

stud

ies b

y re

sear

ch d

esig

n an

d w

ere

ther

efor

e un

able

to

dra

w m

ore

deta

iled

conc

lusio

ns o

r hig

hlig

ht so

me

of th

e in

nova

tive

appr

oach

es in

the

sam

ple.

Thi

s may

ha

ve sk

ewed

resu

lts, a

s stu

dies

that

pro

vide

d m

ore

syst

emati

c de

scrip

tions

of t

heir

met

hods

may

hav

e be

en d

iffer

ent f

rom

thos

e w

ho d

o no

t in

way

s tha

t we

coul

d no

t mea

sure

.

Stud

ies u

sed

mos

tly

qual

itativ

e m

etho

ds

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: N

/A

Data

base

s sea

rche

d fo

r rev

iew

: Pub

Med

, ER

IC, S

ocia

l Ser

vice

Abs

trac

ts, P

sycI

NFO

. Hi

-Lev

el F

indi

ngs:

Stu

dies

of y

outh

inqu

ity a

ppro

ache

s in

the

U.S.

hav

e re

port

ed p

ositi

ve, a

nd in

man

y ca

ses,

la

sting

, cha

nges

in th

eir e

nviro

nmen

ts, i

nclu

ding

sc

hool

s, n

eigh

borh

oods

, and

com

mun

ities

. Adu

lts

lear

ned

to v

alue

you

th a

s exp

erts

in th

eir o

wn

lives

and

vi

ewed

them

as i

mpo

rtan

t sta

keho

lder

s in

scho

ol a

nd

com

mun

ity-le

vel d

ecisi

on-m

akin

g. F

ive

artic

les r

epor

ted

that

adu

lts h

ad a

n in

crea

sed

unde

rsta

ndin

g of

the

expe

rienc

es a

nd n

eeds

of d

iver

se y

outh

bec

ause

of t

he

proj

ect;

spec

ifica

lly, a

dults

wer

e m

ore

will

ing

to e

ngag

e in

div

ersit

y-re

late

d di

scus

sions

with

you

ng p

eopl

e at

sc

hool

. Rel

ation

ship

s bet

wee

n st

uden

ts a

nd te

ache

rs

wer

e im

prov

ed a

nd a

dults

des

crib

ed e

ngag

ing

in m

ore

refle

xivi

ty re

gard

ing

pow

er d

ynam

ics b

etw

een

yout

h an

d ad

ults

.Se

vera

l stu

dies

repo

rted

form

alizi

ng o

ppor

tuni

ties f

or

yout

h vo

ice

into

scho

ol a

nd c

omm

unity

setti

ngs.

Rese

arch

-rel

ated

ben

efits

incl

uded

a w

ide

rang

e of

im

prov

emen

ts to

the

proc

ess o

f doi

ng re

sear

ch a

nd

the

qual

ity o

f the

info

rmati

on u

ncov

ered

. Par

tner

ing

with

you

th fo

r res

earc

h al

so c

halle

nged

dom

inan

t re

sear

ch p

arad

igm

s, in

tegr

ating

acti

vism

rath

er th

an

only

prio

ritizin

g ob

jecti

vity

and

cha

ngin

g pe

rspe

ctive

s of

rese

arch

as s

omet

hing

that

is d

one

to y

outh

to

som

ethi

ng th

at is

don

e w

ith th

em.

Four

teen

per

cent

of s

tudi

es re

port

ed th

at o

ne o

r mor

e po

licie

s had

bee

n ad

opte

d as

a re

sult

of e

ngag

ing

with

yo

uth

in in

quiry

, at t

he sc

hool

dist

rict l

evel

, city

-leve

l (p

olic

y ch

ange

s: in

clud

ing

the

addi

tion

of tw

o bu

s rou

tes

to fa

cilit

ate

easy

acc

ess t

o re

crea

tion

faci

lities

.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

You

th in

quiry

ap

proa

ches

like

YPA

R, y

outh

org

anizi

ng, s

tude

nt v

oice

.Yo

uth

inqu

iry a

ppro

ache

s wer

e de

fined

as a

n el

emen

t of

orga

nize

d gr

oups

whe

re y

outh

par

ticip

ants

met

regu

larly

and

ha

d a

com

mon

pur

pose

.

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es m

ust b

e em

piric

al re

sear

ch p

ublis

hed

in p

eer-

revi

ewed

jour

nals

and

cond

ucte

d in

th

e U

nite

d St

ates

. Stu

dies

mus

t inc

lude

pr

ojec

t par

ticip

ants

of c

hild

ren

or y

outh

25

yea

rs o

r you

nger

. Stu

dies

mus

t also

in

volv

e an

inqu

iry-b

ased

pro

cess

that

in

volv

ed y

outh

in d

ata

colle

ction

, dat

a an

alys

is, d

ata

inte

rpre

tatio

n, o

r use

of

know

ledg

e to

impr

ove

lives

. Stu

dies

mus

t ad

ditio

nally

ass

ess o

utco

mes

rela

ted

to

the

expe

rienc

es, o

utco

mes

, or i

mpa

ct o

f yo

uth

inqu

iry o

n yo

uth

parti

cipa

nts o

r the

ir su

rrou

ndin

g en

viro

nmen

t.

Adol

esce

nt-S

peci

fic F

indi

ngs (

13-1

8-ye

ar-o

lds)

: NA

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

(see

abo

ve)

Revi

ew e

xclu

sion

crit

eria

—Fo

cus

on st

udy

met

hodo

logy

: Stu

dies

that

on

ly in

clud

ed y

outh

age

d 18

-25

wer

e ex

clud

ed if

they

con

siste

d on

ly o

f und

er-

grad

uate

or g

radu

ate

stud

ents

. You

th

inqu

iry a

ppro

ache

s tha

t rep

orte

d yo

uth

parti

cipa

nts a

s sol

ely

rece

ivin

g kn

owle

dge

or in

stru

ction

wer

e ex

clud

ed. O

ther

wise

, st

udie

s wer

e ex

clud

ed fr

om th

e re

view

ba

sed

on a

failu

re to

mee

t the

incl

usio

n cr

iteria

det

aile

d ab

ove.

Page 85: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

85

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Pra

ctitio

ner g

row

th (i

.e.,

adul

ts c

hang

ed th

eir

attitu

des,

per

spec

tives

, und

erst

andi

ng a

nd b

ehav

iors

).

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es:

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18-

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Chan

ges t

o pr

actiti

oner

s, p

olic

ies,

pro

gram

s,

rese

arch

, and

pee

r gro

up n

orm

s. S

peci

fy o

utco

me

and

for w

hom

/wha

t it i

s mea

sure

d: P

eer

grou

p no

rms (

i.e.,

incr

ease

in k

now

ledg

e or

cha

nge

in

attitu

des a

bout

hea

lth re

late

d to

pics

); pr

ogra

m d

evel

opm

ent

or im

prov

emen

t (i.e

., th

e cr

eatio

n of

new

pro

gram

s,

enric

hmen

t of s

ervi

ces,

spac

es, o

r fun

ding

for s

ervi

ces)

; re

sear

ch b

enefi

ts (i

.e.,

impr

ovem

ents

in re

crui

tmen

t, da

ta

qual

ity, i

nter

pret

ation

of r

esul

ts, o

r per

spec

tive

gain

ed);

pass

age

of p

olic

y at

scho

ol, c

ity, o

r sta

te le

vel.

Setti

ng(s

): N

o se

tting

rest

rictio

nCo

untr

y(ie

s): U

.S.

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Com

mun

ity, I

nter

pers

onal

, Sc

hool

Page 86: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

86

Rapid Evidence Review Appendix 5: Evidence Tables

16. K

ling

bei

l DA

, Ren

shaw

T. M

ind

fuln

ess-

Bas

ed In

terv

enti

ons

fo

r Te

ache

rs: A

Met

a-A

naly

sis

of

the

Em

erg

ing

Evi

den

ce-B

ase.

Psy

ArX

iv [

Inte

rnet

]. 2

018

Oct

1 [

cite

d 2

019

Aug

15]

; Pre

Pri

nt.

Ava

ilab

le f

rom

: htt

ps:

//p

syar

xiv.

com

/589

jq/

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

NO

TES

All a

ge/d

evel

opm

enta

l gro

ups i

nclu

ded.

K-1

2 te

ache

rsDa

te ra

nge:

Ince

ption

of d

atab

ases

se

arch

ed -

April

201

8#

of st

udie

s inc

lude

d ov

eral

l: 29

Mos

t stu

dies

use

d sm

all s

ampl

e siz

es. T

he m

ajor

ity

of st

udie

s rel

ied

on se

lf-re

port

mea

sure

s, w

hich

are

su

scep

tible

to re

spon

se b

ias.

Non

e of

the

stud

ies c

ompa

red

the

effec

ts o

f MBI

s with

an

alte

rnati

ve tr

eatm

ent a

ppro

ach.

The

char

acte

ristic

s and

com

pone

nts o

f the

MBI

s in

clud

ed w

ithin

our

ana

lysis

var

ied

wid

ely.

The

m

ajor

ity o

f MBI

s also

incl

uded

seve

ral “

seco

ndar

y” o

r no

n- m

indf

ulne

ss c

ompo

nent

s with

in th

e tr

eatm

ent

pack

age,

yet

few

pro

vide

d a

deta

iled

oper

ation

aliza

tion

of a

ll in

terv

entio

n co

mpo

nent

s bey

ond

min

dful

ness

.

Visu

al a

nd st

atisti

cal

evid

ence

of p

ublic

ation

bi

as su

gges

ted

the

over

all

effec

t esti

mat

e m

ay b

e po

sitive

ly b

iase

d.

Age/

deve

lopm

enta

l gro

up in

clud

ed re

leva

nt to

H.S

. age

d te

ens a

ges 1

3-18

- sp

ecify

by

age

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up.

Onl

y tw

o st

udie

s app

eare

d to

mea

sure

out

com

es o

f MBI

for

seco

ndar

y sc

hool

teac

hers

.9

Data

base

s sea

rche

d: P

yscI

NFO

, ERI

C,

PubM

ed, A

cade

mic

Sea

rch

Com

plet

e,

ProQ

uest

Diss

erta

tion

and

Thes

es

(abs

trac

ts o

nly)

High

-leve

l find

ings

: The

ave

rage

ove

rall

trea

tmen

t eff

ect,

g =

.601

, 95%

CI [

.418

, .78

4], w

as st

atisti

cally

sig

nific

ant (

p <

.001

).

On

the

first

-ord

er p

rimar

y ou

tcom

e of

psy

chol

ogic

al

wel

lbei

ng (k

= 2

3, n

= 1

,248

), M

BIs w

ere

asso

ciat

ed

with

a sm

all-t

o-m

ediu

m tr

eatm

ent e

ffect

, g =

.431

, 95%

CI

[.25

4, .6

08].

On

the

first

-ord

er p

rimar

y ou

tcom

e of

ps

ycho

logi

cal d

istre

ss (k

= 2

7, n

= 1

,469

), M

BIs h

ad a

m

ediu

m tr

eatm

ent e

ffect

, g =

.551

, 95%

CI [

.368

, .73

4].

The

effec

ts o

f MBI

s on

psyc

holo

gica

l wel

lbei

ng a

nd

psyc

holo

gica

l dist

ress

wer

e st

atisti

cally

sign

ifica

nt (p

<

.001

).

Resu

lts fo

r the

seco

nd-o

rder

prim

ary

outc

ome

of

clas

sroo

m c

limat

e an

d te

achi

ng p

racti

ces w

ere

not

stati

stica

lly si

gnifi

cant

.

Trea

tmen

t effe

cts w

ere

smal

ler i

n st

udie

s whe

re M

BIs

wer

e de

liver

ed b

y th

e pr

ogra

m d

evel

oper

s (g

= .5

11)

com

pare

d to

oth

er tr

aine

d st

aff (g

= .7

06).

Fina

lly,

incr

easin

g th

e do

se o

f the

inte

rven

tion

beyo

nd th

e sa

mpl

e av

erag

e (M

= 2

4.42

1 ho

urs)

had

a n

eglig

ible

im

pact

(b =

-.01

1) o

n th

e ob

serv

ed e

ffect

size

.

Ove

rall

effec

ts fo

r tea

cher

s (g

= .6

01) w

ere

simila

r to

findi

ngs i

n pr

evio

us m

eta-

anal

ytic

revi

ews o

f MBI

s with

he

alth

y ad

ult p

opul

ation

s, a

nd a

ssoc

iate

d w

ith la

rger

eff

ects

than

MBI

s tar

getin

g he

alth

car

e pr

ofes

siona

ls or

you

th.

Inte

rven

tion(

s) T

ype/

Nam

e--O

vera

llM

indf

ulne

ss-B

ased

Inte

rven

tions

.Re

view

incl

usio

n cr

iteria

: Stu

dies

incl

uded

m

ust i

nclu

de th

e pr

ovisi

on o

f a M

BI

with

teac

hers

who

wor

ked

in a

pre

-K-1

2 se

tting

(det

erm

inati

on o

f the

“pr

imar

y”

natu

re o

f min

dful

ness

trai

ning

with

in a

gi

ven

inte

rven

tion

was

def

erre

d to

the

self-

iden

tifica

tion

of su

ch b

y th

e au

thor

). N

o in

clus

ion

crite

ria w

as se

t reg

ardi

ng

type

s of o

utco

me

varia

bles

exa

min

ed,

geog

raph

ical

or c

ultu

ral r

estr

ictio

ns, o

r la

ngua

ge o

f pub

licati

on.

13-1

8 ye

ar-o

ld (o

r sim

ilar)

Tee

n sp

ecifi

c fin

ding

s: (o

r se

e Te

en T

able

bel

ow).

Find

ings

wer

e no

t pro

vide

d by

ag

e gr

oup

or sc

hool

type

.

Page 87: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

87

Rapid Evidence Review Appendix 5: Evidence Tables

Inte

rven

tion(

s) T

ype/

Nam

e--e

xam

ined

for 1

3-18

yea

r-ol

ds o

r eq

uiva

lent

(spe

cify

). N

ot a

vaila

ble.

Revi

ew e

xclu

sion

crit

eria

: Stu

dies

that

in

corp

orat

ed o

ther

med

itatio

n ex

erci

ses

with

out t

rain

ing

min

dful

ness

and

in

terv

entio

ns th

at u

sed

min

dful

ness

as

seco

ndar

y co

mpo

nent

s wer

e ex

clud

ed.

Stud

ies o

f MBI

targ

eting

pos

t-sec

onda

ry

stud

ents

enr

olle

d in

teac

hing

pro

gram

s,

educ

ator

s wor

king

in p

ost-s

econ

dary

in

stitu

tions

, and

stud

ies t

hat i

nclu

ded

teac

hers

with

in b

road

er a

dult

sam

ples

w

ere

also

exc

lude

d. N

on-in

terv

entio

n st

udie

s of m

indf

ulne

ss o

r non

-em

piric

al

artic

les w

ere

excl

uded

. Stu

dies

usin

g sin

gle-

case

des

igns

, pur

ely

qual

itativ

e m

etho

ds, a

nd p

re-p

ost d

esig

ns w

ith n

o co

ntro

l gro

up w

ere

also

exc

lude

d.

Out

com

es e

xam

ined

ove

rall

--inc

lude

all

but h

ighl

ight

PSW

EB

outc

omes

.

Psyc

holo

gica

l wel

lbei

ng; p

sych

olog

ical

dist

ress

; cla

ssro

om

clim

ate

and

teac

hing

pra

ctice

s

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent—

incl

ude

all b

ut h

ighl

ight

PSE

WB.

Not

app

licab

le

Out

com

es e

xam

ined

for s

ocia

l/bu

ilt/s

truc

tura

l env

ironm

ents

an

d/or

peo

ple

surr

ound

ing

13-1

8 ye

ar-o

lds (

glob

al/c

ultu

ral,

natio

nal,

com

mun

ity, i

nter

pers

onal

leve

l)--S

peci

fy o

utco

me

and

for w

hom

it is

mea

sure

d.Sc

hool

clim

ate

(teac

her w

ell-b

eing

)

Setti

ng(s

): Al

l sch

ool-b

ased

Coun

try(

ies)

:St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s):

Leve

l (e.

g., g

loba

l/cu

ltura

l, na

tiona

l, co

mm

unity

, in

terp

erso

nal):

Sch

ool

Page 88: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

88

Rapid Evidence Review Appendix 5: Evidence Tables

17. M

ansfi

eld

L, K

ay T

, Mea

ds

C, G

rig

sby-

Duf

fy L

, Lan

e J,

Jo

hn A

, et

al. S

po

rt a

nd D

ance

Inte

rven

tio

ns f

or

Hea

lthy

Yo

ung

Peo

ple

(15-

24 Y

ears

) to

Pro

mo

te S

ubje

ctiv

e W

ell-

Bei

ng: A

Sys

tem

atic

R

evie

w. B

MJ

Op

en [

Inte

rnet

]. 2

018

July

15

[cit

ed 2

019

Aug

7];

8(7

):e02

0959

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

mc/

arti

cles

/PM

C60

8246

0/FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

Hea

lthy

(no

heal

th

cond

ition

dia

gnos

ed b

y a

heal

th p

rofe

ssio

nal)

youn

g pe

ople

ag

ed 1

5-24

yea

rs o

ld

Date

rang

e fo

r rev

iew

: 200

6 –

Sep

2016

# of

stud

ies i

nclu

ded:

11

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens

ages

13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

re

leva

nt a

ge g

roup

: Ado

lesc

ents

age

d 13

-18

(Am

oros

e et

al.,

20

09),

Ages

18-

20 (K

anoj

ia e

t al.,

201

3), A

ges 1

7-22

(Kim

&

Kim

, 200

7), A

ges 1

8-25

(Li e

t al.,

201

5), A

ges 1

3-19

(Lin

dgre

n et

al

., 20

11),

Grad

es 1

1 an

d 12

(Nog

gle

et a

l., 2

012)

, Age

s 15-

19

(Sta

iano

et a

l., 2

013)

.

Hi-L

evel

Fin

ding

s: P

ublis

hed

liter

atur

e su

gges

ts

med

itativ

e ph

ysic

al a

ctivi

ty (y

oga

and

Badu

anjin

Q

igon

g) a

nd g

roup

-bas

ed o

r pee

r-sup

port

ed sp

ort

and

danc

e ha

s som

e po

tenti

al to

impr

ove

subj

ectiv

e w

ell-b

eing

. Gre

y lit

erat

ure

sugg

ests

spor

ts a

nd d

ance

im

prov

e su

bjec

tive

wel

l-bei

ng b

ut id

entif

y ne

gativ

e fe

elin

gs o

f com

pete

ncy

and

capa

bilit

y. T

he a

mou

nt

and

qual

ity o

f pub

lishe

d ev

iden

ce o

n sp

ort a

nd d

ance

in

terv

entio

ns to

enh

ance

subj

ectiv

e w

ell-b

eing

is lo

w.

Bette

r des

igne

d st

udie

s are

nee

ded.

As n

oted

by

auth

or: D

ue to

clin

ical

het

erog

enei

ty

betw

een

stud

ies,

met

a-an

alys

is w

as n

ot a

ppro

pria

te.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

An

y sp

ort o

r dan

ce in

terv

entio

n.

Data

base

s sea

rche

d fo

r rev

iew

: Psy

cIN

FO,

Ovi

d M

EDLI

NE,

ERI

C, W

eb o

f Sci

ence

(Art

s an

d Hu

man

ities

Cita

tion

Inde

x, S

ocia

l Sc

ienc

e an

d Sc

ienc

e Ci

tatio

n In

dex)

, SC

OPU

S, P

ILO

TS, C

INAH

L, S

PORT

Disc

us,

Inte

rnati

onal

Inde

x to

Per

form

ing

Arts

.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

bel

ow)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

Volle

ybal

l (Am

oros

e et

al.,

200

9), Y

oga

(Kan

ojia

et a

l., 2

013)

, Aer

obic

exe

rcise

, bod

y co

nditi

onin

g,

hip-

hop

danc

ing,

and

ice

skati

ng (K

im &

Kim

, 200

7), B

adua

njin

ex

erci

se (L

i et a

l., 2

015)

, Em

pow

erm

ent-b

ased

exe

rcise

in

terv

entio

n pr

ogra

m (L

indg

ren

et a

l., 2

011)

, Krip

alu

Yoga

(N

oggl

e et

al.,

201

2), E

xerg

ame

(EG)

inte

rven

tion

(Sta

iano

et

al.,

2013

).

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: A

ny c

ompa

rativ

e st

udie

s in

vesti

gatin

g an

y fo

rm o

f spo

rt o

r dan

ce

com

pare

d w

ith n

o sp

ort o

r dan

ce, u

sual

ro

utine

or c

ompa

ring

pret

est a

nd p

ost-

test

scor

es in

hea

lthy

youn

g pe

ople

age

d 15

-24

year

s and

mea

surin

g an

y fo

rm o

f su

bjec

tive

wel

l-bei

ng w

ere

incl

uded

.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: any

subj

ectiv

e w

ell-b

eing

out

com

e us

ing

any

reco

gnize

d m

etho

d or

mea

sure

.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Stu

dies

that

incl

uded

pa

rtici

pant

s with

a h

ealth

con

ditio

n,

incl

uded

par

ticip

ants

who

wer

e pa

id

prof

essio

nals

or e

lite

athl

etes

, inc

lude

d pa

rtici

pant

s in

clin

ical

ly b

ased

spor

t an

d da

nce

inte

rven

tions

wer

e ex

clud

ed.

Stud

ies t

hat i

nclu

ded

clin

ical

spor

t-ba

sed

or d

ance

ther

apy,

spor

t and

dan

ce

for c

linic

al p

roce

dure

s (e.

g., s

urge

ry,

med

ical

test

s, d

iagn

ostic

s), o

r wal

king

as

inte

rven

tions

wer

e ex

clud

ed. D

iscus

sion

artic

les,

com

men

tarie

s, o

r opi

nion

pie

ces

not p

rese

nting

em

piric

al o

r the

oreti

cal

rese

arch

wer

e ex

clud

ed.

Page 89: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

89

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: S

port

co

mpe

tenc

e (5

-item

subs

cale

of t

he In

trin

sic M

otiva

tion

Inve

ntor

y), n

eed

for a

uton

omy

(6-it

em sc

ale:

Hol

lem

beak

&

Am

oros

e), n

eed

for r

elat

edne

ss (1

0-ite

m R

iche

r and

Va

llera

nd’s

Feel

ings

of R

elat

edne

ss S

cale

), se

lf-es

teem

(10-

item

Ros

enbe

rg’s

Self-

Este

em S

cale

), bu

rnou

t (15

-item

Ath

lete

Bu

rnou

t Que

stion

naire

) (Am

oros

e et

al.,

200

9), 1

6-ite

m

Ange

r que

stion

naire

, 40-

item

trai

t anx

iety

que

stion

naire

, 10

-item

dep

ress

ion

ques

tionn

aire

, 50-

item

subj

ectiv

e w

ell-

bein

g qu

estio

nnai

re (K

anoj

ia e

t al.,

201

3), m

ood

(Sub

jecti

ve

Exer

cise

Exp

erie

nces

Sca

le) (

Kim

& K

im, 2

007)

, Sel

f-est

eem

(S

elf-e

stee

m S

cale

), m

ood/

min

dful

ness

(Pro

file

of M

ood

Stat

es

scal

e), q

ualit

y of

life

, str

ess (

Perc

eive

d St

ress

Sca

le),

Self-

rate

d sy

mpt

om in

tens

ity (S

CL-9

0 sc

ale)

(Li e

t al.,

201

5), s

elf-e

ffica

cy

(10-

item

Gen

eral

Sel

f-effi

cacy

Sca

le),

Beha

vior

cha

nges

(Soc

ial

Barr

iers

to E

xerc

ise S

elf-e

ffica

cy Q

uesti

onna

ire) (

Lind

gren

et a

l.,

2011

), m

ood

(PO

MS-

shor

t for

m),

affec

t (Po

sitive

and

Neg

ative

Aff

ect S

ched

ule

for C

hild

ren)

, str

ess (

PSS)

, pos

itive

psy

chol

ogy

(Inve

ntor

y of

Pos

itive

Psy

chol

ogic

al A

ttitu

des)

, Res

ilien

ce

(Res

ilien

ce S

cale

), an

ger (

Stat

e Tr

ait A

nger

Exp

ress

ion

Inve

ntor

y-2T

M),

min

dful

ness

(Chi

ld A

ccep

tanc

e M

indf

ulne

ss M

easu

re)

(Nog

gle

et a

l., 2

012)

, sel

f-effi

cacy

(Exe

rcise

Con

fiden

ce S

urve

y),

self-

este

em (R

osen

berg

Sel

f-Est

eem

Sca

le),

peer

supp

ort

(Frie

ndsh

ip Q

ualit

y Q

uesti

onna

ire) (

Stai

ano

et a

l., 2

013)

.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): W

hat W

orks

Cen

tre

for

Wel

lbei

ng m

etho

ds g

uide

, GRA

DE

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): pr

ogra

mm

es o

f spo

rt a

nd d

ance

Co

untr

y(ie

s): U

K-ba

sed

prog

ram

mes

(but

som

e ca

me

from

U

.S.)

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol, f

amily

, w

ork,

recr

eatio

n, O

ST):

recr

eatio

n

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Amor

ose

et a

l., 2

009

Adol

esce

nts a

ged

13-1

8Vo

lleyb

all

The

exte

nt to

whi

ch a

thle

tes’

psy

chol

ogic

al n

eeds

are

sa

tisfie

d du

ring

a se

ason

are

link

ed to

incr

ease

s and

de

crea

ses i

n th

eir p

ositi

ve a

nd n

egati

ve w

ell-b

eing

All f

emal

es, 9

0% C

auca

sian

Kim

& K

im, 2

007

Ages

17-

22Ae

robi

c ex

erci

se, b

ody

cond

ition

ing,

hip

-hop

dan

cing

, an

d ic

e sk

ating

aero

bics

and

hip

-hop

rate

d po

sitive

wel

lbei

ng h

ighe

r th

an b

ody

cond

ition

ing

and

ice

skati

ng g

roup

; lo

wer

psy

chol

ogic

al d

istre

ss

Nog

gle

et a

l., 2

012

Grad

es 1

1 an

d 12

Krip

alu

Yoga

Not

cau

sal d

ue to

smal

l sam

ples

size

, but

sugg

ests

be

nefit

s in

psyc

hoso

cial

wel

lbei

ng

92.2

% C

auca

sian

in ru

ral

wes

tern

Mas

sach

usett

s

Stai

ano

et a

l., 2

013

Ages

15-

19Ex

erga

me

(EG)

inte

rven

tion

Sam

ple

is A

fric

an-

Amer

ican

ove

rwei

ght a

nd

obes

e st

uden

ts fr

om a

ur

ban

publ

ic h

igh

scho

ol

Page 90: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

90

Rapid Evidence Review Appendix 5: Evidence Tables

18. M

arx

R, T

anne

r-S

mit

h E

E, D

avis

on

CM

, Ufh

olz

LA

, Fre

eman

J, S

hank

ar R

, et

al. L

ater

sch

oo

l sta

rt t

imes

fo

r su

pp

ort

ing

the

ed

ucat

ion,

hea

lth,

and

wel

l-b

eing

of

hig

h sc

hoo

l stu

den

ts. C

och

rane

D

atab

ase

of

Sys

tem

atic

Rev

iew

s [I

nter

view

]. 2

017

July

3 [

cite

d 2

019

July

26]

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.co

chra

nelib

rary

.co

m/c

dsr

/do

i/10

.100

2/14

6518

58.C

D00

9467

.pub

2/fu

llFO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

13-

19 y

ear o

lds

Date

rang

e fo

r rev

iew

: Inc

eptio

n of

da

taba

ses i

nclu

ded

– Fe

brua

ry 2

016

# of

stud

ies i

nclu

ded:

11

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens

ages

13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

re

leva

nt a

ge g

roup

: Gra

de 9

to 1

2 st

uden

ts (B

row

n, 2

011;

W

ahlst

rom

, 200

2)

Hi-L

evel

Fin

ding

s:

Prel

imin

ary

evid

ence

from

the

incl

uded

stud

ies

indi

cate

d a

pote

ntial

ass

ocia

tion

betw

een

late

r sch

ool

star

t tim

es a

nd a

cade

mic

and

psy

chos

ocia

l out

com

es,

but q

ualit

y an

d co

mpa

rabi

lity

of th

ese

data

wer

e lo

w a

nd o

ften

prec

lude

d qu

antit

ative

synt

hesis

. Fou

r st

udie

s exa

min

ed th

e as

soci

ation

bet

wee

n la

ter s

choo

l st

art ti

mes

and

aca

dem

ic o

utco

mes

, rep

ortin

g m

ixed

re

sults

. Six

stud

ies e

xam

ined

effe

cts o

n to

tal a

mou

nt

of sl

eep

and

repo

rted

sign

ifica

nt, p

ositi

ve re

latio

nshi

ps

betw

een

late

r sch

ool s

tart

tim

es a

nd a

mou

nt o

f sle

ep.

One

stud

y pr

ovid

ed in

form

ation

con

cern

ing

men

tal

heal

th o

utco

mes

, rep

ortin

g an

ass

ocia

tion

betw

een

decr

ease

d de

pres

sive

sym

ptom

s and

late

r sch

ool s

tart

tim

es. T

here

wer

e m

ixed

resu

lts fo

r the

ass

ocia

tion

betw

een

late

r sch

ool s

tart

tim

es a

nd a

bsen

teei

sm.

Thre

e st

udie

s rep

orte

d m

ixed

resu

lts c

once

rnin

g th

e as

soci

ation

bet

wee

n la

ter s

choo

l sta

rt ti

mes

and

st

uden

t ale

rtne

ss. T

here

was

lim

ited

indi

catio

n of

po

tenti

al a

dver

se e

ffect

s on

logi

stics

, as t

he q

ualit

ative

po

rtion

s of o

ne st

udy

repo

rted

less

inte

racti

on

betw

een

pare

nts a

nd c

hild

ren,

and

ano

ther

repo

rted

st

affing

and

sche

dulin

g di

fficu

lties

. Bec

ause

of t

he

insu

ffici

ent e

vide

nce,

no

firm

con

clus

ions

con

cern

ing

adve

rse

effec

ts c

an b

e m

ade

at th

is tim

e.

As n

oted

by

auth

or: L

imite

d ev

iden

ce b

ase

prev

ente

d de

term

inin

g eff

ects

of l

ater

star

t tim

es w

ith a

ny c

on-

fiden

ce.

Beca

use

of lo

w m

etho

dolo

gica

l sta

ndar

ds, t

he v

arie

ty

of p

artic

ular

inte

rven

tions

and

the

varia

tion

of

outc

omes

mea

sure

d, m

eta-

anal

ysis

was

not

pos

sible

fo

r mos

t of t

he re

cord

ed o

utco

mes

, man

y st

udie

s did

no

t rep

ort s

uffici

ent d

ata

need

ed to

cal

cula

te e

ffect

siz

es, w

eak

inte

rnal

val

idity

of t

his l

itera

ture

(pre

senc

e of

onl

y on

e cl

uste

r RCT

) pre

vent

s str

ong

caus

al

infe

renc

es a

bout

the

effec

ts o

f lat

er sc

hool

star

t tim

es

on h

igh

scho

ol st

uden

t’s o

utco

me.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Rev

iew

incl

uded

inte

rven

-tio

ns th

at in

volv

ed a

com

paris

on b

etw

een

two

or m

ore

diffe

rent

sc

hool

star

t tim

es. “

Late

Sta

rt”

inte

rven

tions

pur

pose

ly m

oved

sc

hool

star

t tim

es la

ter a

nd th

en c

ompa

red

outc

omes

obt

aine

d un

der t

he p

revi

ous o

r ano

ther

ear

lier s

tart

tim

es. A

lso in

clud

ed

stud

ies t

hat c

ompa

red

outc

omes

ass

ocia

ted

with

star

t tim

es

at d

iffer

ent,

but m

atch

ed, s

choo

ls (d

iffer

ent s

hifts

of s

tude

nts

with

in th

e sa

me

scho

ol)

Data

base

s sea

rche

d fo

r rev

iew

: Coc

hran

e Ce

ntra

l Reg

ister

, Coc

hran

e Da

taba

se

of S

Rs, M

EDLI

NE

Ovi

d, E

MBA

SE O

vid,

Ps

ycIN

FO, A

cade

mic

Sea

rch

Com

plet

e EB

SCO

, CIN

AHL

EBSC

O, E

duca

tion

Full

Text

EB

SCO

, Edu

cato

r’s c

ompl

ete

refe

renc

e,

ERIC

Pro

Que

st, G

loba

lHea

lth C

AB H

ealth

, So

ciol

ogic

al A

bstr

acts

Pro

Que

st, J

STO

R,

Briti

sh E

duca

tion

Inde

x, A

ustr

alia

n Ed

ucati

on In

dex,

Diss

erta

tions

and

The

ses

ProQ

uest

, Evi

denc

e fo

r Pol

icy

and

Prac

tice

Info

rmati

on a

nd C

oord

inati

ng C

entr

e Re

view

Dat

abas

es.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equi

vale

nt (s

peci

fy):

“Lat

e St

art”

(Bro

wn,

201

1), D

elay

ed sc

hool

st

art ti

me

from

7:1

5am

to 8

:45a

m (W

ahlst

rom

, 200

2).

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: R

ando

mize

d co

ntro

lled

trai

ls (R

CTs)

(inc

ludi

ng c

lust

er-r

ando

mize

d co

ntro

lled

trai

ls or

rand

omize

d cr

oss-

over

tr

ials)

and

non

-ran

dom

ized

desig

ns su

ch a

s in

terr

upte

d tim

e se

ries s

tudi

es (I

TSs)

with

at

leas

t thr

ee p

re- a

nd p

ost-i

nter

venti

on

mea

sure

men

ts, c

ontr

olle

d be

fore

-and

-aft

er st

udie

s (CB

As),

and

non-

rand

omize

d qu

asi-e

xper

imen

tal c

ontr

olle

d tr

ials

(incl

udin

g po

tenti

ally

clu

ster

and

/or c

ross

-ov

er tr

ials)

that

ass

esse

d th

e im

pact

of a

de

laye

d sc

hool

star

t tim

e in

terv

entio

n on

ad

oles

cent

s age

d 13

-19

wer

e el

igib

le fo

r in

clus

ion

in th

is re

view

.

Page 91: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

91

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

:

Men

tal h

ealth

indi

cato

rs in

clud

ing,

for e

xam

ple,

mea

sure

s of

stre

ss, a

nxie

ty, f

eelin

gs o

f iso

latio

n or

exc

lusio

n, d

epre

ssio

n or

su

icid

al id

eatio

n.

Stud

ent t

ruan

cy o

r atte

ndan

ce.

Teac

her o

r sel

f-rep

orte

d st

uden

t ale

rtne

ss.

St

uden

t aca

dem

ic o

utco

mes

, mea

sure

d, fo

r exa

mpl

e, b

y lo

cally

rele

vant

stan

dard

ized

test

scor

es a

nd c

ours

e gr

ades

, m

idte

rm a

nd fi

nal e

xam

resu

lts, a

nd g

radu

ation

reco

rds.

O

utco

mes

rela

ted

to a

mou

nt o

r qua

lity

of sl

eep

for

stud

ents

, ofte

n re

ferr

ed to

as t

otal

slee

p tim

e (T

ST) f

or

stud

ents

.

Stud

ent s

leep

ines

s or f

atigu

e.

Adve

rse

outc

omes

or p

ossib

le h

arm

s:

In

crea

sed

tran

spor

tatio

n co

sts f

or st

uden

ts, f

amili

es, o

r sc

hool

s.

Decr

ease

d st

uden

t sup

ervi

sion

outs

ide

scho

ol ti

me.

De

crea

sed

time

spen

t with

fam

ily.

Is

sues

with

chi

ld c

are

and

befo

re- a

nd a

fter-s

choo

l car

e fo

r yo

unge

r sib

lings

.

Decr

ease

s in

enro

llmen

t in

extr

acur

ricul

ar a

nd a

thle

tic

activ

ities

.

Pola

rizin

g or

incr

ease

d co

nflic

ts w

ithin

the

scho

ol

com

mun

ity th

roug

h th

is iss

ue.

Di

fficu

lties

for s

choo

l sta

ff (m

akin

g m

edic

al a

ppoi

ntm

ents

, att

endi

ng p

rofe

ssio

nal d

evel

opm

ent w

orks

hops

, etc

.).

Incr

ease

d co

sts a

nd d

ifficu

lties

obt

aini

ng su

bstit

ute

teac

hers

.

Inte

rmed

iate

out

com

es in

clud

ed:

Seco

ndar

y ou

tcom

es in

clud

e:

Out

com

es re

late

d to

hea

lth b

ehav

iors

(e.g

. die

t, ex

erci

se,

toba

cco

use,

alc

ohol

or d

rug

use,

uns

afe

sexu

al p

racti

ces)

.

Heal

th a

nd sa

fety

indi

cato

rs (e

.g. v

ehic

ular

acc

iden

ts, f

alls

or o

ther

acc

iden

ts, a

bduc

tions

, tra

nspo

rtati

on is

sues

).

Soci

al o

utco

mes

(e.g

. cha

nges

in so

cial

supp

orts

, pee

r re

latio

ns, p

artic

ipati

on in

ext

racu

rric

ular

acti

vitie

s, st

uden

t em

ploy

men

t, di

scip

line

refe

rral

s at s

choo

l).

Fam

ily o

utco

mes

(e.g

. cha

nges

in th

e su

perv

ision

of

child

ren/

adol

esce

nts a

nd c

hild

car

e, fa

mily

com

mun

icati

on

and

dyna

mic

s, ro

utine

s, ro

les)

.

Scho

ol o

utco

mes

(e.g

. cha

nges

in re

gist

ratio

n nu

mbe

rs,

scho

ol c

limat

e or

disc

iplin

e re

ferr

als)

.

Com

mun

ity o

utco

mes

(e.g

. rea

ction

s fro

m lo

cal

busin

esse

s, fe

elin

gs o

f saf

ety

on n

eigh

borh

ood

stre

ets)

.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Stu

dies

wer

e ex

clud

ed fr

om

the

revi

ew b

ased

on

a fa

ilure

to m

eet t

he

incl

usio

n cr

iteria

det

aile

d ab

ove.

Page 92: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

92

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: A

vera

ge

hour

s of s

leep

per

nig

ht, w

ake

time,

and

bed

tim

e; st

uden

t ac

hiev

emen

t inf

orm

ation

(e.g

., cr

edit

accu

mul

ation

, gra

de 9

EQ

AO, g

rade

10

Ont

ario

Sec

onda

ry S

choo

l Lite

racy

Test

, ave

rage

gr

ade

9, 1

0, 1

1, a

nd 1

2 m

arks

by

subj

ect)

; eas

e of

com

ing

to

scho

ol a

fter s

ched

ule

chan

ge, s

tude

nt o

pini

on o

n sc

hool

arr

ival

tim

e; sc

hool

per

cepti

ons (

7 qu

estio

n re

gard

ing

gene

ral f

eelin

gs

tow

ards

thei

r sch

ools)

; hou

rs p

er w

eek

spen

t on

hom

ewor

k/st

udyi

ng a

nd sp

orts

; abs

ente

eism

rate

s; p

artic

ipati

on in

spor

ts,

volu

ntee

r acti

vitie

s, a

nd le

ader

ship

pro

gram

s; te

ache

r-rep

orte

d al

ertn

ess a

nd p

artic

ipati

on o

f stu

dent

s in

the

mor

ning

; fee

lings

to

war

ds n

ew sc

hedu

le (B

row

n, 2

011)

, Sch

ool a

nd n

on-s

choo

l ni

ght s

leep

tota

l, ris

e tim

e, a

nd b

ed ti

me;

lette

r gra

des e

arne

d by

all

stud

ents

ove

r a c

ours

e of

6 y

ears

.; da

ytim

e sle

epin

ess;

ta

rdin

ess a

nd a

ttend

ance

rate

s; sl

eep

beha

vior

; con

tinuo

us

enro

llmen

t; gr

adua

tion

rate

s; w

heth

er st

uden

ts a

rriv

ed la

te

due

to o

vers

leep

ing,

fell

asle

ep in

mor

ning

or a

ftern

oon

clas

s;

depr

essio

n; d

ays h

ome

sick;

impa

ct o

f sta

rt ti

me

chan

ge

on sp

orts

; ove

rall

pers

pecti

ves o

n tim

e ch

ange

; tea

cher

, ad

min

istra

tor,

coun

sello

r, nu

rse,

and

par

ent p

ersp

ectiv

es o

n tim

e ch

ange

(Wal

hstr

om, 2

002)

.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): GR

ADE

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it

is m

easu

red:

Teac

her-r

epor

ted

impa

ct o

f cha

nge

on sc

hool

(B

row

n, 2

011)

Setti

ng(s

): Sc

hool

sCo

untr

y(ie

s): C

anad

a, U

.S.,

Isra

el, N

ew Z

eala

nd, C

roati

a, B

razil

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

: (C

olor

ado,

Rho

de Is

land

, Min

neso

ta, K

entu

cky,

Nor

th C

arol

ina,

W

yom

ing)

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fam

ily,

wor

k, re

crea

tion,

OST

): Sc

hool

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Brow

n, 2

011

Grad

e 9

to 1

2“L

ate

Star

t”: D

elay

ed sc

hool

star

t tim

e fr

om 9

:00a

m

to 1

0:00

amPo

sitive

resu

lts a

re sh

own

acro

ss a

cade

mic

indi

cato

rs,

staff

and

stud

ent p

erce

ption

s, a

bsen

teei

sm ra

tes,

as

wel

l as o

vera

ll av

erag

e sle

ep ti

mes

. Ove

rall

achi

evem

ent t

rend

s are

enc

oura

ging

, the

resu

lts a

re

by n

o m

eans

defi

nitiv

e.

Mea

n ag

e of

par

ticip

ants

in

volv

ed w

as 1

8. T

here

is

an a

ckno

wle

dgem

ent t

hat

impl

emen

tatio

n w

as n

ot

with

out i

ts st

rugg

les.

Wah

lstro

m, 2

002

Grad

e 9

to 1

2De

laye

d sc

hool

star

t tim

e fr

om 7

:15a

m to

8:4

5am

Sign

ifica

nt b

enefi

ts su

ch a

s im

prov

ed a

ttend

ance

an

d en

rollm

ent r

ates

, les

s sle

epin

g in

cla

ss, a

nd le

ss

stud

ent-r

epor

ted

depr

essi

on.

Stud

ents

repo

rted

a

nega

tive

outc

ome

of th

e st

art ti

me

chan

ge b

eing

ha

ving

to m

iss a

full

clas

s du

e to

spor

ts g

ame,

whi

le

prev

ious

ly, o

nly

parti

al

clas

ses e

ver h

ad to

be

miss

ed. T

he re

ducti

on in

le

arni

ng ti

me

was

seen

as

prob

lem

atic.

Con

tinuo

us

enro

llmen

t in

the

sam

e di

stric

t or s

ame

scho

ol

rose

sign

ifica

ntly

sinc

e th

e 19

95-1

996

scho

ol y

ear.

Page 93: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

93

Rapid Evidence Review Appendix 5: Evidence Tables

19. N

ashe

eda

A, A

bd

ulla

h H

B, K

raus

s S

E, A

hmed

NB

. A N

arra

tive

Sys

tem

atic

Rev

iew

of

Life

Ski

lls E

duc

atio

n: E

ffec

tive

ness

, Res

earc

h G

aps,

and

Pri

ori

ties

. Int

erna

l Jo

urna

l of

Ad

ole

scen

ce a

nd

Yout

h [I

nter

net]

. 201

9 [c

ited

201

9 A

ug 2

6]; 2

4(3)

:362

-379

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.tan

dfo

nlin

e.co

m/d

oi/

full/

10.1

080/

0267

3843

.201

8.14

7927

8FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

Ado

lesc

ents

10-

19

year

s old

Date

rang

e fo

r rev

iew

: Inc

eptio

n of

da

taba

ses s

earc

hed

– 20

16#

of st

udie

s inc

lude

d: 2

5

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens

ages

13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

re

leva

nt a

ge g

roup

: Mal

e at

hlet

es (m

ean

age

= 17

.1 y

ears

) (Ho

lt et

al.,

200

8), h

igh

scho

ol m

ale

stud

ents

(Mar

yam

et a

l., 2

011)

, hi

gh sc

hool

stud

ents

(mea

n ag

e =

15.9

7 ye

ars)

(Giv

auda

n et

al.,

20

08; G

ivau

dan

et a

l., 2

007)

, 10th

gra

de st

uden

ts (J

egan

nath

an

et a

l., 2

014)

, Del

inqu

ent a

dole

scen

t boy

s (N

aser

i & B

abak

hani

, 20

14),

stud

ents

age

d 14

-18

(Par

vath

y &

Pill

ai, 2

015)

, Stu

dent

s ag

ed 1

2 &

16

(Tutt

le e

t al.,

200

6), h

igh

scho

ol st

uden

ts

(Vat

ankh

ah e

t al.,

201

4), s

tude

nts a

ged

15-1

7 ye

ars (

Yada

v &

Iq

bal,

2009

), st

uden

ts a

ged

13-1

5 ye

ars (

Chau

dhar

y &

Meh

ta,

2008

), Gr

ade

9 st

uden

ts (J

ames

et a

l., 2

006)

Data

base

s sea

rche

d fo

r rev

iew

: Sci

ence

Di

rect

, Wile

y, Sp

ringe

r, EB

SCO

host

, Goo

gle

Scho

lar.

Hi-L

evel

Fin

ding

s: li

fe sk

ills t

end

to b

e eff

ectiv

e in

brin

ging

abo

ut in

divi

dual

cha

nges

rele

vant

to

know

ledg

e, sk

ills a

nd a

ttitu

des i

n ris

k ar

eas a

s wel

l as

psy

chos

ocia

l ski

lls. S

ever

al st

udie

s rep

orte

d de

ficie

ncie

s in

the

tran

sfer

of s

kills

as l

ittle

em

phas

is w

as p

lace

d on

acq

uirin

g sk

ills t

hrou

gh v

ario

us

appr

oach

es su

ch a

s mod

ellin

g, im

itatio

n an

d re

info

rcem

ent.

As n

oted

by

auth

or: Q

ualit

ative

stud

ies o

n lif

e sk

ills

educ

ation

wer

e lim

ited;

onl

y on

e qu

alita

tive

stud

y m

et th

e in

clus

ion

crite

ria o

f effe

ctive

ness

of l

ife sk

ills

expe

rienc

es fo

cusin

g on

you

ng p

eopl

e’s l

earn

ing

expe

rienc

es. .

Man

y of

the

iden

tified

stud

ies w

ere

base

d on

ass

essm

ent o

f life

skill

s com

pone

nts r

athe

r tha

n un

ders

tand

ing

wha

t kno

wle

dge,

skill

s and

atti

tude

s ad

oles

cent

s req

uire

in o

rder

for p

ositi

ve b

ehav

ior c

hang

e to

occ

ur. H

ence

, fut

ure

rese

arch

shou

ld b

e di

rect

ed

tow

ard

inve

stiga

ting

how

life

skill

s pro

gram

kno

wle

dge

is tr

ansla

ted

into

beh

avio

r and

atti

tude

cha

nge.

Sec

ond,

fe

wer

stud

ies h

ave

been

con

duct

ed in

dev

elop

ing

coun

try

cont

exts

in c

ompa

rison

to th

ose

carr

ied

out i

n de

velo

ped

coun

trie

s.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Life

Ski

lls E

duca

tion

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: I

nclu

sion

was

onl

y ge

nera

lly

defin

ed. S

tudi

es w

ere

incl

uded

if th

ere

wer

e re

leva

nt to

the

rese

arch

que

stion

; if

the

conc

epts

and

defi

nitio

ns o

f ter

ms

with

in th

e re

view

wer

e re

leva

nt to

the

rese

arch

que

stion

; if k

ey v

aria

bles

and

m

easu

res i

n th

e re

view

wer

e re

leva

nt to

th

e re

sear

ch q

uesti

on; i

f the

stud

ies h

ad a

co

ncre

te re

sear

ch d

esig

n; a

nd fo

cuse

d on

ad

oles

cent

s age

d 10

-19

year

s.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equi

vale

nt (s

peci

fy):

life

skill

s edu

catio

n pr

ogra

ms (

Holt

et a

l.,

2008

; Mar

yam

et a

l., 2

011;

Jega

nnat

han

et a

l., 2

014;

Par

vath

y &

Pill

ai, 2

015;

Vat

ankh

ah e

t al.,

201

4; Y

adav

& Iq

bal,

2009

; Ch

audh

ary

& M

ehta

, 200

8), A

Team

Aga

inst

AID

S (G

ivau

dan

et

al.,

2008

; Giv

auda

n et

al.,

200

7), l

ife a

nd so

cial

skill

s tra

inin

g (N

aser

i & B

abak

hani

, 201

4), c

ogni

tive

beha

vior

al li

fe sk

ills

trai

ning

(Tutt

le e

t al.,

200

6), l

ife sk

ills a

nd H

IV/A

IDS

educ

ation

pr

ogra

m (J

ames

et a

l., 2

006)

.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Exc

lusio

n fr

om th

e re

view

was

bas

ed o

n a

failu

re to

mee

t the

in

clus

ion

crite

ria d

etai

led

abov

e.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Not

spec

ified

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

tabl

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

(see

tabl

e)

Setti

ng(s

): N

/ACo

untr

y(ie

s): M

ix o

f dev

elop

ed a

nd d

evel

opin

g co

untr

ies.

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol, f

amily

, w

ork,

recr

eatio

n, O

ST):

Scho

ol, I

ndiv

idua

l

Page 94: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

94

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Holt,

200

8M

ean

age

= 17

.1 y

ears

Life

skill

s edu

catio

nLa

ck o

f evi

denc

e at

hlet

es w

ere

dire

ctly

taug

ht a

bout

lif

e sk

ills t

hat w

ere

repo

rted

, rat

her t

he c

oach

cre

ated

op

port

uniti

es fo

r the

stud

ent t

o de

mon

stra

te in

itiati

ves.

Sam

ple

was

onl

y 12

m

ale

athl

etes

, with

dat

a ob

tain

ed fr

om 1

0 pr

actic

es

and

10 g

ames

. Str

ong

qual

ity ra

ting.

Mar

yam

, 201

1Hi

gh sc

hool

mal

e st

uden

tsLi

fe sk

ills e

duca

tion

Life

skill

s pro

gram

s cou

ld e

nhan

ce le

vels

of se

lf-es

teem

in

subj

ects

. Al

l mal

es. M

oder

ate

qual

ity ra

ting.

Giva

udan

, 200

8Hi

gh sc

hool

stud

ents

(mea

n ag

e =

15.9

7 ye

ars)

A Te

am A

gain

st A

IDS

Positi

ve e

ffect

ove

r a m

ediu

m ti

me

span

(1 y

ear f

ollo

w

up p

erio

d) o

n kn

owle

dge

and

self-

effica

cy in

con

dom

us

e. R

esul

ts a

re m

ore

effec

t of p

rogr

ams t

hat a

re

inte

racti

ve a

nd p

rom

ote

life

skill

such

as d

ecisi

on-

mak

ing,

self-

effica

cy, a

nd re

flecti

on o

n no

rms a

nd

attitu

des.

Stro

ng q

ualit

y ra

ting.

Jega

nnat

han,

201

410

th g

rade

stud

ents

Life

skill

s edu

catio

nAm

ong

all g

irls,

scor

es im

prov

ed in

thre

e ou

t of f

our

Life

Ski

lls D

imen

sions

(on

the

Life

Ski

lls D

evel

opm

ent

Scal

e-Ad

oles

cent

For

m) w

here

as b

oys i

mpr

oved

on

only

on

e di

men

sion.

Boy

s sho

wed

impr

ovem

ent o

n th

ree

dim

ensio

ns (A

ttitu

de To

war

d Su

icid

e &

You

th S

elf R

epor

t m

easu

res)

with

no

impr

ovem

ent a

mon

g gi

rls.

Mod

erat

e qu

ality

ratin

g.

Diffi

cult

to d

iscer

n w

hich

di

men

sions

are

bei

ng

refe

renc

ed.

Nas

eri,

2014

Delin

quen

t ado

lesc

ent b

oys

Life

and

soci

al sk

ills t

rain

ing

Phys

ical

and

ver

bal a

ggre

ssio

n of

ado

lesc

ent b

oys

signi

fican

tly re

duce

d be

caus

e of

life

skill

s tra

inin

g,

incl

udin

g an

ger c

ontr

ol, p

robl

em so

lvin

g an

d de

cisio

n-m

akin

g, se

lf-co

gniti

on, c

onfr

ontin

g st

ress

, and

co

mm

unic

ation

skill

s.

All m

ale,

targ

eted

. Str

ong

qual

ity ra

ting.

Parv

athy

, 201

5St

uden

ts a

ged

14-1

8 ye

ars

Life

skill

s edu

catio

nSt

udy

reve

aled

sign

ifica

nt im

pact

of L

ife S

kills

Edu

catio

n tr

aini

ng o

n ad

oles

cent

s (m

easu

res i

nclu

ded

know

ledg

e le

vel,

self-

awar

enes

s, e

mpa

thy

skill

)

Wea

k qu

ality

ratin

g, n

o fu

rthe

r det

ails

on st

udy

prov

ided

.

Tutt

le, 2

006

Stud

ents

age

d 12

& 1

6 ye

ars

Cogn

itive

beh

avio

ral l

ife sk

ills t

rain

ing

Tren

ds in

the

data

seen

with

phy

sical

and

men

tal

heal

th im

prov

ing

sligh

tly fo

r all

subj

ects

, as d

id th

eir

educ

ation

al a

nd v

ocati

onal

stat

us.

Wea

k qu

ality

ratin

g.

Vata

nkha

h, 2

014

High

scho

ol st

uden

tsLi

fe sk

ills e

duca

tion

Resu

lts sh

owed

life

skill

s is e

ffecti

ve o

n in

crea

sing

self-

este

em.

Wea

k qu

ality

ratin

g.

Yada

v, 20

09St

uden

ts a

ged

15-1

7 ye

ars

Life

skill

s edu

catio

nSu

bjec

ts im

prov

ed si

gnifi

cant

ly in

pos

t-con

ditio

n on

se

lf-es

teem

, em

otion

al, e

duca

tiona

l, to

tal a

djus

tmen

t, an

d em

path

y. B

ut, n

o sig

nific

ant d

iffer

ence

was

foun

d on

so

cial

adj

ustm

ent i

n pr

e- a

nd p

ost-c

ondi

tion.

Wea

k qu

ality

ratin

g.

Chau

dhar

y, 20

08St

uden

ts a

ged

13-1

5 ye

ars

Life

skill

s edu

catio

nLi

fe sk

ills e

duca

tion

impr

oved

thei

r sel

f-im

age

as w

ell a

s bo

oste

d th

eir c

onfid

ence

leve

l.W

eak

qual

ity ra

ting.

Jam

es, 2

006

Grad

e 9

stud

ents

Life

skill

s and

HIV

/AID

S ed

ucati

on p

rogr

amSc

hool

s whe

re th

e pr

ogra

m w

as p

artia

lly im

plem

ente

d fo

und

no si

gnifi

cant

ly d

iffer

ent r

espo

nses

on

mos

t va

riabl

es fr

om th

e re

spon

ses o

f stu

dent

s in

the

cont

rol

scho

ols.

The

full

prog

ram

did

not

influ

ence

beh

avio

r in

term

s of c

ondo

m u

se in

the

long

term

indi

catin

g th

at c

ondo

m u

sing

beha

vior

s req

uire

s mor

e th

an ju

st

know

ledg

e, p

ositi

ve a

ttitu

des,

and

bel

iefs

abo

ut it

s use

.

Mod

erat

e qu

ality

ratin

g.

Giva

udan

, 200

7St

uden

ts m

ean

age

= 15

.97

year

sA

Team

Aga

inst

AID

SEff

ect o

n de

pend

ent v

aria

bles

show

that

the

expe

rimen

tal g

roup

impr

oved

sign

ifica

ntly

in a

ll va

riabl

es

(sel

f-kno

wle

dge,

dec

ision

-mak

ing,

self-

effica

cy c

ondo

m

use,

nor

ms a

bout

con

dom

use

, atti

tude

s tow

ards

co

ndom

s, k

now

ledg

e ab

out H

IV/A

IDS,

com

mun

icati

on

on se

xual

ity) a

fter t

he im

plem

enta

tion

of li

fe sk

ills i

n th

e th

ree

diffe

rent

var

iabl

e le

vels

(per

sona

l, in

terv

entio

n,

outc

ome)

Mod

erat

e qu

ality

ratin

g.

Page 95: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

95

Rapid Evidence Review Appendix 5: Evidence Tables

20. O

’Co

nno

r C

A, D

yso

n J,

Co

wd

ell F

, Wat

son

R. D

o u

nive

rsal

sch

oo

l-b

ased

men

tal h

ealt

h p

rom

oti

on

pro

gra

mm

es im

pro

ve t

he m

enta

l hea

lth

and

em

oti

ona

l wel

lbei

ng o

f yo

ung

peo

ple

? A

lite

ratu

re

revi

ew. J

our

nal o

f C

linic

al N

ursi

ng [

Inte

rnet

]. 2

018

Feb

[ci

ted

201

9 Ju

ly 2

6]; 2

7(3-

4):e

412-

e426

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

8926

147

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

5-18

yea

rs o

ld,

cate

goriz

ed a

s: p

rimar

y sc

hool

age

d ch

ildre

n (5

-10

year

s old

); se

cond

ary

scho

ol a

ged

child

ren

(11-

18 y

ears

old

)

Date

rang

e fo

r rev

iew

: 199

5-20

15#

of st

udie

s inc

lude

d: 2

9 .

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens

ages

13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

re

leva

nt a

ge g

roup

: sec

onda

ry sc

hool

age

d ch

ildre

n (1

1-18

ye

ars o

ld)

14-1

6 ye

ars o

ld (B

arne

s 201

2), 1

2-14

yea

rs o

ld (D

e An

da, 1

998;

M

erre

ll, 2

008)

, 13-

15 y

ears

old

(Eco

nom

ou, 2

012)

, 13-

14 y

ears

ol

d (E

ssle

r, 20

06),

10-1

4 ye

ars o

ld (H

ampe

l, 20

07),

7-14

yea

rs

old

(Kim

ber,

2008

), 14

-18

year

s old

(Kin

g, 2

011)

, 12-

16 y

ears

old

(K

uyke

n, 2

013)

, 15-

18 y

ears

old

(Met

z, 2

013)

, 14-

16 y

ears

old

(R

ickw

ood,

200

4), 1

3-16

yea

rs o

ld (S

akel

lari,

201

4)

Data

base

s sea

rche

d fo

r rev

iew

: CIN

AHL,

M

EDLI

NE,

Psy

cIN

FO, E

RIC,

Edu

catio

n Re

sear

ch C

ompl

ete.

Hi-L

evel

Fin

ding

s: A

utho

r stil

l fee

ls co

nfide

nt to

co

nclu

de M

H an

d EW

pro

gram

s are

of v

alue

, but

ca

lls fo

r fur

ther

eva

luati

ve st

udie

s. 1

) Red

uctio

n in

st

ress

pos

t-int

erve

ntion

was

foun

d in

9 st

udie

s and

5

stud

ies f

ound

no

impr

ovem

ent,

4 st

udie

s rep

orte

d in

crea

ses i

n co

ping

skill

s/st

rate

gies

use

d by

chi

ldre

n th

at re

ceiv

ed in

terv

entio

ns. 2

) 4 st

udie

s fou

nd

signi

fican

t inc

reas

e in

soci

al sk

ills/

func

tioni

ng w

hen

com

parin

g pr

e- a

nd p

ost-t

est s

core

s and

Dur

lak

et a

l., 2

011

and

Skla

d et

al.,

201

2 bo

th fo

und

that

in

clud

ed st

udie

s sho

wed

resu

lts o

f enh

ance

d so

cial

sk

ills/

incr

ease

d le

vels

of p

ositi

ve so

cial

beh

avio

r. 5

stud

ies n

oted

evi

denc

e of

redu

ced

anxi

ety

leve

ls an

d w

ere

sust

aine

d at

12

mon

th fo

llow

up.

3) 4

stud

ies

repo

rted

incr

ease

d kn

owle

dge

of M

H. M

ixed

resu

lts

rega

rdin

g atti

tude

s tow

ards

MH.

As n

oted

by

auth

or: S

ome

stud

ies h

ad re

lativ

ely

smal

l sa

mpl

es, m

akin

g ge

nera

lizin

g di

fficu

lt. H

igh

leve

ls of

att

rition

was

a p

robl

em fo

r 4 o

f the

29

stud

ies.

Som

e bi

as w

as e

vide

nt in

stud

ies l

ike

Kram

er e

t al.,

200

9.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Inte

rven

tions

aim

ed a

t im

prov

ing

Men

tal h

ealth

(MH)

and

em

otion

al w

ell-b

eing

(EW

) defi

ned

as :

“bei

ng h

appy

and

co

nfide

nt a

nd n

ot a

nxio

us o

r dep

ress

ed…

the

abili

ty to

be

auto

nom

ous,

pro

blem

-sol

ve, m

anag

e em

otion

s, e

xper

ienc

e em

path

y, be

resil

ient

and

atte

ntive

”12

out

of 2

9 uti

lized

SEL

. Oth

er in

clud

ed st

ress

man

agem

ent

inte

rven

tions

, min

dful

ness

inte

rven

tions

, anx

iety

and

co

ping

skill

s int

erve

ntion

s, a

nd M

H ed

ucati

on/a

nti-s

tigm

a in

terv

entio

ns.

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: E

nglis

h la

ngua

ge, r

epor

ts o

f un

iver

sal i

nter

venti

ons,

con

duct

ed in

scho

ol

envi

ronm

ent

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equi

vale

nt (s

peci

fy):

(see

abo

ve)

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Exc

lude

d re

port

s of t

arge

t in

terv

entio

n, in

terv

entio

ns in

non

-sch

ool

envi

ronm

ents

, and

pap

ers e

valu

ating

SEL

in

terv

entio

ns p

rior t

o 20

08 th

at h

ave

been

in

clud

ed in

two

SEL

revi

ews m

entio

ned

(Dur

lak

et a

l. 20

11; S

klad

et a

l. 20

12).

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Th

ree

them

es w

ere

iden

tified

: 1) h

elp

seek

ing

and

copi

ng (1

4 of

29

pap

ers)

2) s

ocia

l and

em

otion

al w

ell-b

eing

(20

of 2

9 pa

pers

) 3)

psy

cho-

educ

ation

al e

ffecti

vene

ss (a

bilit

y of

a p

rogr

am to

in

crea

se k

now

ledg

e of

MH

and

illne

ss a

s wel

l cha

nge

nega

tive

attitu

des/

belie

fs) (

8 of

29

pape

rs)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: a

nger

, an

xiet

y an

d bl

ood

pres

sure

, ang

er c

ontr

ol (B

arne

s, 2

012)

, se

lf-re

port

mea

sure

s of c

opin

g/re

laxa

tion

(De

Anda

, 199

8),

stud

ent a

ttitu

des/

belie

fs to

war

ds p

eopl

e w

ith m

enta

l illn

ess

(Eco

nom

ou, 2

012)

, kno

wle

dge

abou

t MH

(Ess

ler,

2006

), pe

rcei

ved

self-

effica

cy, p

erce

ived

stre

ss, u

se o

f ada

ptive

co

ping

stra

tegi

es (H

ampe

ll, 2

007)

, mea

sure

s of m

enta

l hea

lth/

asso

ciat

ed h

ealth

beh

avio

rs (K

imbe

r, 20

08),

suic

idal

idea

tion,

he

lp-s

eeki

ng b

ehav

iors

, abi

lity

to id

entif

y su

ppor

t (Ki

ng, 2

011)

, le

vels

of d

epre

ssiv

e sy

mpt

oms,

leve

ls of

stre

ss (K

uyke

n, 2

013)

, kn

owle

dge

of so

cial

and

em

otion

al c

once

pts a

nd e

ffecti

ve

copi

ng st

rate

gies

(Mer

rell,

200

8), e

moti

onal

regu

latio

n,

emoti

onal

aw

aren

ess,

stre

ss le

vels

(Met

z, 2

013)

, kno

wle

dge

of M

H, b

elie

fs to

war

ds p

eopl

e w

ith M

H pr

oble

ms (

Rick

woo

d,

2004

), atti

tude

s tow

ards

MH

(Sak

ella

ri, 2

014)

.

Page 96: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

96

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Sc

hool

env

ironm

ents

Coun

try(

ies)

: U.S

., Sc

otla

nd, S

outh

Afr

ica,

Sw

eden

, Can

ada,

Au

stra

lia, G

reec

e, E

ngla

nd, G

erm

any

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol, f

amily

, w

ork,

recr

eatio

n, O

ST):

Scho

ols

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Barn

es, 2

012

14-1

6 ye

ars o

ldLi

fe S

kills

Tra

inin

gRe

duce

d an

ger,

anxi

ety

and

bloo

d pr

essu

re, i

mpr

oved

an

ger c

ontr

olRe

lativ

ely

smal

l sam

ple

size/

high

leve

l of a

ttriti

on.

De A

nda,

199

812

-14

year

s old

Stre

ss m

anag

emen

t pro

gram

Impr

oved

cop

ing

stra

tegi

es, r

educ

ed le

vel o

f str

ess,

in

crea

sed

use

of re

laxa

tion

stra

tegi

esRa

ndom

izatio

n of

sam

ple

only

use

d fo

r fem

ale

parti

cipa

nts.

Sm

all s

ampl

e.

Econ

omou

, 201

213

-15

year

s old

MH

anti-

stigm

a in

terv

entio

nPo

sitive

cha

nges

in st

uden

ts’ b

elie

fs a

nd a

ttitu

des

tow

ards

peo

ple

with

men

tal i

llnes

s.N

o fo

llow

-up

post

-in

terv

entio

n. C

onve

nien

ce

sam

plin

g.

Essle

r, 20

0613

-14

year

s old

Educ

ation

al in

terv

entio

n to

cha

lleng

e M

H sti

gma/

prom

ote

MH

Incr

ease

d kn

owle

dge

of M

HSa

me

quiz

used

pre

- and

po

st-in

terv

entio

n.

Ham

pel,

2007

10-1

4 ye

ars o

ldSt

ress

man

agem

ent p

rogr

amIn

crea

sed

perc

eive

d se

lf-effi

cacy

, les

s per

ceiv

ed st

ress

an

d m

ore

adap

tive

copi

ng a

t pos

t- an

d fo

llow

-up

asse

ssm

ent.

No

rand

omiza

tion,

no

follo

w-u

p aft

er 3

mon

ths.

Kim

ber,

2008

7-14

yea

rs o

ldSE

L Pr

ogra

mM

odes

t im

prov

emen

t on

men

tal h

ealth

and

ass

ocia

ted

heal

th b

ehav

iors

High

leve

l of a

ttriti

on.

Onl

y fu

lly c

ompl

eted

an

d co

rrec

tly c

ompl

eted

qu

estio

nnai

res w

ere

anal

yzed

.

King

, 201

114

-18

year

s old

Suic

ide

prev

entio

n an

d de

pres

sion

awar

enes

s pr

ogra

mRe

duce

d su

icid

al id

eatio

n, in

crea

se in

hel

p-se

ekin

g be

havi

ors,

impr

oved

abi

lity

to id

entif

y su

ppor

tHi

gh le

vel o

f att

rition

. Sa

mpl

e ch

ose

may

lim

it ge

nera

lizab

ility

.

Kuyk

en, 2

013

12-1

6 ye

ars o

ldM

indf

ulne

ss p

rogr

amM

oder

ate

redu

ction

in lo

w-g

rade

dep

ress

ive

sym

ptom

s im

med

iate

ly fo

llow

ing

inte

rven

tion/

at 3

mon

th fo

llow

-up

, red

uctio

n le

vels

of st

ress

at 3

mon

th fo

llow

-up.

Sam

ple

recr

uite

d fr

om

scho

ols w

ith p

rior i

nter

est

in th

e in

terv

entio

n.

Mer

rell,

200

812

-14

year

s old

SEL

Prog

ram

Incr

ease

d kn

owle

dge

of so

cial

and

em

otion

al c

once

pts

and

effec

tive

copi

ng st

rate

gies

.Re

lativ

ely

smal

l sam

ples

. N

o fo

llow

-up.

Met

z, 2

013

15-1

8 ye

ars o

ldM

indf

ulne

ss p

rogr

amIm

prov

ed e

moti

onal

regu

latio

n, e

moti

onal

aw

aren

ess.

De

crea

se in

psy

chos

omati

c co

mpl

aint

s and

stre

ss le

vels.

Conv

enie

nce

sam

plin

g.

Rick

woo

d, 2

004

14-1

6 ye

ars o

ldEd

ucati

onal

MH

Prog

ram

Incr

ease

d kn

owle

dge

and

redu

ced

nega

tive

belie

fs a

bout

pe

ople

with

MH

prob

lem

s.N

o fo

llow

-up,

no

rand

omiza

tion,

diff

eren

ces

in b

asel

ine

data

for

inte

rven

tion

vs c

ontr

ol

grou

ps.

Sake

llari,

201

413

-16

year

s old

Educ

ation

al M

H Pr

ogra

mIm

prov

ed a

ttitu

des t

owar

ds M

H.Re

lativ

ely

smal

l sam

ple.

Page 97: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

97

Rapid Evidence Review Appendix 5: Evidence Tables

21. O

’Rei

lly M

, Svi

ryd

zenk

a N

, Ad

ams

S, D

og

ra N

. Rev

iew

of

men

tal h

ealt

h p

rom

oti

on

inte

rven

tio

ns in

sch

oo

ls. S

oci

al P

sych

iatr

y an

d P

sych

iatr

ic E

pid

emio

log

y [I

nter

net]

. 201

8 Ju

ly [

cite

d 2

019

July

26

]; 5

3(7)

:647

-662

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

9752

493

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

prim

ary

scho

ol

thro

ugh

high

scho

ol st

uden

tsDa

te ra

nge

for r

evie

w: 2

007-

2017

# of

stud

ies i

nclu

ded:

10

As n

oted

by

auth

or: S

earc

h te

rmin

olog

y w

as ta

rget

ed to

fo

cus o

n m

enta

l hea

lth p

rom

otion

, so

rele

vant

stud

ies

may

hav

e be

en e

xclu

ded

if th

ey fa

iled

to u

se sp

ecifi

c te

rmin

olog

y.M

etho

ds u

sed

wer

e of

var

iabl

e qu

ality

, aut

hors

wer

e va

gue

in d

escr

iptio

n of

the

inte

rven

tion.

.

Coul

d no

t ide

ntify

a

spec

ific

guid

ing

fram

ewor

k fo

r the

revi

ew.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed te

ens

ages

13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

re

leva

nt a

ge g

roup

: Gr

ades

5-9

(age

d 11

-15

year

s old

) (N

eilse

n et

al.,

201

5), 1

0-15

ye

ars o

ld (F

ranz

& P

aulu

s, 2

009)

, Gra

des 4

-9 (K

imbe

r et a

l.,

2008

), 12

-15

year

s old

(Har

alds

son

et a

l., 2

008)

, Gra

des 7

-12

(But

zer e

t al.,

201

7), s

econ

dary

scho

ol st

uden

ts (L

endr

um e

t al

., 20

13).

Hi-L

evel

Fin

ding

s: L

imite

d ad

vanc

emen

ts o

f un

iver

sal i

nter

venti

ons i

n th

e de

cade

pre

cedi

ng

the

revi

ew. D

espi

te m

etho

dolo

gica

l iss

ues,

ther

e is

still

prom

ise in

pur

suin

g un

iver

sal w

ellb

eing

in

terv

entio

ns.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Men

tal h

ealth

pro

moti

on: a

ction

s to

crea

te li

ving

con

ditio

ns a

nd

envi

ronm

ents

that

supp

ort m

enta

l hea

lth a

nd a

llow

peo

ple

to

adap

t and

mai

ntai

n he

alth

y lif

esty

les (

WHO

).

Data

base

s sea

rche

d fo

r rev

iew

: SCO

PUS,

ER

ICAd

oles

cent

-Spe

cific

Fin

ding

s: (s

ee ta

ble)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equi

vale

nt (s

peci

fy):

“U

p” (N

eilse

n et

al.,

201

5), M

indM

atter

s (Fr

anz &

Pau

lus,

20

09),

Soci

al a

nd E

moti

onal

Tra

inin

g (S

ET) (

Kim

ber e

t al.,

200

8),

Heal

th p

rom

otion

pro

gram

adm

inist

ered

as a

scho

ol su

bjec

t ea

ch w

eek

for o

ne y

ear (

Hara

ldss

on e

t al.,

200

8), Y

oga

incl

udin

g m

indf

ulne

ss a

nd m

edita

tion

(But

zer e

t al.,

201

7) S

ocia

l and

Em

otion

al A

spec

ts o

f Lea

rnin

g (S

EAL)

app

roac

h (L

endr

um e

t al

., 20

13).

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudy

mus

t be

a un

iver

sal

men

tal h

ealth

pro

gram

(or e

quiv

alen

t); m

ust

be a

who

le-s

choo

l int

erve

ntion

, pro

gram

, fr

amew

ork,

mod

el, o

r set

of t

ools,

invo

lvin

g m

any

leve

ls of

scho

ol p

erso

nnel

; tar

get

popu

latio

n m

ust b

e sc

hool

age

(gen

eral

ly

from

3-1

8).

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: pro

moti

on o

f men

tal h

ealth

and

/or w

ellb

eing

.Re

view

exc

lusi

on c

riter

ia—

Focu

s on

stud

y m

etho

dolo

gy: S

tudy

cou

ld n

ot b

e pa

rt

of a

boo

k ch

apte

r, ed

itoria

l, or

gui

danc

e do

cum

ent;

stud

y co

uld

not b

e fo

cuse

d on

ris

k fa

ctor

s or r

elat

ed to

thes

e; st

udy

coul

d no

t sim

ply

be p

lann

ing,

dev

elop

men

t, or

pi

lot o

f an

inte

rven

tion;

stud

y co

uld

not

targ

et c

hild

ren

with

pre

-exi

sting

men

tal

heal

th p

rogr

ams.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es:

Self-

repo

rt o

f soc

ial a

nd e

moti

onal

com

pete

nce

(Nei

lsen

et a

l.,

2015

), po

sitive

men

tal h

ealth

/sel

f-rep

ort o

f soc

ial c

ompe

tenc

e (F

ranz

& P

aulu

s, 2

009)

, sel

f-rep

orte

d in

tern

alizi

ng, s

elf-r

epor

ted

exte

rnal

izing

, sel

f-rep

orte

d m

aste

ry, c

onte

ntm

ent i

n sc

hool

, bu

llyin

g (K

imbe

r et a

l., 2

008)

, sen

se o

f wel

lbei

ng, s

elf-r

elia

nce

(Har

alds

son

et a

l., 2

008)

, sel

f-rep

orts

on

moo

d, st

ress

, sle

ep,

acad

emic

per

form

ance

(But

zer e

t al.,

201

7), s

ocia

l and

em

otion

al sk

ills,

beh

avio

r or m

enta

l diffi

culti

es (L

endr

um e

t al.,

20

13).

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): Co

uld

not b

e id

entifi

ed.

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

deg

ree

of sh

ared

exp

ecta

tions

, com

mun

icati

on

amon

g gr

oups

, ass

essm

ent o

f sch

ool e

nviro

nmen

t, bu

llyin

g le

vels

Setti

ng(s

): Sc

hool

env

ironm

ents

Coun

try(

ies)

: Den

mar

k, G

erm

any,

Swed

en, U

.S.,

U.K.

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol, f

amily

, w

ork,

recr

eatio

n, O

ST):

Scho

ol

Page 98: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

98

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Nei

lsen

et a

l., 2

015

11-1

5 ye

ars o

ldU

p: p

rom

oting

men

tal h

ealth

. Com

pose

d of

4

com

pone

nts:

acti

vitie

s for

chi

ldre

n, d

evel

opm

ent o

f st

aff sk

ills,

invo

lvem

ent o

f par

ents

, ini

tiativ

es in

the

ever

yday

life

of s

choo

ls

Stati

stica

lly si

gnifi

cant

cha

nge

of c

hild

ren

repo

rting

hi

gh so

cial

and

em

otion

al c

ompe

tenc

e fr

om b

efor

e th

e in

terv

entio

n (3

3.3%

) to

after

(40.

8%).

Fran

z & P

aulu

s, 2

009

10-1

5 ye

ars o

ldM

indM

atter

s: A

ustr

alia

n pr

ogra

m e

ncou

ragi

ng

resp

ect/

tole

ranc

e an

d in

volv

es a

rang

e of

scho

ol

pers

onne

l and

chi

ldre

n. E

ncou

rage

s res

ilien

ce,

com

mun

icati

on, p

robl

em-s

olvi

ng.

Som

e ch

ange

s in

positi

ve m

enta

l hea

lth, s

ome

impr

ovem

ent i

n so

cial

com

pete

nce.

Effe

cts w

ere

min

imal

.

Kim

ber e

t al.,

200

8Gr

ades

4-9

SET:

del

iver

ed b

y cl

ass t

each

ers d

urin

g sc

hool

ho

urs.

Cov

ers s

elf-a

war

enes

s, m

anag

ing

emoti

ons,

em

path

y, m

otiva

tion,

soci

al c

ompe

tenc

e.

Positi

ve o

utco

mes

ove

r 3 y

ears

in 5

out

of 7

var

iabl

es

(sel

f-rep

ort i

nter

naliz

ing,

ext

erna

lizin

g, m

aste

ry, ‘

I Th

ink

I Am

’, and

con

tent

men

t in

scho

ol).

Effec

t size

s w

ere

smal

l to

med

ium

(0.0

7 to

0.6

0). S

igni

fican

t in

tera

ction

s bet

wee

n SE

T an

d no

n-SE

T sc

hool

s on

all

but o

ne o

utco

me

varia

ble

acro

ss 5

yea

rs (p

artic

ular

ly

exte

rnal

izing

/inte

rnal

izing

beh

avio

rs).

Bully

ing

leve

ls re

mai

ned

cons

isten

tly lo

w in

SET

scho

ols c

ompa

red

to

non-

SET

scho

ols.

Hara

ldss

on e

t al.,

200

812

-15

year

s old

25-3

0 le

sson

s of a

hea

lth p

rom

otion

pro

gram

. Str

ess

inte

rven

tion

adm

inist

ered

by

phys

ioth

erap

ist.

At b

asel

ine

no st

atisti

cally

sign

ifica

nt d

iffer

ence

bet

wee

n tw

o gr

oups

. Tho

se w

ith st

ress

inte

rven

tion

mai

ntai

ned

thei

r sen

se o

f wel

lbei

ng a

nd th

ose

with

out d

eter

iora

ted.

N

o st

atisti

cally

sign

ifica

nt d

iffer

ence

bet

wee

n gr

oups

in

term

s of s

elf-r

elia

nce.

Butz

er e

t al.,

201

7Gr

ades

7-1

235

min

ute

long

Yog

a se

ssio

ns d

eliv

ered

1-2

tim

es

per w

eek

inte

grat

ed in

to P

E cu

rric

ulum

. Inc

lude

d m

indf

ulne

ss/m

edita

tion.

Foc

used

on

stre

ss

man

agem

ent,

emoti

onal

regu

latio

n, c

onfid

ence

bu

ildin

g, p

rom

oting

pee

r rel

ation

ship

s.

44%

had

a p

ositi

ve v

iew

of t

he c

lass

, 25%

had

neg

ative

, an

d th

e re

st m

ixed

. 69%

felt

it he

lped

raise

moo

d an

d m

anag

e st

ress

. 62%

felt

it ha

d a

positi

ve e

ffect

on

sleep

. 25%

felt

it ha

d a

positi

ve e

ffect

on

acad

emic

pe

rfor

man

ce.

Lend

rum

et a

l., 2

013

Seco

ndar

y sc

hool

stud

ents

SEAL

for a

dole

scen

ts w

hole

scho

ol fr

amew

ork.

Sc

hool

visi

ted

once

per

term

ove

r 5 te

rms.

N

o re

port

ed im

pact

on

outc

omes

in so

cial

and

em

otion

al

skill

s, b

ehav

ior o

r men

tal d

ifficu

lties

. Dem

onst

rate

d a

need

for g

reat

er a

war

enes

s of e

moti

onal

hea

lth a

nd

wel

lbei

ng in

scho

ols.

Sch

ool s

taff

need

to b

e be

tter

supp

orte

d an

d in

crea

se th

eir s

kills

.

Page 99: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

99

Rapid Evidence Review Appendix 5: Evidence Tables

22. P

and

ey A

, Hal

e D

, Das

S, G

od

din

gs

AL,

Bla

kem

ore

SJ,

Vin

er R

M. E

ffec

tive

ness

of

univ

ersa

l sel

f-re

gul

atio

n-b

ased

inte

rven

tio

ns in

chi

ldre

n an

d a

do

lesc

ents

: A s

yste

mat

ic r

evie

w a

nd m

eta-

anal

ysis

. JA

MA

Ped

iatr

ics

[Int

erne

t]. 2

018

Jun

1 [c

ited

201

9 Ju

ly 2

6]; 1

72(6

):566

-575

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

9710

097

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

Chi

ldre

n an

d ad

oles

cent

s age

d 0

to 1

9 ye

ars.

Da

te ra

nge

for r

evie

w: B

egin

ning

of

data

base

arc

hive

s - Ju

ly 2

016

# of

stud

ies i

nclu

ded:

49

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: 1

2-15

yea

rs o

ld (B

ower

s et

al.,

201

5), C

hild

ren

ages

7-1

4 (D

e W

it et

al.,

200

7), G

rade

s 9-

12 (F

ishbe

in e

t al.,

201

6), G

rade

s 11

to 1

2 (N

oggl

e et

al.,

20

12),

Stud

ents

from

3 p

ublic

scho

ols (

mea

n ag

e of

13.

6 ye

ars)

(C

ecch

ini e

t al.,

200

7), G

rade

s 9 to

10

(Cos

tigan

et a

l., 2

016)

.

Hi-L

evel

Fin

ding

s: P

ositi

ve o

utco

mes

on

heal

th a

nd

soci

al m

easu

res s

uch

as a

cade

mic

ach

ieve

men

t, so

cial

skill

s, m

enta

l hea

lth, b

ehav

iora

l pro

blem

s,

cond

uct d

isord

ers,

scho

ol su

spen

sions

, and

su

bsta

nce

abus

e w

ere

repo

rted

. Stu

dy fi

ndin

gs

sugg

est t

hat S

R in

terv

entio

ns a

re e

ffecti

ve a

nd th

at

impr

ovem

ents

in e

duca

tiona

l, he

alth

, and

soci

al

outc

omes

can

follo

w im

prov

emen

ts in

SR.

Diff

eren

t ty

pes o

f int

erve

ntion

s can

be

used

to im

prov

e se

lf-re

gula

tion,

and

man

y of

thes

e st

rate

gies

app

ear

effec

tive.

As n

oted

by

auth

or: T

he S

R ou

tcom

e m

easu

res w

ere

not

unifo

rm, a

nd th

ere

was

subs

tanti

al h

eter

ogen

eity

in th

eir

repo

rting

. Con

sider

ing

this

limita

tion

of th

e ev

iden

ce

base

of S

R in

terv

entio

ns, t

he a

utho

rs re

com

men

d th

at

futu

re re

sear

ch in

SR

shou

ld b

e di

rect

ed to

eva

luat

e st

anda

rd m

etho

ds o

f rep

ortin

g SR

out

com

es. T

he

gene

raliz

abili

ty o

f the

rese

arch

find

ings

may

also

be

affec

ted

by th

e su

bsta

ntial

num

ber o

f stu

dies

con

duct

ed

in th

e U

nite

d St

ates

.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

U

nive

rsal

inte

rven

tions

des

igne

d to

pro

mot

e se

lf-re

gula

tion

in

child

ren

and

adol

esce

nts.

Self-

regu

latio

n (S

R): a

psy

chol

ogic

al c

onst

ruct

whi

ch

enco

mpa

sses

a ra

nge

of im

port

ant c

ompe

tenc

ies,

incl

udin

g th

e ca

paci

ty fo

r con

trol

ling

one’

s em

otion

s, th

e ab

ility

to h

ave

positi

ve in

tera

ction

s with

oth

ers,

the

capa

city

for a

void

ing

inap

prop

riate

or a

ggre

ssiv

e ac

tions

, and

the

abili

ty to

car

ry o

ut

self-

dire

cted

lear

ning

. Cog

nitiv

e pr

oces

s con

trib

uting

to S

R ar

e oft

en re

ferr

ed to

as e

xecu

tive

func

tions

, and

they

incl

ude

the

abili

ty to

dire

ct o

r foc

us a

ttenti

on, s

hift

pers

pecti

ve, a

nd a

dapt

fle

xibl

y to

cha

nges

(cog

nitiv

e fle

xibi

lity)

; ret

ain

info

rmati

on

(wor

king

mem

ory)

; and

inhi

bit a

utom

atic

or im

pulsi

ve

resp

onse

s to

achi

eve

a go

al, s

uch

as p

robl

em-s

olvi

ng (i

mpu

lse

cont

rol).

Code

d in

to 5

cat

egor

ies:

cur

ricul

um in

terv

entio

ns, p

hysic

al

activ

ity a

nd e

xerc

ise in

terv

entio

ns, m

indf

ulne

ss a

nd y

oga

inte

rven

tions

, par

entin

g an

d fa

mily

-focu

sed

inte

rven

tions

, and

ot

her s

kills

-bas

ed tr

aini

ng.

Data

base

s sea

rche

d fo

r rev

iew

: MED

LIN

E,

PubM

ed, P

sycI

NFO

, EM

BASE

, ERI

C, C

INAH

L,

Briti

sh E

duca

tion

Inde

x, C

hild

Dev

elop

men

t an

d Ad

oles

cent

Stu

dies

via

EBS

CO, a

nd

CEN

TRAL

.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

Stud

ent S

ucce

ss S

kills

(SSS

) Pro

gram

(B

ower

s et a

l., 2

015)

, Big

Bro

ther

Big

Sist

er P

rogr

am (D

e W

it et

al.,

200

7), M

indf

ul Y

oga

(Fish

bein

et a

l., 2

016)

, Krip

alu

Yoga

(N

oggl

e et

al.,

201

2), P

erso

nal &

Soc

ial R

espo

nsib

ility

mod

el

(Cec

chin

i et a

l., 2

007)

, Hig

h-in

tens

ity in

terv

al tr

aini

ng (H

IIT)

(Cos

tigan

et a

l., 2

016)

.

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es w

ere

elig

ible

if th

ey

1) re

port

ed ra

ndom

ized

clin

ical

tria

ls an

d cl

uste

r ran

dom

ized

tria

ls; 2

) eva

luat

ed

univ

ersa

l int

erve

ntion

s des

igne

d to

impr

ove

SR in

chi

ldre

n an

d ad

oles

cent

s (ag

e 0-

19

year

s); a

nd 3

) inc

lude

d at

leas

t 1 c

hild

-bas

ed

outc

ome

asso

ciat

ed w

ith S

R sk

ills.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Se

lf-re

gula

tion,

dist

al h

ealth

and

soci

al o

utco

mes

(e.g

., ac

adem

ic a

chie

vem

ent,

subs

tanc

e ab

use,

psy

chol

ogic

al st

ress

, w

ell-b

eing

)

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Stu

dies

wer

e ex

clud

ed if

they

fa

iled

to m

eet t

he in

clus

ion

crite

ria d

etai

led

abov

e.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: S

choo

l co

nnec

tedn

ess,

SR

deve

lopm

ent (

Bow

ers e

t al.,

201

5), S

ocia

l sk

ills (

self-

cont

rol),

soci

al a

nxie

ty (D

e W

it et

al.,

200

7), S

R,

psyc

holo

gica

l str

ess,

subs

tanc

e us

e (F

ishbe

in e

t al.,

201

6), S

R,

psyc

holo

gica

l wel

l-bei

ng (N

oggl

e et

al.,

201

2), S

elf-c

ontr

ol, f

air

play

(Cec

chin

i et a

l., 2

007)

, Exe

cutiv

e fu

nctio

n, p

sych

olog

ical

w

ell-b

eing

, psy

chol

ogic

al d

istre

ss, a

nd p

hysic

al se

lf-co

ncep

t (C

ostig

an e

t al.,

201

6)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Page 100: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

100

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18-

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): M

ultip

leCo

untr

y(ie

s): U

S, U

K, C

anad

a, E

urop

ean

coun

trie

s St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s):

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fa

mily

, wor

k, re

crea

tion,

OST

): Sc

hool

, Fam

ily, I

ndiv

idua

l

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Bow

ers,

201

512

-15

year

s old

Stud

ent S

ucce

ss S

kills

(SSS

) Pro

gram

(Cur

ricul

um

inte

rven

tion)

Resu

lts fr

om m

ultip

le p

ath

anal

yses

indi

cate

d m

odel

fit

s bas

ed o

n SS

S pa

rtici

patio

n fo

r beh

avio

ral r

egul

ation

fo

r the

trea

tmen

t gro

up, f

eelin

gs o

f con

nect

edne

ss fo

r fe

mal

es in

the

trea

tmen

t gro

up, a

nd re

adin

g gr

owth

for

low

-ach

ievi

ng st

uden

ts.

De W

it, 2

007

Child

ren

ages

7-1

4Bi

g Br

othe

r Big

Sist

er P

rogr

am (F

amily

bas

ed

inte

rven

tions

)Th

ere

was

sign

ifica

nt b

enefi

t in

soci

al sk

ills i

n in

terv

entio

n gr

oup

com

pare

d to

con

trol

s. (s

ympt

oms o

f em

otion

al p

robl

ems,

sym

ptom

s of s

ocia

l anx

iety

).

Fish

bein

, 201

6Gr

ades

9-1

2M

indf

ul Y

oga

(Min

dful

ness

/Yog

a in

terv

entio

ns)

At p

ost-

test

, stu

dent

s in

the

yoga

con

ditio

n, a

s co

mpa

red

to c

ontr

ol st

uden

ts, e

xhib

ited

tren

ds to

war

d de

crea

sed

alco

hol u

se a

nd im

prov

ed te

ache

r-ra

ted

soci

al s

kills

(p <

.10)

; and

sho

wed

a n

on-s

igni

fican

t in

crea

se in

aro

usal

in re

spon

se to

rele

vant

stim

uli

as m

easu

red

in s

kin

cond

ucta

nce.

Sig

nific

ant e

ffect

s w

ere

not f

ound

on

hypo

thes

ized

prox

imal

mea

sure

s of

sel

f-reg

ulat

ion,

moo

d, m

indf

ulne

ss, o

r inv

olun

tary

en

gage

men

t cop

ing.

Nog

gle,

201

2Gr

ades

11

to 1

2Ki

rpal

u Yo

ga (M

indf

ulne

ss/Y

oga

inte

rven

tions

)Al

thou

gh P

E-as

-usu

al st

uden

ts sh

owed

dec

reas

es

in p

rimar

y ou

tcom

es, y

oga

stud

ents

mai

ntai

ned

or im

prov

ed. T

otal

moo

d di

stur

banc

e im

prov

ed in

yo

ga st

uden

ts a

nd w

orse

ned

in c

ontr

ols (

p =

.015

), as

did

Pro

file

of M

ood

Stat

es-S

hort

For

m (P

OM

S-SF

) Te

nsio

n-An

xiet

y su

bsca

le (p

= .0

02).

Alth

ough

pos

itive

aff

ect r

emai

ned

unch

ange

d in

bot

h, n

egati

ve a

ffect

sig

nific

antly

wor

sene

d in

con

trol

s whi

le im

prov

ing

in

yoga

stud

ents

(p =

.006

). Se

cond

ary

outc

omes

wer

e no

t sig

nific

ant.

Stud

ents

rate

d yo

ga fa

irly

high

, des

pite

m

oder

ate

atten

danc

e.

Cecc

hini

, 200

7St

uden

ts fr

om 3

pub

lic sc

hool

s (m

ean

age

of 1

3.6

year

s)Pe

rson

al &

Soc

ial R

espo

nsib

ility

mod

el (E

xerc

ise-

base

d in

terv

entio

ns)

Find

ings

reve

aled

that

subs

eque

nt to

the

inte

rven

tion

prog

ram

me,

exp

erim

enta

l gro

up A

impr

oved

per

sona

l fe

edba

ck, d

elay

ed g

ratifi

catio

n, se

lf-co

ntro

l, an

d pr

oces

s se

lf-re

gula

tion.

Exp

erim

enta

l gro

ups A

and

B sh

owed

an

impr

ovem

ent i

n in

dica

tors

of p

erso

nal a

nd so

cial

re

spon

sibili

ty re

gard

ing

enjo

ymen

t and

spor

tsm

ansh

ip

and

a de

crea

se in

var

iabl

es re

late

d to

the

driv

e to

win

, ro

ugh

play

, con

tact

foul

s, a

nd p

oor s

port

sman

ship

. No

signi

fican

t cha

nges

wer

e ob

serv

ed in

the

cont

rol g

roup

.

Costi

gan,

201

6Gr

ades

9 to

10

High

-inte

nsity

inte

rval

trai

ning

(HIIT

) (Ex

erci

se-

base

d in

terv

entio

ns)

Whi

le th

e re

sults

wer

e no

t sig

nific

ant,

ther

e w

as sm

all

chan

ge in

psy

chol

ogic

al w

ellb

eing

in th

e in

terv

entio

n gr

oup

com

pare

d to

con

trol

s.

Page 101: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

101

Rapid Evidence Review Appendix 5: Evidence Tables

23. P

enni

ngto

n A

, Wat

kins

M, B

agna

ll A

, et

al. 2

018,

Aug

. A S

yste

mat

ic R

evie

w o

f E

vid

ence

on

the

Imp

acts

of

Join

t D

ecis

ion-

mak

ing

on

Co

mm

unit

y W

ellb

eing

. Ava

ilab

le f

rom

htt

ps:

//w

hatw

ork

swel

lbei

ng.o

rg/p

rod

uct/

join

t-d

ecis

ion-

mak

ing

-ful

l-re

po

rt/.

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

NO

TES

All a

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

All

Date

rang

e: 1

980-

2016

# of

stud

ies i

nclu

ded

over

all:

29Li

mita

tions

incl

uded

thos

e co

mm

on in

evi

denc

e on

the

impa

cts o

f com

plex

soci

al d

eter

min

ants

of h

ealth

and

w

ellb

eing

. It i

s sur

prisi

ng th

at e

vide

nce

on th

e im

pact

s of

inte

rven

tions

that

seek

to m

eani

ngfu

lly in

volv

e co

m-

mun

ities

in d

ecisi

on-m

akin

g is

still

limite

d ne

arly

50

year

s afte

r pub

licati

on o

f the

Lad

der o

f Citi

zen

Parti

ci-

patio

n (A

rnst

ein,

196

9). T

his r

evie

w c

an b

e us

ed a

s a

star

ting

poin

t for

und

erst

andi

ng a

nd a

ddre

ssin

g lim

ita-

tions

and

gap

s in

the

curr

ent e

vide

nce

base

.

Alth

ough

the

vast

maj

ority

of t

he in

clud

ed st

udie

s fo

cuse

d on

a so

cial

ly d

isad

vant

aged

gro

up o

r gro

ups,

ver

y fe

w o

f the

stud

ies a

ttem

pted

to e

xam

ine

the

dist

ributi

on o

f im

pact

s fro

m in

volv

emen

t in

com

mun

ity

deci

sion-

mak

ing

acro

ss d

iffer

ent s

ocio

econ

omic

, eth

nic,

or

oth

er p

oten

tially

disa

dvan

tage

d gr

oups

.

Incl

uded

des

igns

wer

e qu

alita

tive,

mix

ed m

etho

ds,

and

case

stud

ies.

Alm

ost a

ll w

ere

cros

s-se

ction

al.

Onl

y on

e st

udy

incl

udin

g ch

ildre

n an

d ad

oles

cent

s w

as q

uanti

tativ

e (n

ot th

e on

e re

porti

ng o

utco

mes

for

yout

h).

Onl

y on

e st

udy

repo

rted

pe

rson

al o

utco

mes

for

youn

g pe

ople

(age

not

pr

ovid

ed).

Age/

deve

lopm

enta

l gro

up in

clud

ed re

leva

nt to

H.S

. age

d te

ens a

ges 1

3-18

- sp

ecify

by

age

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up:

7 st

udie

s inc

lude

d pa

rtici

pant

s who

wer

e ch

ildre

n or

ad

oles

cent

s.

Data

base

s sea

rche

d:

MED

LIN

E an

d M

EDLI

NE

In-P

roce

ss &

Oth

er

Non

- Ind

exed

Cita

tions

, Soc

ial S

cien

ces C

ita-

tion

Inde

x, ID

OX, P

sycI

NFO

.

High

-leve

l find

ings

: Des

pite

lim

itatio

ns, …

the

avai

labl

e ev

iden

ce c

lear

ly d

emon

stra

tes t

hat

ther

e is

a w

ide

rang

e of

pot

entia

l ben

efits

from

co

mm

unity

invo

lvem

ent i

n de

cisio

n-m

akin

g, w

hich

in

clud

e be

nefit

s to

both

par

ticip

ants

and

thei

r w

ider

com

mun

ities

.

The

revi

ew fi

ndin

gs …

[lin

k] in

crea

sed

leve

ls of

‘co

llecti

ve c

ontr

ol’ t

o be

tter c

omm

unity

hea

lth a

nd

wel

lbei

ng.

The

incl

uded

stud

ies p

rovi

de e

vide

nce

that

join

t de

cisi

on-m

akin

g in

terv

entio

ns c

an b

e su

cces

sful

in

help

ing

to d

eflec

t thr

eats

to th

e lo

cal (

livin

g) e

nvi-

ronm

ent a

nd in

resi

sting

‘hol

low

ing

out’

of n

eigh

-bo

urho

od se

rvic

es a

nd fa

ciliti

es, i

n m

aint

aini

ng

and

enha

ncin

g lo

cal c

ondi

tions

, and

in a

ttra

cting

re

sour

ces t

o cr

eate

bett

er p

lace

s to

live.

15 o

f the

29

incl

uded

stud

ies p

rovi

ded

som

e ev

i-de

nce

of p

oten

tial a

dver

se im

pact

s for

thos

e pa

r-tic

ipati

ng. …

adve

rse

impa

cts w

ere

asso

ciat

ed w

ith

prob

lem

s in

join

t dec

ision

-mak

ing

inte

rven

tion

impl

emen

tatio

n pr

oces

ses.

The

re w

as n

o ev

iden

ce

that

the

parti

cipa

nts m

ade

‘poo

r’ d

ecisi

ons l

eadi

ng

to n

egati

ve e

ffect

s.

Inte

rven

tion(

s) T

ype/

Nam

e--O

vera

ll

Empo

wer

men

t-bas

ed jo

int d

ecisi

on-m

akin

g in

terv

entio

ns a

t th

e co

mm

unity

leve

l ((p

olic

ies,

pla

ns, p

rogr

amm

es, o

r pro

j-ec

ts) 10

defi

ned

usin

g a

Theo

ry o

f Cha

nge:

The

Com

mun

ity

Wel

lbei

ng E

vide

nce

Prog

ram

me

cons

ortiu

m h

as p

rodu

ced

a w

orki

ng T

heor

y of

Cha

nge

(Sou

th e

t al.,

201

7), i

n w

hich

pow

er

is pr

opos

ed to

hav

e a

mec

hani

stic

and

cycl

ical

rela

tions

hip

with

com

mun

ity w

ellb

eing

. It i

s pro

pose

d th

at in

crea

sed

com

-m

unity

pow

er, e

xerc

ised

thro

ugh

mea

ning

ful p

artic

ipati

on in

de

cisio

n-m

akin

g an

d go

vern

ance

will

yie

ld im

prov

ed c

omm

u-ni

ty c

ondi

tions

and

indi

vidu

al b

enefi

ts, e

vent

ually

lead

ing

to

incr

ease

d co

mm

unity

(and

indi

vidu

al) w

ellb

eing

.

Inte

rven

tion

type

s ide

ntifie

d in

clud

ed: c

omm

unity

dev

elop

-m

ent;

urba

n re

new

al; p

artic

ipat

ory

budg

eting

; int

egra

ting

publ

ic se

rvic

es; c

itize

ns’ j

ury;

crim

e pr

even

tion;

pro

tect

and

en

hanc

e co

mm

unity

faci

lity;

nat

ural

disa

ster

reco

very

pla

n-ni

ng.

It is

the

first

syst

emati

c re

view

that

has

spec

ifica

lly e

xam

ined

th

e co

mm

unity

wel

lbei

ng- r

elat

ed im

pact

s of e

mpo

wer

men

t-ba

sed

parti

cipa

tory

inte

rven

tions

con

siste

nt w

ith A

rnst

ein’

s ‘d

egre

es o

f citi

zen

pow

er’.

All o

f the

inte

rven

tions

wer

e de

signe

d w

ith th

e in

tenti

on o

f em

pow

erin

g co

mm

unity

mem

-be

rs to

take

gre

ater

con

trol

of d

ecisi

ons t

hat a

ffect

thei

r liv

es,

alth

ough

som

e fe

ll sh

ort o

f thi

s int

entio

n du

ring

deliv

ery.

Revi

ew in

clus

ion

crite

ria

This

revi

ew fo

cuss

es sp

ecifi

cally

on

curr

ent

evid

ence

from

eva

luati

ons o

f int

erve

ntion

s th

at a

re e

mpo

wer

men

t-bas

ed…

It o

nly

incl

udes

evi

denc

e fr

om e

valu

ation

s of i

nter

-ve

ntion

s …th

at c

onsid

ered

wel

lbei

ng-r

elat

-ed

out

com

es (q

ualit

ative

, or q

uanti

tativ

e). I

t on

ly in

clud

es e

vide

nce

from

eva

luati

ons o

f in

terv

entio

ns se

t in

the

‘livi

ng e

nviro

nmen

t’ of

com

mun

ities

13-1

8-ye

ar-o

ld (o

r sim

ilar)

Tee

n sp

ecifi

c fin

ding

s:

(or s

ee T

een

Tabl

e be

low

)

Enha

nced

per

sona

l dev

elop

men

t of y

outh

pa

rtici

pant

s (em

otion

al, s

ocia

l, co

nfide

nce,

fr

iend

ship

, org

aniza

tiona

l and

fina

ncia

l ski

lls)

(Bla

nche

t-Coh

en, 2

014)

No

othe

r you

th o

utco

mes

repo

rted

in re

view

.

Page 102: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

102

Rapid Evidence Review Appendix 5: Evidence Tables

Inte

rven

tion(

s) T

ype/

Nam

e--e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r eq

uiva

lent

(spe

cify

) –

Yout

h-le

d de

cisio

n-m

akin

g in

com

mun

ity d

evel

opm

ent g

rant

s (B

lanc

het-C

ohen

, 201

4); u

rban

rene

wal

(ODP

M, 2

005)

; urb

an

rene

wal

/gar

deni

ng in

gre

en sp

ace

(Por

ter,

2013

); ur

ban

rene

wal

/red

esig

ning

a n

eigh

borh

ood

park

(Patt

on-L

opez

, 20

15);

com

mun

ity-in

itiat

ed u

rban

dev

elop

men

t (Se

men

za,

2007

).

Revi

ew e

xclu

sion

crit

eria

Evi

denc

e fr

om

heal

thca

re, e

duca

tion,

or w

orkp

lace

se

tting

s, w

hich

hav

e be

en c

over

ed q

uite

ex

tens

ivel

y in

oth

er li

tera

ture

. .. T

radi

tiona

l he

alth

pro

moti

on in

terv

entio

ns (e

.g. t

o ad

dres

s phy

sical

exe

rcise

, sm

okin

g, a

lcoh

ol

cons

umpti

on, d

rug

misu

se) i

nvol

ving

pub

lic

parti

cipa

tion

have

also

bee

n ex

tens

ivel

y re

sear

ched

and

revi

ewed

pre

viou

sly.

Out

com

es e

xam

ined

ove

rall

--inc

lude

all

but h

ighl

ight

PSW

EB

outc

omes

Va

rious

mea

sure

s of c

omm

unity

wel

lbei

ng, d

efine

d as

: ‘Co

mm

unity

wel

lbei

ng is

abo

ut st

rong

net

wor

ks o

f re

latio

nshi

ps a

nd su

ppor

t bet

wee

n pe

ople

in a

com

mun

ity,

both

in c

lose

rela

tions

hips

and

frie

ndsh

ips,

and

betw

een

neig

hbou

rs a

nd a

cqua

inta

nces

’ … In

add

ition

, con

cept

s rel

ated

to

com

mun

ity w

ellb

eing

such

as ‘

soci

al w

ellb

eing

’, ‘so

cial

ca

pita

l’, ‘s

ocia

l coh

esio

n’, ‘

soci

al in

clus

ion’

, and

‘com

mun

ity

resil

ienc

e’ w

ere

also

con

sider

ed…

Whe

n [P

enni

ngto

n et

al.]

re

fer t

o ‘co

mm

unity

wel

lbei

ng’ t

hrou

ghou

t thi

s doc

umen

t, th

is in

clud

es th

e w

ellb

eing

of i

ndiv

idua

ls an

d gr

oups

, and

de

term

inan

ts o

f the

ir w

ellb

eing

, as c

ompo

nent

s of c

omm

unity

w

ellb

eing

. How

ever

, the

repo

rt n

otes

that

com

mun

ity

wel

lbei

ng is

mor

e th

an th

e su

m o

f ind

ivid

uals’

wel

lbei

ng.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

)

Stan

dard

syst

emati

c re

view

met

hodo

logy

, as

des

crib

ed in

the

WW

C- W

B M

etho

ds

Guid

e (S

nape

et a

l., 2

017)

, and

is re

port

ed

follo

win

g PR

ISM

A an

d PR

ISM

A-Eq

uity

gu

idel

ines

.

Sear

ches

of g

rey

liter

atur

e w

ere

cond

ucte

d vi

a th

e Co

nfer

ence

Pro

ceed

ings

Cita

tions

In

dex

(CPC

I), P

roQ

uest

Diss

erta

tions

&

Thes

es, O

penG

rey,

Goog

le, G

oogl

e Sc

hola

r, an

d th

roug

h se

arch

es fo

r, an

d in

spec

tion

of,

spec

ialis

t web

sites

and

dat

abas

es.

A ca

ll fo

r evi

denc

e w

as is

sued

by

Wha

t W

orks

Wel

lbei

ng C

entr

e.

We

also

dire

ctly

con

tact

ed a

cade

mic

ex-

pert

s on

the

heal

th a

nd w

ellb

eing

impa

cts

of e

mpo

wer

men

t- ba

sed

inte

rven

tions

in

com

mun

ities

.

Out

com

es e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r equ

ival

ent—

incl

ude

all b

ut h

ighl

ight

PSE

WB.

En

hanc

ed p

erso

nal d

evel

opm

ent (

Blan

chet

-Coh

en, 2

014)

Out

com

es e

xam

ined

for s

ocia

l/bu

ilt/s

truc

tura

l env

ironm

ents

an

d/or

peo

ple

surr

ound

ing

13-1

8-ye

ar-o

lds (

glob

al/

cultu

ral,

natio

nal,

com

mun

ity, i

nter

pers

onal

leve

l)--S

peci

fy

outc

ome

and

for w

hom

it is

mea

sure

d. V

ario

us m

easu

res o

f co

mm

unity

wel

lbei

ng

Setti

ng(s

): co

mm

uniti

es e

ngag

ed in

join

t dec

ision

-mak

ing

Coun

try(

ies)

: OEC

D co

untr

ies (

UK,

USA

, Can

ada,

Ital

y Is

rael

)St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s)Le

vel (

e.g.

, glo

bal/

cultu

ral,

natio

nal,

com

mun

ity,

inte

rper

sona

l): c

omm

unity

Page 103: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

103

Rapid Evidence Review Appendix 5: Evidence Tables

24. P

unuk

ollu

M, M

arq

ues

M. U

se o

f M

ob

ile A

pp

s an

d T

echn

olo

gie

s in

Chi

ld a

nd A

do

lesc

ent

Men

tal H

ealt

h: A

Sys

tem

atic

Rev

iew

. Evi

den

ce-B

ased

Men

tal H

ealt

h [I

nter

net]

. 201

9 Ju

ly 2

9 [c

ited

201

9 A

ug 1

3]; e

Pub

ahe

ad o

f p

rint

. Ava

ilab

le f

rom

: htt

ps:

//eb

mh.

bm

j.co

m/c

ont

ent/

earl

y/20

19/0

7/29

/eb

men

tal-

2019

-300

093.

info

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

10

to 2

9-ye

ar o

lds.

Da

te ra

nge

for r

evie

w: 2

007-

2019

# of

stud

ies i

nclu

ded:

4

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: A

ges 1

0+ (J

ang

et a

l., 2

017)

, 13

-17

(Joha

nsso

n et

al.,

201

3), 1

4-24

(Kau

er e

t al.,

201

2),

stud

ents

age

d 13

-17

(Whi

ttake

r et a

l., 2

017)

.

Hi-L

evel

Fin

ding

s: D

iffer

ence

bet

wee

n th

e in

terv

entio

n gr

oups

and

the

cont

rol g

roup

s was

no

n-sig

nific

ant o

n pe

rcen

tage

of t

hose

who

repo

rted

th

e pr

ogra

m to

be

help

ful.

No

othe

r hig

h-le

vel

obse

rvati

ons w

ere

mad

e (fo

cus o

n in

divi

dual

stud

ies

due

to sm

all n

umbe

r of s

tudi

es in

clud

ed).

The

auth

or n

otes

that

, bec

ause

of t

he a

ge

of p

artic

ipan

ts, t

he fu

ll eff

ect o

f the

var

ious

in

terv

entio

ns m

ay h

ave

been

obs

cure

d by

the

natu

ral

cour

se o

f chi

ld d

evel

opm

ent a

s the

re is

gen

eral

ly a

st

eep

incr

ease

in d

epre

ssiv

e sy

mpt

oms t

hrou

ghou

t ad

oles

cenc

e.

The

auth

or a

ckno

wle

dges

that

a si

gnifi

cant

di

sadv

anta

ge o

f the

men

tal h

ealth

app

s and

te

chno

logi

es is

that

they

are

not

cur

rent

ly

com

mer

cial

ly a

vaila

ble

whi

ch m

eans

revi

ewer

s ca

nnot

ass

ess t

hem

for t

heir

qual

ity a

nd u

ser-

frie

ndlin

ess.

As n

oted

by

auth

or: O

nly

the

resu

lts o

f “fu

ll” st

udie

s ar

e in

clud

ed, w

hich

unf

ortu

nate

ly n

egle

cts p

oten

tially

av

aila

ble

liter

atur

e th

at w

ould

hav

e su

pple

men

ted

this

wor

k. T

he sm

all n

umbe

r of s

tudi

es a

nd sm

all s

ampl

e siz

es a

lso li

mits

the

pow

er o

f the

revi

ew, a

s doe

s the

va

ryin

g qu

ality

and

bia

s of t

he p

aper

s rev

iew

ed.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Da

taba

ses s

earc

hed

for r

evie

w:

MED

LIN

E, P

sycI

NFO

, EM

BASE

, Alli

ed

and

Com

plem

enta

ry M

edic

ine,

Hea

lth

Tech

nolo

gy A

sses

smen

t Gui

de, C

ochr

ane

Regi

ster

of C

ontr

olle

d Tr

ials.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

bel

ow)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (sp

ecify

): M

obile

app

self-

asse

ssm

ent o

f de

pres

sion

and

suic

ide

risk

(Jang

et a

l., 2

017)

, Aut

omat

ed

tele

phon

e ca

lls w

ith in

tera

ctive

voi

ce re

spon

se a

skin

g pa

rtici

pant

s to

eval

uate

cur

rent

moo

d (Jo

hans

son

et a

l., 2

013)

, M

obile

app

self-

repo

rt o

n m

ood,

stre

ss, d

aily

acti

vitie

s, a

nd

copi

ng st

rate

gies

, (Ka

uer e

t al.,

201

2), M

obile

pho

ne-b

ased

m

ultim

edia

mes

sage

s (CB

T-ba

sed

text

s, v

ideo

mes

sage

s,

cart

oons

) (W

hitta

ker e

t al.,

201

7).

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es w

ere

incl

uded

if

they

wer

e fr

eely

acc

essib

le R

CTs o

r cro

ss-

secti

onal

stud

ies o

n m

enta

l hea

lth a

pps o

r te

chno

logi

es w

hich

had

a p

rimar

y ou

tcom

e m

easu

re re

late

d to

men

tal h

ealth

or

wel

lbei

ng a

nd in

clud

ed st

udy

parti

cipa

nts

unde

r 18

year

s of a

ge.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Dep

ress

ion

scor

es, a

nxie

ty sc

ores

, sui

cide

. Re

view

exc

lusi

on c

riter

ia—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es w

ere

excl

uded

if th

ey

faile

d to

mee

t the

incl

usio

n cr

iteria

det

aile

d ab

ove.

Out

com

es e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es:

depr

essio

n sc

ores

, sui

cide

(Jan

g et

al.,

201

7), m

ood

(Joha

nsso

n et

al.,

201

3), e

moti

onal

self-

awar

enes

s, d

epre

ssiv

e sy

mpt

oms,

an

xiet

y, st

ress

, MH

outc

omes

(Kau

er e

t al.,

201

2), d

epre

ssio

n sc

ores

(Whi

ttake

r et a

l., 2

017)

.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18-

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): ge

nera

l pra

ctice

clin

ics,

hom

es, i

npati

ent s

etting

sCo

untr

y(ie

s):

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Indi

vidu

al

Page 104: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

104

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Jang

et a

l., 2

017

Ages

10+

Mob

ile a

pp se

lf-as

sess

men

t of d

epre

ssio

n an

d su

icid

e ris

kPo

sitive

self-

asse

ssm

ent s

core

s wer

e as

soci

ated

with

sig

nific

ant i

ncre

ased

risk

of d

epre

ssio

n an

d su

icid

e (a

nd

wer

e co

nsist

ent w

ith p

opul

ation

pro

porti

ons s

een

in

prev

ious

ly re

port

ed d

ata)

.

(App

ava

ilabl

e w

orld

wid

e bu

t onl

y in

Kor

ean

lang

uage

.) Hi

gh ri

sk o

f bia

s.

Joha

nsso

n et

al.,

201

313

-17

year

sAu

tom

ated

tele

phon

e ca

lls w

ith in

tera

ctive

voi

ce

resp

onse

ask

ing

parti

cipa

nts t

o ev

alua

te c

urre

nt

moo

d

IVR

is an

app

ropr

iate

follo

w-u

p m

etho

d fo

llow

ing

inpa

tient

psy

chia

tric

trea

tmen

t in

adol

esce

nts w

ith n

o di

ffere

nce

obse

rved

in m

ood

if fo

llow

ed u

p ev

ery

two

day

or e

very

four

day

s.

(Sam

ple

was

rece

nt

inpa

tient

s)

Kaue

r et a

l., 2

012

14-2

4 ye

ars

Mob

ile a

pp se

lf-re

port

on

moo

d, st

ress

, dai

ly

activ

ities

, and

cop

ing

stra

tegi

es.

Incr

ease

d em

otion

al se

lf-aw

aren

ess w

as p

redi

ctive

of

a d

ecre

ase

in d

epre

ssiv

e sy

mpt

oms;

how

ever

, the

in

terv

entio

n w

as n

ot c

ausa

lly re

spon

sible

itse

lf fo

r th

e de

crea

se in

dep

ress

ive

sym

ptom

s. In

terv

entio

n gr

oup

show

ed si

gnifi

cant

incr

ease

s in

ESA

with

m

ediu

m to

larg

e sig

nific

ant m

ain

effec

ts fo

r tim

e fo

r de

pres

sion,

anx

iety

, and

stre

ss. A

naly

sis su

gges

ted

that

pa

rtici

patio

n in

RCT

itse

lf en

hanc

ed m

enta

l hea

lthca

re

and

impr

oved

MH

outc

omes

.

(Sam

ple

was

pati

ents

, ap

p w

as u

sed

as a

clin

ical

as

sista

nce

tool

in g

ener

al

prac

tice)

Whi

ttake

r et a

l., 2

017

Stud

ents

age

d 13

-17

year

sM

obile

pho

ne-b

ased

mul

timed

ia m

essa

ges (

CBT-

base

d te

xts,

vid

eo m

essa

ges,

car

toon

s)N

o sig

nific

ant e

ffect

of C

BT-b

ased

pro

gram

ove

r con

trol

. Bo

th p

rogr

ams d

emon

stra

ted

smal

l im

prov

emen

ts in

de

pres

sion

scor

e im

med

iate

ly a

fter t

he in

terv

entio

n fo

llow

ed b

y a

wor

seni

ng o

f sco

res a

t 12-

mon

th fo

llow

-up

.

Page 105: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

105

Rapid Evidence Review Appendix 5: Evidence Tables

25. R

apo

sa E

B, R

hod

es J

, Sta

ms

GJJ

M, C

ard

N, B

urto

n S

, Sch

war

tz S

, et

al. T

he E

ffec

ts o

f Yo

uth

Men

tori

ng P

rog

ram

s: A

Met

a-A

naly

sis

of

Out

com

e S

tud

ies.

Jo

urna

l of

Yout

h an

d A

do

lesc

ence

[I

nter

net]

. 201

9 Ja

n 19

[ci

ted

201

9 A

ug 2

0]; 4

8:42

3-44

3. A

vaila

ble

fro

m: h

ttp

s://

link.

spri

nger

.co

m/a

rtic

le/1

0.10

07%

2Fs1

0964

-019

-009

82-8

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

You

th a

ges 9

-16

Date

rang

e fo

r rev

iew

: 197

5-20

17#

of st

udie

s inc

lude

d: 7

0As

not

ed b

y au

thor

: The

re w

as s

ubst

antia

l he

tero

gene

ity b

oth

acro

ss st

udie

s in

clud

ed in

this

set

of

ana

lyse

s, a

s w

ell a

s be

twee

n eff

ect s

izes

extr

acte

d fr

om th

e sa

me

stud

y. M

ultip

le m

oder

ator

s w

ere

test

ed to

att

empt

to a

ccou

nt fo

r thi

s he

tero

gene

ity

in th

e cu

rren

t sam

ple

of st

udie

s; h

owev

er, f

urth

er

rese

arch

is n

eede

d to

mor

e pr

ecis

ely

dete

rmin

e w

hich

pro

gram

pra

ctice

s ar

e m

ost e

ffecti

ve fo

r whi

ch

popu

latio

ns o

f men

tors

and

you

th, a

nd fo

r whi

ch

parti

cula

r you

th o

utco

mes

.Al

thou

gh th

e pr

esen

t ana

lyse

s sh

owed

no

evid

ence

of

pub

licati

on b

ias,

it is

impo

rtan

t to

ackn

owle

dge

that

stud

ies

that

do

not s

uppo

rt th

e eff

ectiv

enes

s of

m

ento

ring

prog

ram

s m

ight

be

less

like

ly to

app

ear

in p

eer-

revi

ewed

jour

nals

, dis

sert

ation

s, o

r res

earc

h re

port

s, th

ereb

y in

fluen

cing

inte

rpre

tatio

n of

resu

lts.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: y

outh

age

s 9-1

6 (m

ean

age

12)

Data

base

s sea

rche

d fo

r rev

iew

: Psy

cIN

FO,

ERIC

, and

Pro

Que

st.

Hi-L

evel

Fin

ding

s: A

naly

ses

of th

e da

ta fr

om 7

0 st

udie

s of

you

th m

ento

ring

prog

ram

s re

veal

ed th

at

the

mea

n eff

ect o

f men

torin

g on

you

th o

utco

mes

w

as g

=.21

. Alth

ough

this

effe

ct is

con

side

red

smal

l by

Cohe

n’s

guid

elin

es, i

t fal

ls w

ell w

ithin

the

med

ium

/mod

erat

e ra

nge

of e

mpi

rical

gui

delin

es

for t

he a

vera

ge e

ffect

size

s of

uni

vers

al y

outh

pr

even

tion

prog

ram

s (T

anne

r-Sm

ith e

t al.

2018

). At

the

sam

e tim

e, h

owev

er, m

any

yout

h w

ho

are

refe

rred

to m

ento

ring

prog

ram

s ar

e al

read

y ex

perie

ncin

g su

b-cl

inic

al le

vels

of d

ifficu

lties

an

d sy

mpt

oms,

and

thus

pre

sent

gre

ater

room

fo

r im

prov

emen

t on

outc

ome

asse

ssm

ents

than

yo

uth

in p

rimar

y pr

even

tion

prog

ram

s (J

arjo

ura

et

al. 2

018)

. As

such

, com

paris

ons

with

the

som

ewha

t la

rger

effe

cts

repo

rted

in in

dica

ted

(sec

onda

ry)

prev

entio

n pr

ogra

ms

may

als

o be

war

rant

ed

(Dur

lak

and

Wel

ls 1

998;

Tan

ner-

Smith

et a

l. 20

18).

The

effec

t size

obs

erve

d in

thes

e an

alys

es is

re

mar

kabl

y co

nsist

ent w

ith p

ast c

ompr

ehen

sive

m

eta-

anal

yses

of y

outh

men

torin

g, w

hich

hav

e sh

own

over

all e

ffect

size

s ra

ngin

g fr

om .1

8 to

.21

(DuB

ois

et a

l. 20

02; 2

011)

.It

is im

port

ant t

o no

te th

at e

ven

smal

l to

mod

erat

e im

prov

emen

ts in

asp

ects

of y

outh

func

tioni

ng li

ke

subs

tanc

e us

e, d

epre

ssiv

e sy

mpt

oms,

and

aca

dem

ic

enga

gem

ent c

an h

ave

an im

port

ant i

nflue

nce

on tr

ajec

torie

s of

pos

itive

you

th d

evel

opm

ent,

espe

cial

ly w

hen

thes

e im

prov

emen

ts o

ccur

dur

ing

criti

cal p

erio

ds o

f dev

elop

men

t (Ta

nner

-Sm

ith e

t al

. 201

8).

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Men

torin

g pr

ogra

m:

Inte

rgen

erati

onal

, one

-on-

one.

Men

torin

g is

defin

ed a

s a

non-

pare

ntal

adu

lt or

old

er y

outh

acti

ng in

a n

on-p

rofe

ssio

nal

help

ing

capa

city

with

a sp

ecifi

c yo

unge

r per

son

to p

rom

ote

positi

ve y

outh

out

com

es th

roug

h th

e re

latio

nshi

p.

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es m

ust 1

) inc

lude

a

form

al m

ento

ring

prog

ram

in li

ne w

ith th

e pr

ovid

ed d

efini

tion

for m

ento

ring,

2) i

nclu

de

an e

valu

ation

with

a c

ompa

rison

gro

up

(incl

udin

g RC

Ts a

nd/o

r qua

si-ex

perim

enta

l st

udie

s)

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

abo

ve)

No

signi

fican

t diff

eren

ce b

y ag

e of

men

tee.

Page 106: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

106

Rapid Evidence Review Appendix 5: Evidence Tables

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

(see

abo

ve)

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Stu

dies

that

invo

lved

m

ento

ring

prog

ram

s tha

t had

rela

tions

hips

th

at w

ere

mor

e pr

ofes

siona

l in

natu

re (e

.g.,

tuto

ring,

coa

chin

g) w

ere

excl

uded

from

th

e m

eta-

anal

ysis.

Stu

dies

wer

e ex

clud

ed

durin

g th

e se

cond

roun

d of

scre

enin

g if

they

1)

invo

lved

sim

ilar-a

ge p

eer m

ento

ring,

2)

incl

uded

onl

y gr

oup

men

torin

g, 3

) inv

olve

d ad

ult m

ente

es o

lder

than

18

year

s of a

ge,

4) h

ad in

suffi

cien

t tre

atm

ent v

ersu

s con

trol

gr

oup

diffe

renti

ation

, 5) u

tilize

d ad

junc

tive

men

torin

g (i.

e., e

valu

ation

s in

whi

ch

men

torin

g w

as n

ot o

ne o

f the

prim

ary

or se

cond

ary

com

pone

nts)

, 6) i

nvol

ved

outc

ome

that

faile

d to

fall

into

one

of t

he

follo

win

g br

oad

cate

gorie

s: p

sych

olog

ical

, so

cial

, sch

ool,

heal

th, o

r cog

nitiv

e, a

nd 7

) la

cked

suffi

cien

t inf

orm

ation

to c

ompu

te

an e

ffect

size

and

the

auth

or c

ould

not

be

reac

hed

to su

pply

the

data

or d

id

not r

espo

nd to

requ

ests

for a

dditi

onal

in

form

ation

with

in a

spec

ified

tim

efra

me.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Bro

adly

cod

ed in

to 5

cat

egor

ies:

Psy

chol

ogic

al,

Soci

al, C

ogni

tive,

Hea

lth, o

r Sch

ool

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: S

choo

l: Ac

adem

ic fu

nctio

ning

(e.g

., GP

A, g

radu

ation

rate

, ach

ieve

men

t te

st sc

ores

), ex

trac

urric

ular

eng

agem

ent (

e.g.

, inv

olve

men

t in

com

mun

ity se

rvic

e, sp

orts

acti

vitie

s); P

sych

olog

ical

: ex

tern

aliz

ing

sym

ptom

s (e.

g., a

ggre

ssio

n, d

elin

quen

cy,

bully

ing)

, int

erna

lizin

g sy

mpt

oms (

e.g.

, dep

ress

ion,

anx

iety

), se

lf-re

gula

tion

prob

lem

s (e.

g., a

tten

tiona

l diffi

culti

es,

hype

racti

vity

, sel

f-con

trol

pro

blem

s), o

ther

men

tal h

ealth

(e

.g.,

use

of p

sych

olog

ical

serv

ices

or m

edic

ation

); He

alth

: su

bsta

nce

use,

phy

sical

hea

lth (e

.g.,

exer

cise

, eati

ng

beha

vior

, sex

ual b

ehav

ior)

, wel

l-bei

ng (e

.g.,

qual

ity o

f life

, life

sa

tisfa

ction

); Co

gniti

on: E

xecu

tive

func

tioni

ng (e

.g.,

plan

ning

an

d pr

ioriti

zing,

goa

l orie

ntati

on, w

orki

ng m

emor

y), s

elf-

cogn

ition

(e.g

., pe

rcei

ved

self-

effica

cy, g

row

th m

inds

et, g

rit);

Scho

ol: s

choo

l eng

agem

ent (

e.g.

, sch

ool c

onne

cted

ness

, att

enda

nce,

scho

ol li

king

); So

cial

: soc

ial s

kills

(e.g

., co

oper

ation

, em

path

y, tu

rn-ta

king

), pe

rcei

ved

soci

al su

ppor

t, re

latio

nshi

p qu

ality

(e.g

., pe

rcep

tions

of r

elati

onsh

ip q

ualit

y w

ith te

ache

rs, p

aren

ts, p

eers

)

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18-

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

Setti

ng(s

): co

mm

unity

and

scho

olCo

untr

y(ie

s): U

.S.

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

scho

ol, c

omm

unity

Page 107: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

107

Rapid Evidence Review Appendix 5: Evidence Tables

26. R

od

rig

uez-

Ayl

lon

M, C

aden

as-S

anch

ez C

, Est

evez

-Lo

pez

F, M

uno

z N

E, M

ora

-Go

nzal

ez J

, Mig

uele

s JH

, et

al. R

ole

of

Phy

sica

l Act

ivit

y an

d S

eden

tary

Beh

avio

r in

the

Men

tal H

ealt

h o

f P

resc

hoo

lers

, Chi

ldre

n, a

nd A

do

lesc

ents

: A S

yste

mat

ic R

evie

w a

nd M

eta-

Ana

lysi

s. S

po

rts

Med

icin

e [I

nter

net]

. 201

9 A

pr

16 [

cite

d 2

019

July

26]

; (E

pub

ahe

ad o

f p

rint

). A

vaila

ble

fro

m: h

ttp

s://

ww

w.

ncb

i.nlm

.nih

.go

v/p

ubm

ed/3

0993

59FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

pre

scho

oler

s (2-

5 ye

ars o

f age

), ch

ildre

n (6

-11

year

s of a

ge),

and

adol

esce

nts

(12-

18 y

ears

of a

ge).

Date

rang

e fo

r rev

iew

: Jan

201

3 –

Apr 2

018

# of

stud

ies i

nclu

ded:

114

(12

in m

eta-

anal

ysis)

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: A

dole

scen

ts a

ged

12-1

8 ye

ars

Hi-L

evel

Fin

ding

s: S

mal

l pos

itive

effe

ct o

f ex

erci

se in

terv

entio

ns o

n m

enta

l hea

lth o

utco

me

in a

dole

scen

ts, p

hysic

al a

ctivi

ty w

as in

vers

ely

asso

ciat

ed w

ith p

sych

olog

ical

ill-b

eing

and

pos

itive

ly

asso

ciat

ed w

ith p

sych

olog

ical

wel

l-bei

ng, a

nd th

ere

was

pos

itive

ass

ocia

tion

betw

een

sede

ntar

y be

havi

or

and

depr

essio

n an

d an

inve

rse

asso

ciati

on b

etw

een

sede

ntar

y be

havi

or a

nd sa

tisfa

ction

with

life

and

ha

ppin

ess i

n ch

ildre

n an

d ad

oles

cent

s.

As n

oted

by

auth

or: e

xpan

ding

sear

ch to

mor

e da

taba

ses

may

hav

e pr

oduc

ed m

ore

data

for t

he a

naly

sis. B

ecau

se

of th

e he

tero

gene

ity o

f the

out

com

e m

easu

res,

it

was

not

pos

sible

to c

ondu

ct a

met

a-an

alys

is of

the

pros

pecti

ve lo

ngitu

dina

l stu

dies

.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Phy

sical

acti

vity

and

se

dent

ary

beha

vior

inte

rven

tions

. Da

taba

ses s

earc

hed

for r

evie

w: P

ubM

ed,

Web

of S

cien

ceAd

oles

cent

-Spe

cific

Fin

ding

s: (s

ee ta

ble)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

Yoga

(Tel

les e

t al.,

201

3; D

as e

t al.,

20

16; C

ox e

t al.,

201

7), a

erob

ic e

xerc

ise (H

asan

pour

et a

l.,

2014

; Pen

g et

al.,

201

5), a

erob

ic e

xerc

ise, r

esist

ance

exe

rcise

, or

com

bine

d ex

erci

se (G

oldfi

eld

et a

l., 2

015)

, hig

h-in

tens

ity

inte

rval

trai

ning

(Cos

tigan

et a

l., 2

016)

, Che

n-st

yle

Tai C

hi (L

ee

et a

l., 2

013)

, acti

ve v

ideo

-gam

e pr

ogra

m (S

taia

no e

t al.,

201

3),

Tai C

hi (B

ao e

t al.,

201

5), C

ross

Fit (

Eath

er e

t al.,

201

6).

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es m

ust b

e in

terv

entio

n st

udie

s (RC

Ts a

nd n

on-R

CTs)

and

pro

spec

tive

long

itudi

nal a

nd c

ross

-sec

tiona

l stu

dies

fo

cuse

d on

phy

sical

acti

vity

, sed

enta

ry

beha

vior

and

men

tal h

ealth

; mus

t be

publ

ished

in e

ither

Eng

lish

or S

pani

sh; s

tudy

m

ust i

nclu

de e

ither

pre

scho

oler

s, c

hild

ren,

an

d/or

ado

lesc

ents

; and

mus

t add

ress

the

asso

ciati

on b

etw

een

phys

ical

acti

vity

and

/or

sede

ntar

y be

havi

or a

nd a

t lea

st o

ne

psyc

holo

gica

l ill-

bein

g m

easu

re a

nd/o

r ps

ycho

logi

cal w

ell-b

eing

mea

sure

.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: M

easu

res o

f psy

chol

ogic

al w

ell-b

eing

(e.g

., se

lf-es

teem

, se

lf-im

age,

hap

pine

ss, p

ositi

ve a

ffect

) and

mea

sure

s of

psyc

holo

gica

l ill-

bein

g (e

.g.,

depr

essio

n sy

mpt

oms,

stre

ss,

anxi

ety

sym

ptom

s),

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Gre

y lit

erat

ure

and

conf

eren

ce p

roce

edin

gs w

ere

not i

nclu

ded.

St

udie

s inc

ludi

ng in

divi

dual

s with

phy

sical

or

psy

chol

ogic

al d

isord

ers d

iagn

osed

by

med

ical

reco

rds w

ere

excl

uded

. Stu

dies

in

volv

ing

elite

ath

lete

s, a

s wel

l as t

hose

in

volv

ing

anim

als w

ere

excl

uded

. Mul

tiple

he

alth

beh

avio

r int

erve

ntion

s wer

e al

so

excl

uded

.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: B

attle

’s Se

lf-Es

teem

Inve

ntor

y (T

elle

s et a

l., 2

013)

, Coo

pers

mith

Sel

f-Es

teem

Inve

ntor

y (H

asan

pour

et a

l., 2

014)

, Bru

nel M

ood

Scal

e,

Mul

tiple

Bod

y Se

lf-Re

latio

ns Q

uesti

onna

ire, P

hysic

al S

elf-

Perc

eptio

ns Q

uesti

onna

ire (G

oldfi

eld

et a

l., 2

015)

, Flo

urish

ing,

Ke

ssle

r Psy

chol

ogic

al D

istre

ss, P

hysic

al S

elf-D

escr

iptio

n, O

ne-

item

Fee

lings

Sta

te (C

ostig

an e

t al.,

201

6), P

erce

ived

Str

ess

Scal

e (L

ee e

t al.,

201

3), R

osen

berg

Sel

f-Est

eem

Sca

le (S

taia

no

et a

l., 2

013)

, “I a

m”

stat

emen

t que

stion

naire

(Bao

et a

l., 2

015)

, M

enta

l Hea

lth S

cale

by

Wan

g (P

eng

et a

l., 2

015)

, Sel

f-Effi

cacy

Sc

ale

for C

hild

ren

(Das

et a

l., 2

016)

, Str

engt

h an

d Di

fficu

lties

Q

uesti

onna

ire, P

hysic

al S

elf-D

escr

iptio

n Q

uesti

onna

ire (E

athe

r et

al.,

201

6), O

bjec

tified

Bod

y Co

nsci

ousn

ess S

cale

, Phy

sical

Se

lf-De

scrip

tion

Que

stion

naire

, The

Bod

y Ap

prec

iatio

n Sc

ale

(Cox

et a

l., 2

017)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Page 108: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

108

Rapid Evidence Review Appendix 5: Evidence Tables

Setti

ng(s

): no

t rep

orte

dCo

untr

y(ie

s): M

ostly

OEC

D co

untr

ies,

but

Indi

a, Ir

an,C

hina

, Ko

rea,

wer

e al

so si

tes f

or st

udie

s.

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Indi

vidu

al

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Telle

s et a

l., 2

013

8-13

yea

rsYo

ga v

s phy

sical

exe

rcise

s (45

min

utes

5 d

ays a

wee

k)Th

ere

was

onl

y on

e sig

nific

ant d

iffer

ence

bet

wee

n th

e gr

oups

in so

cial

self-

este

em th

at w

as h

ighe

r in

the

exer

cise

gro

up, a

ll ot

her d

iffer

ence

s wer

e no

t sig

nific

ant.

Hasa

npou

r et a

l., 2

014

13-1

9 ye

ars

60-8

0% m

ax h

eart

rate

acti

vity

vs c

ontr

ol 6

0 m

inut

es

3 da

ys a

wee

kA

signi

fican

t diff

eren

ce b

etw

een

grou

ps w

as o

btai

ned

in p

ost s

elf-e

stee

m sc

ores

(p=0

.001

). O

ne m

onth

afte

r in

terv

entio

n, re

sults

show

ed th

at d

espi

te th

e am

ount

of

tim

e el

apse

d, th

e eff

ects

of a

erob

ic e

xerc

ise sti

ll pe

rsist

ed (p

=0.0

02)

100%

fem

ale

sam

ple.

Gold

field

et a

l., 2

015

14-1

8 ye

ars

Aero

bic

exer

cise

vs c

ontr

ol, r

esist

ance

exe

rcise

vs

cont

rol,

com

bine

d ex

erci

se v

s con

trol

(45

min

utes

3

days

a w

eek)

All g

roup

s (in

clud

ing

cont

rol)

impr

oved

on

body

imag

e.

Onl

y th

e re

sista

nce

grou

p sh

owed

a si

gnifi

cant

redu

ction

in

dep

ress

ive

sym

ptom

s (p=

0.02

). Th

e re

sista

nce

grou

p sh

owed

gre

ater

incr

ease

s tha

n co

ntro

l on

glob

al se

lf-es

teem

but

all

grou

ps (e

xclu

ding

the

cont

rol g

roup

) im

prov

ed o

n vi

gor a

nd g

loba

l sel

f-est

eem

.

Costi

gan

et a

l., 2

016

14-1

6 ye

ars

High

-inte

nsity

inte

rval

trai

ning

with

aer

obic

vs

cont

rol a

nd c

ombi

ned

vs c

ontr

ol (8

-10

min

utes

3

days

a w

eek)

Resu

lts w

ere

not s

igni

fican

t but

a sm

all i

mpr

ovem

ent

in p

sych

olog

ical

wel

l-bei

ng w

as o

bser

ved

in th

e ae

robi

c ex

erci

se g

roup

. Sm

all i

mpr

ovem

ents

in p

sych

olog

ical

w

ell-b

eing

and

per

ceiv

ed a

ppea

ranc

e w

ere

obse

rved

in

the

com

bine

d gr

oup.

Fee

lings

impr

oved

in b

oth

grou

ps

but w

ere

signi

fican

t onl

y in

the

aero

bic

grou

p (p

=0.0

01).

Lee

et a

l., 2

013

11-1

6 ye

ars

Chen

-sty

le T

ai C

hi v

s con

trol

(80

min

utes

1 d

ay a

w

eek)

No

signi

fican

t diff

eren

ce w

as n

oted

in c

hang

es in

stre

ss

leve

ls be

fore

and

afte

r the

inte

rven

tion

betw

een

the

two

grou

ps.

Stai

ano

et a

l., 2

013

15-1

9 ye

ars

Activ

e vi

deo-

gam

e pr

ogra

m (c

ompe

titive

vs c

ontr

ol

and

coop

erati

ve v

s con

trol

) 30-

60 m

inut

es 3

day

s a

wee

k

The

grow

th c

urve

ana

lysis

of s

elf-e

stee

m c

hang

e yi

elde

d no

con

ditio

n eff

ects

. The

re w

ere

no si

gnifi

cant

cha

nges

in

self-

este

em in

any

gro

up.

Bao

et a

l., 2

015

13-1

6 ye

ars

Tai C

hi v

s gym

nasti

cs 6

0 m

inut

es 5

day

s a w

eek

Sign

ifica

nt re

ducti

on o

f anx

iety

in th

e ex

perim

enta

l gr

oup

com

pare

d w

ith th

e co

ntro

l gro

up w

as o

bser

ved.

N

o sig

nific

ant d

iffer

ence

s, in

rela

tion

to p

hysic

al

appe

aran

ce a

nd h

appi

ness

, bet

wee

n th

e Ta

i Chi

and

co

ntro

l gro

ups w

ere

foun

d.

Peng

et a

l., 2

015

14-1

9 ye

ars

Exer

cise

vs c

ontr

ol (5

0-80

% m

ax h

eart

rate

) 80

min

utes

2 d

ays a

wee

kTh

e in

terv

entio

n gr

oup

was

supe

rior t

o th

e co

ntro

l gr

oup

in te

rms o

f anx

iety

, dep

ress

ion,

em

otion

al

imba

lanc

e, a

nd p

sych

olog

ical

bal

ance

. The

diff

eren

ce

was

stati

stica

lly si

gnifi

cant

(p<0

.05)

.

Das e

t al.,

201

611

-16

year

sYo

ga v

s con

trol

60-

120

min

utes

eve

ry w

eekd

ayYo

ga g

roup

show

ed a

sign

ifica

nt in

crea

se in

aca

dem

ic

self-

effica

cy (p

<0.0

01),

soci

al se

lf-effi

cacy

(p<0

.001

), an

d em

otion

al se

lf-effi

cacy

(p<0

.001

), w

here

as th

ere

was

no

signi

fican

t cha

nges

in th

e sc

ores

of t

he c

ontr

ol g

roup

.

Eath

er e

t al.,

201

615

.4 y

ears

Cros

sFit

vs c

ontr

ol 6

0 m

inut

es 2

day

s a w

eek

Ther

e w

ere

no si

gnifi

cant

inte

rven

tion

effec

ts o

n m

enta

l he

alth

or p

oten

tial m

edia

tors

in th

e fu

ll st

udy

sam

ple.

In

terv

entio

n pa

rtici

pant

s cat

egor

ized

as ‘a

t risk

’ of

inte

rnal

izing

pro

blem

s dem

onst

rate

d im

prov

emen

ts in

se

lf-es

teem

, per

ceiv

ed b

ody

fat,

perc

eive

d ap

pear

ance

, ph

ysic

al se

lf-co

ncep

t, an

d to

tal d

ifficu

lties

scor

e. A

m

ediu

m-la

rge

positi

ve e

ffect

on

perc

eive

d bo

dy fa

t was

al

so o

bser

ved

in b

oys.

Cox

et a

l., 2

017

13-1

7 ye

ars

Yoga

vs c

ontr

ol 6

0 m

inut

es 2

day

s a w

eek

Resu

lts sh

owed

sign

ifica

nt (p

=0.0

04),

mod

erat

e de

crea

ses i

n tr

ait b

ody

surv

eilla

nce

and

min

imal

, non

-sig

nific

ant i

ncre

ases

in p

hysic

al se

lf-w

orth

. Cha

nge

in

trai

t bod

y su

rvei

llanc

e w

as in

vers

ely

rela

ted

to c

hang

e in

phy

sical

self-

wor

th a

nd b

ody

appr

ecia

tion

in y

oga

parti

cipa

nts.

Page 109: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

109

Rapid Evidence Review Appendix 5: Evidence Tables

27. S

aler

no J

P. E

ffec

tive

ness

of

Uni

vers

al S

cho

ol-

Bas

ed M

enta

l Hea

lth

Aw

aren

ess

Pro

gra

ms

Am

ong

Yo

uth

in t

he U

nite

d S

tate

s: A

Sys

tem

atic

Rev

iew

. Jo

urna

l of

Sch

oo

l Hea

lth

[Int

erne

t]. 2

016

Dec

[c

ited

201

9 Ju

ly 2

6]; 8

6(12

):922

-931

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

7866

385

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

Sc

hool

chi

ldre

n in

gra

des 5

to 1

2 Da

te ra

nge

for r

evie

w: 1

988-

2016

# of

stud

ies i

nclu

ded:

15

As n

oted

by

auth

or: O

nly

a sin

gle

indi

vidu

al c

ondu

cted

th

e sy

stem

atic

liter

atur

e se

arch

. M

any

stud

ies c

ondu

cted

in sc

hool

s are

usin

g st

udy

desig

ns th

at la

ck st

reng

th in

est

ablis

hing

true

cau

se-

effec

t rel

ation

ship

s.Fo

r exa

mpl

e:O

nly

3 st

udie

s use

d ra

ndom

ized

cont

rolle

d or

Sol

omon

4-

grou

ps st

udy

desig

ns.

Expe

rimen

tal s

tudi

es su

ffere

d fr

om la

ck o

f tru

e ra

ndom

as

signm

ent;

Case

-ser

ies d

esig

n st

udie

s: h

igh

risk

of b

ias;

In m

any

inst

ance

s, in

form

ation

to a

sses

s risk

of b

ias w

as

miss

ing.

Stigm

a is

the

attitu

de m

ost l

inke

d to

poo

r men

tal h

ealth

ou

tcom

es, b

ut o

nly

5 of

11

men

tal h

ealth

atti

tude

st

udie

s add

ress

ed sti

gma.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up:

All i

nter

venti

ons i

nvol

ved

stud

ents

from

gra

des 5

to 1

2.

Data

base

s sea

rche

d fo

r rev

iew

: Psy

cIN

FO,

Coch

rane

Lib

rary

, Pub

Med

Hi-L

evel

Fin

ding

s:

Ove

rall,

uni

vers

al sc

hool

-bas

ed m

enta

l hea

lth

awar

enes

s pro

gram

s app

ear p

rom

ising

but

mor

e re

sear

ch is

nee

ded.

12

stud

ies m

easu

red

stud

ents

’ kno

wle

dge

of m

enta

l he

alth

and

all

foun

d im

prov

emen

t in

know

ledg

e at

po

st-te

st b

ut n

ot a

ll fo

und

stati

stica

l sig

nific

ance

; ni

ne o

ut o

f 11

stud

ies a

sses

sing

attitu

des f

ound

im

prov

emen

ts w

ith 6

find

ing

stati

stica

lly si

gnifi

cant

im

prov

emen

ts, 5

out

of 7

stud

ies a

sses

sing

help

-se

ekin

g fo

und

impr

ovem

ent t

houg

h 2

did

not fi

nd

signi

fican

t effe

cts.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Uni

vers

al, s

choo

l-bas

ed m

enta

l hea

lth a

war

enes

s pro

gram

s of

vario

us fo

rms (

prim

arily

inst

ruct

or-le

d tr

aditi

onal

edu

catio

n cu

rric

ulum

led

by a

facu

lty a

dvise

r, co

unse

lor,

teac

her,

nurs

e,

rese

arch

er, e

tc.)

Revi

ew in

clus

ion

crite

ria—

Stu

dies

mus

t be

con

duct

ed w

ithin

the

Uni

ted

Stat

es in

a

scho

ol se

tting

. Stu

dy p

artic

ipan

ts m

ust b

e st

uden

ts e

nrol

led

in a

K-1

2 sc

hool

. Stu

dy

mus

t be

univ

ersa

l in

natu

re.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

abo

ve)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

Focu

s are

as o

f pro

gram

s inc

lude

d: g

ener

al m

enta

l hea

lth,

suic

ide,

vio

lenc

e

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PS

EWB

outc

omes

: Cha

nge

in k

now

ledg

e, a

ttitu

des,

and

/or

help

-see

king

(will

ingn

ess,

inte

ntion

s, a

ttitu

des,

like

lihoo

d,

beha

vior

s, a

nd k

now

ledg

e).

Revi

ew e

xclu

sion

crit

eria

—St

udie

s tha

t ta

rget

ed st

uden

ts d

iagn

osed

with

men

tal

illne

sses

wer

e no

t inc

lude

d. N

on-r

esea

rch

or g

rey

liter

atur

e ar

ticle

s wer

e no

t inc

lude

d.

Inte

rven

tions

that

incl

uded

par

ents

bey

ond

obta

inin

g st

uden

t con

sent

wer

e ex

clud

ed.

No

rest

rictio

ns o

n st

udy

desig

n.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

abov

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A; JB

I Des

crip

tive

Case

-ser

ies;

Ran

dom

ized

Cont

rol P

seud

o-ra

ndom

ized

Tria

l Criti

cal A

ppra

isal T

ools

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Sc

hool

env

ironm

ents

Coun

try(

ies)

: U.S

.St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): n

ot

repo

rted

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fa

mily

, wor

k, re

crea

tion,

OST

): Sc

hool

Page 110: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

110

Rapid Evidence Review Appendix 5: Evidence Tables

28. S

keen

S, L

aure

nzi C

A, G

ord

on

SL,

du

Toit

S, T

om

linso

n M

, Dua

T, e

t al

. Ad

ole

scen

t M

enta

l Hea

lth

Pro

gra

m C

om

po

nent

s an

d B

ehav

ior

Ris

k R

educ

tio

n: A

Met

a-an

alys

is. P

edia

tric

s [I

nter

net]

. 20

19 J

ul 1

[ci

ted

201

9 Ju

ly 2

6]; (

Ep

ub a

head

of

pri

nt).

Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/3

1262

779

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

ado

lesc

ents

age

d 10

to 1

9.

Date

rang

e fo

r rev

iew

: 200

0-20

18#

of st

udie

s inc

lude

d: 1

58As

not

ed b

y au

thor

: Mos

t inc

lude

d st

udie

s wer

e fr

om

high

-inco

me

setti

ngs,

lim

iting

the

appl

icab

ility

of t

he

findi

ngs t

o lo

w- a

nd m

iddl

e-in

com

e co

untr

ies.

Sam

ples

on

ly in

clud

ed tr

ials.

Very

goo

d re

view

to

use

as a

fram

ewor

k fo

r de

velo

ping

an

adol

esce

nt

wel

lbei

ng p

rogr

am!

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: A

ll in

terv

entio

ns in

clud

ed

adol

esce

nts a

ged

10-1

9

Hi-L

evel

Fin

ding

s: U

nive

rsal

ly d

eliv

ered

inte

rven

tions

ca

n im

prov

e ad

oles

cent

men

tal h

ealth

and

re

duce

risk

beh

avio

r. 7

inte

rven

tion

com

pone

nts

pred

icte

d on

ly p

ositi

ve e

ffect

s (in

terp

erso

nal s

kills

, em

otion

al re

gula

tion,

alc

ohol

and

dru

g ed

ucati

on,

min

dful

ness

, pro

blem

solv

ing,

ass

ertiv

e tr

aini

ng,

stre

ss m

anag

emen

t). O

f thi

s 7, 3

com

pone

nts

pred

icte

d po

sitive

effe

cts a

cros

s mul

tiple

out

com

es

(inte

rper

sona

l ski

lls tr

aini

ng, e

moti

onal

regu

latio

n,

alco

hol a

nd d

rug

educ

ation

). 6

prac

tice

com

pone

nts

wer

e as

soci

ated

with

mix

ed re

sults

(con

flict

re

solu

tion,

cop

ing

skill

s, g

oal s

etting

, rel

axati

on, s

kills

to

resis

t pee

r pre

ssur

e, se

lf-effi

cacy

).

Purp

ose

of re

view

:““

Help

ing

Adol

esce

nts

Thriv

e” is

a W

orld

Hea

lth

Org

aniza

tion

and

Uni

ted

Nati

ons C

hild

ren’

s Fun

d in

itiati

ve u

sed

to d

evel

op a

pa

ckag

e of

evi

denc

e-ba

sed

psyc

holo

gica

l int

erve

ntion

s to

pro

mot

e ad

oles

cent

m

enta

l hea

lth a

nd p

reve

nt

men

tal d

isord

ers a

nd

risk

beha

vior

s am

ong

adol

esce

nts.

As a

par

t of

this

proj

ect,

we

cond

ucte

d a

syst

emati

c re

view

, met

a-an

alys

is, a

nd p

rogr

am

com

pone

nts a

naly

sis

of u

nive

rsal

ly d

eliv

ered

in

terv

entio

ns th

at so

ught

th

ese

aim

s. O

ur p

urpo

se o

f th

is re

view

was

to in

form

th

e de

velo

pmen

t of t

he

inte

rven

tion

pack

age.

Sp

ecifi

cally

, we

wan

ted

to

iden

tify

cont

ent-r

elat

ed

feat

ures

of p

rogr

ams

(kno

wn

as p

rogr

am o

r pr

actic

e co

mpo

nent

s)

that

con

siste

ntly

pre

dict

la

rger

effe

ct si

zes i

n th

ese

prog

ram

s acr

oss a

rang

e of

ou

tcom

es.”

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Ps

ycho

soci

al in

terv

entio

ns (m

ix o

f fac

e-to

-face

and

dig

ital

deliv

ery

met

hods

) inc

ludi

ng c

ompo

nent

s of:

activ

ity

mon

itorin

g an

d sc

hedu

ling,

alc

ohol

and

/or d

rug

educ

ation

, an

ger m

anag

emen

t, as

serti

vene

ss, b

ehav

iora

l acti

vatio

n,

civi

c an

d/or

soci

al re

spon

sibili

ty, c

ogni

tive

rest

rictin

g,

com

mun

icati

on sk

ills,

con

flict

reso

lutio

n, c

opin

g sk

ills,

dec

ision

m

akin

g, e

moti

onal

regu

latio

n, g

oal s

etting

, ins

ight

bui

ldin

g,

inte

rper

sona

l rel

ation

ship

s and

/or s

kills

, men

tal h

ealth

lite

racy

, m

indf

ulne

ss, p

robl

em so

lvin

g, re

laxa

tion,

resis

ting

drug

/al

coho

l-rel

ated

pee

r pre

ssur

e, se

lf-effi

cacy

, sel

f-mon

itorin

g,

soci

al sk

ills,

stre

ss m

anag

emen

t, su

ppor

t net

wor

king

.

Data

base

s sea

rche

d fo

r rev

iew

: Pub

Med

, M

EDLI

NE,

Psy

cIN

FO, S

COPU

S, E

mba

se,

Appl

ied

soci

al S

cien

ces I

ndex

Abs

trac

ts

H.S.

age

d Ad

oles

cent

-Spe

cific

Fin

ding

s: (s

ee a

bove

)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

(see

abo

ve)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es in

clud

ed m

ust 1

) be

RCTs

of p

sych

osoc

ial i

nter

venti

ons 2

) inc

lude

ad

oles

cent

s par

ticip

ants

bet

wee

n 10

and

19

yea

rs o

f age

3) i

nclu

de tr

ial i

nter

venti

ons

with

the

prim

ary

or se

cond

ary

aim

s of

prom

oting

men

tal h

ealth

or p

reve

nting

m

enta

l diso

rder

s, re

duci

ng ri

sk b

ehav

iors

, or

redu

cing

self-

harm

and

suic

ide

4) b

e un

iver

sal i

n its

app

licati

on.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PS

EWB

outc

omes

: Pos

itive

men

tal h

ealth

(men

tal w

ell-b

eing

, re

silie

nce,

cop

ing,

em

otion

al re

gula

tion)

; dep

ress

ive

and

anxi

ous s

ympt

omat

olog

y; v

iole

nce

perp

etra

tion,

agg

ress

ion,

an

d bu

llyin

g; a

nd a

lcoh

ol a

nd o

ther

subs

tanc

e us

e.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: stu

dies

wer

e ex

clud

ed if

they

fa

iled

to m

eet t

he in

clus

ion

crite

ria d

etai

led

abov

e.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

abov

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): GR

ADE

Page 111: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

111

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): m

ultip

le, i

nclu

ding

dig

ital/o

nlin

eCo

untr

y(ie

s): h

igh-

inco

me

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

: not

re

port

edLe

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Scho

ol, I

nter

pers

onal

, In

divi

dual

Page 112: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

112

Rapid Evidence Review Appendix 5: Evidence Tables

29. S

oul

ako

va B

, Kas

al A

, But

zer

B, W

inkl

er P

. Met

a-R

evie

w o

n th

e E

ffec

tive

ness

of

Cla

ssro

om

-Bas

ed P

sych

olo

gic

al In

terv

enti

ons

Aim

ed a

t Im

pro

ving

Stu

den

t M

enta

l Hea

lth

and

Wel

l-B

eing

, and

Pre

vent

ing

Men

tal I

llnes

s. T

he J

our

nal o

f P

rim

ary

Pre

vent

ion

[Int

erne

t]. 2

019

May

28

[cit

ed 2

019

Aug

6];

40(

3):2

55-2

78. A

vaila

ble

fro

m: h

ttp

s://

link.

spri

nger

.co

m/a

rtic

le/1

0.10

07%

2Fs

1093

5-01

9-00

552-

5FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

not

defi

ned

Date

rang

e fo

r rev

iew

: 201

1 - 2

016

# of

stud

ies i

nclu

ded:

10

As n

oted

by

auth

or: D

ue to

larg

e he

tero

gene

ity o

f the

ou

tcom

es m

easu

red,

a m

eta-

anal

ytic

eval

uatio

n w

as n

ot

poss

ible

and

thus

onl

y a

narr

ative

synt

hesis

was

don

e.

Ages

wer

e no

t pro

vide

d w

ith th

e in

clud

ed st

udie

s.

Stud

ies t

hat c

lear

ly

iden

tified

an

adol

esce

nt

popu

latio

n an

d ad

oles

cent

fin

ding

s wer

e in

clud

ed in

th

e Te

en S

peci

fic F

indi

ngs

tabl

e bu

t the

re m

ay

be m

ore

that

wer

e no

t id

entifi

able

.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: 1

2-18

yea

rs o

ld (Y

ager

et

al.,

2013

), Gr

ades

1 th

roug

h 12

(Zen

ner e

t al.,

201

4), S

tude

nts

aged

8 to

15

year

s old

(Mag

gin

& Jo

hnso

n, 2

014)

.

Hi-L

evel

Fin

ding

s: O

vera

ll eff

ectiv

enes

s rep

orte

d in

the

incl

uded

stud

ies w

as si

gnifi

cant

for t

he m

ost

part

. Effe

ct si

zes r

ange

d fr

om sm

all t

o la

rge.

The

au

thor

s of a

ll of

the

stud

ies e

mph

asize

d th

e ne

ed

for a

dditi

onal

hig

h-qu

ality

tria

ls to

furt

her e

xam

ine

the

effec

tiven

ess o

f sch

ool-b

ased

psy

chol

ogic

al

inte

rven

tions

aim

ed a

t im

prov

ing

stud

ent m

enta

l he

alth

and

wel

l-bei

ng, a

nd p

reve

nting

men

tal

illne

ss.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Min

dful

ness

, Soc

ial

Emoti

onal

Lea

rnin

g, C

ogni

tive

Beha

vior

The

rapy

, Yog

a, a

nd

Body

-Imag

e in

terv

entio

ns.

Data

base

s sea

rche

d fo

r rev

iew

: Psy

cIN

FO,

Web

of K

now

ledg

e, M

EDLI

NE,

EM

BASE

, He

alth

Man

agem

ent I

nfor

mati

on C

onso

rtium

.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

Body

imag

e in

terv

entio

ns (Y

ager

et a

l.,

2013

), M

indf

ulne

ss-B

ased

Inte

rven

tion

(sch

ool s

etting

) (Ze

nner

et

al.,

201

4), F

RIEN

DS p

rogr

am (M

aggi

n &

John

son,

201

4)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: S

tudi

es h

ad to

be

eith

er

met

a-an

alys

es o

r sys

tem

atic

revi

ews f

ocus

ed

on in

terv

entio

ns in

scho

ol c

lass

room

s tha

t ta

rget

ed n

on-c

linic

al p

opul

ation

s. W

hen

a m

eta-

anal

ysis

or sy

stem

atic

revi

ew a

lso

inve

stiga

ted

non-

clas

sroo

m-b

ased

stud

ies,

at

leas

t hal

f of t

he st

udie

s rev

iew

ed h

ad

to b

e co

nduc

ted

in c

lass

room

s. T

he sa

me

crite

ria w

ere

used

for s

tudi

es th

at in

clud

ed

clin

ical

and

non

clin

ical

pop

ulati

ons.

Sec

ond,

st

rate

gies

disc

usse

d in

eac

h ar

ticle

had

to b

e cl

assr

oom

-bas

ed p

sych

olog

ical

inte

rven

tions

ai

med

at i

mpr

ovin

g st

uden

t men

tal h

ealth

an

d w

ell-b

eing

, and

pre

venti

ng m

enta

l illn

ess.

Th

ird, s

tudi

es w

ere

only

incl

uded

if th

ey w

ere

rate

d as

hav

ing

high

met

hodo

logi

cal q

ualit

y ac

cord

ing

to A

MST

AR g

uide

lines

.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: no

expl

icit

outc

omes

of i

nter

est i

denti

fied

for t

he

revi

ew.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Stu

dies

wer

e ex

clud

ed if

they

fo

cuse

d on

clie

nt th

erap

y w

ork

or in

divi

dual

co

unse

ling

or m

ento

ring

with

chi

ldre

n. In

ad

ditio

n, st

udie

s tha

t rep

orte

d en

viro

nmen

tal

or p

hysic

al in

fluen

ces o

n m

enta

l hea

lth,

such

as d

iet,

obes

ity p

reve

ntion

, or e

xerc

ise

inte

rven

tions

. Edu

catio

nal i

nter

venti

ons

that

focu

sed

sole

ly o

n pr

ovid

ing

theo

retic

al

desc

riptio

ns a

nd e

xpla

natio

ns o

f men

tal

illne

sses

or s

uici

de w

ere

also

exc

lude

d.

Revi

ews f

ocus

ed o

n st

udie

s inv

estig

ating

in

terv

entio

ns fo

r pre

venti

ng b

ully

ing

in

scho

ols o

r foc

used

exc

lusiv

ely

on c

linic

al

popu

latio

ns w

ere

excl

uded

.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: b

ody

imag

e, a

ttitu

des t

owar

ds e

ating

, hea

lthy

eatin

g be

havi

ors,

dr

ive

for t

hinn

ess (

Yage

r et a

l., 2

013)

, cog

nitiv

e pe

rfor

man

ce,

resi

lienc

e, st

ress

, em

otion

al p

robl

ems,

third

-par

ty ra

tings

(i.

e., t

each

er o

r par

ent r

ating

s) (Z

enne

r et a

l., 2

014)

, lev

els o

f an

xiet

y (M

aggi

n &

John

son,

201

4).

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A St

atem

ent,

PICO

; AM

STAR

for m

etho

dolo

gica

l qua

lity

Page 113: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

113

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Sc

hool

sCo

untr

y(ie

s): n

ot re

port

ed

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

:Le

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Scho

ol, I

ndiv

idua

l

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Yage

r et a

l., 2

013

12-1

8 ye

ars o

ldBo

dy im

age

inte

rven

tions

7 of

the

16 p

rogr

ams w

ere

effec

tive

in im

prov

ing

body

im

age

on a

t lea

st o

ne m

easu

re fr

om p

re- t

o po

st-te

st

(alth

ough

effe

ct si

zes w

ere

smal

l; d=

0.2

2-0.

48).

All o

f th

e eff

ectiv

e in

terv

entio

ns w

ere

cond

ucte

d w

ith y

oung

er

adol

esce

nts a

ged

12 to

13.

5. N

one

of th

e in

terv

entio

ns

targ

eting

ado

lesc

ents

age

d 14

to 1

6 w

ere

foun

d to

be

effec

tive.

How

ever

, som

e in

terv

entio

ns w

ere

foun

d to

be

effe

ctive

in th

is ol

der a

ge g

roup

with

rega

rd to

oth

er

outc

omes

, suc

h as

redu

cing

the

driv

e fo

r thi

nnes

s and

pr

omoti

ng h

ealth

y atti

tude

s tow

ard

eatin

g an

d he

alth

y ea

ting

beha

vior

s. L

ess t

han

20%

of a

ll pr

ogra

ms h

ad

sust

aine

d eff

ects

on

body

imag

e at

follo

w-u

p.

Zenn

er e

t al.,

201

4Gr

ades

1 th

roug

h 12

M

indf

ulne

ss-B

ased

Inte

rven

tions

(sch

ool s

etting

s)24

stud

ies r

epor

ted

a sig

nific

ant m

ediu

m e

ffect

size

(ES)

of

g=0

.40

acro

ss a

ll co

ntro

lled

stud

ies a

nd d

omai

ns.

Rem

arka

bly,

the

ES o

f stu

dies

usin

g pr

e-po

st d

esig

ns o

nly

is ve

ry si

mila

r, w

ith g

=0.4

1. T

he e

ffect

s are

stro

nges

t in

the

dom

ain

of c

ogni

tive

perf

orm

ance

with

a la

rge

and

signi

fican

t ES

of g

=0.8

0 fo

r con

trol

led

stud

ies.

Effe

ct

sizes

are

smal

ler b

ut sti

ll sig

nific

ant i

n th

e do

mai

ns

of re

silie

nce

mea

sure

s (g=

0.36

) and

stre

ss m

easu

res

(g=0

.39)

. Non

-sig

nific

ant E

S fo

r mea

sure

s of e

moti

onal

pr

oble

ms (

g=0.

19) a

nd th

ird-p

erso

n ra

tings

(g=0

.25)

.

Mag

gin

& Jo

hnso

n, 2

014

Stud

ents

age

d 8

to 1

5 ye

ars o

ldCB

T in

terv

entio

n (F

RIEN

DS p

rogr

am)

Stud

ents

cat

egor

ized

as b

eing

at l

ow ri

sk fo

r anx

iety

di

sord

ers d

emon

stra

ted

decr

ease

d le

vels

of a

nxie

ty

at p

ost-t

est.

The

ES (H

edge

s’ g

) was

smal

l (− 

0.26

) but

st

atisti

cally

sign

ifica

nt. T

he h

ighe

st st

atisti

cally

sign

ifica

nt

decr

ease

in le

vel o

f anx

iety

for l

ow ri

sk st

uden

ts w

as

foun

d fo

r fol

low

-up

mea

sure

men

ts th

at o

ccur

red

up to

12

mon

ths p

ost-i

nter

venti

on, w

ith a

smal

l to

med

ium

ES

of -

0.31

. Stu

dies

of l

ow ri

sk st

uden

ts th

at in

clud

ed

follo

w-u

p m

easu

rem

ents

at 1

2 m

onth

s pos

t-int

erve

ntion

w

ere

not s

tatis

tical

ly si

gnifi

cant

and

show

ed a

smal

l ES

of

-0.0

9. H

owev

er, fi

ndin

gs w

ere

not m

aint

aine

d w

hen

low

qu

ality

stud

ies w

ere

rem

oved

from

the

anal

ysis.

Page 114: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

114

Rapid Evidence Review Appendix 5: Evidence Tables

30. T

anne

r-S

mit

h E

E, D

urla

k JA

, Mar

x R

A. E

mp

iric

ally

Bas

ed M

ean

Eff

ect

Siz

e D

istr

ibut

ions

fo

r U

nive

rsal

Pre

vent

ion

Pro

gra

ms

Targ

etin

g S

cho

ol-

Ag

ed Y

out

h: A

Rev

iew

of

Met

a-A

naly

ses.

P

reve

ntio

n S

cien

ce [

Inte

rnet

]. 2

018

No

v [c

ited

201

9 Ju

ly 2

6]; 1

9(8)

:109

1-11

01. A

vaila

ble

fro

m: h

ttp

s://

ww

w.n

cbi.n

lm.n

ih.g

ov/

pub

med

/301

3624

5FO

CU

S O

F R

EV

IEW

RE

VIE

W M

ETH

OD

S

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

Sch

ool-a

ge y

outh

(a

ges 5

-18)

Date

rang

e fo

r rev

iew

: 198

6-20

15#

of st

udie

s inc

lude

d: 7

4 in

met

a-an

alys

es

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: M

ean

age

of p

artic

ipan

ts

in th

e m

eta-

anal

yses

incl

uded

in o

vera

ll m

eta-

anal

ysis

rang

es

from

10.

44 to

16

year

s old

. Mea

n ag

e of

ove

rall

met

a-an

alys

is w

as 1

2.33

with

a st

anda

rd d

evia

tion

of 1

.66.

Hi-L

evel

Fin

ding

s:

All p

rogr

ams:

Acr

oss a

ll pr

even

tion

prog

ram

s inc

lude

d in

the

met

a-an

alys

es (i

.e.,

rega

rdle

ss o

f pro

gram

targ

et),

prog

ram

s had

the

larg

est p

ostte

st e

ffect

s on

know

ledg

e (P

25 [2

5th

perc

entil

e] =

0.2

5, M

edia

n =

0.40

, P75

[75t

h pe

rcen

tile]

= 0

.57)

, and

soci

al c

ompe

tenc

e ou

tcom

es

(P25

= 0

.19,

Med

ian

= 0.

23, P

75 =

0.5

7). C

onve

rsel

y, th

e sm

alle

st e

ffect

s wer

e re

port

ed fo

r sub

stan

ce u

se (P

25

= 0.

05, M

edia

n =

0.07

, P75

= 0

.11)

, mar

ijuan

a us

e (P

25 =

0.

03, M

edia

n =

0.09

, P75

= 0

.13)

, tob

acco

use

(P25

= 0

.04,

M

edia

n =

0.10

, P75

= 0

.16)

, and

alc

ohol

use

out

com

es

(P25

= 0

.05,

Med

ian

= 0.

10, P

75 =

0.1

5). T

he d

istrib

ution

of

the

mea

n eff

ects

var

ied

subs

tanti

ally

acr

oss t

he d

iffer

ent

outc

ome

dom

ains

.Ex

tern

alizi

ng P

reve

ntion

Pro

gram

s: F

iftee

n m

eta-

anal

yses

(nes

= 3

1) e

xam

ined

the

effec

t of u

nive

rsal

ex

tern

alizi

ng p

reve

ntion

pro

gram

s for

you

th. T

hese

pr

ogra

ms h

ad th

e la

rges

t ave

rage

pos

ttest

effe

cts o

n kn

owle

dge

(P25

= 0

.48,

Med

ian

= 0.

72, P

75 =

0.9

8),

inte

rnal

izing

(P25

= 0

.43,

Med

ian

= 0.

43, P

75 =

0.4

3),

and

victi

miza

tion

outc

omes

(P25

= 0

.19,

Med

ian

= 0.

21,

P 75 =

0.2

7). A

vera

ge p

rogr

am e

ffect

s wer

e sm

alle

r fo

r oth

er m

easu

res o

f ext

erna

lizin

g be

havi

or su

ch a

s ag

gres

sive/

disr

uptiv

e be

havi

or, a

ntiso

cial

beh

avio

r, ge

nera

l del

inqu

ency

, and

oth

er c

ondu

ct p

robl

ems.

The

di

strib

ution

s of e

xter

naliz

ing

prev

entio

n pr

ogra

m e

ffect

s te

nded

to b

e un

iform

ly d

istrib

uted

with

in o

utco

me

type

.In

tern

alizi

ng P

reve

ntion

Pro

gram

s: E

leve

n m

eta-

anal

yses

(n

es =

26)

exa

min

ed th

e eff

ect o

f int

erna

lizin

g pr

even

tion

and

prom

otion

pro

gram

s for

you

th. T

hese

pro

gram

s ex

hibi

ted

the

larg

est b

enefi

cial

ave

rage

pos

ttest

effe

cts

on so

cial

com

pete

nce

(P25

= 0

.00,

Med

ian

= 0.

51, P

75

= 0.

78),

whi

ch w

ere

nota

bly

high

er th

an e

ffect

s on

mea

sure

s of i

nter

naliz

ing

beha

vior

(P25

= 0

.09,

Med

ian

= 0.

12, P

75 =

0.4

4), a

nd se

lf-co

ncep

t out

com

es (P

25 =

0.

03, M

edia

n =

0.09

, P75

= 0

.70)

. The

dist

ributi

ons o

f in

tern

alizi

ng p

rogr

am e

ffect

s ten

ded

to b

e po

sitive

ly

skew

ed.

Pros

ocia

l Pro

moti

on P

rogr

ams:

Six

met

a-an

alys

es

(nes

= 4

5) e

xam

ined

the

effec

t of p

roso

cial

pro

moti

on

prog

ram

s for

you

th. P

roso

cial

pro

moti

on p

rogr

ams h

ad

the

larg

est a

vera

ge e

ffect

s on

self-

conc

ept (

P 25 =

0.4

6,

Med

ian

= 0.

58, P

75 =

0.6

9), a

cade

mic

s (P 25

= 0

.26,

Med

ian

= 0.

31, P

75 =

0.4

6), a

nd so

cial

com

pete

nce

outc

omes

(P

25 =

0.2

0, M

edia

n =

0.25

, P75

= 0

.59)

. Mos

t mea

n eff

ects

for p

roso

cial

beh

avio

r pro

moti

on p

rogr

ams f

ell

with

in th

e 0

to 0

.50

rang

e; h

owev

er, t

he d

istrib

ution

of

effe

cts w

as w

ider

for s

ocia

l com

pete

nce

outc

omes

. Fu

rthe

rmor

e, p

roso

cial

pro

gram

s obt

aine

d th

e hi

ghes

t av

erag

e eff

ects

of a

ll pr

even

tion

prog

ram

s on

acad

emic

ou

tcom

es (M

edia

n =

0.31

) and

hig

her a

vera

ge e

ffect

s on

ext

erna

lizin

g be

havi

or o

utco

mes

than

pro

gram

s ta

rgeti

ng e

xter

naliz

ing

prob

lem

s (M

edia

n =

0.24

vs

Med

ian

= 0.

16, r

espe

ctive

ly).

As n

oted

by

auth

or: A

utho

r not

es th

at th

ese

prog

ram

s do

not

add

ress

all

aspe

cts o

f you

th a

djus

tmen

t and

w

ell-b

eing

(did

not

incl

ude

phys

ical

hea

lth o

r aca

dem

ic

achi

evem

ent o

utco

mes

). Au

thor

not

es th

at o

ne m

ay

expe

ct a

hig

her m

agni

tude

of e

ffect

s for

indi

cate

d pr

even

tion

prog

ram

s, a

nd th

us fo

cusin

g on

prim

ary

prev

entio

n pr

ogra

ms m

ay li

mit

effec

ts o

bser

ved

for t

hese

pr

ogra

ms.

Aut

hor a

lso re

com

men

ds th

at e

nviro

nmen

tal-

or p

olic

y-le

vel i

nter

venti

ons s

houl

d no

t be

negl

ecte

d,

whi

ch th

is re

view

doe

s.

Met

a-an

alys

is al

so fo

cuse

d on

sum

mar

izing

the

dist

ributi

on o

f mea

n eff

ect s

izes a

s rep

orte

d in

prio

r m

eta-

anal

yses

, but

not

thos

e eff

ects

repo

rted

in th

e in

divi

dual

stud

ies i

nclu

ded

in th

e m

eta-

anal

yses

.M

any

met

a-an

alys

es in

clud

ed fo

cuse

d on

a si

ngle

ou

tcom

e, a

nd m

any

also

faile

d to

repo

rt m

ean

effec

t size

s se

para

tely

for i

mpo

rtan

t sub

grou

ps o

f you

th (e

.g.,

age,

ra

ce, e

thni

city

, gen

der,

sexu

al o

rient

ation

). Fe

w m

eta-

anal

yses

exa

min

ed o

utco

mes

at f

ollo

w-u

p pe

riods

.

Page 115: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

115

Rapid Evidence Review Appendix 5: Evidence Tables

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Uni

vers

al d

rug

prev

entio

n pr

ogra

ms,

uni

vers

al e

xter

naliz

ing

prev

entio

n pr

ogra

ms,

Uni

vers

al in

tern

alizi

ng p

rogr

ams,

uni

vers

al se

xual

be

havi

or p

reve

ntion

pro

gram

s, u

nive

rsal

pro

soci

al p

rom

otion

pr

ogra

ms.

Data

base

s sea

rche

d fo

r rev

iew

: Di

sser

tatio

ns a

nd T

hese

s (U.

S., U

K, a

nd

Glob

al),

ERIC

, Psy

cIN

FO, P

Q C

rimin

al

Justi

ce, P

Q E

duca

tion,

PQ

Fam

ily

Heal

th, P

Q H

ealth

& M

edic

al C

ompl

ete,

PQ

Hea

lth M

anag

emen

t, PQ

Nur

sing

& A

llied

Hea

lth, P

Q P

sych

olog

y, P

Q

Scie

nce,

PQ

Soc

ial S

cien

ce, S

ocia

l Se

rvic

es a

nd A

bstr

acts

, Soc

iolo

gica

l Ab

stra

cts,

Cam

pbel

l Col

labo

ratio

n,

Coch

rane

Col

labo

ratio

n.

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

abo

ve)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

(see

abo

ve)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: M

eta-

anal

yses

had

to fo

cus o

n un

iver

sal

or p

rimar

y pr

even

tion

prog

ram

s ai

med

at p

reve

nting

pro

blem

atic

beha

vior

or e

moti

onal

pro

blem

s am

ong

yout

h. T

hose

that

con

tain

ed

a m

ix o

f pre

venti

on p

rogr

am ty

pes

wer

e on

ly in

clud

ed if

resu

lts w

ere

pres

ente

d se

para

tely

for t

he u

nive

rsal

pr

even

tion

prog

ram

s. O

nly

psyc

hoso

cial

in

terv

entio

ns th

at in

volv

ed d

irect

wor

k w

ith sc

hool

-age

you

th w

ere

elig

ible

. M

eta-

anal

yses

that

incl

ude

stud

ies

with

old

er/y

oung

er p

artic

ipan

ts w

ere

only

incl

uded

if th

ey p

rese

nted

resu

lts

for y

outh

age

d 5-

18 se

para

tely.

Met

a-an

alys

es h

ad to

repo

rt a

t lea

st o

ne m

ean

effec

t size

on

an a

ttitu

dina

l, be

havi

oral

, or

men

tal h

ealth

out

com

e m

easu

re.

Met

a-an

alys

es m

ust b

e av

aila

ble

in

Engl

ish.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: aca

dem

ics,

soci

al c

ompe

tenc

e, se

lf-co

ncep

t, vi

ctim

izatio

n, v

iole

nce/

abus

e, e

xter

naliz

ing,

inte

rnal

izing

, se

xual

beh

avio

r, su

bsta

nce

use,

alc

ohol

use

, tob

acco

use

, m

ariju

ana

use,

atti

tude

s to

drug

s, p

roso

cial

atti

tude

s,

know

ledg

e

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Met

a-an

alys

es o

f pr

even

tion

prog

ram

s who

se p

rimar

y ai

m w

as to

cha

nge

phys

ical

hea

lth o

r ed

ucati

onal

out

com

es w

ere

excl

uded

. In

terv

entio

ns th

at fo

cuse

d on

cha

ngin

g la

ws o

r pol

icie

s wer

e ex

clud

ed.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

abov

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A St

atem

ent

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Sc

hool

s, c

omm

uniti

esCo

untr

y(ie

s): G

loba

lLe

vel (

e.g.

, nati

onal

, com

mun

ity/n

eigh

borh

ood,

scho

ol,

fam

ily, w

ork,

recr

eatio

n, O

ST):

Scho

ol, C

omm

unity

Page 116: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

116

Rapid Evidence Review Appendix 5: Evidence Tables

31. T

aylo

r, O

ber

le, D

urla

k &

Wei

ssb

erg

, 201

7.P

rom

oti

ng p

osi

tive

yo

uth

dev

elo

pm

ent

thro

ugh

scho

ol-

bas

ed s

oci

al a

nd e

mo

tio

nal l

earn

ing

inte

rven

tio

ns: A

met

a-an

alys

is o

f fo

llow

-up

eff

ects

. ht

tps:

//d

oi.o

rg/1

0.11

11/c

dev

.128

64. h

ttp

s://

dp

i.wi.g

ov/

site

s/d

efau

lt/fi

les/

imce

/ssp

w/p

df/

Tayl

or_

et_a

l_-_

FIN

AL_

do

cum

ent_

6_17

_201

7_2.

pd

f. S

upp

ort

ing

info

rmat

ion

at h

ttp

s://

onl

inel

ibra

ry.w

iley.

com

/do

i/ab

s/10

.111

1/cd

ev.1

2864

.

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

RE

LEVA

NT

FIN

DIN

GS

RE

VIE

W L

IMIT

ATIO

NS

NO

TES

All a

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

K-1

2, m

ean

age

11Da

te ra

nge:

198

1-De

cem

ber 2

014

# of

stud

ies i

nclu

ded

over

all:

82, 1

1 on

ado

lesc

ents

The

SEL

inte

rven

tions

var

ied

in g

ener

al p

roce

dure

s,

whi

ch o

f the

cor

e SE

L co

mpe

tenc

ies w

ere

targ

eted

, and

w

hat o

utco

mes

wer

e us

ed to

ass

ess p

rogr

am im

pact

. Ho

wev

er, m

ost i

ncor

pora

ted

the

4 SA

FE (s

eque

nced

, ac

tive,

focu

sed,

exp

licit)

pro

gram

feat

ures

sugg

este

d as

be

st p

racti

ces f

or S

EL im

plem

enta

tion.

Age

has

sign

ifica

nt

cova

riate

s (e.

g., d

urati

on o

f pro

gram

was

hig

her f

or lo

wer

ag

e gr

oups

). An

alys

es b

y ra

ce a

nd S

ES w

ere

limite

d by

m

issin

g da

ta. L

evel

s of e

ffecti

vene

ss c

ould

not

be

stud

ied

by p

rogr

am c

ompo

nent

s.

Of t

he st

udie

s rep

ortin

g on

the

follo

win

g va

riabl

es:

41.1

.% o

f stu

dent

s w

ere

from

low

SES

ho

useh

olds

; 45.

85%

w

ere

stud

ents

of c

olor

Age/

deve

lopm

enta

l gro

up in

clud

ed re

leva

nt to

H.S

. age

d te

ens a

ges 1

3-18

- sp

ecify

by

age

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up –

14-

18-y

ear-o

lds

Data

base

s sea

rche

d:

High

-leve

l find

ings

: Sta

tistic

ally

sign

ifica

nt M

ean

effec

t size

s for

7 o

utco

mes

rang

ed fr

om g

=.13

to

.33.

Spe

cific

ally,

for P

SEW

B ou

tcom

es o

f SEL

skill

s (.2

3), S

E La

titud

es (.

13),

positi

ve so

cial

beh

avio

r (.1

3), e

moti

onal

dist

ress

(.16

). (a

ll gr

ades

)Ac

ross

age

gro

ups,

soci

al-e

moti

onal

skill

s pre

dict

ed

prim

ary

outc

omes

, but

soci

al-e

moti

onal

atti

tude

s di

d no

t.Ac

ross

age

gro

ups,

no

diffe

renc

es w

ere

foun

d by

st

uden

t div

ersit

y pr

ofile

, SES

, urb

anic

ity, o

r cou

ntry

of

inte

rven

tion

(U.S

. v. a

broa

d).

High

er to

tal s

ampl

e att

rition

at f

ollo

w-u

p w

as

asso

ciat

ed w

ith lo

wer

ES.

Inte

rven

tion(

s) T

ype/

Nam

e—O

vera

ll: U

nive

rsal

scho

ol-b

ased

SE

L pr

ogra

m. M

ost w

ere

clas

sroo

m-b

ased

skill

s dev

elop

men

t on

ly. A

min

ority

also

had

add

ition

al c

ompo

nent

s suc

h as

eff

orts

to e

nhan

ce c

lass

room

or s

choo

l clim

ate,

var

ious

sc

hool

-wid

e in

itiati

ves,

or p

aren

t inv

olve

men

t.

Revi

ew in

clus

ion

crite

ria S

tudi

es h

ad to

hav

e co

llect

ed fo

llow

-up

data

from

inte

rven

tion

and

cont

rol g

roup

s 6 m

onth

s or m

ore

posti

nter

venti

on; c

onta

ined

suffi

cien

t dat

a to

cal

cula

te a

n eff

ect s

ize o

n at

leas

t one

ou

tcom

e

13-1

8-ye

ar-o

ld (o

r sim

ilar)

Tee

n sp

ecifi

c fin

ding

s:

(or s

ee T

een

Tabl

e be

low

): Ac

ross

out

com

es, t

he m

ean

effec

t size

for

14-1

8-ye

ar-o

lds w

as g

=.18

, sig

nific

antly

diff

eren

t fr

om th

e ES

for c

hild

ren

(.27)

or e

arly

ado

lesc

ents

(.1

2), w

hen

cons

ider

ed a

lone

, but

not

in th

e m

eta-

regr

essio

n in

clud

ing

age

and

attriti

on.

Inte

rven

tion(

s) T

ype/

Nam

e--e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r eq

uiva

lent

(spe

cify

): no

t pro

vide

d se

para

tely.

Re

view

exc

lusi

on c

riter

ia S

ee in

clus

ion

crite

ria

Out

com

es e

xam

ined

ove

rall

--inc

lude

all

but h

ighl

ight

PS

WEB

out

com

es: p

ositi

ve so

cial

beh

avio

r; ac

adem

ic

succ

ess;

con

duct

pro

blem

s; e

moti

onal

dis

tres

s; d

rug

use.

So

cial

and

em

otion

al a

sset

s (sk

ills a

nd a

ttitu

des)

wer

e ad

ditio

nal m

easu

red

outc

omes

and

use

d as

pre

dict

ors o

f the

pr

imar

y ou

tcom

es. A

dditi

onal

out

com

es (p

eer a

nd fa

mily

re

latio

nshi

ps, m

enta

l hea

lth a

djus

tmen

t) w

ere

mea

sure

d ac

ross

all

age

grou

ps.

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): Ba

sed

on p

roce

ss u

sed

by

Durla

k, 2

011

(pre

viou

s rev

iew

of S

EL)

Out

com

es e

xam

ined

for 1

3-18

-yea

r-ol

ds o

r equ

ival

ent—

incl

ude

all b

ut h

ighl

ight

PSE

WB:

ove

rall

ES

Out

com

es e

xam

ined

for s

ocia

l/bu

ilt/s

truc

tura

l env

ironm

ents

an

d/or

peo

ple

surr

ound

ing

13-1

8-ye

ar-o

lds (

glob

al/c

ultu

ral,

natio

nal,

com

mun

ity, i

nter

pers

onal

leve

l)--S

peci

fy o

utco

me

and

for w

hom

it is

mea

sure

d: N

ot in

clud

ed (e

xplic

itly)

Setti

ng(s

): Sc

hool

sCo

untr

y(ie

s): U

.S a

nd o

ther

St

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): n

ot

repo

rted

Leve

l (e.

g., g

loba

l/cu

ltura

l, na

tiona

l, co

mm

unity

, in

terp

erso

nal):

scho

ol

Page 117: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

117

Rapid Evidence Review Appendix 5: Evidence Tables

32. T

illm

ann

S, T

ob

in D

, Avi

son

W, G

illila

nd J

. Men

tal H

ealt

h B

enefi

ts o

f In

tera

ctio

ns w

ith

Nat

ure

in C

hild

ren

and

Tee

nag

ers:

A S

yste

mat

ic R

evie

w. J

our

nal o

f E

pid

emio

log

y an

d C

om

mun

ity

Hea

lth

[Int

erne

t]. 2

018

Oct

[ci

ted

201

9 A

ug 2

7]; 7

2(10

):958

-966

. Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

9950

520

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

chi

ldre

n an

d te

enag

ers (

0-18

yea

rs)

Date

rang

e fo

r rev

iew

: 199

0-20

17#

of st

udie

s inc

lude

d: 3

5 As

not

ed b

y au

thor

: The

subj

ectiv

e na

ture

of

obse

rvati

onal

stud

ies d

oes n

ot a

llow

for a

cle

ar ‘y

es’ o

r ‘n

o’ a

nsw

er to

som

e qu

estio

ns d

esig

ned

for i

nter

venti

on-

base

d st

udie

s. F

urth

erm

ore,

pap

ers b

ased

on

qual

itativ

e m

etho

ds w

ere

not i

nclu

ded

in th

is re

view

due

to

the

diffi

culti

es o

f com

parin

g fin

ding

s am

ong

stud

ies.

Th

eir i

nclu

sion

may

hav

e pr

ovid

ed fo

r a m

ore

fulso

me

unde

rsta

ndin

g of

the

bene

fits o

f nat

ure

for t

he m

enta

l he

alth

of c

hild

ren

and

teen

ager

s. A

utho

rs w

ere

unab

le to

co

mpl

ete

a m

eta-

anal

ysis

with

the

35 st

udie

s col

lect

ed

due

to th

e he

tero

gene

ity o

f the

mea

sure

s use

d in

eac

h st

udy.

The

maj

ority

of t

he st

udie

s had

fairl

y sm

all s

ampl

e siz

es a

nd w

ere

from

Eur

ope,

Nor

th A

mer

ica

and

othe

r de

velo

ped

regi

ons w

hich

can

also

lim

it th

e ge

nera

lizab

ility

of

the

findi

ngs.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: (

see

tabl

e)

Hi-L

evel

Fin

ding

s: T

his r

evie

w sh

owed

sign

ifica

nt

positi

ve fi

ndin

gs o

n th

e be

nefit

s of n

atur

e fo

r all

men

tal h

ealth

out

com

es; h

owev

er, A

DD/A

DHD,

ov

eral

l men

tal h

ealth

, str

ess,

resi

lienc

e an

d HR

QO

L w

ere

the

only

out

com

es th

at d

emon

stra

ted

mor

e po

sitiv

e si

gnifi

cant

find

ings

ove

r non

-sig

nific

ant

findi

ngs.

Sev

eral

out

com

es (e

moti

onal

wel

l-bei

ng,

self-

este

em, d

epre

ssio

n) w

ere

asso

ciat

ed w

ith

a gr

eate

r num

ber o

f non

-sig

nific

ant fi

ndin

gs

than

pos

itive

sign

ifica

nt fi

ndin

gs, s

uppo

rting

the

inco

nclu

sive

natu

re o

f the

evi

denc

e re

port

ed in

pr

evio

us re

view

s.Cl

early

add

ition

al re

sear

ch is

nee

ded,

with

mor

e rig

orou

s stu

dy d

esig

ns, t

o co

nfirm

the

bene

fits o

f na

ture

inte

racti

ons a

nd m

enta

l hea

lth o

utco

mes

.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Inte

rven

tions

that

in

clud

e se

ek to

impr

ove

acce

ssib

ility

, eng

agem

ent,

or e

xpos

ure

to n

atur

e (e

.g.,

Wild

erne

ss T

hera

py p

rogr

ams,

Out

door

Ad

vent

ure

Prog

ram

s, G

reen

and

Blu

e Sp

aces

, etc

.)

Data

base

s sea

rche

d fo

r rev

iew

: Pub

Med

, SC

OPU

S, P

sycI

NFO

, Geo

base

, Pro

Que

st,

SPO

RTDi

scus

, Soc

ialo

gica

l Abs

trac

ts, L

eisu

re

and

Tour

ism D

atab

ase,

Phy

sical

Edu

catio

n In

dex,

EM

BASE

Adol

esce

nt-S

peci

fic F

indi

ngs:

(see

tabl

e)

Inte

rven

tion

Type

/Nam

e/Df

s—ex

amin

ed fo

r 13-

18 y

ear-

olds

or

equ

ival

ent (

spec

ify):

(see

tabl

e)

Revi

ew in

clus

ion

crite

ria—

Focu

s on

stud

y m

etho

dolo

gy: T

o be

incl

uded

, stu

dies

mus

t 1)

incl

ude

child

ren

and

teen

ager

s age

d 18

an

d un

der;

2) in

volv

ed a

n in

terv

entio

n th

at

inco

rpor

ated

an

elem

ent o

f nat

ure;

3) a

sses

s ou

tcom

e va

riabl

es th

at in

clud

e a

com

pone

nt

of m

enta

l hea

lth; a

nd 4

) be

of a

qua

ntita

tive

desig

n.

Out

com

es e

xam

ined

ove

rall—

incl

ude

all b

ut h

ighl

ight

PSE

WB

outc

omes

: Em

otion

al w

ell-b

eing

, atte

ntion

defi

cit d

isord

er/

hype

racti

vity

diso

rder

(ADD

/ADH

D), o

vera

ll m

enta

l hea

lth, s

elf-

este

em, s

tres

s, d

epre

ssio

n, re

silie

nce.

Revi

ew e

xclu

sion

crit

eria

—Fo

cus o

n st

udy

met

hodo

logy

: Exc

lusio

n fr

om th

e re

view

w

as b

ased

on

a fa

ilure

to m

eet t

he in

clus

ion

crite

ria d

etai

led

abov

e.

Out

com

es e

xam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: (

see

tabl

e)

Gui

danc

e us

ed to

stru

ctur

e re

view

(e.g

., PR

ISM

A, G

RADE

): PR

ISM

A

Out

com

es e

xam

ined

: Soc

ial/

built

env

ironm

ents

and

/or

peop

le su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Sc

hool

s, w

oodl

ands

, com

mun

ities

Coun

try(

ies)

: U.S

., U.

K., C

anad

aSt

ate/

regi

on/l

ocal

ity(ie

s) (e

ven

with

in o

ther

cou

ntrie

s): n

ot

repo

rted

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fa

mily

, wor

k, re

crea

tion,

OST

): Sc

hool

, Com

mun

ity, I

ndiv

idua

l

Page 118: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

118

Rapid Evidence Review Appendix 5: Evidence Tables

TE

EN

-SP

EC

IFIC

FIN

DIN

GS

AU

THO

RTE

EN

AG

E G

RO

UP

IN S

TUD

YIN

TER

VE

NTI

ON

OU

TCO

ME

NO

TES

Bow

en, 2

016

13-1

6O

utdo

or A

dven

ture

Sign

ifica

nt im

prov

emen

t (p<

0.05

) in

one

mea

sure

of

men

tal h

ealth

(psy

chol

ogic

al w

ell-b

eing

) at t

he 6

-12

mon

th fo

llow

afte

r 15

prog

ram

min

g da

ys d

urin

g a

10-1

2 w

eek

outd

oor a

dven

ture

pro

gram

. No

signi

fican

t effe

ct

on o

vera

ll m

enta

l hea

lth o

r psy

chol

ogic

al d

istre

ss a

t the

6-

12 m

onth

follo

w u

p m

ark.

No

signi

fican

t effe

ct o

n al

l m

easu

res o

f men

tal h

ealth

imm

edia

tely

pos

t-int

erve

ntion

.

Poor

qua

lity

ratin

g.

Bow

en, 2

016

12-1

8W

ilder

ness

The

rapy

No

signi

fican

t effe

ct fr

om p

re-p

ost a

fter t

he 1

0 w

eek

Wild

erne

ss T

hera

py p

rogr

am o

n em

otion

al fu

nctio

ning

in

clin

ical

and

non

-clin

ical

chi

ldre

n ag

es 1

2-18

. No

signi

fican

t eff

ect a

fter a

3 m

onth

follo

w-u

p. N

o sig

nific

ant e

ffect

fr

om p

re-p

ost o

n su

icid

ality

. The

re w

as a

stati

stica

lly

signi

fican

t red

uctio

n (p

<0.1

) at 3

mon

th fo

llow

up

on

suic

idal

ity. S

tatis

tical

ly si

gnifi

cant

impr

ovem

ent (

p <0

.1)

from

pre

- to

post

-inte

rven

tion

in 1

of 4

subs

cale

s of

self-

este

em (s

ocia

l). T

his e

ffect

was

still

obse

rved

at t

he

3 m

onth

follo

w u

p m

ark

(p<0

.1).

Stati

stica

lly si

gnifi

cant

im

prov

emen

t (p<

0.1)

from

pre

- to

post

inte

rven

tion

in

clin

ical

ly d

epre

ssed

chi

ldre

n. N

o sig

nific

ant e

ffect

at t

he

3 m

onth

follo

w u

p on

clin

ical

ly d

epre

ssed

chi

ldre

n. N

o sig

nific

ant e

ffect

from

pre

- to

post

inte

rven

tion

or a

t 3

mon

th fo

llow

up

on n

on-c

linic

ally

dep

ress

ed c

hild

ren.

St

atisti

cally

sign

ifica

nt im

prov

emen

t in

resil

ienc

e fr

om

pre-

to p

ost-i

nter

venti

on (p

<0.1

).

Fair

qual

ity ra

ting.

Cam

mac

k, 2

002

12-1

8Ho

rticu

lture

Pro

gram

No

signi

fican

t effe

ct a

fter t

he 1

0 w

eek

prog

ram

on

self-

este

emFa

ir qu

ality

ratin

g.

Clar

k, 2

004

13-1

8W

ilder

ness

The

rapy

Sign

ifica

nt e

ffect

(p<0

.05)

on

clin

ical

synd

rom

es sc

ales

aft

er th

e 21

-day

Wild

erne

ss T

hera

py p

rogr

am.

Good

qua

lity

ratin

g.

Feda

, 201

512

-15

Park

sPe

rcen

tage

of p

ark

area

with

in a

800

m b

uffer

of h

ome

pred

icte

d pe

rcei

ved

stre

ss (p

<0.0

5), e

ven

whe

n co

ntro

lled

for S

ES a

nd p

hysic

al a

ctivi

ty.

Fair

qual

ity ra

ting.

Gree

nwoo

d, 2

016

16-1

8Ex

posu

re to

the

Out

door

sPo

sitive

sign

ifica

nt in

crea

se (p

< 0

.01)

in p

ositi

ve a

ffect

aft

er ti

me

spen

t in

outd

oor e

nviro

nmen

t, re

ducti

on in

po

sitive

affe

ct a

fter ti

me

spen

t in

indo

or e

nviro

nmen

t. N

o sig

nific

ant e

ffect

of e

nviro

nmen

t on

atten

tiven

ess.

Att

entio

n sc

ores

wer

e re

duce

d sig

nific

antly

mor

e (p

<

0.01

) afte

r 20

min

utes

spen

t in

the

outd

oor e

nviro

nmen

t th

an in

the

indo

or e

nviro

nmen

t.

Poor

qua

lity

ratin

g.

Gubb

els,

201

612

-15

Gree

nery

No

signi

fican

t effe

ct o

f cha

nges

of p

erce

ived

gre

ener

y on

de

pres

sive

sym

ptom

s.Fa

ir qu

ality

ratin

g.

Harp

er, 2

007

13-1

8W

ilder

ness

The

rapy

12 m

onth

s fol

low

ing

the

21 d

ay W

ilder

ness

The

rapy

ther

e w

as a

sign

ifica

nt im

prov

emen

t on

suic

idal

thou

ghts

/id

eatio

n (p

<0.0

1). N

o sig

nific

ant e

ffect

2 m

onth

s fol

low

ing

Wild

erne

ss T

hera

py o

n ot

her c

ompo

nent

s of m

enta

l he

alth

.

Fair

qual

ity ra

ting.

Hind

s, 2

011

12-1

5W

oodl

and

Educ

ation

No

signi

fican

t effe

ct o

f the

2-5

nig

ht W

oodl

and

Educ

ation

pr

ogra

m o

n se

lf-es

teem

.Fa

ir qu

ality

ratin

g.

Huyn

h, 2

013

11-1

6N

atur

al S

pace

, Gre

en S

pace

, Blu

e Sp

ace

Scho

ol su

rrou

ndin

g Bl

ue S

pace

had

a p

ositi

ve, s

igni

fican

t eff

ect (

p<0.

05) o

n em

otion

al w

ell-b

eing

. No

signi

fican

t eff

ect o

f sch

ool s

urro

undi

ng n

atur

al o

r gre

en sp

ace

on

emoti

onal

wel

l-bei

ng.

Fair

qual

ity ra

ting.

Kelz,

201

513

-15

Scho

olya

rdGr

eeni

ng o

f the

scho

olya

rd sa

w a

sign

ifica

nt in

crea

se in

in

tra-

psyc

hic

bala

nce

com

pare

d to

bot

h co

ntro

l sch

ools

(p<0

.01)

. No

signi

fican

t effe

ct o

f the

gre

enin

g of

the

scho

olya

rd o

n ov

eral

l wel

l-bei

ng.

Fair

qual

ity b

eing

.

Page 119: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

119

Rapid Evidence Review Appendix 5: Evidence Tables

Kuo,

200

45-

18Gr

een

Out

door

sGr

een

outd

oor a

ctivi

ties a

fter s

choo

l and

on

wee

kend

s w

ere

signi

fican

tly m

ore

help

ful (

p <

0.01

) in

redu

cing

sy

mpt

oms t

han

built

out

door

or i

ndoo

r acti

vitie

s. T

his

held

for c

hild

ren

with

and

with

out h

yper

activ

ity a

s wel

l as

whe

n ac

tivity

type

was

con

trol

led

for.

Poor

qua

lity

ratin

g.

Mut

z, 2

016

14O

utdo

or A

dven

ture

Sign

ifica

nt in

crea

se in

min

dful

ness

(p<0

.05)

from

T1

to

T2 a

fter a

9 d

ay h

ike.

Sig

nific

ant i

ncre

ase

in m

ean

life

satis

facti

on (p

<0.0

5) fr

om T

1 to

T2.

No

signi

fican

t effe

ct

from

the

hike

on

happ

ines

s. N

o sig

nific

ant e

ffect

on

the

stre

ss su

bsca

le o

f wor

ries.

Sig

nific

ant d

ecre

ase

(p<0

.05)

in

the

stre

ss su

bsca

le o

f dem

and

from

T1

to T

2.

Poor

qua

lity

ratin

g.

Opp

er, 2

014

Grad

e 10

Out

door

Adv

entu

re E

duca

tion

Follo

win

g th

e 23

day

Out

door

Adv

entu

re E

duca

tion

prog

ram

ther

e w

as a

sign

ifica

nt e

ffect

(p<0

.05)

on

moo

d in

gra

de te

n m

ales

. 3 m

onth

s fol

low

ing

the

prog

ram

, th

ere

was

still

a sig

nific

ant e

ffect

on

moo

d in

gra

de 1

0 m

ales

. Sig

nific

ant e

ffect

on

stre

ss (p

<0.0

5) in

gra

de 1

0 m

ales

pos

t int

erve

ntion

, but

no

signi

fican

t effe

ct o

n st

ress

at

3 m

onth

follo

w u

p.

Good

qua

lity

ratin

g.

Ritc

hie,

201

412

-18

Out

door

Adv

entu

re L

eade

rshi

p Ex

perie

nce

No

signi

fican

t effe

ct o

n m

enta

l hea

lth sc

ores

from

pr

e- to

pos

t-int

erve

ntion

to 1

yea

r fol

low

up

of th

e 10

w

eek

Out

door

Adv

entu

re L

eade

rshi

p Ex

perie

nce.

No

signi

fican

t effe

ct o

n se

lf-es

teem

scor

es fr

om p

re- t

o po

st-

inte

rven

tion

to 1

yea

r fol

low

up.

At t

he 1

mon

th fo

llow

up

ther

e w

as a

sign

ifica

nt in

crea

se (p

<0.0

5) in

resil

ienc

e sc

ores

, but

scor

es re

turn

ed to

pre

-inte

rven

tion

leve

ls at

th

e 1

year

follo

w u

p.

Good

qua

lity

ratin

g.

Rom

i, 20

0415

-18

Wild

erne

ss T

hera

pyN

o sig

nific

ant e

ffect

from

the

prog

ram

on

self-

este

em.

No

signi

fican

t diff

eren

ce w

as fo

und

betw

een

the

grou

ps

befo

re a

nd a

fter t

he p

rogr

am.

Fair

qual

ity ra

ting.

Van

Den

Berg

, 201

19-

17N

atur

al (W

oode

d) S

etting

sN

o sig

nific

ant e

ffect

of n

atur

al w

oode

d se

tting

on

conc

entr

ation

.Go

od q

ualit

y ra

ting.

Van

Lier

, 201

612

-18

Gard

ens

Parti

cipa

ting

in g

arde

ning

at h

ome

was

sign

ifica

ntly

as

soci

ated

(p<0

.05)

with

bett

er m

enta

l wel

l-bei

ng. A

lso

signi

fican

tly a

ssoc

iate

d (p

<0.0

5) w

ith lo

wer

leve

ls of

de

pres

sive

sym

ptom

s.

Fair

qual

ity ra

ting.

War

d, 2

016

11-1

4Gr

een

Spac

eTi

me

spen

t in

gree

n sp

ace

was

sign

ifica

ntly,

pos

itive

ly

asso

ciat

ed (p

<0.0

5) w

ith a

ll m

easu

res o

f em

otion

al w

ell-

bein

g in

chi

ldre

n ag

es 1

1-14

; eve

n w

hen

cont

rolle

d fo

r m

oder

ate-

to-v

igor

ous p

hysic

al a

ctivi

ty.

Good

qua

lity

ratin

g.

Whi

tting

ton,

201

610

-15

Out

door

Adv

entu

rePa

rtici

patio

n in

the

Out

door

Adv

entu

re P

rogr

am w

as

asso

ciat

ed w

ith a

sign

ifica

nt in

crea

se in

resil

ienc

y an

d de

crea

se in

em

otion

al re

activ

ity in

girl

s pre

- to

post

-in

terv

entio

n (p

<0.0

5). N

o sig

nific

ant a

ssoc

iate

d be

twee

n pa

rtici

patio

n an

d re

silie

nce

was

obs

erve

d at

the

1 m

onth

fo

llow

up

mar

k.

Good

qua

lity

ratin

g.

Page 120: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

120

Rapid Evidence Review Appendix 5: Evidence Tables

33. V

an G

enug

htse

n LV

, Dus

seld

orp

E, M

asse

y E

K, V

an E

mp

elen

P. E

ffec

tive

sel

f-re

gul

atio

n ch

ang

e te

chni

que

s to

pro

mo

te m

enta

l wel

lbei

ng a

mo

ng a

do

lesc

ents

: a m

eta-

anal

ysis

. Hea

lth

Psy

cho

log

y R

evie

w [

Inte

rnet

]. 2

016

No

v 24

[ci

ted

201

9 Ju

ly 2

6]; 1

1(1)

:53-

71. A

vaila

ble

fro

m: h

ttp

s://

ww

w.t

and

fonl

ine.

com

/do

i/ab

s/10

.108

0/17

4371

99.2

016.

1252

934

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SS

YS

TEM

ATIC

RE

VIE

W L

IMIT

ATIO

NS

N

OTE

S

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

12-

18 y

ears

Date

rang

e fo

r rev

iew

: 199

0-20

12#

of st

udie

s inc

lude

d: 4

0

It w

ould

be

valu

able

to re

peat

the

anal

yses

with

a

larg

er se

t of s

tudi

es. I

n th

is m

eta-

anal

ysis,

stud

ies

inde

xed

in o

nly

four

onl

ine

data

base

s wer

e in

clud

ed.

19

stud

ies u

sed

a cl

uste

red

desig

n. T

his c

lust

ered

de

sign

was

not

take

n in

to a

ccou

nt in

our

met

a-an

alys

es.

Ri

sk o

f misc

ateg

oriza

tion:

Lar

ge v

arie

ty in

the

repo

rting

of c

hang

e te

chni

ques

use

d. F

or e

xam

ple,

se

vera

l tec

hniq

ues w

ere

used

rela

ting

to c

opin

g:

copi

ng p

lann

ing,

cop

ing

trai

ning

, cop

ing

skill

s, a

nd

rela

pse

prev

entio

n. M

any

stud

ies f

aile

d to

defi

ne

such

tech

niqu

es a

ny fu

rthe

r and

they

cou

ld n

ot b

e fu

rthe

r defi

ned

in th

e ta

xono

my.

Existi

ng ta

xono

mie

s ofte

n de

fine

SRTs

for b

ehav

iour

ch

ange

onl

y an

d w

ere

ther

efor

e no

t sui

tabl

e fo

r th

is re

view

on

men

tal w

ellb

eing

, whe

re e

moti

onal

re

gula

tion

is al

so v

ery

impo

rtan

t. ...

affec

t reg

ulati

on

was

und

er-r

epre

sent

ed in

exi

sting

taxo

nom

ies.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up: S

ee a

bove

.

Hi-L

evel

Fin

ding

s: S

elf-r

egul

ation

inte

rven

tions

w

ere

foun

d to

be

smal

l to

mod

erat

ely

effec

tive

at

prom

oting

wel

l-bei

ng. T

arge

ting

adol

esce

nts a

t hig

h ris

k fo

r psy

chol

ogic

al w

ellb

eing

cou

ld b

enefi

t fro

m

the

SRTs

‘ask

ing

for s

ocia

l sup

port

’ and

‘mon

itorin

g an

d ev

alua

tion’

, pos

sibly

in th

at o

rder

.

Inte

rven

tion

Ove

rall:

Sel

f-Reg

ulati

on Te

chni

ques

[SRT

]11 w

hich

w

ere

divi

ded

into

two

cate

gorie

s:

Prim

ary

inte

rven

tions

= u

nive

rsal

, pop

ulati

on-b

ased

.Se

cond

ary

inte

rven

tions

= ta

rget

ed to

spec

ific

risk

grou

ps.

Data

base

s sea

rche

d fo

r rev

iew

: Pub

Med

, Ps

ycIN

FO, W

eb o

f Sci

ence

, and

Em

base

Adol

esce

nt-S

peci

fic F

indi

ngs:

Prim

ary

inte

rven

tions

ha

d a

smal

l-to-

med

ium

effe

ct o

n se

lf-es

teem

and

in

tern

aliz

ing

beha

viou

r. Se

cond

ary

inte

rven

tions

ha

d a

med

ium

-to-

larg

e sh

ort-t

erm

effe

ct o

n in

tern

alizi

ng b

ehav

iour

and

self-

este

em. F

or

prim

ary

inte

rven

tions

the

effec

t size

s wer

e lo

wer

at

long

er te

rm fo

llow

-up,

whe

reas

seco

ndar

y in

terv

entio

ns sh

owed

that

pos

itive

out

com

es w

ere

mai

ntai

ned

at lo

nger

term

follo

w-u

p. N

o sig

nific

ant

effec

ts o

n ex

tern

aliz

ing

beha

viou

r wer

e fo

und

for

eith

er g

roup

of i

nter

venti

ons.

Inte

rven

tions

on

aver

age

used

four

out

of t

he n

ine

SRT

cate

gorie

s.

For p

rimar

y in

terv

entio

ns, t

here

was

not

a

sing

le S

RT th

at w

as a

ssoc

iate

d w

ith a

gre

ater

in

terv

entio

n eff

ect o

n in

tern

aliz

ing

beha

viou

r or

self-

este

em. I

n se

cond

ary

inte

rven

tions

, tho

se

incl

udin

g as

king

for s

ocia

l sup

port

had

a g

reat

eff

ect o

n in

tern

alizi

ng b

ehav

iour

. Tho

se in

clud

ing

mon

itorin

g an

d ev

alua

tion

had

a gr

eate

r effe

ct o

n se

lf-es

teem

.

Inte

rven

tion

exam

ined

for 1

3-18

yea

r-ol

ds o

r equ

ival

ent

(spe

cify

): Se

e ab

ove.

Re

view

incl

usio

n cr

iteria

: The

sear

ch w

as

limite

d to

pap

ers w

ritten

in E

nglis

h, G

erm

an,

or D

utch

. (1)

des

crib

ed a

self-

regu

latio

n in

terv

entio

n th

at (2

) aim

ed a

t im

prov

ing

men

tal o

r psy

chol

ogic

al w

ellb

eing

or

beha

viou

r and

that

repo

rted

cha

nges

in

wel

lbei

ng (3

) and

is e

valu

ated

in a

(qua

si)

rand

omise

d st

udy

amon

g (4

) ado

lesc

ents

.

Out

com

es o

vera

ll—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es:

Resil

ienc

e pr

otec

tive

fact

ors:

dep

ress

ive

sym

ptom

s, a

nxie

ty

sym

ptom

s, h

yper

activ

ity, c

ondu

ct p

robl

ems,

inte

rnal

izin

g pr

oble

ms,

ext

erna

lizin

g pr

oble

ms,

or g

ener

al p

sych

olog

ical

di

stre

ss. A

nd im

prov

ing

wel

lbei

ng fa

ctor

s.12

Revi

ew e

xclu

sion

: Stu

dies

cou

ld n

ot

incl

ude

clin

ical

ly d

iagn

osed

par

ticip

ants

(e

.g.,

inte

rven

tions

aim

ed a

t ado

lesc

ents

w

ith c

linic

ally

dia

gnos

ed d

epre

ssio

n).

Inte

rven

tions

incl

udin

g su

ch p

artic

ipan

t sa

mpl

es w

ere

excl

uded

from

this

stud

y.

Stud

ies w

ere

excl

uded

if th

ey d

id n

ot re

port

bo

th b

asel

ine

and

post

-inte

rven

tion

data

.

Out

com

es fo

r 13-

18 y

ear-

olds

or e

quiv

alen

t (sp

ecify

)—in

clud

e al

l but

hig

hlig

ht P

SEW

B ou

tcom

es: S

ee a

bove

. G

uida

nce

used

to st

ruct

ure

revi

ew (e

.g.,

PRIS

MA,

GRA

DE):

Coch

rane

Out

com

es fo

r Soc

ial/

built

env

ironm

ents

and

/or p

eopl

e su

rrou

ndin

g 13

-18

year

-old

s (N

ation

, Com

mun

ity,

Inte

rper

sona

l) –

Spec

ify o

utco

me

and

for w

hom

/wha

t it i

s m

easu

red:

N/A

Setti

ng(s

): Sc

hool

sCo

untr

y(ie

s): A

ustr

alia

, Isr

ael,

U.S.

, Aus

tral

ia, C

anad

a, U

.K.,

Spai

n, N

ethe

rland

s, S

love

nia,

Kor

ea, H

ong

Kong

, Tha

iland

, M

auriti

us, I

cela

nd

Stat

e/re

gion

/loc

ality

(ies)

(eve

n w

ithin

oth

er c

ount

ries)

: N/A

Leve

l (e.

g., n

ation

al, c

omm

unity

/nei

ghbo

rhoo

d, sc

hool

, fa

mily

, wor

k, re

crea

tion,

OST

): sc

hool

Page 121: Moving Policy Upstream to Advance Adolescent Flourishing ......from flourishing to languishing is part of a two-continua model of mental health.13 Keyes measured flourishing through

121

Rapid Evidence Review Appendix 5: Evidence Tables

34. Y

ap M

BH

, Mo

rgan

AJ,

Cai

rns

K, J

orm

AF,

Het

rick

SE

, Mer

ry S

. Par

ents

in p

reve

ntio

n: A

met

a-an

alys

is o

f ra

ndo

miz

ed c

ont

rolle

d t

rial

s o

f p

aren

ting

inte

rven

tio

ns t

o p

reve

nt in

tern

aliz

ing

p

rob

lem

s in

chi

ldre

n fr

om

bir

th t

o a

ge

18. C

linic

al P

sych

olo

gy

Rev

iew

[In

tern

et].

201

6 D

ec [

cite

d 2

019

July

26]

; 50:

138-

158.

Ava

ilab

le f

rom

: htt

ps:

//w

ww

.ncb

i.nlm

.nih

.go

v/p

ubm

ed/2

7969

003

FOC

US

OF

RE

VIE

WR

EV

IEW

ME

THO

DS

R

ELE

VAN

T FI

ND

ING

SR

EV

IEW

LIM

ITAT

ION

S

NO

TES

All A

ge/d

evel

opm

enta

l gro

ups i

nclu

ded:

You

th a

ged

0-18

ye

ars

Date

rang

e fo

r rev

iew

: Inc

eptio

n of

da

taba

ses s

earc

hed

- 201

5#

of st

udie

s inc

lude

d: 5

1 qu

alita

tive,

42

quan

titati

veAs

not

ed b

y au

thor

: It w

as b

eyon

d th

e sc

ope

of

the

curr

ent r

evie

w to

exa

min

e m

edia

tors

of t

he

inte

rven

tion

effec

ts fo

und;

aut

hors

cou

ld n

ot

adeq

uate

ly a

sses

s th

e qu

ality

of a

ll in

clud

ed tr

ials

be

caus

e of

poo

r rep

ortin

g; a

utho

rs a

lso

coul

d no

t as

sess

for m

oder

ation

by

inte

nsity

or d

urati

on o

f in

terv

entio

n du

e to

inad

equa

te d

escr

iptio

ns o

f thi

s as

pect

of i

nter

venti

on p

rogr

ams

in a

bout

one

-thi

rd o

f in

clud

ed tr

ials

. Clu

ster

ing

effec

ts w

ere

not a

ccou

nted

fo

r in

man

y st

udie

s. F

indi

ngs

may

not

gen

eral

ize to

et

hnic

min

oriti

es o

r dev

elop

ing

coun

trie

s.

Non

e of

the

univ

ersa

l in

terv

entio

ns in

volv

ed

pare

nts o

f tee

ns.

Age/

deve

lopm

enta

l gro

ups i

nclu

ded

rele

vant

to H

S ag

ed

teen

s age

s 13-

18—

spec

ify b

y st

udy

if au

thor

doe

sn’t

aggr

egat

e by

rele

vant

age

gro

up:

3 st

udie

s inc

lude

d ad

oles

cent

s. A

dole

scen

t age

s wer

e no

t pr

ovid

ed.

Hi-L

evel

Fin

ding

s: C

ompa

red

to c

ontr

ols,

par

ent-

ing

inte

rven

tions

redu

ced

child

inte

rnal

izin

g,

depr

essi

ve, a

nd a

nxie

ty sy

mpt

oms,

at a

min

i-m

um o

f 6 m

onth

s aft

er th

e in

terv

entio

n w

as

deliv

ered

. The

mea

n eff

ects

wer

e sm

all-v

ery

smal

l but

com

para

ble

to o

ther

pre

venti

ve in

-te

rven

tions

and

cou

ld h

ave

a su

bsta

ntial

pub

lic

heal

th im

pact

.

Inte

rven

tion

Type

/Nam

e/Df

--Ove

rall:

Ran

dom

ized

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s in

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base

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A

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122

Rapid Evidence Review Appendix 5: Evidence Tables

Out

com

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: Soc

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built

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rrou

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clud

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SA, A

ustr

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land

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k, re

crea

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OST

): Fa

mily

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123

Rapid Evidence Review Appendix 5: Evidence Tables

Endnotes

1. PRP is a 12-session program applicable to children aged 10–14 years with its duration ranging from 90 to 120 min per session. The aim of PRP is: a) to target the link between maladaptive cognitions and emotional-behavioral outcomes by challenging students’ stable explanatory style and b) to promote goal-setting by combating passive responses (Gillham & Reivich, 2004).

2. OVK is a school-based, depression-prevention program of 16 sessions of 50 minutes each, which has been delivered either as targeted or universal and it is applicable to adolescents aged 12–14 years (Tak et al., 2012). OVK shares the same basis as PRP (Beck, 1979, Ellis, 1962), after being culturally modi-fied in order to be applicable to Dutch teenagers (Tak et al., 2012). In OVK, cognitive distortions, explanatory style, coping and social skills are targeted, while OVK has been administered by school personnel and MHPs.

3. PYD programs build skills, assets, and competencies; foster youth agency; build healthy relationships; strengthen the environment; and transform systems to prepare youth for successful adulthood.

4. Such as: • Social, emotional, behavioral, cognitive, and moral competencies • Clear and positive identity • Strength of character • Self-efficacy • Self-determination • Belief in the future • Positive emotions • Bonding • Positive norms • Opportunities for positive social involvement • Recognition for positive behavior • Spirituality • Resilience • Life satisfaction

5. perceived adjustment/comfort levels in school

6. All girls, except for control group, participated in all interventions

7. Young men overall, including at-risk samples.

8. E.g., samples with subthreshold psychological disorder symptoms, or school samples with students at-risk of academic disengagement.

9. Franco Justo, C. (2010). Mindfulness program for increasing resilience and preventing burnouts in secondary school teachers. Revista Complutense de Educacion, 21, 271-288. Manas, I.M., Justo, C.F., & Martinez, E.J. (2011). Reducing levels of teacher stress and the days of sick leave in secondary school teachers through a mindfulness training program. Clinica y Salud, 22, 121-137.

10. “This is the first systematic review to include a substantial body of studies conducted in high-income (OECD) countries that: A. report the meaning-ful involvement of local people in decision-making processes, B. report wellbeing-related impacts, and C. were conducted in a community/living environment “

11. An intervention was defined as SRT if it used techniques that were related to behavioral or emotion self-regulation, including goal setting, planning, self-monitoring, feedback, coping, and relapse prevention

12. Improving wellbeing: well-being, quality of life, internalizing and external-izing behavior (e.g., depression or depressive feelings/thoughts/symptoms anxiety and aggressive behavior), self-esteem, (general) self-efficacy, self-perception and self-concept, locus of control, optimistic thinking and hope-lessness, positive and negative affect, psychological distress, or resilience.

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Rapid Evidence Review Appendix 6: Excluded Reviews

Moving Policy Upstream to Advance Adolescent Flourishing

Rapid Evidence Review Appendix 6: Excluded Reviews

D. Dougherty, N. LeBlanc, P. Armstrong, E. Cope, and the AcademyHealth & ACT for Health Team

With support from Well Being Trust

September 30, 2019

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Rapid Evidence Review Appendix 6: Excluded Reviews

Reviews Excluded from the Rapid Evidence Review following Full Text Review

Review Strategy Rationale for Exclusion

Akhtar, 20181 Forgiveness Therapy Interventions were not universally targeted

Aldridge, 20182 School climate interventions Only relevant study was conducted with 8th graders (not H.S.)

Altafim, 20163 Parent training interventions Adolescents excluded

Anderson, 20154 Community Coalition-Driven interventions Only collected measures of health status (e.g., mortality) and lifestyle factors (e.g., dietary habits), no Psychological, Social, and Emotional Well-Being (PSEWB) outcomes.

Anyon, 20185 Youth Participatory Action Research (YPAR) Only reported types of outcomes rather than findings from studies.

Arango, 20186 Primary preventive interventions Not a systematic review.

Bailey, 20167 Self-Regulation Not a systematic review.

Bakker, 20168 Mental Health Smartphone Apps Not adolescent focused.

Ballard, 20199 Youth Civic Engagement (activism, volunteerism, voting, YPAR; community benefits)

Review, but not systematic review.

Barlow, 201410 Parent training interventions The only 2 studies that included parents of adolescents and outcomes for adolescents, 1) do not focus on teens; 2) focus on parents of substance-abusing teens (not universal).

Barry, 201311 Mental health promotion interventions in Low- and Middle-Income Countries (LMIC)

2013 publication.

Burgdorf, 201912 Mindfulness Parenting Intervention Studies of adolescents focused on youth with psychological difficulties or those at risk of de-veloping them (i.e., not universal)

Corcoran, 201813 School-based Social and Emotional Learning (SEL) programs

No adolescent (13-18) studies and lack of direct PSEWB outcomes, also not really a systematic review.

Curran, 201714 Summary of Positive Youth Development (PYD) Programs

Not really a systematic review.

Das, 201715 Interventions for Adolescent Mental Health 2017; most interventions treatment-focused

Dick, 201516 Summary of recommendations to promote ado-lescent health

Not a systematic review.

Douglas, 201917 Young people mentoring their peers Copy not available. Unclear if Mental Health Practice is a peer-reviewed journal.18

Dray, 201719 School-based resilience promotion programs Not a systematic review (though a very useful single study).

Erbe, 201520 Mindfulness meditation Pre-2018; updated in Dunning et al., 2019; O’Connor et al., 2018; Skeen et al., 2019; Soulakova, 2019; and Klingbeil et al., 2018 for teachers

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126

Rapid Evidence Review Appendix 6: Excluded Reviews

Review Strategy Rationale for Exclusion

Greenberg, 201721 SEL advocacy paper Not a systematic review.

Gus, 201522 Emotion coaching Not a systematic review.

Hagen, 201923 Yoga Not a systematic review.

Haberland, 201724 Adolescent Girl Programs Review focused on implementation factors (e.g., multicomponent v single component; multi-level v single level; saturation), not program effective-ness.

Hodder, 201725 School-based resilience interventions Only measured alcohol, tobacco, and substance use with no measures of PSEWB.

Institute of Medicine and National Research Coun-cil, 201526

Family focused prevention interventions Workshop report (not a systematic review), focus on scaling and not on effectiveness of interven-tion.

Khalsa, 201627 Yoga Does not assess measures of PSEWB.

Khanlou, 201428 Resilience promotion programs Not a systematic review.

Kluve 201729 Labor market interventions Active Labour Market Programmes (ALMPs): specifically, training and skills development, entrepreneurship promotion, employment services and subsidized employ-ment.

The review considers psychosocial outcomes to be outputs and says: “In the interests of a well-defined intervention description, those activities and outputs that are not strictly linked to labour market effects have been omitted. Similarly, a narrow focus has been adopted on individual-level labour market outcomes, leaving aside other potential side effects, such as increased psychosocial well-being.

Langford, 2014/201530 WHO Health Promoting Schools Framework Only 2 studies relevant to mental well-being were conducted with 8th graders. In general, the Framework is for primary schools.

Larouche, 201831 Active School Transport (AST) Not enough adolescent studies to draw mean-ingful conclusions, lack sufficient sample size and properly powered studies are heavily fo-cused on elementary school students.

Lubans, 201632 Summary of mechanisms Review of mechanisms for how physical activ-ity may impact cognitive and mental health in youth, not a review of physical activity interven-tions.

Malti, 201633 School-based interventions to promote empathy related responding in children and adolescents.

Adolescents not included. 35 of 36 studies included did not include participants beyond 6th grade (the sole remaining study did not include participants beyond 8th grade).

Mansfield, 201834 Outdoor recreation for families to promote sub-jective wellbeing.

Only one study included teens as part of 7-16 y.o. age group.

Mewton, 201835 alcohol and drug use prevention programs Only measured alcohol, tobacco, and substance use with no measures of PSEWB.

Morrish, 201836 Emotion regulation interventions Not a systematic review.

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127

Rapid Evidence Review Appendix 6: Excluded Reviews

Review Strategy Rationale for Exclusion

Newton, 201737 Combined student-and-parents-based alcohol, tobacco, and other substance use prevention programs

Only measured alcohol, tobacco, and substance use with no measures of PSEWB.

Onnis, 201838 Social and emotional wellbeing intervention Single study, not a systematic review.

Onrust, 201639 School-based alcohol, tobacco, or other sub-stance use prevention programs

Only measured alcohol, tobacco, and substance use with no measures of PSEWB.

Rhodes, 200640 Model for the influence of mentoring relation-ships

Not a systematic review.

Rose-Clarke, 201941 Peer-facilitated community-based interventions in low- and middle-income countries.

No universal interventions with PSEWB out-comes for high-school-aged teens.

Sanders, 201442 Triple P (Positive Parenting Program) Included a mix of universal, targeted, and treat-ment interventions in its analysis.

Sapthiang, 201943 Advocacy for a Mindfulness/Health Promotion Approach in schools

Not a systematic review.

Saunders, 201744 Population-based survey assessing differences between pet and non-pet owners

Not an PSEWB intervention nor a systematic review.

Slopen, 201845 Housing Assistance No study involving adolescents was interven-tional.

Smedler, 201546 Externalizing prevention programs across a range of settings and delivery methods

Only 5 trials included universal interventions, none of which included adolescents.

Stuart, 201747 Advocacy for whole-school mindfulness focus Not a systematic review.

Tinner 201848 Public health interventions targeting multiple risk behaviors

Only one study looked at PSEWB outcome (so-cial and emotional skills).

Focus of analysis was on SES differences.

Turner, 201449 Survey of students regarding bullying/peer victimization

Not a systematic review.

Van Breda, 201850 Review of resilience-assessing studies No PSEWB interventions, an assessment of predictors of positive PSWEB and resilience-enablers in South African Children/Youth.

Vermeulen-Smit, 201551 Family interventions for drug use prevention Only measured alcohol, tobacco, and substance use with no measures of PSEWB.

Victor, 201852 Loneliness interventions No adolescent studies.

Waddington, 201453 Farmer Field Schools No adolescent findings included.

Waid, 201954 Theory of Positive Youth Development Not a systematic review.

Waters, 201655 Meditation interventions in schools/Contempla-tive Education

Pre-2018 with more recent relevant review.

Yeager 201756 Social and Emotional Learning Programs for Adolescents

Not a systematic review, but a narrative com-mentary invoking selected studies.

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Rapid Evidence Review Appendix 6: Excluded Reviews

Endnotes

1. Akhtar S, Barlow J. Forgiveness Therapy for the Promotion of Mental Well-Being: A Systematic Review and Meta-Analysis. Trauma Violence Abuse [Internet]. 2018 Jan [cited 2019 July 26]; 19(1): 107-122. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27009829

2. Aldridge JM, McChesney KR. The relationships between school climate and adolescent mental health and wellbeing: A systematic literature review. International Journal of Educational Research [Internet]. 2018 Mar [cited 2019 July 26]; 88:121-145. Available from: https://doi.org/10.1016/j.ijer.2018.01.012

3. Altafim ER, Linhares MB. Universal violence and child maltreatment pre-vention programs for parents: A systematic review. Psychosocial Interven-tion [Internet]. 2016 Apr [cited 2019 July 26]; 25(1):27-38. Available from: https://www.sciencedirect.com/science/article/pii/S1132055915000502

4. Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner-Brown J, Krause LK. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database of Sys-tematic Reviews [Internet]. 2015 Jun 15 [cited 2019 July 26]. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009905.pub2/full

5. Anyon Y, Bender K, Kennedy H, Dechants J. A Systematic Review of Youth Participatory Action Research (YPAR) in the United States: Methodologies, Youth Outcomes, and Future Directions. Health Education & Behavior [Internet]. 2018 Dec [cited 2019 Aug 15]; 45(6):865–878. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29749267

6. Arango C, Diaz-Caneja CM, McGorry PD, Rapoport J, Sommer IE, Vorst-man JA, et al. Preventive strategies for mental health. Lancet Psychiatry [Internet]. 2018 July [cited 2019 July 26]; 5(7):591-604. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29773478

7. Bailey R, Jones SM. An Integrated Model of Regulation for Applied Settings. Clinical Child and Family Psychology Review [Internet]. 2019 Mar [cited 2019 July 26]; 22(1):2-23. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30783912

8. Bakker D, Kazantzis N, Rickwood D, Rickard N. Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Develop-ments. JMIR Mental Health [Internet]. 2016 Mar 1 [cited 2019 July 26]; 3(1):e7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26932350

9. Ballard P. Youth Civic Engagement and Health, Wellbeing, and Safety: A Review of Research. 2019 [cited 2019 Aug 2]. Available from: http://www.pacefunders.org/wp-content/uploads/2019/03/PACE_Ballard_Lit-Review.pdf

10. Barlow J, Smailagic N, Huband N, Roloff V, Bennett C. Group-based parent training programmes for improving parental psychosocial health. Cochrane Database of Systematic Reviews [Internet]. 2014 May 17 [cited 2019 July 26]. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002020.pub4/full

11. Barry MM, Clarke AM, Jenkins R, Patel V. A systematic review of the ef-fectiveness of mental health promotion interventions for young people in low- and middle-income countries. BMC Public Health [Internet]. 2013 [cited 2019 July 26]; 13. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24025155

12. Burgdorf V, Szabo M, Abbott MJ. The Effect of Mindfulness Interventions for Parents on Parenting Stress and Youth Psychological Outcomes: A Sys-tematic Review and Meta-Analysis. Frontiers in Psychology [Internet]. 2019 June 6 [cited 2019 Aug 19]; 10:1336. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31244732

13. Corcoran RP, Cheung ACK, Kim E, Xie C. Effective universal school-based social and emotional learning for improving academic achievement: A systematic review and meta-analysis of 50 years of program research. Educational Research Review [Internet]. 2018 Nov [cited 2019 July 26]; 25:56-72. Available from: https://www.sciencedirect.com/science/article/pii/S1747938X17300611

14. Curran T, Wexler L. School-Based Positive Youth Development: A System-atic Review of the Literature. Journal of School Health [Internet]. 2017 Jan [cited 2019 Aug 1]; 87(1):71-80. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1111/josh.12467

15. Das JK et al. 2016. Interventions for adolescent mental health: An overview. J. Adol Health 59:S49-S60.

16. Dick B, Ferguson BJ. Health for the world’s adolescents: a second chance in the second decade. Journal of Adolescent Health [Internet]. 2015 Jan [cited 2019 July 26]; 56(1):3-6. https://www.ncbi.nlm.nih.gov/pubmed/25530601

17. Douglas L, Jackson D, Woods C, Usher K. Reported outcomes for young people who mentor their peers: a literature review. Mental Health Practice [Internet]. 2018 Sep 7 [cited 2019 July 26]; 21(9):35-45. Available from: https://journals.rcni.com/mental-health-practice/evidence-and-practice/reported-outcomes-for-young-people-who-mentor-their-peers-a-literature-review-mhp.2018.e1328/print/abs

18. https://rcni.com/mental-health-practice/about-us

19. Dray J, Bowman J, Campbell E, Freund M, Hodder RK, Wolfenden L, et al. Effectiveness of a pragmatic school-based universal interventions targeting student resilience protective factors in reducing mental health problems in adolescents. Journal of Adolescent Health [Internet]. 2017 Jun [cited 2019 July 26]; 57:74-89. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28384523

20. Erbe R, Lorhmann D. Mindfulness Meditation for Adolescent Stress and Well-Being: A Systematic Review of the Literature with Implications for School Health Programs. Health Educator [Internet]. 2015 [cited 2019 July 26]; 47(2):12-19. Available from: https://eric.ed.gov/?id=EJ1153619

21. Greenberg MT, Domitrovich CE, Weissberg RP, Durlak JA. Social and Emotional Learning as a Public Health Approach to Education. Future of Children [Internet]. 2017 [cited 2019 July 26]; 27(1):13-32. Available from: https://eric.ed.gov/?id=EJ1144819

22. Gus L, Rose J, Gilbert L. Emotion Coaching: A universal strategy for sup-porting and promoting sustainable emotional and behavioural well-being. Educational & Child Psychology [Internet]. 2015 [cited 2019 July 26]; 31(1):31-41. Available from: https://www.bathspa.ac.uk/media/bath-spaacuk/education-/research/emotion-coaching/Emotion_Coaching_posi-tion_paper_Gus_et_al.pdf

23. Hagen I, Nayar US. Yoga for Children and Young People’s Mental Health and Well-Being: Research Review and Reflections on the Mental Health Potentials of Yoga. Frontiers in Psychiatry [Internet]. 2014 Apr 2 [cited 2019 July 26]; 5:35. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24765080

24. Haberland NA, McCarthy KJ, Brady M. A Systematic Review of Adolescent Girl Program Implementation in Low- and Middle-Income Countries: Evidence Gaps and Insights. Journal of Adolescent Health [Internet]. 2018 July [cited 2019 July 26]; 63(1):18-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29434004

25. Hodder RK, Freund M, Wolfenden L, Bowman J, Nepal S, Dray J, et al. Systematic review of universal school-based ‘resilience’ interventions target-ing adolescent tobacco, alcohol or illicit substance use: A meta-analysis. Preventive Medicine [Internet]. 2017 July [cited 2019 July 26]; 100:248-268. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28390835

26. Institute of Medicine and National Research Council. Strategies for Scaling Effective Family-Focused Preventive Interventions to Promote Children’s Cognitive, Affective, and Behavioral Health: Workshop Summary. Washing-ton (DC): The National Academies Press; 2015. 8 p. Available from: https://www.nap.edu/catalog/21718/strategies-for-scaling-tested-and-effective-family-focused-preventive-interventions-to-promote-childrens-cognitive-affective-and-behavioral-health

27. Khalsa SBR, Butzer B. Yoga in school settings: a research review. Annals of the New York Academy of Sciences [Internet]. 2016 Jun [cited 2019 July 26]; 1373(1):45-55. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26919395

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Rapid Evidence Review Appendix 6: Excluded Reviews

28. Khanlou N, Wray R. A Whole Community Approach toward Child and Youth Resilience Promotion: A Review of Resilience Literature. Inter-national Journal of Mental Health and Addiction [Internet]. 2014 [cited 2019 July 26]; 12:64-79. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24523668

29. Kluve J, Puerto S, Robalino D, Romero JM, Rother F, Stoterau J, et al. Interventions to improve the labour market outcomes of youth: a systematic review of training, entrepreneurship promotion, employment services and subsidized employment interventions. Campbell Collaboration [Internet]. 2017 Dec 4 [cited 2019 July 26]; 13. Available from: https://campbellcollabo-ration.org/library/improving-youth-labour-market-outcomes.html

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56. Yeager DS. Social and Emotional Learning Programs for Adolescents. The Future of Children [Internet]. 2017 [cited 2019 July 26]; 27(1):31-52. Available from: https://labs.la.utexas.edu/adrg/files/2013/12/5-Adolescence-Yeager-2.pdf


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