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This five-year randomised controlled trial explored the impact of the Lifestart home visiting parenting programme, on parent and child development outcomes. The Lifestart Programme is a universal and structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. In total, 424 parents and children participated, and outcomes were measured at pre-test (child age

Socio-demographic background and school-level factors are influential on an individual’s educational outcomes. However, limited research has had the ability to examine the impact of a pupil’s socio-demographic profile and school-level factors, whilst accounting for the multidimensional structure of socio-economic status. Using data that combined the Census (2011), School Leavers Survey and School Census for the first time in Northern Ireland (n = 61,373), multilevel modelling was executed to examine the associations between educational attainment (GCSE score), a pupil’s socio-demographic profile (socio-economic status, gender and religious affiliation) and school-level factors (school type and management structure). The findings from this study highlight: the multidimensionality and hierarchy of socio-economic effects; the prevalence of a gender effect; variability in the influence of religious affiliation; the need for a nuanced approach when considering school-level factors, and the importance of interaction terms for an in-depth understanding of attainment trends.

The study undertook a Level 3 efficacy trial of a smoking prevention programme in Grade 8 high-school classrooms. A smoking prevention programme, ‘Dead Cool’, was tested in a randomized controlled trial. 17 Grade 8 classes were randomly assigned to intervention or control arms of the trial. The intervention was a cooperative learning-based intervention of five, 40 min lessons delivered by teachers, but designed by Cancer Focus NI. The primary outcome was smoking as measured by carbon monoxide (CO) in exhaled breath. Measurements of CO were undertaken pre-test, immediately post-test and three months after the intervention. Multi-level modelling indicated the programme prevented smoking initiation in Grade 8 students. Implications for research and design of school-based smoking prevention programmes are discussed.

Background Evidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children’s health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions. Methods Daire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) ‘Nourish’, ii) ‘Engage’, iii) ‘Nourish’ and ‘Engage’ and iv) Control (Delayed). ‘Nourish’ was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. ‘Engage’ was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured. Results Fifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6–7 years and n = 458 aged 10–11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6–7 and 10–11 year old pupils) who received the ‘Nourish’ intervention compared with those that did not (adjusted difference in mean = − 0.82; 95% CI -1.46, − 0.17; P P P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed. Conclusions Improvements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the ‘Nourish’ whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted. Trial registration National Institute of Health (NIH) U.S. National Library of Medicine Clinical Trials.gov (ID: NCT04277312).

This proof of concept study harnesses novel transdisciplinary insights to contrast two school-based smoking prevention interventions among adolescents in the UK and Colombia. We compare schools in these locations because smoking rates and norms are different, in order to better understand social norms based mechanisms of action related to smoking. We aim to: (1) improve the measurement of social norms for smoking behaviors in adolescents and reveal how they spread in schools; (2) to better characterize the mechanisms of action of smoking prevention interventions in schools, learning lessons for future intervention research. The A Stop Smoking in Schools Trial (ASSIST) intervention harnesses peer influence, while the Dead Cool intervention uses classroom pedagogy. Both interventions were originally developed in the UK but culturally adapted for a Colombian setting. In a before and after design, we will obtain psychosocial, friendship, and behavioral data (e.g., attitudes and intentions toward smoking and vaping) from ~300 students in three schools for each intervention in the UK and the same number in Colombia (i.e., ~1,200 participants in total). Pre-intervention, participants take part in a Rule Following task, and in Coordination Games that allow us to assess their judgments about the social appropriateness of a range of smoking-related and unrelated behaviors, and elicit individual sensitivity to social norms. After the interventions, these behavioral economic experiments are repeated, so we can assess how social norms related to smoking have changed, how sensitivity to classroom and school year group norms have changed and how individual changes are related to changes among friends. This Game Theoretic approach allows us to estimate proxies for norms and norm sensitivity parameters and to test for the influence of individual student attributes and their social networks within a Markov Chain Monte Carlo modeling framework. We identify hypothesized mechanisms by triangulating results with qualitative data from participants. The MECHANISMS study is innovative in the interplay of Game Theory and longitudinal social network analytical approaches, and in its transdisciplinary research approach. This study will help us to better understand the mechanisms of smoking prevention interventions in high and middle income settings.

This systematic review aimed to examine empirical evidence relating to the level and developmental appropriateness of service provision for two-year-olds. To be included in this review, studies had to have been published before 2006, had to have an explicit focus on service provision for two-year-olds and had to have a randomly assigned control group. Following the application of the inclusion/exclusion criteria,11 studies were included in the review. The relatively small number of eligible studies and findings suggesting a limited impact from a number of the studies suggests there is a lack of empirical evidence available. Therefore, determinations with regards to what constitutes as developmentally appropriate and effective practice for this age group could not be made.

This study reports the effect of four lessons of a recently developed Irish media literacy teaching intervention on the advertising literacy of children aged 8-11. Covariates of age and gender were also considered. Alongside this, a process evaluation was completed. The results of this pilot RCT show that children aged between 8 and 11 are capable of increasing their knowledge regarding the persuasive intent and the selling intent of marketing messages. The intervention had a statistically significant positive impact on advertising literacy. This study finds no evidence to suggest that advertising literacy is gendered. Qualitative discussions indicate that the teaching materials were well received by both teachers and children. The need for regular advertising literacy lessons for children was unearthed. The challenge of attempting to include more content in an increasingly crowded curriculum was cited as the main barrier to delivering regular media literacy lessons. Recommendations for increased media literacy education in primary school are discussed. These findings are of interest to parties including educators, parents, policy makers and marketers.

Background Inactive lifestyles are becoming the norm and creative approaches to encourage adolescents to be more physically active are needed. Little is known about how gamification techniques can be used in physical activity interventions for young people. Such approaches may stimulate interest and encourage physical activity behaviour. The study investigated the feasibility of implementing and evaluating a physical activity intervention for adolescents which included gamification techniques within schools. We tested recruitment and retention strategies for schools and participants, the use of proposed outcome measures, and explored intervention acceptability. Methods This school-based feasibility study of a randomised cluster trial recruited adolescents aged 12–14 years (n = 224) from five schools (three intervention; two control) in Belfast, Northern Ireland. The 22-week intervention (The StepSmart Challenge) informed by self-determination theory and incorporating gamification strategies involved a school-based pedometer competition. Outcomes, measured at baseline, and post-intervention (at 22 weeks post-baseline and 52 weeks post-baseline) included daily minutes of moderate to vigorous physical activity (MVPA) (measured using ActiGraph accelerometer), mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale), social support for physical activity, time preference (for delayed and larger rewards or immediate and smaller rewards), pro-social behaviour (Strengths and Difficulties Questionnaire (SDQ)) and the influence of social networks. The intervention’s acceptability was explored in focus groups. Results We invited 14 schools to participate; eight showed interest in participating. We recruited the first five who responded; all five completed the trial. Of the 236 pupils invited, 224 participated (94.9%): 84.8% (190/224) provided valid MVPA (minutes/day) at baseline and 57.2% (123/215) at 52 weeks. All other outcomes were well completed apart from the SDQ (65% at baseline). Qualitative data highlighted that participants and teachers found The StepSmart Challenge to be an acceptable intervention. Conclusions The level of interest and high recruitment and retention rates provide support for the feasibility of this trial. The intervention, incorporating gamification strategies and the recruitment methods, using parental opt-out procedures, were acceptable to participants and teachers. Teachers also suggested that the implementation of The StepSmart Challenge could be embedded in a lifelong learning approach to health within the school curriculum. As young people’s lives become more intertwined with technology, the use of innovative gamified interventions could be one approach to engage and motivate health behavioural change in this population. Trial registration NCT02455986 (date of registration: 28 May 2015).

This paper presents a research protocol for a randomised controlled efficacy trial of the ‘Dead Cool’ smoking prevention programme. Dead Cool is a three to four-hour programme designed to be used by teachers with Year 9 students in Northern Ireland. The main outcome of the programme is to prevent students from starting to smoke. The protocol reports a research design intended to test the efficacy of the programme in 20 post-primary school settings. Selected schools included those from secondary /grammar/integrated/single sex/coeducational, rural and urban schools from both the maintained and controlled state sector and independent sector schools. Outcome measures include self-reported behaviours, monitoring of carbon monoxide (CO) in exhaled breath and focus groups designed to assess implementation fidelity and opinions on efficacy in intervention schools and explore the ‘counterfactual’ potential treatments in control schools.

Aim: To analyse the role of sex-focused knowledge in the contraceptive behaviour of sexually active young people in state care.Methods: The sample consisted of 19 care leavers (young people previously in state care) aged 18-22 years, 16 females and 3 males. In-depth interviewing was the method of data collection, and a qualitative strategy resembling modified analytical induction was used to analyse data.Findings: Findings indicated that a lack of information was not the sole, or even the primary reason for engaging in unsafe sexual practices. Other factors such as ambivalence to becoming pregnant also featured in participants’ accounts. Several participants conveyed a relatively weak sense of agency about consistently using contraception. A small number of participants expressed a strong determination to avoid pregnancy, and these appeared to have a level of anxiety about becoming pregnant that motivated them to engage with knowledge about contraception and its use.Conclusion: Lack of sex-focused information is just one aspect of a myriad of complex factors, including socioeconomic disadvantage and/or emotional deprivation, that influences contraceptive behaviour.

Research on the effects of breastfeeding on child cognitive development has produced conflicting results, and many studies do not account for infant stimulation in the home. The aim of this study is to determine whether breastfeeding predicts enhanced cognitive development in one-year-old infants after controlling for the main socio-economic and environmental factors, including stimulation in the home. This cross-sectional observational study involved 137 infants and their mothers. Information on maternal socio-demographic factors and breastfeeding practices was obtained through semi-structured interview. Stimulation in the home was measured using the HOME Inventory. Cognitive development was assessed using the Bayley Scales of Infant Development. Mean cognitive scores were significantly higher in breast-fed infants (110) compared with formula-fed infants (105). Breastfeeding duration had a positive linear association with cognitive scores at one year. In linear regression, the adjusted standardised beta ...

The Growth, Learning and Development (GLAD) study aimed to examine how a broad range of factors influence child weight during the first year of life. Assessments were undertaken within a multidisciplinary team framework. The sample was drawn from the community and data collection was undertaken in the four Greater Belfast Trusts. Twohundred and thirty-four families took part, each receiving a total of five home visits during which physical growth, oral-motor skills and development were assessed. Psychosocial evaluation examined parent-child interaction, feeding and other parental and child characteristics using quantitative and observational techniques. This paper outlines the main findings and recommendations from the GLAD study.

The paper presents a protocol for ‘A randomized controlled trial of functional family therapy (FFT): an Early Intervention Foundation (EIF) partnership between Croydon Council and Queen's University Belfast’. The protocol describes a trial that uses FFT as an alternative intervention to current use of the youth justice system and local authority care with the aim of reducing crime/recidivism in young people referred to Croydon Council. The trial will take place over a period of 36 months and will involve up to 154 families. Croydon Council will employ a team of five Functional Family Therapists who will work with families to promote effective outcomes. The Centre for Effective Education at Queen's University Belfast will act as independent evaluators of outcomes for families and young people. The work is supported from the United Kingdom Economic & Social Research Council/Early Intervention Foundation Grant Number ES/M006921/1

This study explored the patterning of young people's sexual health competence, and how this relates to sexual health outcomes. A survey of 381 young people attending two sexual health clinics in Northern Ireland was carried out between 2009 and 2010. Latent profile analysis of self-rated decision making, self-rated sexual health knowledge, and knowledge of sexually transmitted disease questionnaire scores was used to determine typologies of sexual health competence. Analysis revealed three categories of sexual health competence and explored their association with other behaviours and social characteristics. Young people's subjective opinion of their sexual health competency, when not matched with a corresponding knowledge of sexual health, could place people at an increased risk of poor sexual health outcomes. Greater levels of peer pressure to have sex and early sexual debut were associated with poorer sexual health knowledge. This finding warrants further investigation, as the importance of self-perceived competence for sexual health screening and education programmes are considerable.