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Network meta-analysis is a popular statistical technique for synthesizing evidence from studies comparing multiple interventions. Benefits of network meta-analysis, over more traditional pairwise meta-analysis approaches, include evaluating efficacy/safety of interventions within a single framework, increased precision, comparing pairs of interventions that have never been directly compared in a trial, and providing a hierarchy of interventions in terms of their effectiveness. Network meta-analysis is relatively underutilized in prevention science. This paper therefore presents a primer of network meta-analysis for prevention scientists who wish to apply this method or to critically appraise evidence from publications using the method. We introduce the key concepts and assumptions of network meta-analysis, namely, transitivity and consistency, and demonstrate their applicability to the field of prevention science. We then illustrate the method using a network meta-analysis examining the comparative effectiveness of brief alcohol interventions for preventing hazardous drinking among college students. We provide data and code for all examples. Finally, we discuss considerations that are particularly relevant in network meta-analyses in the field of prevention, such as including non-randomized evidence.

Young adulthood is a developmentally risky period for hazardous or high-intensity alcohol consumption that can progress to an alcohol use disorder (AUD). Brief interventions offer one promising approach for reducing alcohol consumption and related harms among young adults. However, there are numerous methodological and theoretical challenges associated with optimizing intervention design, identifying mechanisms of action, understanding individual and contextual moderators of effects, and scaling up these interventions for widespread implementation and utilization. The current article serves as an editorial introduction to this special issue of Psychology of Addictive Behaviors, titled "Brief Alcohol Interventions for Young Adults," which aims to highlight critical inflection points and opportunities for advancing the scientific study of brief alcohol interventions among young adults.The articles in this special issue address innovative methods and approaches that can be used to personalize and strengthen the magnitude and durability of brief intervention effects; considerations of intervention components and technology enhancements; and implementation science considerations for producing population-level changes in alcohol use to reduce AUD among young adults.In this editorial introduction, we discuss several common themes from the articles included in the special issue and highlight important directions for future research aimed at strengthening the effects, disentangling mechanisms, and scaling up brief alcohol interventions for broader impact on the young adult population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Recovery high schools (RHSs) provide educational programming and therapeutic support services for young people in recovery from substance use disorders (SUDs). The objectives of this study were to examine whether students with SUDs who attended RHSs report less delinquency and substance use than students with SUDs who attended non-RHSs, and how students' social problem solving styles might moderate those associations. Participants were students from a longitudinal quasi-experimental study of adolescents who enrolled in high schools after receiving treatment for SUDs. The propensity-score balanced sample included 260 adolescents (143 in RHSs, 117 in non-RHSs) enrolled in schools in Minnesota, Wisconsin, or Texas (M age = 16; 83% White; 44% female). Negative binomial regression models were used to compare delinquency and substance use outcomes for RHS and non-RHS students at 6-month and 12-month follow-ups. The results indicated that students attending RHSs after discharge from SUD treatment reported less frequent delinquent behavior while intoxicated, and fewer days of substance use relative to students attending non-RHSs. Negative problem solving styles moderated the effect of RHS attendance on substance use outcomes, with RHSs providing minimal beneficial effects for those students endorsing maladaptive problem solving styles. We conclude that RHSs offer a promising continuing care approach for adolescents in recovery from SUD problems, but may vary in their effectiveness for students with impulsive, careless, or avoidant problem solving styles.

Introduction In the field of adolescent development, meta-analysis offers valuable tools for synthesizing and assessing cumulative research evidence on the effectiveness of programs, practices, and policies intended to promote healthy adolescent development. When examining the impact of a program implemented across multiple primary studies, variation is often observed in the methodological attributes of those primary studies, such as their implementation methods, program components, participant characteristics, outcome measurement, and the systems in which programs are deployed. Differences in methodological attributes of primary studies represented in a meta-analysis, referred to as complexity, can yield variation in true effects across primary studies, which is described as heterogeneity. Methods We discuss heterogeneity as a parameter of interest in meta-analysis, introducing and demonstrating both graphical and statistical methods for evaluating the magnitude and impact of heterogeneity. We discuss approaches for presenting characteristics of heterogeneity in meta-analytic findings, and methods for identifying and statistically controlling for aspects of methodological complexity that may contribute to variation in effects across primary studies. Results Topics and methods related to assessing and explaining heterogeneity were contextualized in the field of adolescent development using a sample of primary studies from a large meta-analysis examining the effectiveness of brief alcohol interventions for youth. We highlighted approaches currently underutilized in the field and provided R code for key methods to broaden their use. Conclusions By discussing various heterogeneity statistics, visualizations, and explanatory methods, this article provides the applied developmental researcher a foundational understanding of complexity and heterogeneity in meta-analysis.

IntroductionDysphagia affects several children in USA and around the globe. Videofluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are the most objective studies to define swallowing function. The presence of tracheal aspiration during VFSS or FEES in children with dysphagia is associated with an increased risk of aspiration pneumonia. However, the association of laryngeal penetration with aspiration pneumonia remains unclear. This systematic review aims to assess the risk of aspiration pneumonia in children with dysphagia with laryngeal penetration on VFSS/FEES and compare it with children with tracheal aspiration and children with neither tracheal aspiration nor laryngeal penetration.Methods and analysisThis study will be a systematic review and meta-analysis. Systematic electronic searches will be conducted on PubMed, EMBASE, Web of Science, CINHAL, Scopus, Cochrane CENTRAL, LILACS and WHO Global Index Medicus. We will include studies published through 6 October 2021. Primary outcome will be the incidence of aspiration pneumonia. Secondary outcomes will be incidence of hospitalisation, paediatric intensive care unit admission, enteral tube requirement, growth, symptoms improvement and mortality. The Cochrane Risk of Bias In Non-Randomised Studies of Interventions tool will be used to assess the risk of bias. Meta-analysis will be used to pool the studies. We will pool dichotomous outcomes to obtain an odd ratio (OR) and report with 95% CI. Continuous outcomes will be pooled to obtain mean difference and reported with 95% CI. Overall grade of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and findings will be presented in a summary of findings table.Ethics and disseminationThis study is a systematic review without contact with patients. Therefore, IRB approval is not required. Authors consent to publishing this review. Data will be kept for review by editors and peer reviewers. Data will be available to general public on request.PROSPERO registration numberCRD42020222145.

Background Haemolytic uraemic syndrome (HUS) is a common cause of acquired kidney failure in children and rarely in adults. The most important risk factor for development of HUS is a gastrointestinal infection by Shiga toxin-producing Escherichia coli (STEC). This review addressed the interventions aimed at secondary prevention of HUS in patients with diarrhoea who were infected with a bacteria that increase the risk of HUS. Objectives Our objective was to evaluate evidence regarding secondary preventative strategies for HUS associated with STEC infections. In doing so, we sought to assess the effectiveness and safety of interventions as well as their potential to impact the morbidity and death associated with this condition. Search methods We searched the Cochrane Kidney and Transplant Register of Studies up to 12 November 2020 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. Selection criteria Studies were considered based on the methods, participants, and research goals. Only randomised controlled trials were considered eligible for inclusion. The participants of the studies were paediatric and adult patients with diarrhoeal illnesses due to STEC. The primary outcome of interest was incidence of HUS. Data collection and analysis We used standard methodological procedures as recommended by Cochrane. Summary estimates of effect were obtained using a random-effects model, and results were expressed as risk ratios (RR) and their 95% confidence intervals (CI) for dichotomous outcomes. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Main results We identified four studies (536 participants) for inclusion that investigated four different interventions including antibiotics (trimethoprim-sulfamethoxazole), anti-Shiga toxin antibody-containing bovine colostrum, Shiga toxin binding agent (Synsorb Pk: a silicon dioxide-based agent), and a monoclonal antibody against Shiga toxin (urtoxazumab). The overall risk of bias was unclear for selection, performance and detection bias and low for attrition, reporting and other sources of bias. It was uncertain if trimethoprim-sulfamethoxazole reduced the incidence of HUS compared to no treatment (47 participants: RR 0.57, 95% CI 0.11-2.81, very low certainty evidence). Adverse events relative to this review, need for acute dialysis, neurological complication and death were not reported. There were no incidences of HUS in either the bovine colostrum group or the placebo group. It was uncertain if bovine colostrum caused more adverse events (27 participants: RR 0.92, 95% CI 0.42 to 2.03; very low certainty evidence). The need for acute dialysis, neurological complications or death were not reported. It is uncertain whether Synsorb Pk reduces the incidence of HUS compared to placebo (353 participants: RR 0.93, 95% CI 0.39 to 2.22; very low certainty evidence). Adverse events relevant to this review, need for acute dialysis, neurological complications or death were not reported. One study compared two doses of urtoxazumab (3.0 mg/kg and 1.0 mg/kg) to placebo. It is uncertain if either 3.0 mg/kg urtoxazumab (71 participants: RR 0.34, 95% CI 0.01 to 8.14) or 1.0 mg/kg urtoxazumab (74 participants: RR 0.95, 95% CI 0.79 to 1.13) reduced the incidence of HUS compared to placebo (very low certainty evidence). Low certainty evidence showed there may be little or no difference in the number of treatment-emergent adverse events with either 3.0 mg/kg urtoxazumab (71 participants: RR 1.00, 95% CI 0.84 to 1.18) or 1.0 mg/kg urtoxazumab (74 participants: RR 0.95, 95% CI 0.79 to 1.13) compared to placebo. There were 25 serious adverse events reported in 18 patients: 10 in the placebo group, and 9 and 6 serious adverse events in the 1.0 mg/kg and 3.0 mg/kg urtoxazumab groups, respectively. It is unclear how many patients experienced these adverse events in each group, and how many patients experienced more than one event. It is uncertain if either dose of urtoxazumab increased the risk of neurological complications or death (very low certainty evidence). Need for acute dialysis was not reported. Authors' conclusions The included studies assessed antibiotics, bovine milk, and Shiga toxin inhibitor (Synsorb Pk) and monoclonal antibodies (Urtoxazumab) against Shiga toxin for secondary prevention of HUS in patients with diarrhoea due to STEC. However, no firm conclusions about the efficacy of these interventions can be drawn given the small number of included studies and the small sample sizes of those included studies. Additional studies, including larger multicentre studies, are needed to assess the efficacy of interventions to prevent development of HUS in patients with diarrhoea due to STEC infection.

IntroductionPrevalence rates of breastfeeding remain low even though the World Health Organization (WHO) and the American Academy of Pediatrics recommend exclusive breast feeding for the first 6 months of life in combination with appropriate complementary feeding beyond six 6 months of age. There have been several studies that address the implication of drinking animal milk and/or infant formula on children’s health and development when breast feeding is not offered during the first year of life. Vast improvements have been made in infant formula design, which may increase its benefits compared with animal’s milk. The objective of this review is therefore to synthesise the most recent evidence on the effects of the consumption of animal milk compared with infant formula in non-breastfed or mixed breastfed infants aged 6–11 months.Methods and analysisWe will conduct a systematic review and meta-analysis of studies that assessed the effect of animal milk compared with formula or mixed-fed (breastmilk and formula) on infants aged 6–11 months. The primary outcomes of interest include anaemia, gastrointestinal blood loss, weight for age, height for age and weight for height. We will include randomised and non-randomised studies with a control group. We will use the Cochrane risk of bias tools to assess the risk of bias. We will use meta-analysis to pool findings if the identified studies are conceptually homogenous and data are available from more than one study. We will assess the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.Ethics and disseminationThis is a systematic review, so no patients will be directly involved in the design or development of this study. The findings from this systematic review will be disseminated to relevant patient populations and caregivers and will guide the WHO’s recommendations on formula consumption versus animal milk in infants aged 6–11 months.Trial registration numberCRD42020210925.

Recovery high schools are one form of continuing care support for adolescents with substance use or other co-occurring disorders. Using a controlled quasi-experimental design, we compared mental health symptom outcomes at 6 months for adolescents who attended recovery high schools vs. non-recovery high schools (e.g., traditional or alternative schools). The propensity score balanced sample included 194 adolescents (134 in recovery schools, 60 in non-recovery schools) enrolled in schools in MN, WI, or TX (average age = 16; 86% White; 51% female). Baseline data indicated that this is a dually diagnosed population—94% of students met criteria for at least one mental health diagnosis and 90% had received mental health treatment distinct from treatment for substance use disorders. Results from multilevel logistic regression models indicated that at the 6-month follow-up, adolescents attending both recovery and non-recovery high schools reported substantial improvements in mental health symptoms. However, there were no significant differences in mental health outcomes between the two groups. We conclude that although recovery high schools offer promise for reducing substance use and improving academic success, and while adolescents’ mental health symptoms improved between baseline and follow-up, recovery high schools may have minimal differential effects on adolescents’ mental health symptoms.

Aims To illustrate a machine learning-based approach for identifying and investigating moderators of alcohol use intervention effects in aggregate-data meta-analysis. Methods We illustrated the machine learning technique of random forest modeling using data from an ongoing meta-analysis of brief substance use interventions implemented in general healthcare settings. A subset of 40 trials testing brief alcohol interventions (BAIs) was used; these trials provided 344 estimates of post-intervention effects on participants’ alcohol use as well as data on 20 potential moderators of intervention effects. These candidate moderators included characteristics of trial methodology and implementation, intervention design and participant samples. Results The best-fitting random forest model identified 10 important moderators from the pool of 20 candidate moderators. Meta-regression utilizing the selected moderators found that inclusion of prescriptive advice in a BAI session significantly moderated BAI effects on alcohol use. Observed effects were also significantly moderated by several methodological characteristics of trials, including the type of comparison group used, the overall level of attrition and the strategy used to address missing data. In a meta-regression model that included all candidate moderators, fewer coefficients were found to be significant, indicating that the use of a preliminary data reduction technique to identify only important moderators for inclusion in final analyses may have yielded improved statistical power to detect moderation. Conclusions Machine learning methods can be valuable tools for clarifying the influence of trial, intervention and sample characteristics on alcohol use intervention effects, in particular when numerous candidate moderators are available.

Collegiate recovery programs (CRPs) offer resources and programming for postsecondary students in addiction recovery to ensure they can initiate or maintain their recovery and complete college. To achieve these goals, CRPs offer a variety of activities that research and theory suggests should produce positive outcomes among their students; yet the lack of systematic evaluation research in this area means it is unknown which programming components may drive outcomes. Recovery capital theory posits a variety of factors at multiple ecological levels that might influence students’ recovery experience and their engagement and success in community programs like CRPs. To address this complexity in research and evaluation work on CRPs, we provide a recovery capital-oriented theory of change and logic model for CRP evaluations, and demonstrate how this model could be used with an exemplar case. This is followed by a recovery capital-oriented data collection toolkit for future research and evaluation. These efforts should help to inform program planners and evaluators interested in understanding the influence of the ecosystem of recovery-oriented systems of care in CRPs for emerging adults.

This review of reviews presents an empirically based set of mean effect size distributions for judging the relative impact of the effects of universal mental health promotion and prevention programs for school-age youth (ages 5 through 18) across a range of program targets and types of outcomes. Mean effect size distributions were established by examining the findings from 74 meta-analyses of universal prevention and promotion programs that included more than 1100 controlled outcome studies involving over 490,000 school-age youth. The distributions of mean effect sizes from these meta-analyses indicated considerable variability across program targets and outcomes that differed substantially from Cohen's (1988, Statistical power analysis for the behavioral sciences (2nd ed.)) widely used set of conventions for assessing if effects are small, medium, or large. These updated mean effect size distributions will provide researchers, practitioners, and funders with more appropriate evidence-based standards for judging the relative effects of universal prevention programs for youth. Limitations in current data and directions for future work are also discussed.

Social control and procedural justice theories indicate that informal social control reduces problem behaviors. However, many schools have implemented formal control mechanisms such as school secur...

Recovery high schools (RHSs) are an alternative high school option for adolescents with substance use disorders (SUDs), designed to provide a recovery-focused learning environment. The aims of this study were to examine the characteristics of youth who choose to attend RHSs, and to compare them with local and national comparison samples of youth in recovery from SUDs who were not enrolled in RHSs. We conducted secondary analysis of existing data to compare characteristics of youth in three samples: (1) adolescents with SUDs who enrolled in RHSs in Minnesota, Texas, and Wisconsin after discharge from treatment (RHSs; n = 171, 51% male, 86% White, 4% African American, 5% Hispanic); (2) a contemporaneously recruited local comparison sample of students with SUDs who did not enroll in RHSs (n = 123, 60% male, 77% White, 5% African American, 12% Hispanic); and (3) a national comparison sample of U.S. adolescents receiving SUD treatment (n = 12,967, 73% male, 37% White, 15% African American, 30% Hispanic). Students enrolled in RHSs had elevated levels of risk factors for substance use and relapse relative to both the local and national comparison samples. For instance, RHS students reported higher rates of pre-treatment drug use, past mental health treatment, and higher rates of post-treatment physical health problems than adolescents in the national comparison sample. We conclude that RHSs serve a population with greater co-occurring problem severity than the typical adolescent in SUD treatment; programming offered at RHSs should attend to these complex patterns of risk factors. SUD service delivery policy should consider RHSs as an intensive recovery support model for the most high-risk students with SUDs.

Much research focuses on what might be possible with digital games in the classroom. This study focuses on what is currently probable and typical. It uses a controlled quasi-experimental design to compare outcomes for students of 13 teachers in 10 diverse urban, suburban, and rural schools. The teachers integrated a set of 55 typical educational games into their curricula on Jacksonian democracy. Teachers reported strong engagement benefits for the game condition and a strong interest in using games of this type in the future in their surveys and interviews. Each teacher taught at least one classroom with the games and at least one classroom without the games. When the one teacher who reported a failed implementation was dropped from the analysis, the results showed significantly higher gains for the game condition in terms of multiple-choice factual outcomes, open-response factual outcomes, evidentiary depth, and student engagement outcomes. When the failed implementation was included, the game condition...

Recovery high schools (RHSs) provide post-treatment education and recovery support for young people with substance use disorders (SUDs). This is the first quasi-experimental outcome study to determine RHS effectiveness relative to students in non-RHSs.To examine effects of RHS attendance on academic and substance use outcomes among adolescents treated for SUDs 6 months after recruitment to the study.A quasi-experimental design comparing outcomes for adolescents with treated SUDs who attended RHSs for at least 28 days versus a propensity-score balanced sample of students with treated SUDs who did not attend RHSs. The sample included 194 adolescents (134 in RHSs, 60 in non-RHSs) enrolled in Minnesota, Wisconsin, or Texas schools (M age = 16; 86% White; 49% female). Multilevel linear regression models were used to examine the effect of RHS attendance on students' outcomes, after adjusting for a range of potential confounders.Adolescents attending RHSs were significantly more likely than non-RHS students to report complete abstinence from alcohol, marijuana, and other drugs at the 6-month follow-up (OR = 4.36, p = .026), significantly lower levels of marijuana use (d = -0.51, p = .034) and less absenteeism from school (d = -0.56, p = .028).These results indicate that RHSs have significantly beneficial effects on substance use and school absenteeism after 6 months for adolescents treated for SUDs.

In response to continued concerns over crime and violence, schools are increasingly employing visible security measures such as cameras, metal detectors, and security personnel. These security measures are not mutually exclusive, but few studies have considered the relationship between the use of multiple forms of security and youth’s exposure to drugs, fighting, property crime, and firearms at school. To address this issue, we analyzed nationally representative school administrator-reported data from the School Survey on Crime & Safety, using a quasi-experimental design with propensity scores to adjust for potential confounding factors. The results indicated that utilization of multiple security measures reduced the likelihood of exposure to property crime in high schools, but most other security utilization patterns were associated with poorer school safety outcomes. Our findings provide guidance to policymakers in considering whether to use – or expand – visible school security measures in schools.

This systematic review and meta-analysis synthesized findings from studies examining culturally sensitive substance use treatment for racial/ethnic minority youth. An extensive literature search located eight eligible studies using experimental or quasi-experimental designs. The meta-analysis quantitatively synthesized findings comparing seven culturally sensitive treatment conditions to seven alternative conditions on samples composed of at least 90% racial/ethnic minority youth. The results from the meta-analysis indicated that culturally sensitive treatments were associated with significantly larger reductions in post-treatment substance use levels relative to their comparison conditions (g=0.37, 95% CI [0.12, 0.62], k=7, total number participants=723). The average time between pretest and posttest was 21weeks (SD=11.79). There was a statistically significant amount of heterogeneity across the seven studies (Q=26.5, p=0.00, τ2=0.08, I2=77.4%). Differential effects were not statistically significant when contrasts were active generic counterparts of treatment conditions (direct "bona fide" comparisons; g=-0.08, 95% CI [-0.51, 0.35]) and 'treatment as usual' conditions (g=0.39, 95% CI [-0.14, 0.91]). Strong conclusions from the review were hindered by the small number of available studies for synthesis, variability in comparison conditions across studies, and lack of diversity in the adolescent clients served in the studies. Nonetheless, this review suggests that culturally sensitive treatments offer promise as an effective way to address substance use among racial/ethnic minority youth.

This evaluation examined the effects of afterschool programs-supported by an afterschool system intermediary organization (ASIO)-on middle school students' academic performance and examined how those effects varied by student characteristics and program engagement. In this longitudinal, quasi-experimental matched comparison group evaluation, propensity score matching was used to create demographically balanced samples of ASIO-supported afterschool program participants and nonparticipants. Students enrolled in the afterschool programs did not differ from non-participants in growth over time on most academic outcomes. Students attending the afterschool programs showed less growth on certain state test scores compared to nonparticipants. Student demographic characteristics did not consistently influence participant outcomes. Among program participants only, students who were enrolled more than 1 year demonstrated a 7-percentile-point increase in state test scores per year of program engagement. There was no consistent evidence that ASIO-supported afterschool program participation was associated with improved student academic outcomes. However, study results support increased emphasis on afterschool program retention, given that longer duration of participation in the afterschool programs was associated with more growth on multiple academic outcomes.

BACKGROUND: Late adolescence is a time of increased drinking, and alcohol plays a predominant role in college social experiences. Colleges seeking to prevent students’ hazardous drinking may elect to implement brief alcohol interventions (BAIs). However, numerous manualized BAIs exist, so an important question remains regarding the comparative effectiveness of these different types of BAIs for college students. AIM: This study uses network meta-analyses (NMA) to compare seven manualized BAIs for reducing problematic alcohol use among college students. METHODS: We systematically searched multiple sources for literature, and we screened studies and extracted data in duplicate. For the quantitative synthesis, we employed a random-effects frequentist NMA to determine the effectiveness of different BAIs compared to controls, and estimated the relative effectiveness ranking of each BAI. RESULTS: A systematic literature search resulted in 52 included studies: on average, 58% of participants were male, 75% were binge drinkers, and 20% were fraternity/sorority-affiliated students. Consistency models demonstrated that BASICS was consistently effective in reducing students’ problematic alcohol use (ES range: g=−0.23, 95%CI [−0.36,−0.16] to g=−0.36, 95% CI [−0.55,−0.18]), but AlcoholEDU (g=−0.13, 95%CI [−0.22,−0.04]), e-CHUG (g=−0.35, 95%CI [−0.45,−0.05]), and THRIVE (g=−0.47, 95%CI [−0.60,−0.33]) were also effective for some outcomes. Intervention rankings indicated that BASICS, THRIVE, and AlcoholEDU hold the most promise for future trials. CONCLUSIONS: Several BAIs appear effective for college students. BASICS was the most effective but is resource intensive and may be better suited for higher risk students; THRIVE and e-CHUG are less resource intensive and show promise for universal prevention efforts.

Background Collegiate Recovery Programs (CRPs) are campus-based support programs for substance use and recovery needs among college students. These CRPs utilize a variety of program activities and components aimed at promoting healthy development and sobriety while encouraging college retention among participants. Objectives Describe the types of activities and administrative structures used in CRPs, examine the characteristics of students involved in this sample, and explore changes in students’ outcomes after they have enrolled in a CRP. Methods This multi-site study collected de-identified data from six CRPs on participating students’ sociodemographic characteristics, academic performance, substance use, and socioemotional well-being. One CRP administrator from each participating site completed a survey on CRP programming. Data were harmonized across sites and descriptively summarized. Results Participating CRPs had been in operation since 2007 to 2012. Five of the six sites provided individual-level student data for a total of 861 students (56% male, 89% White, 91% undergraduate). Student histories indicated the majority had received treatment for a substance use disorder (82%) or mental health concern (77%), 56% had criminal justice involvement, and the majority were in recovery less than five years. Student GPA improved in three of the four sites that provided student GPA data. Conclusions CRPs collect diverse types of data on participating students, but more effort is needed to focus on systematic data collection. Findings from this study suggest that CRPs play an important role in providing needed services for this vulnerable population of college students.

Previous meta-analyses have shown that psychotherapy improves gastrointestinal symptoms in adults with irritable bowel syndrome (IBS); however, the impact on functioning in daily activities is unknown. Meta-analysis was used to estimate the effect of psychotherapy on mental health and daily functioning in adults with IBS. An extensive literature search located 28 eligible randomized controlled trials (RCTs) providing outcome data for mental health and 18 RCTs providing data for daily functioning. Compared to a mixed group of control conditions, psychotherapy produced significantly greater improvements to mental health (d−=0.41) and daily functioning (d−=0.43). Cognitive behavior therapy (CBT) was evaluated in the largest number of trials (21 trials), followed by hypnosis (4 trials), psychodynamic (3 trials), and relaxation (2 trials). The psychotherapeutic modalities were comparable with respect to their effect on mental health. CBT produced the greatest improvements to daily functioning, and this effect was significantly larger than that produced by relaxation therapy. These results have important clinical implications for treatment of adults with IBS.

This Campbell systematic review examines the impact of later school start times on student academic performance, mental health and family and community outcomes. The review summarises findings from 17 reports of 11 interventions in six countries. Later school start times appear to increase sleeping time. And there is a positive association between later school start times and academic and psychosocial outcomes. The evidence on absenteeism and student alertness is mixed. However, the quality of the evidence and comparability of studies is low. Adverse effects may be reduced interaction with parents, and staffing and scheduling difficulties. There is insufficient evidence to draw firm conclusions concerning these possible adverse effects. Plain language summary Later school start times may produce benefits for students but more evidence is needed There is a positive association between later school start times and academic and psychosocial outcomes. The review in brief Later school start times may have beneficial effects for student mental health and academic performance. There appear to be some positive effects from later start times, but the evidence base is too weak to have confidence in the findings. Additional research is needed. What is this review about? Later school start times have been implemented around the world as a means of avoiding the potentially negative impacts that early morning schedules can have on adolescent students. Even mild sleep deprivation has been associated with significant health and educational concerns: increased risk for accidents and injuries, impaired learning, aggression, memory loss, poor self‐esteem, and changes in metabolism. This review examines the effects of later start times on these outcomes. What is the aim of this review? This Campbell systematic review examines the impact of later school start times on student academic performance, mental health and family and community outcomes. The review summarises findings from 17 reports of 11 interventions in six countries. What studies are included? Included studies were randomized controlled trials, controlled before‐and‐after studies, and interrupted time series studies with data for students aged 13 to 19 years and that compared different school start times. Studies had to report either primary outcomes of interest (academic outcomes, amount or quality of sleep, mental health indicators, attendance, or alertness) or secondary outcomes (health behaviors, health and safety indicators, social outcomes, family outcomes, school outcomes, or community outcomes) were eligible. The evidence base covers 17 studies reporting on 11 unique interventions with 297,994 participants. Six studies took place in the USA, and one study each was in Brazil, Canada, Croatia, Israel, and New Zealand. What are the main results in this review? Later school start times appear to increase sleeping time. And there is a positive association between later school start times and academic and psychosocial outcomes. The evidence on absenteeism and student alertness is mixed. However, the quality of the evidence and comparability of studies is low. Adverse effects may be reduced interaction with parents, and staffing and scheduling difficulties. There is insufficient evidence to draw firm conclusions concerning these possible adverse effects. What do the findings in this review mean? This systematic review on later school start times suggests several potential benefits for this intervention and points to the need for higher quality primary studies. However, because of the limited evidence base, we could not determine the effects of later school start times with any confidence. How up‐to‐date is this review? The review authors searched for studies published up to February 2016. This Campbell systematic review was published in December 2017. Executive summary/Abstract Background A number of school systems worldwide have proposed and implemented later school start times as a means of avoiding the potentially negative impacts that early morning schedules can have on adolescent students. Even mild sleep deprivation has been associated with significant health and educational concerns: increased risk for accidents and injuries, impaired learning, aggression, memory loss, poor self‐esteem, and changes in metabolism. Although researchers have begun to explore the effects of delayed school start time, no one has conducted a rigorous review of evidence to determine whether later school start times support adolescent health, education, and well‐being. Objectives We aimed to assess the effects of a later school start time for supporting health, education, and well‐being in high school students. Secondary objectives were to explore possible differential effects of later school start times in student subgroups and in different types of schools; to identify implementation practices, contextual factors, and delivery modes associated with positive and negative effects of later start times; and to assess the effects of later school start times on the broader community (high school faculty and staff, neighborhood, and families). Search methods We conducted the main search for this review on 28 October 2014 and updated it on 8 February 2016. We searched CENTRAL as well as 17 key electronic databases (including MEDLINE, Embase, ERIC, PsycINFO, and Sociological Abstracts), current editions of relevant journals and organizational websites, trial registries, and Google Scholar. Selection criteria We included any randomized controlled trials, controlled before‐and‐after studies, and interrupted time series studies with sufficient data points that pertained to students aged 13 to 19 years and that compared different school start times. Studies that reported either primary outcomes of interest (academic outcomes, amount or quality of sleep, mental health indicators, attendance, or alertness) or secondary outcomes (health behaviors, health and safety indicators, social outcomes, family outcomes, school outcomes, or community outcomes) were eligible. Data collection and analysis At least two review authors independently determined inclusion and exclusion decisions through screening titles, abstracts, and full‐text reports. Two review authors independently extracted data for all eligible studies. We presented findings through a narrative synthesis across all studies. When two or more study samples provided sufficient information to permit effect size calculations, we conducted random‐effects meta‐analyses to synthesize effects across studies. Results Our search located 17 eligible records reporting on 11 unique studies with 297,994 participants; the studies examined academic outcomes, amount and quality of sleep, mental health indicators, attendance, and student alertness. Overall, the quality of the body of evidence was very low, as we rated most studies as being at high or unclear risk of bias with respect to allocation, attrition, absence of randomization, and the collection of baseline data. Therefore, we cannot be confident about the effects of later school start times. Preliminary evidence from the included studies indicated a potential association between later school start times and academic and psychosocial outcomes, but quality and comparability of these data were low and often precluded quantitative synthesis. Four studies examined the association between later school start times and academic outcomes, reporting mixed results. Six studies examined effects on total amount of sleep and reported significant, positive relationships between later school start times and amount of sleep. One study provided information concerning mental health outcomes, reporting an association between decreased depressive symptoms and later school start times. There were mixed results for the association between later school start times and absenteeism. Three studies reported mixed results concerning the association between later school start times and student alertness. There was limited indication of potential adverse effects on logistics, as the qualitative portions of one study reported less interaction between parents and children, and another reported staffing and scheduling difficulties. Because of the insufficient evidence, we cannot draw firm conclusions concerning adverse effects at this time. It is important to note the limitations of this evidence, especially as randomized controlled trials and high‐quality primary studies are difficult to conduct; school systems are often unwilling or unable to allow researchers the necessary control over scheduling and data collection. Moreover, this evidence does not speak to the process of implementing later school starts, as the included studies focused on reporting the effects rather than exploring the process. Authors’ conclusions This systematic review on later school start times suggests several potential benefits for this intervention and points to the need for higher quality primary studies. However, as a result of the limited evidence base, we could not determine the effects of later school start times with any confidence.

Meta-analysis is a statistical technique that allows an analyst to synthesize effect sizes from multiple primary studies. To estimate meta-analysis models, the open-source statistical environment R is quickly becoming a popular choice. The meta-analytic community has contributed to this growth by developing numerous packages specific to meta-analysis. The purpose of this study is to locate all publicly available meta-analytic R packages. We located 63 packages via a comprehensive online search. To help elucidate these functionalities to the field, we describe each of the packages, recommend applications for researchers interested in using R for meta-analyses, provide a brief tutorial of two meta-analysis packages, and make suggestions for future meta-analytic R package creators.

To conduct a meta-analysis of the effects of juvenile drug courts on general recidivism, drug recidivism, and drug use, and to explore variability in effects across characteristics of the drug courts and juvenile participants. We conducted a comprehensive literature search to identify randomized and controlled quasi-experimental studies that reported the effects of juvenile drug courts in the United States. Random-effects meta-analysis models were used to estimate mean odds ratio effect sizes, and meta-regression models were used to explore variability in effects. The literature search yielded 46 eligible evaluation studies. The meta-analysis found that, overall, juvenile drug courts were no more or less effective than traditional court processing, with mean effects sizes that were not statistically significant for general recidivism, drug recidivism, or drug use. There was statistically significant heterogeneity in those effect sizes, but none of the drug court or participant characteristics coded from the study reports were associated with that variability. However, the juvenile drug court evaluations were generally of poor methodological quality, with very few studies employing random assignment and many instances of substantial baseline differences between drug court and comparison groups. Juvenile drug courts were not found to be categorically more or less effective than traditional court processing for reducing recidivism or drug use. The great variability in effects, nonetheless, suggests that there may be effective drug courts, but no distinctive characteristics of the more effective courts could be identified from the descriptive information provided in the generally low quality research studies currently available.

ABATRACTMany U.S. schools attempt to create safe learning environments by implementing visible security measures such as cameras, metal detectors, and security personnel. This study explored utilization patterns of visible security measures and several associated predictors. Data included school administrator and student responses from multiple waves of two nationally representative surveys. Three latent classes of visible security measures were identified. Membership in the heaviest security latent class was most likely among large urban high schools in the South and was associated with student race/ethnicity and school disorder. Implications for research on effectiveness of visible security measures are discussed.

Adolescents who experience multiple victimization (i.e., victimization on a regular basis) are at greater risk for having negative academic outcomes including lower achievement and poorer attendance than those who do not experience such victimization. Yet, the role of school contexts in this relationship remains unclear. Nevertheless, school-based efforts to reduce victimization often focus on altering contexts without sufficient evidence of associations with improved student outcomes. School security measures constitute one such suite of contextual interventions aimed at reducing victimization. This study tested a moderated mediation model in which the relationship between multiple victimization and academic performance is mediated by absenteeism, and the relationship between multiple victimization and absenteeism is moderated by the presence of school security measures. Participants were 5930 (49.6% female and 79.51% White) 12- to 18-year-old adolescents from a national sample collected through the 2011 School Crime Supplement to the National Crime Victimization Survey. Results of path analysis models indicated that the relationship between multiple victimization and academic performance was partially mediated by absenteeism, and that both metal detectors and security guards moderated the relationship between multiple victimization and absenteeism. Additional analyses revealed the utility of considering subpopulations of victims characterized by specific facets of their contexts. Implications for practitioners and researchers are discussed.