1. Our vision: Healthier communities, Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethical, Excellence, Caring, Commitment, Courage The One Stop Shop Project – increasing school capacity to support student health and wellbeing, and its impact on student tobacco use Justine Daly, John Wiggers, Karen Gillham, Megan Freund & Rebecca Hodder Hunter New England Population Health September 2007

2. 2 Background  Tobacco use contributes to the burden of illness in young people  A significant proportion of young people smoke  Peer group pressure, inexperience and curiosity may be a contributing factor to underage tobacco smoking  There is little strong evidence that interventions have a positive effect on uptake.

3. 3 Background  Two important factors are: –Resilience factors: personal skills and traits of the young person –Protective factors: positive influences within the young person’s environment  Schools as a setting for health promotion.  Despite the existence of these programs, uptake and implementation is poor  Possible barriers to implementation may include: –School staff engagement –Appropriate allocation of resources –Utilisation of a capacity building model

4. 4 Aims  A pilot program was undertaken to increase the health and wellbeing of young people attending three regional high schools in New South Wales, Australia  In particular the program aimed to: –increase resilience and protective characteristics of young people attending the schools –reduce tobacco use by young people attending the three schools

5. 5 Method – Design & Participants Design  Pre-post - data collected via cross-sectional student surveys: –Prior to the intervention (2002) –Four years after intervention commencement (2006)  A multi-strategic capacity building approach based on MindMatters –National Mental Health program undertaken within schools Participants  Three regional high schools from one disadvantaged Local Government Area  Student in years 7 to 10

6. 6 Method - Measures  Student survey –An amended version of the California Healthy Kids Survey was utilised –All students in years 7 to 10 were asked to complete survey –Variables included Resilience factor score Protective factor score Two measures of tobacco use: -No. students who had ever smoked a cigarette -No. students who had smoked one or more cigarettes in the last 3 months

7. 7 Method - Intervention A multi-strategic intervention was used: 1)Needs based approach Student, Youth Services, staff and parent surveys to inform health and wellbeing planning 2)Local consensus and adaptation Establishment of core groups Health and Wellbeing Planning based on needs assessment Collaborative Review and Re-focusing Workshops 3)Professional development and training MindMatters Level 1 training Attendance and presentation at MindMatters conferences School specific training by MindMatters support officer

8. 8 Method - Intervention 4)Additional support: PO embedded in one of the three schools Seed funding 5)Resources and tools provided: Database: -Collation of student, parent and staff data -Production of summary reports Health and Wellbeing Action Planning Guide. This included: -Health and Wellbeing Planning model -Step by step instructions to conduct future needs assessments and workshops -Templates for Health and Wellbeing Action planning, budgets and endorsement; workshop agendas and minutes

9. 9 Results  Present results from student surveys pre and post test –Resilience factors –Protective factors –Tobacco measures  Response rates: –Pre-test 1485 (79%) –Post test 1203 (62%)

10. 10 Results  Median resilience and protective factors scores *p=0.0001 *p<0.01

11. 11 Results  Proportion of students reported having ever smoked a cigarette *p<0.0001

12. 12 Results  Proportion of students who reported smoking one or more cigarettes in the last 3 months *p<0.001

13. 13 Conclusions & Recommendations  Suggests project was effective in addressing student resilience and protective factors, and student tobacco use in disadvantaged schools  Potential to significantly impact on young people’s health and wellbeing, and long-term health outcomes  Suggests additional resource and capacity building approach is important  Recommendations for schools/organisations: –Continue to monitor and address resilience and protective factors  Recommendations for researchers: –More rigorous research design is required to further investigate the potential of this program (eg. Other health risk behaviours) and find the best model

14. 14 Acknowledgements  With grateful acknowledgements of: –Staff and students of three schools involved Hunter New England Population Health is a unit of the Hunter New England Area Health Service. Supported by funding from NSW Health through the Hunter Medical Research Institute and 1999 NSW Drug Summit Developed in partnership with the University of Newcastle.