The Lancet https://doi.org/10.1016/S0140-6736(18)31615-5 (2018)

Teachers, students, and school experiences educate and shape adolescents; therefore, schools represent a promising platform for delivering interventions designed to improve adolescents’ health and quality of life.

Credit: Olekcii Mach/Alamy Stock Photo

Sachin Shinde and colleagues were interested in determining whether a health intervention program to improve school climate and health-promoting behaviours would work in a large population in the Nalanda district (state of Bihar) in India, a populous region whose human development index in 2015 was at the bottom of the 36 Indian states and territories. To do this, they randomly assigned the schools to one of three groups: in one, the intervention was delivered by teachers; in another, it was delivered by a lay counsellor; and finally, a third group only received the standard, government-run life-skills course. They then measured how the intervention influenced bullying, violence, depressive symptoms, attitudes towards gender equity, and knowledge of sexual health. Interestingly, they found that their intervention only changed these behaviours and attitudes when it was delivered by the lay counsellors, and not by the teachers.

Taken together, these results show that interventions aimed at improving school climate can be effective ways of changing attitudes and behaviours in low/middle-income countries and highlight the importance of correctly choosing the person to administer such interventions.