Postura frente a los cambios de roles percibidos

The criteria and definitions used for considering which studies to include in this review are outlined below. These inclusion criteria were operationalised into exclusion criteria to inform our screening of studies found (see Appendix 3). The results of this screening process are detailed in Chapter 3.

Date

We included only studies published in and after 1985, as this is when PYD interventions first began to be

developed.30,44_{Our original proposal did not restrict included studies by date; we added this exclusion}

criterion at an early stage in the review, including this in our registered protocol.51

Language

We included only studies published in English because PYD interventions appear to be a phenomenon particular to anglophone countries.30,44_{Our original proposal did not exclude studies published in other languages;}

we added this exclusion criterion at an early stage in the review, including this in our registered protocol.51

Types of participant

We included studies in which the majority of participants were aged 11–18 years. Although the World

Health Organization defines adolescents, the target group for PYD, as those aged 10–19 years,53_to

increase this review’s UK policy relevance, we chose 11–18 years as our age range as this encompasses

those engaged in secondary education in the UK. We excluded studies of populations targeted on the basis of pre-defined physical and mental health conditions (because we are interested in PYD as primary prevention) but not those that targeted participants on the basis of pre-existing risk behaviour or other forms of targeting (e.g. area-level deprivation). We also excluded interventions that targeted parents/carers alongside young people in order to focus on family functioning.

Types of intervention and setting

Informed by existing theoretical frameworks,30,44_{PYD interventions were defined as programmes that}

involve voluntary education with the aim not merely of preventing problem behaviour but also of promoting generalised (beyond health) and positive (beyond avoiding risk) development, which were defined as promoting:

l bonding (developing the child’s relationship with a healthy adult, positive peers, school, community,

or culture)

l resilience (strategies for adaptive coping responses to change and stress and for promoting

psychological flexibility and capacity)

l social competence (developmentally appropriate interpersonal skills and rehearsal strategies for

practising these skills, including communication, assertiveness, refusal and resistance, conflict-resolution and interpersonal negotiation strategies for use with peers and adults)

l emotional competence (identifying feelings in self or others, skills for managing emotional reactions or

impulses, or skills for building the youth’s self-management strategies, empathy, self-soothing or

frustration tolerance)

l cognitive competence (cognitive abilities, processes or outcomes including academic performance,

logical and analytic thinking, problem-solving, decision-making, planning, goal-setting and self-talk skills)

l behavioural competence (skills and reinforcement for effective verbal, non-verbal and other actions)

l moral competence (empathy, respect for cultural or societal rules and standards, a sense of right and

wrong or a sense of moral or social justice)

l self-determination (capacity for empowerment, autonomy, independent thinking or self-advocacy, or

their ability to live and grow by self-determined internal standards and values, which may or may not include group values)

l spirituality (beliefs in a higher power, internal reflection or meditation; supporting youth in exploring a

spiritual belief system or sense of spiritual identity, meaning or practice)

l self-efficacy (personal goal-setting, coping and mastery skills, or techniques to change negative

self-efficacy expectancies or self-defeating cognitions)

l clear and positive identity (healthy identity formation and achievement in youth, including positive

identification with a social or cultural subgroup that supports young people’s healthy development of a

sense of self)

l belief in the future (belief in his or her future potential, goals, options, choices or long-range hopes and

plans were classified as promoting belief in the future, including guaranteed tuition to post-secondary institutions, school-to-work linkages, future employment opportunities or future financial incentives to encourage continued progress on a pro-social trajectory; or optimism about a healthy and productive adult life)

l recognition for positive behaviour (response systems for rewarding, recognising or reinforcing children’s

pro-social behaviours were classified as using recognition for positive behaviour)

l opportunities for pro-social involvement (activities and events in which youths could actively participate,

make a positive contribution and experience positive social exchanges) and/or

l pro-social norms (clear and explicit standards for behaviour that minimised health risks and supported

pro-social involvement).

Included interventions either needed to address at least one of these forms of asset but could be applied to different domains such as family, community, school, or needed to address more than one of these assets in a single domain.

Our original funding proposal defined PYD interventions in terms of voluntary education provided by youth workers and addressing generalised, positive development in terms of vocational, academic, social or cognitive skills; self-confidence; positive identities, attitudes and aspirations; and/or relationships with adults or peers. However, we used the more theoretically informed definition listed above from an earlier

stage in the review, which was included in our registered protocol.51

We included studies in which interventions were provided in community settings (which could include schools) outside of normal school time. Our definition excluded PYD delivered in school time because this

involves a distinctive theory of change and has been the subject of recent reviews.54,55_{It also excludes}

interventions delivered in custodial or probationary settings, clinical settings or employment training for school leavers, again because such interventions will involve distinctive theories of change, and, in the case of clinical and employment training settings, will feature participants not meeting our inclusion criteria.

Types of studies

We included multiple types of studies based on whether or not they could answer the individual RQs. In order to address RQ1, we included studies describing a PYD intervention theory of change in relation to our outcomes. We defined theory in the same way as in our previous National Institute for Health Research (NIHR)/Public Health Research (PHR)-funded review of the effects of schools and school-environment

interventions on health.56_{Included studies either dealt exclusively with theory of change or addressed it}

alongside the reporting of empirical data.

In order to address RQ2, we included studies reporting on process evaluations of PYD intervention. Included studies reported on how the planning, delivery, receipt or causal pathways of PYD varied or were influenced by characteristics of place or person using quantitative and/or qualitative data. These studies either reported exclusively on process evaluations or reported process data alongside outcome or economic data. In order to address RQ3, we included studies reporting on outcome and economic evaluations of PYD interventions. We included experimental (RCTs) and quasi-experimental studies (employing non-randomised prospective comparison groups). Control groups needed to receive usual care or no treatment. Economic studies addressing RQ3 were defined in terms of their comparison of the costs and consequences of two or more interventions or, where there was good reason to believe that outcomes were similar, involved cost-minimisation analyses. In order to address RQ4, we have drawn on the syntheses of all of the above study types.

Types of outcomes

This review included studies addressing substance use (i.e. smoking, alcohol use and/or drug use) or violence (i.e. perpetration and/or victimisation involving physical violence aimed at person(s) as opposed to damage to property).

Informed by existing systematic reviews that focus on substance use and violence among young people,57–60

outcome measures could draw on either dichotomous or continuous variables and/or self-report or

observational data. They could use measures of frequency (monthly, weekly or daily), the number of episodes of use or an index constructed from multiple measures. Alcohol measures could examine alcohol consumption or problem drinking. Drug outcomes could examine general or specific illicit drug use. Measures of violent and aggressive behaviour could examine the perpetration or victimisation of physical violence including violent crime.