Change i Perceived Stress in School-age Students When Adding Physiotherapists to a School's Health Team.

Study Overview
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Brief Summary
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School stress and performance requirements have been shown to contribute to mental illness among children and young people. Student health teams have an important role regarding mental health of children and young people. Swedish student health teams include various health and pedagogical professionals, but physiotherapists are uncommon, despite the good effects school-related physical activity interventions have had on reducing anxiety and improving well-being in children and young people. Haga School, Dals-Ed has now employed physiotherapists as part of the student health team to support students in learning to define, reduce and manage stress. The purpose of the research project is to investigate changes in perceived stress level and stress-related symptoms, as well as study results and absence from school during two years for students in grades 4 to 9 at Haga School. A questionnaire will be sent out on four occasions over two years. Group level statistics on study results and school absence will be compared with years previous to the introduction of the school physiotherapist. The research contributes to increased knowledge about effects of having a physiotherapist as part of a student health team in Sweden.

Detailed Description
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School stress and performance requirements have been shown to contribute to mental illness among children and young people. Student health teams have an important role regarding mental health of children and young people. Swedish student health teams include various health and pedagogical professionals, but physiotherapists are uncommon, despite the good effects school-related physical activity interventions have had on reducing anxiety and improving well-being in children and young people. Haga School, Dals-Ed has now employed physiotherapists as part of the student health team to support students in learning to define, reduce and manage stress. The purpose of the research project is to investigate changes in perceived stress level and stress-related symptoms, as well as study results and absence from school during two years for students in grades 4 to 9 at Haga School. A questionnaire will be sent out on four occasions over two years. Group level statistics on study results and school absence will be compared with years previous to the introduction of the school physiotherapist. The research contributes to increased knowledge about effects of having a physiotherapist as part of a student health team in Sweden.

Official Title
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Change in Perceived Stress Level and Stress-related Symptoms in Elementary School Students During Active Stress Prevention Work With the Addition of a Physiotherapist to the School's Student Health Team.

Conditions
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Stress-related Problem

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Registered students in grades 4-9 at Haga School in Dals-Ed, Sweden Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 9 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in perceived stress | Measured with single question on questionnaire with 4 possible levels to choose from, ranging from not at all to very much. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Reasons for stress | Single question about stressors chosen from a list of 7 stressors or no stressors | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| School stress factors School stress factors School stress factors | Single question about factors that contribute to perceived stress in school, chosen from a list of 16 stressors. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stress-related symptoms | Measured with number of stress-related symptoms chosen from a list of 7 symptoms or no symptoms. | Change between inclusion and 8 month, 12 and 20 month follow-ups | 
| Prevalence of specific stress-related symptoms | Number of students who report each specific symptom from a list of 7 symptoms or no symptoms. | Change between inclusion and 8 month, 12 and 20 month follow-ups | 
| Stress-alleviating factors | Single question regarding handling of stress symptoms, chosen from list of 9 suggestions or open-ended answer. | Change between inclusion and 8 month, 12 and 20 month follow-ups | 
| Headache prevalence | Single question regarding prevalence of headache during the last month with 5 possible levels, ranging from never to always. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Stomach-ache prevalence | Single question regarding prevalence of stomach-ache during the last month with 5 possible levels, ranging from never to always. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Prevalence of irritability | Single question regarding irritation or bad mood during the last month with 5 possible levels ranging from never to always. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Prevalence of depressive feelings | Single question regarding feeling sad or depressed feelings during the last month with 5 possible levels ranging from never to always. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Sleeping habits | Single question about sleep quality with 5 possible answers ranging from very bad to very good. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Well-being at school | Single question regarding well-being at school with 5 possible levels, ranging from very bad to very good. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Physical activity | Single question about amount of physical activity during the last 7 days, with 8 possible levels, ranging from less than 1 hour to more than 10 hours | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| Transportation to school | Single question about commuting to school with four possible answers, walking, bicycling, bus, car/moped. | Change between inclusion and 8 month, 12 and 20 month follow-ups. | 
| School absence | Group level school absence retrieved from school statistics. Measured in number of days. days. | Change between school-year 2021-2022 and 2023-2024. | 
| Study results | Group level study results for each grade. Measured in grades E-A. | Change between school-year 2021-2022 and 2023-2024. | 
| Eligibility upper-level secondary school | Group level eligibility for upper-level secondary school programs for students in Grade 9. Measured in number of students eligible for upper-level secondary school. | Change between school-year 2021-2022 and 2023-2024. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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School health services, Physical therapy modalities, Mental health, Child, Adolescent