The social ecology of girls' bullying practices: exploratory research in two London schools

This exploratory study adopts a socio‐ecological approach to examine the context of school bullying. It asks: (1) what are students' accounts of bullying practices?; (2) how are these enabled and constrained by the school‐environment?; (3) how is gender implicated? Qualitative data were collected from girls in two schools in London via focus groups (one in each school; students aged 12‐15) and seven semi‐structured interviews (in one school; students aged 16‐18); and from school policy documents. Our interpretation of girls' accounts, informed by Giddens' structuration theory, suggests that bullying practices were spatially patterned in the schools and often characterised by the regulation of girls' sexuality and sexual‐harassment. Repeated acts of aggression were fluid with regard to the bully and victim role, challenging the dominant view of bullying as characterised by consistent disparities in power between individuals. Schools structured bullying behaviour via policies and practices that ignored these forms of abuse and which focused on and may have been complicit in the making of stable ‘bully’ and ‘victim’ roles, thus indirectly contributing to the reproduction of unhealthy relationships between students. In terms of gender, traditional gendered and sexual discourses appear to structure the identities of the schools and girls in our study.     

Social contexts in adolescent smoking: does school policy matter?

According to an ecological perspective in psychology and in line with social cognitive theory, smoking behaviour is determined by different social contexts (for example, peers, family and school) providing adolescents with important role models. This paper investigates the effects of personal characteristics as well as family, peer and school context variables on youth smoking behaviour. We hypothesize that school smoking policy variables predict adolescents' smoking in addition to other context variables. Data were obtained from a self-report survey administered to 3364 students in 40 secondary schools in Bavaria, Germany. For both younger (10-15 years) and older (16-21 years) students, strong associations were found between smoking behaviour and (i) smoking best friends and friends in general, (ii) other substance use and (iii) school performance. In the younger age group, the non-existence of smoking bans for students was associated with an increased risk of being smoker. For the older students, a positive association was found between the presence of smoking teachers on school grounds and smoking behaviour. Results are discussed considering methodological aspects and public health concerns.     

School Socioeconomic Composition and Adolescent Sexual Initiation in Malawi

Numerous studies have documented the determinants of sexual behavior among adolescents in less‐developed countries, yet relatively little is known about the influence of social contexts such as school and neighborhood. Using two waves of data from a school‐based longitudinal survey conducted in Malawi from 2011–13, this study advances our understanding of the relationship between school‐level socioeconomic contexts and adolescents’ sexual activity. The results from two‐level multinomial logistic regression models suggest that high socioeconomic composition of the student body in school decreases the odds of initiation of sexual activity, independent of other important features of schools and individual‐level characteristics. This study also finds that the association between school socioeconomic composition and sexual activity is statistically significant among male adolescents but not female adolescents, suggesting that schools’ socioeconomic contexts may be more relevant to male adolescents’ initiation of sexual activity.     

Making sense of differences between medical schools through Bourdieu’s concept of ‘field’

Medical Education 2010: 44 : 645–652 Objectives Most basic medical education studies focus on one medical school, and the social and educational significance of differences between schools remains poorly understood. Sociologists have called for more comparative studies and for research on the institutional context of medical education. This paper introduces Bourdieu’s concept of ‘field’ as a tool for conducting such analyses. Context A ‘field’ is any arena in which there is a struggle over resources (capital), akin to a ‘game’ between players who occupy different positions depending on the resources they have. Prior studies show that higher education institutions compete in a field for various forms of capital which are reflected in their curricula and the students they attract. Methods This paper argues that medical education can be conceptualised as a field within which medical schools compete for different forms of capital, such as students, funding and prestige. The structure of the UK medical education field is analysed as a specific example of how Bourdieu’s framework can be applied. It is argued that UK medical schools’ varying curricula and admissions criteria serve to distinguish them from their competitors and to facilitate access to different forms of capital. Competition within the field helps to maintain inter‐school differences, with implications for both curriculum reform and students’ beliefs and aspirations. Conclusions Medical schools have varying curricula, reputations, and types and levels of resources. They compete with one another on all these fronts and attract different types of students and staff. Research and practice in basic medical education must take account of the position of any given medical school in relation to its competitors and to external agencies in order to critically consider the ethos of its curriculum and the perspectives of its students and staff. Bourdieu’s concept of field offers one useful way of accomplishing this.     

“Aspirations of people who come from state education are different”: how language reflects social exclusion in medical education

Despite repeated calls for change, the problem of widening access (WA) to medicine persists globally. One factor which may be operating to maintain social exclusion is the language used in representing WA applicants and students by the gatekeepers and representatives of medical schools, Admissions Deans. We therefore examined the institutional discourse of UK Medical Admissions Deans in order to determine how values regarding WA are communicated and presented in this context. We conducted a linguistic analysis of qualitative interviews with Admissions Deans and/or Staff from 24 of 32 UK medical schools. Corpus Linguistics data analysis determined broad patterns of frequency and word lists. This informed a critical discourse analysis of the data using an “othering” lens to explore and understand the judgements made of WA students by Admissions Deans, and the practices to which these judgments give rise. Representations of WA students highlighted existing divides and preconceptions in relation to WA programmes and students. Through using discourse that can be considered othering and divisive, issues of social divide and lack of integration in medicine were highlighted. Language served to reinforce pre-existing stereotypes and a significant ‘us’ and ‘them’ rhetoric exists in medical education. Even with drivers to achieve diversity and equality in medical education, existing social structures and preconceptions still influence the representations of applicants and students from outside the ‘traditional’ medical education model in the UK. Acknowledging this is a crucial step for medical schools wishing to address barriers to the perceived challenges to diversity.     

‘If you feel that nobody wants you you'll withdraw into your own’: Gypsies/Travellers,networks and healthcare utilisation

Gypsies and Travellers are the unhealthiest group in British society, suffering from higher levels of physical and mental illness, lower life expectancy and with low levels of healthcare utilisation. They also continue to experience the highest level of prejudice and discrimination in society. While studies indicate that social networks play an important role in shaping health beliefs and the response to symptoms, evidence on the influence of networks on health is unclear and contradictory. This article draws on social network theory and research into the relation between discrimination and health to critically examine how networks mediate between collective experiences of racism and health‐related behavior. Qualitative interviews with 39 adult Gypsies and Travellers were conducted in the South‐East of England to explore the wider structural and institutional context and the influence those contexts play in shaping health beliefs and decisions whether to access formal health services. The findings indicate that the influence networks play in shaping health behaviour is dependent on the particular social context of the group and its status in relation to wider social structures, making generalization problematic.     

Cultural safety and the challenges of translating critically oriented knowledge in practice

Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge‐translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical theoretical perspectives that foster a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge‐translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of ‘culture’, ‘safety’, and ‘cultural safety’ need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge‐translation process is a ‘social justice curriculum for practice’ that would foster a philosophical stance of critical inquiry at both the individual and institutional levels.     

Sociodemographic and substance use characteristics associated with typologies and composition of social support networks among youth experiencing homelessness in Los Angeles,USA

Youth experiencing homelessness are a vulnerable population with increased behavioural health risks. Social networks are a consistent correlate of youths’ substance use behaviours. However, less is known about the reciprocal relationships among these constructs. This study classified youth experiencing homelessness according to their social support network type (e.g. instrumental, emotional, service) and composition (e.g. family, peers, service staff) and linked their membership in these social network classes to sociodemographic and substance use characteristics. Four waves of cross‐sectional data were collected between October 2011 and June 2013 from youth experiencing homelessness, ages 14–29, at three drop‐in centres in Los Angeles, CA (N = 1,046). This study employed latent class analysis to identify subgroups of youth experiencing homelessness according to the type and composition of their social support networks. Multinomial logistic regression analyses were then conducted to identify the sociodemographic and substance use characteristics associated with social support network class membership. Five latent classes of youths’ social support networks were identified: (a) high staff emotional and service support; (b) high home‐based peer and family emotional, service and instrumental support; (c) moderate street‐ and home‐based peer emotional support; (d) low or no support and (e) high home‐based peer and family emotional and instrumental support. Multinomial logistic regression models indicated that race/ethnicity, gender, sexual orientation, literal homelessness, former foster care experience, depression, heroin and marijuana use were significant correlates of social support network class membership. Results indicate distinct classes of social support networks among youth experiencing homelessness, with certain sociodemographic and substance use characteristics implicated in youths’ social networks.     

Peer Influence on Marijuana Use in Different Types of Friendships

PurposeAlthough several social network studies have demonstrated peer influence effects on adolescent substance use, findings for marijuana use have been equivocal. This study examines whether structural features of friendships moderate friends' influence on adolescent marijuana use over time.MethodsUsing 1-year longitudinal data from the National Longitudinal Study of Adolescent Health, this article examines whether three structural features of friendships moderate friends' influence on adolescent marijuana use: whether the friendship is reciprocated, the popularity of the nominated friend, and the popularity/status difference between the nominated friend and the adolescent. The sample consists of students in grade 10/11 at wave I, who were in grade 11/12 at wave II, from two large schools with complete grade-based friendship network data (N = 1,612).ResultsIn one school, friends' influence on marijuana use was more likely to occur within mutual, reciprocated friendships compared with nonreciprocated relationships. In the other school, friends' influence was stronger when the friends were relatively popular within the school setting or much more popular than the adolescents themselves.ConclusionsFriends' influence on youth marijuana use may play out in different ways, depending on the school context. In one school, influence occurred predominantly within reciprocated relationships that are likely characterized by closeness and trust, whereas in the other school adopting friends' drug use behaviors appeared to be a strategy to attain social status. Further research is needed to better understand the conditions under which structural features of friendships moderate friends' influence on adolescent marijuana use.     

‘Stop it,that's enough’: Bystander intervention and its relationship to school connectedness and shame management

Bystanders are an invaluable source of information about school bullying. Anti-bullying efforts to deliver justice are hampered if bystanders remain reluctant to discourage bullying; but given that bystanders who intervene to prevent bullying may be at increased risk of retaliation, why would they do so? This study aims to answer what promotes bystander intervention in the context of school bullying using a restorative justice approach. Data were collected through the Cross-national School Behaviour Research Project from 1,452 secondary school students (49% girls) in grades 7–10 in Bangladesh. Students who scored higher on school connectedness were more likely to intervene. High shame acknowledgement (accepting responsibility, making amends) and low shame displacement (blaming or hitting out at others) were also significant predictors of intervening in bullying. Regression analysis indicates that school connectedness compensates for the adverse effect of non-adaptive shame management (low acknowledgement and high displacement) on bullying prevention. Under a ‘whole-of-school’ approach, bystanders who can be referred to as ‘soft targets’ are moved more easily by a sense of collective shame/guilt and responsibility than ‘hard targets’ (such as bullies) whose emotional shell protects them from being ashamed/guilty. Establishing an ethical climate within schools that encourages a culture of mutual respect, shared responsibility and social inclusion may be a positive step towards promoting bystander intervention.     

Older mature students' experiences of applying to study medicine in England: an interview study

Medical Education 2010: 44: 1084–1094 CONTEXT Increasingly, medical schools are considering mature applicants, including graduate entrants. At present, the majority of mature students are in their early or mid‐20s and are entering medicine immediately or soon after completing a first degree. However, ‘older’ mature students, who have worked in other occupations for a number of years, are also applying to study medicine. Although it is likely that these students have particular needs, their experiences of applying to study medicine and related decision‐making processes have not been examined in detail to date. METHODS Participants at three English medical schools took part in in‐depth interviews examining their pathways into medical school. This analysis uses the findings from interviews with 15 older mature students. RESULTS This study demonstrates how older mature students’ decision‐making processes and experiences of application processes are heavily influenced by their personal circumstances and backgrounds. Their choices are constrained geographically and in terms of their identity, and also by perceptions of the openness of some medical schools to their applications. There are negative implications for some students who are unable to secure places at their preferred ‘local’ schools. CONCLUSIONS Although the choice of medical school may be limited for this group of applicants as a result of their pre‐existing personal circumstances, medical schools are perceived to differ substantially in their willingness to consider older students from varied working and educational backgrounds. The ability of these applicants to join the medical profession may partly depend on geographical location. The provision of a central information facility outlining institutional requirements and preferences would be a useful starting point, although it would be unable to address the broad and complex range of issues that face older mature students.     

Experts’ views regarding Australian school‐leavers’ knowledge of nutrition and food systems

Objective: To explore Australian experts’ views regarding strengths and gaps in school‐leavers’ knowledge of nutrition and food systems ( N&FS) and factors that influence that knowledge. Method: Semi‐structured interviews were conducted with 21 highly experienced food‐related experts in Australia. Qualitative data were analysed thematically using Attride‐Stirling's thematic network framework. Results: Two global themes and several organising themes were identified. The first global theme, ‘structural curriculum‐based problems’, emerged from three organising themes of: inconsistencies in provided food education programs at schools in Australia; insufficient coverage of food‐related skills and food systems topics in school curricula; and the lack of trained school teachers. The second global theme, ‘insufficient levels of school‐leavers knowledge of N&FS ’, was generated from four organising themes, which together described Australian school‐leavers’ poor knowledge of N&FS more broadly and knowledge translation problem for everyday practices. Conclusion: Study findings identified key problems relating to current school‐based N&FS education programs in Australia and reported knowledge gaps in relation to N&FS among Australian school‐leavers. Implications: These findings provide important guidance for N&FS curriculum development, to clearly articulate broadly‐based N&FS knowledge acquisition in curriculum policy and education documents for Australian schools.     

Alcohol, Tobacco, and Other Drug Use Prevention Programs in U.S. Schools: A Descriptive Summary

This report identifies the prevalence of state, local, and commercially developed substance abuse prevention programs in middle and high schools from 2001 to 2007, using survey data from nationally representative samples of 1,206 schools. Based on school administrators’ reports, schools and school districts offer students an average of 1.62 prevention programs during their school years from elementary through high school. Bivariate and multivariate regression analyses were conducted with school demographic characteristics public versus private, size, population density, region of the country, school race/ethnic composition, and socioeconomic status of the student body (SES) as predictors of total number of programs that students received and of the relative use of local, state, and commercial programs. Schools in the West had significantly fewer prevention programs than those in other regions of the country. Students in predominantly White and in higher SES schools received significantly more prevention programs than students in majority African American, majority Hispanic, or in lower SES affluent schools. The most frequently reported programs that students received were locally developed. D.A.R.E. was the most widely adopted prevention program. Findings from this study suggest that schools often develop their own curriculum to suit their students’ needs, and students are exposed to multiple prevention programs through their school years, making it difficult to examine the effectiveness of any single program in preventing and reducing substance use among students.     

Meeting the social and behavioral health needs of students: rethinking the relationship between teachers and school social workers

BACKGROUND: While school‐based mental health professionals obviously must provide mental health services to students directly, the literature is increasingly identifying an empowerment role for these professionals, whereby they support teachers as primary service providers. The purpose of this study was to identify subtypes of school social workers within the context of collaborative practice, and to identify individual and contextual factors associated with these classifications as well as overall levels of collaboration. METHODS: Latent class analysis, conducted using data collected as part of the National School Social Work Survey 2008 (N = 1639), was employed to examine underlying subtypes of school social work practitioners in relation to collaborative practices and to examine predictors of collaborative practice. RESULTS: Four broad categories of school social workers were identified, including (1) noncollaborators, (2) system‐level specialists, (3) consultants, and (4) well‐balanced collaborators. These classes were associated with the number of schools served, grade level, education, and clinical licensure status; level of administrative responsibility was not associated with class membership. CONCLUSION: While school social workers varied in collaborative practices, opportunities exist to enhance their role in educating and supporting teachers to serve as primary providers to students with social, mental health, and behavioral needs. The implications for school‐based mental health providers, teachers, administrators, policymakers, and researchers are discussed.     

School Disrepair and Substance Use Among Regular and Alternative High School Students

BACKGROUND: The physical environment influences adolescent health behavior and personal development. This article examines the relationship between level of school disrepair and substance use among students attending regular high school (RHS) and alternative high school (AHS). METHODS: Data were collected from students (N = 7058) participating in 2 randomized controlled trials of a school-based substance abuse prevention program implemented across the United States. Students provided substance use and demographic information on a self-reported survey. Data for the physical disrepair of schools were collected from individual rater observations of each school environment. We hypothesized that school disrepair would be positively associated with substance use controlling for individual characteristics and a socioeconomic status proxy. Multilevel mixed modeling was used to test the hypothesized association and accounted for students nested within schools. RESULTS: Findings indicated that students attending AHS with greater school disrepair were more likely to report the use of marijuana and other illicit drugs (ie, cocaine, heroin). Students attending RHS with greater school disrepair were less likely to report smoking cigarettes. CONCLUSIONS: Differences in findings between RHS and AHS students are discussed, and implications for substance use prevention programming are offered. Students attending AHS with greater school disrepair may require more substance abuse prevention programming, particularly to prevent illicit substance use.     

Immigrant status and acculturation influence substance use among New Zealand youth

Objective: To investigate the associations between generational status, acculturation and substance use among immigrant and non‐immigrant secondary school students in New Zealand. Methods: A nationally representative sample of secondary school students in New Zealand was selected using a two‐stage cluster sample design. Of the 8,999 students in the sample, 23.81% were first‐generation immigrants and 20.90% were second‐generation immigrants; the remaining 55.29% students are collectively referred to as ‘non‐immigrant’ peers. Logistic regression models adjusted the associations of interest for age, gender, ethnicity, socioeconomic status and experience of ethnic discrimination. Results: First and second‐generation immigrants showed significantly lower risks of smoking cigarettes compared with their non‐immigrant peers. Similar trends were apparent for consuming alcohol and marijuana weekly. The inclusion of some characteristics suggestive of acculturation in multivariable models did not influence the relationship between generational status and smoking cigarettes, but attenuated the apparent protective effect of being a first‐generation immigrant with regard to alcohol and marijuana use. Conclusions and implications: The study shows the lower likelihood of substance use among newer immigrants in a nationally representative sample of New Zealand youth. Policies and health programs that build on this positive profile and reduce the risk of adverse changes over time require attention.     

‘You’re judged all the time!’ Students’ views on professionalism: a multicentre study

Medical Education 2010: 44 : 814–825 Objectives This study describes how medical students perceive professionalism and the context in which it is relevant to them. An understanding of how Phase 1 students perceive professionalism will help us to teach this subject more effectively. Phase 1 medical students are those in the first 2 years of a 5‐year medical degree. Methods Seventy‐two undergraduate students from two UK medical schools participated in 13 semi‐structured focus groups. Focus groups, carried out until thematic saturation occurred, were recorded and transcribed verbatim. Data were analysed and coded using NVivo 8, using a grounded theory approach with constant comparison. Results From the analysis, seven themes regarding professionalism emerged: the context of professionalism; role‐modelling; scrutiny of behaviour; professional identity; ‘switching on’ professionalism; leniency (for students with regard to professional standards), and sacrifice (of freedom as an individual). Students regarded professionalism as being relevant in three contexts: the clinical, the university and the virtual. Students called for leniency during their undergraduate course, opposing the guidance from Good Medical Practice. Unique findings were the impact of clothing and the online social networking site Facebook on professional behaviour and identity. Changing clothing was described as a mechanism by which students ‘switch on’ their professional identity. Students perceived society to be struggling with the distinction between doctors as individuals and professionals. This extended to the students’ online identities on Facebook. Institutions’ expectations of high standards of professionalism were associated with a feeling of sacrifice by students caused by the perception of constantly ‘being watched’; this perception was coupled with resentment of this intrusion. Students described the significant impact that role‐modelling had on their professional attitudes. Conclusions This research offers valuable insight into how Phase 1 medical students construct their personal and professional identities in both the offline and online environments. Acknowledging these learning mechanisms will enhance the development of a genuinely student‐focused professionalism curriculum.     

The contextual effect of school attachment on young adolescents' alcohol use

BACKGROUND: The school is a primary context for social interaction, cultivation of interpersonal skills, formation of peer groups, self-expression, and development of self. Several studies have demonstrated that the social context of the school has important implications for determining the likelihood that an adolescent will follow a prosocial path through adolescence as opposed to becoming involved in delinquent behavior. METHODS: Using a data set of 4,216 youth in 32 middle schools and junior high schools across the United States, this paper examines the effect of a student's own level of school attachment as well as the contextual level of school attachment (the normative level of school attachment in a school) on 5 alcohol-related measures: recent use of alcohol, intention to use alcohol, normative beliefs about peer use of alcohol, attitudes toward alcohol use, and aspirations consistent with alcohol use. RESULTS: This study demonstrates that regardless of a student's own level of school attachment, students who attend schools where the pupils overall tend to be well attached to school are less likely to use alcohol. In addition, they also have lower intentions to use alcohol, perceive that fewer of their peers at school use alcohol, and more strongly hold aspirations that are inconsistent with alcohol use. CONCLUSIONS: Our findings, along with the findings of related studies, provide support for the hypothesis that improvement of school climate may result in less substance use among students.     

A new measure of unhealthy school environments and its implications for critical assessments of health promotion in schools

The theory of human functioning and school organisation informed by Basil Bernstein’s sociology of education suggests that to gain the commitment and promote the health of students, particularly those from disadvantaged backgrounds, schools require radical transformations eroding various ‘boundaries’: between and among staff and students; between students’ academic learning and broader social development and welfare; and between schools and their local communities. Existing research examining this theory has reported associations between school-level proxy measures of student commitment and lower rates of student smoking, drinking alcohol, use of drugs and violence. But this research has not directly assessed whether reduced school boundaries explain this. We piloted a new scale derived from teacher reports to measure unhealthy school boundaries and examined its inter-item reliability and its criterion validity in terms of associations with various measures of school commitment and smoking. Data on boundaries came from 101 teachers across 40 schools. Data on student commitment and smoking came from 6667 students. We assessed reliability by examining correlations between scale-items and criterion validity in terms of associations with student-reported commitment and smoking. Inter-item reliability was sub-optimal but better within the subscales about boundaries between academic/broader learning and schools/local communities. The scale had good criterion validity, strongly associated with reduced student-reported school commitment and increased student-reported smoking. We reflect on the implications of these findings in terms of critical perspectives on health promotion in schools and the strengths and limitations of quantitative research in examining health behaviours as opposed to practices.