Academic journal article International Public Health Journal

Evaluation of the Project P.A.T.H.S. in Mainland China: Views of the Program Implementers in Senior High Schools

Academic journal article International Public Health Journal

Evaluation of the Project P.A.T.H.S. in Mainland China: Views of the Program Implementers in Senior High Schools

Article excerpt

Introduction

While adolescence is often regarded as a period with rapid physical development, it is also a transitional period during which adolescents have to go through many challenges (1). According to World Health Organization (WHO), adolescents may engage in a range of risk behaviors and health issues, including violent behaviors, alcohol and drug abuse, tobacco use, self-harm, and mental health issues (2). These health compromising behaviors often have negative impacts on the current and future health of adolescents (3). Based on the statistics of WHO (2), health compromising behaviors among adolescents are prevalent throughout the world.

The problem of health comprising behaviors among adolescents have also drawn public attention in China. In the study of Hesketh, Ding, and Tomkins (4), it was found that nearly 16% of the junior and senior school students responding to the survey were ever smokers. Alcohol use among Chinese adolescents is another serious problem that more attention should be paid. A meta-analytic study of Feng and Newman (5) indicated that over 35% of male students and over 20% of female students in senior high schools had used alcohol in the last 30 days. Regarding illicit drug use, the prevalence rate was about 4% based on a survey of 15 secondary schools in Wuhan (6). A large-scale study (7) investigated self-harm behaviors among secondary school students in China, and the findings suggested that 17% of the students had injured themselves deliberately in the past 12 months, which was higher that Western countries (7, 8).

Mental health issue is another leading cause of health problem among adolescents (9). According to a large-scale survey in China, approximately 10% of Chinese school children had suffered from one or more types of psychiatric disorders (10). Correspondingly, it was estimated that every trained child psychiatrist has to serve more than 40,000 children with behavioral and emotional problems in mainland China (11). Thus, prevention of health compromising behaviors and mental health problems among children and adolescents is an urgent and important job in mainland China. Unfortunately, there is a lack of prevention programs designed for Chinese adolescents.

Both individual and contextual factors affect adolescent behavior and shape their development (12). Turbin et al. (13) suggested that adolescent involvement in health-promoting behaviors were more likely to be affected by protective and risk factors in social context (e.g., family and peers), rather than by their individual-level factors. Therefore, providing prevention in the social context would be effective to reduce the risk of adolescent behavior problems and psychiatric disorders. As school is an important place for adolescents to learn knowledge, develop social skills and build social support (1), it would be appropriate to implement prevention programs in school setting, since Chinese adolescents spend more than 8 hours at school each day (14). Therefore, a school-based positive youth development (PYD) program for the general adolescent population is a promising approach to promote holistic development in adolescents.

With respect to the above-mentioned issues, a PYD program entitled "P.A.T.H.S. to Adulthood: A Jockey Club Youth Enhancement Scheme" was initiated in Hong Kong in the 2005-2006 academic year and then piloted in mainland China from 2007-2008 academic year to 2009-2010 academic year (15, 16). The initial version of the Project P.A.T.H.S. was designed by the first author and his collaborators from five universities in Hong Kong and funded by The Hong Kong Jockey Club Charities Trust. Two tiers of programs were included in the project to help adolescents with different levels of need. The Tier 1 Program provides a series of curricula-based training programs to the general adolescent population in junior secondary schools that students participate in 10 to 20 hours of training on 15 PYD constructs in each school year, whereas the Tier 2 Program is designed for one-fifth of the students who have greater psychosocial needs (17). …

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