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The Gatehouse Project: can a multilevel school intervention affect emotional wellbeing and health risk behaviours?
  1. Lyndal Bond1,
  2. George Patton1,
  3. Sara Glover1,
  4. John B Carlin2,
  5. Helen Butler1,
  6. Lyndal Thomas1,2,
  7. Glenn Bowes3
  1. 1Centre for Adolescent Health, Royal Children’s Hospital, Murdoch Children’s Research Institute and Department of Paediatrics, University of Melbourne, Australia
  2. 2Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute and University of Melbourne Department of Paediatrics, Royal Children’s Hospital, Australia
  3. 3Department of Paediatrics, University of Melbourne, Australia
  1. Correspondence to:
 Dr L Bond
 Centre for Adolescent Health, 2 Gatehouse Street, Parkville 3052 Victoria, Australia;


Study objective: The aim of this study was to determine the effect of a multilevel school based intervention on adolescents’ emotional wellbeing and health risk behaviours.

Design: School based cluster randomised controlled trial. Students were surveyed using laptop computers, twice in the first year of intervention and annually thereafter for a further two years.

Setting: Secondary schools.

Participants: 2678 year 8 students (74%) participated in the first wave of data collection. Attrition across the waves was less than 3%, 8%, and 10% respectively with no differential response rate between intervention and control groups at the subsequent waves (98% v 96%; 92% v 92%, and 90% v 89% respectively).

Main results: A comparatively consistent 3% to 5% risk difference was found between intervention and control students for any drinking, any and regular smoking, and friends’ alcohol and tobacco use across the three waves of follow up. The largest effect was a reduction in the reporting of regular smoking by those in the intervention group (OR 0.57, 0.62, and 0.72 at waves 2, 3, and 4 respectively). There was no significant effect of the intervention on depressive symptoms, and social and school relationships.

Conclusions: While further research is required to determine fully the processes of change, this study shows that a focus on general cognitive skills and positive changes to the social environment of the school can have a substantial impact on important health risk behaviours.

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  • Funding: The Gatehouse Project was supported by grants from the Queen’s Trust for Young Australians, Victorian Health Promotion Foundation, National Health and Medical Research Council and Department of Human Services, Victoria, Murdoch Children’s Research Institute, Sydney Myer Fund and the Catholic Education Office. Dr Lyndal Bond was funded by a Victorian Health Promotion Foundation/Department of Human Services Public Health Fellowship.

  • Conflicts of interest: none declared.

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