Changing schools, changing health? Design and implementation of the Gatehouse Project

Purpose: To describe the Gatehouse Project which addresses the social context of high school with an aim of changing students' sense of school connection and in turn, health risk behavior and well-being. Methods: Distinguishing features of the project were its conceptual framework, implementation process, and evaluation design. The conceptual framework derived from attachment theory and focused on three aspects of the school social context: security, communication, and participation. Implementation was standardized around a survey of the school social environment, creation of a school-based action team, and the implementation of strategies matched to a school's profile of need. In addition, an early high school curriculum addressed the skills relevant to social functioning and emotional adjustment. The evaluation design was based on a cluster randomized trial involving 26 schools. It used follow-up of an individual cohort and repeat cross-sectional surveys to capture outcomes at an individual student and whole-school level. Results and Conclusions: The Gatehouse Project drew on both health and education research to develop and coordinate a broad-based school health promotion intervention. It represents a promising new direction for school-based preventive work. (C) Society for Adolescent Medicine, 2003.