School programs targeting stress management in children and adolescents: A meta-analysis Gerda Kraag a, ⁎ , Maurice P. Zeegers b,c , Gerjo Kok a , Clemens Hosman d,e , Huda Huijer Abu-Saad f,g a Department of Psychology, Maastricht University, Maastricht, The Netherlands b Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, United Kingdom c Academic Centre of General Practice, Catholic University of Leuven, Leuven, Belgium d Department of Health Education, Maastricht University, Maastricht, The Netherlands e Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands f Department School of Nursing, American University of Beirut, Beirut, Lebanon g Department of Nursing Science, Maastricht University, Maastricht, The Netherlands Received 11 July 2005; received in revised form 1 June 2006; accepted 28 July 2006 Abstract Introduction: This meta-analysis evaluates the effect of school programs targeting stress manage- ment or coping skills in school children. Methods: Articles were selected through a systematic literature search. Only randomized controlled trials or quasi-experimental studies were included. The standardized mean differences (SMDs) between baseline and final measures were computed for experimental and control groups. Experi- mental groups were groups that either received an intervention of (a) relaxation training, (b) social problem solving, (c) social adjustment and emotional self-control, or (d) a combination of these interventions. If no baseline measurement was available, SMDs were calculated between final measures of the groups. The overall pooled effect size was calculated and the pooled effect sizes of improvement on stress, coping, (social) behavior, and self-efficacy by random effects meta-analysis. The dependence of the results on study characteristics (i.e. methodological quality and type of intervention) was evaluated using meta-regression analysis. Results: Nineteen publications met the inclusion criteria of controlled trials for class programs, teaching coping skills or stress management. Overall effect size for the programs was - 1.51 [95% Journal of School Psychology 44 (2006) 449 – 472 ⁎ Corresponding author. Department of Experimental Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Tel.: +31 43 388 4084; fax: +31 43 388 4196 1908. E-mail address: g.kraag@psychology.unimaas.nl (G. Kraag). 0022-4405/$ - see front matter © 2006 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jsp.2006.07.001