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ORIGINAL RESEARCH article

Front. Educ., 29 July 2024
Sec. Higher Education
This article is part of the Research Topic Education Not Cancelled: Pathways from absence to post-secondary education View all 7 articles

Secondary school students’ perspectives on supports for overcoming school attendance problems: a qualitative case study in Germany

  • 1Faculty of Education, Institute of Special and Inclusive Education, Leipzig University, Leipzig, Germany
  • 2Department of Education, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden
  • 3Department of Social Work, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden

Introduction: School attendance problems (SAPs) affect both the education and development of young learners. There is a need to better understand what supports are needed to overcome and prevent SAPs from students’ perspectives. The aim of the current study is to explore students’ perspectives on what challenges they faced, and what they perceived as helpful in overcoming attendance challenges on their pathways towards completing their education.

Method: We conducted interviews with students (n = 9) in a local comprehensive school (Stadtteilschule) in the city-state Hamburg in Germany. Students were in their final year before obtaining a certificate that qualifies them for possible admission to post-secondary education. Data was analyzed using qualitative content analysis.

Results: Findings show that students experienced complex challenges to school attendance that were associated with emotional distress, negative school experiences, and reduced well-being. Our findings point to common protective mechanisms in students’ perceptions of what helped them overcome SAPs. The key drivers of school attendance are located within students and their social contexts, including personal resilience, supportive relationships at school, and the social environment.

Discussion: Based on students’ views, we present a model that illustrates the interconnectedness of perceived challenges and supports in the function of risk and protective factors moving across ecological systems in the development of SAPs. We highlight how these areas can guide prevention and intervention to support students in successfully completing their education and transitioning into multiple post-secondary pathways.

1 Introduction

While schools have a responsibility to provide a safe environment in which children and youth can develop positive relationships and competencies to master challenges in life (Lehmann et al., 2021), the school environment may also contain stressors related to emotional and mental health issues, further impacting students’ ability to attend (Hamilton, 2024). In a world characterized by constant change and growing complexity, school attendance for young individuals becomes a crucial foundation for their future prospects, academic achievement, well-being and wider development (Allison et al., 2019; Heyne et al., 2022; Kearney et al., 2022a; Hinze et al., 2023). Attendance at school prepares young people for successful transition to adulthood, and support their educational trajectories. In light of this, attendance may be a predictor of school success (Heyne et al., 2024).

Unfortunately, there are still many young people facing difficulties that prevent them from remaining or going to school regularly (Dee, 2024). This vulnerable group may struggle with personal challenges, emotional or behavioral problems (Wilkins and Bost, 2014; Askeland et al., 2020), and/or face risk factors in the family, social or school environment (Kearney et al., 2022b). These factors may moderate psychosocial and educational outcomes in young people, which in turn affects their ability to attend school and graduate as well (Melvin et al., 2019; Gren Landell, 2023). When young people stop being in school, it has significant consequences, particularly in relation to mental health and well-being, academic performance and acquirement of qualifications to access post-secondary education (Ansari et al., 2020; Epstein et al., 2020; Liu et al., 2021; Kearney et al., 2023; Keppens, 2023). For these and other reasons, the support of school attendance is highly important. In Germany, young learners can obtain a secondary school certificate after nine or 10 school years. This qualifies learners to continue in either general education or vocational education and training (VET) at upper secondary or post-secondary level (Cedefop, 2020). However, School Attendance Problems (SAPs) may impede youth at this stage from graduating and progressing towards post-secondary education pathways. Particularly, viewpoints from German students who experience SAPs and who are in the specific situation of transitioning to a post-secondary path offer interesting insights into what ensures that their “education is not cancelled.” Exploring student voices could enrich our understanding of both stressful events as risk markers to SAPs and protective dimensions that promote and prevent SAPs in the transition to post-secondary education (Sundelin et al., 2023).

In light of this observation, the purpose of the current study is to explore secondary school students’ perspectives in Hamburg on what factors and supports have helped (and will continue to help) them overcome various school attendance challenges and facilitate their transition to post-secondary education despite facing adversities.

2 Background: the German education system

Germany is a federal republic with 16 more or less different education systems. The legal conditions of school attendance as well as the consequences of school absences are the subject of school legislation in the federal states of Germany. Since our study was conducted in the state of Hamburg, we restrict our focus to the system and regulations of Hamburg.

Compulsory schooling is a fundamental aspect of the German education system, requiring all individuals to attend school for a specified period (Pischke and von Wachter, 2008). Hamburg’s Education Act (HmbSG; §§ 37 to §41a) provides the legislation with effect for attendance and school actions in the context of compulsory schooling at state level. In Hamburg, compulsory schooling lasts for a total of 11 school years. Full-time compulsory schooling covers all children and young people aged 6 to 15 years. Part-time compulsory schooling for young people aged 15–18 is fulfilled after the end of lower secondary school, or in a non-school setting (for example, as part of VET). The school and parents/legal guardians are defined as responsible for assuring compulsory schooling. The responsibility for monitoring lies within the respective school. Days of absence are registered in the class register and individual school reports (Ricking, 2023a).

The German school system portrays the separation model because it sorts students into different educational paths early on (Keppens and Spruyt, 2019). Students are enrolled in different types of secondary schools after attending primary school (“Grundschule”). In Hamburg, there are two types of secondary schools: the eight-year long grammar school (“Gymnasium”) and the comprehensive school (“Stadtteilschule”). Grammar schools provide extended education where young people achieve an advanced level school leaving certificate (“Abitur”).

The local comprehensive school is unique of the school system in Hamburg. That means, students can achieve three types of school-leaving qualifications: general certificate of secondary of secondary education (“Erster Bildungsabschluss”), intermediate level certificate of secondary education (“Mittlerer Bildungsabschluss”), and the advanced level school leaving certificate at comprehensive school (“Abitur auf der Stadtteilschule”) at the end of year 13 (Ministry of Labour, Social, Family Affairs and Integration, n.d.) (see Figure 1).

Figure 1
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Figure 1. Hamburg’s school structure and school-leaving qualifications.

Meanwhile, students’ performances are constantly graded throughout the school year and summed up in reports to determine further educational options and appropriate school-leaving qualification tracks (Falkenberg and Ringarp, 2021). The general or intermediate leaving certificates are a prerequisite for two potential routes. Graduates have either the option to choose vocational education or training (VET) courses or progress to grammar school to obtain a higher education entrance qualification. Both routes offer possibilities to progress to post-secondary levels (Cedefop, 2020). Vocational education and training have a positive reputation in Germany, as it provides young people opportunities to advance in industry (Beutner and Medvedev, 2016). In summary, the local comprehensive school (Stadtteilschule) provided an interesting context for our study to examine supports that successfully guide young learners toward attendance, successful graduation, and multiple routes into the post-secondary world.

In Hamburg, the Guidebook published by the Hamburg Education Authority provides measures to be taken to address violations of compulsory schooling (Hamburg Authority for Schools and Vocational Training, 2013). In the approach to supporting school attendance in Hamburg, different professional actors are involved: class teachers, counselling or special teachers, and school social workers. Social workers from the Regional Education and Guidance Centre (ReBBz) serve as additional contact point (Beutner and Medvedev, 2016). Absenteeism as a matter of “permanent school attendance violation” may also lead to legal measures in Germany. This involves the local school authority which has the option of imposing fines on parents or youth concerned (Ricking and Rothenburg, 2020; Enderle et al., 2023).

3 Understandings, classifications, and qualitative research of school attendance problems

Numerous efforts have been made to conceptualize and address patterns of SAPs across a spectrum of categories and functional dimensions, including sub-phenomena such as school refusal, truancy, withdrawal and exclusion (Heyne et al., 2018). While this has resulted in a substantial body of literature, it has resulted in a fragmented, narrow perspective on the phenomenon (Kearney et al., 2019). Much of the focus has been on why students have been absent from school, often pointing to punitive, student-centered approaches (Enderle et al., 2023). Researchers have pushed for a semantic shift in the field from absenteeism or school refusal to school attendance. This has also led to a focus on the complex dynamics within and around school environments and students that contribute to experiences of attendance issues (Heyne et al., 2019; Gentle-Genitty et al., 2020; Walther-Hansen et al., 2024). Rather than referring to a single sub-phenomenon, this article uses the term of SAPs in its more flexible definition, applying it to encompass a broader, multi-faceted understanding (Heyne et al., 2022). SAPs feature a continuum of active engagement or disengagement in teaching and learning practices (Kearney, 2021), e.g., mental absence during lessons, tardiness, periodic absences, skipping classes, and complete absence from school for an extended period (Kearney, 2016).

SAPs are believed to be a complex phenomenon with no singular identified cause. Research indicates that attendance and absenteeism are influenced by a variety of risk and protective factors, located in different domains, including the individual, family, school environment, and wider community (e.g., Lenzen et al., 2016; Gubbels et al., 2019; Kearney and Gonzálvez, 2022; Ricking, 2023b). In the approach to understanding complexities and mechanisms of SAPs, Heyne et al. (2024, p. 12) advocate for “exploring associated with school attendance and absenteeism, considering both proximal and distal factors”. Ecological systems theory moves beyond limited views of understanding SAPs and provides a holistic framework to analyze and understand the complex and dynamic interplay of factors contributing to SAPs (Melvin et al., 2019; El Zaatari and Maalouf, 2022).

3.1 School attendance problems through ecological systems theory

Ecological systems theory informs educational research about how proximal processes and environmental contexts as well as the complex person-environment interactions (Richman et al., 2004; El Zaatari and Maalouf, 2022) shape developmental outcomes, such as attendance patterns (Bronfenbrenner, 2005; Woolley and Grogan-Kaylor, 2006). Informed by an ecological understanding, Melvin et al. (2019) developed a comprehensive framework called Kids and Teens at School (KiTeS) that is related to attendance. Specifically, the framework structures the contributing factors across micro-, meso-, exo-, macro-, and chrono systems, while the individual is situated within the systems.

Building on this framework, we can categorize risk and protective influences on attendance and absenteeism from previous quantitative research, reviews and meta-analyses into these levels or ecological systems (Ingul et al., 2012; Rasasingham, 2015; Balkis et al., 2016; Gubbels et al., 2019; Malika et al., 2021; Leduc et al., 2022). The following list is not intended to be exhaustive, but rather to provide an overview to contextualize the findings and insights from the quantitative research presented here.

3.1.1 Factors at student level

At the level of student, a range of mental health and/or somatic challenges are associated with SAPs: these include academic issues, interpersonal concerns, high stress levels, behavior problems, performance anxiety, sleep problems, emotional disorders related to internalizing problems like general anxiety, social phobia, depression, somatic complaints (Finning et al., 2019; Askeland et al., 2020; Leduc et al., 2022). Conversely, good performance, self-efficacy and positive mindsets are examples of protective influences (Henry and Huizinga, 2007; Ingul and Nordahl, 2013; Maric et al., 2013; Malika et al., 2021; Benoit et al., 2024). The ecological model also highlights individuals’ sense of agency - the capacity to act and exercise choices - (Sadownik, 2023), which may empower students to have the tenacity to pursue a goal despite any attendance challenges that occur.

3.1.2 Micro- and mesosystem peers, school, and family

The microsystem entails settings, activities, and interpersonal relationships that directly influence an individual’s attendance or absenteeism, including both peers, school, family, and other close entities (Bronfenbrenner, 2005; Bronfenbrenner and Morris, 2007).

Examples of peer-related factors associated with SAPs are social conflicts, for example bullying experiences and victimization (Malcolm et al., 2003; Malika et al., 2021; Leduc et al., 2022; Schlesier et al., 2023). Further, levels of care, respect and peer support and friendships are inversely related to absenteeism (De Wit et al., 2010; Hendron and Kearney, 2016).

Research suggests that factors in the microsystem school as key social context are both strong predictors to SAPs and serve a protective function for youth at risk of SAPs. This entails the quality of teacher-student relationships, the perceived teacher support and caring behavior for the student (Pellegrini, 2007; Ingul et al., 2012; Rasasingham, 2015; Geiser Werren and Isaak, 2016; Brouwer-Borghuis et al., 2019; Malika et al., 2021; Lee et al., 2023). Further studies show that a positive school climate is related to a decreased risk of developing SAPs (Price, 2015; Rasasingham, 2015; Hendron and Kearney, 2016; Van Eck et al., 2017; Brouwer-Borghuis et al., 2019; Karlberg et al., 2020; Ricking, 2023b). Positive school climates exist when students feel comfortable, accepted and safe in an environment where they can interact with people they trust (Naff et al., 2023). A sense of connectedness to peers, teachers and school is associated with higher motivation and engagement, and thus school attendance (Van Eck et al., 2017; Korpershoek et al., 2020). Essentially, supportive social environments are foundational to positive school behavior, which influence students’ perceptions of school as enjoyable and meaningful and ultimately lead to school attendance and achievement (Woolley and Grogan-Kaylor, 2006). Studies of SAPs in vulnerable populations demonstrate the complex interactions between student and teacher behaviors, highlighting the dynamics in the microsystem school that contribute to SAPs. For instance, teachers’ misconceptions about students with SAPs from transcultural, ethnic backgrounds may lead to inadequate support and influence student-teacher-relationships (Martin et al., 2020).

Family-related risk factors are low parental involvement or lack of interest in school work, and parent pathology (Hendron and Kearney, 2016; Gubbels et al., 2019; Leduc et al., 2022) while parents’ educational expectations and support are associated with high school completion (Ross, 2016). Recent literature highlights that children from families with low income, low socioeconomic status, or immigrant background are at higher risk of developing SAPs (Kearney and Benoit, 2022).

The mesosystem involves the interrelations between the individual’s different microsystems. Like school’s partnership with families and other stakeholders (Sundelin et al., 2023) that have been shown effective to improve attendance rates (Gren Landell, 2021).

3.1.3 Exosystem

The exosystem includes external settings that do not involve the student directly but affect their microsystem. As such, structural aspects like curricula (Leduc et al., 2022) and negative classroom management (Havik et al., 2015), teaching practices (Henry and Huizinga, 2007), or the approach to intervention (Keppens and Spruyt, 2020) are associated with SAPs. Ultimately, systemic school-based approaches as well as tiered systems of support characterized by a proactive, responsive system can be included in both the microsystems and the exosystem because they direct support to the individual student, but are also part of the immediate community (Kearney and Graczyk, 2020; Boaler and Bond, 2023).

3.1.4 Macrosystem

The macrosystem encompasses broader societal and cultural influences on attendance, mainly programs or initiatives, but also the education (and welfare) system or state/government policies (Freeman and Simonsen, 2015; Keppens and Spruyt, 2019; Childs and Scanlon, 2022).

3.1.5 Chronosystem

Changes over time affect development and can influence school attendance. The chronosystem refers to aspects of time (Rosa and Tudge, 2013). Broadly understood, it implies an individual’s own developmental life course, such as transitions from primary to secondary school (Melvin et al., 2019), and events occurring during the period through which the person lives, such as the COVID-19 pandemic (Naff et al., 2023).

3.2 School attendance problems through resilience theory

Risk/resilience theory provides a valuable lens through which to view SAPs. Resilience is defined as individuals’ “capacity for constructive adaptation to adversity” (Olsson et al., 2003, p. 6). In the context of SAPs, resilience can be viewed as a reflection of how individuals cope with risks that negatively impact their school attendance behaviors. To date, the majority of research has had a focus on understanding risk factors contributing to adolescent absenteeism and attendance (Melvin et al., 2019). The adoption of resilience theory encourages a balanced view of risk and resilience factors to take into account both the vulnerabilities and the strengths of the students that lead to the development of school attendance (problems). Attention to protective factors proves beneficial to identify processes that promote positive adaptation while protecting against threats to well-being (Ungar, 2013).

An example demonstrating the relation of the concept of resilience and SAPs can be evidenced in the alignment and intersection of resilience research with studies on absenteeism. Supportive relationships have been shown repeatedly as resilience factor that mitigate the impact of risk factors in youth development (Richardson, 2008; Ungar, 2011). Consistent, supportive interactions with adults in school and at home can enable students’ ability to overcome barriers to regular attendance (Woolley and Bowen, 2007; Tomaszewska-Pękała et al., 2020).

However, this observation suggests that resilience is not merely an individual trait but results from a complex interplay between individuals and their multiple environments. This implicates an ecological understanding of resilience-related processes with interacting protective and risk factors across levels shaping the development of SAPs.

3.3 Ecological theory of resilience: an integrated perspective on school attendance problems

The current study is mainly guided by an ecological model approach as overarching theoretical framework, whilst combining it with a resilience perspective to focus on what can lead to a positive development for the individual in the presence of difficult life experiences (Luthar et al., 2000; Acle-Tomasini et al., 2016; Cotton et al., 2017; Devenney and O’Toole, 2021).

Resilience within the ecological model can be defined as capacity of individuals to navigate to psychological, social, cultural, and physical resources that sustain their well-being. The personal agency of individuals to negotiate “for what they need is dependent upon the capacity and willingness of people’s social ecologies to meet those needs” (Ungar, 2013, p. 256). This definition highlights the dynamic and interactive process of resilience within the social ecology, where multiple systems contribute to resilient outcomes (Ungar et al., 2013). According to Fergus and Zimmerman (2005), resilience factors can be divided into resources (environmental factors) and assets (personal factors). In other words, resources may be conditions and interactions within and between eco-systemic levels, such as school experiences, family interactions and social support (Richardson, 2008). Resources interact with personal assets, such as young learners’ self-regulation and sense of efficacy (Thun-Hohenstein et al., 2020). In turn, both resources and assets are critical elements of resilience, which in turn can promote attendance or prevent attendance difficulties.

Applying this integrated perspective forms a comprehensive view on the interplay of individual and environmental factors that facilitate or hinder the development of young learners’ connection to school (Heyne et al., 2024) and their attendance behaviors.

Given the impact of the social environment on adolescents’ health and well-being, social elements can provide protection against the risk of non-attendance (Warne et al., 2020; Kearney et al., 2022b). In light of this, student engagement theories can contribute to valuable insights into school attendance, covering various facets of school engagement, such as behavioral, cognitive, and emotional investment in academic achievement, as described by Kearney and Gonzálvez (2022). As we aim to explore elements and support measures that may mitigate the risk and enhance attendance and successful transitions to post-secondary education, we consider it a useful starting point to identify patterns of engagement (Kearney and Gonzálvez, 2022) as resilient routes at individual and broader level. Student engagement concepts can be linked to socio-emotional, behavioral and academic support available in individuals’ environment (e.g., Clycq et al., 2017). By highlighting support sources, we can emphasize the dynamic interaction between risk and resilience elements associated with SAPs in youths’ stories. As described by Clycq et al. (2014, 2017), we connect a wider macro-structural context with individual resilience, as demonstrated by the encounters of a student within the family, peer group, and community.

3.4 Youth voices regarding attendance problems and support

As we experience rapid changes in educational and social landscapes, listening to voices of stakeholders are important (Keppens and Spruyt, 2020; Johnsen et al., 2021). Research on absenteeism interventions shows mixed results, with many programs only achieving small to moderate improvements (Keppens and Spruyt, 2020; Eklund et al., 2022). This variability can be attributed to the complex, individualized nature of the factors affecting attendance, such as personal, familial, and contextual influences. Given these mixed outcomes, incorporating student perspectives is crucial for developing more effective interventions.

In this regard, qualitative studies aimed at capturing students’ unique perceptions, experiences, and views in this area can help to design tailored attendance strategies that are contextually relevant and supportive of their specific needs (Tarabini et al., 2019; Corcoran and Kelly, 2023). Previous qualitative research into youths’ experiences of SAPs highlight areas of hindering or supportive factors to attendance that are connected to the person and their social environments. In what follows, we summarize studies focusing on youths’ perceptions of SAPs and support, making reference to eco-systemic levels.

3.4.1 Youth characteristics as protective factor

At individual level, a qualitative study of children’s perceptions of reasons for being absent highlights themes such as anxiety and depression (Baker and Bishop, 2015). Oehme (2007) has studied school refusers’ subjective theories for their absence in Germany. The study revealed participants’ complex argumentation structures for explaining their absence from school associated with academic difficulties, depression, or negative self-perception. A qualitative study on youth’s perceptions of anxiety-related absenteeism (Dannow et al., 2020) found that academic aspirations were related to motivation for returning to school. Another study of enrolling German youth with emotional and behavioral difficulties highlights motivation, wish for participation and self-efficacy as areas of resilience to overcome the risk of SAPs (Heckner, 2013). Additionally, an increase in self-confidence appeared to be important to youths experiencing school refusal (Heyne et al., 2021). Most recently, research from Wright (2023) explored perceptions of primary school children in England. Children share the experience of receiving support that may have helped them to self-regulate their emotions, particularly anxiety.

3.4.2 Direct social interactions in microsystems

Gregory and Purcell (2014) were able to show that, from the adolescents’ perspective, bullying was a reason for absenteeism. In contrast, adolescents experienced friendship as a motivator to attend school and a support in coping with stress (How, 2015), they value social contact with peers (Heyne et al., 2021). The perception of peer relationships was interconnected with a sense of belonging, school experience and personal wellbeing (Richards and Clark-Howard, 2023).

Although qualitative studies mostly report school-level factors as having negative effects on absenteeism from youth’s perspective (Dannow et al., 2020), some studies have identified school-related factors and resilience domains as important in supporting attendance (Heckner, 2013).

Several studies into youth voices have highlighted the significance of positive relationships between students and teachers within the school environment. How (2015) identified positive relationships with teachers as a protective factor, emphasizing the importance of teachers demonstrating care, respect, and providing individualized support to students. Wright (2023) further explored this theme by emphasizing that access to a key trusted adult who listened and met youth’s social, emotional wellbeing as well as learning needs was important. A common theme in young people’s accounts regarding intervention, particularly in the context of school refusal, were supportive relationships with at least one adult – characterized by kindness, caring behavior and availability (e.g., Gabrielsen and Havik, 2021; Heyne et al., 2021; Kljakovic et al., 2021). The importance of being understood and heard was frequently highlighted by youth (e.g., Nuttall and Woods, 2013; Baker and Bishop, 2015; Heyne et al., 2021). Additionally, Sundelin et al. (2023) show the importance of listening, showing empathy, and caring for students’ concerns as essential components of experienced supportive adult-student interactions. Findings from studies of the experiences of students with school refusal involved in an Australian re-engagement program and Canadian alternative settings highlight the need of being recognized, understood and feeling a sense of belonging. Students also expressed the need for “compassionate and caring educators, who were aware of the mental health difficulties” (McKay-Brown and Birioukov, 2021, p. 95) their students are experiencing.

In Oehme’s (2007) research, youth also report on family-related reasons that hindered their attendance, such as family conflicts, parental problems and lack of interest in school. Similarly, students in the study of Dannow et al. (2020) talk about their parents’ limited understanding and knowledge concerning school absenteeism. Young adults with a history of school refusal from immigrant and ethnic minority backgrounds express a sense of obligation to live up to their parents’ dreams of academic success as well as parental misunderstanding (Brault et al., 2022). Studies included in a systematic review of qualitative research in New Zealand identify illness and death in family as experienced barrier to attendance while also mentioning the importance of “family supporting them to attend school and helping them re-engage after a period of absenteeism “(Richards and Clark-Howard, 2023, p. 85). Another aspect as reported by students to be important is regular home-school communication (Nuttall and Woods, 2013).

3.4.3 Impact of extended community and society

Related to experiences of the exosystem, structure and quiet surroundings in school are viewed as helpful in supporting school attendance (Heyne et al., 2021; Havik and Ingul, 2022). At structural level, participants disliked lessons “which were academically challenging, repetitive and boring” (Wright, 2023, p. 87). The quality of the pedagogical approach, curriculum and having a choice over subjects appeared as a theme in Richards and Clark-Howard (2023), while the need for adjustments to learning was another supportive factor to attendance according to youth (Wright, 2023).

3.4.4 School as key facilitative environment

The above findings corroborate existing reviews of qualitative studies. Among the identified themes by Richards and Clark-Howard (2023), students’ relationships with teachers and peers emerged as the most prevalent topic. Students discussed the need of teacher support and their non-attendance as a response to negative interactions causing them to disengage. In a systematic review of existing UK-based literature on lived experiences of persistently non-attending youth, Corcoran and Kelly (2023) generated seven themes: difficult relationships with peer group, inconsistent relationships with and support from adults, negative experiences of school transition, negative experiences of learning in school, emotional wellbeing and mental health needs, others’ negative perceptions of the individual’s needs, personal beliefs about attendance. Through the synthesis, an overarching higher-order concept was developed which exemplifies the relation between macrosystems. It captures the need of a sense of belonging which holds “the positive experiences of feeling connected, listened to and receiving individualized support as conducive to regular school attendance “(Corcoran and Kelly, 2023, p. 10).

Previous research has provided valuable insights into SAPs, but there are a few gaps that require further exploration. In understanding SAPs and support, there is a need “to include perspectives on who is most affected: the student.” (Warne et al., 2020, p. 4). In addition, the existing literature often emphasizes hindering factors contributing to SAPs, while overlooking the investigation of factors and supports that help students overcome these challenges or promote school attendance. Therefore, a more balanced approach is needed to fully understand the interplay of risk and protective factors in the development of SAPs. A qualitative study can allow us to analyze what is perceived as helpful and how, in what kind of situations, it unfolds as a protective mechanism in relation to risks.

4 Aim and research questions

The aim of the study is to explore attendance-related challenges, as well as key factors and supports that are perceived as helpful and important for overcoming SAPs from youths’ perspectives. The main focus is on secondary school students’ views and experiences of what supports their transition to post-secondary contexts in a local comprehensive school (Stadtteilschule) in the city state Hamburg in Germany. We address the following research questions:

• RQ1: What kinds of challenges for attendance can be identified in Hamburg secondary school students’ accounts?

• RQ2: What is perceived as helpful support and important factors to overcome SAPs and enable successful transitions to post-secondary education from the perspective of secondary school students in Hamburg?

• RQ3: How can the identified challenges and factors from RQ1-2 be organized into an ecological framework of risk and resilience of students and their social contexts as a basis for attendance support?

5 Methods

5.1 Study design

The current study is part of the international research project School Attendance Problems in International Comparative Perspectives (SAPIC). The project uses a mixed method approach combining quantitative analysis of large-scale data on the national level with qualitative case studies on the organizational and individual level (Kreitz-Sandberg et al., 2021,2022; Fredriksson et al., 2023, 2024). At the individual level, the case studies put the situation and views of young people with experience of SAPs in focus, exploring their individual perspectives on support. Within the case study, focus group interviews with school professionals and teachers were also conducted at respective schools. This article builds on interviews with 15- to 18-year-old adolescents with experience of SAPs in German schools, in Hamburg.

5.2 Participants and data collection

In total, ten individual in-depth interviews were conducted with students in lower secondary school in July 2023. Two secondary comprehensive schools (Stadtteilschulen) from lower socio-economic areas in two different districts in Hamburg were selected and contacted for the study. Using a snow-balling strategy (Friebertshäuser and Langer, 2013), the research team contacted school leaders and other professionals who were asked to identify students who have or had experience with SAPs according to the professionals to participate in individual interviews. The degree of non-attendance was not relevant for participation in the study. The recruitment stopped at this number to not place additional burden or stress on participating schools, ensuring that the study adheres to ethical standards as approved by the Hamburg authority for schools and vocational training.

In line with the scope of this study, the authors decided to include in the analysis interviews with students who were in their last year of lower secondary education (year 10) before they obtain their school-leaving qualification and transition to either upper secondary education or VET. One interview did not meet this criterion. The final sample for analysis consisted of n = 9 secondary school students. The recruited students fell into overlapping risk categories, for instance young carers (Ricking and Albers, 2019), experiencing mental health and behavioral problems, coming from low-income families and migration background (e.g., Malika et al., 2021; Brault et al., 2022). Four of the students were female. The description of participants’ school experiences and challenges are outlined in the results section.

The interviews were conducted with adolescents in separate rooms at their school. Parents were asked to fill out an informed consent for their children to participate in the study. Additionally, interviewed adolescents were given written and oral information about the study prior to the interviews. They were informed that participation was voluntary, that their answers remain anonymous, and that they could terminate the interview at any point. At the same time as the interviews, adolescents gave their written and oral consent to data being processed and stored in accordance with data protection regulations.

Semi-structured interviews were conducted in German at both school locations the interview guide was designed based on the study’s research questions and literature. Students were asked about the support they received, their thoughts on what has helped and what could have been done differently. In addition, they could express what advice they would have for schools in promoting attendance among students. The interviews lasted between 13 and 38 min. All interviews were audio recorded and converted to transcript and pseudonymized.

5.3 Ethical considerations

The Institute of Monitoring and Improving Educational Quality in Hamburg (Institut für Bildungsmonitoring und Qualitätsentwicklung; IfBQ) as part of the authority for schools and vocational training (Behörde für Schule und Berufsbildung; BSB) has approved data collection in Hamburg schools (Dnr. e514.101.5000–002/222,047; Decision 31.03.2023). Data was handled according to the German law for data protection. In both the analyses and presentation of results, attention was given to protect privacy of data. Students and parents/guardians were given appropriate information as described above. All names used in the quotations are fictitious and do not allow for personal identification.

5.4 Data analysis

For data analysis, we employed qualitative content analysis to describe themes and patterns in statements of young people (Graneheim et al., 2017; Kuckartz and Rädiker, 2023). More specifically, we employed an abductive approach to qualitative content analysis (Graneheim et al., 2017) including both inductive and deductive approaches during different stages in the analysis process. An example of the coding process with the number of codes for each category can be accessed in Supplementary material. Each interview was transcribed verbatim (Dresing and Pehl, 2018) and the program f4analyse was used to assist the data coding. The analysis was conducted according to the following steps:

1. First, transcriptions were explored numerous times by the first author and meaning-carrying units related to the aim of the study were extracted. To organize the data, two sets of categories were identified in relation to the RQs (1) Experienced challenges for SAPs and (2) Helpful elements and resources related to attendance support. Each RQ represents an overarching theme in the results section.

2. Descriptions of challenges or obstacles to school attendance constituted the first unit of analysis to allow for a general picture of young people’s risk background regarding RQ1. In a first inductive exploration, quotations related to obstacles, challenges and experiences of non-attendance were sorted into the first category map to find patterns and themes in the data.

3. In the main analysis process to answer RQ2, the primary focus was on factors that young people identified as helpful or important in the decision to either attend or not attend school and ultimately complete their education and progress into upper or post-secondary education. Using an inductive approach, we included students’ statements about elements of (school-based) support as well as more implicit perceptions of support and engaging factors that counteracted the development of SAPs. When operationalizing (social) support described by the students, we directed attention to “perceptions of general support or specific supportive behaviors (available or acted on) from people in their social network, which enhances their functioning or may buffer them from adverse outcomes” (Malecki and Demaray, 2003, p. 231).

4. In the next steps, meaning-carrying units were condensed and abstracted into codes as part of content analysis. During the process of developing codes, we looked for redundancy in codes. When no new codes emerged from the data, saturation was considered to be reached. The codes were compared and sorted into subcategories.

5. To ensure theoretical sufficiency, the identification of subcategories was consistently compared with ecologically-based protective and risk factor categories. In a first step, we looked for classifications of protective processes sitting at three levels: individual, family, and social environment which is further divided into school environment and broader social environment like community, institution and system (Olsson et al., 2003; Bengel et al., 2009). In a second step, we acknowledged that certain codes occurred across ecological levels and were not aligned to a single level or system. We revisited the material, looking for recurring emotions present in students’ statements and the main source, actor or environment that students attributed to school (non-)attendance. Therefore, relational, behavioral and emotional aspects were compared to conceptual understandings of the sense of school belonging that could capture subjective feelings of connection, understanding and support by others in the school social environment (Allen et al., 2016; El Zaatari and Maalouf, 2022).

6. Following this step, categories and subcategories for RQ1 and RQ2 were adjusted. In a deductive manner, the meaning-carry units and codes were checked again and sorted into the subcategories. In few cases, the meaning units needed to be re-coded and they resulted in another subcategory. Tentative codes and emerged subcategories were discussed by all authors and revised until consensus was reached, i.e., dialogical intersubjectivity (Kvale, 1996).

The authors engaged in ongoing reflexive practices to acknowledge their own biases and assumptions that could influence data analysis. This included transparent documentation of the coding process, reflection on biases, and discussion of context-specific meanings among the international group of authors. Critical dialogues with international research colleagues from different cultural and national backgrounds further ensured the quality and integrity of the study by bringing diverse and more nuanced interpretations.

6 Results

Following the research questions, we first present the backgrounds and self-reported challenges of Hamburg secondary students that emerged from data analysis (RQ1). Second, we show the results of what was experienced as helpful (RQ2). The exemplary quotations are translated from German, using a language translation tool. The translation was checked by the authors. The quotations are numbered (Q1, Q2…) and the corresponding original German excerpts can be found in the Supplementary material.

6.1 Experiences of school attendance problems and perceived challenges

When listening to Hamburg youth’s voices, diverse descriptions of having had frequent or extended SAPs emerged. The majority reports being periodically absent in the early years of secondary school (grade 5 to 7), while others describe skipping classes now and then. The characteristics of youths’ self-reported degree and type of absence are summarized in Table 1.

Table 1
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Table 1. Characteristics of youths and reported school attendance problems.

In the interviews, students illustrate various different reasons as to why they experienced SAPs due to social, emotional, and learning problems inside and outside of the school environment. Few students report a shift to disengagement in school as way of mental absence and boredom (e.g., Kearney and Gonzálvez, 2022). In general, all cases present complex and unique educational trajectories. The analysis indicated that all students experienced challenges that can be identified as risk factors across the levels of individual, family, school, and peers. The driving mechanisms for school attendance difficulties were emotional stress, negative school experiences and reduced well-being in the majority of student statements. These statements were categorized according to the main source, actor, or environment that students attributed to their feelings of stress and inability to attend school. Consequently, four main categories emerged relating to the overarching theme of experienced challenges to attendance (see Figure 2).

Figure 2
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Figure 2. Category system for RQ1 - experienced challenges to attendance.

6.1.1 Mental health problems and emotional distress

Most notably, a common feature of young people’s histories were experiences and reflections surrounding mental health challenges, including depression, trauma and social anxiety. The statements highlight how difficulties in attending school result from the interplay between mental health problems, low self-esteem and external stressors in the school environment, such as academic pressure or transitions between educational stages.

During the time when I suffered from depression. That was in eighth grade. Hm, and then it was also very, very difficult for me to come to class because I had, let's say, experienced a lot of traumas and I was just afraid to come to school (Amira, Q1)

I suffer from an anxiety disorder and yes, I also believe that a lot of young people have a mental illness, unfortunately. And I think if you then put even more pressure on these children and expect even more […] it's completely over. (Leila, Q2a)

Leila displays an example of how performance pressure can also increase mental health issues. It seems that mental illness or a diagnosis were onset factors to their non-attendance while other students had experienced these as a result or maintenance factors to attendance problems and changes in environment. Nadja mentioned the transition and adjustment from primary to secondary school as stressful factor that was connected to lower self-esteem and the fear of making mistakes or being ridiculed in front of the class.

For me personally it was the beginning, the (…) transition from Primary School to Secondary School. […] I didn't really participate as much as I should have because I was afraid that I would be laughed at or that something bad happened if I said something wrong. […] then I just didn't want to go to school (Nadja, Q2b)

6.1.2 Lack of social belonging

This category encompasses youths’ experiences of disconnection and detachment from the social environment in school, particularly the impact of peer relations. A central topic was the experience of bullying and victimization in class. On the one hand, negative interactions and problems with peers were described as making them feel uncomfortable and as a consequence, they stayed away from school:

It was also because I simply had a lot of problems in my class. I didn't really enjoy my time at school, but yes, that's why I didn't go to school sometimes (Noah, Q3)

On the other hand, the fear of negative reactions from peers evoked negative emotional feelings, somatic complaints and reduced wellbeing in class.

in fifth grade there was a bit of teasing […] which made me feel a bit uncomfortable and I actually didn't go to school a few times and pretended that I was ill, had a stomach ache or something." (Nadja, Q4)

When asked about reasons why youth do not attend school, students mention negative interactions with peers that are perceived as stressful and affecting the motivation to come to school.

6.1.3 Negative teacher-student dynamics and lack of enjoyment in learning

This category is derived from descriptions of youth regarding teacher behaviors, classroom dynamics, and delivery of education that created a sense of being pushed away from meaningful learning opportunities. Statements in this category address the impact of teachers on students’ school experiences, including perspectives on relationships with teachers, as well as teaching methods and pressure exerted by teachers that affect motivation, engagement and enjoyment in class. Students described that school was boring, or that teaching methods did not meet their skill level.

I have a teacher who I just don't like that much and I don't have so much fun in class (Luckas, Q5)

Another common topic in statements were stress experiences, especially related to perceived high academic demands, exams and grades. Students feel that stress and anxiety intensified if they did not meet schools’ and teachers’ performance expectations.

It often depends on the teacher, how the teachers create psychological pressure. Especially with all the exams and everything, they really put a lot of pressure on you, so you really don't like going there because you know they are just putting you down because you haven't studied enough or else. (Leila, Q6)

6.1.4 Stressors in the home environment

This category concerns descriptions of youths’ situation and experiences at home, as it affected their attendance behavior. Amira describes feelings of helplessness and exhaustion due to parent’s sickness, caring for siblings and financial instability. Janik feels pressure from his parents, such as the expectation to advance to higher levels in education and perform well in school.

They also have money problems, for example, and are somehow not doing well financially and that really stresses me out. And I don't know how to deal with something like that and that's why I ended up playing truant" (Amira, Q7)

At home, there's some stress because of school, that you have to manage everything, particularly if you continue to upper secondary, and you have to handle all things, make more effort and if you hear that all the time, you just don't have no more desire [to go to school] (Janik, Q8)

Overall, youth talk about parental behaviors or stress at home that placed emotional burden on them, and thus impacted students’ ability to attend school and/or cope with school demands.

6.2 Perceptions and experiences of helpful elements and resources related to attendance support

In the analysis of factors that students perceived as helpful in overcoming attendance challenges and transitioning into post-secondary education, we identified three main categories with respective sub-categories (see Figure 3).

Figure 3
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Figure 3. Category system for RQ2 - views of students on support and helpful factors.

6.2.1 Personal resilience

This main category emerged as central topic when listening to students’ voices about what has helped or still helps them to attend school. The quotes indicate assets and personal strengths of students to handle difficult situations and strive for aspired educational pathways, including self-regulation abilities, optimism and future orientation, dimensions known from the literature on personal resilience (Thun-Hohenstein et al., 2020).

6.2.1.1 Academic engagement and future orientation

The sub-category is based on codes that refer to competence-related statements, essentially the relation between school attendance, academic performance, engagement and hopes for future education opportunities. When asked about why students attended school, they highlight the personal value of school reports and good grades to achieve a school-leaving certificate. The statements also point towards optimism and confidence about the own educational future.

In tenth grade, the report is very important, to get a school-leaving certificate. (Samir, Q9)

Because I just want to get good grades and stuff. That's why I have to pay attention in class. If I'm not there, then I can't keep up (Malik, Q10)

Malik also shares his opinion about the potential negative consequence of absence because it would adversely affect one’s graduation and limit job opportunities.

I don't think that's good, because it messes up your school leaving certificate or your life if you don't get the right job or if the employer sees that you weren't there much at school. Then he has no confidence in you. (Malik, Q11)

The goal of obtaining an advanced school-leaving certificate was highlighted by most of the students because it is necessary to progress to higher education. Having this goal in mind seemed to be a central motivator to attend school regularly. Students recognize a lack of regular attendance or participation in class can hinder their ability to achieve good grades and graduate. This is the main reason why they remain academically engaged in the learning process to enter their preferred path of post-secondary education.

6.2.1.2 Regaining a sense of agency

In this sub-category, students reflect on situations in which they regained a personal strength by navigating their way to psychological assets. This seemed to make them resilient in the face of stress or challenges associated with attendance. For example, Noah actively ignored classmates who teased him. The strategy Leila mentioned was to go outside, take a deep breath, and self-regulate to deal with social anxiety and panic.

In addition, students describe how changes in self-confidence and self-esteem affected well-being and feelings of safety in school which helped to cope with previous barriers to attendance, such as peer victimization.

It just stopped with the fact that I then built myself up more and more against it and gained more self-confidence […] That helped. (Nadja, Q12)

The importance of personal strategies to manage stress or challenging situations created a buffer for negative school experiences, and thus supported school attendance.

6.2.2 Feelings of connectedness and belonging in school

Most of students’ responses were coded in this main category. Subsumed under this category were statements indicating subjective perceptions of the quality of social interactions, relational characteristics, and involvement in the learning environment that demonstrate a sense of school belonging and relatedness as components of well-being and health (Allen et al., 2016). Feeling connected to school acts as a protective mechanism that plays a central role in shaping school attendance outcomes at multiple ecological levels, not just at a single ecological level.

6.2.2.1 Trusting and supportive relationships with teachers and other professions

The category relates to descriptions of youth about how communication, trust, understanding in social relations with professional actors in the microsystem school helped navigate challenges and foster a sense of belonging and well-being. Reports generally refer to supportive behaviors or actions that were experienced as helpful to buffer them from adverse outcomes (Malecki and Demaray, 2003). In the responses, youths listed different teachers as generally helpful where they turned to for support. They describe significant interactions with teachers whom they trusted and felt comfortable confiding in to discuss their challenges and concerns. These teachers were approachable, attentive, and responsive listeners.

In general, the teachers, who are always open to talking. (Janik, Q13)

Some teachers, especially our class teacher […] and we actually always trust her with everything (Nadja, Q14)

We just discussed how I was feeling, how I felt about it […] she gave me tips on what I could do about it (Noah, Q15)

Somehow, they made sure that you enjoyed coming to school again. (Leila, Q16)

When asked about what they would have done differently, Noah expresses the belief that having approached a teacher sooner might have prevented or mitigated the development of attendance issues.

Back then, I should have gone to the teacher faster or earlier. It probably wouldn't have escalated so much, as it has then. (Noah, Q17)

Others report the importance of having access to emotional support from different sources like social workers or “Vertrauenslehrer” (confidant teachers) in the school environment. For example, Leila describes the positive impact of communication:

Well, we also have social workers at the school, of course you can always go to them, you can also make appointments with them, talk to them. That's good (Leila, Q18)

Zara mentions that support from social workers should be made available for all students struggling with difficulties:

We have social workers […] they also have a place where you as a student can knock on the door and talk to them. But I would say that they could perhaps advertise it a bit more for the people who need it. (Zara, Q19)

Overall, students recall interactions with teachers and other professionals that helped them overcome prior negative experiences and facilitated their return to school. As such, supportive relations with teachers built coping abilities in relation to experienced mental health or peer problems. The stories also make visible the youths’ agency. Particularly, they refer to behaviors that helped them to navigate their way to resources they needed to handle challenges in school (Ungar, 2013).

6.2.2.2 Supportive peer relationships

Concerning the peer level, youth mention the positive impact of having supportive friends, classmates and confidants. For example, Amira turned to support from one good friend that helped her coping with various difficulties.

What definitely made me forget my worries was my best friend. […] I am also very, very grateful. […] that was my counseling. (Amira, Q20)

Overall, students highlight the value of having trustworthy friends who offer support, understanding, and assistance. Peers with similar and shared experiences were particularly perceived as helpful.

6.2.2.3 Call for recognition of individuals’ needs

This sub-category results from youths’ wishes regarding what is important in the support for SAPs. Essentially, youths talk about the approach of school in relation to individual problems and needs.

Maybe ask WHY first. You don't always know why he [the student] doesn't attend. Then try to implement what he thinks. Let's say he doesn't like a teacher. Maybe then try to help him somehow so that he gets closer to the teacher. (Luckas, Q21)

Show a bit of understanding for the pupils, yes. (…) Just understanding for their problems (Leila, Q22)

Students express the desire for educators to prioritize emotional needs instead of only focusing on academic school outcomes. These statements reveal how school influences students’ feelings of being accepted, listened to and supported that improves school attendance when they are struggling.

6.2.2.4 Social integration and positive school climate

This sub-category is based on codes indicating students’ shared desire for fostering social cohesion in school. As an exemplary helpful strategy, the idea of pairing students to promote positive relationships is mentioned in interviews. Zara describes her idea about fostering a positive class climate by designing rooms more colorful:

The classroom climate should definitely improve. […] in terms of class climate, [the teacher] could perhaps decorate the classroom a bit, like more colorful (Zara, Q23a)

Students also emphasize the importance of avoiding stigmatization, bullying, or addressing exclusion issues. They call for school practices to control misbehaviors and shape social dynamics of the classroom.

I would say, if you are an outsider or excluded or bullied, that the school takes it seriously, and I mean that it takes the students seriously (Zara, Q23b)

As example, when asked what schools should do to prevent SAPs, Zara expresses the responsibility of school to create an inclusive school environment where students feel accepted and included. This description points to positive school climate factor as element of a sense of school belonging.

6.2.2.5 Safe spaces in school

Another important factor that created a sense of connectedness and well-being included designated safe spaces as characteristic of the physical school structure. In particular, students with anxiety experienced this as a helpful setting to withdraw and relax when feeling unwell at school.

The rooms where you can retreat if you need some time. Or the common room here [in school] for the tenth graders, where you can just play table football during the break. (Janik, Q24)

6.2.2.6 Meaningful and enjoyable learning experiences

For many students, facilitators of attendance are related to the quality of teaching and instruction, characterized by relevant and tailored learning practices according to students’ interests and needs for autonomy. More creative and fun teaching approaches are noted as important in fostering motivation to attend classes.

As a teacher, you have to come up with a good [teaching] concept for the lesson that is both instructive, but also a bit of fun. […] it's just more enjoyable to go there (Leila, Q25)

The students also note the role of teachers who motivate them to attend their lessons and encourage them to come to school. Some of the students believe that tailored language and engaging teaching methods could contribute to positive academic outcomes for all, while improving attendance. Particularly, this entails the organization of lessons, a quieter atmosphere of the learning environment and adaptive academic language.

6.2.3 Supportive mechanisms in wider social environment

This main category emphasizes youth voices on the importance of fostering positive relationships between families and schools, as well as implementing proactive measures to address issues promptly and effectively.

6.2.3.1 Parent–child relationships

The role of parental support that exists in the family microsystem is highlighted by youths in different ways. Students underscore the need for parents to discuss concerns, build trust, and support the child to address attendance challenges. In addition, parents play a proactive role, for instance, through active encouragement and their child’s upbringing on the attitude towards education and school attendance.

Well, first of all my mother, she helps me a lot to go to school (Malik, Q26)

My mother didn't think it was particularly great that I skipped lessons. She encouraged me to go [to school] anyway, even if the teachers were annoying and even if I didn't feel like going, because attendance is important (Leila, Q27)

Especially, the supportive role of mothers in motivating and encouraging attendance seemed important in the student perspective.

6.2.3.2 Parental involvement

This sub-category concerns parental involvement as parent-school communication built in the mesosystem. Generally, students wish for a more proactive approach, suggesting schools to check on the student and inform their parents if they are unaware of the student skipping school:

If you know that the person is playing truant, come by again and let the parents know that he might be playing truant. Maybe they [parents] don't know about it either (Luckas, 28)

Youths further describe how schools should communicate with parents to manage the child’s absenteeism. Students recommend that schools should explain to families the importance of the child’s school attendance and emphasize the negative consequences of the behavior on academic performance, school-leaving certificates, and future job opportunities.

6.2.3.3 Sanction systems

In some cases, students talk about the role of legal measures, specifically fines. Schools can take this action as a last resort, when warnings and efforts to restore regular attendance have failed. Schools must report a case of “permanent school attendance violation” to the school authority, which issues the fine to be paid by parents or students. For example, Janik explains that the prospect of fines acts as a deterrent, influencing his decision to attend school regularly.

I don't feel like paying for simply not attending. I can just attend and not have to pay anything (Janik, Q29)

Samir believes that the fine is not appropriate sometimes, especially for those who cannot afford it or where other circumstances could prevent students from attending school.

I really think €250 is a bit too much for a fine, because sometimes you can't do anything. For example, if you live further away from school (Samir, Q30)

Students express mixed feelings about the fairness of fines. They suggest a system where students could provide explanations to their absence before fines are issued. However, the underlying message might be interpreted as a call for schools to investigate causes to students’ SAPs.

7 Discussion

This article sought to explore perspectives of secondary school students in Hamburg regarding experienced challenges to attendance (RQ1), alongside key factors and supports perceived as helpful and important in overcoming SAPs on their pathways towards post-secondary education (RQ2). The statements from youths imply conditions that increase the risk of SAPs, as well as social and personal resources that act as buffers to mitigate the risk of negative impacts on attendance. Identified factors from youths’ perspectives appear to interact and move across multiple ecological contexts with direct and indirect impact (Kearney and Gonzálvez, 2022). Thus, for answering RQ3, we structure the complexity of findings across ecological levels in order to visually represent the interconnectedness of proximal processes and environmental contexts (Bronfenbrenner, 2005) that influence attendance outcomes (see Figure 4).

Figure 4
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Figure 4. Model of risks and resources related to school attendance support across ecological levels from the views of students.

7.1 Ecological model of risks and resources to attendance from students’ perspectives

In accordance with the underlying theoretical framework, we propose areas of perceived support and helpful elements within a model of attendance support from the views of youths, as (Nuttall and Woods, 2013; Naff et al., 2023) did this in a similar manner. The Figure 4 recognizes the balance of risk and protective factors that are connected to the systems as outlined in Melvin et al. (2019). The student is at the core, accounting for individual-level aspects. The student is surrounded by the micro- and meso systems of school, peers and family, and more distal systems at higher levels (exo and macro) that account for social and contextual factors as identified in this research. The levels are reflected in a resilience-based perspective, referring to structural, social, and personal protective factors. Given the interaction of factors between and across systems (Nuttall and Woods, 2013), the interrelations between factors from different levels may have inhibited or enhanced youth’s ability to overcome attendance challenges, and should thus not be seen as stand-alone factors. It should be noted that the categorization of factors into different levels is not clear-cut as some factors may be found overlapping in several systems (e.g., the choice of teaching styles can be part of the exosystem, reflecting educational curricula, or a characteristic of the direct relations in the microsystem).

Based on this structure, we can further analyze what is perceived as helpful and how, in what kind of situations, supportive elements relate to identified risk factors.

7.1.1 Link between student and other systems

With regard to RQ1, we identified mental health problems, including descriptions of emotional distress, anxiety, somatic and depression symptoms in youths’ stories as reason for SAPs. These findings are consistent with risk factors for the development of school refusal and chronic absenteeism reported in quantitative and qualitative literature (Baker and Bishop, 2015; Finning et al., 2019; Gubbels et al., 2019; Malika et al., 2021; McKay-Brown and Birioukov, 2021; Leduc et al., 2022; Corcoran and Kelly, 2023; Benoit et al., 2024). Youth descriptions suggest an interplay with contextual aspects, where school or teachers placing high demands on their performance led to increased stress levels and decreased motivation. Looking at students’ reports from our study, they seem to experience certain stressors in environmental contexts that have reciprocal and unintended effects on emotional well-being and attendance behavior (e.g., performance pressure). In fact, some of these have been identified as psychosocial risk factors for SAPs (Wille et al., 2008; Ross, 2016; Gubbels et al., 2019), and as factors listed in other qualitative research, such as strict and harsh teaching styles (Dannow et al., 2020) or pressure of completing exams (Corcoran and Kelly, 2023). Students’ complaints emphasize how negative interactions with teachers and the stress of academic expectations contribute to adverse educational experiences for students. Similar to above, the findings point to the critical role of mental health in influencing school attendance and participation, highlighting the negative impact of school environments to trigger emotional distress.

In contrast, the category of “personal resilience” revealed internal assets that strengthened students’ connection to school. Students from our study presented future optimism, set goals and aspired academic post-secondary academic pathways that affected their willingness to attend and engage in school, despite negative experiences. Motivation to perform as a positive factor to attendance is evidenced in literature on youth voices (Nuttall and Woods, 2013; Baker and Bishop, 2015; How, 2015; Dannow et al., 2020; Kljakovic et al., 2021; Corcoran and Kelly, 2023). However, students in our study described specific extrinsic motivators, including the pressure to achieve high grades and pass exams to obtain a favorable school-leaving certificate or job qualification. These statements highlight that motivation and hopes for the future do not develop in a vacuum but as the result of interactive dynamics of each ecological system. By attending school, students probably feel better prepared to succeed with their school-leaving exams and therefore better prepared for post-secondary education and employment. German youth in Heckner’s (2013) study talked about this topic in a similar way, as grades and graduation certificates determined their opportunities for participation in society. We assume that attitudes about the importance of a school-leaving certificate are mediated by distal factors. First, students in Year 10 are entering late adolescence with possible changes in self-identity and beliefs about their future (e.g., chronosystem). Second, schools’ and family’ expectations and beliefs about education and the need for certificates to access post-secondary education or training in the German context may have impacted motivational attitudes. The potential link between the value of academic achievement and future educational opportunities could be an indicator of how structural contexts influence the development of engagement among youths (Clycq et al., 2017; Melvin et al., 2019), but also their interpretation of how support in schools should be structured.

Students who felt empowered with higher levels of self-esteem and coping abilities seemed to be more resistant to both negative school experiences and mental health issues that impacted attendance behavior. This is in line with previous research that outlined self-efficacy and self-regulation as areas of protective influence to overcome internalizing symptoms associated with SAPs (Heckner, 2013; Ingul and Nordahl, 2013; Wright, 2023). Statements from students in our study can extend Corcoran and Kelly’s observation in their review of qualitative studies about how youths with experience of attendance challenges characterize their situation as non-coping (Corcoran and Kelly, 2023). In this regard, our findings support a more strengths-based understanding of how the ability to cope with negative experiences or feelings serves as a buffer to reduce or prevent SAPs.

However, our study suggests that well-being and coping was built through the perception of positive relations and social support in microsystemic environments. This suggestion supports earlier qualitative studies that show that positive experiences of school and support from adults encourage individual resiliency (Heckner, 2013; Heyne et al., 2021).

7.1.2 Micro- and mesosystems: relationships with peers, school and family

Related to RQ1, almost all interviewed youth express that difficult relationships with peers, particularly bullying, were one onset factor that intensified negative emotions, stress and (social) anxiety which made them stay away from school or lessons. This is in line with previous studies suggesting that peer problems are a risk factor for both anxiety and absenteeism (Malcolm et al., 2003; Malika et al., 2021; Leduc et al., 2022; Schlesier et al., 2023). However, descriptions of negative reactions from classmates did not contribute directly to SAPs. Rather, these experiences resulted in lower well-being and internalizing problems, which then affected attendance behavior. The experience of bullying was linked to transitions to secondary school, which could be an indicator to a chronosystemic factor that contributed to attendance difficulties (Corcoran and Kelly, 2023). The situations of youth illustrate how the accumulation of risk factors put them at higher risk of school disengagement (Tomaszewska-Pękała et al., 2020; Corcoran and Kelly, 2023).

In contrast, related to the theme of RQ2, the main category of “Feelings of Connectedness and Belonging in School” presents an area of resilience in microsystems of students. One key set of factors with protective function in the development of SAPs relates to the school environment, namely social support sources from interpersonal interactions (Malecki and Demaray, 2003). Youths’ perceptions of being supported is a central theme in our study. It seems to be strongly linked to a sense of belonging, well-being, agency, and self-determination which in turn increases the engagement to stay/return to school and education, which aligns with theoretical understandings (Rohlfs, 2011; Rose et al., 2013; Wilkins and Bost, 2014; Allen et al., 2016; Tomaszewska-Pękała et al., 2020; Ricking, 2023b).

At peer level, the availability of supportive and trusting friends or classmates could ameliorate risk experiences of students. This is confirmed by existing research (How, 2015; Heyne et al., 2021; Richards and Clark-Howard, 2023). There is a need to explore how friendships play a different role in students’ microsystem, e.g., peers may have differential impacts on attendance difficulties depending on different age phases.

Students’ perceptions in our study reveal the protective function of student-teacher relationships and teacher support in the microsystem school. Essentially, experienced supportive relationships were characterized by teachers who listened, showed understanding and provided assistance in overcoming negative feelings related to attendance. These descriptions are consistent with themes found in qualitative studies (Nuttall and Woods, 2013; How, 2015; Gabrielsen and Havik, 2021; Heyne et al., 2021; McKay-Brown and Birioukov, 2021; Corcoran and Kelly, 2023; Sundelin et al., 2023). This can also be confirmed by previous quantitatively oriented research (Ingul et al., 2012; Rasasingham, 2015; Korpershoek et al., 2020; Malika et al., 2021; Lee et al., 2023).

What seems particularly distinctive to our study is that teachers were the primary reason given for going back to school or attend lessons. Apart from teachers, students also named other professions in school that act as a support source in coping with challenges related to attendance. However, they were not attributed the same prominent role as teachers.

In our study, youths emphasize that the effectiveness of emotional support from school professionals depends on the quality of the contact and on emotional problems and needs being taken seriously. This is similar to previous findings suggesting that support should be provided in a personalized way (Corcoran and Kelly, 2023) and meet emotional well-being and learning needs (Dannow et al., 2020; Wright, 2023). In youth’s stories, we observe a high degree of self-reflection regarding their own active role in seeking help and communicating with adults to address concerns and prevent the development of SAPs. This implies that relationships develop their protective effect on reducing SAPs through the link between perceptions of available, caring support and students’ determination to accept this support (Malecki and Demaray, 2003).

In line with these findings and theory, we argue that relational elements within the school environment provide a key area of resilience, contributing to engagement and thereby school attendance. As such, good relations with peers and school-based professionals contributed to positive school experiences, well-being and connectedness to school, while bullying contributed to reduced well-being and non-attendance. This is emphasized in descriptions of students to strengthen positive connections between classmates, indicating an inclusive school climate where young people are seen and taken seriously which, in turn, can lead to higher engagement.

Concluding, a supportive school environment entails both close relationships with a caring adult, peers, and opportunities for meaningful participation as conducive to school attendance. This aspect corroborates the concept by Corcoran and Kelly (2023) of the need of a sense of belonging. However, our findings extend this by the suggestion that the balance between experienced socio-emotional support, feelings of acceptance or belonging, abilities for handling challenging situations contribute to resilience formation and facilitate attendance (Tomaszewska-Pękała et al., 2020, p. 457).

Another area that is relevant in relation to risk and resilience was the family setting, from our sample reported on family as barrier to their attendance. As one reason, parental illness and death in family was mentioned as a reason. One girl described the herself in the role of a young carer, a phenomenon described in the literature as a risk factor for absenteeism (Ricking and Albers, 2019).

In relation to conditions at home, students describe parents pushing too hard by imposing high expectations on their child’s academic outcome. This perception could relate to the significance of performance and grades to access advanced certificates in the German education context. It is conceivable that academic pressure is not only exerted by teachers, but also by parents that seem to cause stress-related feelings about school. Similar to the literature on SAPs of children of migrants (Brault et al., 2022), their parents’ hopes for academic success may be the source of academic pressure. However, it is not only students from transcultural backgrounds in our study who face high parental expectations for academic success, which seems to add to students’ stress load. In contrast, almost all students in our study highlighted the significance of parents in encouraging attendance, e.g., shaping positive attitudes towards attendance despite negative school experiences. The influence of family support in helping students re-engage after a period of absence was also discussed in other studies (Richards and Clark-Howard, 2023).

Students referred to school-family communication as a necessary intervention effort to address SAPs of the child. Although school-family communication has been identified in other studies (Nuttall and Woods, 2013; Hendron and Kearney, 2016; Corcoran and Kelly, 2023), recommendations from students in our study about what this communication should look like have not been previously reported. From students’ perspective, communication is most effective when schools emphasize the negative effects of absenteeism on attainment of school-leaving certificates, future employment, and overall academic performance. This seemed even more important in cases where parents became a maintaining factor for SAPs because they lack interest in school work, something that has been shown as risk factor (Benoit et al., 2024). It can be presumed that hopes and personal aspirations for academic success in connection with society’s expectations may have influenced students’ suggestions about how schools “educate” families on the significance of school attendance. For example, experiences of education in family and the transmitted meaning of education in school might be reflected in these suggestions.

7.1.3 Exosystem: Structural, institutional and legislative contexts

Findings from our study also suggest that structural aspects of learning, teaching and the organizational- institutional structure can have both negative and positive influence on attendance.

Students mentioned engaging teaching practices as helpful for attendance. On the one hand, they refer to a pedagogical teaching concept where teachers consider individual interests and not only curriculum-based content. Elements of creative and “fun” lessons are a shared desire to increase enjoyable learning experiences and improve attendance. However, influenced by German education policy and curriculum, teachers only have limited options of implementing variation in teaching contents. On the other hand, however, students describe motivational and attentive teachers who adapt their instructional language to meet academic levels. In this respect, the style of teaching can be influenced by teachers’ personality and characterize the immediate environment (microsystem). The teacher as a person seemed as a helpful factor in building motivation to attend a lesson. This is supported by qualitative and quantitative studies which highlight the need for adjustment and personalized instruction (Henry and Huizinga, 2007; Dannow et al., 2020; Heyne et al., 2021; Corcoran and Kelly, 2023; Richards and Clark-Howard, 2023). Still, pedagogy and curriculum do not seem to have direct influence on students’ ability to attend school, but rather contribute to a broader academic sphere (El Zaatari and Maalouf, 2022) that shapes the sense of school belonging as protective mechanism.

Another aspect of adjustment to needs included spaces for relaxation, recreation and withdrawal. These settings seemed to facilitate students’ ability of coping with emotional distress. Thus, it also exerted a positive effect on well-being and the perception of a positive school climate, ultimately supporting attendance. This finding illustrates how structural settings function as protective factors in relation to risks by supporting students’ resilience and positive perceptions of the context. It further confirms findings from other research on the role of safe settings on coping (Heyne et al., 2021) and shows that we need to consider the interaction of protective factors in order to understand the positive effects on strengthening school attendance can have a calm and safe setting was shown to facilitate coping among students with internalizing problems who feel unwell at school.

One main finding that has not been touched upon previously in qualitative studies is the topic of legal measures, (e.g., fines) that are quite unique to intervention approaches in addressing absenteeism the German context. The students’ perceptions of this system of sanctions are ambivalent. For some, the financial consequence connected to the fine has a preventive effect to keep non-attendance levels low. However, the threat of this type of legal punishment does not guarantee attendance in the form of active engagement in learning but may mean that the student is physically present but not mentally engaged (Kearney and Gonzálvez, 2022). Among students, there seems to be an awareness about not issuing sanctions too fast. Rather, the investigation of reasons in a case of absenteeism might be more appropriate. Still, this pattern needs to further investigated.

7.2 Lessons learned for educational practice and future directions

The findings from our study can guide the work of schools and educators. When considering potential prevention and intervention strategies to mitigate risk and encourage resilience relative to attendance, “a combination of personal attributes, positive relationships, and institutional supports “(Richardson, 2008, p. 24) may be beneficial. The ecological lens allows for identification of conditions for effective supports within youth’s specific school and social context that can be met on the road to promote attendance. The findings from our study provide some ideas for the work of schools and educators. To account for the central protective mechanism of a sense of school belonging, schools can establish a learning environment where young people feel welcome, safe, included, and accepted in order to develop the sense of belonging and connectedness with school. This implies that teachers and school professionals can build positive relationships and act proactively, e.g., listen to concerns, check on students, react to problems, support students at emotional, academic and behavioral level in challenging situations (Tomaszewska-Pękała et al., 2020). Schools might involve parents and establish close collaboration with families as resources to support attendance in the long term (Rasasingham, 2015; Tomaszewska-Pękała et al., 2020). This is particularly valuable to strengthen parental influence on youth’s commitment to attending school regularly. When working with underrepresented youth, schools may consider the diverse cultural, psychological and social backgrounds of their families with the goal of strengthening their relationship to education (Martin et al., 2020; Brault et al., 2022; Kearney and Benoit, 2022). Next to attendance monitoring, schools can establish early detection systems to identify at-risk students with the aim to intervene as early as possible (Rasasingham, 2015; Ricking and Albers, 2019). As mentioned by youths in various qualitative studies, professionals in school may assess and screen for indicators of SAPs, such as peer problems, mental health issues, disengagement in learning, performance pressure or lower levels of well-being. While youths’ experiences suggest that a combination of personal, social, familial and structural resources might prevent the development of SAPs, it is essential to leverage the entire system (Heyne et al., 2024) as part of a holistic, systemic approach to attendance support (Boaler and Bond, 2023). One potential example is the use of multi-tiered systems of support to address SAPs (Kearney and Graczyk, 2020). This is consistent with students’ emphasis on learning and emotional needs that might be addressed at different tiers (e.g., differentiating instruction at Tier 1, individualized interventions with focus on internalizing problems at Tier 2 and 3). Thus, attendance should be viewed in connection with young learners’ interactions and experiences within their environment, the curriculum, and peers (Heyne et al., 2024). Overall, the key supporting mechanisms suggest a relationship- and resource-oriented pedagogy that takes the students’ perspectives, integrates their voices and utilizes the available resources and strengths.

In summary, or study stresses the need for a whole-school approach in supporting all students in their academic and socio-emotional development. Above all, prevention and attendance support should strengthen feelings of safety, acceptance and a sense of belonging in the classroom, as well as focus on the emotional well-being, motivation and self-image of individual students.

7.3 Strengths and limitations

This study built on a small-scale qualitative sample, which must be regarded as a limitation. Given the small sample size, the theoretical saturation for each category is limited, as the full range of student experiences may not have been captured. To address this gap, findings from similar qualitative studies could be integrated to provide complementary insights and help validate and extend the findings presented in this research.

We selected students who have experienced SAPs but had managed to overcome the problems. This decision was made both for methodological reasons, as we believed that these students would be willing to talk to us, and for conceptual reasons, as we were interested in what preceded positive outcomes. The students who talked to us can be considered a “positive sample.” Students who are prepared to talk about their absenteeism may have different perspectives than students who have been absent, but who are not open to talking about it. However, the results seem to confirm research with student groups that presented extended school non-attendance.

The selection of the participants can have affected the results as the informants consisted of a group of students with various histories of SAPs. The self-reported severity of SAPs differed among youth. The degree of non-attendance could vary between just skipping some classes to long-term absenteeism. For some, this was a very recent experience, while for others the experience was farther in the past. Accordingly, risk and protective factors may differ with regard to adversity, and thus, what is being experienced as helpful by some, may not apply to everyone else. Specifically, we may need more studies on salutogenic factors for students who belong to disadvantaged populations, minorities or who have, for whatever reason, developed chronic absenteeism (Malika et al., 2021; Naff et al., 2023). The sample size is restricted to a specific context, which may limit the transferability of the findings. However, since our findings are compatible with previous research from other countries (e.g., How, 2015; Dannow et al., 2020; Heyne et al., 2021; McKay-Brown and Birioukov, 2021; Richards and Clark-Howard, 2023), it might tell us something about students’ perspectives even outside the German context.

Finally, we did not consider conditions of the pandemic in this article, although the topic occurred during conversations. This may be a topic for further elaboration in the future. With regard to our theoretical model, we would like to mention that such factors that are specific for certain times, such as the school closures during the COVID-19 pandemic, should be studied further in the future and discussed in relation to the chronosystemic factors within Bronfenbrenner’s model.

7.4 Future studies

In light of the study described here, we suggest a number of ideas for future research. More evidence needs to be gathered on ways to build sustainable structures in schools where supportive factors outweigh possible challenges for students who develop SAPs. More qualitative research is needed on what strengthens or weakens students’ connection to school. In particular, we suggest that intervention studies should be conducted in which researchers and practitioners establish educational practices and identify resource areas based on resilience-oriented research to support school attendance. Such projects could develop modes of prevention rather than using all resources to solve problems after they qualify for additional attention or support in a “wait-to-fail” approach. We encourage school leadership and professionals to investigate classroom atmospheres, key players, school climate and inclusion–exclusion processes in the school community, students’ emotions and their lived experiences in relation to school attendance. Such analysis could focus on processes across eco-systemic levels.

We also suggest conducting more comparative research to gain deeper understanding of the occurrence of SAPs in relation to specific school and welfare systems, reflecting the exo- and macrosystem. Although research on SAPs is an extended international research field, there are few studies that use comparisons as a means of understanding by identifying and exploring unique, shared or divergent experiences. That could be used to raise awareness and reveal perspectives of students in other countries on what factors and supports have helped them. This would allow for the identification of overarching support mechanisms, but would also uncover differences in youth’s perspectives on SAPs as a reflection of their context, interactions, and experiences.

Finally, the interaction of risk and protective factors in the ecological model presented could be validated and further investigated in quantitative research. In combination with qualitative findings, we can understand more about the interaction of contextual and individual factors.

8 Conclusion

From the perspective of secondary school students with experience of SAPs in the city-state Hamburg in Germany, our study aimed to explore what challenges they have faced and what factors and supports have helped them to overcome attendance challenges on their educational paths to completing their education and transition to post-secondary education.

First, in exploring challenges for attendance, our study identified complex and unique descriptions in students’ accounts that put them at higher risk for disengagement and attendance problems (e.g., mental health problems, bullying, performance pressure, stress at home).

Second, using the ecological lens with a resilience perspective, the study investigated supports and factors that have been important to students in ameliorating the negative effects of experienced attendance challenges. Individual factors (e.g., self-esteem, motivation, future orientation, coping) were perceived as having positive effects on youth’s ability to engage and attend. These characteristics of individual resiliency make youth persist towards obtaining school-leaving certificates and pursuing their education. Yet, support from others and positive relationships provided a solid basis in building resilience and overcoming attendance challenges. Considering micro-and mesosystemic areas of resilience, emotional, cognitive and behavioral support mechanisms enacted through educators, peers and family (e.g., trusting relationships, positive school climate, varied instruction, encouraging parents, family-school collaboration) constituted students’ feelings of well-being, connectedness and belonging in school as key mechanisms that enhanced or hindered school attendance. More distant levels of contextual influence (exo, chrono, macro) are connected to areas of resilience. They permeated students’, schools’ and parents’ beliefs about education, the structure of the education system, and the value of school leaving certificates, and attendance.

Third, we presented a model of risks and resources to attendance, based on students’ perspectives. The model shows the complex interplay between perceived challenges and supports in the function of risk and protective factors in the development of SAPs. Specifically, our findings highlighted how protective mechanisms unfold in relation to risks, building resilience in both students and their environments.

The study reports important areas for prevention and intervention that can support students with school attendance challenges and strengthen their relationship with education in secondary school. Ultimately, the study contributes to the broader discussion on taking systemic, proactive approaches to promote attendance, emphasizing the need for exploring the lived experiences of students to support them in achieving their educational goals and transitioning to post-secondary settings successfully.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors upon reasonable request by interested researchers, following data protection plans in line with ethical considerations.

Ethics statement

The Swedish Ethical Review Authority approved the basic application of the international study SAPIC (Dnr 2020-05441, Linköping department, Decision 24.11. 2020). The application with diary number Dnr 2022-06350-02 for change was submitted to The Ethical Review Authority on 2022-11-22 and became valid on 2022-12-02. The change concerned the storage, processing and analysis of data collected abroad (Decision 2022-12-09). The studies involving humans were approved by Monitoring and Improving Educational Quality in Hamburg (Institut für Bildungsmonitoring und Qualitätsentwicklung; IfBQ) as part of the authority for schools and vocational training (Behörde für Schule und Berufsbildung; BSB) has approved data collection in Hamburg schools (Dnr. e514.101.5000-002/222,047; Decision 31.03.2023). The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants' legal guardians/next of kin.

Author contributions

CE: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Visualization, Writing – original draft, Writing – review & editing. SK-S: Conceptualization, Funding acquisition, Investigation, Project administration, Supervision, Writing – review & editing. ÅB: Conceptualization, Funding acquisition, Writing – review & editing. JI: Conceptualization, Funding acquisition, Writing – review & editing. UF: Conceptualization, Funding acquisition, Writing – review & editing. HR: Project administration, Resources, Supervision, Writing – review & editing.

Funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was funded by the Swedish Research Council (VR 2019-04639).

Acknowledgments

The authors would like to thank Jasmin Brandt for her assistance in the data collection and preliminary analysis of the interviews. We would also like to express our gratitude to the schools who supported our study. In particular, we would like to thank all students who participated in the interviews. Their willingness to share their perspectives and experiences enriched our research and was essential in advancing our understanding in the field of school attendance.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/feduc.2024.1405395/full#supplementary-material

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Keywords: school attendance, school absenteeism, student perspective, resilience, ecological systems approach, secondary education, post-secondary education

Citation: Enderle C, Kreitz-Sandberg S, Backlund &, Isaksson J, Fredriksson U and Ricking H (2024) Secondary school students’ perspectives on supports for overcoming school attendance problems: a qualitative case study in Germany. Front. Educ. 9:1405395. doi: 10.3389/feduc.2024.1405395

Received: 22 March 2024; Accepted: 02 July 2024;
Published: 29 July 2024.

Edited by:

Christopher Kearney, University of Nevada, Las Vegas, United States

Reviewed by:

Zack Maupin, Chapman University, United States
Laelia Benoit, Yale University, United States

Copyright © 2024 Enderle, Kreitz-Sandberg, Backlund, Isaksson, Fredriksson and Ricking. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Chiara Enderle, Y2hpYXJhLmVuZGVybGVAdW5pLWxlaXB6aWcuZGU=

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