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School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews

      Abstract

      Purpose

      Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches.

      Methods

      We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively.

      Results

      We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective.

      Conclusions

      There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying.

      Keywords

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      References

        • Sawyer S.M.
        • Afifi R.A.
        • Bearinger L.H.
        • et al.
        Adolescence: A foundation for future health.
        Lancet. 2012; 379: 1630-1640
        • WHO
        Global and regional estimates of violence against women.
        WHO, Geneva2013
        • Patton G.C.
        • Coffey C.
        • Cappa C.
        • et al.
        Health of the world's adolescents: A synthesis of internationally comparable data.
        Lancet. 2012; 379: 1665-1675
        • Bloom D.E.
        • Cafiero E.T.
        • Jané-Llopis E.
        • et al.
        The global economic burden of noncommunicable diseases.
        World Economic Forum, Geneva2011
        • Bonell C.
        • Farah J.
        • Harden A.
        • et al.
        Systematic review of the effects of schools and school environment interventions on health: Evidence mapping and synthesis.
        Public Health Res. 2013; 1
        • United Nations
        The millennium development goals report.
        United Nations, New York2012
        • Rutter M.
        • Maugham B.
        • Mortimore P.
        • et al.
        Fifteen thousand hours: Secondary schools and their effects on children.
        Open Books, London1979
        • Faggiano F.
        • Vigna-Taglianti F.D.
        • Versino E.
        • et al.
        School-based prevention for illicit drugs use: A systematic review.
        Prev Med. 2008; 46: 385-396
        • Farrington D.P.
        • Ttofi M.M.
        School-based programs to reduce bullying and victimization.
        Campbell Syst Rev. 2010;
        • Foxcroft D.R.
        • Tsertsvadze A.
        Universal school-based prevention programs for alcohol misuse in young people.
        Cochrane Database Syst Rev. 2011; 9
        • Thomas R.E.
        • McLellan J.
        • Perera R.
        School-based programmes for preventing smoking.
        Cochrane Database Syst Rev. 2013; 4: CD001293
        • Viner R.M.
        • Ozer E.M.
        • Denny S.
        • et al.
        Adolescence and the social determinants of health.
        Lancet. 2012; 379: 1641-1652
        • Centers for Disease Control and Prevention
        SHPPS 2012: School health policies and pratices survey. Trends over time 2010-2012.
        Centers for Disease Control and Prevention, Atlanta GA2013 (Available at:) (Accessed January 24, 2015)
        • PSHE Association
        PSHE association annual survey responses summary 2014.
        PSHE Association, London2014
        • Caird J.
        • Sutcliffe K.
        • Kwan I.
        • et al.
        Mediating policy-relevant evidence at speed: Are systematic reviews of reviews a useful approach?.
        Evid Policy. 2015; 11: 81-97
        • Jackson C.
        • Sweeting H.
        • Haw S.
        Clustering of substance use and sexual risk behaviour in adolescence: Analysis of two cohort studies.
        Br Med J Open. 2012; 2: e000661
        • Buck D.
        Clustering of unhealthy behaviours over time.
        The King's Fund, London2012
        • Oringanje C.
        • Meremikwu M.M.
        • Eko H.
        Interventions for preventing unintended pregnancies among adolescents.
        Cochrane Database Syst Rev. 2009; 4: CD005215
        • Resnick M.D.
        • Bearman P.S.
        • Blum R.W.
        • et al.
        Protecting adolescents from harm: Findings from the national longitudinal study on adolescent harm.
        J Am Med Assoc. 1997; 278: 823-832
        • Shea B.J.
        • Grimshaw J.M.
        • Wells G.A.
        • et al.
        Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews.
        BMC Med Res Methodol. 2007; 7: 10
        • Caird J.
        • Sutcliffe K.
        • Kwan I.
        • et al.
        Mediating policy-relevant evidence at speed: Are systematic reviews of systematic reviews a useful approach?.
        Evid Policy. 2014; (ISSN 1744-2648)
        • Blank L.
        • Baxter S.K.
        • Payne N.
        • et al.
        Systematic review and narrative synthesis of the effectiveness of contraceptive service interventions for young people, delivered in educational settings.
        J Pediatr Adolesc Gynecol. 2010; 23: 341-351
        • Harden A.
        • Brunton G.
        • Fletcher A.
        • et al.
        Teenage pregnancy and social disadvantage: A systematic review integrating trials and qualitative studies.
        Br Med J. 2009; 339: b4254
        • Allen-Meares P.
        • Montgomery K.L.
        • Kim J.S.
        School-based social work interventions: A cross-national systematic review.
        Social Work. 2013; 58: 253-262
        • Mason-Jones A.J.
        • Crisp C.
        • Momberg M.
        • et al.
        A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health.
        Syst Rev. 2012; 1: 49
        • Owen J.
        • Carroll C.
        • Cooke J.
        • et al.
        School-linked sexual health services for young people (SSHYP): A survey and systematic review concerning current models, effectiveness, cost-effectiveness and research opportunities.
        Health Technol Assess. 2010; 14: 1-228
        • McQueston K.
        • Silverman R.
        • Glassman A.
        The efficacy of interventions to reduce adolescent childbearing in low- and middle-income countries: A systematic review.
        Stud Fam Plann. 2013; 44: 369-388
        • Blank L.
        • Baxter S.
        • Goyder E.
        • et al.
        Promoting well-being by changing behaviour: A systematic review and narrative synthesis of the effectiveness of whole secondary school behavioural interventions.
        Ment Health Rev J. 2010; 15: 43-53
        • Langford R.
        • Campbell R.
        • Magnus D.
        • et al.
        The WHO Health Promoting School framework for improving the health and well-being of students and staff.
        Cochrane Database Syst Rev. 2014; 4: CD008958
        • Limbos M.A.
        • Chan L.S.
        • Warf C.
        • et al.
        Effectiveness of interventions to prevent youth violence a systematic review.
        Am J Prev Med. 2007; 33: 65-74
        • Ttofi M.M.
        • Farrington D.P.
        Effectiveness of school-based programs to reduce bullying: A systematic and meta-analytic review.
        J Exp Criminol. 2011; 7: 27-56
        • Vreeman R.C.
        • Carroll A.E.
        A systematic review of school-based interventions to prevent bullying.
        Arch Pediatr Adolesc Med. 2007; 161: 78-88
        • Wilson S.J.
        • Lipsey M.
        The effects of school-based social information processing interventions on aggressive behavior, part II: Selected/indicated pull-out programs.
        Campbell Syst Rev. 2006; 6
        • Wood S.
        • Mayo-Wilson E.
        School-based mentoring for adolescents: A systematic review and meta-analysis.
        Res Social Work Pract. 2012; 22: 257-269
        • Wilson D.
        • Gottfredson D.C.
        • Najaka S.
        School-based prevention of problem behaviors: A meta-analysis.
        J Quant Criminol. 2001; 17: 247-272
        • Thomas R.
        • Perera R.
        School-based programmes for preventing smoking (Cochrane Review).
        Cochrane Database Syst Rev. 2006; : CD001293
        • Müller-Riemenschneider F.
        • Bockelbrink A.
        • Reinhold T.
        • et al.
        Long-term effectiveness of behavioural interventions to prevent smoking among children and youth.
        Tob Control. 2008; 17: 301-302
        • Saraf D.S.
        • Nongkynrih B.
        • Pandav C.S.
        • et al.
        A systematic review of school-based interventions to prevent risk factors associated with noncommunicable diseases.
        Asia Pac J Public Health. 2012; 24: 733-752
        • Coppo A.
        • Galanti M.R.
        • Giordano L.
        • et al.
        School policies for preventing smoking among young people.
        Cochrane Libr. 2014; 10: CD009990
        • Sussman S.
        • Sun P.
        • Dent C.W.
        A meta-analysis of teen cigarette smoking cessation.
        Health Psychol. 2006; 25: 549-557
        • Fletcher A.
        • Bonell C.
        • Hargreaves J.
        School effects on young people's drug use: A systematic review of intervention and observational studies.
        J Adolesc Health. 2008; 42: 209-220
        • Soole D.W.
        • Mazerolle L.
        • Rombouts S.
        School-based drug prevention programs: A review of what works.
        Aust N Z J Criminol. 2008; 41: 259-286
        • Fletcher A.
        • Bonell C.
        • Gardner F.
        • et al.
        The government's Troubled Families Programme: A flawed response to riots and youth offending.
        Br Med J. 2012; 344: e3403
        • Thomson D.
        • Russell K.
        • Becker L.
        • et al.
        The evolution of a new publication type: Steps and challenges of producing overviews of reviews.
        Res Synth Methods. 2010; 1: 198-211

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