Abstract
BackgroundSchools may have important effects on students' and staff's health. Rather than treating schools merely as sites for health education, 'school-environment' interventions treat schools as settings which influence health. Evidence concerning the effects of such interventions has not been recently synthesised.Methods/designSystematic review aiming to map and synthesise evidence on what theories and conceptual frameworks are most commonly used to inform school-environment interventions or explain school-level influences on health; what effects school-environment interventions have on health/health inequalities; how feasible and acceptable are school-environment interventions; what effects other school-level factors have on health; and through what processes school-level influences affect health.We will examine interventions aiming to promote health by modifying schools' physical, social or cultural environment via actions focused on school policies and practices relating to education, pastoral care and other aspects of schools beyond merely providing health education. Participants are staff and students age 4-18 years.We will review published research unrestricted by language, year or source. Searching will involve electronic databases including Embase, ERIC, PubMed, PsycInfo and Social Science Citation Index using natural-language phrases plus reference/citation checking.Stage 1 will map studies descriptively by focus and methods. Stage 2 will involve additional inclusion criteria, quality assessment and data extraction undertaken by two reviewers in parallel. Evidence will be synthesised narratively and statistically where appropriate (undertaking subgroup analyses and meta-regression and where no significant heterogeneity of effect sizes is found, pooling these to calculate a final effect size).DiscussionWe anticipate: finding a large number of studies missed by previous reviews; that non-intervention studies of school effects examine a greater breadth of determinants than are addressed by intervention studies; and that intervention effect estimates are greater than for school-based health curriculum interventions without school-environment components.
Highlights
Schools may have important effects on students’ and staff’s health
We anticipate: finding a large number of studies missed by previous reviews; that non-intervention studies of school effects examine a greater breadth of determinants than are addressed by intervention studies; and that intervention effect estimates are greater than for school-based health curriculum interventions without school-environment components
UK young people have among the worst health in Europe and there are marked inequalities in health across the social scale, with considerable implications for later health and economic costs[1,2]
Summary
Schools may have important effects on students’ and staff’s health. Rather than treating schools merely as sites for health education, ‘school-environment’ interventions treat schools as settings which influence health. Other actions aim to address factors such as disengagement and lack of social support that are risk factors for multiple adverse outcomes [13,14] The latter include: increasing student participation in decision-making; providing staff with training on how to re-engage disaffected students; and encouraging students to take on new responsibilities such as becoming peer mediators[15]. These interventions take a ‘socio-ecological’ [16] approach to promoting health, whereby health is understood to be influenced by individual characteristics and behaviours, and the wider social, cultural and economic context
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