Abstract
Background: School closures have been a recommended non-pharmaceutical intervention in pandemic response owing to the potential to reduce transmission of infection between children, school staff and those that they contact. However, given the many roles that schools play in society, closure for any extended period is likely to have additional impacts. Literature reviews of research exploring school closure to date have focused upon epidemiological effects; there is an unmet need for research that considers the multiplicity of potential impacts of school closures. Methods: We used systematic searching, coding and synthesis techniques to develop a systems-based logic model. We included literature related to school closure planned in response to epidemics large and small, spanning the 1918-19 'flu pandemic through to the emerging literature on the 2019 novel coronavirus. We used over 170 research studies and a number of policy documents to inform our model. Results: The model organises the concepts used by authors into seven higher level domains: children's health and wellbeing, children's education, impacts on teachers and other school staff, the school organisation, considerations for parents and families, public health considerations, and broader economic impacts. The model also collates ideas about potential moderating factors and ethical considerations. While dependent upon the nature of epidemics experienced to date, we aim for the model to provide a starting point for theorising about school closures in general, and as part of a wider system that is influenced by contextual and population factors. Conclusions: The model highlights that the impacts of school closures are much broader than those related solely to health, and demonstrates that there is a need for further concerted work in this area. The publication of this logic model should help to frame future research in this area and aid decision-makers when considering future school closure policy and possible mitigation strategies.
Highlights
Closing schools in order to limit the transmission of infection during epidemics has long been a recommended course of non-pharmaceutical action under certain circumstances[1]
The logic model The resulting logic model contains more than 100 concepts that are organised into seven higher level domains: children’s health and wellbeing, children’s education, impacts on teachers and other school staff, the school organisation, considerations for parents and families, public health considerations, and broader economic impacts
The final component in the logic model is the presence of the ethical principles that apply throughout school closure processes and which are embedded in decision-making
Summary
Closing schools in order to limit the transmission of infection during epidemics has long been a recommended course of non-pharmaceutical action under certain circumstances[1] The logic underpinning this policy is clear: school children mix at close proximity for extended periods of time, can have poor hygiene, and can infect parents, carers and other contacts outside of the school setting. Conclusions: The model highlights that the impacts of school closures are much broader than those related solely to health, and demonstrates that there is a need for further concerted work in this area The publication of this logic model should help to frame future research in this area and aid decision-makers when considering future school closure policy and possible mitigation strategies
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