The effectiveness and acceptability of comprehensive and multicomponent school health services: A systematic review

Forfatter(e)

Montgomery, P. Knerr, W. Ross, D. A. Patterson, J.

År

2021

DOI

10.1016/j.jadohealth.2021.08.010

Tidsskrift

Journal of Adolescent Health

Sider

No Pagination Specified

Kategori(er)

Atferdsproblemer, antisosial atferd og atferdsforstyrrelser Selvskading/selvmord Livskvalitet og trivselRus (alkohol, illegale rusmidler)

Tiltakstype(r)

Skole/barnehagebaserte tiltak

Abstract

PURPOSE: Comprehensive school-based health services were reviewed as part of preparing World Health Organization guidelines.

METHODS: Six databases were searched for controlled trials with schoolchildren aged 5-19 years, involving school-linked health services incorporating 4 of 7 health areas.

RESULTS: Seventeen quasi-experimental studies conducted in high-income countries found school health services associated with reductions in suicide planning (male: 7.1% vs. 7.7%, p < .01), hospitalization (relative risks 3.403, 95% confidence interval [CI] 1.536 to 8.473, p < .05), emergency department visits (odds ratio .85, 95% CI .75 to .95, p = .006), school absence (odds ratio .78, 95% CI .69 to .87, p < .0001), carrying weapons (male: 16.1% vs. 25.1%, p < .01), fighting (male: 32.6% vs. 43.1%, p < .01), sexual activity (53.5% vs. 60.5%, p < .05), drinking alcohol (60.1% vs. 70.5%, p < .001), using drugs (28.0% vs. 38.3%, p < .001), and physical activity (female: 57.4% vs. 50.4%, p < .01). They can be cost-saving, were also associated with smoking and less contraceptive use, and had no effect on depression prevalence. Acceptability/satisfaction was good. The certainty of evidence was low to moderate. Heterogeneity was high for some outcomes.

CONCLUSIONS: Results suggest moderate desirable and trivial undesirable effects of school health services in high-income countries. This article compiles evidence on effectiveness, cost-effectiveness, and acceptability into one review, enabling decision-makers to consider all essential factors.