Module 3 Case-BHD421

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Langford et al. BMC Public Health (2015) 15:130 DOI 10.1186/s12889-015-1360-y

RESEARCH ARTICLE Open Access

The World Health Organization’s Health Promoting Schools framework: a Cochrane systematic review and meta-analysis Rebecca Langford1*, Christopher Bonell2, Hayley Jones1, Theodora Pouliou1, Simon Murphy3, Elizabeth Waters4, Kelli Komro5, Lisa Gibbs4, Daniel Magnus1 and Rona Campbell1

Abstract

Background: Healthy children achieve better educational outcomes which, in turn, are associated with improved health later in life. The World Health Organization’s Health Promoting Schools (HPS) framework is a holistic approach to promoting health and educational attainment in school. The effectiveness of this approach has not yet been rigorously reviewed.

Methods: We searched 20 health, education and social science databases, and trials registries and relevant websites in 2011 and 2013. We included cluster randomised controlled trials. Participants were children and young people aged four to 18 years attending schools/colleges. HPS interventions had to include the following three elements: input into the curriculum; changes to the school’s ethos or environment; and engagement with families and/or local communities. Two reviewers identified relevant trials, extracted data and assessed risk of bias. We grouped studies according to the health topic(s) targeted. Where data permitted, we performed random-effects meta-analyses.

Results: We identified 67 eligible trials tackling a range of health issues. Few studies included any academic/ attendance outcomes. We found positive average intervention effects for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small. On average across studies, we found little evidence of effectiveness for zBMI (BMI, standardized for age and gender), and no evidence for fat intake, alcohol use, drug use, mental …