Evidence map›Paper›PMID 25886385›Full record

SynthesisBMC public health2015

The World Health Organization's Health Promoting Schools framework: a Cochrane systematic review and meta-analysis.

Rebecca Langford, Christopher Bonell, Hayley Jones, Theodora Pouliou, Simon Murphy, Elizabeth Waters, Kelli Komro, Lisa Gibbs, Daniel Magnus, Rona Campbell

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC public health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 230 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
230citing papers in PubMed, 20 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

230 citing papers in PubMed, 20 syntheses or guidelines pooled it.

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170 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rebecca LangfordSchool of Social & Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK. beki.langford@bristol.ac.uk.
Christopher BonellSocial Science Research Unit, Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, UK. c.bonell@ioe.ac.uk.
Hayley JonesSchool of Social & Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK. hayley.jones@bristol.ac.uk.
Theodora PouliouSchool of Social & Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK. dora.pouliou@gmail.com.
Simon MurphyCardiff School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK. murphys7@Cardiff.ac.uk.
Elizabeth WatersJack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, 3053, Melbourne, Australia. ewaters@unimelb.edu.au.
Kelli KomroHealth Outcomes and Policy, Institute for Child Health Policy, University of Florida, 1329 SW 16th Street, Gainesville, FL, 32610-0177, USA. komro@ufl.edu.
Lisa GibbsJack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, 3053, Melbourne, Australia. lgibbs@unimelb.edu.au.
Daniel MagnusSchool of Social & Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK. drdanmagnus@gmail.com.
Rona CampbellSchool of Social & Community Medicine, University of Bristol, 39 Whatley Rd, Bristol, BS8 2PS, UK. rona.campbell@bristol.ac.uk.

Funding

British Heart FoundationCancer Research UKMedical Research Council MR/K023233/1Medical Research Council MR/K025643/1Wellcome Trust
6 · The paper itself

Abstract

backgroundHealthy 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.

methodsWe 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.

resultsWe 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 health, violence and bullying others. It was not possible to meta-analyse data on other health outcomes due to lack of data. Methodological limitations were identified including reliance on self-reported data, lack of long-term follow-up, and high attrition rates.

conclusionThis Cochrane review has found the WHO HPS framework is effective at improving some aspects of student health. The effects are small but potentially important at a population level.

Indexed as

Health BehaviorAchievementAdolescentBody Mass IndexChildChild, PreschoolDietFemaleFruitHumansMaleMental HealthPhysical FitnessProgram EvaluationRandomized Controlled Trials as TopicSchool Health Services

Identifiers

PMID25886385
PMCPMC4339015

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.