Investigating the effectiveness of school health services delivered by a health provider: A systematic review of systematic reviews

Levinson, Julia; Kohl, Kid; Baltag, Valentina; Ross, D. A.

doi:10.1371/journal.pone.0212603

Cited by 34 publications

(31 citation statements)

References 30 publications

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“…This systematic review and meta-analysis is the first, to our knowledge, to evaluate the quantitative effects of various childhood obesity prevention policies on children's BMI and BMI-Z score in an interventional design. There are many systematic reviews or meta-analysis studies that have been performed in specific settings such as schools only [ 12 , 13 , 60 ] or were performed for single-axis interventions such as physical activity only [ 10 , 61 ], diet only [ 13 ] or with limited duration of intervention [ 62 ] or follow-up [ 63 , 64 ] and different age ranges [ 9 , 10 , 60 , 64 ]. The current comprehensive meta-analysis evaluated the isolated effects of settings, intervention materials, duration and length of follow up, with a focus on the adiposity-related outcome of BMI or BMI-Z score .…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials

Taghizadeh

Farhangi

2020

J Transl Med

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Background Childhood obesity persists as a serious public health problem. In the current meta-analysis, we summarized the results of controlled trials that evaluated the effect of obesity prevention policies in children and adolescents. Methods Three databases (SCOPUS, PubMed and Embase) were searched for studies published before the 6th April 2020, by reported outcome measures of body mass index (BMI) and BMI-Zscore. Forty-seven studies reported BMI, while 45 studies reported BMI-Zscore as final outcome. Results The results showed that the obesity-prevention policies had significant effect in reducing BMI (WMD: − 0.127; CI − 0.198, − 0.056; P < 0.001). These changes were not significant for BMI-Zscore (WMD: − 0.020; CI − 0.061, 0.021; P = 0.340). In dose–response meta-analysis, a non-linear association was reported between the duration of intervention and BMI (Pnonlinearity < 0.001) as well as BMI-Zscore (Pnonlinearity = 0.023). In subgroup analysis, the more favorite results were observed for 5–10 years old, with combination of physical activity and diet as intervention materials. Conclusion In conclusion, the obesity prevention policies in short-term periods of less than 2 years, in rather early age of school with approaches of change in both of diet and physical activity, could be more effective in prevention of childhood obesity. Trial registration PROSPERO registration number: CRD42019138359

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Section: Discussionmentioning

confidence: 99%

The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials

Taghizadeh

Farhangi

2020

J Transl Med

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“…For example, dental care in Iceland, which is free for all children, is not considered part of SHS; or social workers who are employed by the municipality in Austria. Frequently, these differences between countries are cultural and historical; the overarching effectiveness of delivering healthcare within school services, as opposed to an alternative primary care setting, remains to be investigated further [30].…”

Section: Discussionmentioning

confidence: 99%

School health in Europe: a review of workforce expenditure across five countries

Pol

Postma

Jansen

2020

BMC Health Serv Res

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Background: Most European countries have implemented a form of school health services (SHS) to provide young children and adolescents with various types of healthcare. No estimations on SHS expenditure for European countries have been published until now. We estimated SHS workforce expenditure in Europe, expected to serve as the main driver of school healthcare costs. Methods: Using two networks of experts on healthcare provision for children we contacted various country representatives to provide data on the number of professionals working in SHS and salaries. These data were used, together with publicly available data, to estimate annual SHS workforce expenditure on the national level. Results: We received sufficient data for five European countries, and estimated the SHS workforce expenditure. Nurses were the most widely reported professionals working in this field, followed by doctors and psychologists. Our SHS expenditure estimations ranged from €43,000 for Estonia to €195,300 in Norway (per 1000 pupils). For Norway, Estonia, Finland and Iceland, school nurses were the main drivers of SHS expenditure, mainly due to their large numbers, while in Austria, school doctors played the largest role in SHS expenditure. Conclusions: We estimated the spending on SHS workforce for five European countries, which comprises relatively minor parts of total healthcare spending (0.16 to 0.69%). Many questions regarding SHS spending in Europe remain, due to a general lack of data on national levels.

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“…Training teachers to perform some less technical health care delivery tasks within the school environment has been found not only to relieve health professionals of unwarranted workload but also to expand the total output of education and primary health care systems in resource-limited settings [7,[15][16][17]. Various global initiatives acknowledge the critical role of schools as a strategic platform for programmatic health interventions [18,19]. In many countries, tasks such as screening for malnutrition, immunizations and deworming have been successfully performed by trained teachers in the school setting [20,21].…”

Section: Introductionmentioning

confidence: 99%

School-based vision screening in Quetta, Pakistan: a qualitative study of experiences of teachers and eye care providers

et al. 2021

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Background Visual impairment in children is a significant public health problem affecting millions of children globally. Many eye problems experienced by children can be easily diagnosed and treated. We conducted a qualitative study with teachers and optometrists involved in a school-based vision screening programme in Quetta district of Pakistan to explore their experiences of training, vision screening and referrals and to identify factors impacting on the effectiveness of the programme. Methods Between April 2018 and June 2018, we conducted semi-structured in-depth interviews with 14 teachers from eight purposefully selected schools with high rates of inaccurate (false positive) referrals. Interviews were also conducted with three optometrists from a not-for profit private eye care hospital that had trained the teachers. Interviews were audio recorded and professionally transcribed. NVIVO software version 12 was used to code and thematically analyze the data. Results Findings suggest that the importance of school-based vision screening was well understood and appreciated by the teachers and optometrists. Most participants felt that there was a strong level of support for the vision screening programme within the participating schools. However, there were a number of operational issues undermining the quality of screening. Eight teachers felt that the duration of the training was insufficient; the training was rushed; six teachers said that the procedures were not sufficiently explained, and the teachers had no time to practice. The screening protocol was not always followed by the teachers. Additionally, many teachers reported being overburdened with other work, which affected both their levels of participation in the training and the time they spent on the screening. Conclusions School-based vision screening by teachers is a cost-effective strategy to detect and treat children’s vision impairment early on. In the programme reviewed here however, a significant number of teachers over referred children to ophthalmic services, overwhelming their capacity and undermining the efficiency of the approach. To maximise the effectiveness and efficiency of school-based screening, future initiatives should give sufficient attention to the duration of the teacher training, experience of trainers, support supervision, refresher trainings, regular use of the screening guidelines, and the workload and motivation of those trained.

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Investigating the effectiveness of school health services delivered by a health provider: A systematic review of systematic reviews

Cited by 34 publications

References 30 publications

The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials

The effectiveness of pediatric obesity prevention policies: a comprehensive systematic review and dose–response meta-analysis of controlled clinical trials

School health in Europe: a review of workforce expenditure across five countries

School-based vision screening in Quetta, Pakistan: a qualitative study of experiences of teachers and eye care providers

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