Mental health and educational outcomes: Health Promoting Schools a systematic review
Creators: name: Hoare, Erin
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: Education

description: Registration for OSF Submitted 4 August 2022 1. Review title Assessing the effectiveness of the Health Promoting Schools framework: An updated systematic review of mental health and educational outcomes 2. Original language title. Not applicable. 3. Anticipated or actual start date. 4 August 2022 4. Anticipated completion date. 1 October 2022 5. Stage of review at time of this submission. Preliminary searches are completed. Pilot of the study selection process has commenced. 6. Named contact. Dr Erin Hoare, Graduate School of Education, University of Melbourne. 7. Named contact email. ehoare@student.unimelb.edu.au 8. Named contact address Not applicable. 9. Named contact phone number. Not applicable. 10. Organisational affiliation of the review. Graduate School of Education, University of Melbourne. 11. Review team members and their organisational affiliations. Dr Erin Hoare, Graduate School of Education, University of Melbourne Professor Susan Sawyer, Murdoch Children’s Research Institute Dr Monika Raniti, Murdoch Children’s Research Institute Dr Michelle Andrews Luke, University of Melbourne Dr Cheree Murrihy, University of Melbourne 12. Funding sources/sponsors. This review is not funded. 13. Conflicts of interest. No conflict of interest to declare. 14. Collaborators. None. 15. Review question. 1. What is the effectiveness of the Health Promoting Schools framework for mental health and educational outcomes for children and young people, since March 2013? 16. Searches. The search will be conducted using EBSCOHost and specifically databases; MEDLINE, CINAHL Nursing and Academic Edition, PsychINFO, and EMBASE. The below PICOS definitions and exclusion and inclusion criteria will inform the search terms. All peer-reviewed literature published since March 2013 will be eligible for review. Non-English language papers will be ineligible for inclusion. Search terms will be limited to title and abstract only. Table 1. PICOS definitions PICOS Definitions Participants Primary and secondary school attending aged children and adolescents Interventions Health Promoting Schools framework, requiring three areas of school life targeted (as per previous literature (Langford et al., 2015)). 1. Formal health curriculum - whereby health related topics are formally included in the school curriculum 2. School ethos and environment - informal initiatives which promote health and wellbeing promoting attitudes and values, and also the physical environment of the school 3. Inclusion of families and wider school community - wider school community is recognised and engaged as important contributors to children and young people’s beliefs surrounding health behaviours. Comparisons Schools with ‘as usual’, or with a non-health focussed intervention implemented. Outcomes Mental health and wellbeing; educational outcomes Study Design Quasi-randomised control trials Table 2. Inclusion and exclusion criteria Inclusion Exclusion Cluster randomised control trials were eligible for review, with clusters at school, district or other geographical location. Studies had to compare the Health Promoting Schools framework with a control/comparison group. Study designs other than cluster randomised control trials. Participants aged 4 years to 18 years were eligible, which corresponds to school attending age groups. Participant groups aged outside of the 4-18-year age group. It is possible that the intervention considers outcomes beyond student cohorts (such as teacher-related outcomes) and these specific findings are not within the scope of this study, however the study remains eligible for inclusion if the student outcomes are reported. Published on or after 15 March 2013 (corresponding to the final search date of the previous systematic review published in 2015 (Langford et al., 2015)) Publications dated before 15 March 2013. Studies had to report on mental health or wellbeing outcomes such as; depression, anxiety and other common mental health disorders and associated symptomatology (mood, stress, worry, motivation), mental health attitudes or behaviours (e.g., stigma, prejudice, help-seeking behaviours), knowledge of mental health (e.g., disorder and symptom recognition), mental health skills (e.g., mindfulness, coping skills), and mental wellbeing outcomes (e.g., life satisfaction, subjective psychological wellbeing, happiness). Studies that were potentially eligible for review will be reviewed by the investigative group and decision made as to whether study is to be included. AND/OR Studies had to report on educational outcomes such as academic performance, cognitive function, attention, school attendance or other measures of engagement, student satisfaction or enjoyment at school, or other educational outcomes as identified as appropriate. Studies that reported on serious mental illness, substance use, and/or specific clinical mental health disorders that are not consider ‘common’ (e.g., personality disorders, disordered eating), were ineligible for review, as these conditions are greater in complexity in terms of the course and trajectory, in comparison to the evidence base for mental health promotion strategies for depression and anxiety. Schools have to demonstrate activities across three Health Promoting Schools areas: Studies ineligible if only implemented one or two of the domains. (i) The school curriculum component had to; focus on health or wellbeing topics or both, were a defined education class taught by qualified professionals during class time. School curriculum ineligibility included if they purely focused on improving educational outcomes including school readiness, curriculum that were delivered in passive modes (e.g., through posters or newsletters), or were delivered outside class time. (ii) The environment and ethos component had to update the physical or social environment, for example, physical changes to school infrastructure, provision of additional services or equipment, updated school policies relating to health and wellbeing, building capacity among teachers on health and wellbeing (beyond what is Interventions that changed the physical or social environment of the school, without the aim of promoting health and wellbeing were ineligible. Decisions on individual studies will be determined among the research investigative group. required to teach the curriculum), revised classroom management techniques, increased physical education classes, providing additional opportunities for students and staff to engage in physical activity, updated approaches to promoting healthy behaviours or reducing unhealthy behaviours, peer mentoring and buddy programs, inclusion of school health action team, support for students to be engaged in health and wellbeing topics such as through debates or competitions. (iii) Interventions were eligible if they engaged families and the wider school community with the aim of building health promoting environment and communities, for example through newsletters and communications to families, through parent workshops and other education initiatives, through involving community members as guest speakers, and through including parents and community members on school committees. Interventions that involved families and wider school community for the purpose other than to promote health and wellbeing were ineligible. Decisions on individual studies will be determined among the research investigative group. Interventions were required to be universal in that they targeted the entire school student population. Studies were ineligible if they only targeted specific sub-population groups. Available in English language Language other than English Peer-reviewed publication Grey literature was ineligible for review given the difficulties in appraising and ensuring quality and transparency in reporting. 17. URL to search strategy. Not available 18. Condition or domain being studied. Mental health and educational outcomes. 19. Participants/population. Students attending mainstream primary or secondary schools. 20. Intervention(s), exposure(s). Cluster randomised control trials were eligible for review, with clusters at school, district or other geographical location. Studies had to compare the Health Promoting Schools framework with a control/comparison group. Schools have to demonstrate activities across three Health Promoting Schools areas: (i) The school curriculum component had to; focus on health or wellbeing topics or both, were a defined education class taught by qualified professionals during class time. (ii) The environment and ethos component had to update the physical or social environment, for example, physical changes to school infrastructure, provision of additional services or equipment, updated school policies relating to health and wellbeing, building capacity among teachers on health and wellbeing (beyond what is required to teach the curriculum), revised classroom management techniques, increased physical education classes, providing additional opportunities for students and staff to engage in physical activity, updated approaches to promoting healthy behaviours or reducing unhealthy behaviours, peer mentoring and buddy programs, inclusion of school health action team, support for students to be engaged in health and wellbeing topics such as through debates or competitions. (iii) Interventions were eligible if they engaged families and the wider school community with the aim of building health promoting environment and communities, for example through newsletters and communications to families, through parent workshops and other education initiatives, through involving community members as guest speakers, and through including parents and community members on school committees. 21. Comparator(s)/control. Comparison groups had to implement no health-related intervention. Waitlist controls were eligible. 22. Types of study to be included. Cluster randomised control trials were eligible for review, with clusters at school, district or other geographical location. 23. Context. The inclusion and exclusion criteria are described above. 24. Main outcome(s). Studies had to report on change in mental health or educational outcomes such as; depression, anxiety and other common mental health disorders and associated symptomatology (mood, stress, worry, motivation), mental health attitudes or behaviours (e.g., stigma, prejudice, help-seeking behaviours), knowledge of mental health (e.g., disorder and symptom recognition), mental health skills (e.g., mindfulness, coping skills), and mental wellbeing outcomes (e.g., life satisfaction, subjective psychological wellbeing, happiness). Educational outcomes include academic performance, cognitive function, attention, school attendance or other measures of engagement, student satisfaction or enjoyment at school, or other educational outcomes as identified as appropriate. Studies that were potentially eligible for review will be reviewed by the investigative group and decision made as to whether study is to be included. 25. Additional outcome(s). None. 26. Data extraction (selection and coding). PRISMA guidelines will be utilisied in this review. One reviewer will screen titles and abstracts and an additional review will screen 10% for quality assurance. The articles eligible for full text review will be reviewed by two reviewers. Discrepancies will be resolved by two reviewers. Data extract will occur using a data extraction tool, detailing study authors, date, aim, intervention components, participant characteristics (both intervention and control), and outcomes. 27. Risk of bias (quality) assessment. Quality assessment will occur across all identified outcomes, using the GRADE assessment criteria. 28. Strategy for data synthesis. Data will be synthesised relative to each mental health and eduational outcome, informed by the studies that emerge from the search. 29. Analysis of subgroups or subsets. No analysis of subgroups will occur. 30. Type and method of review. Mental health; school based health promotion 31. Language. English. 32. Country. Australia. 33. Other registration details. None. 34. Reference and/or URL for published protocol. None. 35. Dissemination plans. The systematic review will form the Masters thesis for the lead author, and a subsequent peer-reviewed publication. 36. Keywords. Systematic review; mental health and wellbeing; young people; school-based health promotion. 37. Details of any existing review of the same topic by the same authors. None. 38. Current review status. Planning. 39. Any additional information. None. 40. Details of final report/publication(s) or preprints if available. None.