Warwick I et al, 2009 Healthy Schools Programme Rapid review Taken together, the evidence on which this review draws suggests that well designed, whole-school approaches to promoting health can have an impact on health- as well as education-related outcomes among children and young people. Healthy school approaches such as the National Healthy School Programme appear to assist those in schools to develop and implement a wide-range of activities for pupils. The NHSP, in particular, has been perceived to bring about changes associated with improved learning among pupils – such as improved concentration, greater participation in physical activity and increased confidence. Although limited, some evidence suggests that there is a link between school-based programmes to promote health – such as those that focus on increasing physical activity and improving nutrition – and improved academic attainment. + Include
simultaneously and where the study design is not rigorous enough to enable the identification of causal influences. S,2006 Health Promoting Schools School children review of controlled studies of school health promotion Various This synthesis identified good quality systematic reviews that covered mental health, aggressive behaviour, healthy eating, physical activity, substance use and misuse, driver education, and peer approaches. The systematic review, which evaluated health outcomes of programmes that used elements of the health promoting schools approach, included small studies of variable quality. No reviews evaluated the of the programmes or interventions. 12 controlled before-and-after studies that evaluated interventions that involved health promoting activities in three areas: the school ethos or environment, or both; the curriculum and the family or community, or both; and demonstrations of the school’s active participation. Schools were not required to have signed up for the health promoting schools initiative, and studies of programmes ++ Include
such as and bullying, which have previously proved difficult to influence SWPHO, 2011 South West Descriptive analysis of the Healthy Schools Plus Programme - Cohort 1 Healthy Schools Plus Program School children analysis Uptake Exclude No outcome/ impact data Beam M et al, 2012 survey policy and systems school meals Schools made significant changes in all content and effect sizes were moderate to large. 80% of the schools they approached to participate agreed. Of 1,909 schools recruited, 1,514 + Include Sufficient similarities to Welsh
Healthy School Program School children competitive foods and beverages health education physical education physical activity outside of physical education before- and after-school programs school employee wellness Participating schools improved environmental policies and practices to prevent childhood obesity. The program is a resource to implement recent federal and policies. (79%) continued or completed HSP. Of participants, 42 completed the inventory at baseline and were ineligible for the study, leaving 1,295 (86%) of continuing and completed schools that provided both a baseline and inventory. Improvements over baseline were reported in all categories with the most common improvements in the areas of school employee wellness and school meals. Employee wellness changes were easy to make, giving schools an early “win” to maintain momentum. The schools were also motivated to model to be relevant. Self report data with no comparison group, relevant measures however. trial
change school meals to respond to recent public demands. Less common were changes in physical education and policy and systems, which are most often controlled by the school districts. Schools also changed less in the area of physical activity outside of physical education. The common changes were in before- and afterschool programs, which schools implement with community partners and which did not focus on the school day. J et al, 2012 Sample of 511 children, aged years, and vegetable intake Engagement with the NHSP may be an effective way of increasing and vegetable Children attending schools engaged with the NHSP ate a median of two (interquartile range, + Include Small scale study 9
Healthy Schools Programme School children aged 7-9 years who were attending 10 randomly selected schools in Day in the Life a validated 24-h recall method of dietary assessment. consumption in primary school children. 0-8.0) portions of fruit and vegetables, compared to one portion (interquartile range, 0-8.0) consumed by pupils attending a school not engaged with the programme (P=0.001). Gender was also a significant predictor of and vegetable consumption, with girls being 1.68 times more likely to consume 2.5 or more portions of fruit and vegetables. After adjustment for free school meal eligibility (as a measure of status) and gender, pupils attending schools engaged with NHSP were twice as likely to eat 2.5 portions of fruit and Self selection for scheme, schools could differ in other areas that would have an impact economic
vegetables or more per day Muirhead VE et al, 2012 Healthy Schools Programme Elementary Canada Secondary data analysis, between outcomes in HPS and non HPS by oral health measures Oral health Percentage of children in each school requiring preventive care, dental treatment, urgent dental treatment and children with > or = two decayed Schools participating in Ontario’s Healthy Schools programme had better school oral health outcomes than schools. School neighbourhood socio-economic factors affected school oral health outcomes, which could suggest that schools situated in poorer neighbourhoods may benefit more from health promotion activities than those in more affluent neighbourhoods. Schools participating in the "Healthy Schools" program had a significantly lower percentage of children with > or = two decayed teeth (p < 0.001) and children requiring urgent dental treatment (p = 0.004) than non-participating schools. School participation/ neighbourhood factors interactions showed that a significantly lower percentage of children in low-income "Healthy Schools" had preventive and urgent dental treatment needs and > or = two decayed teeth than in low-income schools (p < 0.001). + Include Self selection for scheme, schools differ in other areas that would have an impact participating economic
Wong MC et al, 2009 WHO health promoting schools 12 yr olds, Hong Kong survey Stratified random sample of 1408 children; 891 parents and 91 teachers from 4 health promoting schools (HPS) and 4 non-HPS Resilience scores This study shows that the HSA scheme under WHO has the potential to exert positive changes in students and teachers and the concept of HPS is effective in building resilience among major school stakeholders. The HPS students were to have better scores than non-HPS students (average age 12.4 year-old in both groups) in all dimensions with significantly higher scores in 'Peer Support' (p = 0.013), 'Making a Difference' (p = 0.011), 'About Me' (p = 0.027) and 'Generally Happy' (p = 0.011). There was no difference in the scores between and HPS parents. The HPS teachers reported significantly higher scores in Health Policies' (p = 0.023), 'Social Environment' (p = 0.049), 'School Community + Include Relatively small scale study in Hong Kong – relevance to UK may be limited.
Relations' (p = 0.048), 'Personal Skills Building' (p = 0.008) and 'Partnership & Health Services' (p = 0.047). Schagen et al, 2005 National Healthy School Standard Health related behaviour (HRBQ) survey. between responses of children in schools achieving National Healthy School Standard HRBQ elements Using HRBQ data, many pupil-level outcomes were explored, but relatively few indicated significant differences and even those tended to be quite small. Exclude Exploratory study with few definitive outcomes; schools included at early stage of scheme References