Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
BMC Public Health. 2011 Jun 9;11:453. doi: 10.1186/1471-2458-11-453.
Schools may have important effects on students' and staff's health. Rather than treating schools merely as sites for health education, 'school-environment' interventions treat schools as settings which influence health. Evidence concerning the effects of such interventions has not been recently synthesised.
METHODS/DESIGN: Systematic review aiming to map and synthesise evidence on what theories and conceptual frameworks are most commonly used to inform school-environment interventions or explain school-level influences on health; what effects school-environment interventions have on health/health inequalities; how feasible and acceptable are school-environment interventions; what effects other school-level factors have on health; and through what processes school-level influences affect health.We will examine interventions aiming to promote health by modifying schools' physical, social or cultural environment via actions focused on school policies and practices relating to education, pastoral care and other aspects of schools beyond merely providing health education. Participants are staff and students age 4-18 years.We will review published research unrestricted by language, year or source. Searching will involve electronic databases including Embase, ERIC, PubMed, PsycInfo and Social Science Citation Index using natural-language phrases plus reference/citation checking.Stage 1 will map studies descriptively by focus and methods. Stage 2 will involve additional inclusion criteria, quality assessment and data extraction undertaken by two reviewers in parallel. Evidence will be synthesised narratively and statistically where appropriate (undertaking subgroup analyses and meta-regression and where no significant heterogeneity of effect sizes is found, pooling these to calculate a final effect size).
We anticipate: finding a large number of studies missed by previous reviews; that non-intervention studies of school effects examine a greater breadth of determinants than are addressed by intervention studies; and that intervention effect estimates are greater than for school-based health curriculum interventions without school-environment components.
学校可能对学生和教职员工的健康产生重要影响。“学校环境”干预措施并非仅仅将学校视为进行健康教育的场所，而是将其视为影响健康的环境。最近尚未对这些干预措施的效果进行综合评估。
方法/设计：旨在绘制并综合评估有关理论和概念框架最常用于为学校环境干预措施提供信息或解释学校层面健康影响的证据；学校环境干预措施对健康/健康不平等的影响；学校环境干预措施的可行性和可接受性；其他学校层面因素对健康的影响；以及学校层面的影响如何通过哪些过程影响健康。我们将研究通过针对与教育、学生关怀和学校除提供健康教育之外的其他方面相关的学校政策和实践进行的行动来改变学校的物理、社会或文化环境，从而促进健康的干预措施。参与者为 4-18 岁的教职员工和学生。我们将审查不受语言、年份或来源限制的已发表研究。搜索将涉及电子数据库，包括 Embase、ERIC、PubMed、PsycInfo 和社会科学引文索引，使用自然语言短语和参考/引文检查。第 1 阶段将根据重点和方法对研究进行描述性映射。第 2 阶段将包括额外的纳入标准、由两名审查员平行进行的质量评估和数据提取。将根据需要对证据进行叙述性和统计性综合（进行亚组分析和元回归，如果没有发现效应大小的显著异质性，则将这些合并以计算最终的效应大小）。
我们预计：发现以前的综述遗漏的大量研究；非干预性学校效果研究比干预性研究更广泛地考察了决定因素；并且干预效果估计值大于没有学校环境组成部分的基于学校的健康课程干预措施。
