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关于以学校为基础的健康促进干预措施及其在发展中国家的影响,我们了解多少?文献综述。

What is known about school-based interventions for health promotion and their impact in developing countries? A scoping review of the literature.

作者信息

Mukamana O, Johri M

机构信息

Research Center of the Sainte-Justine University Hospital, Montréal, H3T 1C5, Canada

Unité de Santé Internationale, et Axe Risques, prévention et promotion de la santé, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, H2X 0A9, Canada Département d'administration de la santé, École de santé publique, Université de Montréal, Montréal, H3N 1X9, Canada.

出版信息

Health Educ Res. 2016 Oct;31(5):587-602. doi: 10.1093/her/cyw040. Epub 2016 Aug 10.

Abstract

Schools can play an important role in health promotion mainly by improving students' health literacy, behaviors and academic achievements. School-based health promotion can be particularly valuable in developing countries facing the challenges of low health literacy and high burden of disease. We conducted a scoping review of the published literature focusing on school-based interventions for health promotion and their impact in developing countries. We included 30 studies meeting specific criteria: (i) studies mainly targeted school going children or adolescents; (ii) admissible designs were randomized controlled trials, controlled before-after studies or interrupted time series; (iii) studies included at least one measure of impact and (iv) were primary studies or systematic reviews. We found that school-based interventions can be classified in two main categories: those targeting individual determinants of health such as knowledge, skills and health behaviors and those targeting environmental determinants such as the social and physical environment at the school, family and community level. Findings suggest that a comprehensive approach addressing both individual and environmental determinants can induce long-term behavior change and significantly improve health and educational outcomes. We highlight the need for further study of the long-term impact of school-based interventions on health outcomes in developing countries.

摘要

学校在促进健康方面可发挥重要作用,主要是通过提高学生的健康素养、行为能力和学业成绩。对于面临健康素养低下和疾病负担沉重挑战的发展中国家而言,以学校为基础的健康促进尤为重要。我们对已发表的文献进行了一项范围综述,重点关注以学校为基础的健康促进干预措施及其在发展中国家的影响。我们纳入了30项符合特定标准的研究:(i)研究主要针对在校儿童或青少年;(ii)可接受的设计为随机对照试验、前后对照研究或中断时间序列研究;(iii)研究至少包括一项影响指标;(iv)为原始研究或系统评价。我们发现,以学校为基础的干预措施可分为两大类:一类针对健康的个体决定因素,如知识、技能和健康行为;另一类针对环境决定因素,如学校、家庭和社区层面的社会和物理环境。研究结果表明,综合解决个体和环境决定因素的方法可促使长期行为改变,并显著改善健康和教育成果。我们强调需要进一步研究以学校为基础的干预措施对发展中国家健康结果的长期影响。

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