c. schools are access sites for students to receive increased and improved care, which might not be adequately received elsewhere d. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Any of these three school health assessments will be helpful in data-driven decision making and action planning. SRs were included in this overview if at least 50% of the studies within the SR fulfilled the following criteria: (a) participants were children (ages 59) or adolescents (ages 1019) enrolled in schools; (b) interventions were school-based or school-linked health services, involved a health provider (see definitions in S1 Appendix), and were of any duration or length of follow-up; (c) intervention effectiveness was compared to either no intervention, an alternative intervention, the same intervention in a different setting (i.e. Similarly, some states require portions of the Healthy School Report Card to be completed. Through meta-analysis of two RCTs, the authors found that school vision screening combined with provision of free spectacles resulted in a statistically significant 60% increase in the wearing of spectacles at 38 months follow-up as compared to vision screening combined with prescription for spectacles only [21]. Evans and colleagues reviewed seven RCTs from China, India, and Tanzania on vision screening for correctable visual acuity deficits at or before school entry (Table 3H) [21]. No SR examined comprehensive or multi-component school health services, despite the fact that comprehensive services may be more efficient, easier to implement, and more sustainable than single interventions [40]. Additionally, resources differ by income level and therefore effective interventions in HIC may need to be tailored or changed entirely in order to be feasible in LMIC and LIC. Two SRs on dental health screening [18] and behavioral interventions for caries prevention [30] found limited evidence of effectiveness. Brief exploratory review These items include: (1) overlap (see below), (2) rating of confidence from the AMSTAR 2 checklist [14], (3) date of publication, and (4) match between the scope of the included SRs and the overview itself. The need for quality health care for519-year-olds is great, but globally the quality ofhealth services for them are variable and coverageis limited. The remaining three SRs also assessed FRIENDS and PRP along with additional often-overlapping programs. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Using electronic health records (EHRs) to link school nurses and health care systems is usually limited in scope despite EHRs advancement in these health care systems. Given that FRIENDS has been endorsed by WHO [44] and was found to be effective in decreasing anxiety symptoms in all four SRs where it was mentioned in this overview [28,32,34,39], policy makers and school health officials may consider incorporating this or similar programs into existing school health services. McDonald and Drey narratively assessed group-based art therapy as an intervention for children with Oppositional Defiant Disorder (ODD), Separation Anxiety Disorder (SAD), moderate to severe behavior problems, or learning disorders [33]. Prevention and treatment of mood disorders was assessed in five SRs, all of which targeted children and adolescents using RCTs of established programs. School health services (SHS), as defined in thisguideline, are services provided by a health workerto students enrolled in primary or secondaryeducation, either within school premises or in ahealth service situated outside the school. Although prevalence of visual impairment varies widely by ethnic group and age [41], WHO estimates that at least 19 million children below age 15 are visually impaired [42]. Articles that received conflicting votes (ineligible vs. potentially or probably eligible) were discussed and consensus was reached. Hennegan and Montgomery found a high level of heterogeneity and substantial risk of bias in the included studies overall, thus they were unable to make conclusions about the effectiveness of menstrual management interventions [22]. The most promising evidence from a SR was on topical application of fluoride gel for the prevention of dental caries [25], although the necessity of this intervention may be questioned where flouridated commerical toothpaste is readily available. A key limitation of this overview is that only publications self-titled systematic reviews were included. Mostcountries have some form of SHS, but many suchprogrammes currently are not evidence-based,are not implemented well, are underfunded and/orare delivered with limited reach and scope. Table D. Classification of primary studies within included systematic reviews for use in corrected covered area calculation. Institute for Medical Informatics, Biometrics and Epidemiology, Ludwig-Maximilians-Universitt (LMU) Munich, Munich, Bavaria, Germany, Affiliation: There is potential to analyze this data at both the individual and population level to understand the links between health and education as well as the links between health interventions and outcomes. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. It can even provide reports, process results, students transcripts and . Tips for Selecting an Electronic Documentation System, Healthcare Information and Management Systems(HIMSS), U.S. Department of Health & Human Services: Health Information Privacy, Your Rights Under HIPAA. II. Arora and colleagues did not find any RCTs that looked at the effectiveness of dental health screening versus no screening on improving oral health outcomes, but their search did locate six RCTs from the United Kingdom and India with dental care attendance as the outcome [18]. Valentina Baltag, CCA values for all health areas and calculations are available in Tables C and D in S5 Appendix. Any existing overviews or SRs of SRs that emerged from the searches were not themselves included, but the SRs within them were extracted and screened. Automated Records Management. Another limitation is that this overview only included randomized and non-randomized controlled trials, quasi-experimental studies and other controlled study designs where health professionals delivered the intervention. This document replaces the School Nurse Role in Electronic School Health Records (January 2014). Among those approaches, pairing children with health services occupies an important place. SRs addressed various intervention types: universal interventions [19,24,28,32,34,39]; targeted interventions for military-connected children [29], children and adolescents at risk for depression and/or anxiety [28,34], refugee and war-traumatized youth [36], and children referred to therapy [33]; and indicated interventions for children and/or adolescents diagnosed with autism spectrum disorder [23], depression [24,28,39], or anxiety [24,34,39]. Higgins and OSullivan assessed the FRIENDS for Life program, a manual-based cognitive behavioral anxiety prevention program comprised of ten sessions with developmentally-tailored programs for different age groups [32]. Children's health records can help child care providers identify preven-tive health needs such as immunizations or dental care, prepare a special care plan for children with chronic health conditions . It is likely that some interventions may have the same or perhaps an even better level of effectiveness when delivered by non-health providers, such as a teacher, as compared to when delivered by health providers. National School Health Data Set: Every Students Counts! broad scope, and wide readership a perfect fit for your research every time. Body and Mind Classroom Resources for Teachers, Unit 6: Mental Health, Child Development, & Hygiene, Unit 7: Injury Prevention and Safety Promotion, U.S. Department of Health & Human Services, Nutrition, physical activity/physical education through 8 content areas loosely aligned with Coordinated School Health (CSH), Nutrition, physical activity, asthma, sexual health, safety, and tobacco, structured around the eight-component CSH model; assessment is customized by users selection of topics, 11 characteristics of a healthy school and community model that incorporates the eight-component CSH model and effective teaching and learning indicators, based on the development of the whole child, Assessment and planning; evaluation tool for the Healthy Schools Program, Assessment and planning; compatible with a School Improvement Plan, PDF and paper version; access to Online Analysis Tool (OAT), On-site technical assistance sessions for selected sites, Training manual, free on-site workshops, technical assistance, Online resources, trainings, consultancy, and technical assistance, School champion enters information online after consulting with others, Completed inventory generates an action plan based on local priorities, Team creates an action plan based on assessment results using online tool or available template, Healthy School Improvement Plan is created automatically once data is entered into OAT; completed Online Analysis Tool generates a Healthy School Improvement Plan, Resource database and technical assistance based on the inventory; national recognition program, Resources through Web site and partner organizations. This is problematic given that health disparities for children and adolescents are greater in LMIC and LIC than in higher income countries [10]. Cookies used to make website functionality more relevant to you. A school health assessment is a systematic collection, review, and analysis of information about school health-related policies and programs for the purpose of improving students' health and educational outcomes. Julia Levinson, State and local stakeholders are encouraged to use other data, such as youth behavior surveys and public health surveillance, to identify which health risks have the greatest impact on students. A strength of this overview is that it attempted to answer a question that has not yet been answered regarding the effectiveness of both comprehensive and specific school health services delivered by a health provider. 80% (n = 16) of SRs included in this overview were given ratings of low or critically low confidence using the AMSTAR 2 checklist, although this is not unusual given the stringency of the checklist. Although at least 102 countries have school health services, there is no rigorous, evidence-based guidance on which school health services are effective and should be implemented in schools. The information can then be used for policy development, planning, and school improvement efforts. Eleven SRs included studies located in countries with high-income or upper-middle income economies only [19,20,2325,2933,37,38,39]. implementation guidance calls for the prioritization of school health programs as an important step towards universal health coverage and urges that "Every school should be a health promoting school" [ 10 ]. e0212603. methodology and select findings, WHO guideline on school health services: Web Annex C. Systematic overview of systematic reviews of comprehensive school health services: methodology and select findings, WHO guideline on school health services: Web Annex D. Systematic reviews of the effectiveness and acceptability of comprehensive school health services: methodology, WHO guideline on school health services: Web Annex E. Systematic reviews of the effectiveness and acceptability of comprehensive school health services: evidence summaries, WHO guideline on school health services: Web Annex F. Systematic reviews of the effectiveness and acceptability of comprehensive school health services: GRADE evidence profiles and evidence-to-decision table, WHO guideline on school health services: Web Annex G. Survey of expert opinion on school health services: methodology and select findings, WHO guideline on school health services: Web Annex H. Menu of interventions with WHO resources, Maternal, Newborn, Child & Adolescent Health & Ageing. school district county sch yr grade special health problems/parent concerns: quick reference: physical exam: k/1 6 11 3 7 . Kid Kohl, Funding issues. For useful recommendations to be made regarding school health services, cost-effectiveness must be more closely examined by primary studies and SRs. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Education on the wearing of spectacles in addition to vision screening as compared to vision screening alone did not have a significant effect [21]. PLoS ONE 14(6): Given the wide reach of schools and the fact that school health services already exist in most countries, international guidelines are needed to clarify whether school health services can be effective, and if so, which interventions should and should not be included. Academic performance records, such as grades and report cards, provide insight about. The AMSTAR 2 checklist [17] was used to appraise quality of included SRs. Additionally, at least 94 countries or territories include some form of school health services that are routinely delivered, as opposed to special research interventions [9]. The significance of records management to public healthcare facilities and institutions includes operational cost reduction and elimination of duplicated overhead costs; eliminates the creation. School records include books, documents, diskettes and files that contain information on what goes on in school as well as other relevant information pertaining to the growth and development of the school. To receive email updates about this page, enter your email address: We take your privacy seriously. The gaps in the SR literature identified by this overview will inform the commissioning of new SRs by WHO to feed into evidence-based global recommendations. A protocol was developed a priori that outlined the overview objectives, aims, operational definitions, search strategy, inclusion/exclusion criteria, and quality appraisal methods. Silver Spring, MD: Author. These SRs contained 270 primary studies, 225 of which were unique and 45 were included in more than one SR. It is difficult to determine overall effectiveness of school health services from this overview because the included SRs do not sufficiently cover the health areas most relevant for children and adolescents. Building on a method suggested by Shea and colleagues [17], grades of confidence in the results of each SR were generated based on critical flaws and non-critical weaknesses. The final SR on mental health services examined well-being interventions for children with a parent in the military [29]. CDC twenty four seven. School health services staff can help all students with preventive care such as flu shots and vision and hearing screening, as well as acute and emergency care. Citation: Levinson J, Kohl K, Baltag V, Ross DA (2019) Investigating the effectiveness of school health services delivered by a health provider: A systematic review of systematic reviews. Qualified professionals such as school nurses, nurse practitioners, dentists, health educators, physicians, physician assistants, and allied health personnel provide these services. 1100 Wayne Ave, Suite #925 Silver Spring, MD 20910-5669, 2023 NASN | Terms Of Use | Privacy Policy | Accessibility Statement | LiveChat. Quality appraisal of primary studies. This overview was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) [11]. They found statistically significant improvements in self-reported measures of anxiety for participants who completed the program as compared to those in the control group [32]. This means they may be reviewed by teachers and other school ocials who have a legitimate educational interest in the information. AMSTAR 2 classifications and results. Vaccinations have been identified as the most common type of intervention in schools in at least 35 countries or territories [9], and there is evidence of effectiveness from primary studies regarding feasibility of school-based vaccination programs [48,49]. The search strategy is presented in S2 Appendix. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. What is a school health assessment?A school health assessment is a systematic collection, review, and analysis of information about school health-related policies and programs for the purpose of improving students health and educational outcomes. WHO reports densities of less than one physician per 1000 population in 76 countries and less than three nurses or midwives per 1000 population in 87 countries [50]. However, this conclusion should be interpreted cautiously due to small effect sizes, small sample sizes, and conflicting evidence on the effectiveness of music therapy between Sullivan and Simonson [36] and Gold and colleagues [23]. Five of the included studies examined the same weekly sleep education program from the Australian Centre for Education in Sleep. The grading system is available in Tables E and F in S6 Appendix. Characteristics of included systematic reviews. The mismatch in the SR literature identified by this overview demonstrates that more research must be done before an answer to this question can be determined. It is unclear if this finding indicates a lack of primary studies on comprehensive or multi-component school health services, or if primary studies do exist but no SR has been conducted. The data was too heterogeneous to meta-analyze, and the authors determined that the certainty of the evidence of the benefit of dental screening in increasing dental attendance was very low [18]. For . Meta-analysis found small but statistically significant effect sizes in favor of music therapy for gestural communication, verbal communication, and behavioral problems [23]. Among 1014 year olds, the leading causes of death were lower respiratory infections, drowning, road injury, diarrheal diseases, and meningitis [47]. A majority of the studies (80%) were given low or critically low levels of confidence. Hennegan and Montgomery assessed the effectiveness of hardware and software menstrual management interventions (Table 3B) [22]. Items 2, 3 and 4 of Ballard and Montgomerys four-item checklist for risk of bias in overviews of reviews, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US. You will be subject to the destination website's privacy policy when you follow the link. Due to the heterogeneity of the SRs included in this overview, it was not possible to perform a meta-analysis. In addition to SRs that did not meet these inclusion criteria, SRs were excluded if the review was superseded by a newer version. 2. 1654 references were screened and 20 systematic reviews containing 270 primary studies were assessed narratively. Depending on the content and approach of the school health assessment, there might be ways to use data gathered from any of these tools to create a generalized view of school health systems, programs, and services in a state, district, school, or community. Schools are essential for young people to acquireknowledge, socioemotional skills including selfregulationand resilience, and critical thinking skillsthat provide the foundation for a healthy future. This overview used the corrected covered area (CCA), a comprehensive and validated measure, to determine overlap [16]. Finally, creative therapy interventions seem to be effective for indicated populations of school-age children, such as children with autism spectrum disorder [23,33]. Finally, overlap of primary trials between SRs can bias results of an overview [15]. In contrast with Gold and colleagues [23], this SR by Sullivan and Simonson found negative effects from music therapy interventions [36]. Two SRs found evidence for the potential effectiveness of educational interventions for children and adolescents with asthma diagnoses (Table 3A) [31,37]. Although mortality and morbidity statistics vary by region and country, it is clear that the health areas included in this overview reflect a small subset of the global burden of disease for children and adolescents. S6 Appendix. Competing interests: The authors have declared that no competing interests exist. You may know to keep a file of those records. School health assessments give schools a snapshot in time of programs and policies that address student and staff health. Outcomes across studies differed, but the authors noted trends toward improvement in menstruation knowledge, management practices, psychosocial outcomes, and school attendance. Why are there different school health assessments?Different school health assessments are available to address specific areas of concern in school health and school improvement efforts. Web Annex B. In the remaining twelve SRs, 50% to 74% of included studies fulfilled all the inclusion criteria [19,20,2225,28,31,32,3436]. Telehealth programs are expensive, with mobile telehealth carts costing anywhere from $20,000 to $60,000, which doesn't include costs related to staffing, routine maintenance, and upkeep. We are also grateful for advice from the WHO school health services guideline Steering Group and Guideline Development Group members. | 3 Registration Options. That marked the highest percentage since at least 1968, the earliest year for which the CDC has online records. Only one quasi-experimental study from the United States in 1999 was included in the SR. However, it should be noted that these SRs found mixed evidence of maintenance of effects over time [28,32,34,39]. It provides useful information on the progress and development made within the school. Mostly favorable evidence of effectiveness was found in a SR of social-emotional interventions for refugee and war-traumatized youth from 26 countries [36]. The four SRs that included PRP found mixed evidence [34] or no evidence of effectiveness [19,24,28,39], bringing the popularity of this intervention into question. Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland. Silver Spring, MD: Author. This overview found only one SR that assessed obesity treatment and prevention delivered by a health professional in schools, despite the fact that over 340 million school-age children and adolescents were overweight or obese in 2016 [46]. What should I do if I am participating in a program that requires one assessment and the state requires a different one?You can request help from the three organizations listed in this document. (2019). Schools are considered to be an ideal platform for oral health promotion through education, services, and the school environment [6]. Second, the ability of overviews to make valid and accurate conclusions is dependent upon the accuracy, rigor, and inclusiveness of the SRs themselves. The use of an assessment and action planning process provides a coordinated framework for school improvement and wellness efforts. In addition, school health data provides the potential to determine the most effective interventions to support the well being of children. Each of these three assessment tools allows users to analyze the comprehensiveness of the policies, programs, and infrastructure in place to address student and staff health. division of school health school health record name: last, first, middle birthdate: month, day, year gender: male female father's name: last, first, middle . Although all SRs were included if at least 50% of the primary studies within them fulfilled all inclusion criteria, SRs where closer to 100% of primary studies fulfilled all criteria were considered to be better matched than those with closer to 50%. Centers for Disease Control and Prevention. Meta-analysis results indicated a statistically significant effect on the before-after change in caries prevalence [25]. . For students with chronic health conditions, school nurses and other health care providers play a large role in the daily management of their conditions. This overview found 20 SRs covering 270 primary studies. When autocomplete results are available use up and down arrows to review and enter to select. This overview makes an important first step toward that guideline. This structure can help schools avoid duplication, refine purpose, and coordinate various initiatives across the whole school. Gold and colleagues assessed daily music therapy as an intervention to improve verbal and gestural communicative skills and reduce behavioral problems in children diagnosed with autism spectrum disorder [23]. In 1995, WHO launched the GlobalSchool Health Initiative, which aimed to strengthenapproaches to health promotion in schools. Confidence in results ranged from high (three or fewer non-critical weaknesses) to critically low (more than three critical flaws with or without non-critical weaknesses) [17]. Risk of bias across SRs was determined using Ballard and Montgomerys four-item checklist for overviews of SRs [13]. Furthermore, this overview exposes a mismatch between the SR literature on effectiveness of school health services and the actual school health services that are most commonly delivered. The Secondary Education Commission has recommended the maintenance of cumulative record of each pupil by the class teachers. The full list of the specific reasons for exclusion of full texts is available in Table A within S3 Appendix. Small but statistically significant effect sizes were found in favor of the intervention for mean plaque levels and oral hygiene, but no statistical significance was found for change in gingivitis indices [27]. In 2015, the top five leading causes of death for 59 year olds were lower respiratory infections, diarrheal diseases, meningitis, drowning, and road injury [47]. To convey to the teacher the results of the examination in such terms as to be useful to her in guiding the physical and mental growth of her .