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Thus, responsibility for interventions may need to be redistributed in countries with limited access to health professionals. The school nurse will be an integral member of a child's larger healthcare team, assuring implementation of the plan of care and providing timely information from the school health record about student response to care. A majority of the studies (80%) were given low or critically low levels of confidence. A SR that focused on behavioral education, such as demonstrating how to correctly brush teeth, found no evidence for reduction in caries [30], whereas a SR on oral hygiene and caries education found evidence for decreased plaque and improved hygiene [27]. For example, a PHR enables you to: Track and assess your health. It can even provide reports, process results, students transcripts and . If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. School health records give the provision for a school nurse to communicate information to students, families, the school multidisciplinary team, emergency personnel, other healthcare providers, and school nurse substitutes. Eleven of the SRs used meta-analysis to combine results [1828], whereas the remaining nine SRs narratively synthesized results [2937]. When autocomplete results are available use up and down arrows to review and enter to select. About eight-in-ten U.S. murders in 2021 - 20,958 out of 26,031, or 81% - involved a firearm. 570 were duplicates, leaving 1150 titles and abstracts to be screened. However, all included primary studies were delivered in HIC [26]. Finally, meta-analysis by Werner-Seidler and colleagues of 81 RCTs on the effectiveness of depression and anxiety prevention and group therapy programs found small yet statistically significant effect sizes in favor of the intervention groups for both depression and anxiety as compared to control groups [28]. Searches were performed on June 15, 2018. Table C. Calculation of corrected covered areas (CCAs). This overview considered SRs published in 2016, 2017, or 2018 to be up-to-date. The primary objective of this overview was to explore the effectiveness of school-based or school-linked health services delivered by a health provider for improving the health of school-age children and adolescents. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. School health assessments give schools a snapshot in time of programs and policies that address student and staff health. school district county sch yr grade special health problems/parent concerns: quick reference: physical exam: k/1 6 11 3 7 . Primary studies included within the SRs were published between 1967 and 2017. 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 . Evans and colleagues found strong evidence from China, Tanzania, and India that school vision screening for correctable visual acuity deficits increased wearing of spectacles when spectacles were provided at no cost [21]. Staff from all three organizations can assist schools in meeting both their state requirements and their program requirements. Valentina Baltag, 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. Schools are considered to be an ideal platform for oral health promotion through education, services, and the school environment [6]. In 2015, the global means for the primary and secondary net school enrollment rates were 90% and 65%, respectively, thus the potential reach of school health services is wide [8]. 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. PubMed, Web of Science, ERIC, PsycINFO, and the Cochrane Library were searched systematically. Retain all of your child's school accounts can help you see trends and patterns over time. 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]. 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. PLoS ONE 14(6): 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. Today, electronic patient records are the accepted norm. The significance of records management to public healthcare facilities and institutions includes operational cost reduction and elimination of duplicated overhead costs; eliminates the creation. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Third, the scopes of individual SRs often differ from the scope of the overview, a problem that Ballard and Montgomery call a scope mismatch [13]. The corrected covered area (CCA) was found to be 1, indicating only slight overlap between the 20 SRs. For . Here are the product of records till keepand why they're important. Although overviews offer a comprehensive method for synthesizing evidence, they also come with important methodological limitations. One of the central questions of this overview was whether the school health services that are regularly delivered across the globe are evidence-based. Two SRs on dental health screening [18] and behavioral interventions for caries prevention [30] found limited evidence of effectiveness. 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]. The digital versions of patients' paper charts promise extensive benefits for personalized, safe and reliable medical care and treatment. Maintaining accurate records is essential to provid- ing quality care and protecting the health and safety of children in child care settings. How often do assessment questions get updated?All three school health assessments are reviewed regularly by each organization and by national expert panels. 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. 1720 references were identified from the systematic literature search. 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 ]. Children as young as eight are among dozens injured by a missile barrage fired at Pavlohrad; Russia has built some of the 'most extensive defences in the world' as its leaders fear a major . 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. To investigate the effectiveness of school health services for improving the health of school-age children and adolescents, a systematic review of systematic reviews (overview) was conducted. All information these cookies collect is aggregated and therefore anonymous. For students with chronic health conditions, school nurses and other health care providers play a large role in the daily management of their conditions. . The search strategy was developed for PubMed and then adapted for the other four databases. (2019). The formula for the CCA is: You may know to keep a file of those records. The final two items in the four-item checklist are (3) date of publication to ensure that results are up-to-date, and (4) matching of the scope to confirm that primary studies within SRs are relevant to the overview. 425 of these articles were ineligible. 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. 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. Electronic health records: An essential tool in keeping students healthy (Position Statement). Table F. Answers to AMSTAR 2 checklist questions 116. However, it was unclear whether these studies involved a health provider [22]. Figure 1 shows how school health services uses various methods to support students. In a sensitivity analysis that we conducted comparing systematic* with systematic review we found that the number of search results increased almost three-fold, but did not reveal any new articles that would eventually have met the subsequent eligibility criteria (search results available on request). Finally, for 1519 year olds, the leading causes of death were road injury, self-harm, interpersonal violence, diarrheal diseases, and lower respiratory infections [47]. The need for quality health care for519-year-olds is great, but globally the quality ofhealth services for them are variable and coverageis limited. This overview and the upcoming WHO guideline will specifically address school health services delivered by health providers. Only one of the 20 SRs included in this overview examined studies from a majority of LMIC and LIC [22,38]. 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. 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. The information can then be used for policy development, planning, and school improvement efforts. Articles that received conflicting votes (ineligible vs. potentially or probably eligible) were discussed and consensus was reached. If school health services are to truly improve the health of children and adolescents, they must comprehensively address the most pressing problems of this population. It provides useful information on the progress and development made within the school. In emergencies, school officials can provide information from education records to protect the health or safety of the student or others. S3 Appendix. Excluded full text articles. CCA values for all health areas and calculations are available in Tables C and D in S5 Appendix. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. We are also grateful for advice from the WHO school health services guideline Steering Group and Guideline Development Group members. 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. Comprehensive school programs that promote healthy school environments, health and nutrition literacy, and physical activity are one of the six key areas for ending childhood obesity recommended by WHO [45]. Health records have played an increasingly important role throughout history as an important le-gal document for the exercise of individuals' rights. In 1995, WHO launched the GlobalSchool Health Initiative, which aimed to strengthenapproaches to health promotion in schools. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. The computer software organizes data in ways that are easy to interpret and put to use. 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. If consensus was not possible during title/abstract or full text screening, a third reviewer (DR), who had the casting vote, would have been asked to independently screen the article. Prevention and treatment of mood disorders was assessed in five SRs, all of which targeted children and adolescents using RCTs of established programs. The use of an assessment and action planning process provides a coordinated framework for school improvement and wellness efforts. David Anthony Ross, Affiliation: The search strategy is presented in S2 Appendix. Similarly, some states require portions of the Healthy School Report Card to be completed. This may be solved by coordinating school visits from hospital-based health professionals or by linking schools with local health centers for children and adolescents to access as needed. A SR and meta-analysis by Bastounis and colleagues on the educational and preventative Penn Resiliency Program (PRP) and its derivatives found small, non-significant effect sizes for the prevalence of both depression and anxiety, favoring the intervention in the former and the control in the latter [19]. The CCA is calculated using three variables: the number of index publications (r), the number of total publications (N), and the number of SRs within the overview (c). This document replaces the School Nurse Role in Electronic School Health Records (January 2014). School health services staff also are responsible for coordinating care by communicating with the students family and health care providers so that they can stay healthy and ready to learn. This SR did not discuss the quality or risk of bias of included studies [35]. For more detailed information on how to coordinate these assessments, contact the three organizations by going to the Web sites listed at the end of this document. School health will be fully integrated into the greater healthcare system to provide a holistic, child-centered, health system. The records that school nurses keep in their daily care of over 95% of U.S. school-aged children provide an important window into child health in our nation. Independent Oversight and Advisory Committee, WHO guideline on school health services: Web Annex A. Compendium, WHO guideline on In order for policy makers and leaders in school health to make evidence-based recommendations on which services should be available in schools, who should deliver them, and how should they be delivered, more SRs must be done. II. Review quality was assessed using a modified Ballard and Montgomery four-item checklist. Evaluations are also conducted to refine and improve the tools. After removal of 705 articles with definitely ineligible titles/abstracts, 445 full text articles were screened using the ranked inclusion/exclusion criteria (S1 Appendix). More research should be done to identify the content and methods of deliver that make some oral health education interventions more effective than others. 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]. 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. This systematic review of systematic reviews, henceforth referred to as an overview, will inform the upcoming development of a WHO guideline that addresses the school health services component of health-promoting schools and feeds into the FRESH framework. All schools funded by the Alliance for a Healthier Generation are required to use the Healthy Schools Inventory for planning, national recognition, and program evaluation. A meta-analysis of two studies on sanitary pad provision found a moderate but statistically non-significant effect on school attendance. 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]. Hardware interventions included provision of sanitary products and software interventions focused on menstrual management education. 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]. Access to education and safe and supportive schoolenvironments have been linked to better healthoutcomes. In the remaining twelve SRs, 50% to 74% of included studies fulfilled all the inclusion criteria [19,20,2225,28,31,32,3436]. 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. These SRs must assess routine, multi-component school health services and the characteristics that make them effective, with special attention to content, quality, intensity, method of delivery, and cost. 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. Most schools rely upon grant funding and other financial aid to cover the implementation costs, but this often involves stringent requirements. 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. Saving Lives, Protecting People, School Health Index: A Self-Assessment and Planning Guide, National Center for Chronic Disease Prevention and Health Promotion, Physical Activity and Sedentary Behaviors and Academic Grades, Tobacco Product Use Behaviors and Academic Grades, Other Health Behaviors and Academic Grades, Characteristics of an Effective Curriculum, Tips for Promoting School Employee Wellness, Physical Education Curriculum Analysis Tool, Health Education Curriculum Analysis Tool (HECAT), Body Mass Index (BMI) Measurement in Schools, Inclusive School Physical Education and Physical Activity, Physical Activity Before and After School, What School Nutrition Professionals Need to Know About COVID-19, Modifying School Spaces During Mealtimes to Reduce Spread of COVID-19, Supporting Students with Chronic Health Conditions in School-Based OST Programs, Healthy and Supportive School Environments, Strategies to Create a Healthy and Supportive School Environment, Strategies to Help Parents and Families Create Healthy and Supportive School Environments, How Families Can Support Student Health and Emotional Well-being, Toolkit for Schools: Engaging Parents to Support Student Health and Emotional Well-being, Youth Risk Behavior Surveillance System (YRBSS), School Health Policies and Practices Study (SHPPS), e-Learning Series: Training Tools for Healthy Schools, Comprehensive School Physical Activity Program, Guide to Evaluating Professional Development, Understanding the Training of Trainers Model, Professional Development Follow-Up Support, How to Build a Training Cadre: A Step-by-Step Process, Guide to Promoting Professional Development, Whole School, Whole Community, Whole Child (WSCC), Encourage healthy eating in school and at home, Dental Sealants Can Improve Students Oral Health, Give Your Kids a Healthy Body and Mind This Summer, Engaging Parents to Promote Healthy Schools, Funded Nongovernmental Organizations for Healthy Schools, BAM! Silver Spring, MD: Author. An index publication is the first appearance of a primary study within an overview. Five databases were searched through June 2018. Hennegan and Montgomery assessed the effectiveness of hardware and software menstrual management interventions (Table 3B) [22]. Given the wide reach of schools [8] and the fact that school health services already exist in at least 102 countries [9], research on the effectiveness of school health services in LMIC and LIC must be prioritized in order to fulfill Sustainable Development Goal 3.8 and reach universal health coverage by 2030 [51]. They help us to know which pages are the most and least popular and see how visitors move around the site. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. However, it should be noted that these SRs found mixed evidence of maintenance of effects over time [28,32,34,39]. Nonetheless, it is interesting to note that all four of the SRs given moderate or high levels of confidence were Cochrane reviews. This overview measured overlap using the corrected covered area (CCA) [16] and did not exclude overlapping studies. Only one quasi-experimental study from the United States in 1999 was included in the SR. 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%. Calculations for the CCA can be found in Tables C and D in S5 Appendix. The AMSTAR 2 checklist [17] was used to appraise quality of included SRs. This overview primarily found evidence for special research interventions, suggesting a need for assessment of routinely-delivered school health services. While this overview found significant gaps in the evidence for certain health areas, this does not necessarily mean that relevant high quality primary trials have not been conducted. One reviewer (JL) assessed all SRs and a second (KK) duplicated appraisal of 10%, with 94% agreement and only minor disagreements that did not impact grades of confidence. Among those approaches, pairing children with health services occupies an important place. 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. Click to Enlarge | PDF [PDF 466 KB] | JPEG | PNG. Improvements in trauma-related symptoms and impairment were found through narrative assessment of creative expression interventions, cognitive behavioral interventions, and multifaceted interventions [36]. PLOS ONE promises fair, rigorous peer review, There was 92% agreement between reviewers for all items within the standard form, with discrepancies only in level of detail. 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. SRs on oral health interventions focused on prevention [25,30], screening [18], and education [27,30] (Table 3E). Schools are essential for young people to acquireknowledge, socioemotional skills including selfregulationand resilience, and critical thinking skillsthat provide the foundation for a healthy future. 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]. Leading causes of disability-adjusted life years (DALYs) for 1019 year olds were iron deficiency anemia, road injury, depressive disorders, lower respiratory infections, and diarrheal diseases [47]. For example, the exclusion of observational studies limits the ability of this overview to assess interventions where controlled studies may be unethical or impractical, such as for an intervention that has been clearly shown to be effective when delivered in a different context and the school health service program wishes to include it. The sixth study assessed a 4-day program in Brazil. Citations identified from the systematic search were uploaded to Covidence systematic review software [12] and duplicates were automatically deleted. Another important gap that this overview reveals is a lack of research on interventions carried out in LMIC and low-income countries (LIC). 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. Yet no SRs on vaccinations fulfilled the inclusion criteria for this overview, suggesting the need for these SRs to be conducted, focusing on whether vaccinations for this age group should be delivered as part of a school health service or not, rather than on whether the vaccination per se is effective. In 2000, WHO, the United Nations Educational, Scientific and Cultural Organization (UNESCO), the United Nations Children's Fund (UNICEF) and the World Bank developed a partnership for Focusing Resources on Effective School Healtha FRESH Start approach [2]. There were no date restrictions on publication of included SRs. National Association of School Nurses. 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. They help us to know which pages are the most and least popular and see how visitors move around the site. All three tools are useful for internal planning and program improvement. S6 Appendix. However, in the studies included in both Gold and colleagues and McDonald and Dreys SRs, the numbers of participants per intervention group were very small: 410 and 1225 per study, respectively, introducing possibility of bias [23,33]. CDC twenty four seven. Kavanagh and colleagues examined depression and anxiety group counseling programs based on cognitive behavioral therapy (CBT) and found statistically significant reductions of depressive symptoms at both four weeks and three months follow-up [24,39]. Records are being kept on students who are well (screening, immunization, and episodic health room care); and students with chronic health conditions (emergency care planning; daily treatment and response data for students with conditions such as asthma; severe allergies; seizure disorders; and Type I Diabetes). Five SRs covered depression and/or anxiety prevention and early intervention programs, with the FRIENDS for Life program (FRIENDS) and the Penn Resiliency Program (PRP) most common [19,24,28,32,34]. Table E. AMSTAR 2 checklist with designations of critical and non-critical. 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. Health Record to Teacher: Purpose: 1. 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]. Although three SRs mentioned the cost of specialized professionals delivering interventions versus teachers or a school nurse [26,32,36], cost, let alone cost-effectiveness, was not closely analyzed in any of the included SRs. health record explaining the purpose of school health records, services offered by school health personnel, and the desirability of periodic health examinations. 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. It is an important aspect of (school) Administration. Further, they strengthen the rigor of included studies and improve decision-making ability. This overview found 20 SRs covering 270 primary studies. The effectiveness of school-based mental health services was assessed in nine SRs (Table 3C) [19,23,24,28,29,3234,36,39].