School-based interventions to promote adolescent health: A systematic review in low- and middle-income countries of WHO Western Pacific Region

Xu, Tao; Tomokawa, Sachi; Gregorio, Ernesto R.; Mannava, Priya; Nagai, Moritaka; Sobel, Howard

doi:10.1371/journal.pone.0230046

Cited by 59 publications

(49 citation statements)

References 20 publications

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“…Health education intervention on malnutrition will improve the health status of adolescents now, when they become adults, and for the optimal growth and development of their offspring to prevent the cycle of intergenerational transmission of malnutrition in adolescents. The effectiveness of the intervention in this review concurs with evidence from systematic reviews that showed statistically significant improvement in knowledge, attitudes and practices [53][54][55][56]. The effectiveness of the intervention in this review also concurs with other health education interventions on the knowledge, attitudes and practices regarding physical health, psychosocial health and reproductive health among adolescents in India, Saudi Arabia and Zimbabwe [57][58][59].…”

Section: Discussionsupporting

confidence: 78%

Systematic Review: Effect of Health Education Intervention on Improving Knowledge, Attitudes and Practices of Adolescents on Malnutrition

et al. 2020

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Adolescence is a phase in the life cycle of human beings. Adequate knowledge, attitudes and practices towards malnutrition are necessary for proper growth and development and for their future children. This systematic review aimed to determine the effect of health education intervention to improve the knowledge, attitudes and practices of adolescents on malnutrition. PubMed, Scopus, clinical trials, CINAHL, SAGE, Science Direct and Medline were searched according to Preferred Reporting Item for Systematic Reviews and Meat-analysis (PRISMA) guidelines to identified published studies from January 2013 to December 2019 based on the inclusion and exclusion criteria. A total of eight studies were included in this review. Data extraction was done based on randomized controlled trial only. Three out of the eight studies had low risk of bias, the overall evidence of the study was moderate. Findings from this study suggest that health education intervention among adolescents have significantly improved their knowledge, attitudes and practices. More specific interventions should be conducted in low and middle income countries since they bear more of the burden of malnutrition globally.

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Section: Discussionsupporting

confidence: 78%

Systematic Review: Effect of Health Education Intervention on Improving Knowledge, Attitudes and Practices of Adolescents on Malnutrition

et al. 2020

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“…These challenges are not unique to the UAE. Several studies have reported similar hurdles in implementing SNPs in developing countries (15)(16)(17)(18)(19)(20). Along the same line, it was highlighted that the lack of funding, awareness, and coordination and cooperation among the stakeholders, learning and development opportunities, and enforcement of policies and procedures constitute the main barriers to implementing the school wellness policies in the United States and adopting nutrition guidelines in schools in Canada (21).…”

Section: Discussionmentioning

confidence: 91%

Towards the Upscaling of School Nutrition Programs in Dubai: an Exploratory Study

AlGurg¹,

Mahfouz²,

Otaki³

et al. 2021

Preprint

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BackgroundSchool nutrition programs impact the intellectual, social, and emotional development of school children, as well as their future risk of developing Non-Communicable Diseases. While many stakeholders are involved in the development, implementation, and evaluation of school nutrition programs in Dubai, United Arab Emirates, little is known about the complementarity among those stakeholders, and the means to upscale school nutrition programs while ensuring effective, efficient, and equitable implementation. Accordingly, this study aims at exploring the perceptions of a diverse group of stakeholders, positioned at differing levels of the public health and education ecosystems in the United Arab Emirates, in relation to current guidelines and practices around the planning, implementation, and evaluation of school nutrition programs in Dubai, United Arab Emirates.MethodsThe study relied on a qualitative design, based on semi-structured key informant interviews. A total of 29 interviews were carried-out. Those interviewees included leaders and directors from different institutions, decision- and policy- makers, nutritionists, school nurses and nurse managers, and school principals and vice principals. All stakeholders were interviewed by the research team. Data was transcribed, and then thematically analyzed using the health systems’ model as an analytic framework.ResultsThe thematic analysis of interview data identified five interrelated themes. The first theme relates to the limited coordination across regulatory local and federal entities, and the multiplicity of guidelines issued by the different stakeholders. The challenges around the human and financial resourcing of school nutrition programs constituted the second theme. The third theme was the weakly coordinated implementation efforts. The fourth theme was the need for better performance measurement, and the fifth theme flagged the need for improved inclusiveness for health needs and cultural preferences of the diverse student body in Dubai.ConclusionThis study emphasizes that all the involved stakeholders need to better collaborate to upscale the school nutrition program in Dubai. This will require the formation of a unified governing body, which would identify and develop a single stream of resources, and sets in place a reliable, all encapsulating and equitable implementation plan along with an overarching monitoring and evaluation framework.

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“…Further, it should be noted that almost all tools were gathered from high-income countries, which draws attention to low-and middle-income countries (LMIC) and the potential for both policy development and implementation evaluation as a means to support ongoing health needs in such populations. Findings from systematic review research highlight a lack of policy/intervention initiatives from LMIC which sought to address child health promotion in the school setting (58). Accordingly, further work is warranted to examine the t of existing tools for school contexts in LMIC countries, and to determine how tools from high-income countries may be adapted for use in LMIC to optimize e ciency and sharing of resources.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of School Health Policy Measurement Tools: Implementation Determinants and Outcomes

McLoughlin

Allen

Walsh‐Bailey

et al. 2021

Preprint

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Background: Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students, and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed. The purposes of the present systematic review of quantitative measures of school policy implementation are to identify quantitative measures of implementation determinants and Proctor model implementation outcomes and assess pragmatic and psychometric properties of such measures.Methods: Peer-reviewed journal articles published 1995-2020 were included if they: 1) had multiple-item quantitative measures of school policy implementation; and 2) addressed overall wellness, tobacco, physical activity, nutrition, obesity prevention, and mental health/bullying/social-emotional learning. The final sample comprised 86 measurement tools from 67 peer-review articles. We extracted study characteristics, such as psychometric and pragmatic measure properties, from included articles based on three frameworks: Implementation Outcomes Framework, 2) Consolidated Framework for Implementation Research, and 3) Policy Implementation Determinants Framework.Results: Most implementation tools were developed to measure overall wellness policies which combined multiple policy topics (n=35, 40%) and were in survey form (n=75, 87%). Fidelity was the most frequently prevalent implementation outcome (n=70, 81%), followed by adoption (n=32, 81%). The implementation determinants most assessed were readiness for implementation, including resources (n=43, 50%), leadership (n=42, 49%), and policy communication (n=41, 48%). Overall, measures were low-cost and had easy readability. However, lengthy tools and lack of reported validity/reliability data indicate low transferability.Conclusions: Implementation science can contribute to more complete and rigorous assessment of school health policy implementation processes, which can improve implementation strategies and ultimately the intended health benefits. Several high-quality measures of implementation determinants and implementation outcomes can be applied to school health policy implementation assessment. D&I researchers can also benefit from measurement experiences of school health researchers.

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School-based interventions to promote adolescent health: A systematic review in low- and middle-income countries of WHO Western Pacific Region

Cited by 59 publications

References 20 publications

Systematic Review: Effect of Health Education Intervention on Improving Knowledge, Attitudes and Practices of Adolescents on Malnutrition

Systematic Review: Effect of Health Education Intervention on Improving Knowledge, Attitudes and Practices of Adolescents on Malnutrition

Towards the Upscaling of School Nutrition Programs in Dubai: an Exploratory Study

A Systematic Review of School Health Policy Measurement Tools: Implementation Determinants and Outcomes

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