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general psychology

Firouz meroei milan

School Health Promomtion 2

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Results of Searches

• 448 titles and abstracts • 45 papers and reports

scrutinised• 15 reviews met inclusion

criteria

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Focus of Reviews

0 1 2 3 4 5 6

Driver education

Eating Disorders

Health Promting School

Peer approaches

Health Eating/Physical Activity

Substance Misuse

Mental Health

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Results: Mental Health• Universal approaches (17):

– Whole school and HPS approaches better– Longer programmes better– Promotion of MH > prevention of MI– Medium to large effects

• Depression and self esteem (7 SRs + 5 studies)– Primary prevention better (medium to large effects)– Self esteem programmes modest effects– Knowledge based prgrammes not effective– Suicide prevention – potential for harm

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Results: Mental Health• Aggressive behaviour (221)

– Range of different programmes effective– Better studies and well implemented

programmes > effect – Effects > high risk groups

• Violence prevention (16) – Cognitive and behavioural strategies both

effective – Primary prevention, multiple settings, qualified

leaders, and longer time scales > effect • Violence Prevention (44)

– Non response and relationship programmes effective

– Small to moderate effects overall

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Results: Substance Use • Smoking (76)– Most programmes (including information,

social competence and multimodal) not effective

– Some social influences programmes positive

• Drug prevention (207) – Universal programme focus – Impact small to very small

• Drugs psycho-education (62)– 18/62 some evidence of effect – Best programmes can achieve is short term

delay

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Green, Howes, Waters, Maher, Oberklaid 2005

• Emotional and social health in primary school • (8 reviews) • Most studies of short class based programmes• But more effect from: • Sustained approaches (> I year)• Whole school approaches with changes to

school ethos • Focus on promotion • Involving parents• Targeted programmes have a place

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Problems with Evidence

• Process and implementation measures rarely not reported

• Quality of studies – Study size; implementation fidelity cf

statistical power – Cluster design – Loss to follow up– Sensitivity of outcome measures

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Issues

• Participation • Autonomy• Programme fidelity • Randomisation • Time scales

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Conclusions

• School health promotion programmes can be effective but by no means always are

• Health Promoting Schools approach supported

• Long time scales • Programmes more effective when focusing

on positive health and wellbeing– Mental health– Health eating and physical activity

• Substance misuse programmes don’t work

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Conclusions• Poor mental health is the most

important cause of disability throughout the life course

• There is no health without mental health

• Public mental health is going to become more and more of an issue

• More discussion needed on the nature of mental well-being, but enough consensus to get started

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Conclusions

• Key places to start promoting mental health – Ourselves– Families– Schools