unclear if a health provider was involved), followed by if less than 50% of studies within a SR fulfilled all inclusion criteria. The full list of the specific reasons for exclusion of full texts is available in Table A within S3 Appendix. There was 92% agreement between reviewers for all items within the standard form, with discrepancies only in level of detail. We are also grateful for advice from the WHO school health services guideline Steering Group and Guideline Development Group members. 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. 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]. Two reviewers (KK and JL) screened all titles and abstracts using the inclusion/exclusion criteria and excluded all articles that were definitely ineligible. When autocomplete results are available use up and down arrows to review and enter to select. Suggested citation: National Association of School Nurses. 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]. This overview measured overlap using the corrected covered area (CCA) [16] and did not exclude overlapping studies. school district county sch yr grade special health problems/parent concerns: quick reference: physical exam: k/1 6 11 3 7 . WHO guideline on school health services This overview and the upcoming WHO guideline will specifically address school health services delivered by health providers. In this overview, SRs with at least 50% of included studies fulfilling all criteria were included after extensive discussion between the authors and experts in the field. School health assessments give schools a snapshot in time of programs and policies that address student and staff health. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. However, there was no risk of bias assessment in this SR and therefore the results must be interpreted cautiously. This overview used the corrected covered area (CCA), a comprehensive and validated measure, to determine overlap [16]. You will be subject to the destination website's privacy policy when you follow the link. The final three SRs either did not state the locations of included studies [27,34] or provided regions rather than specific country locations [26]. You can review and change the way we collect information below. 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. 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 . More research should be done to identify the content and methods of deliver that make some oral health education interventions more effective than others. That marked the highest percentage since at least 1968, the earliest year for which the CDC has online records. Through a comprehensive literature search, the overview aimed to identify health areas and specific school health service interventions that have at least some evidence of effectiveness. 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. These reasons for exclusion applied to 183 and 126 SRs, respectively. Staff from all three organizations can assist schools in meeting both their state requirements and their program requirements. 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]. Second, the ability of overviews to make valid and accurate conclusions is dependent upon the accuracy, rigor, and inclusiveness of the SRs themselves. This was never required as consensus was always reached. Duplication of effort is something all three organizations would like to avoid. Data Availability: All relevant data are within the manuscript and its Supporting Information files. The digital versions of patients' paper charts promise extensive benefits for personalized, safe and reliable medical care and treatment. In 1995, WHO launched the GlobalSchool Health Initiative, which aimed to strengthenapproaches to health promotion in schools. The Healthy School Report Card is already aligned with the schools improvement process. No literature is currently available showing the number of hospitals and health care systems that provide EHR access to school nurses. While results from primary studies were statistically significant in both SRs, heterogeneity of interventions precluded meta-analysis by Walter and colleagues [37] and no reason was given for why meta-analysis was not performed by Geryk and colleagues [31]. Six SRs included at least one study from countries with lower-middle income or lower income economies [18,21,22,28,35,36]. School health assessments give schools a snapshot in time of programs and policies that address student and staff health. PDF The Role of Records Keeping for Effective Primary Schools School health will be fully integrated into the greater healthcare system to provide a holistic, child-centered, health system. In addition, school-age childrenand adolescents have positive physical, sexual,psychosocial and neurocognitive health anddevelopment needs as they progress from childhoodto adulthood. I am Tim Stephens. Only one of the 20 SRs included in this overview examined studies from a majority of LMIC and LIC [22,38]. All three tools are useful for internal planning and program improvement. 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. For . Copyright 2022 webdev. 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. Table B. S6 Appendix. 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. S4 Appendix. You may know to keep a file of those records. An important consideration in overviews is the degree of overlap, or the use of the same primary study in multiple included SRs. Thus, responsibility for interventions may need to be redistributed in countries with limited access to health professionals. health record explaining the purpose of school health records, services offered by school health personnel, and the desirability of periodic health examinations. 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. 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. PDF Maintaining Child Health Records in Child Care Settings The school sends you reports that tell you how your child is doing in school and what the school is doing for him. Silver Spring, MD: Author. Cookies used to make website functionality more relevant to you. (2019). High overlap can contribute to biased results [15]. 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. 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]. A recent guideline from the International Agency for Prevention of Blindness (IAPB) reiterates the importance of free spectacles and goes further to suggest that low- and middle-income countries (LMIC) adopt comprehensive school eye health programs [43]. Following the recommendation of the AMSTAR 2 developers [17], individual ratings were not combined into an overall score. Due to the diversity in outcome measures and intervention intensities, the authors felt unable to make any evidence-based recommendations [30]. S7 Appendix gives the PRISMA checklist that was used. In emergencies, school officials can provide information from education records to protect the health or safety of the student or others. DoE Issues New Guidance on FERPA and Student Health Records 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]. As part of the records types, the academic records are known as an important asset for . These SRs contained 270 primary studies, 225 of which were unique and 45 were included in more than one SR. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Walter and colleagues found that family asthma educational programs for children and their parents or caregivers improved quality of life for both caregivers and children, and decreased asthma exacerbations for children [37]. Strongest evidence in favor of oral health interventions emerged from a SR on universal topical application of fluoride gel for the prevention of dental caries [25]. Quality appraisal of primary studies. In allWHO regions, school-age children and adolescents(those aged 519 years) experience a range oflargely preventable health problems, includingunintentional injury, interpersonal violence, sexualand reproductive health issues, communicablediseases, noncommunicable diseases and mentalhealth issues. http://www.who.int/school_youth_health/gshi/en/, http://www.schoolsandhealth.org/Pages/WASH.aspx, http://www.who.int/school_youth_health/resources/information_series/en/, https://data.worldbank.org/?year_high_desc=false, http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD012595.pub2/full, http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005023.pub3/full, http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD004381.pub2/abstract, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002280.pub2/abstract, https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups, https://eppi.ioe.ac.uk/cms/Default.aspx?tabid=2418, http://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment, https://www.iapb.org/resources/school-eye-health-guidelines/, http://apps.who.int/iris/bitstream/handle/10665/43027/924159215X_eng.pdf;jsessionid=7E674C27FAC37B003AB96A2DC13C7407?sequence=1, http://apps.who.int/iris/bitstream/handle/10665/204176/9789241510066_eng.pdf?sequence=1, http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight, http://www.who.int/healthinfo/global_burden_disease/en/, Corrections, Expressions of Concern, and Retractions. In addition, both the Healthy School Report Card and the Healthy Schools Inventory may be used to collect data for evaluation.Are there requirements to use a school health assessment?Yes, in some states and districts. The same two reviewers screened the full text of all the potentially or probably eligible articles using a ranked list of the inclusion criteria (S1 Appendix). It can even provide reports, process results, students transcripts and . SHI | Using School Health Assessments | Healthy Schools | CDC Maintaining Student Records One of your essential duties as a teacher is to maintain student records. The remaining three SRs also assessed FRIENDS and PRP along with additional often-overlapping programs. 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. The sixth study assessed a 4-day program in Brazil. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Excluded full text articles and reasons for exclusion. The search strategy was developed for PubMed and then adapted for the other four databases. 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. Table 1 summarizes the characteristics of the 20 included SRs. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 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. Nonetheless, it is interesting to note that all four of the SRs given moderate or high levels of confidence were Cochrane reviews. A health book contains the names of students/Pupils who brings complains to the clinic, . CDC twenty four seven. 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). Chung and colleagues systematically reviewed and meta-analyzed universal sleep education programs as compared to no additional sleep intervention from Australia, New Zealand, Brazil, and Hong Kong (Table 3G) [20]. They help us to know which pages are the most and least popular and see how visitors move around the site. 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. 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]. School Nurses' Role Expands With Access To Students' Online Health Records 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. Education on the wearing of spectacles in addition to vision screening as compared to vision screening alone did not have a significant effect [21]. The SRs were written in English and published between 2006 and 2018. 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]. 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. The final SR on mental health services examined well-being interventions for children with a parent in the military [29]. This document replaces the School Nurse Role in Electronic School Health Records (January 2014). 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. Evaluations are also conducted to refine and improve the tools. School Health Services | Healthy Schools | CDC Finally, creative therapy interventions seem to be effective for indicated populations of school-age children, such as children with autism spectrum disorder [23,33]. Linking School Nurses With Health Care Systems Using EHRs: An Health Record to Teacher: Purpose: 1. One reviewer (JL) extracted summary data from each selected article using a customized standard form with independent data extraction performed for 15% of included SRs by one of the other reviewers (DR or KK). Table C. Calculation of corrected covered areas (CCAs). school health services 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. Today, electronic patient records are the accepted norm. Reasons for exclusion were selected from the ranked list. 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]. Explaining the Importance: Proper Academic Records Management These cookies may also be used for advertising purposes by these third parties. A majority of the studies (80%) were given low or critically low levels of confidence. Additionally, reference lists of included articles were scanned for any relevant SRs. In the remaining twelve SRs, 50% to 74% of included studies fulfilled all the inclusion criteria [19,20,2225,28,31,32,3436]. c. schools are access sites for students to receive increased and improved care, which might not be adequately received elsewhere d. The details of the quality appraisal of primary studies included in the SRs are given in Table B in S4 Appendix. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Panelists evaluate questions based on best practices and emerging research on addressing heath behaviors and the school health environment. 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]. Calculations for the CCA can be found in Tables C and D in S5 Appendix. Nonetheless, these criteria were necessary to give the overview a reasonable scope. Finally, overlap of primary trials between SRs can bias results of an overview [15]. The FRESH framework promotes four pillars: health-related school policies, provision of safe water and sanitation, skills-based health education and school-based health and nutrition services [2]. 570 were duplicates, leaving 1150 titles and abstracts to be screened. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. It is compulsory and can never be jettisoned. Schroeder and colleagues found that school nurses are well positioned to deliver nutritional counseling, design and coordinate physical activity interventions, and educate parents, students, and staff on health, nutrition, and fitness [26]. Vision screening linked with free provision of spectacles, as a component of a comprehensive school eye health program, is an example of a cost-effective form of school health services that may be implemented. Centers for Disease Control and Prevention. 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. 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. Meaningful use of school health data - PubMed 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. doi:10.1371/journal.pone.0212603, Editor: Danuta Wasserman, Karolinska Institutet, SWEDEN, Received: February 5, 2019; Accepted: May 27, 2019; Published: June 12, 2019. Searches were performed on June 15, 2018. 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]. When used properly, EHRs have the potential to "maximize quality, decrease cost, and prevent errors, as well as promote the interoperability of school health records with providers in other care settings." School nurses might use an EHR for: Tracking student health trends Ensuring health documentation is secure and compliant This implies that a narrower range of SRs would have been eligible if a stricter cut-off had been selected, and vice versa. 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. division of school health school health record name: last, first, middle birthdate: month, day, year gender: male female father's name: last, first, middle . No review evaluated the effectiveness of a multi-component school health services intervention addressing multiple health areas. Eleven of the SRs used meta-analysis to combine results [1828], whereas the remaining nine SRs narratively synthesized results [2937]. To receive email updates about this page, enter your email address: We take your privacy seriously. Eleven SRs included only cluster- and individually-randomized controlled trials [1921,24,27,28,30,32,34,37], seven SRs included other types of controlled and uncontrolled experimental studies in addition to RCTs [22,25,26,31,33,35,36], and two SRs included only QEs [29] or controlled clinical trials [23]. Silver Spring, MD: Author. 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. 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]. Now, as both schools and health care systems seek to ensure that children coping with chronic conditions such as diabetes and asthma get the comprehensive, coordinated care the students need, the schools and health systems are forming partnerships to better integrate their 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. Further, they strengthen the rigor of included studies and improve decision-making ability. The AMSTAR 2 checklist [17] was used to appraise quality of included SRs. Meta-analysis found small but statistically significant effect sizes in favor of music therapy for gestural communication, verbal communication, and behavioral problems [23]. Figure 1 shows how school health services uses various methods to support students. Funding issues. Access to education and safe and supportive schoolenvironments have been linked to better healthoutcomes. Electronic Health Records: An Essential Tool for School Nurses - NASN However, the SR suggested that the studies were ineffective in changing self-reported risky behaviors, although follow-up was either immediate or short-term (less than 6 months) [35]. Journal of school health, 86 (8), 585-594. Additional systematic reviews are needed that analyze the effectiveness of comprehensive school health services, and specific services for under-researched health areas relevant for this population. | 3 Registration Options. 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. 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. A universal educational intervention on oral hygiene and caries produced weaker evidence of effectiveness [27]. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. For example, a PHR enables you to: Track and assess your health. A meta-analysis of two studies on sanitary pad provision found a moderate but statistically non-significant effect on school attendance. Table 2 presents the remaining three of the four items of Ballard and Montgomerys checklist for overviews of reviews: (2) levels of confidence in results for each included SR, (3) publication year, and (4) match in scope to the overview.
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