Dataset Information

Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK).

ABSTRACT:

Background

School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems.

Methods/design

A realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK). The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting). Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a 'reality check' on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health.

SUBMITTER: Pearson M

PROVIDER: S-EPMC3488465 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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Publications

Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK).

Pearson Mark M Chilton Roy R Woods Helen B HB Wyatt Katrina K Ford Tamsin T Abraham Charles C Anderson Rob R

Systematic reviews 20121020

<h4>Background</h4>School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evi ...[more]

PMID: 23083508

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Project description:Biomedical Research Centres (BRCs) are partnerships between healthcare organisations and universities in England. Their mission is to generate novel treatments, technologies, diagnostics and other interventions that increase the country's international competitiveness, to rapidly translate these innovations into benefits for patients, and to improve efficiency and reduce waste in healthcare. As NIHR Oxford BRC (Oxford BRC) enters its third 5-year funding period, we seek to (1) apply the evidence base on how best to support the various partnerships in this large, multi-stakeholder research system and (2) research how these partnerships play out in a new, ambitious programme of translational research.Organisational case study, informed by the principles of action research. A cross-cutting theme, 'Partnerships for Health, Wealth and Innovation' has been established with multiple sub-themes (drug development, device development, business support and commercialisation, research methodology and statistics, health economics, bioethics, patient and public involvement and engagement, knowledge translation, and education and training) to support individual BRC research themes and generate cross-theme learning. The 'Partnerships' theme will support the BRC's goals by facilitating six types of partnership (with patients and citizens, clinical services, industry, across the NIHR infrastructure, across academic disciplines, and with policymakers and payers) through a range of engagement platforms and activities. We will develop a longitudinal progress narrative centred around exemplar case studies, and apply theoretical models from innovation studies (Triple Helix), sociology of science (Mode 2 knowledge production) and business studies (Value Co-creation). Data sources will be the empirical research studies within individual BRC research themes (who will apply separately for NHS ethics approval), plus documentary analysis and interviews and ethnography with research stakeholders. This study has received ethics clearance through the University of Oxford Central University Research Ethics Committee.We anticipate that this work will add significant value to Oxford BRC. We predict accelerated knowledge translation; closer alignment of the innovation process with patient priorities and the principles of responsible, ethical research; reduction in research waste; new knowledge about the governance and activities of multi-stakeholder research partnerships and the contexts in which they operate; and capacity-building that reflects the future needs of a rapidly-evolving health research system.

Project description:BackgroundSubstance misuse is now encountered in settings beyond addiction specialty care, with schools a point-of-contact for student access to behavioral health services. Marijuana is a leading impetus for adolescent treatment admissions despite declining risk perception, for which the Teen Marijuana Check-Up (TMCU)-a tailored adaptation of motivational enhancement therapy-offers an efficacious service option. To bridge the knowledge gap concerning effective and affordable technical assistance strategies for implementing empirically supported services, the described trial will test such a strategy to facilitate school-based TMCU implementation.MethodsA type II effectiveness/implementation hybrid trial will test a novel strategy for a TMCU purveyor to provide technical assistance on an 'as-needed' basis when triggered by a fidelity drift alarm bell, compared to resource-intensive 'gold-standard' technical assistance procedures of prior efficacy trials. Trial procedures adhere to the EPIS framework as follows: (1) initial mixed-method exploration of the involved school contexts and identification of TMCU interventionist candidates in elicitation interviews; (2) interventionist preparation via a formally evaluated training process involving a two-day workshop and sequence of three training cases; (3) post-training implementation for 24 months for which trained interventionists are randomized to 'as-needed' or 'gold-standard' technical assistance and self-referring students randomized (in 2:1 ratio) to TMCU or waitlist/control; and (4) examination of TMCU sustainment via interventionist completion of biannual outcome assessments, cost analyses, and exit interviews. Hypothesized effects include non-differential influence of the competing technical assistance methods on both TMCU fidelity and intervention effectiveness, with lesser school costs for the 'as-needed' than 'gold-standard' technical assistance and greater reduction in the frequency of marijuana use expected among TMCU-exposed students relative to those assigned to waitlist/control.DiscussionThis trial-occurring in Washington state as legislative, fiscal, and sociocultural forces converge to heighten exposure of American adolescents to marijuana-related harms-is set to advance understanding of best implementation practices for this and other efficacious, school-based interventions through examination of a data-driven technical assistance method. If shown to be clinically useful and affordable, the concept of a fidelity drift alarm could be readily translated to other empirically supported services and in other health settings.Trial registrationClinicalTrials.gov NCT03111667 registered 7 April 2017.

Project description:IntroductionThe COVID-19 pandemic has resulted in significant morbidity and mortality and devastated economies globally. Among groups at increased risk are healthcare workers (HCWs) and ethnic minority groups. Emerging evidence suggests that HCWs from ethnic minority groups are at increased risk of adverse COVID-19-related outcomes. To date, there has been no large-scale analysis of these risks in UK HCWs or ancillary workers in healthcare settings, stratified by ethnicity or occupation, and adjusted for confounders. This paper reports the protocol for a prospective longitudinal questionnaire study of UK HCWs, as part of the UK-REACH programme (The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers).Methods and analysisA baseline questionnaire will be administered to a national cohort of UK HCWs and ancillary workers in healthcare settings, and those registered with UK healthcare regulators, with follow-up questionnaires administered at 4 and 8 months. With consent, questionnaire data will be linked to health records with 25-year follow-up. Univariate associations between ethnicity and clinical COVID-19 outcomes, physical and mental health, and key confounders/explanatory variables will be tested. Multivariable analyses will test for associations between ethnicity and key outcomes adjusted for the confounder/explanatory variables. We will model changes over time by ethnic group, facilitating understanding of absolute and relative risks in different ethnic groups, and generalisability of findings.Ethics and disseminationThe study is approved by Health Research Authority (reference 20/HRA/4718), and carries minimal risk. We aim to manage the small risk of participant distress about questions on sensitive topics by clearly participant information that the questionnaire covers sensitive topics and there is no obligation to answer these or any other questions, and by providing support organisation links. Results will be disseminated with reports to Government and papers submitted to pre-print servers and peer reviewed journals.Trial registration numberISRCTN11811602; Pre-results.

Dataset Information

Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK).

Background

Methods/design

Publications

Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK).

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