title: School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews.
abstract: OBJECTIVE
  Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches.
  
  
  METHODS
  We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively.
  
  
  RESULTS
  We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective.
  
  
  CONCLUSIONS
  There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying.
authors.affiliation: Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Nichola
authors.initials: N
authors.lastname: Shackleton
authors.affiliation: Department of Social Science, University College London Institute of Education, London, United Kingdom.
authors.forename: Farah
authors.initials: F
authors.lastname: Jamal
authors.affiliation: University College London Institute of Child Health, London, United Kingdom.
authors.forename: Russell M
authors.initials: RM
authors.lastname: Viner
authors.affiliation: Department of Social Science, University College London Institute of Education, London, United Kingdom.
authors.forename: Kelly
authors.initials: K
authors.lastname: Dickson
authors.affiliation: School Of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Patton
authors.affiliation: Department of Social Science, University College London Institute of Education, London, United Kingdom. Electronic address: c.bonell@ioe.ac.uk.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bonell
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D058445:Bullying / Q000517:prevention & control; D005260:Female; D006266:Health Education / Q000379:methods; D006293:Health Promotion; D006801:Humans; D008297:Male; D015397:Program Evaluation; D060728:Reproductive Health / Q000193:education; D012196:Review Literature as Topic; D012572:School Health Services; D012736:Sex Education; D000074606:Smoking Prevention
keywords: Adolescent; Alcohol; Drugs; Schools; Sexual health; Smoking; Systematic reviews; Violence