From: Impact of school policies on non-communicable disease risk factors – a systematic review
S/No | Study | Year | Country | Study Design | Sample size (n) | Participant Inclusion Criteria | Policy/ Policy Intervention | Outcome/s measured | Quality |
---|---|---|---|---|---|---|---|---|---|
1 | Anthamatten et al. | 2011 | USA | Observational study; case-control | n = 3688 | Participation in Learning Landscape Program; recent schoolyard renovation, the size of the school, and the social and demographic characteristics of the school population. | Physical Activity (learning landscape program)(Renovation of school grounds) | Utilization of school yards for Physical Activity | Weak |
2 | Blum et al. | 2008 | USA | Quasi-experimental | n = 456 students from 7 schools; | Students from grade 9-11 | Elimination from SSB (Diet) and other junk food in schools food policy | Change in students beverage servings/day | Weak |
3 | Covelli et al. | 2008 | USA | Quasi-experimental - Repeated Measures | n = 48 (Intervention = 31; control = 17) | (1) be of African-American ethnicity, (2) be between 14 and 17 years old, (3) be able to read and write in English, (4) have obtained a signed parental/guardian consent form, and (5) have signed a participant assent form. | Integration of health promotion in existing curriculum (Provision of cognitive behavioral components of health knowledge, health promotion concepts, nutrition, and exercise). | Health promotion knowledge, behaviors related to fruit and vegetable intake and exercise; blood pressure | Weak |
4 | Evans-Whipp et al. | 2010 | USA | Cross-sectional | n = 3466 from 285 schools | One class per school was invited to take part in the study. Selected classes were from three-year levels: Grade 5 (age 10), Year 7 (age 12) and Year 9 (age 14). | Existing School tobacco policies (Washington and Victoria) - Comprehensive smoking bans, policy orientation towards abstinence and harm minimization principles, possession of tobacco products among students | Current tobacco use; daily tobacco use; students perception about school smoking | Moderate |
5 | Evans-Whipp et al. | 2013 | USA and Australia | Cross-sectional | n = 1848 | Students from grade 5,7 or 9 | School alcohol policies (IYDS) | Current alcohol use; alcohol use in schools ground | Moderate |
6 | Foster et al. | 2008 | USA | RCT | n = 10 schools; n = 1349 students | Not mentioned | School self-assessment; nutrition education; nutrition policy; social marketing; and parent outreach. | Sales of lower-fat à la carte foods; lower fat food choices; fruit and vegetable intake; Environmental and behavioral perceptions | Strong |
7 | French et al. | 2004 | USA | RCT | n = 20 schools | Presence of an à la carte area in the school cafeteria operated by the school food service; a food service director and principal willing to take part in the study for two school years; an informed consent | School nutrition policy initiative | BMI-SD, height, overweight, obese | Weak |
8 | Fung et al. | 2013 | Canada | Cross-sectional | n = 5215(in 2003); n = 5508(in 2011) | All public schools were invited to participate | School food and nutrition policy (Children’s Lifestyle and School Performance Study-CLASS) | Dietary Status, Nutrient Intake, and Weight Status | Moderate |
9 | Gibson et al. | 2008 | USA | RCT | n = 4905 children (Intervention = 2505 and control = 2400) | Not mentioned | Physical Activity Across the Curriculum(PACC) - 90 mins moderate intensity physical activity delivered as part of academic instruction | Physical activity level | Weak |
10 | Hamilton et al. | 2005 | Australia | RCT | n = 4636 adolescents from 30 government high schools | Not mentioned | School-based smoking intervention(The Smoking Cessation for Youth Project-SCYP) - Curricular, parent, nurse counselling cessation support and policy components | The primary outcome variable was regular smoking(smoking on 4 or more days in the previous week) and the more traditional measure of ‘current smoking’ within the last 30 days was used for secondary analyses | Strong |
11 | Llargues et al. | 2011 | Spain | RCT | 509 (Control: 237, Intervention: 272) | All the children born in 2000 who attended any of the schools in Granollers were eligible to participate | Teacher Training, Develop activities related to food habits and/or physical activity | Primary outcome: Difference in BMI progression Secondary outcomes: changes in eating habits and in physical activity | Strong |
12 | Knox et al. | 2012 | Australia | Quasi-experimental | 182 pupils attending year (n = 115 Inter; 77 control) | Not mentioned | Physical Activity - Brisk Walking Lessons | Adiposity variables, BP, lipids, lipoproteins, glucose, insulin, high sensitivity C-reactive protein, high molecular weight adenopectin, aerobic fitness, physical activity behavior and diet | Weak |
13 | Jhonson et al. | 2009 | USA | Cross-sectional | n = 9151 students from 64 middle schools | All public schools that enroll seventh-grade students and participate in USDA school meal programs were eligible to participate | School district SSB policies | exposure of SSB and student consumption of SSB during the school days; school district policies about SSB and exposure to SSB in schools | Moderate |
14 | Lovato et al. | 2006 | USA | Cross-sectional | n = 522,318 students from 81 secondary schools | Not mentioned | School/ District tobacco control policies - scale for prohibition, strength, and characteristics of enforcement. Seven policy components: developing, overseeing and communicating the policy, purpose, and goals, prohibition, strength of enforcement, tobacco use prevention education and assistance to overcome tobacco addictions (Perception of policy) | Student smoking | Weak |
15 | Manios et al. | 1999 | Greece | RCT | n = 4171 students (Intervention); n = 1510 students (control) | All students in the first grade of selected schools | Multicomponent workbooks covering dietary issues, physical activity and fitness, dental health hygiene, smoking and accident prevention | Health Knowledge, Dietary, Physical Activity, Fitness, Anthropometric Measurements, Biochemical Indices | Moderate |
16 | Moore and Tapper | 2008 | UK | Randomized controlled trial | 43 primary schools | The school was excluded if existing tuck shop, selling any food | Fruit Truck Shops | Purchase and Intake of Fruits | Moderate |
17 | Murnaghan et al. | 2008 | Canada | Cross-Sectional | n = 4709 grade 10 students | Not mentioned | Policy banning smoking in school property participated in provincially directed school-based smoking prevention program | Occasional and Current Smoking | Weak |
18 | O Brien et al. | 2010 | USA | Cross-Sectional | n = 80,428 students in 328 schools across the state of Maine. n = 123 intervention;205 non-intervention schools | Not mentioned | Comprehensive school health education, physical education and physical activity, school nutrition and food services, health promotion and wellness, school counselling physical and behavioral health services, school climate, physical environment, youth, parent, family and community involvement | Behavior change: physical activity, nutrition, and tobacco use | Weak |
19 | Paek et al. | 2013 | USA | Cross-Sectional | n = 983; 14 schools | All regular public schools containing grades 9, 10, 11, or 12 were included in the sampling frame | Tobacco-free school policy | Frequency of smoking | Weak |
20 | Patel et al. | 2012 | India | Cross-Sectional | n = 172 students from 2 schools | Male adolescents (aged 13-15 yrs.) not meeting the age criteria were excluded | Tobacco promotion and availability around schools | Current smoking and smokeless tobacco use | Weak |
21 | Schwartz et al. | 2009 | USA | Quasi- Experimental | Not mentioned | Removal of snacks of low nutritional value | Intake of beverages, salty snacks and sweet snacks | Weak | |
22 | Spence et al. | 2013 | UK | Natural Experiment | n = 385 [2003–4]; n = 632 [2008–9] | Not mentioned | Nutrient-based standards | Mean daily intakes of macro & micro nutrients in school lunch packed lunch and total diet | Weak |
23 | Vandongen et al. | 1995 | USA | Cross-Sectional | 1147 students from 30 schools | Not mentioned | Fitness, fitness + school nutrition, school-based nutrition, school + home nutrition, home-based nutrition | BP, Dietary Intake, 1.6 km run and Leger shuttle run, anthropometric measurements (subscapular skinfold) BMI, percentage fat | Weak |
24 | Raczynski et al. | 2009 | Australia | RCT | n = 2202 | Not mentioned | Comprehensive legislation to combat obesity | BMI | Weak |
25 | Harris et al. | 1997 | USA | Quasi- Experimental | n = 170 | Not mentioned | Modified school lunches, Enhanced nutrition education and increased opportunities for physical activities | Calorie intake, Physical fitness assessment, Knowledge, skills and attitudes related to nutrition and physical fitness | Weak |
26 | Holt et al. | 2013 | USA | Quasi- Experimental | Four elementary schools(grade k-5; 68 classroom teachers; 1284 students | Not mentioned | District mandated Physical Activity Policy (20 min) | The level of intensity of physical activity | Weak |
27 | Jaenke et al. | 2012 | Australia | Quasi- Experimental | n = 127 children (11-12 years) | Eligibility for participation in the study was for students to be enrolled in school Grades 5 or 6. | Nutrition education, gardening program | Food preference assessment, fruit and vegetable intake | Weak |