The effects of schools and school-environment interventions on health: evidence mapping and syntheses

Lead investigator
Professor Chris Bonell, Oxford University
  • Research indicates that UK young people have among the worst health in Europe and there are marked inequalities in health across the social scale, with considerable implications for later health problems and economic costs.
  • Schools can significantly affect the mental and physical health of students and staff (and perhaps parents and the local community). Some ‘school-environment’ (SE) projects try to promote health by changing the way schools are run. Some studies suggest these SE projects can bring benefits for students such as reduced violence and drug use, increased physical activity, and healthy eating. Some research also suggests that, even in the absence of these SE projects, some schools simply have healthier students than others. These differences can’t be explained away simply because the schools admit different sorts of students or are in different sorts of neighbourhoods, but seem to reflect how the schools are run and the quality of relationships between students and staff.
  • The SE approach has been influenced by the World Health Organisation (WHO) framework for ‘health promoting schools’, which addresses school ‘ethos’ (values and priorities), family/community involvement and curriculum.
Aims & objectives
To examine the effects of school environment interventions and of school-level influences on the health and wellbeing of students, staff, parents and the local community, and how this can inform the development and implementation of future interventions.
Study design

Systematic review and stakeholder consultation in two stages:

 Stage 1

Create a descriptive map of available evidence, and  carry out preliminary synthesis of intervention logic models and theories of school-level effects on health. Include studies pertinent to our research questions (RQs) in the following way:

  • RQ 1 – Literature describing/explaining the theories and conceptual frameworks that are used to inform SE interventions or explain school-level influences on health;
  • RQ 2 – Evaluation studies reporting on SE intervention effects on health, as well as cost, economic and econometric studies examining the costs of SE interventions;
  • RQ 3 – Process evaluations of SE interventions;
  • RQ 4 – Multi-level and ecological (school) studies of school-level influences on health;
  • RQ 5 – Qualitative studies exploring the processes by which school-level factors might influence health.
 Stage 2

In-depth reviews and syntheses of evidence addressing our research questions.

Further information & publications
Start date
April 2010
End date
December 2011