Coordinated School Health Programs and Academic Achievement: A Systematic Review of the Literature
Abstract
Background: Few evaluations of school health programs measure academic outcomes. K‐12 education needs evidence for academic achievement to implement school programs. This article presents a systematic review of the literature to examine evidence that school health programs aligned with the Coordinated School Health Program (CSHP) model improve academic success. Methods: A multidisciplinary panel of health researchers searched the literature related to academic achievement and elements of the CSHP model (health services, counseling/social services, nutrition services, health promotion for staff, parent/family/community involvement, healthy school environment, physical education, and health education) to identify scientifically rigorous studies of interventions. Study designs were classified according to the analytic framework provided in the Guide developed by the Community Preventive Services Task Force. Results: The strongest evidence from scientifically rigorous evaluations exists for a positive effect on some academic outcomes from school health programs for asthmatic children that incorporate health education and parental involvement. Strong evidence also exists for a lack of negative effects of physical education programs on academic outcomes. Limited evidence from scientifically rigorous evaluations support the effect of nutrition services, health services, and mental health programs, but no such evidence is found in the literature to support the effect of staff health promotion programs or school environment interventions on academic outcomes. Conclusions: Scientifically rigorous evaluation of school health programs is challenging to conduct due to issues related to sample size, recruitment, random assignment to condition, implementation fidelity, costs, and adequate follow‐up time. However, school health programs hold promise for improving academic outcomes for children.
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Previous reviews have found limited evidence of SBHC effectiveness in improving healthcare utilization and academic outcomes.
“Previous reviews have found limited evidence of SBHC effectiveness in improving healthcare utilization and academic outcomes.19,37–41”
From School-Based Health Centers to Advance Health Equity (2016) · cites this paper as [38]
The association between mental health and counseling services and decreased absenteeism and tardiness is inconsistent.
“Inconsistent association between mental health and counseling services and decreased absenteeism and tardiness.”
From Critical connections: health and academics (2015) · cites this paper as [26]
Students with asthma have lower cognitive performance and increased school absenteeism.
“Students with asthma have been shown to have lower cognitive performance and increased school absenteeism.26,32,58,59”
From Critical connections: health and academics (2015) · cites this paper as [26]
Nine programs that included a health education component increased academic grades and test scores, decreased school absences, improved student behavior, and reduced school dropout.
“9 programs that included a health education component increased academic grades and test scores, decreased school absences, improved student behavior, and reduced school dropout.26”
From Critical connections: health and academics (2015) · cites this paper as [26]
Student participation in school breakfast programs such as the USDA School Breakfast Program is associated with increased academic grades and standardized test scores, reduced absenteeism, and improved cognitive function.
“student participation in school breakfast programs such as the US Department of Agriculture's School Breakfast Program has been shown to be associated with increased academic grades and standardized test scores, reduced absenteeism, and improved cognitive function,26,39,41,44,46”
From Critical connections: health and academics (2015) · cites this paper as [26]
Breakfast consumption has small, positive associations with different academic outcomes including cognitive performance and attendance.
“These reviews generally found small, positive associations between breakfast consumption and different academic outcomes including cognitive performance and attendance.”
From Critical connections: health and academics (2015) · cites this paper as [26]
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- Authors
- Murray, N. G., Low, B. J., Hollis, C., Cross, A. W., & Davis, S. M.
- Affiliations
- University of Northern British Columbia (CA)
- University of New Mexico (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Murray, Nancy G.
- ORCID
- Davis, Sally M.
- Venue
- Journal of School Health
- Publisher
- Wiley
- Published
- 2007-10-26
- Volume
- 77
- Issue
- 9
- Pages
- 589-600
- ISSN
- 0022-4391 (ISSN-L)
- 1746-1561
- OpenAlex
- W2110109512
- Cited by
- 251
- References
- 44
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 11 · 2021: 16 · 2020: 16 · 2019: 10 · 2018: 13 · 2017: 20 · 2016: 16 · 2015: 24 · 2014: 24 · 2013: 17 · 2012: 15
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of School Health (publishedVersion)
- PubMed (publishedVersion)
- UNM’s Digital Repository (University of New Mexico) (submittedVersion)
- Funders
- U.S. Public Health Service (U48CCU609653, U48/CCU61081807)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
- Keywords
- coordinated school health programs, academic performance, school health programs, health education, parental involvement, physical education, nutrition services, asthma, school-based mental health services, school environment, program evaluation, K-12 education
- MeSH terms
- Asthma, Child, Child Health Services, Child Welfare, Educational Status, Female, Health Education, Humans, Interpersonal Relations, Male, Mental Health Services, Physical Education and Training, School Health Services
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