E-poster Presentation 2014 World Cancer Congress

Impact of school policies on NCD risk factors – A systematic review (#1178)

Tina Rawal 1 , Ankur Singh 1 , Gaurang Nazar 1 , Kiran Saluja 1 , shalini Bassi 1 , MinHae Park 2 , Monika Arora 1
  1. Public Health Foundation of India, Delhi, DELHI, India
  2. London School of Hygiene and Tropical Medicine, London, United Kingdom

Background: A set of modifiable lifestyle behaviours (unhealthy diet, physical inactivity, tobacco and alcohol use) are common risk factors for major non-communicable diseases (NCDs), including several types of cancer. These behaviours are largely adopted from a young age. The school setting has been recognized as having great potential for inculcating healthy lifestyle habits among children and adolescents.

Aim:To identify, systematically analyze and collate the existing literature on the impact of school policies on health related behaviours (unhealthy diet, physical inactivity, tobacco and alcohol use).

Methods: A systematic review of peer-reviewed literature from 1990 to 2014 (January) was undertaken using Medline (Ovid), EMBASE and Web of Science search engines. Inclusion criteria included school children or adolescents between the age-group of 6 – 18 years, experimental or observational study design. Data were double extracted using a pre-piloted form. The outcomes (health related behaviours) and effect measures were assessed for different school policies. Due to variations in the effect measures used and the different assessments of behavioural outcomes, a narrative synthesis of the data was considered appropriate.

Results: Overall, 28 studies were included in the review; 18 were intervention studies and 10 were observational studies. In total, 7 studies assessed the effect of combined nutrition and physical activity policy interventions, 1 focused on school alcohol policies, 1 focused on comprehensive legislation to combat obesity and others focused individually on nutrition (8), physical activity (4) and tobacco control policies (7). The policy interventions varied greatly in the identified studies. Irrespective of the non-uniformity of the outcome measures and the effect estimates, results consistently showed effectiveness of policy interventions in reduction of NCD risk factors.

Conclusions: This review suggests that school policy interventions targeting behavioural risk factors at a young age could play a role in the effective prevention and control of NCDs.