Wie wirksam sind schulbasierte Interventionen zur Prävention und/oder Reduktion von Substanzkonsum bei Schülern/-innen in Grund- und Sekundarschulen? Eine systematische Übersicht vorhandener Reviews

OBJECTIVE: The aim of this study is to provide a current overview of the effectiveness of school-based interventions on prevention and/or reduction of substance use among children and adolescents aged 5–19 years. METHODS: A systematic literature search was conducted in PubMed, Cochrane Library, Campbell Collaboration, NICE and ERIC. Systematic reviews and meta-analyses published between 2007 and 2013 were included in the analysis. 2 reviewers assessed the quality of the identified review articles and extracted the data. RESULTS: 14 review articles of moderate to good quality fulfilled the a-priori defined inclusion criteria. Capacity-promoting interventions, e. g., those focusing on strengthening self-confidence and peer resistance, show promising evidence of effectiveness. Multi-component and multi-level interventions are more suitable for the prevention of alcohol and cannabis consumption. Findings on the prevention of tobacco consumption are inconsistent. The effectiveness of knowledge-based interventions is limited. The long-term effectiveness of smoke-free competitions cannot be conclusively evaluated as the findings are discrepant. CONCLUSIONS: School-based interventions should include capacity-promoting components and should address further levels beyond the individual, for example, organisational changes of the school setting. Further research is needed, in particular on the effectiveness of multi-component and multi-level interventions for the prevention of tobacco consumption.ZIEL DER STUDIE: Aktuelle Übersicht über die Wirksamkeit von schulbasierten Interventionen zur Prävention und/oder Reduktion des Substanzkonsums bei Kindern und Jugendlichen zwischen 5 und 19 Jahren. METHODIK: Eine systematische Literaturrecherche wurde in den Datenbanken PubMed, Cochrane Library, Campbell Collaboration, NICE und ERIC durchgeführt. Eingeschlossen wurden systematische Reviews und Meta-Analysen, die zwischen 2007 und 2013 publiziert wurden. 2 Reviewerinnen bewerteten die Qualität der identifizierten Übersichtsarbeiten und extrahierten die Daten. ERGEBNISSE: 14 Übersichtsarbeiten von moderater bis guter Qualität erfüllten die a priori definierten Einschlusskriterien. Fähigkeitsfördernde Interventionen, die z. B. auf eine Stärkung des Selbstbewusstseins und die Peerresistenz abzielen, zeigen vielversprechende Wirksamkeitshinweise. Mehrkomponenten- und Mehrebenen-Interventionen eignen sich vor allem zur Prävention von Alkohol- und Cannabiskonsum. Zur Prävention von Tabakkonsum ist die Studienlage inkonsistent. Die Wirksamkeit von wissensbasierten Interventionen ist begrenzt. Die langfristige Wirksamkeit von Rauchfrei-Wettbewerben ist aufgrund diskrepanter Ergebnisse nicht abschließend zu bewerten. SCHLUSSFOLGERUNGEN: Schulbasierte Interventionen sollten fähigkeitsfördernde Komponenten enthalten und über das Individualverhalten hinaus weitere Ebenen, wie organisationale Veränderungen des Settings Schule, adressieren. Weiterer Forschungsbedarf besteht vor allem zur Wirksamkeit von Mehrkomponenten- und Mehrebenen-Interventionen zur Prävention des Tabakkonsums

What Works in Community-Based Interventions Promoting Physical Activity and Healthy Eating? A Review of Reviews

Chronic diseases, such as type II diabetes, are on the rise worldwide. There is consistent evidence that physical activity and healthy eating are important lifestyle factors which affect the risk for chronic diseases. Community-based interventions are of particular public health interest as they reach target groups in their natural living environment and may thus achieve high population-level impacts. We conducted a systematic literature search to assess the effectiveness of community-based interventions to promote physical activity and healthy eating. Specifically, we searched for promising intervention strategies in this setting. We narratively summarized the results of 18 systematic reviews. Among children and adolescents, we found moderate evidence for effects on weight change in primary school-aged children for interventions containing a school component. The evidence for interventions aimed at general adult populations was inconclusive. Self-monitoring, group-based components, and motivational signs to encourage stair use were identified as promising strategies to increase physical activity. Among adults at risk for type II diabetes, evidence was found for beneficial effects on weight change and diabetes incidence. However, interventions for this group were not integrated in more comprehensive community-based approaches

Retrospective assessment of self-reported exposure to medical ionizing radiation: Results of a feasibility study conducted in Germany

BACKGROUND: Exposure to medical ionizing radiation has been increasing over the past decades and constitutes the largest contributor to overall radiation exposure in the general population. While occupational exposures are generally monitored by national radiation protection agencies, individual data on medical radiation exposure for the general public are not regularly collected. The aim of this study was to determine the feasibility of assessing lifetime medical ionizing radiation exposure from diagnostic and therapeutic procedures retrospectively and prospectively within the framework of the German National Cohort study. METHODS: Retrospective assessment of individual medical radiation exposure was done using an interviewer-based questionnaire among 199 participants (87 men and 112 women) aged 20–69 randomly drawn from the general population at two recruitment locations in Germany. X-ray cards were distributed to 97 participants at one recruitment center to prospectively collect medical radiation exposure over a 6-month period. The Wilcoxon–Mann–Whitney test was used to test differences in self-reported median examination frequencies for the variables age, sex, and recruitment center. To evaluate the self-reported information on radiological procedures, agreement was assessed using health insurance data as gold standard for the time period 2005 to 2010 from 8 participants. RESULTS: Participants reported a median of 7 lifetime X-ray examinations (interquartile range 4–13), and 42% (n = 83) reported having had a CT scan (2, IQR = 1–3). Women reported statistically significant more X-ray examinations than men. Individual frequencies above the 75th percentile (≥15 X-ray examinations) were predominantly observed among women and in individuals >50 years of age. The prospective exposure assessment yielded a 60% return-rate of X-ray cards (n = 58). 16 (28%) of the returned cards reported radiological examinations conducted during the 6-month period but generally lacked more detailed exposure information. X-ray examinations reported for the period for which health insurance data were available provided a moderately valid measure of individual medical radiation exposure. CONCLUSIONS: The assessment of more recent medical examinations seems in the German National Cohort study feasible, whereas lifetime medical radiation exposure appears difficult to assess via self-reports. Health insurance data may be a potentially useful tool for the assessment of individual data on medical radiation exposure both retrospectively and prospectively

Additional file 1: of Retrospective assessment of self-reported exposure to medical ionizing radiation: results of a feasibility study conducted in Germany

Retrospective questionnaire to assess medical radiation exposure within the German National Cohort