Study designs of evaluations included in the review
All study designs were eligible for inclusion.
Specific interventions included in the review
Relevant interventions were cardiovascular health promotion programmes aimed at children. The interventions evaluated in the studies included in the review were divided into three categories as follows.
School-based behavioural interventions: these included a rap contest, nursing classroom presentations, and social influences resistance training.
School-based behavioural interventions with the addition of family and/or community involvement: these included classroom curricula, health screening for children and parents, and home- and school-based programmes.
Studies that examined various influences on health, independent of the education system: these included community education and correlational studies regarding health attitudes and behaviours.
Participants included in the review
Elementary school children were eligible for inclusion.
The participants ranged in grade level from one to eight, with fifth-graders being evaluated most often (14 of the 22 studies included in the review). Of the 22 studies included in the review, 13 provided information on ethnicity, with African-Americans and Caucasians studied almost equally. Asian-Americans and American Indians were stated as being under-represented in less than 10% of the samples. The socioeconomic class of the participants varied, but there was a predominance of middle-class participants. The distribution of girls and boys was equal. The study locations included the major regions of the USA, Canada and Australia. Details of the participants' age and gender, and study location were not provided for each study.
Outcomes assessed in the review
Studies reporting cardiovascular risk factor reduction behaviours were eligible for inclusion. The main outcomes reported in the review included health behaviours, health knowledge and physiologic measures (serum cholesterol, saliva analysis, serum thiocynate, lung capacity, and urine for sodium or potassium assessment).
How were decisions on the relevance of primary studies made?
The author did not state how the papers were selected for the review, or how many reviewers performed the selection.