Strategies for enhancing the implementation of school‐based policies or practices targeting risk factors for chronic disease

Luke Wolfenden; Nicole K Nathan; Rachel Sutherland; Sze Lin Yoong; Rebecca K Hodder; Rebecca J Wyse; Tessa Delaney; Alice Grady; Alison Fielding; Flora Tzelepis; Tara Clinton‐McHarg; Benjamin Parmenter; Peter Butler; John Wiggers; Adrian Bauman; Andrew Milat; Debbie Booth; Christopher M Williams

doi:10.1002/14651858.CD011677.pub2

Estrategias para la mejoría de la implementación de políticas o prácticas escolares dirigidas a los factores de riesgo de enfermedades crónicas

Appendices

Appendix 1. Search Strategy

MEDLINE search strategy

#	Searches
1	schools/
2	((primary or elementary or middle or junior or high or secondary) adj (school* or student*)).mp.
3	kinder*.mp.
4	1 or 2 or 3
5	implement*.tw.
6	dissemination.tw.
7	adopt*.tw.
8	practice.tw.
9	organi?ational change*.tw.
10	diffusion.tw.
11	system* change*.tw.
12	quality improvement*.tw.
13	transformation.tw.
14	translation.tw.
15	transfer.tw.
16	uptake.tw.
17	sustainab*.tw.
18	institutionali*.tw.
19	routin*.tw.
20	maintenance.tw.
21	capacity.tw.
22	incorporation.tw.
23	adherence.tw.
24	program*.tw.
25	integration.tw.
26	scal* up.tw.
27	5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26
28	exp Obesity/
29	Weight Gain/
30	exp Weight Loss/
31	obes*.tw.
32	(weight gain or weight loss).tw.
33	(overweight or over weight or overeat* or over eat*).tw.
34	weight change*.tw.
35	((bmi or body mass index) adj2 (gain or loss or change)).tw.
36	exp Primary Prevention/
37	(primary prevention or secondary prevention).tw.
38	(preventive measure* or preventative measure*).tw.
39	(preventive care or preventative care).tw.
40	(obes* adj2 (prevent* or treat*)).tw.
41	28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40
42	exp Exercise/
43	physical activity.tw.
44	physical inactivity.tw.
45	exp Motor Activity/
46	(physical education and training).tw.
47	exp "Physical Education and Training"/
48	Physical Fitness/
49	sedentary.tw.
50	exp Life Style/
51	exp Leisure Activities/
52	exp Sports/
53	Dancing/
54	dancing.tw.
55	(exercise* adj aerobic*).tw.
56	sport*.tw.
57	((lifestyle* or life style) adj5 activ).tw.
58	42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57
59	exp Diet/
60	nutrition*.tw.
61	healthy eating.tw.
62	Child Nutrition Sciences/
63	fruit*.tw.
64	vegetable*.tw.
65	canteen*.tw.
66	food service*.tw.
67	menu*.tw.
68	calorie*.tw.
69	Energy Intake/
70	energy density.tw.
71	Eating/
72	Feeding Behavior/ or feeding behaviour.mp.
73	dietary intake.tw.
74	Food Habits/
75	Food/
76	Carbonated Beverages/ or soft drink*.mp.
77	soda.tw.
78	sweetened drink*.tw.
79	Dietary Fats, Unsaturated/ or Dietary Fats/
80	confectionar*.tw.
81	(school adj (lunch* or meal*)).tw.
82	menu plan*.tw.
83	((feeding or food or nutrition) adj program).tw.
84	cafeteria*.tw.
85	Nutritional Status/
86	59 or 60 or 61 or 62 or 63 or 64 or 65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85
87	exp Smoking/
88	exp "Tobacco Use Cessation"/
89	smok*.tw.
90	Nicotine/
91	Tobacco/ or "Tobacco Use"/
92	((ceas* or cess* or prevent* or stop* or quit* or abstin* or abstain* or reduc) adj5 (smok or tobacco or nicotine)).tw.
93	"Tobacco Use Disorder"/
94	ex‐smoker*.tw.
95	anti‐smok*.tw.
96	87 or 88 or 89 or 90 or 91 or 92 or 93 or 94 or 95
97	alcohol drinking/ or binge drinking/
98	alcohol*.tw.
99	Alcoholic Intoxication/ or Alcoholism/
100	drink*.tw.
101	liquor*.tw.
102	beer*.tw.
103	wine*.tw.
104	spirit*.tw.
105	drunk*.tw.
106	intoxicat*.tw.
107	binge.tw.
108	97 or 98 or 99 or 100 or 101 or 102 or 103 or 104 or 105 or 106 or 107
109	41 or 58 or 86 or 96 or 108
110	Randomized Controlled Trial/
111	clinical trial/ or controlled clinical trial/
112	random allocation/
113	Double‐Blind Method/
114	Single‐Blind Method/
115	placebos/
116	Research Design/
117	Intervention Studies/
118	Evaluation Studies/
119	Comparative Study/
120	exp Longitudinal Studies/
121	Cross‐Over Studies/
122	clinical trial.tw.
123	latin square.tw.
124	(time adj series).tw.
125	(before adj2 after adj3 (stud* or trial* or design*)).tw.
126	((singl* or doubl* or trebl* or tripl) adj5 (blind or mark)).tw.
127	placebo*.tw.
128	random*.tw.
129	(matched adj (communit* or school* or population*)).tw.
130	control*.tw.
131	(comparison group* or control group*).tw.
132	matched pairs.tw.
133	outcome stud*.tw.
134	(quasiexperimental or quasi experimental or pseudo experimental).tw.
135	(nonrandomi?ed or non randomi?ed or psuedo randomi?ed or quasi randomi?ed).tw.
136	prospectiv*.tw.
137	volunteer*.tw.
138	110 or 111 or 112 or 113 or 114 or 115 or 116 or 117 or 118 or 119 or 120 or 121 or 122 or 123 or 124 or 125 or 126 or 127 or 128 or 129 or 130 or 131 or 132 or 133 or 134 or 135 or 136 or 137
139	4 and 27 and 109 and 138
140	limit 139 to ("child (6 to 12 years)" or "adolescent (13 to 18 years)")

Embase Classic and Embase search strategy

#	Searches
1	schools/
2	((primary or elementary or middle or junior or high or secondary) adj (school* or student*)).mp.
3	kinder*.mp.
4	1 or 2 or 3
5	implement*.tw.
6	dissemination.tw.
7	adopt*.tw.
8	practice.tw.
9	organi?ational change*.tw.
10	diffusion.tw.
11	system* change*.tw.
12	quality improvement*.tw.
13	transformation.tw.
14	translation.tw.
15	transfer.tw.
16	uptake.tw.
17	sustainab*.tw.
18	institutionali*.tw.
19	routin*.tw.
20	maintenance.tw.
21	capacity.tw.
22	incorporation.tw.
23	adherence.tw.
24	program*.tw.
25	integration.tw.
26	scal* up.tw.
27	5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26
	exp Obesity/
29	Weight Gain/
30	exp Weight Loss/
31	obes*.tw.
32	(weight gain or weight loss).tw.
33	(overweight or over weight or overeat* or over eat*).tw.
34	weight change*.tw.
35	((bmi or body mass index) adj2 (gain or loss or change)).tw.
36	exp Primary Prevention/
37	(primary prevention or secondary prevention).tw.
38	(preventive measure* or preventative measure*).tw.
39	(preventive care or preventative care).tw.
40	(obes* adj2 (prevent* or treat*)).tw.
41	28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40
42	exp Exercise/
43	physical activity.tw.
44	physical inactivity.tw.
45	exp Motor Activity/
46	(physical education and training).tw.
47	exp "Physical Education and Training"/
48	Physical Fitness/
49	sedentary.tw.
50	exp Life Style/
51	exp Leisure Activities/
52	exp Sports/
53	Dancing/
54	dancing.tw.
55	(exercise* adj aerobic*).tw.
56	sport*.tw.
57	((lifestyle* or life style) adj5 activ).tw.
58	42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57
59	exp Diet/
60	nutrition*.tw.
61	healthy eating.tw.
62	Child Nutrition Sciences/
63	fruit*.tw.
64	vegetable*.tw.
65	canteen*.tw.
66	food service*.tw.
67	menu*.tw.
68	calorie*.tw.
69	Energy Intake/
70	energy density.tw.
71	Eating/
72	Feeding Behavior/ or feeding behaviour.mp.
73	dietary intake.tw.
74	Food Habits/
75	Food/
76	Carbonated Beverages/ or soft drink*.mp.
77	soda.tw.
78	sweetened drink*.tw.
79	Dietary Fats, Unsaturated/ or Dietary Fats/
80	confectionar*.tw.
81	(school adj (lunch* or meal*)).tw.
82	menu plan*.tw.
83	((feeding or food or nutrition) adj program).tw.
84	cafeteria*.tw.
85	Nutritional Status/
86	59 or 60 or 61 or 62 or 63 or 64 or 65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85
87	exp Smoking/
88	exp "Tobacco Use Cessation"/
89	smok*.tw.
90	Nicotine/
91	Tobacco/ or "Tobacco Use"/
92	((ceas* or cess* or prevent* or stop* or quit* or abstin* or abstain* or reduc) adj5 (smok or tobacco or nicotine)).tw.
93	"Tobacco Use Disorder"/
94	ex‐smoker*.tw.
95	anti‐smok*.tw.
96	87 or 88 or 89 or 90 or 91 or 92 or 93 or 94 or 95
97	alcohol drinking/ or binge drinking/
98	alcohol*.tw.
99	Alcoholic Intoxication/ or Alcoholism/
100	drink*.tw.
101	liquor*.tw.
102	beer*.tw.
103	wine*.tw.
104	spirit*.tw.
105	drunk*.tw.
106	intoxicat*.tw.
107	binge.tw.
108	97 or 98 or 99 or 100 or 101 or 102 or 103 or 104 or 105 or 106 or 107
109	41 or 58 or 86 or 96 or 108
110	Randomized Controlled Trial/
111	clinical trial/ or controlled clinical trial/
112	random allocation/
113	Double‐Blind Method/
114	Single‐Blind Method/
115	placebos/
116	Research Design/
117	Intervention Studies/
118	Evaluation Studies/
119	Comparative Study/
120	exp Longitudinal Studies/
121	Cross‐Over Studies/
122	clinical trial.tw.
123	latin square.tw.
124	(time adj series).tw.
125	(before adj2 after adj3 (stud* or trial* or design*)).tw.
126	((singl* or doubl* or trebl* or tripl) adj5 (blind or mark)).tw.
127	placebo*.tw.
128	random*.tw.
129	(matched adj (communit* or school* or population*)).tw.
130	control*.tw.
131	(comparison group* or control group*).tw.
132	matched pairs.tw.
133	outcome stud*.tw.
134	(quasiexperimental or quasi experimental or pseudo experimental).tw.
135	(nonrandomi?ed or non randomi?ed or psuedo randomi?ed or quasi randomi?ed).tw.
136	prospectiv*.tw.
137	volunteer*.tw.
138	110 or 111 or 112 or 113 or 114 or 115 or 116 or 117 or 118 or 119 or 120 or 121 or 122 or 123 or 124 or 125 or 126 or 127 or 128 or 129 or 130 or 131 or 132 or 133 or 134 or 135 or 136 or 137
139	4 and 27 and 109 and 138
140	limit 139 to (school child <7 to 12 years> or adolescent <13 to 17 years>)

MEDLINE In‐Process & Other Non‐Indexed Citations Search Strategy

#	Searches
1	schools/
2	((primary or elementary or middle or junior or high or secondary) adj (school* or student*)).mp.
3	kinder*.mp.
4	1 or 2 or 3
5	implement*.tw.
6	dissemination.tw.
7	adopt*.tw.
8	practice.tw.
9	organi?ational change*.tw.
10	diffusion.tw.
11	system* change*.tw.
12	quality improvement*.tw.
13	transformation.tw.
14	translation.tw.
15	transfer.tw.
16	uptake.tw.
17	sustainab*.tw.
18	institutionali*.tw.
19	routin*.tw.
20	maintenance.tw.
21	capacity.tw.
22	incorporation.tw.
23	adherence.tw.
24	program*.tw.
25	integration.tw.
26	scal* up.tw.
27	5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26
28	exp Obesity/
29	Weight Gain/
30	exp Weight Loss/
31	obes*.tw.
32	(weight gain or weight loss).tw.
33	(overweight or over weight or overeat* or over eat*).tw.
34	weight change*.tw.
35	((bmi or body mass index) adj2 (gain or loss or change)).tw.
36	exp Primary Prevention/
37	(primary prevention or secondary prevention).tw.
38	(preventive measure* or preventative measure*).tw.
39	(preventive care or preventative care).tw.
40	(obes* adj2 (prevent* or treat*)).tw.
41	28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40
42	exp Exercise/
43	physical activity.tw.
44	physical inactivity.tw.
45	exp Motor Activity/
46	(physical education and training).tw.
47	exp "Physical Education and Training"/
48	Physical Fitness/
49	sedentary.tw.
50	exp Life Style/
51	exp Leisure Activities/
52	exp Sports/
53	Dancing/
54	dancing.tw.
55	(exercise* adj aerobic*).tw.
56	sport*.tw.
57	((lifestyle* or life style) adj5 activ).tw.
58	42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57
59	exp Diet/
60	nutrition*.tw.
61	healthy eating.tw.
62	Child Nutrition Sciences/
63	fruit*.tw.
64	vegetable*.tw.
65	canteen*.tw.
66	food service*.tw.
67	menu*.tw.
68	calorie*.tw.
69	Energy Intake/
70	energy density.tw.
71	Eating/
72	Feeding Behavior/ or feeding behaviour.mp.
73	dietary intake.tw.
74	Food Habits/
75	Food/
76	Carbonated Beverages/ or soft drink*.mp.
77	soda.tw.
78	sweetened drink*.tw.
79	Dietary Fats, Unsaturated/ or Dietary Fats/
80	confectionar*.tw.
81	(school adj (lunch* or meal*)).tw.
82	menu plan*.tw.
83	((feeding or food or nutrition) adj program).tw.
84	cafeteria*.tw.
85	Nutritional Status/
86	59 or 60 or 61 or 62 or 63 or 64 or 65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85
87	exp Smoking/
88	exp "Tobacco Use Cessation"/
89	smok*.tw.
90	Nicotine/
91	Tobacco/ or "Tobacco Use"/
92	((ceas* or cess* or prevent* or stop* or quit* or abstin* or abstain* or reduc) adj5 (smok or tobacco or nicotine)).tw.
93	"Tobacco Use Disorder"/
94	ex‐smoker*.tw.
95	anti‐smok*.tw.
96	87 or 88 or 89 or 90 or 91 or 92 or 93 or 94 or 95
97	alcohol drinking/ or binge drinking/
98	alcohol*.tw.
99	Alcoholic Intoxication/ or Alcoholism/
100	drink*.tw.
101	liquor*.tw.
102	beer*.tw.
103	wine*.tw.
104	spirit*.tw.
105	drunk*.tw.
106	intoxicat*.tw.
107	binge.tw.
108	97 or 98 or 99 or 100 or 101 or 102 or 103 or 104 or 105 or 106 or 107
109	41 or 58 or 86 or 96 or 108
110	Randomized Controlled Trial/
111	clinical trial/ or controlled clinical trial/
112	random allocation/
113	Double‐Blind Method/
114	Single‐Blind Method/
115	placebos/
116	Research Design/
117	Intervention Studies/
118	Evaluation Studies/
119	Comparative Study/
120	exp Longitudinal Studies/
121	Cross‐Over Studies/
122	clinical trial.tw.
123	latin square.tw.
124	(time adj series).tw.
125	(before adj2 after adj3 (stud* or trial* or design*)).tw.
126	((singl* or doubl* or trebl* or tripl) adj5 (blind or mark)).tw.
127	placebo*.tw.
128	random*.tw.
129	(matched adj (communit* or school* or population*)).tw.
130	control*.tw.
131	(comparison group* or control group*).tw.
132	matched pairs.tw.
133	outcome stud*.tw.
134	(quasiexperimental or quasi experimental or pseudo experimental).tw.
135	(nonrandomi?ed or non randomi?ed or psuedo randomi?ed or quasi randomi?ed).tw.
136	prospectiv*.tw.
137	volunteer*.tw.
138	110 or 111 or 112 or 113 or 114 or 115 or 116 or 117 or 118 or 119 or 120 or 121 or 122 or 123 or 124 or 125 or 126 or 127 or 128 or 129 or 130 or 131 or 132 or 133 or 134 or 135 or 136 or 137
139	4 and 27 and 109 and 138
140	(exercis* or diet* or physical fitness or energy intake or food* or fat* or tobacco).tw.
141	109 or 140
142	(randomi?ed controlled trial* or single blind method or placebo* or research design or intervention stud* or cross over stud*).tw.
143	138 or 142
144	4 and 27 and 141 and 143

Age limits are not applied to Medline In Process records

PsycINFO search strategy

#	Searches
1	schools/
2	((primary or elementary or middle or junior or high or secondary) adj (school* or student*)).mp.
3	kinder*.mp.
4	1 or 2 or 3
5	implement*.tw.
6	dissemination.tw.
7	adopt*.tw.
8	practice.tw.
9	organi?ational change*.tw.
10	diffusion.tw.
11	system* change*.tw.
12	quality improvement*.tw.
13	transformation.tw.
14	translation.tw.
15	transfer.tw.
16	uptake.tw.
17	sustainab*.tw.
18	institutionali*.tw.
19	routin*.tw.
20	maintenance.tw.
21	capacity.tw.
22	incorporation.tw.
23	adherence.tw.
24	program*.tw.
25	integration.tw.
26	scal* up.tw.
27	5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26
28	exp Obesity/
29	Weight Gain/
30	exp Weight Loss/
31	obes*.tw.
32	(weight gain or weight loss).tw.
33	(overweight or over weight or overeat* or over eat*).tw.
34	weight change*.tw.
35	((bmi or body mass index) adj2 (gain or loss or change)).tw.
36	exp Primary Prevention/
37	(primary prevention or secondary prevention).tw.
38	(preventive measure* or preventative measure*).tw.
39	(preventive care or preventative care).tw.
40	(obes* adj2 (prevent* or treat*)).tw.
41	28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40
42	exp Exercise/
43	physical activity.tw.
44	physical inactivity.tw.
45	exp Motor Activity/
46	(physical education and training).tw.
47	exp "Physical Education and Training"/
48	Physical Fitness/
49	sedentary.tw.
50	exp Life Style/
51	exp Leisure Activities/
52	exp Sports/
53	Dancing/
54	dancing.tw.
55	(exercise* adj aerobic*).tw.
56	sport*.tw.
57	((lifestyle* or life style) adj5 activ).tw.
58	42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57
59	exp Diet/
60	nutrition*.tw.
61	healthy eating.tw.
62	Child Nutrition Sciences/
63	fruit*.tw.
64	vegetable*.tw.
65	canteen*.tw.
66	food service*.tw.
67	menu*.tw.
68	calorie*.tw.
69	Energy Intake/
70	energy density.tw.
71	Eating/
72	Feeding Behavior/ or feeding behaviour.mp.
73	dietary intake.tw.
74	Food Habits/
75	Food/
76	Carbonated Beverages/ or soft drink*.mp.
77	soda.tw.
78	sweetened drink*.tw.
79	Dietary Fats, Unsaturated/ or Dietary Fats/
80	confectionar*.tw.
81	(school adj (lunch* or meal*)).tw.
82	menu plan*.tw.
83	((feeding or food or nutrition) adj program).tw.
84	cafeteria*.tw.
85	Nutritional Status/
86	59 or 60 or 61 or 62 or 63 or 64 or 65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85
87	exp Smoking/
88	exp "Tobacco Use Cessation"/
89	smok*.tw.
90	Nicotine/
91	Tobacco/ or "Tobacco Use"/
92	((ceas* or cess* or prevent* or stop* or quit* or abstin* or abstain* or reduc) adj5 (smok or tobacco or nicotine)).tw.
93	"Tobacco Use Disorder"/
94	ex‐smoker*.tw.
95	anti‐smok*.tw.
96	87 or 88 or 89 or 90 or 91 or 92 or 93 or 94 or 95
97	alcohol drinking/ or binge drinking/
98	alcohol*.tw.
99	Alcoholic Intoxication/ or Alcoholism/
100	drink*.tw.
101	liquor*.tw.
102	beer*.tw.
103	wine*.tw.
104	spirit*.tw.
105	drunk*.tw.
106	intoxicat*.tw.
107	binge.tw.
108	97 or 98 or 99 or 100 or 101 or 102 or 103 or 104 or 105 or 106 or 107
109	41 or 58 or 86 or 96 or 108
110	Randomized Controlled Trial/
111	clinical trial/ or controlled clinical trial/
112	random allocation/
113	Double‐Blind Method/
114	Single‐Blind Method/
115	placebos/
116	Research Design/
117	Intervention Studies/
118	Evaluation Studies/
119	Comparative Study/
120	exp Longitudinal Studies/
121	Cross‐Over Studies/
122	clinical trial.tw.
123	latin square.tw.
124	(time adj series).tw.
125	(before adj2 after adj3 (stud* or trial* or design*)).tw.
126	((singl* or doubl* or trebl* or tripl) adj5 (blind or mark)).tw.
127	placebo*.tw.
128	random*.tw.
129	(matched adj (communit* or school* or population*)).tw.
130	control*.tw.
131	(comparison group* or control group*).tw.
132	matched pairs.tw.
133	outcome stud*.tw.
134	(quasiexperimental or quasi experimental or pseudo experimental).tw.
135	(nonrandomi?ed or non randomi?ed or psuedo randomi?ed or quasi randomi?ed).tw.
136	prospectiv*.tw.
137	volunteer*.tw.
138	110 or 111 or 112 or 113 or 114 or 115 or 116 or 117 or 118 or 119 or 120 or 121 or 122 or 123 or 124 or 125 or 126 or 127 or 128 or 129 or 130 or 131 or 132 or 133 or 134 or 135 or 136 or 137
139	4 and 27 and 109 and 138
140	4 and 27 and 109
141	(diet* or energy intake or food habits or fat).tw.
142	randomi?ed controlled trial*.tw.
143	109 or 141
144	138 or 142
145	4 and 27 and 143 and 144
146	limit 145 to (180 school age or 200 adolescence )

CINAHL Search Strategy

#	Query
S139	S4 AND S27 AND S110 AND S138 Limiters ‐ Age Groups: Child: 6‐12 years, Adolescent: 13‐18 years
S138	S111 OR S112 OR S113 OR S114 OR S115 OR S116 OR S117 OR S118 OR S119 OR S120 OR S121 OR S122 OR S123 OR S124 OR S125 OR S126 OR S127 OR S128 OR S129 OR S130 OR S131 OR S132 OR S133 OR S134 OR S135 OR S136 OR S137
S137	AB volunteer*
S136	AB prospectiv*
S135	(nonrandomised or nonrandomized or non randomized or non randomised or psuedo randomised or psuedo randomized or quasi randomised or quasi randomized
S134	AB quasiexperimental or quasi experimental or pseudo experimental
S133	AB outcome stud*
S132	AB matched pairs
S131	AB (comparison group* or control group*)
S130	AB control*
S129	(matched n1 (communit* or school* or population*))
S128	AB random*
S127	AB placebo*
S126	((singl* or doubl* or trebl* or tripl) n5 (blind or mark))
S125	(before n2 after n3 (stud* or trial* or design*))
S124	(MH "Time Series")
S123	"latin square"
S122	AB clinical trial*
S121	(MH "Crossover Design") OR "Cross‐Over Studies"
S120	(MH "Prospective Studies") OR "Longitudinal Studies"
S119	(MH "Comparative Studies")
S118	(MH "Evaluation Research") OR "Evaluation Studies"
S117	(MH "Experimental Studies") OR "Intervention Studies"
S116	(MH "Study Design")
S115	(MH "Placebos")
S114	(MH "Single‐Blind Studies")
S113	(MH "Double‐Blind Studies")
S112	(MH "Random Assignment")
S111	(MH "Randomized Controlled Trials") OR (MH "Clinical Trials+")
S110	S42 OR S57 OR S87 OR S97 OR S109
S109	S98 OR S99 OR S100 OR S101 OR S102 OR S103 OR S104 OR S105 OR S106 OR S107 OR S108
S108	AB binge
S107	AB intoxicat*
S106	AB drunk*
S105	AB spirit*
S104	AB wine*
S103	AB beer*
S102	AB liquor*
S101	AB drink*
S100	(MH "Alcoholism") OR (MH "Alcoholic Intoxication")
S99	AB alcohol*
S98	(MH "Binge Drinking") OR (MH "Drinking Behavior")
S97	S88 OR S89 OR S90 OR S91 OR S92 OR S93 OR S94 OR S95 OR S96
S96	AB anti‐smok*
S95	AB ex‐smoker*
S94	(MH "Substance Use Disorders")
S93	((ceas* or cess* or prevent* or stop* or quit* or abstin* or abstain* or reduc) n5 (smok or tobacco or nicotine))
S92	(MH "Tobacco")
S91	(MH "Nicotine")
S90	AB smok*
S89	(MH "Smoking Cessation Programs") OR (MH "Tobacco Abuse Control (Saba CCC)") OR (MH "Tobacco Abuse (Saba CCC)") OR "Tobacco Use Cessation"
S88	(MH "Smoking+")
S87	S58 OR S59 OR S60 OR S61 OR S62 OR S63 OR S64 OR S65 OR S66 OR S67 OR S68 OR S69 OR S70 OR S71 OR S72 OR S73 OR S74 OR S75 OR S76 OR S77 OR S78 OR S79 OR S80 OR S81 OR S82 OR S83 OR S84 OR S85 OR S86
S86	(MH "Nutritional Status")
S85	"cafeteria*"
S84	((feeding or food or nutrition) n1 program)
S83	"menu plan*"
S82	(school n1 (lunch* or meal*))
S81	(MH "Candy")
S80	"confectionar*"
S79	(MH "Dietary Fats")
S78	"sweetened drink*"
S77	"soda"
S76	(MH "Carbonated Beverages") OR "soft drink*"
S75	(MH "Food")
S74	(MH "Food Habits")
S73	(MH "Food Intake") OR "dietary intake"
S72	(MH "Eating Behavior") OR "feeding behaviour"
S71	(MH "Eating")
S70	(MH "Energy Density")
S69	(MH "Energy Intake")
S68	"calorie*"
S67	"menu*"
S66	(MH "Food Services") OR "food service*"
S65	AB canteen*
S64	fruit*
S63	(MH "Vegetables") OR "vegetable*"
S62	(MH "Fruit+")
S61	"Child Nutrition Sciences" OR (MH "Child Nutrition")
S60	healthy eating
S59	nutrition*
S58	(MH "Diet+")
S57	S43 OR S44 OR S45 OR S46 OR S47 OR S48 OR S49 OR S50 OR S51 OR S52 OR S53 OR S54 OR S55 OR S56
S56	((lifestyle* or life style) n5 activ)
S55	AB sport*
S54	(exercise* n1 aerobic*)
S53	(MH "Dancing+") OR "Dancing"
S52	(MH "Sports+")
S51	(MH "Leisure Activities+")
S50	(MH "Life Style+") OR (MH "Life Style, Sedentary")
S49	"sedentary"
S48	(MH "Physical Fitness")
S47	(MH "Physical Education and Training") OR "physical education and training"
S46	(MH "Motor Activity+")
S45	physical inactivity
S44	(MH "Physical Activity")
S43	(MH "Exercise+")
S42	S28 OR S29 OR S30 OR S31 OR S32 OR S33 OR S34 OR S35 OR S36 OR S37 OR S38 OR S39 OR S40 OR S41
S41	(obes* n2 (prevent* or treat*))
S40	preventive care or preventative care
S39	preventative measure*
S38	preventive measure*
S37	"secondary prevention"
S36	"Primary Prevention"
S35	((bmi or body mass index) n2 (gain or loss or change))
S34	weight change*
S33	(overweight or over weight or overeat* or over eat*)
S32	(weight gain or weight loss)
S31	obes*
S30	(MH "Weight Loss")
S29	(MH "Weight Gain")
S28	(MH "Obesity+")
S27	S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11 OR S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20 OR S21 OR S22 OR S23 OR S24 OR S25 OR S26
S26	AB scal* up
S25	AB integration
S24	AB program*
S23	AB adherence
S22	AB incorporation
S21	AB capacity
S20	AB maintenance
S19	AB routin*
S18	AB institutionali*
S17	AB sustainab*
S16	AB uptake
S15	AB transfer
S14	AB translation
S13	AB transformation
S12	AB quality improvement*
S11	AB system* change*
S10	AB diffusion
S9	AB organisational change* or organizational change*
S8	AB practice
S7	adopt*
S6	AB dissemination
S5	AB implement*
S4	S1 OR S2 OR S3
S3	kinder*
S2	((primary or elementary or middle or junior or high or secondary) n1 (school* or student*))
S1	(MH "Schools") OR (MH "Schools, Elementary") OR (MH "Schools, Middle") OR (MH "Schools, Secondary")

COCHRANE LIBRARY search strategy

School* or ((primary or elementary or middle or junior or high or secondary) and student*) or kinder*

in Title, Abstract, Keywords and

Implement* or dissemination or adopt* or practice or "organisational change*" or "organizational change*" or diffusion or "system* change*" or "quality improvement*" or transformation or translation or transfer or uptake or sustainab* or institutionali* or routin* or maintenance or capacity or incorporation or adherence or program* or integration or "scal* up"

in Title, Abstract, Keywords and

Obes* or "Weight Gain" or "Weight Loss" or overweight or "over weight" or overeat* or "over eat*" or "weight change*" or ((bmi or body mass index) and (gain or loss or change)) or "Primary Prevention" or "secondary prevention" or "preventive measure*" or "preventative measure" or "preventive care" or "preventative care" or Exercise or "physical activity" or "physical inactivity" or "Motor Activity" or "physical education and training" or "Physical Fitness" or sedentary or "Life Style" or lifestyle or "Leisure Activities" or sport* or Dancing or aerobic* or diet or nutrition* or "healthy eating" or "Child Nutrition Sciences" or fruit* or vegetable* or canteen* or "food service*" or menu* or calorie* or "Energy Intake" or "energy density" or eating or "Feeding Behavior" or "Feeding Behaviour" or "dietary intake" or food or "Carbonated Beverage*" or "soft drink*" or soda or "sweetened drink*" or "Dietary Fats" or confectionar* or "school lunch*" or "school meal*" or "menu plan*" or ((feeding or food or nutrition*) and program*) or cafeteria* or smok* or Tobacco or Nicotine or alcohol* or drink* or liquor* or beer* or wine* or spirit* or drunk* or intoxicat* or binge in Title, Abstract, Keywords

Dissertations and Theses search strategy

ti(School* OR ((primary OR elementary OR middle OR junior OR high OR secondary) AND student*) OR kinder*)

AND

ab(Implement* OR dissemination OR adopt* OR practice OR "organisational change*" OR "organizational change*" OR diffusion OR "system* change*" OR "quality improvement*" OR transformation OR translation OR transfer OR uptake OR sustainab* OR institutionali* OR routin* OR maintenance OR capacity OR incorporation OR adherence OR program* OR integration OR "scal* up")

AND

ti(Obes* OR "Weight Gain" OR "Weight Loss" OR overweight OR "over weight" OR overeat* OR "over eat*" OR "weight change*" OR ((bmi OR body mass index) AND (gain OR loss OR change)) OR "Primary Prevention" OR "secondary prevention" OR "preventive measure*" OR "preventative measure" OR "preventive care" OR "preventative care" OR Exercise OR "physical activity" OR "physical inactivity" OR "Motor Activity" OR "physical education and training" OR "Physical Fitness" OR sedentary OR "Life Style" OR lifestyle OR "Leisure Activities" OR sport* OR Dancing OR aerobic* OR diet OR nutrition* OR "healthy eating" OR "Child Nutrition Sciences" OR fruit* OR vegetable* OR canteen* OR "food service*" OR menu* OR calorie* OR "Energy Intake" OR "energy density" OR eating OR "Feeding Behavior" OR "Feeding Behaviour" OR "dietary intake" OR food OR "Carbonated Beverage*" OR "soft drink*" OR soda OR "sweetened drink*" OR "Dietary Fats" OR confectionar* OR "school lunch*" OR "school meal*" OR "menu plan*" OR ((feeding OR food OR nutrition*) AND program*) OR cafeteria* OR smok* OR Tobacco OR Nicotine OR alcohol* OR drink* OR liquor* OR beer* OR wine* OR spirit* OR drunk* OR intoxicat* OR binge)

AND

ab("Randomized Controlled Trial*" OR "Randomised Controlled Trial*" OR "clinical trial*" OR random* OR "Double‐Blind Method" OR "Single‐Blind Method" OR placebo* OR "Research Design" OR "Intervention Stud*" OR "Evaluation Stud*" OR "Comparative Stud*" OR "Longitudinal Stud*" OR "Cross‐Over Stud*" OR "latin square" OR (time AND series) OR ((before AND after) AND (stud* OR trial* OR design*)) OR ((singl* OR doubl* OR trebl* OR tripl*) AND (blind* OR mark)) OR (matched AND (communit* OR school* OR population*)) OR control* OR "comparison group*" OR "control group*" OR "matched pairs" OR "outcome stud*" OR quasiexperimental OR "quasi experimental" OR "pseudo experimental" OR nonrandomized OR nonrandomised OR "non randomised" OR "non randomized" OR "psuedo randomised" OR "psuedo randomized" OR "quasi randomised" OR "quasi randomized" OR prospective* OR volunteer*)

ERIC search strategy

ti,ab(School* OR ((primary OR elementary OR middle OR junior OR high OR secondary) AND student*) OR kinder*)

AND ab(Implement* OR dissemination OR adopt* OR practice OR "organisational change*" OR "organizational change*" OR diffusion OR "system* change*" OR "quality improvement*" OR transformation OR translation OR transfer OR uptake OR sustainab* OR institutionali* OR routin* OR maintenance OR capacity OR incorporation OR adherence OR program* OR integration OR "scal* up")

AND ti,ab(Obes* OR "Weight Gain" OR "Weight Loss" OR overweight OR "over weight" OR overeat* OR "over eat*" OR "weight change*" OR ((bmi OR body mass index) AND (gain OR loss OR change)) OR "Primary Prevention" OR "secondary prevention" OR "preventive measure*" OR "preventative measure" OR "preventive care" OR "preventative care" OR Exercise OR "physical activity" OR "physical inactivity" OR "Motor Activity" OR "physical education and training" OR "Physical Fitness" OR sedentary OR "Life Style" OR lifestyle OR "Leisure Activities" OR sport* OR Dancing OR aerobic* OR diet OR nutrition* OR "healthy eating" OR "Child Nutrition Sciences" OR fruit* OR vegetable* OR canteen* OR "food service*" OR menu* OR calorie* OR "Energy Intake" OR "energy density" OR eating OR "Feeding Behavior" OR "Feeding Behaviour" OR "dietary intake" OR food OR "Carbonated Beverage*" OR "soft drink*" OR soda OR "sweetened drink*" OR "Dietary Fats" OR confectionar* OR "school lunch*" OR "school meal*" OR "menu plan*" OR ((feeding OR food OR nutrition*) AND program*) OR cafeteria* OR smok* OR Tobacco OR Nicotine OR alcohol* OR drink* OR liquor* OR beer* OR wine* OR spirit* OR drunk* OR intoxicat* OR binge)

AND ab("Randomized Controlled Trial*" OR "Randomised Controlled Trial*" OR "clinical trial*" OR random* OR "Double‐Blind Method" OR "Single‐Blind Method" OR placebo* OR "Research Design" OR "Intervention Stud*" OR "Evaluation Stud*" OR "Comparative Stud*" OR "Longitudinal Stud*" OR "Cross‐Over Stud*" OR "latin square" OR (time AND series) OR ((before AND after) AND (stud* OR trial* OR design*)) OR ((singl* OR doubl* OR trebl* OR tripl*) AND (blind* OR mark)) OR (matched AND (communit* OR school* OR population*)) OR control* OR "comparison group*" OR "control group*" OR "matched pairs" OR "outcome stud*" OR quasiexperimental OR "quasi experimental" OR "pseudo experimental" OR nonrandomized OR nonrandomised OR "non randomised" OR "non randomized" OR "psuedo randomised" OR "psuedo randomized" OR "quasi randomised" OR "quasi randomized" OR prospective* OR volunteer*) Narrowed by

Education level: [Clear(Clear Education level) Education level]: NOT (Higher Education AND Postsecondary Education AND Preschool Education AND Adult Education AND Two Year Colleges)

SCOPUS search strategy

TITLE‐ABS ( ( school* OR ( ( primary OR elementary OR middle OR junior OR high OR secondary ) AND student* ) OR kinder* ) ) AND TITLE ( implement* OR dissemination OR adopt* OR practice OR "organisational change*" OR "organizational change*" OR diffusion OR "system* change*" OR "quality improvement*" OR transformation OR translation OR transfer OR uptake OR sustainab* OR institutionali* OR routin* OR maintenance OR capacity OR incorporation OR adherence OR program* OR integration OR "scal* up" ) AND TITLE‐ABS ( obes* OR "Weight Gain" OR "Weight Loss" OR overweight OR "over weight" OR overeat* OR "over eat*" OR "weight change*" OR bmi OR "body mass index" OR "Primary Prevention" OR "secondary prevention" OR "preventive measure*" OR "preventative measure" OR "preventive care" OR "preventative care" OR exercise OR "physical activity" OR "physical inactivity" OR "Motor Activity" OR "physical education and training" OR "Physical Fitness" OR sedentary OR "Life Style" OR lifestyle OR "Leisure Activities" OR sport* OR dancing OR aerobic* OR diet OR nutrition* OR "healthy eating" OR "Child Nutrition Sciences" OR fruit* OR vegetable* OR canteen* OR "food service*" OR menu* OR calorie* OR "Energy Intake" OR "energy density" OR eating OR "Feeding Behavior" OR "Feeding Behaviour" OR "dietary intake" OR food OR "Carbonated Beverage*" OR "soft drink*" OR soda OR "sweetened drink*" OR "Dietary Fats" OR confectionar* OR "school lunch*" OR "school meal*" OR "menu plan*" OR cafeteria* OR smok* OR tobacco OR nicotine OR alcohol* OR drink* OR liquor* OR beer* OR wine* OR spirit* OR drunk* OR intoxicat* OR binge OR "feeding program*" OR "food program*" OR "nutrition* program*" ) AND TITLE ( ( "clinical trial*" OR random* OR "Double‐Blind Method" OR "Single‐Blind Method" OR placebo* OR "Research Design" OR "Intervention Stud*" OR "Evaluation Stud*" OR "Comparative Stud*" OR "Longitudinal Stud*" OR "Cross‐Over Stud*" OR "latin square" OR "time series" OR "before and after" OR control* OR "comparison group*" OR "control group*" OR "matched pairs" OR "outcome stud*" OR quasiexperimental OR "quasi experimental" OR "pseudo experimental" OR nonrandomized OR nonrandomised OR "non randomised" OR "non randomized" OR "psuedo randomised" OR "psuedo randomized" OR "quasi randomised" OR "quasi randomized" OR prospective* OR volunteer* OR "singl* blind*" OR "singl* mask*" OR "doubl* blind*" OR "doubl* mask*" OR "trebl* blind*" OR "trebl* mask*" OR "tripl* blind*" OR "tripl* mask*" ) )

Appendix 2. 'Risk of bias' assessment tool

RANDOM SEQUENCE GENERATION Selection bias (biased allocation to interventions) due to inadequate generation of a randomised sequence
Criteria for a judgement of ‘Low risk’ of bias.	The investigators describe a random component in the sequence generation process such as: Referring to a random number table; Using a computer random number generator; Coin tossing; Shuffling cards or envelopes; Throwing dice; Drawing of lots; Minimization. Minimization may be implemented without a random element, and this is considered to be equivalent to being random.
Criteria for the judgement of ‘High risk’ of bias.	The investigators describe a non‐random component in the sequence generation process. Usually, the description would involve some systematic, non‐random approach, for example: Sequence generated by odd or even date of birth; Sequence generated by some rule based on date (or day) of admission; Sequence generated by some rule based on hospital or clinic record number. Other non‐random approaches happen much less frequently than the systematic approaches mentioned above and tend to be obvious. They usually involve judgement or some method of non‐random categorization of participants, for example: Allocation by judgement of the clinician; Allocation by preference of the participant; Allocation based on the results of a laboratory test or a series of tests; Allocation by availability of the intervention.
Criteria for the judgement of ‘Unclear risk’ of bias.	Insufficient information about the sequence generation process to permit judgement of ‘Low risk’ or ‘High risk’.
ALLOCATION CONCEALMENT Selection bias (biased allocation to interventions) due to inadequate concealment of allocations prior to assignment
Criteria for a judgement of ‘Low risk’ of bias.	Participants and investigators enrolling participants could not foresee assignment because one of the following, or an equivalent method, was used to conceal allocation: Central allocation (including telephone, web‐based and pharmacy‐controlled randomization); Sequentially numbered drug containers of identical appearance; Sequentially numbered, opaque, sealed envelopes.
Criteria for the judgement of ‘High risk’ of bias.	Participants or investigators enrolling participants could possibly foresee assignments and thus introduce selection bias, such as allocation based on: Using an open random allocation schedule (e.g. a list of random numbers); Assignment envelopes were used without appropriate safeguards (e.g. if envelopes were unsealed or nonopaque or not sequentially numbered); Alternation or rotation; Date of birth; Case record number; Any other explicitly unconcealed procedure.
Criteria for the judgement of ‘Unclear risk’ of bias.	Insufficient information to permit judgement of ‘Low risk’ or ‘High risk’. This is usually the case if the method of concealment is not described or not described in sufficient detail to allow a definite judgement – for example if the use of assignment envelopes is described, but it remains unclear whether envelopes were sequentially numbered, opaque and sealed.
BLINDING OF PARTICIPANTS AND PERSONNEL Performance bias due to knowledge of the allocated interventions by participants and personnel during the study
Criteria for a judgement of ‘Low risk’ of bias.	Any one of the following: No blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be influenced by lack of blinding; Blinding of participants and key study personnel ensured, and unlikely that the blinding could have been broken.
Criteria for the judgement of ‘High risk’ of bias.	Any one of the following: No blinding or incomplete blinding, and the outcome is likely to be influenced by lack of blinding; Blinding of key study participants and personnel attempted, but likely that the blinding could have been broken, and the outcome is likely to be influenced by lack of blinding.
Criteria for the judgement of ‘Unclear risk’ of bias.	Any one of the following: Insufficient information to permit judgement of ‘Low risk’ or ‘High risk’; The study did not address this outcome.
BLINDING OF OUTCOME ASSESSMENT Detection bias due to knowledge of the allocated interventions by outcome assessors
Criteria for a judgement of ‘Low risk’ of bias.	Any one of the following: No blinding of outcome assessment, but the review authors judge that the outcome measurement is not likely to be influenced by lack of blinding; Blinding of outcome assessment ensured, and unlikely that the blinding could have been broken.
Criteria for the judgement of ‘High risk’ of bias.	Any one of the following: No blinding of outcome assessment, and the outcome measurement is likely to be influenced by lack of blinding; Blinding of outcome assessment, but likely that the blinding could have been broken, and the outcome measurement is likely to be influenced by lack of blinding.
Criteria for the judgement of ‘Unclear risk’ of bias.	Any one of the following: Insufficient information to permit judgement of ‘Low risk’ or ‘High risk’; The study did not address this outcome.
INCOMPLETE OUTCOME DATA Attrition bias due to amount, nature or handling of incomplete outcome data
Criteria for a judgement of ‘Low risk’ of bias.	Any one of the following: No missing outcome data; Reasons for missing outcome data unlikely to be related to true outcome (for survival data, censoring unlikely to be introducing bias); Missing outcome data balanced in numbers across intervention groups, with similar reasons for missing data across groups; For dichotomous outcome data, the proportion of missing outcomes compared with observed event risk not enough to have a clinically relevant impact on the intervention effect estimate; For continuous outcome data, plausible effect size (difference in means or standardized difference in means) among missing outcomes not enough to have a clinically relevant impact on observed effect size; Missing data have been imputed using appropriate methods.
Criteria for the judgement of ‘High risk’ of bias.	Any one of the following: Reason for missing outcome data likely to be related to true outcome, with either imbalance in numbers or reasons for missing data across intervention groups; For dichotomous outcome data, the proportion of missing outcomes compared with observed event risk enough to induce clinically relevant bias in intervention effect estimate; For continuous outcome data, plausible effect size (difference in means or standardized difference in means) among missing outcomes enough to induce clinically relevant bias in observed effect size; ‘As‐treated’ analysis done with substantial departure of the intervention received from that assigned at randomization; Potentially inappropriate application of simple imputation.
Criteria for the judgement of ‘Unclear risk’ of bias.	Any one of the following: Insufficient reporting of attrition/exclusions to permit judgement of ‘Low risk’ or ‘High risk’ (e.g. number randomized not stated, no reasons for missing data provided); The study did not address this outcome.
SELECTIVE REPORTING Reporting bias due to selective outcome reporting
Criteria for a judgement of ‘Low risk’ of bias.	Any of the following: The study protocol is available and all of the study’s pre‐specified (primary and secondary) outcomes that are of interest in the review have been reported in the pre‐specified way; The study protocol is not available but it is clear that the published reports include all expected outcomes, including those that were pre‐specified (convincing text of this nature may be uncommon).
Criteria for the judgement of ‘High risk’ of bias.	Any one of the following: Not all of the study’s pre‐specified primary outcomes have been reported; One or more primary outcomes is reported using measurements, analysis methods or subsets of the data (e.g. subscales) that were not pre‐specified; One or more reported primary outcomes were not pre‐specified (unless clear justification for their reporting is provided, such as an unexpected adverse effect); One or more outcomes of interest in the review are reported incompletely so that they can not be entered in a meta‐analysis; The study report fails to include results for a key outcome that would be expected to have been reported for such a study.
Criteria for the judgement of ‘Unclear risk’ of bias.	Insufficient information to permit judgement of ‘Low risk’ or ‘High risk’. It is likely that the majority of studies will fall into this category.
OTHER BIAS Bias due to problems not covered elsewhere in the table
Criteria for a judgement of ‘Low risk’ of bias.	The study appears to be free of other sources of bias.
Criteria for the judgement of ‘High risk’ of bias.	There is at least one important risk of bias. For example, the study: Had a potential source of bias related to the specific study design used; or Has been claimed to have been fraudulent; or Had some other problem.
Criteria for the judgement of ‘Unclear risk’ of bias.	There may be a risk of bias, but there is either: Insufficient information to assess whether an important risk of bias exists; or Insufficient rationale or evidence that an identified problem will introduce bias.

Figure 1

Study flow diagram.

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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Strategies for enhancing the implementation of school‐based policies or practices targeting risk factors for chronic disease
Patient or population: School aged children (5 ‐ <18 years) Settings: School Intervention: Any strategy (e.g. educational materials, educational meetings, audit and feedback, opinion leaders, education outreach visits) with the intention of improving the implementation of health promoting policies, programs or practices for physical activity, healthy eating, obesity prevention, tobacco use prevention or alcohol use prevention in schools Comparison: No intervention or usual practice (22 trials), alternate intervention (2 trials) or minimal support comparison group (3 trials)
Outcomes	Impact	Number of Participants (trials)	Quality of the evidence (GRADE)^d
Implementation of school‐based policies, practices or programs that aim to promote healthy or reduce unhealthy behaviours relating to child diet, physical activity, obesity, or tobacco or alcohol use	We are uncertain whether strategies improve the implementation of school‐based policies, practices or programs that aim to promote healthy or reduce unhealthy behaviours relating to child diet, physical activity, obesity, or tobacco or alcohol use. Among 13 trials reporting dichotomous implementation outcomes—the proportion of schools or school staff (e.g. classes) implementing a targeted policy or practice—the median unadjusted (improvement) effect sizes ranged from 8.5% to 66.6%. Of seven trials reporting the percentage of a practice, program or policy that had been implemented, the median unadjusted effect (improvement), relative to the control ranged from ‐8% to 43%. The effect, relative to control, reported in two trials assessing the impact of implementation strategies on the time per week teachers spent delivering targeted policies or practices ranged from 26.6 to 54.9 minutes per week.	1599 schools (27 trials)	Very low^a,b
Measures of student physical activity, diet, weight status, tobacco or alcohol use	We are uncertain whether strategies to improve the implementation of school‐based policies, practices or programs targeting risk factors for chronic disease impact on measures of student physical activity, diet, weight status, tobacco or alcohol use	29,181 students^f (21 trials)	Very low^a,b,c
Knowledge, skills or attitudes of school staff involved regarding the implementation of health promoting policies, or practices	We are uncertain whether strategies to improve the implementation of school‐based policies, practices or programs targeting risk factors for chronic disease impact on the knowledge, skills or attitudes of school staff	1347 stakeholders (3 trials)	Very low^a,b
Cost or cost‐effectiveness of strategies to improve the implementation	We are uncertain whether strategies to improve the implementation of school‐based policies, practices or programs targeting risk factors for chronic disease are cost‐effective	42 schools (1 trial) 473 students (1 trial)^g	Very low^a,b,d
Unintended adverse effects of strategies to improve implementation on schools, school staff or children	We are uncertain whether strategies to improve the implementation of school‐based policies, practices or programs targeting risk factors for chronic disease result in unintended adverse effects or consequences	68 schools and 4603 students^h (2 trials)	Very low^b,c
High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
^aDowngraded one level due to limitations in the design. ^bDowngraded one level due to unexplained heterogeneity. ^cDowngraded one level due to indirectness. ^dDowngraded one level due to imprecision. ^eGRADE Working Group grades of evidence ^fTwo trials measured student behaviour through the use of non‐student data (e.g. purchases) and did not provide student sample sizes. ^gOne trial reported on the impact of an intervention on school level revenue. One trial reported on cost‐effectiveness. ^hOne trial measured adverse events through the use of non‐student data (i.e. canteen profits) and did not provide student sample sizes.

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Table 1. Interventions across studies

Trial

Audit and feedback

Clinical practice guidelines

Continuous quality improvements

Distribution

of supplies

External

funding

Education

games

Education

materials

Education

meeting

Education

outreach visits

Inter‐

professional

education

Length of consultation

Local consensus

process

Local opinion

leader

Managerial supervision

Monitoring performance

of delivery

Pay for performance

Tailored intervention

The use of communication

technology

Other

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Table 1. Interventions across studies

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Table 2. Definition of EPOC subcategories utilised in the review

EPOC subcategory	Definition
Audit and feedback	A summary of health workers’ performance over a specified period of time, given to them in a written, electronic or verbal format. The summary may include recommendations for clinical action.
Clinical practice guidelines	Clinical guidelines are systematically developed statements to assist healthcare providers and patients to decide on appropriate health care for specific clinical circumstances'(US IOM).
Educational materials	Distribution to individuals, or groups, of educational materials to support clinical care, i.e. any intervention in which knowledge is distributed. For example this may be facilitated by the Internet, learning critical appraisal skills; skills for electronic retrieval of information, diagnostic formulation; question formulation.
Educational meetings	Courses, workshops, conferences or other educational meetings.
Educational outreach visits, or academic detailing	Personal visits by a trained person to health workers in their own settings, to provide information with the aim of changing practice.
External funding	Financial contributions such as donations, loans, etc. from public or private entities from outside the national or local health financing system.
Inter‐professional education	Continuing education for health professionals that involves more than one profession in joint, interactive learning.
Length of consultation	Changes in the length of consultations.
Local consensus processes	Formal or informal local consensus processes, for example agreeing a clinical protocol to manage a patient group, adapting a guideline for a local health system or promoting the implementation of guidelines.
Local opinion leaders	The identification and use of identifiable local opinion leaders to promote good clinical practice.
Managerial supervision	Routine supervision visits by health staff.
Monitoring the performance of the delivery of healthcare	Monitoring of health services by individuals or healthcare organisations, for example by comparing with an external standard.
Other	Strategies were classified as other if they did not clearly fit within the standard subcategories.
Pay for performance – target payments	Transfer of money or material goods to healthcare providers conditional on taking a measurable action or achieving a predetermined performance target, for example incentives for lay health workers.
Procurement and distribution of supplies	Systems for procuring and distributing drugs or other supplies.
Tailored interventions	Interventions to change practice that are selected based on an assessment of barriers to change, for example through interviews or surveys.
The use of information and communication technology	Technology based methods to transfer healthcare information and support the delivery of care.

Table 2. Definition of EPOC subcategories utilised in the review

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Table 3. Summary of intervention, measures and absolute intervention effect size in included studies

Trial	Trial name	Targeted risk factor	Implementation strategies	Comparison	Primary Implementation outcome and measures	Effect size	P < 0.05
Alaimo 2015	School Nutrition Advances Kids (SNAK)	Nutrition	Clinical practice guidelines, educational materials, educational outreach visits, external funding, local consensus processes, tailored interventions	Usual practice or waiting‐list control	Continuous: i) Nutrition policy score and ii) Nutrition education and/or practice score (2 measures)	Median (range) 0.65 (0.2 to 1.1)	0/2
Cunningham‐Sabo 2003	Pathways	Nutrition^c	Clinical practice guidelines, educational materials, educational meetings, educational outreach visits	Usual practice	Continuous: Nutrient content of school meals % of calories from fat breakfast/lunch (2 measures)	Median (range) ‐3% (‐3.3% to ‐2.7%)	1/2
De Villiers 2015	HealthKick	Nutrition^c	Local opinion leaders, educational materials, educational outreach visits, education meetings	Minimal support control	Dichotomous: % implementing a variety of policies and practices (3 measures)	Median (range) 25% (12.5% to 29.5%)	Not reported
Delk 2014	No trial name	Physical activity	Local consensus process, educational meetings, clinical practice guidelines, educational outreach visits, tailored interventions, other	Different implementation strategy	Continuous: % of teachers that conducted activity breaks weekly (1 measure 2 comparisons) Dichotomous: % implementing a variety of policies and practices (2 measures 4 comparisons)	Median (range) 13.3% (11.1% to 15.4%) Median (range) 26.5% (19.4% to 31.9%)	6/6
French 2004	Trying Alternative Cafeteria Options in Schools (TACOS)	Nutrition	Local consensus processes, tailored intervention, educational meetings, pay for performance	Usual practice or waiting‐list control	Continuous % of program implementation (5 measures)	Median (range) 33% (11% to 41%)	5/5
Gingiss 2006	Texas Tobacco Prevention Initiative	Tobacco	Educational meetings, educational outreach visits, external funding, local consensus processes	Usual practice	Dichotomous: % implementing a variety of policies and practices (10 measures)	Median (range) 18.5% (‐1% to 59%)	7/10
Heath 2002	El Paso Coordinated Approach to Child Health (El Paso CATCH)	Nutrition^c	Educational materials, educational meetings, educational outreach visits	Usual practice	Continuous: % fat in school meal (2 measures) Sodium of school meals (2 measures)	Effect size Median (range) ‐1.7% (‐4.4% to 1%) Median (range) ‐29.5 (‐48 to ‐11)	1/4
Hoelscher 2010	Travis County Coordinated Approach To Child Health (CATCH) Trial	Nutrition and physical activity	Educational materials, educational meetings, educational outreach visits, pay for performance, other, the use of information and communication technology, local consensus process	Different implementation strategy	Continuous: Mean number of lessons/or activities (5 measures) Dichotomous: % implementing a variety of policies and practices (2 measures)	Median (range) 0.8 (‐0.4 to 1.2) Median (range) 4.4% (3.6% to 5.2%)	4/7
Lytle 2006	Teens Eating for Energy and Nutrition at School (TEENS)	Nutrition	Educational materials, educational meetings, local opinion leaders, local consensus processes	Usual practice or waitling‐list control	Dichotomous: % of schools offering or selling targeted foods (4 measures)	Median (range) 8.5% (4% to 12%)	2/4
Mathur 2016	Bihar School Teachers Study (BSTS)	Tobacco	Local opinion leader, continuous quality improvement, education materials, education meeting, local consensus process	Usual practice or waiting‐list control	Dichotomous: % implementing a variety of policies and practices (2 measures)	Median (range) 56.9% (36.3% to 77.5%)	2/2
McCormick 1995	The North Carolina School Health and Tobacco Education Project (SHTEP)/ Skills Management and Resistance Training (SMART)	Tobacco	Educational meetings, local consensus processes, educational materials	Minimal support control	Dichotomous: % later implementation of curriculum for school district (1 measure) Continuous: Mean extent later implementation for school district (% of total curriculum activities taught) (1 measure)	Effect Size (95%CI) 16.7% (‐37.7% to 64.1%) Mean difference^a 0.56%	0/2
Mobley 2012	HEALTHY study	Nutrition^c	Educational games, educational meetings, external funding, tailored intervention, educational materials, educational outreach, other, the use of information and communication technology	Usual practice or waiting‐list control	Dichotomous: % schools meeting various nutrition goals (12 measures)	Median (range) 15.5% (0% to 88%)	Not reported
Nathan 2012	Good for Kids. Good for Life	Nutrition	Educational materials, educational meetings, local consensus processes, local opinion leaders, other, monitoring the performance of the delivery of the healthcare, tailored interventions	Minimal support control	Dichotomous: % Schools implementing a vegetable and fruit break (1 measure)	Mean difference (95%CI) 16.2% (5.6% to 26.8%)	1/1
Nathan 2016	No trial name	Nutrition	Audit and feedback, continuous quality improvement, education materials, education meeting, local consensus process, local opinion leader, tailored intervention, other	Usual practice	Dichotomous: % implementing a variety of policies and practices (2 measures)	Median (range) 35.5% (30.0% to 41.1%)	2/2
Naylor 2006	Action Schools! British Columbia (BC)	Physical activity	Educational materials, educational meetings, educational outreach meetings, local consensus process, other, tailored Interventions	Usual practice or waiting‐list control	Continuous: Minutes per week of physical activity implemented in the classroom (1 measure 2 comparisons)	Median (range) 54.9 minutes (46.4 to 63.4)	2/2
Perry 1997	Child and Adolescent Trial for Cardiovascular Health (CATCH)	Nutrition and physical activity^d	Educational materials, educational meetings, educational outreach visits, other	Usual practice or waiting‐list control	Continuous: % of kilocalories from fat in school lunch (1 measure) Mean milligrams of sodium in lunches (1 measure) Cholesterol milligrams in lunches (1 measure) Quality of PE lesson % of 7 activities observed (1 measure)	Effect size Mean difference (95%CI) ‐4.3% (‐5.8% to ‐2.8%) Mean difference (95%CI) ‐100.5 (‐167.6 to ‐33.4) Mean difference (95%CI) ‐8.3 (‐16.7 to 0.1) Mean difference (95%CI) 14.3% (11.6% to 17.0%)	3/4
Perry 2004	The Cafeteria Power Plus project	Nutrition	Educational meetings, educational outreach visits, educational materials, local consensus processes, other	Usual practice or waiting‐list control	Continuous: % of program implementation (2 measures) Mean number of fruit and vegetables available (2 measures)	Median (range) 14% (‐2% to 30%) Median (range) 0.64 (0.48 to 0.80)	2/4
Sallis 1997	Sports, Play, and Active Recreation for Kids (SPARK)	Physical activity	Educational materials, educational meetings, educational outreach visits, length of consultation, other	Usual practice or waiting‐list control	Continuous: Duration (minutes) per week of physical education lessons (1 measure) Frequency (per week) of physical education lessons (1 measures)	Mean difference (95%CI) 26.6 (15.3 to 37.9) Mean difference (95%CI) 0.8 (0.3 to 1.3)	2/2
Saraf 2015	No trial name	Nutrition, physical activity and tobacco	Educational games, educational materials, educational meetings, local consensus processes, local opinion leaders, tailored Interventions, other	Usual practice	Dichotomous: % implementing a variety of policies and practices (6 measures)	Median (range) 36.9% (‐5.3% to 79.5%)	5/6
Saunders 2006	Lifestyle Education for Activity Program (LEAP)	Physical activity	Educational materials, educational meetings, educational outreach visits, local consensus processes, local opinion leaders, other	Usual practice or waiting‐list control	Continuous: School level policy and practice related to physical activity from the school administrators perspective (9 measures)	N/A^b	Not reported
Simons‐Morton 1988	Go for Health	Nutrition^c	Educational materials, educational outreach visits, local consensus processes, local opinion leaders, managerial supervision, monitoring of performance, other	Usual practice	Continuous: Macronutrient content of school meals (2 measures)	N/A^b	Not reported
Story 2000	5‐a‐Day Power Plus	Nutrition	Educational meetings, other	Usual practice	Continuous: Mean number of fruit and vegetables available (2 measures) % of guidelines implemented and % of promotions held (4 measures)	Median (range) 1.15 (1 to 1.3) Median (range) 38.4% (28.5% to 43.8%)	6/6
Sutherland 2017	Supporting Children’s Outcomes using Rewards, Exercise and Skills (SCORES)	Physical activity	Audit and feedback, education materials, education meeting, education outreach visits, local opinion leader, other	Usual practice or waiting‐list control	Dichotomous: % implementing a variety of policies and practices (2 measures) Continuous: Physical education lesson quality score (1 measures) % of program implementation (4 measures)	Median (range) 19% (16% to 22%) Mean difference 21.5^a Median (range) ‐8% (‐18% to 2%)	0/2 1/1 0/4
Whatley Blum 2007	No trial name	Nutrition	Clinical practice guidelines, educational materials, educational meetings, educational outreach visits, external funding, distribution of supplies, local consensus process, other	Usual practice or waiting‐list control	Continuous: % of food and beverage items meeting guideline nutrient and portion criteria (6 measures)	Median (range) 42.95% (15.7% to 60.6%)	5/6
Wolfenden 2017	No trial name	Nutrition	Audit and feedback, continuous quality improvement, external funding, education materials, education meeting, education outreach visits, local consensus process, local opinion leader, tailored intervention, other	Usual practice	Dichotomous: % implementing a variety of policies and practices (2 measures)	Median (range) 66.6% (60.5% to 72.6%)	2/2
Yoong 2016	CAFÉ	Nutrition	Audit and feedback, continuous quality improvement, education materials, tailored intervention	Usual practice	Dichotomous: % implementing a variety of policies and practices (2 measures)	Median (range) 21.6% (15.6% to 27.5%)	0/2
Young 2008	Trial of Activity for Adolescent Girls (TAAG)	Physical activity	Education materials, education meetings, educational outreach visits, inter‐professional education, local consensus processes, local opinion leaders	Usual practice	Dichotomous: % implementing a variety of policies and practices (7 measures) Continuous: Average number of physical activity programs taught (1 measure)	Median (range) 9.3% (‐6.8% to 55.5%) Effect Size (95%CI) 5.1 (‐0.4 to10.6)	1/8
^aNo measure of variability. ^bDid not report aggregate results by group. ^cPhysical activity was also a targeted risk factor however, this component did not meet our inclusion criteria (e.g. implementation outcomes unavailable, study staff implemented physical activity component etc.) and was therefore, not considered in our review. ^dTobacco use was also a targeted risk factor however, this component did not meet our inclusion criteria (e.g. implementation outcomes unavailable) and was therefore, not considered in our review.

Table 3. Summary of intervention, measures and absolute intervention effect size in included studies

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