Preventive recommendations for school-aged children and adolescents in primary care: a systematic review

To systematically identify preventive recommendations for healthy school-aged children and adolescents (6-18 years) in high-income settings published from 2010 onwards, assess the quality of clinical practice guidelines, and inform subsequent prioritization of preventive actions in primary care.

Bibliographic databases (PubMed, Embase, Web of Science, and Cochrane Library), guideline repositories, Google, and Google Scholar were initially searched in 2020 and last updated on 7 July 2025. Titles/abstracts were screened by one reviewer and full texts by two independent reviewers. Data were extracted by two reviewers, and clinical practice guidelines were appraised using AGREE II.

The 104 included documents yielded 166 recommendation statements. The most frequently addressed topics were sexually transmitted infections, hypertension, tobacco use, and dyslipidemia. Consensus across documents was strongest for tobacco prevention, screening for sexually transmitted infections, and adolescent depression screening, whereas recommendations for dyslipidemia and hypertension differed across sources. A minority of clinical practice guidelines achieved consistently high scores across AGREE II domains.

Preventive recommendations for school-aged children and adolescents in primary care show areas of convergence and persistent uncertainty. The findings provide a basis for subsequent context-sensitive prioritization of preventive actions and highlight the need for more methodologically robust and implementation-oriented guidance.