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Promover el clima y la salud en las escuelas con la intervención SEHER en escuelas secundarias de varios componentes

Sachin Shinde¹, Helen A Weiss², Beena Varghese³

¹Sangath, Porvorim, Goa, India; MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.

Lancet (London, England)

|November 27, 2018

Resumen

Una intervención de promoción de la salud escolar mejoró significativamente el bienestar de los estudiantes y el clima escolar cuando fue impartida por consejeros laicos. Los maestros que ofrecían el mismo programa no mostraron un impacto significativo, lo que destaca la importancia del agente de entrega para los resultados de salud de los adolescentes.

Área de la Ciencia:

Salud de los adolescentes
Intervenciones de salud pública
Programas basados en la escuela

Sus antecedentes:

Los entornos escolares influyen significativamente en la salud y el éxito académico de los adolescentes.
El aumento de la retención en la escuela secundaria en los países de ingresos bajos y medios requiere estrategias escalables de promoción de la salud.
Los entornos sociales escolares de calidad son cruciales para mejorar la salud y el bienestar de los adolescentes.

Objetivo del estudio:

Evaluar la eficacia de una intervención de promoción de la salud de toda la escuela (SEHER) con múltiples componentes para mejorar el clima escolar y los resultados de salud entre los adolescentes indios.
Comparar el impacto de la intervención SEHER realizada por consejeros laicos frente a los profesores.

Principales métodos:

Un ensayo aleatorizado de grupo en el que participaron 75 escuelas secundarias del gobierno de la India.
Tres ramas: SEHER impartido por consejeros laicos (SM), SEHER impartido por maestros (TSM) y un grupo de control.
Resultado primario: el clima escolar medido por el cuestionario Beyond Blue School Climate (BBSCQ); los resultados secundarios incluyeron depresión, acoso escolar, violencia, actitudes de equidad de género y conocimiento de salud reproductiva.

Principales resultados:

La intervención SEHER realizada por consejeros laicos (SM) mejoró significativamente el clima escolar en comparación con el grupo de control (aMD 7.57, p<0.0001).
La intervención de SM también mostró mejoras significativas en los resultados secundarios como la reducción de la depresión, la intimidación y la violencia, y el aumento de la equidad de género y el conocimiento de la salud reproductiva.
La intervención impartida por el profesor (TSM) no mostró mejoras significativas en el clima escolar o en los resultados secundarios en comparación con el grupo de control.

Conclusiones:

La intervención SEHER es efectiva para mejorar el clima escolar y los resultados de la salud de los adolescentes cuando es impartida por consejeros laicos.
El agente de entrega es crítico; los maestros no fueron efectivos en la entrega de esta intervención.
La investigación futura debería explorar la ampliación de la intervención SEHER con agentes de ejecución adecuados en diversos entornos.

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