5. Discussion
5. DISCUSSION
The proposal to implement life checks for children and young people was
prompted by concern about the emotional wellbeing and resilience of young
people at the transition from primary to secondary school, and the desire to help
young people assess their personal risk factors and engage in positive health
behaviours. We identified a total of 70 relevant studies, just under half of which
were outcome evaluations (N=34). This body of evidence was spread fairly evenly
according to effectiveness in school settings and effectiveness outside school
settings. One of the two main groups of studies relates to regular and/or annual
health checks conducted within existing services. Examples are sports ‘pre-
participation examinations’; the Danish ‘health dialogue’; and annual ‘well visits’
and preventive health checks provided in the USA. These examples fit with the
idea of the young person's life check being one of a number of periodic checks
throughout the life span. The second group of studies provide evidence about the
effectiveness of a one-off health and wellbeing consultation, a central feature of
the life check for this age group.
Since the life check is a new policy proposal and aims to cover both physical and
emotional health, we had to develop complex and sophisticated search strategies
covering diverse literatures (health promotion and public health, resilience and
wellbeing, and youth transitions) and concepts (e.g. counselling, advice,
assessment, health literacy). This strategy paid off, because we identified studies
which covered nearly all the components and topics suggested in the life-check
proposal. However, despite searching within the literature on transitions and
including the concept of ‘health literacy’ within our search terms, we found only
one study evaluating an intervention in the style of the life check proposal and
none of the studies explicitly used the term ‘health literacy’. The latter is likely to
be explained by the fact that health literacy is a fairly new concept (Sihota and
Lennard, 2004). We did some quick searches within our excluded studies and
found approximately 76 reports on youth transitions. We checked whether we had
missed any relevant studies, but found that most of these reports had been
excluded because they provided guidance, counselling and mentoring to improve
academic achievement, rather than health and emotional wellbeing.
A scoping review is intended to provide a preliminary assessment of the potential
size and scope of the available research literature. While a scoping review uses
some of the methods common to the standard stages of a systematic review, it
does so in a limited manner. Our searches were systematic and explicitly reported
,but they were not fully exhaustive. For example, we did not attempt to search the
‘grey’ literature, we did not scan the reference lists of relevant studies, and we did
not search all available electronic databases. This means that we may have
underestimated the total amount of literature available. Our screening, coding and
analysis of studies were also systematic and transparent, but, because we did not
retrieve full reports, we had to work with the limited information available in titles
and abstracts. Consequences of this are the inclusion of studies which may have
been irrelevant on inspection of the full report and/or exclusion of studies which
may have been relevant on inspection of the full report.
There is no way of checking whether the 70 studies we have identified are an
over- or under-estimate of the literature. Previous experience suggests that more
exhaustive searching tends to identify new studies. However, the yield from
searching more and more sources usually tails off, making additional searching
A scoping review of the evidence relevant to life checks for young people aged 9 to 14 years
24