5. Discussion
labour intensive relative to new yield. We therefore consider our estimate of 70
studies to be a fair one. Other strengths of this scoping review are that it has
provided a useful overview of the kinds of evidence that are available. It has also
raised several salient conceptual issues around the relationship between the
research literature and the life-check proposal (e.g. the creation of new ‘one-off’
health checks versus the use of existing periodic health examinations). The
results of the scoping review could be used to judge whether or not a full
systematic review is required, and, if so, to identify a potential focus for the
review.
A full systematic review would need to appraise both the potential benefits and
harms of intervening in young people’s lives during their transition years. It is
possible that, for some young people, a one-off life check might impose an
undesirable level of negative self-reflection. For others, a life check may help with
adjustment and prevent emotional health problems that may be linked to
damaging health behaviours. An important question to consider would be whether
an annual activity that takes place throughout the school years is needed to
maximise benefit and minimise harm, rather than a periodic check that happens at
school entry and then transition. The practical, and therefore, ethical implications
of the life check are currently unclear, in terms of what support and services are
available and acceptable to young people identified as in need of help that
extends beyond an agreed health guidance plan.
It was not clear from this scoping review to what extent life check style
interventions varied according to setting and age group. Any future work should
consider whether the aims and options offered by a life check need to be tailored
according to different age groups and settings. The life check aims to impact on
physical and emotional health and wellbeing. Physical and emotional health and
wellbeing are broad terms which could be interpreted and measured in a number
of ways. For example, emotional health could be assessed through measures of
depression, self-esteem or ‘good’ behaviour. Indeed, the studies in this review
which tested the effectiveness of life check style interventions focused on different
aspects of physical and emotional health and wellbeing, such as health
behaviour, blood pressure, weight, disease, emotional distress, self-esteem and
depression. Any future work should consider carefully the intended outcomes of a
life check in order to be clear about what would constitute evidence of
effectiveness. Prioritising outcomes should involve different perspectives,
including the perspectives of young people themselves.
The results of this scoping review suggest a considerable body of relevant
research evidence addressing questions about the effectiveness, acceptability
and uptake of the life check. A full systematic review which evaluates a life check
within the context of both a regular/annual process, or a one-off personal health
MOT may be able to provide answers to some of the issues raised above. Since
we found studies evaluating life check style interventions in a variety of settings
and according to a range of outcomes, such a review could also consider where
the life checks might be best located (school, health services, community or the
home) and the most relevant outcomes of interest.
A scoping review of the evidence relevant to life checks for young people aged 9 to 14 years
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