1. Background
proposed to offer young people a ‘personal health MOT’1 at the transition
between primary and secondary education, with an emphasis on enabling young
people to explore their emotional wellbeing as well as their physical health
(Department for Education and Skills, 2005b). The Scottish Executive has also
established a programme to support young people through the ‘teenage transition’
(Scottish Executive, 2003). In a literature review commissioned by the Health
Education Board in Scotland, Furlong (2002) reviewed the youth transitions
literature and health implications, outlining the increasing complexities involved in
the areas of psychosocial and health outcomes, and the subsequent difficulties in
unravelling these relationships. Slootmaker (2005) also identified adolescence as
a transitional period and explored the potential for targeting adolescents at this
stage through multi-media.
The concept of the life check is relatively new, and has not yet been fully defined.
Questions of setting, intervention provider, and appropriate content have yet to be
addressed fully, as has the essential and central query of effectiveness. Existing
interventions, such as pre-school immunisation and vision screening, may be
considered as components of a life check, for example, but on their own they are
not what is envisaged for the life check. Components may include initial self-
assessments; emotional and/or physical health check-ups; tailored advice,
support and referral; and the development of personal health guides or plans.
Although the proposed life checks will involve the provision of specialist support
staff, Our Health, Our Care, Our Say identified the need for people to take control
of their own health and wellbeing (Department of Health, 2006, p 31). The
emphasis of life checks will be on support for young people to take responsibility
for their own wellbeing. Life checks can be understood within the context of health
literacy, defined as ‘the capacity of an individual to obtain, interpret and
understand basic health information and services in ways that are health-
enhancing’ (Sihota and Lennard, 2004, p 5).
Schools represent a potential setting for life checks and have already been
identified as a suitable setting for health promotion activities through the joint
DH/DfES National Healthy Schools Programme in the UK and through Scotland's
Health Promoting Schools Unit. In an extension of these programmes, the
possibilities for integrating a number of services for young people at a school site
have been explored. The Green Paper Every Child Matters (Department for
Education and Skills, 2003) describes plans to promote ‘extended schools’ in the
UK. Extended schools are those which work with local providers to offer a number
of extended services, often provided outside the school day, such as childcare
and parenting support. One of the five core services offered by extended schools
is ‘swift and easy referral to specialist services such as speech therapy and health
drop ins’ (Teachernet, 2006). This involves schools linking with Primary Care
Trust services (e.g. school nurses, child and adolescent mental health services
(CAMHS) and speech and language therapists) to provide access to services and
to enable easier referral of children to specialised services. The DfES has made
£680 million available for the establishment of extended schools between 2006
and 2008, and the Schools White Paper outlines its plans for the progress:
By 2008, we want half of all primary schools and a third of all secondary
schools to be providing access to these extended services, with all schools
doing so by 2010. (Department for Education and Skills, 2005a, p 76)
1 In the UK, all licensed motor vehicles are required to have a Ministry of Transport (MOT)
Certificate of Roadworthiness. This is an official document provided after a vehicle has
undergone tests of roadworthiness and safety.
A scoping review of the evidence relevant to life checks for young people aged 9 to 14 years