Health promotion and prevention for vulnerable children and adolescents in daycare centers and schools-Approaches to increase reach

Background There are socioeconomic disparities in the participation of health-promoting and primary prevention programs in childhood and adolescence. Objectives The aim of this study is to give a broad overview of approaches to increase reach in health promotion and prevention among vulnerable children and adolescents in daycare centres and schools and to identify intervention characteristics conducive to reach. Materials and methods The authors conducted a scoping review of peer-reviewed articles and reviews published between 2010 and 2018 in the databases Cochrane Library, DoPHER, PubMed, PsychINFO, SCOPUS and Web of Science. A total of 32 full texts, including 16 intervention studies, 10 descriptive studies and 6 reviews, were included. Results A wide range of approaches was identified, but no robust evidence on effects on reach could be found. Intervention characteristics that are most strongly associated with increased reach among vulnerable children and adolescents include (1) universal approach, (2) multicomponent design, (3) settings approach, (4) structural and environmental change, (5) local governance and partnership approach, (6) involvement of parents and siblings and (7) tailoring. Conclusions An initial overview of the types and modes of action of approaches has been generated. Certain conceptual features can increase the reach of interventions in socioeconomically disadvantaged children and adolescents. The central research desideratum is that the perspective of social determinants of health and the associated methodological-theoretical requirements must be given greater consideration in intervention studies.