![]() ![]() ![]() ![]() We considered observed effects to be of public health importance when applied at the population level. Moderate‐quality evidence also showed that multiple risk behaviour universal school‐based interventions improved the odds of physical activity (OR 1.32, 95% CI 1.16 to 1.50 I² = 0% n = 4 studies 6441 participants). No studies aimed to prevent self‐harm or gambling alongside other behaviours.Įvidence suggests that for multiple risk behaviours, universal school‐based interventions were beneficial in relation to tobacco use (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.60 to 0.97 n = 9 studies 15,354 participants) and alcohol use (OR 0.72, 95% CI 0.56 to 0.92 n = 8 studies 8751 participants both moderate‐quality evidence) compared to a comparator, and that such interventions may be effective in preventing illicit drug use (OR 0.74, 95% CI 0.55 to 1.00 n = 5 studies 11,058 participants low‐quality evidence) and engagement in any antisocial behaviour (OR 0.81, 95% CI 0.66 to 0.98 n = 13 studies 20,756 participants very low‐quality evidence) at up to 12 months' follow‐up, although there was evidence of moderate to substantial heterogeneity (I² = 49% to 69%). Behaviours that were most frequently addressed included alcohol use (n = 55), drug use (n = 53), and/or antisocial behaviour (n = 53), followed by tobacco use (n = 42). On average, studies aimed to prevent four of the primary behaviours. ![]() Most studies were conducted in the USA (n = 55 79%). We included in the review a total of 70 eligible studies, of which a substantial proportion were universal school‐based studies (n = 28 40%). ![]()
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