Later school start times for supporting the education, health and well-being of high school students

摘要: Background A number of school systems worldwide have proposed and implemented later start times as a means avoiding the potentially negative impacts that early morning schedules can on adolescent students. Even mild sleep deprivation has been associated with significant health educational concerns: increased risk for accidents injuries, impaired learning, aggression, memory loss, poor self-esteem, changes in metabolism. Although researchers begun to explore effects delayed time, no one conducted rigorous review evidence determine whether support health, education, well-being. Objectives We aimed assess time supporting well-being high students. Secondary objectives were possible differential student subgroups different types schools; identify implementation practices, contextual factors, delivery modes positive times; broader community (high faculty staff, neighborhood, families). Search methods We main search this 28 October 2014 updated it 8 February 2016. We searched CENTRAL well 17 key electronic databases (including MEDLINE, Embase, ERIC, PsycINFO, Sociological Abstracts), current editions relevant journals organizational websites, trial registries, Google Scholar. Selection criteria We included any randomized controlled trials, before-and-after studies, interrupted series studies sufficient data points pertained students aged 13 19 years compared times. Studies reported either primary outcomes interest (academic outcomes, amount or quality sleep, mental indicators, attendance, alertness) secondary (health behaviors, safety social family outcomes) eligible. Data collection analysis At least two authors independently determined inclusion exclusion decisions through screening titles, abstracts, full-text reports. Two extracted all eligible studies. presented findings narrative synthesis across When more study samples provided information permit effect size calculations, we random-effects meta-analyses synthesize studies. Main results Our located records reporting 11 unique 297,994 participants; examined academic alertness. Overall, body was very low, rated most being at unclear bias respect allocation, attrition, absence randomization, baseline data. Therefore, cannot be confident about times. Preliminary from indicated potential association between psychosocial but comparability these low often precluded quantitative synthesis. Four mixed results. Six total significant, relationships sleep. One concerning an decreased depressive symptoms There results absenteeism. Three limited indication adverse logistics, qualitative portions less interaction parents children, another staffing scheduling difficulties. Because insufficient evidence, draw firm conclusions time. It is important note limitations especially trials high-quality are difficult conduct; unwilling unable allow necessary control over collection. Moreover, does not speak process implementing starts, focused rather than exploring process. Authors' conclusions This systematic suggests several benefits intervention need higher However, result base, could confidence.