Cardiovascular health promotion through primary schools: A systematic mapping and review of reviews

Background and Objectives: Cardiovascular disease (CVD) is a major cause of premature mortality and morbidity in the UK and globally, driving health inequality and spiralling healthcare costs. Reducing CVD and its risk factors is a global policy priority. There is growing recognition that CVD risk trajectories are shaped in early life, with risk factors developing in children aged as early as 3–11 years, leading to later CVD events. Our objective with this study was to advance the evidence base on cardiovascular health promotion with children through primary schools. Methods: We conducted a systematic mapping and review of reviews to examine the factors associated with successful cardiovascular health promotion in primary schools and the intervention elements that impact knowledge and behaviour. Our work was informed by the needs of a community-based CVD-prevention initiative in London which sought to address the challenge of high CVD and childhood obesity rates locally. Results: Of 141 articles screened, only 15 focused on CVD health. Key findings revealed that curriculum-based approaches embedded in school routines and complemented by engaging children in a process of experiential learning can lead to statistically significant improvement in both knowledge and health behavioural change outcomes. The evidence shows that supporting children to attain positive CVD health-related behaviours is vital as they enter the foundational years of compulsory education. Conclusion: Schools, in particular primary schools, are crucial for early modelling and establishing the lifelong healthy habits that will positively impact children’s healthy behaviours and the wider population’s CVD health.