Universal Anxiety Interventions in United States Schools: A Systematic Review

Objective: We reviewed studies pertaining to randomized controlled universal/Tier 1, teacher-led intervention trials in United States (US) schools, and their impact on anxiety in K-12 students. Methods: We searched 7 databases and one search engine. Anxiety was the main outcome measure. Studies published through July 5, 2018 were appraised using the Cochrane Collaborations tool. Results: We included 4 studies, all indicating efficacy for lowering anxiety symptoms. Internal bias was unclear for 3. Conclusion: Despite a call from the National Institute of Mental Health for population-based, upstream public health interventions, empirical evidence is scarce. Findings from this review are reflected by the absence of such studies from the Healthy People 2020 recommendations for evidence-based resources consumer page. There appears to be a need for development and testing of universal teacher-led anxiety interventions in US schools.

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Limitations of the Randomized Controlled Trial in Evaluating Population-Based Health Interventions

American Journal of Preventive Medicine ◽

10.1016/j.amepre.2007.04.007 ◽

2007 ◽

Vol 33 (2) ◽

pp. 155-161 ◽

Cited By ~ 259

Author(s):

Robert William Sanson-Fisher ◽

Billie Bonevski ◽

Lawrence W. Green ◽

Cate D’Este

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Population Based ◽

Health Interventions ◽

Randomized Controlled

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Regional Contribution of Previable Infant Deaths to Infant Mortality Rates in the United States

American Journal of Perinatology ◽

10.1055/s-0039-1695014 ◽

2019 ◽

Author(s):

MacKenzie Lee ◽

Eric S. Hall ◽

Meredith Taylor ◽

Emily A. DeFranco

Keyword(s):

United States ◽

Infant Mortality ◽

Infant Death ◽

The United States ◽

Mortality Rates ◽

Population Based ◽

Infant Mortality Rate ◽

Infant Deaths ◽

Live Births ◽

Healthy People 2020

Objective Lack of standardization of infant mortality rate (IMR) calculation between regions in the United States makes comparisons potentially biased. This study aimed to quantify differences in the contribution of early previable live births (<20 weeks) to U.S. regional IMR. Study Design Population-based cohort study of all U.S. live births and infant deaths recorded between 2007 and 2014 using Centers for Disease Control and Prevention's (CDC's) WONDER database linked birth/infant death records (births from 17–47 weeks). Proportion of infant deaths attributable to births <20 vs. 20 to 47 weeks, and difference (ΔIMR) between reported and modified (births ≥20 weeks) IMRs were compared across four U.S. census regions (North, South, Midwest, and West). Results Percentages of infant deaths attributable to birth <20 weeks were 6.3, 6.3, 5.3, and 4.1% of total deaths for Northeast, Midwest, South, and West, respectively, p < 0.001. Contribution of < 20-week deaths to each region's IMR was 0.34, 0.42, 0.37, and 0.2 per 1,000 live births. Modified IMR yielded less regional variation with IMRs of 5.1, 6.2, 6.6, and 4.9 per 1,000 live births. Conclusion Live births at <20 weeks contribute significantly to IMR as all result in infant death. Standardization of gestational age cut-off results in more consistent IMRs among U.S. regions and would result in U.S. IMR rates exceeding the healthy people 2020 goal of 6.0 per 1,000 live births.

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