{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:25:25Z","timestamp":1774621525511,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Alcohol and tobacco use in adolescence are major public health concerns that shape long-term health trajectories and undermine healthy behaviour development. Schools are key settings for health promotion, offering structured environments to foster self-regulation, social skills, and protective behaviours. This scoping review mapped recent school-based educational strategies designed to prevent alcohol and tobacco use among adolescents and to examine whether the included studies reported any involvement of school nurses. Methods: Review followed Arksey and O\u2019Malley\u2019s framework and adhered to JBI guidance and PRISMA-ScR. Searches were conducted in PubMed and Web of Science (2019\u20132024) to identify school-based educational interventions targeting alcohol and\/or tobacco use among primary or secondary school children. The primary search targeted prevention strategies, complemented by nursing-related terms to identify nurse involvement. A standardised charting form captured study characteristics, intervention formats, theoretical foundations, implementation factors, and any reported participation of health professionals. Data extraction was performed independently by two reviewers. Results: Eleven studies met the inclusion criteria. Most were randomised controlled trials (81.8%). Educational strategies included online (45.5%), hybrid (27.3%), and face-to-face (27.3%) formats. Programs focused on social skills, self-regulation, harm reduction, or resilience. Digital formats were cost-effective but showed challenges in engagement and sustained participation, while face-to-face or hybrid approaches offered relational support but were vulnerable to implementation drift. No study reported nurse involvement. Conclusions: School-based prevention strategies can contribute to healthier behaviours related to substance use by reinforcing socioemotional competencies and reducing early exposure to substances. However, persistent barriers such as low engagement, inconsistent delivery, and the absence of health professionals limit their impact. The role of school nurses could be considered in future school-based prevention programmes.<\/jats:p>","DOI":"10.3390\/children13040453","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:50:15Z","timestamp":1774533015000},"page":"453","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["School-Based Alcohol and Tobacco Prevention Strategies: A Scoping Review and the Missing Role of School Nurses"],"prefix":"10.3390","volume":"13","author":[{"given":"Paula","family":"Concha-Gacitua","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Universidad del Desarrollo, Las Condes 7610658, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6158-161X","authenticated-orcid":false,"given":"Amalia","family":"Sillero Sillero","sequence":"additional","affiliation":[{"name":"Escola Universit\u00e0ria Gimbernat, Adscrita a la Universitat Aut\u00f2noma de Barcelona (UAB), 08174 Sant Cugat, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Ayuso-Marga\u00f1on","sequence":"additional","affiliation":[{"name":"Public Health Nursing, Mental Health and Maternal-Child Health, Faculty of Nursing, University of Barcelona, 08907 L\u2019Hospitalet de Llobregat, Spain"},{"name":"North Florida Primary Health Care, Florida Nord, L\u2019Hospitalet de Llobregat, 08905 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J.","family":"Golusda","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad del Desarrollo, Las Condes 7610658, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Montserrat-Gala","sequence":"additional","affiliation":[{"name":"Department of Medicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1897-5949","authenticated-orcid":false,"given":"Eva","family":"Guti\u00e9rrez-Naharro","sequence":"additional","affiliation":[{"name":"Escola Universit\u00e0ria Gimbernat, Adscrita a la Universitat Aut\u00f2noma de Barcelona (UAB), 08174 Sant Cugat, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1824-6864","authenticated-orcid":false,"given":"Raquel","family":"Ayuso-Marga\u00f1on","sequence":"additional","affiliation":[{"name":"Social Determinants and Health Education Research Group (SDHEd), Hospital del Mar Research Institute, 08003 Barcelona, Spain"},{"name":"Hospital del Mar Nursing School (ESIHMar), Universitat Pompeu Fabra, 08003 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S2352-4642(20)30390-4","article-title":"Prevalence and trends in tobacco use among adolescents aged 13\u201315 years in 143 countries, 1999\u20132018: Findings from the Global Youth Tobacco Surveys","volume":"5","author":"Ma","year":"2021","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_2","unstructured":"World Health Organisation (2025, November 26). Adolescent and Young Adult Health. Available online: https:\/\/www.who.int\/teams\/maternal-newborn-child-adolescent-health-and-ageing\/adolescent-and-young-adult-health."},{"key":"ref_3","unstructured":"ESPAD Group (2020). ESPAD Report 2019: Results from the European School Survey Project on Alcohol and Other Drugs, Publications Office of the European Union."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"172906","DOI":"10.1016\/j.pbb.2020.172906","article-title":"Effect of alcohol use on the adolescent brain and behaviour","volume":"192","author":"Lees","year":"2020","journal-title":"Pharmacol. Biochem. Behav."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pedn.2022.01.006","article-title":"Physical and mental health outcomes associated with adolescent E-cigarette use","volume":"64","author":"Livingston","year":"2022","journal-title":"J. Pediatr. Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/s41432-023-00945-w","article-title":"What are the health impacts of nicotine and tobacco products on young people?","volume":"24","author":"Deery","year":"2023","journal-title":"Evid. Based Dent."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Yu, C., and Chen, J. (2025). Global Burden of substance use disorders among adolescents during 1990\u20132021 and a forecast for 2022\u20132030: An analysis for the Global Burden of Disease 2021. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-22107-6"},{"key":"ref_8","unstructured":"Crockett, L.J., Carlo, G., and Schulenberg, J.E. (2023). Substance use across adolescence and early adulthood: Prevalence, causes, developmental roots, and consequences. APA Handbook of Adolescent and Young Adult Development, American Psychological Association."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3866","DOI":"10.1007\/s12144-023-04944-z","article-title":"A meta-analysis study on peer influence and adolescent substance use","volume":"43","author":"Watts","year":"2024","journal-title":"Curr. Psychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e016060","DOI":"10.1136\/bmjopen-2017-016060","article-title":"Effectiveness of a pragmatic school-based universal resilience intervention in reducing tobacco, alcohol and illicit substance use in a population of adolescents: Cluster-randomised controlled trial","volume":"7","author":"Hodder","year":"2017","journal-title":"BMJ Open"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Tinner, L., Palmer, J.C., Lloyd, E.C., Caldwell, D.M., MacArthur, G.J., Dias, K., Langford, R., Redmore, J., Wittkop, L., and Watkins, S.H. (2022). Individual, family and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8\u201325 years: A systematic review and meta-analysis. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-13072-5"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/phr07170","article-title":"Interventions integrating health and academic education in schools to prevent substance misuse and violence: A systematic review","volume":"7","author":"Tancred","year":"2019","journal-title":"Public Health Res."},{"key":"ref_13","unstructured":"World Health Organization (2025, November 26). Global Alcohol Action Plan 2022\u20132030. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240090101."},{"key":"ref_14","unstructured":"Council of the European Union (2025, November 26). EU Drugs Strategy 2021\u20132025. Available online: https:\/\/op.europa.eu\/en\/publication-detail\/-\/publication\/bc6700c8-03ba-11ec-8f47-01aa75ed71a1\/language-en."},{"key":"ref_15","unstructured":"World Health Organization (2025, November 26). Targets of Sustainable Development Goal 3. Available online: https:\/\/www.who.int\/europe\/about-us\/our-work\/sustainable-development-goals\/targets-of-sustainable-development-goal-3."},{"key":"ref_16","unstructured":"World Health Organization (2025, November 26). Targets of Other Sustainable Development Goals Directly Linked to Health. Available online: https:\/\/www.who.int\/europe\/about-us\/our-work\/sustainable-development-goals\/targets-of-other-sustainable-development-goals-directly-linked-to-health."},{"key":"ref_17","unstructured":"WHO Framework Convention on Tobacco Control (2025, November 26). Global Strategy to Accelerate Tobacco Control: Advancing Sustainable Development Through the Implementation of the WHO FCTC 2019\u20132025. Available online: https:\/\/fctc.who.int\/resources\/publications\/m\/item\/global-strategy-to-accelerate-tobacco-control-2025."},{"key":"ref_18","unstructured":"Centers for Disease Control and Prevention (2025, November 26). Preventing Excessive Alcohol Use with Proven Strategies, Available online: https:\/\/www.cdc.gov\/alcohol\/prevention\/proven-strategies.html."},{"key":"ref_19","unstructured":"National Service for the Prevention and Rehabilitation of Drug and Alcohol Use (SENDA) (2025, November 12). National Drug Strategy 2021\u20132030, Available online: https:\/\/www.senda.gob.cl\/wp-content\/uploads\/2021\/02\/Estrategia-Nacional-de-Drogas-version-web.pdf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1093\/ntr\/nty007","article-title":"Evidence from Qualitative Studies of Youth About the Impacts of Tobacco Control Policy on Young People in Europe: A Systematic Review","volume":"21","author":"Papanastasiou","year":"2019","journal-title":"Nicotine Tob. Res."},{"key":"ref_21","unstructured":"World Health Organization (2025, November 26). United Nations Educational, Scientific and Cultural Organization. Making Every School a Health-Promoting School: Global Standards and Indicators for Health-Promoting Schools and Systems, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240025059."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Villanueva-Blasco, V.J., Eslava, D., Olave-Porr\u00faa, L., Quintana, J.B., and Rodr\u00edguez de Fonseca, F. (2025). Selective prevention programs for substance and behavioral addictions in adolescents: A systematic review. Front. Psychol., 16.","DOI":"10.3389\/fpsyg.2025.1671822"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Puertas, R., Vaca-Gallegos, S., L\u00f3pez-N\u00fa\u00f1ez, C., and Ruisoto, P. (2022). Prevention of Alcohol Consumption Programs for Children and Youth: A Narrative and Critical Review of Recent Publications. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.821867"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1177\/1942602X20906534","article-title":"School Nurses\u2019 Role in Self-Management, Anticipatory Guidance, and Advocacy for Students with Chronic Illness","volume":"35","author":"McCabe","year":"2020","journal-title":"NASN Sch. Nurse"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/josh.70027","article-title":"Investigating Primary School Nurses\u2019 Activities That Are Effective in Health Promotion and Primary Prevention: A Systematic Review","volume":"95","author":"Mugo","year":"2025","journal-title":"J. Sch. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e250116","DOI":"10.1001\/jamahealthforum.2025.0116","article-title":"Role of School Nurses in the Health and Education of Children","volume":"6","author":"Dickson","year":"2025","journal-title":"JAMA Health Forum"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e2022057992","DOI":"10.1542\/peds.2022-057992","article-title":"Improving Substance Use Prevention, Assessment, and Treatment Financing to Enhance Equity and Improve Outcomes Among Children, Adolescents, and Young Adults","volume":"150","author":"Camenga","year":"2022","journal-title":"Pediatrics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/1942602X20985420","article-title":"Interprofessional Collaboration in School-Based Settings Part 1: Definition and the Role of the School Nurse","volume":"36","author":"McIntosh","year":"2021","journal-title":"NASN Sch. Nurse"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: Towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"Int. J. Soc. Res. Methodol."},{"key":"ref_30","unstructured":"Peters, M., Godfrey, C., McInerney, P., Soares, C., Khalil, H., and Parker, D. (2017). Guidance for the Conduct of JBI Scoping Reviews. JBI Reviewer\u2019s Manual, The Joanna Briggs Institute."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_32","unstructured":"Joanna Briggs Institute (2025, November 26). JBI Manual for Evidence Synthesis: Scoping Reviews. Available online: https:\/\/jbi-global-wiki.refined.site\/space\/MANUAL\/355862729."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1186\/s13643-021-01821-3","article-title":"Scoping reviews: Reinforcing and advancing the methodology and application","volume":"10","author":"Peters","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1111\/add.16403","article-title":"An on-line school-based substance use harm reduction programme: The Illicit Project randomized controlled trial results","volume":"119","author":"Debenham","year":"2024","journal-title":"Addiction"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100648","DOI":"10.1016\/j.invent.2023.100648","article-title":"24-month outcomes of an eHealth universal program for students and parents to prevent adolescent alcohol use: A cluster randomized controlled trial in schools","volume":"33","author":"Slade","year":"2023","journal-title":"Internet Interv."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Griffin, K.W., Williams, C., Botvin, C.M., Sousa, S., and Botvin, G.J. (2022). Effectiveness of a hybrid digital substance abuse prevention approach combining e-Learning and in-person class sessions. Front. Digit. Health, 4.","DOI":"10.3389\/fdgth.2022.931276"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Haug, S., Boumparis, N., Wenger, A., Schaub, M.P., and Paz Castro, R. (2022). Efficacy of a Mobile App-Based Coaching Program for Addiction Prevention Among Apprentices: A Cluster-Randomized Controlled Trial. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192315730"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1007\/s11121-022-01394-0","article-title":"Adolescent Substance Use Behavior Change Through School Intervention Is Improved by Teacher and School Implementation Support Together, Especially for Girls","volume":"23","author":"Layland","year":"2022","journal-title":"Prev. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.amepre.2022.06.017","article-title":"Longer-Term Efficacy of a Digital Life-Skills Training for Substance Use Prevention","volume":"63","author":"Haug","year":"2022","journal-title":"Am. J. Prev. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e2021051005","DOI":"10.1542\/peds.2021-051005","article-title":"An Internet Quiz Game Intervention for Adolescent Alcohol Drinking: A Clustered RCT","volume":"148","author":"Ho","year":"2021","journal-title":"Pediatrics"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"51","DOI":"10.5114\/ain.2021.107710","article-title":"Summative evaluation of the \u201cDebate\u201d programme for alcohol related problems prevention\u2014Pilot study","volume":"34","author":"Piekarz","year":"2021","journal-title":"Alcohol. Drug Addict."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e15438","DOI":"10.2196\/15438","article-title":"A Web-Based, Computer-Tailored Intervention to Reduce Alcohol Consumption and Binge Drinking Among Spanish Adolescents: Cluster Randomized Controlled Trial","volume":"22","author":"Mercken","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/her\/cyaa006","article-title":"Resilience-based alcohol education: Developing an intervention, evaluating feasibility and barriers to implementation using mixed-methods","volume":"35","author":"Graber","year":"2020","journal-title":"Health Educ. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e74","DOI":"10.1016\/S2589-7500(19)30213-4","article-title":"Combined prevention for substance use, depression, and anxiety in adolescence: A cluster-randomised controlled trial of a digital online intervention","volume":"2","author":"Teesson","year":"2020","journal-title":"Lancet Digit. Health"},{"key":"ref_45","unstructured":"Joanna Briggs Institute (2025, December 21). JBI Levels of Evidence. Available online: https:\/\/jbi.global\/sites\/default\/files\/2019-05\/JBI-Levels-of-evidence_2014_0.pdf."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/wvn.12144","article-title":"An Evidence-Based Approach to Scoping Reviews","volume":"13","author":"Khalil","year":"2016","journal-title":"Worldviews Evid. Based Nurs."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.ypmed.2015.12.004","article-title":"Interventions for prevention and treatment of tobacco smoking in school-aged children and adolescents: A systematic review and meta-analysis","volume":"85","author":"Peirson","year":"2016","journal-title":"Prev. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"276","DOI":"10.56183\/iberoeds.v3i1.629","article-title":"Hybrid Education: Current Challenges","volume":"3","year":"2023","journal-title":"Ibero-Am. J. Educ. Soc. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s10648-023-09773-x","article-title":"Active student participation in whole-school interventions in secondary school. A systematic literature review","volume":"35","author":"Berti","year":"2023","journal-title":"Educ. Psychol. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13011-023-00518-1","article-title":"Digital interventions for substance use disorders in young people: Rapid review","volume":"18","author":"Monarque","year":"2023","journal-title":"Subst. Abus. Treat. Prev. Policy"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1146\/annurev.psych.52.1.1","article-title":"Social cognitive theory: An agentic perspective","volume":"52","author":"Bandura","year":"2001","journal-title":"Annu. Rev. Psychol."},{"key":"ref_52","unstructured":"Overton, W.F., Molenaar, P.C.M., and Lerner, R.M. (2015). Positive youth development and relational-developmental-systems. Handbook of Child Psychology and Developmental Science: Theory and Method, John Wiley & Sons, Inc.. [7th ed.]."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s12187-011-9112-8","article-title":"Youth Developmental Assets in Global Perspective: Results from International Adaptations of the Developmental Assets Profile","volume":"4","author":"Scales","year":"2011","journal-title":"Child Ind. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1111\/cdev.12864","article-title":"Promoting positive youth development through school-based social and emotional learning interventions: A meta-analysis of follow-up effects","volume":"88","author":"Taylor","year":"2017","journal-title":"Child Dev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e306","DOI":"10.2196\/jmir.6588","article-title":"Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review","volume":"19","author":"Erbe","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Kontak, J.C., Macrae, C., Caldwell, H.A.T., Feicht, B., Heath, S., Hancock Friesen, C.L., and Kirk, S.F. (2025). The process of student engagement in school health promotion: A scoping review. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-22121-8"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s12310-021-09423-z","article-title":"Developing Treatment Integrity Measures for Teacher-Delivered Interventions: Progress, Recommendations and Future Directions","volume":"14","author":"Sutherland","year":"2022","journal-title":"Sch. Ment. Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1037\/spq0000019","article-title":"Implementation science and school psychology","volume":"28","author":"Forman","year":"2013","journal-title":"Sch. Psychol. Q."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"48","DOI":"10.17151\/hpsal.2018.23.2.4","article-title":"Estrategias con adolescentes para prevenir el consumo problem\u00e1tico de alcohol: Modalidades y \u00e1mbitos de aplicaci\u00f3n","volume":"23","author":"Biolatto","year":"2018","journal-title":"Hacia La Promoci\u00f3n De La Salud"},{"key":"ref_60","first-page":"565","article-title":"Systematic Review of Family Drug Prevention Programs: Efficacy and Indexing in Best Practice Portals","volume":"24","author":"Marmolejo","year":"2024","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.2196\/mental.4534","article-title":"Mixing Online and Face-to-Face Therapy: How to Benefit From Blended Care in Mental Health Care","volume":"3","author":"Wentzel","year":"2016","journal-title":"JMIR Ment. Health"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1080\/10474412.2020.1830409","article-title":"Using Systems-Level Consultation to Establish Data Systems to Monitor Coaching in Schools: A Framework for Practice","volume":"31","author":"Barrett","year":"2021","journal-title":"J. Educ. Psychol. Consult."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1007\/s12310-023-09578-x","article-title":"Implementation of a School Mental Health Learning Collaborative Model to Support Cross-Sector Collaboration","volume":"15","author":"Heatly","year":"2023","journal-title":"Sch. Ment. Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/josh.12310","article-title":"The Whole School, Whole Community, Whole Child Model: A New Approach for Improving Educational Attainment and Healthy Development for Students","volume":"85","author":"Lewallen","year":"2015","journal-title":"J. Sch. Health"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1111\/josh.12305","article-title":"A Whole School Approach: Collaborative Development of School Health Policies, Processes, and Practices","volume":"85","author":"Hunt","year":"2015","journal-title":"J. Sch. Health"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Best, N.C., and Thomas, C.S. (2024). SDOH and School Nurse-Led Interventions: Improving Health and Education Outcomes Among School-Aged Children and Adolescents. Transforming Social Determinants to Promote Global Health, Springer Nature.","DOI":"10.1007\/978-3-031-61160-5_28"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e20160852","DOI":"10.1542\/peds.2016-0852","article-title":"Role of the School Nurse in Providing School Health Services","volume":"137","author":"Holmes","year":"2016","journal-title":"Pediatrics"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1177\/10598405231195655","article-title":"A Mixed Methods Exploration of Texas School Nurses\u2019 Involvement in Addressing Substance Use and Sexual\/Reproductive Health Among Students in Alternative High Schools","volume":"41","author":"Johnson","year":"2025","journal-title":"J. Sch. Nurs."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/10598405211068120","article-title":"The Evolution of the Role of U.S. School Nurses in Adolescent Mental Health at the Individual, Community, and Systems Level: An Integrative Review","volume":"39","author":"Hoskote","year":"2023","journal-title":"J. Sch. Nurs."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Asadi, Z., Teymourlouy, A.A., Hashjin, A.A., and Pourasghari, H. (2025). Factors affecting school health policies and ways to improve them: A qualitative study. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-24579-y"},{"key":"ref_71","first-page":"1","article-title":"Perception of school climate, academic performance and risk behaviors in adolescence","volume":"45","author":"Lunetti","year":"2022","journal-title":"Ric. Psicol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/4\/453\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:30:48Z","timestamp":1774618248000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/4\/453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":71,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["children13040453"],"URL":"https:\/\/doi.org\/10.3390\/children13040453","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]}}}