School-Based Interventions for Migrant Students in the Framework of the Health Promoting Whole-School Approach: An Umbrella Review

Round 1

Reviewer 1 Report

As a reviewer, I have read the paper ‘School-based interventions for migrant students in the framework of the health-promoting whole-school approach: An umbrella review’ submitted to ‘Sustainability’ in depth. The manuscript is an interesting piece on the important topic of migrant students. The introduction, however, misses a clear structure and thorough explanation of the main concepts in the manuscript – “migrants” on the one hand, and the “Health Promoting School (HPS) approach” on the other hand. Moreover, the article needs careful language revision as some paragraphs are not always clear because of grammatical errors. The results’ section is comprehensive and very interesting, but a clear visualization could help readers see the forest for the trees. In this respect, my overall recommendation for the paper is to accept with major revision.

Below, my report leading up to my decision to accept with major revision is discussed in more detail.

 

1.     Abstract and keywords

In the second part of the abstract – in which the results are discussed – not everything is clear. The reader needs more information to grasp what is written in that part. For me, an abstract should be crystal clear – without having to read the article first. For example, at this point the reader does not know what is meant by “The component that accounts for the higher number of strategies is the one of individual skills”. Why ‘higher’ number? And what is meant by ‘the one of individual skills’. The authors should revise their abstract accordingly.

 

2.     Introduction

The introduction – and in extension the entire manuscript - would profit from language revision (by the authors but proofreading by a native speaker would also be profitable). There are multiple language errors (e.g., “... are a vulnerable population at risk of to drop-out…”, “… the strengths and resources that immigrant carry with them…”), which make the introduction hard to fully understand.

Some statements are not clear to me (they are rather vague and need more specification), for example “As this population is impacted by various factors…” What do the authors mean by various factors?

The introduction also contains the theoretical framework of this manuscript. However, the concepts used in this manuscript are not explained very thoroughly. The introduction would profit from subtitles – also to make the line of reasoning stronger. Now, some issues are only touched upon very briefly. Not to say that the introduction must become much longer, but the concepts that are central should be extended a bit. For example, what is meant by ‘migrants’ in this manuscript* (there are a lot of different definitions out there, and I can imagine that in the articles involved in the review, migrants are sometimes defined slightly different – this is also clear already in the keywords of the search string the authors used) and can the authors give more specific information about the Health Promoting School model and its six components? This would help readers to fully grasp this paragraph.

*This is slightly touched upon in the discussion section, but an explanation should come sooner.

 

3.     Materials and methods

Who are ‘they’ in the following sentence: “They focus on broad themes or issues for which many competing interventions exist and have been evaluated by literature, therefore they highlight available reviews addressing these interventions and their findings.”

Can the authors give a sound reasoning why they chose articles from 2005 onwards?

The authors state: ‘We identified additional literature by searching manually and based on the reference lists of selected papers’. Can the authors say something about the reliability and validity of this additional strategy?

The authors state: “Due to the commonalities in the experiences of migrant youth in receiving countries, we did not limit the search by geographic location, resulting in an international sampling of literature.” Can they back up the statement about the commonalities across countries with literature/data?

Here too grammatical errors, such as “when in doubt, if a paper met or not some of the criteria, they were included to be screened in the second stage of full-text analysis.” Or: “The studies that met all inclusion criteria and were subsequently coded for data extraction.”

This is surprising: “A quality assessment procedure was not used in this umbrella review, as most of the studies would have been rated of weak quality and eliminated.” Such-like statement raises questions: What is meant here, that the selected articles were actually not of really good quality?

 

4.     Results

The results’ section is very comprehensive. Maybe, next to the (very large) table, a more concise image could be created to summarize the results. The authors could use, for example, a bubble chart or a table with crosses, to show the reader what the effects of the interventions mentioned are. In so doing, the image can show the results at a single glance.

The following sentence is hard to understand: “Belonging to one specific component has been agreed based on the elements to which each strategy contributes the most, even if some strategies could be seen as cross-cutting to some extent.”

The table is very interesting, but as the table is spread out over different pages, the heading should be repeated each time.

Sentence that is difficult to grasp: “Therefore, it’s important to clarify that some teachers’ training or parents’ engagement also focus on the individual level, however, since the target is not the student, but someone who is part of the school environment or the surrounding community, activity that specifically involve teachers and parents have been included in the respective categories.”

The results’ section is very interesting and in general has a good read. Here too, language editing should be undertaken by the authors. To give only two examples: “It seems quite clear that this kind of intervention have different effects by socio-economic statuses, but there’s only limited evidence for widening inequalities”. And: “Peer support among students from different background is aimed to learn the importance of respecting and welcoming cultural differences and it’s crucial to enhance the school social environment component.”

 

5.     Discussion

In my opinion, this paragraph is very clarifying and should have come way sooner in the manuscript: “The current umbrella review examined the effectiveness of school-based strategies aimed at promoting migrant students’ health and academic outcomes. Twenty-one reviews were analyzed, and 18 strategies were identified and classified into 6 areas of intervention linked to the six components of the Health Promoting School model: individual skills, school physical environment, school social environment, school policies, health and social services, and community links.”

“This confirms the value of this approach in providing a vision to guide educational systems, together with its flexibility and potential to address different emerging issue.” What is ‘this’? This sentence is unclear.

Interesting discussion with some critical points. I enjoyed reading this discussion.

 

Author Response

We thank you for your thoughtful suggestions and insights, which have helped us improved the paper significantly. We are also grateful for your positive feed-backs.

The manuscript has been rechecked and the necessary changes have been made in accordance with your suggestions. The responses to all comments have been prepared and given below.

 

As a reviewer, I have read the paper ‘School-based interventions for migrant students in the framework of the health-promoting whole-school approach: An umbrella review’ submitted to ‘Sustainability’ in depth. The manuscript is an interesting piece on the important topic of migrant students. The introduction, however, misses a clear structure and thorough explanation of the main concepts in the manuscript – “migrants” on the one hand, and the “Health Promoting School (HPS) approach” on the other hand. Moreover, the article needs careful language revision as some paragraphs are not always clear because of grammatical errors. The results’ section is comprehensive and very interesting, but a clear visualization could help readers see the forest for the trees. In this respect, my overall recommendation for the paper is to accept with major revision.

Below, my report leading up to my decision to accept with major revision is discussed in more detail.

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We changed the paper according to your suggestions:

• We did a careful language revision throughout the manuscript and we clarified several sentences
• We reviewed the abstract
• We improved the introduction by explaining the main concepts better
• We added the methodological information requested
• We added a table to summarize the results

 

 

1. Abstract and keywords

In the second part of the abstract – in which the results are discussed – not everything is clear. The reader needs more information to grasp what is written in that part. For me, an abstract should be crystal clear – without having to read the article first. For example, at this point the reader does not know what is meant by “The component that accounts for the higher number of strategies is the one of individual skills”. Why ‘higher’ number? And what is meant by ‘the one of individual skills’. The authors should revise their abstract accordingly.

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We reviewed the abstract to make it crystal clear.

 

2. Introduction

The introduction – and in extension the entire manuscript - would profit from language revision (by the authors but proofreading by a native speaker would also be profitable). There are multiple language errors (e.g., “... are a vulnerable population at risk of to drop-out…”, “… the strengths and resources that immigrant carry with them…”), which make the introduction hard to fully understand.

Some statements are not clear to me (they are rather vague and need more specification), for example “As this population is impacted by various factors…” What do the authors mean by various factors?

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We did a careful language revision throughout the manuscript and we clarified the sentences you reported.

 

The introduction also contains the theoretical framework of this manuscript. However, the concepts used in this manuscript are not explained very thoroughly. The introduction would profit from subtitles – also to make the line of reasoning stronger. Now, some issues are only touched upon very briefly. Not to say that the introduction must become much longer, but the concepts that are central should be extended a bit. For example, what is meant by ‘migrants’ in this manuscript* (there are a lot of different definitions out there, and I can imagine that in the articles involved in the review, migrants are sometimes defined slightly different – this is also clear already in the keywords of the search string the authors used) and can the authors give more specific information about the Health Promoting School model and its six components? This would help readers to fully grasp this paragraph.

*This is slightly touched upon in the discussion section, but an explanation should come sooner.

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We divided the introduction into subtitles. Moreover, we explained the core theoretical concept better. We added a definition of migrants, and we better introduced this concept. We described the Health Promoting School model more in depth, defining the six components. We moved into this section the components explanations that were included in the results section in the previous version.

We also reformulated the study aims better to explain the link with the Health Promoting School model.

 

3. Materials and methods

Who are ‘they’ in the following sentence: “They focus on broad themes or issues for which many competing interventions exist and have been evaluated by literature, therefore they highlight available reviews addressing these interventions and their findings.”

Response: Thanks for the very useful suggestions. We reformulated the sentence.

 

Can the authors give a sound reasoning why they chose articles from 2005 onwards?

Response: Thanks for the very useful suggestions, which have helped us improve the paper. We decided to focus on the last 15 years of research. The characteristics of migration are constantly changing. We, therefore, wanted to look at a significant but shortened historical period. We added an explanation about this methodological choice in the method section – Inclusion and Exclusion Criteria paragraph.

 

The authors state: ‘We identified additional literature by searching manually and based on the reference lists of selected papers’. Can the authors say something about the reliability and validity of this additional strategy?

Response: Thanks for the very useful observation. We specified the reasons that guided us in using these additional reviews. These additional reviews were not focused on school exclusively but they included school-based interventions in their analysis.

 

The authors state: “Due to the commonalities in the experiences of migrant youth in receiving countries, we did not limit the search by geographic location, resulting in an international sampling of literature.” Can they back up the statement about the commonalities across countries with literature/data?

Response: Thanks for the very useful suggestions. We reformulated the sentence and we added a literature reference to justify this choice.

 

Here too grammatical errors, such as “when in doubt, if a paper met or not some of the criteria, they were included to be screened in the second stage of full-text analysis.” Or: “The studies that met all inclusion criteria and were subsequently coded for data extraction.”

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We did a careful language revision throughout the manuscript and we clarified the sentences you reported.

 

This is surprising: “A quality assessment procedure was not used in this umbrella review, as most of the studies would have been rated of weak quality and eliminated.” Such-like statement raises questions: What is meant here, that the selected articles were actually not of really good quality?

Response: Thanks for the very useful suggestions. We specified that the reviews followed rigorous procedures. However, much methodological information is missing in the reviews selected, probably due to the characteristics of the journals and different disciplinary backgrounds. This lack of information would have affected the assessment procedure.

 

4. Results

The results’ section is very comprehensive. Maybe, next to the (very large) table, a more concise image could be created to summarize the results. The authors could use, for example, a bubble chart or a table with crosses, to show the reader what the effects of the interventions mentioned are. In so doing, the image can show the results at a single glance.

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We added a table with crosses to summarize the results and give an overview.

 

The following sentence is hard to understand: “Belonging to one specific component has been agreed based on the elements to which each strategy contributes the most, even if some strategies could be seen as cross-cutting to some extent.”

Response: Thanks for the very useful suggestions, which have helped us improve the paper. We clarified the sentences you reported.

 

The table is very interesting, but as the table is spread out over different pages, the heading should be repeated each time.

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. Considering the new summary table, we split the old table for each component. Moreover, we changed the references to reduce each table. During the proofread step, we will check that the table fits on a single page

 

Sentence that is difficult to grasp: “Therefore, it’s important to clarify that some teachers’ training or parents’ engagement also focus on the individual level, however, since the target is not the student, but someone who is part of the school environment or the surrounding community, activity that specifically involve teachers and parents have been included in the respective categories.”

Response: Thanks for the very useful suggestions, which have helped us improve the paper. We clarified the sentences you reported.

 

The results’ section is very interesting and in general has a good read. Here too, language editing should be undertaken by the authors. To give only two examples: “It seems quite clear that this kind of intervention have different effects by socio-economic statuses, but there’s only limited evidence for widening inequalities”. And: “Peer support among students from different background is aimed to learn the importance of respecting and welcoming cultural differences and it’s crucial to enhance the school social environment component.”

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We did a careful language revision throughout the manuscript and we clarified the sentences you reported.

 

5. Discussion

In my opinion, this paragraph is very clarifying and should have come way sooner in the manuscript: “The current umbrella review examined the effectiveness of school-based strategies aimed at promoting migrant students’ health and academic outcomes. Twenty-one reviews were analyzed, and 18 strategies were identified and classified into 6 areas of intervention linked to the six components of the Health Promoting School model: individual skills, school physical environment, school social environment, school policies, health and social services, and community links.”

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We anticipated this information in the study aims.

 

“This confirms the value of this approach in providing a vision to guide educational systems, together with its flexibility and potential to address different emerging issue.” What is ‘this’? This sentence is unclear.

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We clarified the sentences you reported.

 

Interesting discussion with some critical points. I enjoyed reading this discussion.

Response: Thanks for your positive feedback.

 

Reviewer 2 Report

This article’s topic is very interesting and presents some usefull reflections in the field of School Interventions for migrant students in the field of the health and the learning improvement. The article is well organized, clear and appropriate regarding the language and references reported. I believe that a greater and deeper description of the methods and criteria used by the authors in their "clusterization process", can be helpfull to the readers to betters understand results and discussion.

 

Author Response

We thank you for your thoughtful suggestions and insights, which have helped us improved the paper significantly. We are also grateful for your positive feed-backs.

The manuscript has been rechecked and the necessary changes have been made in accordance with your suggestions. The responses to all comments have been prepared and given below.

 

This article’s topic is very interesting and presents some usefull reflections in the field of School Interventions for migrant students in the field of the health and the learning improvement. The article is well organized, clear and appropriate regarding the language and references reported. 

Response: Thanks very much for your positive feedback.

 

I believe that a greater and deeper description of the methods and criteria used by the authors in their "clusterization process", can be helpfull to the readers to betters understand results and discussion.

Response: Thanks for the very useful suggestions, which have helped us improve the paper significantly. We added information about the clusterization process.

Round 2

Reviewer 1 Report

Thank you for thoroughly revising the paper. The paper is much more clear, the summarizing table in the results section is perfect, and the English has already improved a lot. There are still some imperfections English-wise, but I reckon that with a last check, these will easily be resolved.