School Personnel and Student Knowledge of Diabetes and Obesity: A Systematic Review and Meta-Analysis of School-Based Interventions

Abstract

Introduction: Schools are key environments for preventing and managing adolescent diabetes, yet the knowledge and preparedness of school personnel and students remain variable. This systematic review examined the effectiveness of professional development and school-based educational programs in improving knowledge, attitudes, and self-efficacy related to type 1 and type 2 diabetes.
Methods: A PRISMA-guided search of major databases identified peer-reviewed studies published between 2000 and 2025. Eligible studies evaluated training or educational interventions delivered in school settings and reported outcomes on diabetes knowledge or preparedness. Data extraction and quality appraisal were performed independently by two reviewers. When possible, a random-effects meta-analysis was conducted using pre- and post-intervention mean knowledge scores with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic, and certainty of evidence was evaluated using GRADE.
Results: Sixteen studies met inclusion criteria. Overall, baseline knowledge of diabetes and obesity among school personnel was limited. Professional development programs consistently improved educator knowledge, self-efficacy, and readiness to support students with chronic conditions. Studentfocused educational interventions also led to increased knowledge. Meta-analysis of four studies showed a significant improvement in post-intervention knowledge (Cohen’s d = 1.65, 95% CI: 1.07–2.23, p < 0.001), although heterogeneity was high (I² = 92%).
Discussion: School-based training and educational initiatives effectively enhance diabetes-related knowledge among both educators and students. However, variability in intervention design and outcome measures contributes to heterogeneity, and few studies evaluate long-term retention of knowledge.
Implications for Research and Practice: Standardised, evidence-based training for school personnel and comprehensive student education are needed to strengthen school capacity for diabetes prevention and management. Future research should employ rigorous designs, common outcome metrics, and follow-up assessments to determine sustained impact.