How to deal with sickness absence among primary school pupils?

Abstract Background Missing school can lead to lower educational achievement, early school dropout and health problems. To address sickness absence in secondary schools the intervention Medical Advice for sick reported students (MASS) has been developed. Because of fundamental differences in relation to the children's age and in the schools' organisational structure, the original MASS is not suited to primary schools. The aim of this study was to adapt MASS to primary education. Methods The intervention mapping approach steps 1 through 4 were used to adapt MASS to primary schools (MASS-PS), including a literature search, stakeholder interviews and pre-testing. Results In step 1, a planning group was formed and a logic model of the problem was created based on a literature search and interviews with stakeholders. In step 2, a logic model of change was created to determine the behavioural and environmental factors that need to change to achieve the goals of the intervention. In step 3, a theoretical basis and practical strategies to adjust MASS to primary education were determined. In step 4, practical support materials were developed and two pre-tests of the materials were performed with stakeholders and end-users. Conclusions Intervention mapping was successfully used to adapt MASS to primary schools. The main changes were the lowering of the threshold for extensive sickness, consultations between teacher and absenteeism coordinator and the addition of a social worker and remedial educationalist as experts next to the child and youth healthcare physician. The second pre-test did not yield any adaptations, indicating good acceptance in practice. With MASS, extensive sickness absence among primary school pupils can be addressed as a ‘red flag' for underlying problems. Key messages Intervention mapping steps one through four were sucessfully used to adapt a secondary school intervention to adress sickness absence among students (MASS) to primary schools. With the adapted MASS intervention, extensive sickness absence among primary school pupils can be addressed as a ‘red flag’ for underlying problems.