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Mullhall P, Taggart L, McDermott G, Slater P, Fitzpatrick B, Murphy MH, Hassiotis A, Johnston A. 'Walk Buds': A walking intervention to increase physical activity, physical fitness, and emotional wellbeing, in 9-13 year old children with intellectual disabilities. Results of a clustered randomised feasibility trial. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13260. [PMID: 38937072 DOI: 10.1111/jar.13260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/30/2024] [Accepted: 05/26/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Children with intellectual disability are less physically active and more sedentary than typically developing peers. To date no studies have tested the feasibility of a school-based walking intervention for children with Intellectual Disability. METHOD A clustered randomised controlled trial (cRCT), with an embedded process evaluation, was used to test the feasibility of a school-based walking intervention. Eight schools (n = 161 pupils aged 9-13 years) were randomised into either an intervention arm or an 'exercise as usual' arm. Measures included physical activity, physical fitness and emotional wellbeing. Baseline and 3-month follow-up data were collected. RESULTS The 'Walk Buds' intervention was found to be acceptable to teaching staff and pupils, with an uptake rate of the walking sessions offered of 84%. CONCLUSION A number of challenges were experienced, relating to the COVID-19 pandemic, and difficulties collecting accelerometer data. Barriers, facilitators and required changes identified through the mixed methods process evaluation are discussed.
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Affiliation(s)
- Peter Mullhall
- Institute of Nursing and Paramedic Science, Ulster University, Belfast, Northern Ireland
| | - Laurence Taggart
- Institute of Nursing and Paramedic Science, Ulster University, Belfast, Northern Ireland
| | - Gary McDermott
- Institute of Nursing and Paramedic Science, Ulster University, Belfast, Northern Ireland
| | - Paul Slater
- Institute of Nursing and Paramedic Science, Ulster University, Belfast, Northern Ireland
| | - Ben Fitzpatrick
- Institute of Nursing and Paramedic Science, Ulster University, Belfast, Northern Ireland
| | - Marie H Murphy
- The School of Sport, Ulster University, Belfast, Northern Ireland
| | - Angela Hassiotis
- Division of Psychiatry, University College London, Belfast, Northern Ireland
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Edwards R, Byrne J, Grace M. Enabling pupils to flourish: six evidence-based principles of whole-school wellbeing promotion. Front Public Health 2024; 12:1335861. [PMID: 39267652 PMCID: PMC11390642 DOI: 10.3389/fpubh.2024.1335861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 08/14/2024] [Indexed: 09/15/2024] Open
Abstract
Schools have become increasingly important as health promotion settings, seeking to improve pupils' health and wellbeing through adopting a whole-school approach. A strong evidence-base highlights that focusing on the social, emotional and psychological aspects of pupils' wellbeing enables them to flourish, enjoy life and be better equipped to overcome challenges. However, it is acknowledged that further evidence is required regarding: (1) what happens in primary schools, (2) the impact of the English education system, (3) complexity and context, and (4) capturing children's voices. This article, therefore, addresses these gaps by asking the question: How do schools use whole-school wellbeing promotion to enable pupils to flourish? Taking an exploratory approach the study used a three-phase, mixed methods design to address the research problem by undertaking a systematic literature review, a secondary data analysis and a case study to capture multiple stakeholder voices including pupils. As appropriate for this research design, the findings from each phase were integrated into an overarching analysis which is presented in this article. Six broad principles formed consistent threads across the findings: (1) enabling children to flourish, (2) integrating wellbeing with key school goals, (3) promoting wellbeing and building capital, (4) building on virtuous cycles, (5) managing complexity and context, and (6) evaluating wellbeing promotion through listening to different voices. As well as presenting new knowledge addressing the identified research gaps, this study has demonstrated that schools can avoid 'reinventing the wheel' by adopting existing practices and resources and adapting them to their own setting. It is, therefore, hoped the six evidence-based principles of this study are equally transferable to schools within the English education system and more broadly. In addition, the paper highlights recognized challenges to staffing and resourcing and raises the question over whether schools receive sufficient funding to deliver the whole-school initiatives that government recommends. This article provides readers with an exploration of what has been achieved in schools and it is outside its scope to address specific issues about funding and other practical logistics for implementing whole-school wellbeing promotion, therefore further research is recommended.
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Affiliation(s)
- Rowan Edwards
- School of Education, University of Southampton, Southampton, United Kingdom
| | - Jennifer Byrne
- School of Education, University of Southampton, Southampton, United Kingdom
| | - Marcus Grace
- School of Education, University of Southampton, Southampton, United Kingdom
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Nagy-Pénzes G, Vincze F, Víghné Arany Á, Bíró É. Impact of a Primary School Health Promotion Programme on Adolescents' Health Behaviour and Well-Being. CHILDREN (BASEL, SWITZERLAND) 2024; 11:919. [PMID: 39201855 PMCID: PMC11352284 DOI: 10.3390/children11080919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND/OBJECTIVES Schools can play a key role in promoting health among adolescents, and Hungarian legislation gives them sufficient space to do so. In our study, we examined the impact of a multiyear school health promotion programme on pupils' health behaviour and well-being. METHODS We carried out our investigation in an intervention and a control primary school in Hungary. All 5th and 7th grade pupils were invited to participate in the questionnaire-based survey between 2017 and 2021. The effect of the intervention was quantified using univariate and multivariate logistic regression analyses. RESULTS Our results show that for those behaviours where pupils' personal choices had a greater influence (unhealthy eating, smoking, screen time), the health promotion programme was more effective. For those behaviours where family background and parental influence were more pronounced (healthy eating, physical activity), the intervention had less impact. Self-perceived health was better in the 7th-grade intervention group. CONCLUSIONS Our findings are in line with the conclusion of systematic reviews that more intensive, longer-term, multi-behavioural school health promotion programmes can be effective in promoting positive behaviour. To be more effective, it would be worth using a well-structured curriculum, well-developed teaching materials, and greater involvement of teachers, parents, and various local organisations.
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Affiliation(s)
- Gabriella Nagy-Pénzes
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.V.); (É.B.)
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.V.); (É.B.)
| | | | - Éva Bíró
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (F.V.); (É.B.)
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Plumet R, Gautier S, Lefebvre N, Gautier H, Herr M. The prevention school diary: Evaluability assessment of a widely adopted intervention in Ile-de-France. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202752. [PMID: 38865777 DOI: 10.1016/j.jeph.2024.202752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVES The prevention school diary is distributed each year to children aged between 10 and 11 years old by La Ligue contre le cancer, a French association promoting prevention and research against cancer. While they write their homework in the diary, children can learn about a range of health determinants. This diary promotes health in a fun and educational way, as it integrates drawings made by children about the different themes covered by the diary. This paper aims to present the evaluability assessment of this intervention in Ile-de-France (Paris area), where it is already widely deployed. MATERIAL AND METHODS We have traced the history of the prevention school diary and assessed how it is currently used in Ile-de-France by leading interviews with county committees of La Ligue contre le cancer. Successive versions of the diary and results of teacher satisfaction surveys were examined. All information collected was integrated into a logic model, which characterizes the main components, actors, and effects of the intervention. RESULTS The prevention school diary was created in the West of France in the late 90s. It was then implemented in Paris and extended to other counties of Ile-de-France. Currently, six counties collaborate on the production of a common diary. Whereas it only dealt with tobacco consumption at the beginning, the prevention school diary now covers nutrition, physical activity, sun exposure, sleep and screen use, addiction, as well as safety in some counties. Three levels of intervention have been identified, depending on whether or not the distribution of the diary is followed by the production of drawings for the next edition or health education sessions. The expected effects of the prevention school diary have been integrated into a logic model emphasizing children, school, and family level. Outcomes include Capabilities (knowledge and skills), Opportunities, and Motivation to adopt healthy Behaviours, according to the theoretical model of behaviour change COM-B. CONCLUSION The evaluability assessment phase enabled us to gain a better understanding of the conditions under which the intervention is deployed, and thus to identify the factors to be considered for a broad assessment of its effectiveness. It is especially important since the intervention is already well established in Ile-de-France.
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Affiliation(s)
- Romane Plumet
- UFR Simone-Veil Santé, Université Versailles St-Quentin-en-Yvelines (UVSQ), Montigny-le-Bretonneux, France
| | - Sylvain Gautier
- UFR Simone-Veil Santé, Université Versailles St-Quentin-en-Yvelines (UVSQ), Montigny-le-Bretonneux, France; Epidemiology and Public Health Department, Raymond Poincaré Hospital, AP-HP, Garches, France; Center for Research in Epidemiology and Population Health (CESP), Inserm U1018, UVSQ, Paris-Saclay University, Villejuif, France
| | - Natacha Lefebvre
- La Ligue contre le cancer, comité de l'Essonne, Briis sous Forge, France
| | - Hervé Gautier
- La Ligue contre le cancer, comité de l'Essonne, Briis sous Forge, France
| | - Marie Herr
- UFR Simone-Veil Santé, Université Versailles St-Quentin-en-Yvelines (UVSQ), Montigny-le-Bretonneux, France; Epidemiology and Public Health Department, Raymond Poincaré Hospital, AP-HP, Garches, France; Center for Research in Epidemiology and Population Health (CESP), Inserm U1018, UVSQ, Paris-Saclay University, Villejuif, France.
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Takens FE, Indyk I, Chinapaw MJM, Ujčič-Voortman JK, van Nassau F, Busch V. Qualitative multi-stakeholder evaluation of the adoption, implementation and sustainment of the school-based dietary intervention "Jump-in". BMC Public Health 2024; 24:1337. [PMID: 38760727 PMCID: PMC11102190 DOI: 10.1186/s12889-024-18814-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Comprehensive school-based programs applying the WHO Health Promoting School Model have the potential to initiate and sustain behavior change and impact health. However, since they often include intervention efforts on a school's policies, physical environment, curriculum, health care and involving parents and communities, they significantly 'intrude' on a complex system that is aimed primarily at education, not health promotion. More insights into and concrete strategies are therefore needed regarding their adoption, implementation, and sustainment processes to address the challenge to sustainable implementation of HPS initiatives in a primarily educational setting. This study consequently evaluates adoption, implementation and sustainment processes of Amsterdam's Jump-in healthy nutrition HPS intervention from a multi-stakeholder perspective. METHODS We conducted semi-structured interviews and focus groups with all involved stakeholders (n = 131), i.e., Jump-in health promotion professionals (n = 5), school principals (n = 7), at-school Jump-in coordinators (n = 7), teachers (n = 20), parents (n = 50, 9 groups) and children (n = 42, 7 groups) from 10 primary schools that enrolled in Jump-in in the school year 2016-2017. Included schools had a higher prevalence of overweight and/or obesity than the Dutch average and they were all located in Amsterdam's low-SEP neighborhoods. Data were analyzed using a directed content analysis, in which the Determinants of Innovation Model was used for obtaining theory-based predetermined codes, supplemented with new codes emerging from the data. RESULTS During intervention adoption, all stakeholders emphasized the importance of parental support, and accompanying workshops and promotional materials. Additionally, parents and teachers indicated that a shared responsibility for children's health and nuanced framing of health messages were important. During implementation, all stakeholders needed clear guidelines and support structures. Teachers and children highlighted the importance of peer influence, social norms, and uniform application of guidelines. School staff also found further tailoring of the intervention and dealing with financial constraints important. For long-term intervention sustainment, incorporating the intervention policies into the school statutes was crucial according to health promotion professionals. CONCLUSIONS This qualitative evaluation provides valuable insights into factors influencing the adoption, implementation, and sustainment processes of dietary interventions, such as the importance of transparent and consistent intervention guidelines, clear communication regarding the rationale behind intervention guidelines, and, stakeholders' involvement in decision-making.
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Affiliation(s)
- Froukje E Takens
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands.
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Indira Indyk
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Joanne K Ujčič-Voortman
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Vincent Busch
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
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Bjørnsen HN, Bjørnebekk G, Brandmo C. Schools as a Source of Mental Health Literacy: Adjusting and Validating a Mental Health Literacy Scale. Health Promot Pract 2024; 25:391-398. [PMID: 36942353 PMCID: PMC11064467 DOI: 10.1177/15248399231161090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Over the last decade, there has been a growing interest in mental health literacy (MHL) in health promotion, largely motivated by increased awareness of MHL as a modifiable determinant of mental health. Accordingly, MHL has been associated with the health-promoting school approach emerging over the last 20 years. To succeed in promoting MHL, it is of vast importance to evaluate working strategies and interventions to address MHL using validated instruments. The current study describes the revision and psychometric testing of a modified version of the 10-item adolescents' positive MHL measure, the MHPK-10, the only identified instrument measuring adolescents' positive MHL. The MHPK-10 was adjusted to address the previously documented ceiling effects and was further optimized for use in schools by reworking it to measure learning rather than self-reported knowledge, becoming the new nine-item Mental Health Learning Scale (MHLS-9). The MHLS-9 was tested on a national sample of N = 2,012 Norwegian ninth graders. Data were analyzed by confirmatory factor analysis (CFA) and tests of reliability and validity. The revised CFA model for the MHLS-9 showed an improved fit over the original CFA model for the MHPK-10. The MHLS-9s' CFA model revealed excellent factor determinacy (.95) and scale reliability (ω = .91). Thus, the MHLS-9 is an improved measure for the positive component of MHL for use in school settings, enabling researchers and practitioners to evaluate and focus positive MHL interventions in schools using a short, reliable, and valid measure for adolescents' learning about the factors promoting good mental health.
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Vonk L, Eekhout I, Huijts T, Levels M, Jansen MWJ. School health promotion and fruit and vegetable consumption in secondary schools: a repeated cross-sectional multilevel study. BMC Public Health 2024; 24:1098. [PMID: 38644493 PMCID: PMC11034157 DOI: 10.1186/s12889-024-18546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/08/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Worldwide, recommendations for fruit and vegetable consumption are not met, which can cause chronic diseases. Especially adolescence is an important phase for the development of health behaviours. Therefore, in the Netherlands, the Healthy School program was established to aid schools in promoting healthy lifestyles among their students. We examined to what extent the variation between secondary schools regarding students' fruit and vegetable consumption could be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. Additionally, we examined whether Healthy School certification was related to the outcomes, and whether the association differed for subgroups. METHODS We performed a repeated cross-sectional multilevel study. We used data from multiple school years from the national Youth Health Monitor on secondary schools (grades 2 and 4, age ranged from approximately 12 to 18 years) of seven Public Health Services, and added data with regard to Healthy School certification, general school characteristics and school population characteristics. We included two outcomes: the number of days a student consumed fruit and vegetables per week. In total, we analysed data on 168,127 students from 256 secondary schools in the Netherlands. RESULTS Results indicated that 2.87% of the variation in fruit consumption and 5.57% of the variation in vegetable consumption could be attributed to differences at the school-level. Characteristics related to high parental educational attainment, household income, and educational track of the students explained most of the variance between schools. Additionally, we found a small favourable association between Healthy School certification and the number of days secondary school students consumed fruit and vegetables. CONCLUSIONS School population characteristics explained more variation between schools than Healthy School certification and general school characteristics, especially indicators of parental socioeconomic status. Nevertheless, Healthy School certification seemed to be slightly related to fruit and vegetable consumption, and might contribute to healthier dietary intake. We found small differences for some subgroups, but future research should focus on the impact in different school contexts, since we were restricted in the characteristics that could be included in this study.
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Affiliation(s)
- Lisanne Vonk
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, 6400 AA, Heerlen, P.O. Box 33, the Netherlands.
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD, Maastricht, P.O. Box 616, the Netherlands.
| | - Iris Eekhout
- Expertise Center Child Health, Netherlands Organisation for Applied Scientific Research (TNO), 2301 DA, Leiden, P.O. Box 3005, the Netherlands
| | - Tim Huijts
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Mark Levels
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, 6400 AA, Heerlen, P.O. Box 33, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD, Maastricht, P.O. Box 616, the Netherlands
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Välimäki M, Hipp K, Acton F, Echsel A, Grădinaru IA, Hahn-Laudenberg K, Schulze C, Stefanek E, Spiel G, O'Brien N. Engaging with immigrant students' voices in the school environment: an analysis of policy documents through school websites. BMC Public Health 2024; 24:1083. [PMID: 38641601 PMCID: PMC11027541 DOI: 10.1186/s12889-024-18427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/25/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND For students to feel happy and supported in school, it is important that their views are taken seriously and integrated into school policies. However, limited information is available how the voices of immigrant students are considered in European school contexts. This study generated evidence from written documents to ascertain how student voice practices are described at school websites. METHODS Between 2 March and 8 April 2021, we reviewed the policy documents publicly available on school websites. The schools located in areas of high immigration in six European countries: Austria, England, Finland, Germany, Romania, and Switzerland. The READ approach was used to guide the steps in the document analysis in the context of policy studies (1) ready the materials, 2) data extraction, 3) data analysis, 4) distil the findings). A combination of qualitative and quantitative approaches with descriptive statistics (n, %, Mean, SD, range) was used for analysis. RESULTS A total of 412 documents (305 schools) were extracted. Based on reviewing school websites, reviewers'strongly agreed' in seven documents (2%) that information related to seeking student voices could be easily found. On the contrary, in 247 documents (60%), reviewers strongly indicated that information related to seeking student voices was missing. No clear characteristics could be specified to identify those schools were hearing students' voices is well documented. The most common documents including statements related to student voice were anti-bullying or violence prevention strategies (75/412) and mission statements (72/412). CONCLUSIONS Our document analysis based on publicly accessible school websites suggest that student voices are less frequently described in school written policy documents. Our findings provide a baseline to further monitor activities, not only at school level but also to any governmental and local authorities whose intention is to serve the public and openly share their values and practices with community members. A deeper understanding is further needed about how listening to student voices is realized in daily school practices.
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Affiliation(s)
- Maritta Välimäki
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.
- School of Public Health, University of Helsinki, Helsinki, Finland.
| | - Kirsi Hipp
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
- School of Health and Social Services, Häme University of Applied Sciences, Hämeenlinna, Finland
| | - Faye Acton
- Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Angelika Echsel
- School of Health Professions; Institute of Occupational Therapy, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Ioan-Alexandru Grădinaru
- Faculty of Philosophy and Social-Political Sciences, "Al. I. Cuza" University of Lași, Lași, Romania
| | | | - Christina Schulze
- School of Health Professions; Institute of Occupational Therapy, Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | - Georg Spiel
- Pro Mente: Kinder Jugend Familie (Pro Mente: Children Youth Family), Klagenfurt am Wörthersee, Austria
| | - Niamh O'Brien
- Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK.
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Larsson R, Ljung E, Josefsson S, Ljung T. 'We get to learn as we move': effects and feasibility of lesson-integrated physical activity in a Swedish primary school. BMC Public Health 2024; 24:1087. [PMID: 38641777 PMCID: PMC11027527 DOI: 10.1186/s12889-024-18509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/03/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Physical activity (PA) promotes health in adults as well as children. At the same time, a large proportion of children do not meet the recommendations for PA, and more school-based efforts to increase PA are needed. This study investigates the effectiveness and feasibility of lesson-integrated PA in a Swedish primary school. METHODS We evaluate a new method called 'Physical Activity and Lesson in Combination' (abbreviated FALK in Swedish) using a mixed methods approach; a quasi-experimental study followed by qualitative interviews. Two schools participated in the study, one constituting the intervention group (I-school, n = 83) and the other the control group (C-school, n = 81). In addition to regular physical education, the I-school had three 30-minute FALK lessons each week. A total of 164 students aged 7-9 years wore pedometers for a whole week, four times over two semesters, and the number of steps per day (SPD) and the proportion of students with < 10,000 SPD were compared. Statistical differences between the schools were tested with ANOVA, Chi2, t-tests, and ANCOVA. Interviews with students (n = 17), parents (n = 9) and teachers (n = 9) were conducted and analysed using qualitative content analysis. RESULTS The results show that FALK led to the I-school getting more SPD and fewer students with < 10,000 SPD. Also, FALK was experienced as a positive, clear, and flexible method, simultaneously encouraging PA and learning. Challenges experienced concerned the teachers' work situation, time, finding suitable learning activities, outdoor school environment changes, and extreme weather conditions. CONCLUSIONS This study indicates that FALK has the desired effects on PA and is a feasible method of integrating PA into theoretical teaching. We conclude that FALK is worth testing at more schools, given that implementation and sustainment of FALK considers both general enablers and barriers, as well as context-specific factors at the individual school.
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Affiliation(s)
- Robert Larsson
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, 721 23, Västerås, Box 883, Sweden.
| | - Eva Ljung
- Borlänge municipality, Borlänge, Sweden
| | | | - Thomas Ljung
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, 721 23, Västerås, Box 883, Sweden
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Arnaiz P, Bergman MM, Seelig H, Adams L, Dolley D, Gerber M, Joubert N, Nqweniso S, Steinmann P, Utzinger J, Randt RD, Walter C, Pühse U, Müller I. Acceptability and perceived feasibility of the KaziKidz health promotion intervention among educators and caregivers in schools from South Africa: a qualitative descriptive study. BMC Public Health 2024; 24:934. [PMID: 38561742 PMCID: PMC10985953 DOI: 10.1186/s12889-024-18456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Despite the uncontested benefits of physical activity, its promotion lags behind in the public health agenda of low- and middle-income countries (LMICs). School-based interventions are promising strategies to foster health during childhood, but evidence of their effectiveness is limited and inconclusive for LMICs. Thus, further investigation is needed on contextual factors associated with intervention implementation in low-resource settings. We studied the acceptability and feasibility of the KaziKidz health promotion intervention and its implementation and make recommendations to improve future adoption and sustainability. METHODS KaziKidz was implemented in four primary schools from low-income communities in South Africa in 2019. Semi-structured interviews with four school principals, three focus group interviews with 16 educators, and another three with 16 caregivers were conducted between October and November 2021. Participants were purposively recruited. Interview transcripts were analyzed via thematic analysis using a deductive and reflexive approach. RESULTS Three main themes influencing intervention implementation and adoption were identified: (1) prioritizing teachers' needs (2), integrating the program into the school structure, and (3) creating opportunities in the community. Supporting recommendations included: (theme 1) adopting intervention approaches that are inclusive of educators' health and providing them with capacity development and external support; (theme 2) fostering a feeling of ownership and belonging among school stakeholders to adapt interventions to specific resources and needs; and (theme 3) raising community awareness to encourage individuals to claim power over and actively engage with the program. CONCLUSIONS Comprehensive interventions comprising health support, adequate training, and ongoing assistance for educators combined with school-wide and community outreach actions seeking to strengthen program ownership, accountability, and engagement can enhance uptake of school-based interventions and long-term maintenance. TRIAL REGISTRATION ISRCTN15648510, registered on 17/04/2020.
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Affiliation(s)
- Patricia Arnaiz
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | | | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Danielle Dolley
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nandi Joubert
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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F K, A W, S S, K B, R L. Primary-school-aged children inspire their peers and families to eat more vegetables in the KiiDSAY project: a qualitative descriptive study. BMC Pediatr 2024; 24:175. [PMID: 38461327 PMCID: PMC10924354 DOI: 10.1186/s12887-024-04643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 02/13/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND While vegetable intakes in Australia remain sub-optimal across all age groups, children are rarely consulted about their ideas on how to increase consumption. Qualitative research involving children provides an opportunity to consider their views. The aim of the Kids initiative inspires Dietary Success in Adults and Youth (KiiDSAY) project was to explore the views of school-aged children, who had participated in a school-based nutrition education program, about inspiring their peers and families to eat more vegetables. METHODS A total of 26 children (15 boys) aged 10-12 years from four primary schools in New South Wales, Australia, participated in seven focus group interviews. Purposeful sampling was used to recruit participants. The study involved open-ended semi-structured questions conducted via Zoom that were audio-recorded, transcribed verbatim and analysed using thematic analysis with deductive and inductive coding in NVivo. RESULTS Four major themes emerged: (i) taste; (ii) family environment; (iii) healthy eating; and (iv) change makers; with subthemes that were embedded within Social Cognitive Theory and Ecological Model of Health Behaviour theoretical frameworks. CONCLUSIONS Children's inputs hold great potential for informing future interventions, particularly when designing or refining school-based nutrition programs. Children offered suggestions on how to inspire increased vegetable consumption among their peers and families that could be taken into consideration for future research and practice. These included: cooking activities in the home and school settings using recipes that creatively hide/mask/enhance the flavour of vegetables, involving positive role models and supportive school environments. Additionally, children recommended a sequential approach to the delivery of recipes starting from fruit-based and transitioning to vegetable-based recipes. Given the challenges faced in increasing children's vegetable consumption, particular focus on future research in this area is warranted. TRIAL REGISTRATION FEAST Trial registered 14th December 2020 with the Australian and New Zealand Clinical Trials Registry (ACTRN12620001347954).
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Affiliation(s)
- Karpouzis F
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, 3125, Australia.
| | - Walsh A
- School of Behavioural and Health Sciences, Australian Catholic University, VIC, Melbourne, Australia
| | - Shah S
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ball K
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, 3125, Australia
| | - Lindberg R
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, 3125, Australia
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12
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Karpouzis F, Lindberg R, Walsh A, Shah S, Abbott G, Ball K. Impact and process evaluation of a primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: pragmatic cluster non-randomized controlled trial. BMC Public Health 2024; 24:657. [PMID: 38429629 PMCID: PMC10905805 DOI: 10.1186/s12889-024-18079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/12/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Environmentally sustainable food initiatives accompanying nutrition education, such as the Food Education and Sustainability Training (FEAST) program, have gained traction in school settings. The aim of this trial was to conduct an impact and process evaluation of FEAST, to evaluate its effect on children's fruit and vegetable (F&V) intakes, and secondary outcomes: F&V variety consumed, nutrition knowledge, food preparation/cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours, and food production knowledge. METHODS FEAST was a 10-week curriculum-aligned program, designed to educate children about healthy eating, food waste, and sustainability, while teaching cooking skills. It was implemented by classroom teachers, face-to-face and online, during COVID-19 school closures, in Australia in 2021. A custom designed survey was used to collect baseline and post-intervention data from students. Generalised linear mixed models (GLMM) estimated group differences in pre-post changes for primary and secondary outcomes. Surveys were also administered to students and teachers to evaluate intervention implementation. RESULTS Twenty schools participated and self-selected to be either intervention schools (n = 10) or wait-list control (WLC) schools (n = 10). A total of 977, 5th and 6th grade children participated in the trial with a mean age of 11.1 years (SD ± 0.7). The FEAST intervention, compared to WLC, did not result in significant increases in primary outcomes nor secondary outcomes. The process evaluation revealed FEAST was well-received by students and teachers, but COVID-19 school closures hindered implementation fidelity with a less intense program delivered under the constraints of pandemic lockdowns. CONCLUSIONS This is the first cluster non-randomized controlled trial designed to independently evaluate FEAST in the primary-school setting. No evidence was found for improved F&V intakes in children, nor secondary outcomes. However, the positive process evaluation results suggest that further trials of the program are warranted. If implemented as originally designed (pre-pandemic), with increased duration and complemented by supporting school policies, such programs have the potential to improve children's daily F&V intakes, cooking skills and food waste behaviours. This would support the Australian curriculum and contribute to: health promotion within schools and sustainable schools initiatives, the national agenda to reduce food waste and sustainable development goals. AUSTRALIAN AND NEW ZEALAND CLINICAL TRIALS REGISTRY: [ACTRN12620001347954]- Registered prospectively on 14/12/2020.
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Affiliation(s)
- F Karpouzis
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.
- , Rose Bay Nth, Australia, PO Box 2108, NSW, 2030.
| | - R Lindberg
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - A Walsh
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - S Shah
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - G Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - K Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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13
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Adomako Gyasi P, Zhou L, Chen Z, Numawoseh EE, Opoku-Agyemang AS. Barriers to school-based health programs implementation in basic schools in Ghana: education stakeholders' perspective. HEALTH EDUCATION RESEARCH 2024; 39:55-67. [PMID: 38124375 DOI: 10.1093/her/cyad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/21/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
School health has been identified as a neglected aspect of primary health care in Ghana, leading to compromised health, well-being and life satisfaction among students. To address this concern, this study identified the barriers hindering the implementation of school-based health programs in Ghana. It employed a qualitative approach, including 116 respondents who participated in interviews. The collected data were analyzed using thematic analysis with the aid of NVivo software. In line with the research objective, findings show that the implementation of school-based health programs faces several teething challenges that serve as barriers to the success and sustainability of the programs. These barriers included resource constraints; a lack of adequate parental and community participation and a lack of adequate collaboration between stakeholders' management and leadership issues, governance issues and political issues. The findings from the study have a relevant and innovative contribution to achieving good health and well-being and quality education as part of the 2030 Agenda for Sustainable Development Goals and shaping primary healthcare management in the context of a developing country. It recommends that policymakers and health practitioners pay special attention to school-based health programs as a key strategy for primary health care management in developing countries.
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Affiliation(s)
- P Adomako Gyasi
- Department of Health Policy and Management, School of Management, Jiangsu University, XueFu Road 301, Zhenjiang 212013, PR China
| | - L Zhou
- Department of Health Policy and Management, School of Management, Jiangsu University, XueFu Road 301, Zhenjiang 212013, PR China
| | - Z Chen
- Department of Health Policy and Management, School of Management, Jiangsu University, XueFu Road 301, Zhenjiang 212013, PR China
| | - E E Numawoseh
- Department of Social and Political Sciences, Brunel University London, Kingston Ln, London, Uxbridge UB8 3PH, UK
| | - A S Opoku-Agyemang
- College of Nursing, Chamberlain University, 1951 Kidwell Dr, Tysons Corner, VA 22182, USA
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14
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Busch V, Steenkamer I, van Nassau F, van Opdorp P, van Houtum L, Verhoeff A, Twisk J. The Effects of the Jump-In Whole-School Intervention on the Weight Development of Children in Amsterdam, the Netherlands. THE JOURNAL OF SCHOOL HEALTH 2024; 94:37-46. [PMID: 37518834 DOI: 10.1111/josh.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/13/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND This study assessed the effects of the "Jump-in" whole-school intervention in Amsterdam, the Netherlands, on children's weight development by comparing children exposed to the intervention and controls from 3 other large Dutch cities. Jump-in is a comprehensive intervention that aims to stimulate healthy nutrition and physical activity in children at primary schools in Amsterdam. In addition, the relationship between the intervention's implementation degree and its effectiveness was studied. METHODS Demographic and anthropometric data, collected by youth health care professionals via routine health checks at T0 (2014) and T1 (2019), were used to analyze possible intervention effects by comparing the weight development of children exposed to the Jump-in intervention versus unexposed controls. Implementation logs from health promotion professionals were used to determine intervention effects per implementation degree. Multilevel regression analyses were used for all analyses. RESULTS In total, 4299 children were included mean age ± 5.5 years (T0), 10.6 years (T1), and ≈50% boys/girls at both times. Receiving the fully implemented intervention resulted in a decline in standardized body-mass index (zBMI) compared to the controls (-0.23, confidence interval [CI] -0.33, -0.13). It also led to higher odds to move into a healthier weight category over time (odds ratio [OR] 1.36, CI 1.06, 1.74), yet no statistically significant shift towards a healthy weight was found. CONCLUSIONS Relative to the controls, children exposed to the intervention showed positive zBMI developments, with stronger effects when the implementation degree was higher. Despite positive results, creating more impact might require the further integration of school-based programs into whole-systems approaches that include other energy-balance behaviors.
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Affiliation(s)
- Vincent Busch
- Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Ilona Steenkamer
- Department of Healthy Living, Public Health Service (GGD), Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Vrije Universiteit, De Boelelaan 1089a, 1081 HV Amsterdam, Amsterdam, The Netherlands
| | - Paul van Opdorp
- Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Arnoud Verhoeff
- Department of Sociology, University of Amsterdam, Nieuwe Achtergracht 166, 1018WV, Amsterdam, the Netherlands; Director, Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
- Department of Sociology, University of Amsterdam. Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands
| | - Jos Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
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Diamantis DV, Shalit A, Katsas K, Zioga E, Zota D, Kastorini CM, Veloudaki A, Kouvari M, Linos A. Improving Children's Lifestyle and Quality of Life through Synchronous Online Education: The Nutritional Adventures School-Based Program. Nutrients 2023; 15:5124. [PMID: 38140383 PMCID: PMC10745706 DOI: 10.3390/nu15245124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
The early introduction of effective nutritional educational programs is pivotal for instilling sustainable healthy behaviors. The present work aims to present a best practice example of a nutrition and overall lifestyle school-based training program, the Nutritional Adventures ("Diatrofoperipeteies"). Conducted during 2020-2022 in Greek primary schools, this synchronous, online educational initiative included two 1-school-hour activities with a nutrition instructor. Additionally, schools were randomly assigned to supplementary "at-home" supported-by-parents or "in-class" supported-by-educators educational activities. In total, n = 12,451 students of 84 primary schools participated. Parent-completed questionnaires were selected in the recruitment and post-intervention phase (40% participation rate); overall, the working sample was n = 1487 students. In the post-intervention phase, a significant increase in Mediterranean diet adherence was observed (KIDMED score: mean increment = 0.25 units; p < 0.001), particularly fruit and vegetable consumption. Time spent on physical activity increased, while screen time decreased. Students' total quality of life significantly improved (PedsQL; mean increment = 1.35 units; p < 0.001), including on all of its subscales (physical, emotional, social, and school function). Supplementary educational activities that were supported by educators rather than parents yielded a more favorable impact on students' lifestyle and quality of life. The Nutritional Adventures program can be regarded as a successful initiative in primary schools, yielding immediate advantages that extend beyond promoting healthy dietary habits.
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Affiliation(s)
- Dimitrios V. Diamantis
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
| | - Almog Shalit
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Konstantinos Katsas
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Evangelia Zioga
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
| | - Dina Zota
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
| | | | - Afroditi Veloudaki
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
| | - Matina Kouvari
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Athena Linos
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece; (D.V.D.); (A.S.); (K.K.); (E.Z.); (D.Z.); (A.V.); (A.L.)
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Reed H, Murphy S, Evans R. Optimising a co-production framework for developing public health interventions: application and testing of school-based Research Action Groups. Health Res Policy Syst 2023; 21:133. [PMID: 38098091 PMCID: PMC10720185 DOI: 10.1186/s12961-023-01086-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
Existing frameworks for developing public health interventions have limited guidance for researchers on how to work with stakeholders to co-produce context-specific interventions. To address this, a promising framework for the co-production of public health interventions was developed through a previous review of school-based co-production. The present study aimed to optimise this co-production framework through applying and testing it in real-world secondary school contexts. Within schools, Research Action Groups (RAGs) were established with multiple school stakeholders supported by an external facilitator to use school data to produce school-specific mental health and wellbeing interventions. A mixed method process evaluation of two contextually diverse case study secondary schools in the UK was used to optimise the co-production framework. The process evaluation sought the views of those involved (students, school staff, school Senior Management Team (SMT) members, and the external co-production facilitator/researcher) on the co-production functions they were involved in so they could be modified, if needed. Data collected for the process evaluation during co-production were a researcher diary (n = 45 entries), and observations of student photography (n = 21) and RAG meetings (n = 8). Post co-production, interviews, and surveys with RAG students (n = 18) and staff (n = 8), and two school-specific SMT focus groups (n = 10) were conducted. The study identified four recommendations to optimise and integrate co-production into real world practice. They include the need to: assess schools for their readiness to undertake co-production; more effectively communicate the necessity to have stakeholders from the whole system involved; work with SMTs throughout co-production functions; involve stakeholders outside the school to support producing solutions to change school mental health and wellbeing priorities. The framework is intended to be used by researchers to integrate stakeholders into a shared decision-making process to develop interventions that meet the needs and contexts of individual schools. It could be transferred to other settings to support the development of public health interventions for other health areas, and populations. Further evaluation to test its use in other settings is needed.
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Affiliation(s)
- Hayley Reed
- DECIPHer, School of Social Sciences, Cardiff University, Spark, Maindy Rd, Cardiff, CF24 4HQ, United Kingdom.
| | - Simon Murphy
- DECIPHer, School of Social Sciences, Cardiff University, Spark, Maindy Rd, Cardiff, CF24 4HQ, United Kingdom
| | - Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, Spark, Maindy Rd, Cardiff, CF24 4HQ, United Kingdom
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Lábiscsák-Erdélyi Z, Somhegyi A, Veres-Balajti I, Kósa K. Daily Optional Physical Education Does Not Counteract Increasing Inactivity by Age among Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1929. [PMID: 38136131 PMCID: PMC10741883 DOI: 10.3390/children10121929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/25/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND This paper describes the outcomes of an integrated health promotion programme implemented in a Hungarian high school offering health education in the curriculum, daily optional physical education, teacher training in applying a person-centered approach in teaching, and parental involvement in school activities. METHODS The evaluation used mixed methods of which results of the before-6-months-after quantitative survey among pupils is described. The health status and behaviour of students were assessed by applying the Hungarian version of the HBSC questionnaire. RESULTS Significant improvement was found in the self-rated health of girls (6.6% increase in being of excellent health, p = 0.04), and the consumption of sweets and sugary soft drinks decreased significantly for both genders (boys: -10.2%, p = 0.01; girls: -6.06%, p = 0.04). However, the proportion of physically inactive girls significantly increased (girls: 11.2%, p = 0.01), and substance use did not change significantly. DISCUSSION AND CONCLUSIONS The intervention had significant positive impacts on subjective health and dietary habits and could counteract the secular trend of increasing tobacco, alcohol, and drug consumption by age among adolescents, but this unfortunately does not include physical inactivity. Offsetting the most widespread health risk behavior, physical inactivity, may require mandatory daily physical education in schools.
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Affiliation(s)
- Zsuzsa Lábiscsák-Erdélyi
- Department of Physiotherapy, Faculty of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary;
| | - Annamária Somhegyi
- Schools for Health in Europe Network Foundation, National Center for Spinal Disorders, 1126 Budapest, Hungary;
| | - Ilona Veres-Balajti
- Department of Physiotherapy, Faculty of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary;
| | - Karolina Kósa
- Department of Behavioral Sciences, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
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18
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Liu ZH, Wang YL, Yu YS, Ren Y, Zhang T, Liu HQ, Wu XY. The individual and combined associations of health behaviours with health-related quality of life amongst junior high school students in China. Front Public Health 2023; 11:1283721. [PMID: 37900025 PMCID: PMC10602644 DOI: 10.3389/fpubh.2023.1283721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 09/20/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives This study aimed to investigate the individual and joint associations of sedentary behaviour, physical activity (PA), sleep and breakfast eating on health-related quality of life (HRQoL) amongst Chinese junior high school students. Methods Data were from 783 junior high school students who participated in a health behaviour and health survey in Jining city of Shandong province of China. HRQoL was measured by the EuroQol five-dimensional questionnaire, youth version (EQ-5D-Y). Multivariable logistic and linear regressions were applied to examine the associations between health behaviours and HRQoL. Results Multivariable regression analyses showed that using a computer ≥ 2 h a day (vs. < 2 h/day) is associated with increased likelihood of having health problems in the three EQ-D-Y dimensions, including walking, looking after self and doing usual activities. Lower PA is associated with more problems in feeling worried, sad or unhappy, and with a lower visual analogue scale (VAS) score. Students who had insufficient sleep time (e.g., <7 h/day), and skipped eating breakfast were more likely to experience lower HRQoL in the dimensions of having pain or discomfort, and feeling worried, sad or unhappy, and a lower VAS score than those students who had longer sleep time and no breakfast skipping. Students who reported having the combined ≥ 2 unhealthy behaviours relative to the peers with 0-1 unhealthy behaviours were more likely to have lower HRQoL. Conclusion The findings in the present study underline the importance of promoting healthy behaviours in order to improve HRQoL amongst Chinese junior high school students.
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Affiliation(s)
- Ze Hua Liu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yi Lin Wang
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yue Shuang Yu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yan Ren
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Tong Zhang
- Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Hong Qing Liu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Xiu Yun Wu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
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Elsadek YE, Edwebi S, Turner A, Vinall-Collier K, Csikar J, Pavitt S. A systematic review of school-based student peer-led oral health interventions to promote the oral health of school children. BMC Oral Health 2023; 23:742. [PMID: 37817155 PMCID: PMC10566183 DOI: 10.1186/s12903-023-03482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Poor oral health in children highlights the need for prevention and effective interventions. During late childhood and adolescence, peer relationships can play a vital role in adopting and maintaining positive health behaviours. AIM To identify the oral health outcomes of school-based student peer-led delivery of oral health interventions. METHODS A search strategy was developed, piloted, and run in four electronic databases: Medline via Ovid, Web of Science, CINAHL via EBSCO, and CENTRAL (Cochrane Central Register of Controlled Trials) using key concepts of peer, oral health and adolescent in the school context. Methodological quality was assessed using QuaDs quality assessment tool. All articles were independently screened by two researchers and data was analysed using narrative data synthesis. The PRISMA checklist complemented by aspects of the Synthesis Without Meta-analysis (SWiM) was used to report this systematic review. RESULTS There were 7572 identified, 24 studies progressed to full-text review, ten studies met the eligibility criteria and were included in the review. Only six studies based their interventions on psychological & behavioural theory. Intervention delivered by peers showed improvements in both clinical and self-reported outcomes when compared to other delivery methods (e.g., professionals). Quality of included studies was reported according to QuaDs guidance. CONCLUSION Peer-led interventions were more effective in improving oral health status and behaviours when compared to other modes of delivery. Future research should assess if a bi-directional impact of peer-led interventions can be seen. Specifically, if there is added value for school-based student peer-leader's including their own oral health knowledge, skills, attitude and preventative behaviours.
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Affiliation(s)
- Yasmen E Elsadek
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
| | - Sakina Edwebi
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Abigail Turner
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Karen Vinall-Collier
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Julia Csikar
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Sue Pavitt
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Yoong SL, Lum M, Wolfenden L, Jackson J, Barnes C, Hall AE, McCrabb S, Pearson N, Lane C, Jones JZ, Nolan E, Dinour L, McDonnell T, Booth D, Grady A. Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Cochrane Database Syst Rev 2023; 8:CD013862. [PMID: 37606067 PMCID: PMC10443896 DOI: 10.1002/14651858.cd013862.pub3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health. OBJECTIVES To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions. SEARCH METHODS We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes. MAIN RESULTS We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3). AUTHORS' CONCLUSIONS ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions.
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Affiliation(s)
- Sze Lin Yoong
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Melanie Lum
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jannah Z Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Erin Nolan
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Lauren Dinour
- College of Education and Human Services, Montclair State University, Montclair, New Jersey, USA
| | - Therese McDonnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Debbie Booth
- Auchmuty Library, University of Newcastle, Callaghan, Australia
| | - Alice Grady
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
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21
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Moore SE, Brennan SF, Lavelle F, Dean M, McKinley MC, Olgacher D, McCole P, Hunter RF, Dunne L, O’Connell NE, Elliott CT, McCarthy D, Woodside JV. Capturing the whole-school food environment in primary schools. Public Health Nutr 2023; 26:1671-1678. [PMID: 37272413 PMCID: PMC10410367 DOI: 10.1017/s1368980023001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/23/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The school food environment (SFE) is an ideal setting for encouraging healthy dietary behaviour. We aimed to develop an instrument to assess whole-SFE, test the instrument in the school setting and demonstrate its use to make food environment recommendations. DESIGN SFE literature and UK school food guidance were searched to inform instrument items. The instrument consisted of (i) an observation proforma capturing canteen areas systems, food presentation and monitoring of food intake and (ii) a questionnaire assessing food policies, provision and activities. The instrument was tested in schools and used to develop SFE recommendations. Descriptive analyses enabled narrative discussion. SETTING Primary schools. PARTICIPANTS An observation was undertaken at schools in urban and rural geographical regions of Northern Ireland of varying socio-economic status (n 18). School senior management completed the questionnaire with input from school caterers (n 16). RESULTS The instrument captured desired detail and potential instrument modifications were identified. SFE varied. Differences existed between food policies and how policies were implemented and monitored. At many schools, there was scope to enhance physical eating environments (n 12, 67 %) and food presentation (n 15, 83 %); emphasise healthy eating through food activities (n 7, 78 %) and increase parental engagement in school food (n 9, 56 %). CONCLUSIONS The developed instrument can measure whole-SFE in primary schools and also enabled identification of recommendations to enhance SFE. Further assessment and adaptation of the instrument are required to enable future use as a research tool or for self-assessment use by schools.
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Affiliation(s)
- Sarah E Moore
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
| | - Sarah F Brennan
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
| | - Fiona Lavelle
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Moira Dean
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Michelle C McKinley
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Dilara Olgacher
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
| | - Patrick McCole
- Queen’s Management School, Queen’s University Belfast, BelfastBT9 5EE, United Kingdom of Great Britain and Northern Ireland
| | - Ruth F Hunter
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Laura Dunne
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Niamh E O’Connell
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Chris T Elliott
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Danielle McCarthy
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Jayne V Woodside
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
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22
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Hahnraths MTH, Winkens B, van Schayck OCP. Effects of School-Based Health-Promoting Activities on Children's Health: A Pragmatic Real-World Study. Nutrients 2023; 15:3349. [PMID: 37571286 PMCID: PMC10420810 DOI: 10.3390/nu15153349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
More insight into the health effects of scaled-up school-based interventions in real-world settings is vital to sustainably integrate health in all schools. This study investigated the effectiveness of the scaled-up Healthy Primary School of the Future (HPSF) initiative in real-world school contexts on children's health (behaviours). From 2019 to 2022, eleven Dutch primary schools implemented HPSF-related activities. In 315 children from study years four to six (aged 7-11 years) from these schools, anthropometric measurements were performed, and questionnaires assessing the children's dietary behaviours and physical activity were administered. COVID-19 greatly limited the implementation of HPSF-related activities. Therefore, the results were compared between schools categorised as medium implementers and schools categorised as low implementers. After correction for baseline, waist circumference in the medium implementer group was significantly higher at one-year follow-up (B = 1.089, p = 0.003) and two-year follow-up (B = 1.665, p < 0.001) compared with waist circumference in the low implementer group. No significant effects were observed for other outcomes. This study showed hardly any effects of the scaled-up HPSF initiative, mainly due to the limited implementation caused by COVID-19. More research investigating the real-world effectiveness of HPSF and comparable programmes is greatly encouraged to advance the field of school-based health promotion.
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Affiliation(s)
- Marla T. H. Hahnraths
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
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23
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Yoong SL, Lum M, Wolfenden L, Jackson J, Barnes C, Hall AE, McCrabb S, Pearson N, Lane C, Jones JZ, Dinour L, McDonnell T, Booth D, Grady A. Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Cochrane Database Syst Rev 2023; 6:CD013862. [PMID: 37306513 PMCID: PMC10259732 DOI: 10.1002/14651858.cd013862.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Dietary intake during early childhood can have implications on child health and developmental trajectories. Early childhood education and care (ECEC) services are recommended settings to deliver healthy eating interventions as they provide access to many children during this important period. Healthy eating interventions delivered in ECEC settings can include strategies targeting the curriculum (e.g. nutrition education), ethos and environment (e.g. menu modification) and partnerships (e.g. workshops for families). Despite guidelines supporting the delivery of healthy eating interventions in this setting, little is known about their impact on child health. OBJECTIVES To assess the effectiveness of healthy eating interventions delivered in ECEC settings for improving dietary intake in children aged six months to six years, relative to usual care, no intervention or an alternative, non-dietary intervention. Secondary objectives were to assess the impact of ECEC-based healthy eating interventions on physical outcomes (e.g. child body mass index (BMI), weight, waist circumference), language and cognitive outcomes, social/emotional and quality-of-life outcomes. We also report on cost and adverse consequences of ECEC-based healthy eating interventions. SEARCH METHODS We searched eight electronic databases including CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Scopus and SportDiscus on 24 February 2022. We searched reference lists of included studies, reference lists of relevant systematic reviews, the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov and Google Scholar, and contacted authors of relevant papers. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-RCTs, stepped-wedge RCTs, factorial RCTs, multiple baseline RCTs and randomised cross-over trials, of healthy eating interventions targeting children aged six months to six years that were conducted within the ECEC setting. ECEC settings included preschools, nurseries, kindergartens, long day care and family day care. To be included, studies had to include at least one intervention component targeting child diet within the ECEC setting and measure child dietary or physical outcomes, or both. DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened titles and abstracts and extracted study data. We assessed risk of bias for all studies against 12 criteria within RoB 1, which allows for consideration of how selection, performance, attrition, publication and reporting biases impact outcomes. We resolved discrepancies via consensus or by consulting a third review author. Where we identified studies with suitable data and homogeneity, we performed meta-analyses using a random-effects model; otherwise, we described findings using vote-counting approaches and via harvest plots. For measures with similar metrics, we calculated mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. We calculated standardised mean differences (SMDs) for primary and secondary outcomes where studies used different measures. We applied GRADE to assess certainty of evidence for dietary, cost and adverse outcomes. MAIN RESULTS: We included 52 studies that investigated 58 interventions (described across 96 articles). All studies were cluster-RCTs. Twenty-nine studies were large (≥ 400 participants) and 23 were small (< 400 participants). Of the 58 interventions, 43 targeted curriculum, 56 targeted ethos and environment, and 50 targeted partnerships. Thirty-eight interventions incorporated all three components. For the primary outcomes (dietary outcomes), we assessed 19 studies as overall high risk of bias, with performance and detection bias being most commonly judged as high risk of bias. ECEC-based healthy eating interventions versus usual practice or no intervention may have a positive effect on child diet quality (SMD 0.34, 95% confidence interval (CI) 0.04 to 0.65; P = 0.03, I2 = 91%; 6 studies, 1973 children) but the evidence is very uncertain. There is moderate-certainty evidence that ECEC-based healthy eating interventions likely increase children's consumption of fruit (SMD 0.11, 95% CI 0.04 to 0.18; P < 0.01, I2 = 0%; 11 studies, 2901 children). The evidence is very uncertain about the effect of ECEC-based healthy eating interventions on children's consumption of vegetables (SMD 0.12, 95% CI -0.01 to 0.25; P =0.08, I2 = 70%; 13 studies, 3335 children). There is moderate-certainty evidence that ECEC-based healthy eating interventions likely result in little to no difference in children's consumption of non-core (i.e. less healthy/discretionary) foods (SMD -0.05, 95% CI -0.17 to 0.08; P = 0.48, I2 = 16%; 7 studies, 1369 children) or consumption of sugar-sweetened beverages (SMD -0.10, 95% CI -0.34 to 0.14; P = 0.41, I2 = 45%; 3 studies, 522 children). Thirty-six studies measured BMI, BMI z-score, weight, overweight and obesity, or waist circumference, or a combination of some or all of these. ECEC-based healthy eating interventions may result in little to no difference in child BMI (MD -0.08, 95% CI -0.23 to 0.07; P = 0.30, I2 = 65%; 15 studies, 3932 children) or in child BMI z-score (MD -0.03, 95% CI -0.09 to 0.03; P = 0.36, I2 = 0%; 17 studies; 4766 children). ECEC-based healthy eating interventions may decrease child weight (MD -0.23, 95% CI -0.49 to 0.03; P = 0.09, I2 = 0%; 9 studies, 2071 children) and risk of overweight and obesity (RR 0.81, 95% CI 0.65 to 1.01; P = 0.07, I2 = 0%; 5 studies, 1070 children). ECEC-based healthy eating interventions may be cost-effective but the evidence is very uncertain (6 studies). ECEC-based healthy eating interventions may have little to no effect on adverse consequences but the evidence is very uncertain (3 studies). Few studies measured language and cognitive skills (n = 2), social/emotional outcomes (n = 2) and quality of life (n = 3). AUTHORS' CONCLUSIONS ECEC-based healthy eating interventions may improve child diet quality slightly, but the evidence is very uncertain, and likely increase child fruit consumption slightly. There is uncertainty about the effect of ECEC-based healthy eating interventions on vegetable consumption. ECEC-based healthy eating interventions may result in little to no difference in child consumption of non-core foods and sugar-sweetened beverages. Healthy eating interventions could have favourable effects on child weight and risk of overweight and obesity, although there was little to no difference in BMI and BMI z-scores. Future studies exploring the impact of specific intervention components, and describing cost-effectiveness and adverse outcomes are needed to better understand how to maximise the impact of ECEC-based healthy eating interventions.
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Affiliation(s)
- Sze Lin Yoong
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Melanie Lum
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Alix E Hall
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Cassandra Lane
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Jannah Z Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Lauren Dinour
- College of Education and Human Services, Montclair State University, Montclair, New Jersey, USA
| | - Therese McDonnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Debbie Booth
- Auchmuty Library, University of Newcastle, Callaghan, Australia
| | - Alice Grady
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
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24
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Bird M, Neely KC, Montemurro G, Mellon P, MacNeil M, Brown C, Sulz L, Storey K. Parental Perspectives of Sleep in the Home: Shaping Home-School Partnerships in School-Based Sleep Promotion Initiatives. Prev Chronic Dis 2023; 20:E38. [PMID: 37167552 DOI: 10.5888/pcd20.220395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Sleep is a critical component of child health and the prevention of chronic disease. Children may benefit from school-based sleep promotion; however, parents need to be involved for healthy sleep strategies learned at school to be translated to the home. The objective of this study was to explore parental perspectives on sleep behaviors and responsiveness to school-based sleep promotion. METHODS Twenty-five parents of school-aged children were purposively sampled for interviews from July 2019 through April 2020 in Alberta, Canada. Descriptive qualitative methodology was used, and data were generated through semistructured interviews and researcher field notes. Interviews were transcribed and themes were identified by using latent content analysis. RESULTS Three themes emerged from analysis: 1) sleep is valued and supported, 2) barriers to healthy sleep exist, and 3) schools are allies in promoting sleep. Parents perceived that sleep was essential for their child's health, facilitated healthy sleep practices in the home, and highlighted barriers (busy schedules and poor parental role models) that affected sleep. Parents supported and expressed value in school-based sleep promotion and noted factors that affected the success of school-based sleep promotion. CONCLUSION Parents are responsive to school-based sleep promotion. Promotion efforts should include resources that engage and involve parents in the school community. Throughout the development of resources to support school-based sleep promotion, additional consideration of parent-reported barriers to promoting healthy sleep in the home should be included.
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Affiliation(s)
- Melissa Bird
- Alberta Health Services, Calgary, Alberta, Canada
| | - Kacey C Neely
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | | | - Pamela Mellon
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Megan MacNeil
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Cary Brown
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lauren Sulz
- Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, 3-300 ECHA, 11405-87 Ave, Edmonton, AB Canada T6G 1C9
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25
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Ramires VV, Dos Santos PC, Barbosa Filho VC, Bandeira ADS, Marinho Tenório MC, de Camargo EM, Ravagnani FCDP, Sandreschi P, de Oliveira VJM, Hallal PC, Silva KS. Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews. J Phys Act Health 2023:1-14. [PMID: 37156540 DOI: 10.1123/jpah.2022-0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents. METHODS We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review's research question. Data charting form included the identification of the study, health outcomes, and PE classes' strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary. RESULTS An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted. CONCLUSIONS These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.
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Affiliation(s)
- Virgílio Viana Ramires
- Department of Physical Education, Federal Institute Sul-rio-grandense-IFSUL, Campus Pelotas, Pelotas, Pelotas, RS,Brazil
| | | | | | | | | | - Edina Maria de Camargo
- Department of Physical Education, Federal University of Paraná-UFPR, Curitiba, PR,Brazil
| | - Fabrício Cesar de Paula Ravagnani
- Department of Physical Education, Institute of Education, Science and Technology of Mato Grosso do Sul-Campus Campo Grande, Campo Grande, MS,Brazil
| | - Paula Sandreschi
- Department of Health Promotion, Ministry of Health of Brazil, Brasília, DF,Brazil
| | - Victor José Machado de Oliveira
- Department of Physical Education, Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Manaus, AM,Brazil
| | - Pedro Curi Hallal
- Department of Epidemiology, Federal University of Pelotas-UFPEL, Pelotas, RS,Brazil
| | - Kelly Samara Silva
- Department of Physical Education, Federal University of Santa Catarina, Florianopolis, SC,Brazil
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Duvendack M, Sonne L, Garikipati S. Gender Inclusivity of India's Digital Financial Revolution for Attainment of SDGs: Macro Achievements and the Micro Experiences of Targeted Initiatives. THE EUROPEAN JOURNAL OF DEVELOPMENT RESEARCH 2023:1-23. [PMID: 37361476 PMCID: PMC10127960 DOI: 10.1057/s41287-023-00585-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 06/28/2023]
Abstract
For decades, India has led the drive for financial inclusion of poor rural women to facilitate attainment of development objectives like poverty alleviation and women's empowerment. More recently, it has promoted digital financial inclusion to further its fight against poverty and gender inequality and support the attainment of UN's Sustainable Development Goals (SDGs). In this paper we take stock of how India's digital financial revolution has affected financial transactions and services with a focus on gender inclusivity for the attainment of the SDGs. We propose a framework to understand the gender inclusivity of digital financial inclusion initiatives that connects the macro developments in the sector with the micro-level experiences of improving women's access and use of these services. We draw on India's nationwide developments and present a case study of an initiative that specifically promotes gender inclusive finance. Our findings suggest that India has made great advances in promoting digital financial inclusion but at the same time, the country has struggled to achieve gender parity even within specific finance-focused programmes designed to improve gender inclusivity. We reflect on policy implications of these findings.
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Affiliation(s)
- Maren Duvendack
- School of International Development, University of East Anglia, Norwich, UK
| | - Lina Sonne
- O. P. Jindal Global University, Sonipat, India
| | - Supriya Garikipati
- School of Politics and International Relations, University College Dublin, Dublin, Ireland
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Kalubi J, Riglea T, O'Loughlin EK, Potvin L, O'Loughlin J. Health-Promoting School Culture: How Do We Measure it and Does it Vary by School Neighborhood Deprivation? THE JOURNAL OF SCHOOL HEALTH 2023. [PMID: 36869578 DOI: 10.1111/josh.13304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/23/2022] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The context in which school-based health-promoting interventions are implemented is key for the delivery and success of these interventions. However, little is known about whether school culture differs by school deprivation. METHODS Using data from PromeSS, a cross-sectional study of 161 elementary schools in Québec, Canada, we drew from the Health Promoting Schools theoretical framework to develop four measures of health-promoting school culture (i.e., school physical environment, school/teacher commitment to student health, parent/community engagement with the school, ease of principal leadership) using exploratory factor analysis. One-way ANOVA with post-hoc Tukey-Kramer analyses was used to examine associations between each measure and social and material deprivation in the school neighborhood. RESULTS Factor loadings supported the content of the school culture measures and Cronbach's alpha indicated good reliability (range: 0.68-0.77). As social deprivation in the school neighborhood increased, scores for both school/teacher commitment to student health and parent/community engagement with the school decreased. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Implementation of health-promoting interventions in schools located in socially deprived neighborhoods may require adapted strategies to address challenges related to staff commitment and parental and community involvement. CONCLUSION The measures developed herein can be used to investigate school culture and interventions for health equity.
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Affiliation(s)
- Jodi Kalubi
- École de santé publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, Québec, H3N 1X9, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 7101 avenue du Parc, Montréal, Québec, H3N 1X9, Canada
- Carrefour de l'innovation et de l'évaluation en santé, University of Montreal Hospital Research Center (CRCHUM), Tour Saint-Antoine. 850 Rue Saint-Denis, Montréal, Québec, Canada. H2X 0A9; Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | - Teodora Riglea
- École de santé publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, Québec, H3N 1X9, Canada
- Carrefour de l'innovation et de l'évaluation en santé, University of Montreal Hospital Research Center (CRCHUM), Tour Saint-Antoine. 850 Rue Saint-Denis, Montréal, Québec, Canada. H2X 0A9; Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | - Erin K O'Loughlin
- Carrefour de l'innovation et de l'évaluation en santé, University of Montreal Hospital Research Center (CRCHUM), Tour Saint-Antoine. 850 Rue Saint-Denis, Montréal, Québec, Canada. H2X 0A9; Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | - Louise Potvin
- École de santé publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, Québec, H3N 1X9, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 7101 avenue du Parc, Montréal, Québec, H3N 1X9, Canada
| | - Jennifer O'Loughlin
- École de santé publique de l'Université de Montréal, 7101 avenue du Parc, Montréal, Québec, H3N 1X9, Canada
- Carrefour de l'innovation et de l'évaluation en santé, University of Montreal Hospital Research Center (CRCHUM), Tour Saint-Antoine. 850 Rue Saint-Denis, Montréal, Québec, Canada. H2X 0A9; Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
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Khanal SP, Budhathoki CB, Okan O. Improving adolescent health literacy through school-based health literacy intervention: a mixed-method study protocol. BMC Public Health 2023; 23:407. [PMID: 36855125 PMCID: PMC9973246 DOI: 10.1186/s12889-023-15316-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Health-promoting actions might benefit from adolescent health literacy (AHL), however, there is scant research on it in Nepal. This study identifies adolescent students' health literacy (HL) needs and trials an intervention to improve their HL and intention to take health-promoting actions. METHODS This study employs a pre-and post-test mixed-method intervention involving three phases. First, we will conduct a formative and summative evaluation to identify participants' HL needs and design an intervention using quantitative and qualitative methods. Second, the intervention will be administered to the intervention group. Finally, formative and summative post-tests will be conducted to assess the effectiveness of the intervention. We will select four community schools from Birendranagar municipality based on random sampling. In quantitative research, data will be collected from adolescents selected through a census with standardized scales such as the HLS-Child-Q15, self-efficacy, social support, and health-promoting actions. A framework analysis was conducted to analyze qualitative data collected from focus group discussions with purposively chosen adolescents and key informant interviews with Health and Physical Education teachers and school nurses. The difference in difference approach will be used to analyze the intervention's outcome, i.e., the participants' improved HL, and health-promoting actions. DISCUSSION This is one of the first studies to explore HL in this group in Nepal. This study will provide the first insights into the overall level of AHL, potential AHL determinants, and the relationship between AHL and the intention to participate in health-promoting activities. The data can then be used to inform health promotion and health literacy initiatives.
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Affiliation(s)
- Shanti Prasad Khanal
- Central Department of Education, Faculty of Education, Tribhuvan University, Kirtipur, Nepal.
| | | | - Orkan Okan
- TUM Department of Sport and Health Sciences, Technical University , Munich, Germany
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Díaz-Martínez F, Sánchez-Sauco MF, Cabrera-Rivera LT, Sánchez CO, Hidalgo-Albadalejo MD, Claudio L, Ortega-García JA. Systematic Review: Neurodevelopmental Benefits of Active/Passive School Exposure to Green and/or Blue Spaces in Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3958. [PMID: 36900969 PMCID: PMC10001910 DOI: 10.3390/ijerph20053958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Today more than half of the world's population lives in urban areas. Children spend about 40 h a week in the school environment. Knowing the influence of school exposure to green/blue spaces could improve the children's health, creating healthier environments and preventing exposure to legal/illegal drugs. This systematic review summarized the main results of published studies on active or passive exposure to green or blue spaces in different domains of child neurodevelopment. In August 2022, five databases were searched and twenty-eight eligible studies were included in the analysis. Cognitive and/or academic performance was the most frequently studied (15/28). Most studies evaluate passive exposure to green/blue spaces (19/28) versus active exposure (9/28). Only three studies addressed the relationship between blue space and neurodevelopment. The main results point toward mixed evidence of a protective relationship between green/blue space exposure and neurodevelopment, especially in improving cognitive/academic performance, attention restoration, behavior, and impulsivity. Renaturalizing school spaces and promoting "greener" capacities for school environmental health could improve children's neurodevelopment. There was great heterogeneity in methodologies and adjustment for confounding factors across studies. Future research should seek a standardized approach to delivering school environmental health interventions beneficial to children's development.
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Affiliation(s)
- Francisco Díaz-Martínez
- Paediatric Environmental Health Specialty Unit, Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, University of Murcia, 30120 Murcia, Spain
- Environment and Human Health Lab, Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, 28009 Madrid, Spain
| | - Miguel F. Sánchez-Sauco
- Paediatric Environmental Health Specialty Unit, Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, University of Murcia, 30120 Murcia, Spain
- Environment and Human Health Lab, Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, 28009 Madrid, Spain
| | - Laura T. Cabrera-Rivera
- Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, 28009 Madrid, Spain
- International Exchange Program for Minority Students, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Environmental Health, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00921, USA
| | | | | | - Luz Claudio
- International Exchange Program for Minority Students, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Environmental Medicine and Public Health, Division of International Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Juan A. Ortega-García
- Paediatric Environmental Health Specialty Unit, Department of Pediatrics, Clinical University Hospital Virgen of Arrixaca, University of Murcia, 30120 Murcia, Spain
- Environment and Human Health Lab, Instituto Murciano de Investigación Sanitaria (IMIB), University of Murcia, 30120 Murcia, Spain
- Global Alliance to Renaturalize Child and Adolescent Health (GreenRooting.org), Spanish Association of Pediatrics, 28009 Madrid, Spain
- International Exchange Program for Minority Students, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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AlZahrani SG. Healthy Schools Framework in Saudi Arabia: A Narrative Review. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2023. [DOI: 10.51847/lj2fbaa0vm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Nutrient Content and Compliance with Sodium Standards in Elementary School Meals in the United States Pre- and Post-COVID-19. Nutrients 2022; 14:nu14245386. [PMID: 36558545 PMCID: PMC9784979 DOI: 10.3390/nu14245386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/01/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Various federal policies have weakened school meal nutrition standards in the United States since the passage of the Healthy, Hunger-Free Kids Act in 2010, including temporary school meal nutrition waivers to promote post-COVID-19 pandemic recovery. This study used school menu and nutrient data from a nationally representative sample of 128 elementary school districts to examine differences in nutrients (average calories, total fat, saturated fat, sodium, total sugar, and fiber) and alignment with United States Department of Agriculture (USDA) sodium targets in 2019 (pre-pandemic) and in 2022 (post-pandemic). Data were analyzed using analysis of variance accounting for repeated measures within school districts, adjusting for geographic region and urbanicity. Small differences in the nutrient content for both breakfast and lunch were observed between 2019 and 2022. Most weeks met USDA sodium Target 1 for breakfast (≥95% of weeks) and Target 1 (≥96% of weeks) and Target 1A for lunch (≥92% of weeks) in both 2019 and 2022, although compliance decreased slightly when condiments were included. Additionally, meals provided on average 57 g of total sugar. Overall, many meals are already in alignment with lower sodium targets. Simple strategies, such as offering lower sodium condiments, can further reduce sodium in school meals. The total sugar levels observed highlight that the USDA should consider limits on added sugars in school meals.
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Zhao Y, Xu X, Cai G, Hu Z, Hong Y. Promoting Strategies for Healthy Environments in University Halls of Residence under Regular Epidemic Prevention and Control: An Importance-Performance Analysis from Zhejiang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16014. [PMID: 36498080 PMCID: PMC9740966 DOI: 10.3390/ijerph192316014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/14/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
In the post-epidemic era, regular epidemic prevention and control is a daunting and ongoing task for nations all around the world. University halls of residence have been important spaces where university students balance their studies, work, and personal lives after COVID-19. Therefore, a healthy physical living environment deserves more attention. This paper compares situations before and after COVID-19 in an effort to evaluate the impact of indoor environments in university halls of residence on students. The study proposed eight vital dimensions for creating a healthy university hall of residence environment and, from 14 September to 4 October 2022, used an online questionnaire to collect data from 301 university students studying in Zhejiang, China. The key quality of service characteristics for fostering a healthy environment in university halls of residence were discovered using descriptive statistical analysis and revised importance-performance analysis (IPA). We found that an improved indoor physical environment and efficient arrangement of indoor space were crucial for the health of university students. The quality of educational services could be improved, and indoor exercise should be utilized effectively, both of which can contribute significantly to a healthy indoor environment. This study aims to contribute to the development of future initiatives to support healthy physical living environments in university halls of residence.
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Affiliation(s)
- Yulu Zhao
- School of Civil Engineering and Architecture, Zhejiang Sci–Tech University, Hangzhou 310018, China
| | - Xinye Xu
- School of Civil Engineering and Architecture, Zhejiang Sci–Tech University, Hangzhou 310018, China
| | - Gangwei Cai
- College of Civil Engineering and Architecture, Zhejiang University, Hangzhou 310058, China
| | - Zhetao Hu
- School of Civil Engineering and Architecture, Zhejiang Sci–Tech University, Hangzhou 310018, China
| | - Yan Hong
- School of Civil Engineering and Architecture, Zhejiang Sci–Tech University, Hangzhou 310018, China
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Hahnraths MTH, Jansen JPM, Winkens B, van Schayck OCP. The Effects of a Multi-Component School-Based Nutrition Education Intervention on Children's Determinants of Fruit and Vegetable Intake. Nutrients 2022; 14:4259. [PMID: 36296942 PMCID: PMC9607228 DOI: 10.3390/nu14204259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Evidence suggests that multi-component school-based health-promoting interventions have great potential to improve children's fruit and vegetable intake. However, interventions that combine classroom-based curricula with experiential learning strategies (e.g., cooking) are relatively seldom described. This study investigates the short-term and longer-term effects of a multi-component school-based nutrition education intervention combining classroom-based and experiential learning strategies on children's determinants of their fruit and vegetable intake (knowledge, taste preferences, attitudes, and intention). Using a comparative quasi-experimental study design, data were collected, via child-reported questionnaires, at the baseline, directly after the intervention, and three months after the intervention from 4 control and 15 intervention classes from Dutch primary schools. A total of 192 children in grades three and four (aged 8-10 years) constituted the participants. After correction for the baseline, sex, age, and the fruit or vegetable product assessed in the questionnaire; the intervention group showed a significant increase in knowledge (p = 0.001; standardized effect size (ES = 0.60), taste preference (p = 0.002; ES = 0.52), attitude towards the assessed fruit or vegetable product (p = 0.004; ES = 0.48), and general attitude towards healthy products (p = 0.01; ES = 0.39) over the short term, when compared to the control group. The effects of the intervention did not continue to be significant over the longer term. The findings implicate short-term intervention success, although more research and intervention adaptations are recommended to increase the impact of such programs, especially over the long term.
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Affiliation(s)
- Marla T. H. Hahnraths
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Jorieke P. M. Jansen
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Chai HH, Gao SS, Fung MHT, Duangthip D, Lo ECM, Chu CH. Principals' Perspectives on Joining a Kindergarten Outreach Dental Service: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12452. [PMID: 36231752 PMCID: PMC9566290 DOI: 10.3390/ijerph191912452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
In this qualitative study, the researchers explored principals' perspectives on a free outreach dental service with silver diamine fluoride (SDF) therapy for children in kindergarten. Two researchers recruited kindergarten principals using purposive sampling. They conducted individual semi-structured interviews to collect the principals' perspectives regarding their adoption of and experience with the service. They manually transcribed the interview verbatim into text and followed a thematic approach for data analysis. The researchers interviewed eight principals. The principals identified the prevalent caries status and importance of oral health promotion for kindergarten children. They acknowledged that the service enhanced dental knowledge, fostered oral hygiene practice and improved children's oral health. To adopt this service, they needed to ensure adequate capacity to perform the service. They had no concern with staining by SDF because the parents were informed and consented to the SDF therapy. They appreciated the free service provided by a professional team managed by a reputable university. In conclusion, the principals were generally satisfied with the outreach dental service. They realised the necessity of oral health promotion. They found that parents accepted the SDF therapy although the SDF stained their children's carious teeth. They needed support from their teachers and the children's parents to run the service.
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Affiliation(s)
- Hollis Haotian Chai
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361005, China
| | - Sherry Shiqian Gao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361005, China
| | | | | | | | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Cohen JFW, Polacsek M, Hecht CE, Hecht K, Read M, Olarte DA, Patel AI, Schwartz MB, Turner L, Zuercher M, Gosliner W, Ritchie LD. Implementation of Universal School Meals during COVID-19 and beyond: Challenges and Benefits for School Meals Programs in Maine. Nutrients 2022; 14:nu14194031. [PMID: 36235683 PMCID: PMC9571988 DOI: 10.3390/nu14194031] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022] Open
Abstract
School meals play a major role in supporting children’s diets and food security, and policies for universal school meals (USM) have the potential to contribute to positive child health outcomes. During the COVID-19 pandemic, schools provided free school meals to all students in the United States, but this national USM policy ended in school year (SY) 2022–2023; however, a few states have adopted policies to continue USM statewide for SY 2022–2023. Research examining the challenges and strategies for successful continuation of USM is essential, along with studying pandemic-related challenges that are likely to persist in schools. Therefore, we conducted a study in Maine (with a USM policy) to evaluate the impact of COVID-19 and the concurrent implementation of USM, as well as examine differences in implementation by school characteristics, throughout the state. A total of n = 43 school food authorities (SFAs) throughout Maine completed surveys. SFAs reported multiple benefits of USM including increased school meal participation; reductions in the perceived stigma for students from lower-income households and their families; and no longer experiencing unpaid meal charges and debt. SFAs also experienced challenges due to the COVID-19 pandemic, particularly regarding costs. When considering future challenges, most respondents were concerned with obtaining income information from families, product and ingredient availability, and the costs/financial sustainability of the school meal programs. Overall, USM may have multiple important benefits for students and schools, and other states should consider implementation of a USM policy.
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Affiliation(s)
- Juliana F. W. Cohen
- Center for Health Inclusion, Research and Practice (CHIRP), Merrimack College, 315 Turnpike Street, North Andover, MA 01845, USA
- Department of Public Health and Nutrition, Merrimack College, 315 Turnpike Street, North Andover, MA 01845, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
- Correspondence: ; Tel.: +1-978-837-5456
| | - Michele Polacsek
- Center for Excellence in Public Health, University of New England, 716 Stevens Ave, Portland, ME 04103, USA
| | - Christina E. Hecht
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA
| | - Ken Hecht
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA
| | - Margaret Read
- Share Our Strength, No Kid Hungry, Washington, DC 20005, USA
| | - Deborah A. Olarte
- Center for Health Inclusion, Research and Practice (CHIRP), Merrimack College, 315 Turnpike Street, North Andover, MA 01845, USA
| | - Anisha I. Patel
- Division of General Pediatrics, Stanford University, Palo Alto, CA 94304, USA
| | - Marlene B. Schwartz
- Rudd Center for Food Policy and Obesity, Department of Human Development and Family Sciences, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT 06103, USA
| | - Lindsey Turner
- College of Education, Boise State University, 1910 University Drive, Boise, ID 83725, USA
| | - Monica Zuercher
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA
| | - Wendi Gosliner
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA
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Wirnitzer KC, Tanous DR, Motevalli M, Göbel G, Wirnitzer G, Drenowatz C, Ruedl G, Cocca A, Kirschner W. Study protocol of "From Science 2 School"-prevalence of sports and physical exercise linked to omnivorous, vegetarian and vegan, diets among Austrian secondary schools. Front Sports Act Living 2022; 4:967915. [PMID: 36249320 PMCID: PMC9554638 DOI: 10.3389/fspor.2022.967915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
The increasing prevalence of unhealthy lifestyle choices contribute to almost all chronic conditions negatively affecting individual and public health. As the most beneficial preventative solution, a healthy lifestyle focusing on the dual approach of physical activity (PA) and a healthful diet is highly recommended. Considering the growing number of people interested in sustainable, plant-based diets, it seems crucial to analyze lifestyle behaviors with a special focus on diet type to delve deeper into the unenthusiastic health status among young populations. Therefore, this multidisciplinary study aims to survey and scale health behaviors with a special focus on the prevalence of traditional and vegetarian diets in connection with PA levels among Austrian pupils (10-19 years), teachers and principals in secondary education levels I and II. Following a cross-sectional design, sociodemographic and school-related data along with a complete profile of lifestyle behaviors, including detailed information regarding diet, PA, sports & exercise, and other health-related behaviors, were collected using online-based questionnaires. A total number of 8,845 children/adolescents (~1.2% of the eligible 771,525 Austrian secondary school pupils) and 1,350 adults (~1.5% of total eligible 89,243 Austrian teachers/principals) participated in the study. As this is the first investigation to explore the prevalence of veganism/vegetarianism amongst a large group of pupils, the present study will add an important contribution to overcome the lack of knowledge on PA, sports & exercise linked to healthy alternative diets. With a sustainable healthy lifestyle, a healthy transition from childhood to adulthood occurs, which can result in growing healthier functioning generations at all social levels. As a study protocol, the present article is intended to present comprehensive details of the study design, objectives, and the associated analytical procedures of the "From Science 2 School" study.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Georg Göbel
- Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
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García-Ros R, Pérez-González F, Tomás JM, Sancho P. Effects of self-regulated learning and procrastination on academic stress, subjective well-being, and academic achievement in secondary education. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03759-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
The main objective of this study was to test a structural theoretical model of the effects of self-regulated learning on academic stress, subjective well-being, and academic achievement in Secondary Education, considering academic procrastination as a mediator. An additional aim was to explore whether these relationships were moderated by gender and educational level. Participants were 728 students in compulsory and post-compulsory secondary education in a large city in Eastern Spain. Path analysis results indicated that the proposed model showed satisfactory fit, with the three dimensions of self-regulated learning significantly predicting the educational outcomes considered, and that procrastination mediated these relationships. Overall, the model is able to predict 9.8% of the variance of academic stress, 23.1% of students wellbeing, and 14% of academic achievement. Moreover, the multi-group routine revealed no moderation effects due to gender, but educational level moderated two relationships, between self-efficacy and academic achievement and between metacognitive strategies and procrastination. Additionally, supplementary models were tested for three specific subjects (Spanish Language, Foreign Language and Mathematics), which showed an improvement in explained variance, being respectively: 29%, 28% and 27%. Results are discussed in light of previous research and in terms of their impact on educational practice.
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Ramos M, Tejera E, Cabeza E. Evaluation of the Health Promoting Schools (CEPS) Program in the Balearic Islands, Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10756. [PMID: 36078479 PMCID: PMC9517870 DOI: 10.3390/ijerph191710756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate the structure, process, and results obtained by the CEPS Program. METHODS We combined quantitative and qualitative methods. We reviewed our databases, the health projects and reports sent by the schools, and the notes taken during the assessment visits to the schools. We included all the schools participating in the CEPS Program between 2014-2015 and 2018-2019 for structure purposes, but only those participating for at least two years for the process and results. We used a descriptive analysis as well as a content analysis. RESULTS 84 schools participated in the CEPS Program. Attrition (24%) occurred mainly after the first year. Most schools performed at least one situation analysis (88.1%) and had at least one teacher trained (73.8%). One of three obtained a certificate (35.7%) or grant (38.1%). For the process and results, we selected 44 schools. Teachers' participation stood out (61.4% transformative and 38% representative) over the participation of other agents. The coordination of the health committee with other committees and with other local resources was a crucial element. Of the schools, 40.9% had high quality projects, 50% medium, and 9.1% low. Of the schools, 40.9% showed positive health results. CONCLUSION We identified the characteristics of high-quality health-promoting schools.
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Affiliation(s)
- Maria Ramos
- Balearic Islands Public Health Department, 07010 Palma, Spain
- Balearic Islands Health Research Institute (IdisBa), 07120 Palma, Spain
| | - Elena Tejera
- Balearic Islands Public Health Department, 07010 Palma, Spain
| | - Elena Cabeza
- Balearic Islands Public Health Department, 07010 Palma, Spain
- Balearic Islands Health Research Institute (IdisBa), 07120 Palma, Spain
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Mugler N, Baurecht H, Lam K, Leitzmann M, Jochem C. The Effectiveness of Interventions to Reduce Sedentary Time in Different Target Groups and Settings in Germany: Systematic Review, Meta-Analysis and Recommendations on Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10178. [PMID: 36011821 PMCID: PMC9408392 DOI: 10.3390/ijerph191610178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sedentary behavior is an important risk factor for several chronic diseases and is associated with an increased risk of mortality. We assessed the effectiveness of interventions to reduce sedentary time in Germany and provide recommendations on interventions to reduce sedentary time in children and adults. METHODS We comprehensively searched PubMed, Web of Science and the German Clinical Trials Register up to April 2022 for intervention studies targeting sedentary behavior in Germany. We performed a systematic review and qualitative synthesis of the interventions and a meta-analysis in children. RESULTS We included 15 studies comprising data from 4588 participants. The results of included primary studies in adults and children showed inconsistent evidence regarding change in sedentary time, with a majority of studies reporting non-significant intervention effects. The meta-analysis in children showed an increase in sedentary time for children in the control and intervention groups. CONCLUSION We found inconsistent evidence regarding the effectiveness of interventions to reduce time spent sedentary and our meta-analysis showed an increase in sedentary time in children. For children, we recommend physical and social environment interventions with an active involvement of families. For adults, we recommend physical environment interventions, such as height-adjustable desks at work.
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Smith C, Goss HR, Issartel J, Meegan S, Belton S. LifeLab: Co-Design of an Interactive Health Literacy Intervention for Socioeconomically Disadvantaged Adolescents'. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1230. [PMID: 36010120 PMCID: PMC9406774 DOI: 10.3390/children9081230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022]
Abstract
Low socioeconomic populations, when compared to more affluent groups, are at greater risk of initiating risky behaviours and consequently developing health complications. Health literacy has been identified as a possible means to improve and sustain positive health behaviours, with adolescence being a time point when such behaviours can be embedded. To develop a meaningful health intervention, it has been recommended that relevant stakeholders be included in the design phase. This formative evaluation study was the second phase of co-design of an engaging health literacy intervention 'LifeLab' with, and for, socioeconomically disadvantaged adolescents in Ireland. In Spring 2021, a series of co-design workshops (n = 17) were facilitated with a convenience sample of adolescents from socially disadvantaged areas (n = 22) to gather their perceptions, feedback, and suggested changes on the LifeLab learning activities that had emerged from Phase 1 of the work. The data was analysed using reflexive thematic analysis, resulting in the development of three themes: (i) preferred learning engagement strategies, (ii) practical and logistical considerations and (iii) ideas for LifeLab content. The results highlight the value in adopting a participatory approach, as participants offered an array of suggestions and details to maximise the potential for LifeLab to be contextually relevant and engaging; suggestions which will directly inform the development and implementation of the intervention.
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Affiliation(s)
- Craig Smith
- School of Health and Human Performance, Dublin City University, D09 NA55 Dublin, Ireland
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Al-Qahtani AM. Lifestyle habits among Najran University students, Najran, Saudi Arabia. Front Public Health 2022; 10:938062. [PMID: 36045736 PMCID: PMC9421256 DOI: 10.3389/fpubh.2022.938062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Abstract
Background Unhealthy lifestyles have been linked to increased cardiovascular disease, diabetes, and other non-communicable diseases. University students have been reported to adopt unhealthy lifestyles and undesirable eating choices. Objectives The study aimed to estimate the prevalence of healthy eating habits; determine the prevalence of physical activity habits; to estimate the smoking habits among male health sciences college students at Najran University, Najran, Saudi Arabia. Methods The present questionnaire-based descriptive cross-sectional study (convenient sample) was carried out among undergraduate male students enrolled in the health sciences colleges at Najran University, Najran, Saudi Arabia, from 1st May to 31st May, 2019. Around 500 students were recruited and were requested to answer a self-administered questionnaire about eating habits, physical activity, and tobacco smoking habits. Descriptive results were summarized in percentage and frequency. Cross tabulation using chi-square test was performed to measure the impact of demographic variable on eating pattern, physical activity and smoking behavior. Pearson's correlation was done using two tailed tests to determine the type of relationship between different variables. The SPSS (version 26) was used to perform statistical analysis. Results A total of 454 complete responses from the male students from Najran University were obtained. The majority (74%) were aged 21 years and above, unmarried (94.9%), had healthy BMI (47.4%), and suffered mild (41.4%) to moderate (32.4%) levels of stress during the previous month. The study findings showed a low daily frequency of consumption of vegetables and fruits. There was a low prevalence of daily consumption of vegetables (16%) and fruits (9%). More than 10% of all students reported no consumption of fruits and vegetables. Students who felt severely stressed during the previous month were significantly not eating any vegetables (p = 0.022) and fruits (p < 0.001), and had high salt intake (p = 0.045). Married participants had a significantly (p = 0.03) higher servings of vegetables per day. Furthermore, 32.15% of participants were not practicing 30 min of physical activity 5 days per week. The study showed a low prevalence (47.57%) of physical activity among the participants. However, none of the participants' variables were significantly associated with routine physical activity. In addition, the study showed a relatively high prevalence of smoking (25.77%) among Najran university male students. The participants' age (p 0.01), overall health (p = 0.02) and level of stress (p = 0.001) experienced during the last month were significantly associated with the length of exposure to secondhand smoke. Whereas, smoking any kind of tobacco daily (25.77%) was significantly (p = 0.005) related to the age of participants. A high number of participants aged 21 years and above (52.72%) were significantly (p = 0.019) exposed to secondhand smoke. Conclusion To conclude, the study findings showed a low daily frequency of consumption of vegetables and fruits, a relatively high prevalence of smoking and a low level of awareness regarding the health risks of smoking; and a large number of participants were physically inactive among male university students. Intervention programs in university students should concentrate on improving nutrition attitudes and knowledge toward good diet, tobacco-smoking cessation strategies, and structured intervention programs to encourage physical activity. However, these interventions should be pilot-tested for feasibility and acceptability before implementation.
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Goswami N, Hansen D, Gumze G, Brix B, Schmid-Zalaudek K, Fredriksen PM. Health and Academic Performance With Happy Children: A Controlled Longitudinal Study Based on the HOPP Project. Front Cardiovasc Med 2022; 9:820827. [PMID: 35722126 PMCID: PMC9203822 DOI: 10.3389/fcvm.2022.820827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Overweight/obesity in children and adolescents, largely arising due to increased food intake and reduced physical activity, is a major health concern. Physical activity (PA) integrated into learning has been shown to not only lead to improved health outcomes and wellbeing but also positively affect academic performance. The Health and Academic Performance with Happy Children (HAPHC) project aims at enhancing health and academic performance in elementary school children via implementation of a daily unit of Physical Activity Across the Curriculum (PAAC), which is carried out within the school setting. In this project, PA as an integrated part of learning will be evaluated and the learning material adapted for a large scale implementation across several European countries. Methods In three European countries (Austria, Slovenia, and Belgium), 12 primary schools in total will be recruited to act as either intervention or control school in a large intervention study, which applies the PAAC pedagogy during lectures. It is estimated that, at least 3,000+ children across the three countries will be recruited in this study. All teachers of intervention schools will receive training and materials/teaching equipment that will allow them to integrate a daily PA unit of 45 min over 3 years across the curriculum. In response to the daily PA intervention, the following primary outcomes will be assessed: changes in health related physiological factors, academic achievement, psycho-social aspects and wellbeing. Impact of Project The HAPHC project aims at promoting public health by increasing PA at an early age within the school setting and therewith preventing the increasing risk of non-communicable diseases across Europe. HAPHC project aims to develop knowledge and materials, which will ensure that the PAAC can be scalable to other European countries. Trial Registration Number ClinicalTrials.gov, identifier: NCT04956003.
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Affiliation(s)
- Nandu Goswami
- Physiology Division, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
- Health Sciences, Alma Mater Europaea, Maribor, Slovenia
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Dominique Hansen
- REVAL/BIOMED, Faculty of Rehabilitation Sciences, Hasselt/Heart Centre Hasselt, Jessa Hospital, Hasselt University, Hasselt, Belgium
- *Correspondence: Dominique Hansen
| | - Goran Gumze
- Health Sciences, Alma Mater Europaea ECM, Maribor, Slovenia
| | - Bianca Brix
- Physiology Division, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Karin Schmid-Zalaudek
- Physiology Division, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Per Morten Fredriksen
- Faculty of Health and Social Science, Inland Norway University of Applied Sciences, Hamar, Norway
- School of Health Sciences, Kristiania University College, Oslo, Norway
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Isabel Salazar Cobo M, Jager G, de Graaf C, Zandstra EH. Dynamic changes in hedonic and emotional responses to fruit varying in portion size. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hill A, Alston L, Needham C, Peeters A, LaMontagne AD, Nichols M. Systematic review of the effectiveness of health promotion interventions targeting obesity prevention in school-based staff. Health Promot Int 2022; 37:6631503. [PMID: 35788312 PMCID: PMC9437818 DOI: 10.1093/heapro/daac061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
School-based employee interventions can benefit the health of staff and have the potential to influence the health of school students through role-modelling. However, interventions within schools typically focus on students, with very few studies addressing obesity and related health behaviours among school staff. A systematic review of the peer-reviewed literature published between January 2000 and May 2020 was undertaken to synthesize the evidence on the impact that school-based obesity prevention programmes have on the staff they employ. Search terms were derived from four major topics: (i) school; (ii) staff; (iii) health promotion and (iv) obesity. Terms were adapted for six databases and three independent researchers screened results. Studies were included if they reported on the outcomes of body weight, dietary behaviours and/or physical activity. Of 3483 papers identified in the search, 13 studies met the inclusion criteria. All 13 studies included an intervention that focussed on improving nutrition, physical activity or both. All included studies demonstrated a positive outcome for either dietary intake, weight or body mass index or physical activity outcomes, however not all results were statistically significant. The included studies showed promising, although limited, impacts on employee health outcomes. This review demonstrated a lack of global focus and investment in interventions targeting school staff, particularly in contrast to the large amount of research on school-based health promotion initiatives focussed on students. There is a need for further research to understand effective interventions to promote health and prevent obesity in this large, diverse and influential workforce.
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Affiliation(s)
- Amy Hill
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong 3220, VIC, Australia
| | - Laura Alston
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong 3220, VIC, Australia.,Deakin Rural Health, Faculty of Health, Deakin University, Geelong 3220, VIC, Australia.,Colac Area Health, Research, Colac 3250, VIC, Australia
| | - Cindy Needham
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong 3220, VIC, Australia
| | - Anna Peeters
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong 3220, VIC, Australia
| | - Anthony D LaMontagne
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong 3220, VIC, Australia
| | - Melanie Nichols
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong 3220, VIC, Australia
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Zhou J, Liu H, Wen H, Wang X, Wang Y, Yang T. The Association Between Physical Activity and Mathematical Achievement Among Chinese Fourth Graders: A Moderated Moderated-Mediation Model. Front Psychol 2022; 13:862666. [PMID: 35615189 PMCID: PMC9126125 DOI: 10.3389/fpsyg.2022.862666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/07/2022] [Indexed: 11/20/2022] Open
Abstract
This study explored the association between out-of-school physical activity (PA) and mathematical achievement in relation to mathematical anxiety (MA), as well as the influence of parents' support for their children's physical activity on this association, to examine whether parental support for physical activity affects mental health and academic performance. Data were collected from the responses of 22,509 (52.9% boys) children in Grade 4 from six provinces across eastern, central, and western China who completed the mathematics component and the physical education and health component of the national-level education quality assessment. A moderated moderated-mediation model was tested using PROCESS v3.4 and SPSS v19.0, with socioeconomic status, school location, and body mass index as controlled variables. Out-of-school physical activity had a positive effect on children's mathematical achievement, and math anxiety partially mediated this association. The indices of conditional moderated mediation through the parental support of both girls and boys were, respectively, significant, indicating that children can benefit from physical activity, and that increased perceived parental support for physical activity can alleviate their children's math anxiety and improve their mathematics, regardless of gender. However, gender differences were observed in the influence of parental support for physical activity on anxiety: Although girls' math anxiety levels were significantly higher, the anxiety levels of girls with high parental support were significantly lower than those of boys with low parental support.
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Affiliation(s)
- Jing Zhou
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
| | - Hongyun Liu
- Faculty of Psychology, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, Beijing Normal University, Beijing, China
| | - Hongbo Wen
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
| | - Xiuna Wang
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
| | - Yehui Wang
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
| | - Tao Yang
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
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Yu T, Xu J, Jiang Y, Hua H, Zhou Y, Guo X. School educational models and child mental health among K-12 students: a scoping review. Child Adolesc Psychiatry Ment Health 2022; 16:32. [PMID: 35477408 PMCID: PMC9047301 DOI: 10.1186/s13034-022-00469-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The promotion of mental health among children and adolescents is a public health imperative worldwide, and schools have been proposed as the primary and targeted settings for mental health promotion for students in grades K-12. This review sought to provide a comprehensive understanding of key factors involved in models of school education contributing to student mental health development, interrelationships among these factors and the cross-cultural differences across nations and societies. METHODS This scoping review followed the framework of Arksey and O'Malley and holistically reviewed the current evidence on the potential impacts of school-related factors or school-based interventions on student mental health in recent 5 years based on the PubMed, Web of Science, Embase and PsycExtra databases. RESULTS/FINDINGS After screening 558 full-texts, this review contained a total of 197 original articles on school education and student mental health. Based on the five key factors (including curriculum, homework and tests, physical activities, interpersonal relationships and after-school activities) identified in student mental development according to thematic analyses, a multi-component school educational model integrating academic, social and physical factors was proposed so as to conceptualize the five school-based dimensions for K-12 students to promote student mental health development. CONCLUSIONS The lessons learned from previous studies indicate that developing multi-component school strategies to promote student mental health remains a major challenge. This review may help establish appropriate school educational models and call for a greater emphasis on advancement of student mental health in the K-12 school context among different nations or societies.
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Affiliation(s)
- Ting Yu
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Jian Xu
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China.
| | - Yining Jiang
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Hui Hua
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Yulai Zhou
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
| | - Xiangrong Guo
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
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Kuzik N, da Costa BGG, Hwang Y, Verswijveren SJJM, Rollo S, Tremblay MS, Bélanger S, Carson V, Davis M, Hornby S, Huang WY, Law B, Salmon J, Tomasone JR, Wachira LJ, Wijndaele K, Saunders TJ. School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review. Int J Behav Nutr Phys Act 2022; 19:40. [PMID: 35382825 PMCID: PMC8979786 DOI: 10.1186/s12966-022-01258-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/08/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5-18 years) attending school. METHODS This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results. RESULTS Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries. CONCLUSIONS Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.
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Affiliation(s)
- Nicholas Kuzik
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Bruno G G da Costa
- School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Yeongho Hwang
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | | | - Scott Rollo
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Department of Health Sciences, Carleton University, Ottawa, Canada
| | - Stacey Bélanger
- Département de Pédiatrie, Faculté de Médicine, Université de Montréal and CHU Sainte Justine, CIRENE (Centre Intégré du Réseau en Neurodéveloppement de L'Enfant), Montréal, Quebec, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Melanie Davis
- Physical and Health Education (PHE) Canada, Ottawa, Canada
| | - Susan Hornby
- Pan-Canadian Joint Consortium for School Health (JCSH), Summerside, Canada
| | - Wendy Yajun Huang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Barbi Law
- School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| | - Lucy-Joy Wachira
- Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | | | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
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Biallas RL, Rehfuess E, Stratil JM. Adverse and other unintended consequences of setting-based interventions to prevent illicit drug use: A systematic review of reviews. J Public Health Res 2022. [DOI: 10.1177/22799036221103362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article explores adverse and unintended consequences (AUCs) of setting-based public health interventions to prevent illicit drug use, including the mechanisms leading to these AUCs. Additionally, the reporting of AUCs in systematic reviews was assessed. Therefore, we conducted a systematic review of reviews and searched four big databases were searched. We included systematic reviews concerned with setting-based interventions to prevent illicit drug use. We used AMSTAR 2 to rate the overall confidence of the results presented in the reviews. Data on study characteristics, types and mechanisms of AUCs were extracted. An a priori categorisation of consequences drew on the WHO-INTEGRATE framework, and the categorisation of mechanisms on the Behaviour Change Wheel. For reviews reporting AUCs, the same information was also retrieved from relevant primary studies. Findings were synthesised narratively and in tables. Finally, we included 72 reviews, of which 18 reported on AUCs. From these, 11 primary studies were identified. Most of the reviews and primary studies were conducted in educational settings. The most prevalent AUCs reported in systematic reviews and primary studies were paradoxical health effects (i.e. increase of drug use). Potential mechanisms discussed primarily focussed on the change though social norms and practices. Changes of knowledge and perception were also mentioned. Concluding, the identified reviews and primary studies paid insufficient attention to AUCs of public health interventions to prevent illicit drug use. Where reported, it was mostly as an afterthought and narrowly framed as health related. No mentions of potential broader social consequences were found.
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Affiliation(s)
- Renke L Biallas
- Institute for Medical Information Processing, Biometry and Epidemiology, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jan M Stratil
- Institute for Medical Information Processing, Biometry and Epidemiology, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Impact of School-Based Health Behavioral Intervention on Awareness, Practice Pattern of Healthy Lifestyle, and Cardiometabolic Risk Factors among School Children of Shimla: A Cluster-Randomized, Intervention Study. Indian J Pediatr 2022; 89:343-350. [PMID: 34110581 DOI: 10.1007/s12098-021-03786-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess the impact of multicomponent intervention on knowledge and practice of health behaviors among school children. The secondary objective was to assess mean change in cardiometabolic risk factors such as anthropometric measurements and biochemical profile. METHODS A cluster-randomized, controlled trial was conducted among adolescents aged 13-18 y from government and private senior secondary schools in Shimla city. Multicomponent health behavioral intervention was delivered through teachers. Subjective and objective measures of knowledge and health behaviors were the primary outcomes. RESULTS There was no significant effect of intervention on nutrition knowledge adjusted mean difference (aMD) 2.4 (95% CI: -3.7 to 8.7; p = 0.43), and the dietary habits adjusted mean difference 2.9 (95% CI: -0.3 to 6.2; p = 0.08) between the intervention and control group. However, significant improvement in odds of dietary practices 2.4 (95% CI: 1.1 to 5.0; p = 0.03) and decreased odds of consumption of junk food 3.8 (95% CI: 1.6 to 9.3; p = 0.003) was observed. There was no effect on physical activity odds 2.9 (95% CI: 0.8 to 11.6; p = 0.12) or screen time with aMD 0.9 (95% CI: 0.7 to 1.2; p = 0.52). Anthropometric measurements and biochemical profile also did not differ except low-density lipoprotein cholesterol which had significantly lower aMD: -7.2 (95% CI: -13.6 to -1.0; p = 0.02). There was no change in alcohol and tobacco consumption with odds 0.8 (95% CI: 0.6 to 1.2; p = 0.33) and 1.0 (95% CI: 0.7 to 1.5; p = 0.87), respectively after intervention. CONCLUSIONS Multipronged interventions targeting lifestyle behaviors of adolescents at multilevels are vital to curb rising trends of noncommunicable diseases. This quintessentially calls for wider support across multiple sectors and creation of sustained enabling macro- and micro-environment. The trial is registered in the Clinical Trial Registry of India under the registration number CTRI/2018/01/011312 dated 12/01/2018 Registered, retrospectively.
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Bandeira ADS, Ravagnani FCDP, Barbosa Filho VC, de Oliveira VJM, de Camargo EM, Tenório MCM, Sandreschi PF, Dos Santos PC, Ramires VV, Hallal PC, Silva KS. Mapping recommended strategies to promote active and healthy lifestyles through physical education classes: a scoping review. Int J Behav Nutr Phys Act 2022; 19:36. [PMID: 35346232 PMCID: PMC8962044 DOI: 10.1186/s12966-022-01278-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding which strategies have been recommended for the promotion of active and healthy lifestyles through physical education (PE) classes can guide PE policies and practice. Therefore, we summarized worldwide recommendations regarding strategies for PE classes that have aimed to promote active and healthy lifestyles among school-aged children and adolescents. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were utilized. A literature search was carried out in June 2020 in eight peer-reviewed literature databases, in addition to searches in institutional and personal libraries. The eligibility criteria included any online document that included recommendations targeting any dimension of PE classes (e.g., policy and environment, curriculum, appropriate instruction, student assessment, and strategies that interact with PE) published since 2000. RESULTS In total, 2,408 potentially eligible documents were screened. Of these, 63 were included in the final analysis. The recommended strategies were as follows: six referred to policy and environment (valuing PE, higher frequency and duration of classes, inclusive PE classes, mandatory daily classes, evaluation of PE classes, and qualified teachers), five to curriculum (structure, type of content, cross-cutting themes, and components that improve PE classes), four to appropriate instruction (promotion of physical activities, inclusion of social issues, employment of the use of innovative technologies, and organization of the teaching-learning process), and three to student assessment (understanding human movement concepts, evaluation of contents, and assessment methods to develop an active and healthy lifestyle). CONCLUSION Twenty-one strategies recommended for PE classes linked to five dimensions aimed at different target populations were identified. Over half were linked to the dimensions of policy and environment and appropriate instruction. PE is recommended to be mandatory and valued at all educational levels, with weekly frequency that contributes to an active and healthy lifestyle. This review shows that guaranteeing different experiences beyond sports, improving social inclusion, using innovative technologies, and providing adequate materials and spaces to be important challenges and ways to guide policies, programs, and new research in this field of knowledge. Open Science Framework Registration: https://osf.io/harwq/.
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Affiliation(s)
| | | | | | | | - Edina Maria de Camargo
- Federal Technological University of Paraná, Department of Physical Education, Curitiba, Brazil
| | | | - Paula Fabricio Sandreschi
- Department of Physical Education, Federal University of Santa Catarina, Florianopolis, Brazil
- Ministry of Health of Brazil, Primary Health Care Secretariat, Health Promotion Department, General Coordination To Promote Physical Activity and Intersectoral Initiatives, Brasilia, Brazil
| | | | - Virgílio Viana Ramires
- Sul-Rio-Grandense Federal Institute of Education, Science and Technology, Camaquã Campus, Brazil
| | - Pedro Curi Hallal
- Federal University of Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil
| | - Kelly Samara Silva
- Department of Physical Education, Federal University of Santa Catarina, Florianopolis, Brazil
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