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Masson J, Darlington-Bernard A, Darlington EJ. Promoting wellbeing within the Health Promoting Schools framework: Could life skills be a means rather than an end? JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202748. [PMID: 38851055 DOI: 10.1016/j.jeph.2024.202748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/10/2024]
Abstract
This paper explores the evolution and challenges of health promotion in educational settings, focusing on the Health Promoting Schools framework. Central to this approach is the empowerment of students through participatory strategies and community engagement to address health determinants and reduce inequities. Well-being, a subjective and multifaceted concept, is crucial for student success, with positive school climates playing a key role. Additionally, life skills (LS) are identified as potential tools for promoting student well-being, though their definition and assessment remain ambiguous. The paper concludes by highlighting the need for further research and clarity in order to maximize the impact of health promotion efforts in schools.
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Affiliation(s)
- Julien Masson
- Lumière Lyon2 University -Education Cultures Politiques Research unit, France.
| | | | - Emily Joan Darlington
- Claude Bernard Lyon1 University - Health, Systemic, Process, UR 4129 Research Unit, France
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Carducci B, Dominguez G, Kidd E, Oh C, Jain R, Khan A, Bhutta ZA. Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs. Nutr Rev 2024:nuae030. [PMID: 38767979 DOI: 10.1093/nutrit/nuae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
CONTEXT The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. OBJECTIVE Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. DATA SOURCES A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. DATA EXTRACTION Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. DATA ANALYSIS A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. CONCLUSIONS This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022303255.
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Affiliation(s)
- Bianca Carducci
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Georgia Dominguez
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Emily Kidd
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Christina Oh
- Western University, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Reena Jain
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Amira Khan
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Centre of Excellence in Women, and Child Health, Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public, Health University of Toronto Health Sciences Building, Toronto, ON, Canada
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Vennegoor G, van Assema P, Molleman GRM, van Empelen P, Dieleman J, Jansen MWJ. Fidelity, adaptation and integration of whole-school health promotion within Dutch schools: a cross-sectional survey study. Health Promot Int 2023; 38:daad173. [PMID: 38124497 PMCID: PMC10733658 DOI: 10.1093/heapro/daad173] [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] [Indexed: 12/23/2023] Open
Abstract
Implementing comprehensive health promotion programs in the school setting can be challenging, as schools can be considered complex adaptive systems. As a first step towards understanding what works in improving implementation for which schools and under which conditions, this study aimed to examine the degree of implementation of health promoting school (HPS) programs, in terms of five dimensions of fidelity (adherence, dose, participant responsiveness, quality of delivery and program differentiation), and the dimensions of adaptation and integration. The HPS Implementation Questionnaire was distributed among ± 2400 primary, secondary, secondary vocational and special needs schools in the Netherlands. Employees of 535 schools (22.3%) filled out the questionnaire. Data were analysed by descriptive statistics and ANOVA tests. The average degree of implementation was 2.55 (SD = 0.58, range = 0.68-3.90; scaled 0-4). The lowest scores were achieved for participant responsiveness and adherence, and the highest for integration and adaptation. Schools that identified as HPS reported significantly higher overall degree of implementation, adherence, dose, participant responsiveness, program differentiation and adaptation than schools that didn't. Primary schools achieved a significantly higher degree of implementation, dose, participant responsiveness, quality of delivery and integration than other school types. In conclusion, many schools work on student health and well-being to some extent, but the vast majority have much room for improvement. Higher implementation scores for schools that identified as HPS underline the value of HPS programs. A broader perspective on health and more insight into conditions for effectiveness and implementation in secondary and secondary vocational schools are needed.
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Affiliation(s)
- Gerjanne Vennegoor
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Patricia van Assema
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gerard R M Molleman
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Department of Healthy Living, Public Health Service Gelderland-Zuid, P.O. Box 1120, 6501 BC Nijmegen, The Netherlands
| | - Pepijn van Empelen
- Expertise Center Child Health, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 3005, 2301 DA Leiden, The Netherlands
| | - Joyce Dieleman
- Public Health Service Noord- en Oost Gelderland, Academic Collaborative Center AGORA, P.O. Box 3, 7200 AA Zutphen, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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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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Francis-Oliviero F, Loubières C, Grové C, Marinucci A, Shankland R, Salamon R, Perez E, Garancher L, Galera C, Gaillard E, Orri M, González-Caballero JL, Montagni I. Improving Children's Mental Health Literacy Through the Cocreation of an Intervention and Scale Validation: Protocol for the CHILD-Mental Health Literacy Research Study. JMIR Res Protoc 2023; 12:e51096. [PMID: 37796588 PMCID: PMC10587813 DOI: 10.2196/51096] [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: 07/24/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Children's mental health is a public health priority, with 1 in 5 European children younger than 12 years having a behavioral, developmental, or psychological disorder. Mental health literacy (MHL) is a modifiable determinant of mental health, promoting psychological well-being and reducing mental health problems. Despite its significance, no interventions or scales currently exist for increasing and measuring MHL in this population. OBJECTIVE This study has dual objectives: (1) cocreating and evaluating an intervention on children's MHL, and (2) developing and validating a scale that measures children's MHL. METHODS Our study focuses on children aged 9-11 years attending primary school classes in various settings, including urban and rural areas, and priority education zones within a French department. Using a participatory research approach, we will conduct workshops involving children, parents, teachers, and 1 artist to cocreate an intervention comprising multiple tools (eg, a pedagogical kit and videos). This intervention will undergo initial evaluation in 4 classes through observations, interviews, and satisfaction questionnaires to assess its viability. Concurrently, the artist will collaborate with children to create the initial version of the CHILD-MHL scale, which will then be administered to 300 children. Psychometric analyses will validate the scale. Subsequently, we will conduct a cluster randomized controlled trial involving a minimum of 20 classes, using the CHILD-MHL scale scores as the primary end point to evaluate the intervention's efficacy. Additional interviews will complement this mixed methods evaluation. Both the intervention and the scale are grounded in the Child-Focused MHL model. RESULTS The first tool of the intervention is the pedagogical kit Le Jardin du Dedans, supported by the public organization Psycom Santé Mentale Info and endorsed by UNICEF (United Nations Children's Fund) France. The second tool is a handbook by the Pan American Health Organization and the World Health Organization, which is addressed to teachers to sensitize them to children's mental health problems. The third is a 5-page supplementary leaflet produced by the nongovernmental organization The Ink Link, which teaches children the notion of MHL. Finally, we produced 56 items of the MHL Scale and listed existing education policies for children's mental health. CONCLUSIONS After its robust evaluation, the intervention could be extended to several schools in France. The scale will be the first in the world to measure children's MHL. It will be used not only to evaluate interventions but also to provide data for decision makers to include MHL in all educational policies. Both the intervention and the scale could be translated into other languages. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51096.
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Affiliation(s)
- Florence Francis-Oliviero
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Christine Grové
- School of Curriculum Teaching & Inclusive Education, Monash University, Clayton, Australia
- Fulbright Association, Science, Technology, Engineering and Mathematics College, Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Canberra, Australia
| | - Alexandra Marinucci
- School of Educational Psychology & Counselling, Monash University, Clayton, Australia
| | - Rebecca Shankland
- Laboratory Développement, Individu, Processus, Handicap, Éducation, Department of Psychology, Education and Vulnerabilities, Université Lumière Lyon 2, Lyon, France
| | - Réda Salamon
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
| | | | | | - Cédric Galera
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
| | - Elsa Gaillard
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | | | - Ilaria Montagni
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
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van Dongen BM, Ridder MAM, Wolters L, Steenhuis IHM, Renders CM. Increasing community capacity to improve the implementation of Health Promoting Schools: barriers and facilitators from the FLASH intervention. Health Promot Int 2023; 38:daad115. [PMID: 37776534 PMCID: PMC10541852 DOI: 10.1093/heapro/daad115] [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] [Indexed: 10/02/2023] Open
Abstract
Building community capacity is important for the successful implementation of a Health Promoting School. To identify how capacity building can be encouraged in secondary schools, four schools engaged in the Fit Lifestyle at School and at Home (FLASH) intervention for 3 years. This study explores barriers and facilitators that school personnel, parents and pupils experienced in the capacity-building process. Thirty-one stakeholders were interviewed. Transcripts were analysed thematically based on the five actions of the intervention: (i) appoint a Healthy School coordinator and build a team, (ii) determine ambitions, (iii) design and (iv) implement the action plan and (v) evaluate and improve. The time and support allocated to coordinators helped them evolve their role from executors of health-promotion activities to coordinators, instigators and gatekeepers of the implementation process. Participatory tools helped identify shared values among stakeholders to determine context-specific ambitions and leverage points for interventions. Coordinators indicated that they lacked the skills and authority to engage pupils and parents and to reach the broader community. Coordinators struggled with translating promising ideas into action plans of coherent and mutually supportive activities and embedding them into policy. Strong leadership of Healthy School coordinators, who focus on the capacity-building process and foster collaborative relationships, is essential to build community capacity. In this process, more guidance is needed on how to involve the broader community in various phases. Furthermore, coordinators can benefit from professional development to align jointly designed activities into a comprehensive action plan embedded into Healthy School policies.
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Affiliation(s)
- Bonnie Maria van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Monica Antonia Maria Ridder
- Human Movement and Education Division, Windesheim University of Applied Sciences, Campus 2, 8017 CA Zwolle, The Netherlands
| | - Loïs Wolters
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Ingrid Hendrika Margaretha Steenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Carry Mira Renders
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Healthy Society, Windesheim University of Applied Sciences, Campus 2, 8017 CA Zwolle, The Netherlands
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Coşkun Şimşek D, Günay U. The effects of stress on adolescents' school engagement. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:35-43. [PMID: 36214732 DOI: 10.1111/jcap.12397] [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: 02/21/2022] [Revised: 09/05/2022] [Accepted: 09/18/2022] [Indexed: 02/04/2023]
Abstract
PROBLEM Adolescents experience stress due to physical, cognitive, emotional and sexual development. This descriptive study was conducted to find out whether stress experienced by adolescents affected their school engagement. METHODS The sample was 440 students studying in a high schools in the Eastern Anatolia region of Turkey between October 2020 and January 2021. The data were collected using the Sociodemographic Information Form, the Adolescent Stress Questionnaire (ASQ-S) and the School Engagement Scale. FINDINGS Statistically significant differences were found between adolescents' sociodemographic characteristics and mean scores on the ASQ-S subdimension and total scores (p ˂ 0.05). A strong negative association was found between adolescents' ASQ mean subdimension and total scores and their School Engagement Scale mean subdimension and total scores (p ˂ 0.05). CONCLUSIONS It was found that adolescents' sociodemographic characteristic affected their stress levels and school engagement and that high stress levels experienced by adolescents negatively affected their school engagement.
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Affiliation(s)
- Didem Coşkun Şimşek
- Department of Pediatric Nursing, Faculty of Health Sciences, Fırat University, Elazığ, Turkey
| | - Ulviye Günay
- Department of Pediatric Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
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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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Bartelink N, van Dongen B, Kremers S, Renders C, van Vlokhoven B, van Koperen M, van Assema P. Supporting schools during the implementation of the health-promoting school approach: The roles of a healthy school advisor. Front Public Health 2022; 10:960873. [PMID: 36589979 PMCID: PMC9797735 DOI: 10.3389/fpubh.2022.960873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The health-promoting school (HPS) approach was developed by the World Health Organization to create health promotion changes in the whole school system. Implementing the approach can be challenging for schools because schools are dynamic organizations with each a unique context. Many countries worldwide have a health promotion system in place in which healthy school (HS) advisors support schools in the process of implementing the HPS approach. Even though these HS advisors can take on various roles to provide support in an adaptive and context-oriented manner, these roles have not yet been described. The current study aims to identify and describe the key roles of the HS advisor when supporting schools during the dynamic process of implementing the HPS approach. Methods The study was part of a project in which a capacity-building module was developed for and with HS advisors in the Netherlands. In the current study, a co-creation process enabled by participatory research was used in which researchers, HS advisors, national representatives, and coordinators of the Dutch HS program participated. Co-creation processes took place between October 2020 and November 2021 and consisted of four phases: (1) a narrative review of the literature, (2) interviews, (3) focus groups, and (4) a final check. Results Five roles were identified. The role of "navigator" as a more central one and four other roles: "linking pin," "expert in the field," "critical friend," and "ambassador of the HPS approach." The (final) description of the five roles was recognizable for the HS advisors that participated in the study, and they indicated that it provided a comprehensive overview of the work of an HS advisor in the Netherlands. Discussion The roles can provide guidance to all Dutch HS advisors and the regional public health organizations that employ them on what is needed to provide sufficient and context-oriented support to schools. These roles can inspire and guide people from other countries to adapt the roles to their own national context.
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Affiliation(s)
- Nina Bartelink
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands,School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, Netherlands,*Correspondence: Nina Bartelink
| | - Bonnie van Dongen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,Bonnie van Dongen
| | - Stef Kremers
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Carry Renders
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Boukje van Vlokhoven
- Sector Organization for Secondary Education (VO-raad), Utrecht, Netherlands,Programma Gezonde School (Healthy School Program), Utrecht, Netherlands
| | - Marije van Koperen
- Programma Gezonde School (Healthy School Program), Utrecht, Netherlands,Department of Public Health and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Patricia van Assema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
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Driessen-Willems M, Severens F, Darlington E, Bartelink N, Kremers S, van Assema P, Bessems K. Exploring the implementation dynamics of the Health Promoting School approach in Europe: a qualitative study among school health representatives. HEALTH EDUCATION 2022. [DOI: 10.1108/he-12-2021-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeAdapting the Health Promotion School (HPS) approach to context specifics is acknowledged as being essential for implementation and achieving optimal effectiveness. This study aims to explore implementation variations on seven HPS spectra (such as top-down to bottom-up involvement of stakeholders) on which implementation of the HPS approach can vary, and the factors that relate to navigation on these spectra.Design/methodology/approachIn 2020, fourteen HPS researchers and professionals from ten European countries participated in semi-structured interviews.FindingsNavigation variations on the HPS spectra occurred throughout most spectra. Further, a tendency was found towards spectrum extremes of addressing multiple core-components, implementing non-disruptive Health Promotion (HP) programmes, and evaluating the HPS approach through an action-oriented research approach. Important general factors were resources, staff capacity and time available to staff members for implementing the HPS approach. Some spectra required more specific factors like organisational skills, leadership or a certain level of democracy.Practical implicationsThe implementation of the HPS approach should be supported by implementation strategies addressing the spectrum-specific factors, but more generic factors such as staff capacity, resources and the level of democracy should also be considered.Originality/valueThis study explores navigation variations throughout HPS spectra rather than the HPS approach in general. It also nuances implementation diversity across and within different European contexts.
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Barcelona J, Centeio E, Phillips S, Gleeson D, Mercier K, Foley J, Simonton K, Garn A. Comprehensive school health: teachers' perceptions and implementation of classroom physical activity breaks in US schools. Health Promot Int 2022; 37:6722651. [PMID: 36166261 DOI: 10.1093/heapro/daac100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Modifications to the social-ecological model, such as Whole School, Whole Community, Whole Child (WSCC) frameworks, have been utilized in comprehensive school health interventions. Classroom physical activity breaks are used when implementing whole-of-school approaches. However, the onus to implement classroom physical activity breaks is on school stakeholders. This study aimed to explore teacher and principal perceptions and implementation of physical activity breaks in elementary schools. Further, this study investigated how theoretical factors representative of the social-ecological model and their interactions affect teacher and principal perceptions and utilization of classroom physical activity breaks. Interviews were conducted to understand teacher and principal perceptions and implementation. A total of 12 classroom teachers and five principals participated in semi-structured interviews which were analyzed using constant comparison and deductive analysis to identify relationships and themes coded across the social-ecological and WSCC models. To ensure fidelity individuals that led the professional development (n = 2) were also interviewed. Three main themes emerged as part of the data analysis: (i) The Connection Between Intrapersonal Knowledge and Interpersonal Professional Development, (ii) Resources, Sharing Means Caring and (iii) The Policy Level Creates Time. Teachers and principals valued knowledge and resources and felt that policy facilitated implementation. Results suggest that classroom physical activity breaks are influenced by multiple factors across varied levels of the social-ecological model. Understanding this relationship can inform future professional development to increase the provision of classroom physical activity breaks among teachers.
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Affiliation(s)
- Jeanne Barcelona
- Department of Kinesiology, Health and Sports Studies, Wayne State University, Detroit, MI, USA
| | - Erin Centeio
- Department of Kinesiology and Rehabilitation Science, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Sharon Phillips
- Department of Population Health, School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA
| | - Dara Gleeson
- Social and Behavioral Sciences Department, Yale School of Public Health, New Haven, CT, USA
| | - Kevin Mercier
- Department of Health and Sports Sciences, Adelphi University, Garden City, NY, USA
| | - John Foley
- Department of Physical Education, State University of New York at Cortland, Cortland, NY, USA
| | - Kelly Simonton
- Division of Kinesiology & Health, The University of Wyoming, Laramie, WY, USA
| | - Alex Garn
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA, USA
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Components Affecting the Promotion of COVID-19 Disease Prevention Behaviors among Iranian Students: A Qualitative Study by Using the PRECEDE Model. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7807401. [PMID: 36033561 PMCID: PMC9410811 DOI: 10.1155/2022/7807401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 07/23/2022] [Indexed: 11/26/2022]
Abstract
Background COVID-19 is a social health problem. Several risk factors threaten students, and schools can provide a suitable environment for managing and performing health promotion programs. Given the extensive spread of the disease and the existence of multilevel components affecting the adoption of preventive behaviors, understanding the views and opinions of the audience about the barriers and facilitators affecting the behavior using qualitative studies can be one of the ways to have a successful intervention. Materials and Methods This was a qualitative study performed by a directed content analysis method while using the PRECEDE model (predisposing, reinforcing, enabling constructs in educational diagnosis and evaluation). In total, 38 individuals (teachers, parents, and students) were entered into the study using the purposive sampling method. Data were collected by semistructured interviews, and the implemented data were systematically classified into five stages (condensed meaning units, code, subcategory, category, and theme) and were arranged and analyzed. Results The findings are classified into three themes of predisposing, enabling, and reinforcing factors. In addition, perceived sensitivity, perceived intensity, mental beliefs, behavior outcome evaluation, and perceived power were considered as subcategories of predisposing factors, whereas normative beliefs and motivation for adherence to protocols were subcategories of reinforcing factors, and control beliefs were subcategories of enabling factors. Conclusion Our findings could be used as a guide to design educational interventions aiming at promoting COVID-19 prevention behaviors in schools.
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Ogasawara R, Yamanaka H, Kobayashi J, Tomokawa S, Sugita E, Hirano T, Kigawa M, Nishio A, Akiyama T, Nam EW, Gregorio ER, Estrada CAM, Thongthien P, Kanyasan K, Devkota B, Hun J, Ma Y, Yamamoto BA. Status of school health programs in Asia: National policy and implementation. Pediatr Int 2022; 64:e15146. [PMID: 35445487 PMCID: PMC9322300 DOI: 10.1111/ped.15146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The WHO's Health Promoting Schools (HPS) framework is based on an understanding of the reciprocal relationship between health and education, and the need to take a holistic approach to health promotion in schools. We aim to clarify the degree to which the HPS framework is reflected in the national policies of eight target countries and the issues surrounding its successful implementation. METHODS Date were collected through two expert workshops with participants from eight Asian countries: Cambodia, China, Japan, Korea, Lao PDR, Nepal, the Philippines, and Thailand. In the first workshop, data collected on national policy were mapped against the HPS framework. From this, key issues were identified, and follow-up data collection was conducted in each country for a second workshop. RESULTS We identified a policy shift toward the HPS framework in six out of the eight countries. Neither Japan nor Korea had changed their national policy frameworks to reflect an HPS approach; however, in the latter, model programs had been introduced at a local level. We identified various barriers to successful implementation, especially in relation to mental health and wellbeing. CONCLUSION Given the recent shift toward the HPS approach in six out of the eight countries in this study, there is a need to conduct research to assess the impact of this framework on the health and wellbeing of students and school staff. At the same time, we call for more dialog in the context of Japan to explore the possible benefits of introducing the HPS framework into schools.
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Affiliation(s)
- Rie Ogasawara
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Hiroshi Yamanaka
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Sachi Tomokawa
- Sports Science Department, Faculty of Education, Shinshu University, Nagano, Japan
| | - Elli Sugita
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Takanori Hirano
- Faculty of Sociology, Momoyama Gakuin University, Osaka, Japan
| | - Mika Kigawa
- Faculty of Health and Social Services, Kanagawa University of Human Services, Kanagawa, Japan
| | - Akihiro Nishio
- Health Administration Center, Gifu University, Gifu, Japan
| | - Takeshi Akiyama
- Department of Health Science, Nagano College of Nursing, Nagano, Japan
| | - Eun Woo Nam
- Global Health Lab, Department of Health Administration for MPH and PhD Program, Yonsei University, Wonju City, Korea
| | - Ernesto R Gregorio
- Department of Health Promotion and Education, College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Crystal Amiel M Estrada
- Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Pimpimon Thongthien
- Office of Basic Education Commission, Ministry of Education, Bangkok, Thailand
| | - Kethsana Kanyasan
- Faculty of Education, National University of Laos, Vientiane Capital, Lao PDR
| | | | - Jeudyla Hun
- Department of School Health, Ministry of Education, Youth, and Sport, Phnom Penh, Cambodia
| | - Yinghua Ma
- Institute of Child and Adolescent Health, Peking University, Beijing, China
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Jain YK, Joshi NK, Bhardwaj P, Singh K, Suthar P, Joshi V. Developing a health-promoting school using Knowledge to Action framework. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:306. [PMID: 34667806 PMCID: PMC8459839 DOI: 10.4103/jehp.jehp_1139_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND There is a lack of organized effort in the arena of school health promotion, which has been recognized as an effective approach to combat the growing incidence of communicable and noncommunicable diseases. With this view, a study was conducted to develop comprehensive and replicable model for health promotion in schools. MATERIALS AND METHODS The Knowledge to Action (KTA) framework recognized by the World Health Organization as an implementational framework was used in an implementation study in a school of urban Jodhpur to assess the challenges and gaps associated with health promotion interventions in the school. Baseline regarding knowledge application and practices was gathered using interviews with school staff, parents, and group interaction with students. Knowledge synthesis was done by a thorough search of available literature and the gathered baseline. Resource mapping was carried out using checklists developed from knowledge synthesis. Tailor-made tools were constructed for knowledge implementation for each component of the action cycle. Knowledge of facts related to health behaviors among students was evaluated using pre- and postquestionnaires and practical application of knowledge was assessed using a checklist of 28 indicators on a 5-point Likert scale. Values of tests were gathered and compared with test values 3 and 6 months after the implementation of tailored interventions using descriptive and inferential statistics. RESULTS Increase in correct answers by students (42% to 96%) and average response for indicators on the Likert scale (3.23-4.86) was seen on repeated interventions over 6 months. Tobacco consumption by school staff reduced by 20% and an increase in willingness among teachers was observed on follow-up interviews. CONCLUSION The study thus developed a model for health promotion in a school with the help of the KTA framework using tailored interventions that could further be evolved in other setups based on local needs and available resources.
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Affiliation(s)
- Yogesh Kumar Jain
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nitin Kumar Joshi
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine and School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Department of Paediatrics and School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Praveen Suthar
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vibha Joshi
- Resource Center Health Technology Assessment, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Kossman MK, McCrae AJ, Pryor RR, Frank SC, Hayford R, Logan PC, Moakley MG, Register-Mihalik JK, Kerr ZY. Barriers and Facilitators Faced by Athletic Trainers Implementing National Athletic Trainers' Association Inter-Association Task Force Preseason Heat-Acclimatization Guidelines in US High School Football Players. J Athl Train 2021; 56:816-828. [PMID: 33150946 DOI: 10.4085/321-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT The aim of the National Athletic Trainers' Association Inter-Association Task Force (NATA-IATF) preseason heat-acclimatization guidelines was to acclimatize high school athletes to the environment during the first 2 weeks of the preseason and reduce the risk of exertional heat illness. OBJECTIVE To identify barriers and facilitators that high school athletic trainers (ATs) encountered when implementing the NATA-IATF guidelines. DESIGN Qualitative study. SETTING Individual phone interviews with all participants. PATIENTS OR OTHER PARTICIPANTS Thirty-three ATs (16 men, 17 women; age = 36.0 ± 12.0 years, athletic training experience = 12.9 ± 10.5 years) representing 19 states (4 with state mandates) were interviewed before data saturation was achieved. Participants were purposefully sampled from a larger investigation based on stratification of US Census region and preidentified high school compliance with the NATA-IATF guidelines. MAIN OUTCOME MEASURE(S) A cross-sectional, semistructured phone interview (6 steps) was conducted with each participant and then transcribed verbatim. A 7-person research team (5 coders, 2 auditors) coded the data into themes and categories, focusing on consensus of data placement to reduce bias and ensure accuracy. RESULTS Facilitators and barriers that influenced successful guideline implementation were (1) perceived stakeholder access, (2) perceived stakeholder role, (3) capability and capacity, (4) school culture, (5) logistical support, (6) resources, (7) physical environment, and (8) consistency of the guidelines. Overall, participants discussed facilitators and barriers within each category based on their experiences and circumstances. CONCLUSIONS Athletic trainers faced numerous concerns regarding compliance with the NATA-IATF preseason heat-acclimatization guidelines. Multiple levels of influence should be targeted to improve implementation. These include intrapersonal factors by giving ATs the education and self-efficacy to support advocacy for implementation, interpersonal components by establishing strong collaborative networks for change, community and environmental factors by optimizing school culture and community resources for implementation, and policy aspects by establishing consistent guidelines across all bodies.
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Affiliation(s)
- Melissa Kay Kossman
- School of Health Professions, University of Southern Mississippi, Hattiesburg
| | - Andrew J McCrae
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Riana R Pryor
- Department of Exercise and Nutrition Sciences, Center for Research and Education in Special Environments, SUNY, University at Buffalo, NY
| | - Simone C Frank
- Department of Health Behavior, University of North Carolina at Chapel Hill
| | - Ryan Hayford
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
| | - Paige C Logan
- Department of Health Behavior, University of North Carolina at Chapel Hill
| | - Margaret G Moakley
- Department of Health Behavior, University of North Carolina at Chapel Hill
| | | | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
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Gugglberger L. A brief overview of a wide framework-Health promoting schools: a curated collection. Health Promot Int 2021; 36:297-302. [PMID: 33742214 DOI: 10.1093/heapro/daab037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Maina BW, Juma K, Igonya EK, Osindo J, Wao H, Kabiru CW. Effectiveness of school-based interventions in delaying sexual debut among adolescents in sub-Saharan Africa: a protocol for a systematic review and meta-analysis. BMJ Open 2021; 11:e044398. [PMID: 34020975 PMCID: PMC8144038 DOI: 10.1136/bmjopen-2020-044398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/12/2021] [Accepted: 04/23/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Early sexual debut is associated with poor sexual and reproductive health outcomes across the life course. A majority of interventions aimed at delaying sexual debut among adolescents in sub-Saharan Africa (SSA) have been implemented in schools with mixed findings on the effectiveness of such interventions. This systematic review will summarise and synthesise existing evidence on the effectiveness of school-based interventions in delaying sexual debut among adolescents aged 10-19 years. METHODS AND ANALYSIS We will conduct a comprehensive database search of peer-reviewed studies published in PubMed, Scopus, Science Direct, Web of Science, HINARI and EBSCO (PsycINFO, Global Health, CINAHL) and in Cochrane library, National Institute of Health and Turning Research into Practice databases for ongoing studies yet to be published. All studies conducted in SSA between January 2009 and December 2020, regardless of the study design, will be included. Two authors will independently screen all retrieved records and relevant data on sexual debut extracted.Data will be pooled using the random effects model. Dichotomous outcomes will be reported as risk ratios and continuous data as mean difference at 95% CI. Heterogeneity will be assessed using the I² statistic. Findings will be presented in tables and charts, while providing a description of all included studies, themes and concepts drawn from literature. ETHICS AND DISSEMINATION Ethical approval is not required. The findings will be disseminated through peer-reviewed publications, presentations at relevant conferences and other convening focusing on adolescent sexual and reproductive health.
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Affiliation(s)
- Beatrice W Maina
- Population Dynamics and Reproductive Health, African Population and Health Research Center, Nairobi, Kenya
- School of Public Health, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Kenneth Juma
- Population Dynamics and Reproductive Health, African Population and Health Research Center, Nairobi, Kenya
| | - Emmy Kageha Igonya
- Population Dynamics and Reproductive Health, African Population and Health Research Center, Nairobi, Kenya
| | - Jane Osindo
- Research Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
| | - Hesborn Wao
- Research Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
| | - Caroline W Kabiru
- Research Capacity Strengthening, African Population and Health Research Center, Nairobi, Kenya
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Elsenburg LK, Abrahamse ME, Harting J. Implementation of a Dutch school-based integrated approach targeting education, health and poverty-a process evaluation. Health Promot Int 2021; 37:6153941. [PMID: 33647968 PMCID: PMC8851351 DOI: 10.1093/heapro/daab028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
This study provides an evaluation of the implementation of a school-based integrated approach to improve academic outcomes by targeting children’s education, health, and poverty. A two-year municipal subsidy program was provided to four primary schools in a deprived urban neighborhood in Amsterdam. Schools were put in charge of the implementation and coordination of the program. The municipality and district authorities provided assistance. This study evaluated whether the program functioned as integrated approach, i.e., whether it targeted multiple domains and environments by involving various agencies and actors, and what factors facilitated or hampered this. It also yielded an overview of the initiatives implemented and the facilitators and barriers of successful implementation of initiatives. Principals’ perceptions served as the main input for this study. We thematically analyzed seven written customized plans for spending the subsidy (one to two per school), 15 transcripts of interviews with the principals (three to four per school) and the minutes of 16 meetings between principals, policy officers, and researchers. According to the principals, the schools had made great progress in the education domain and in improving the school’s pedagogical climate, but in the health and poverty domains less progress had been made. Apart from the municipality, relatively few external agencies and actors had been actively involved in the program, and progress in other environments than the school was hardly achieved. This study shows that functioning of the program as integrated approach was facilitated by connections between initiatives, and that hired, well-trusted third parties may be crucial to establish these connections. Lay summary This study evaluated whether a two-year municipal program to improve academic outcomes by targeting children’s education, health, and poverty, provided to primary schools in a deprived urban neighborhood, functioned as intended, and if so why, or if not, why not. The program was intended to function as integrated approach. This means that it was supposed to target the mentioned domains, the school, home, and neighborhood environment, and to involve various agencies and actors, such as school staff, policy officers, parents, children, and external organizations. The school principals could implement multiple, self-chosen, initiatives. According to the principals, on whose perceptions this evaluation study was primarily based, both teaching and the school climate improved during the program. However, improvements in children’s health and poverty levels, and outside the school environment in general, were more difficult to achieve. In addition, the program involved mainly school staff and policy officers. The program thus functioned as an integrated approach, but only to a limited extent. The functioning of the program as integrated approach was facilitated by involving hired third parties to stimulate interconnection of initiatives, i.e., initiatives serving the same goals, involving multiple agencies and actors, and/or being implemented in the same location.
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Affiliation(s)
- L K Elsenburg
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M E Abrahamse
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - J Harting
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Sartipizadeh M, Yazdi-Feyzabadi V, Alipouri Sakha M, Zarrin A, Bazyar M, Zahirian Moghadam T, Zandian H. Evaluating the health promoting schools in Iran: across-sectional study. HEALTH EDUCATION 2021. [DOI: 10.1108/he-04-2020-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeHealth-promoting schools have been associated with improvements in the health status of students globally. This study is a secondary analysis study assessing Iranian HPSs.Design/methodology/approachThis was a cross-sectional study on routinely collected data using an external audit 63-item checklist, which was utilized to evaluate 440 HPSs between 2014 and 2017. The mean score for each of the checklists' components was calculated. Nonparametric tests were conducted to investigate the association between the presence of a school caregiver, students' educational level and the school's score.FindingsWhile the number of five- and four-star schools increased significantly, one- to three-star schools declined. Providing clinical and counseling services had negative growth. Despite the steady growth of the staff's health, this category still had the lowest score among; on the contrary, physical activity had the highest score in 2017. The presence of a full-time school caregiver and middle schools were both significantly correlated with achieving higher scores (p < 0.005).Originality/valueIt seems that in addition to developing school facilities to promote physical activities, measures should be taken to promote access to counseling services, considering health issues of students and staff and finally increasing the number of full-time school caregiver
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Neely KC, Montemurro GR, Storey KE. A Canadian-wide perspective on the essential conditions for taking a comprehensive school health approach. BMC Public Health 2020; 20:1907. [PMID: 33317496 PMCID: PMC7734767 DOI: 10.1186/s12889-020-09987-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/29/2020] [Indexed: 12/22/2022] Open
Abstract
Background The primary purpose of this research was to explore Comprehensive School Health (CSH) stakeholders’ perceptions of the essential conditions for taking a CSH approach in other contexts across Canada. The secondary purpose was to examine the need for and development of an evaluative tool or resource to assess the implementation of the essential conditions. Methods Data were generated through individual semi-structured interviews (n = 38) and small group interviews (n = 3) with 45 participants across Canada involved in implementing policies or programs which take a CSH approach. Interviews were subjected to content analysis. Results There was positive support for the essential conditions and results indicated the essential conditions are relevant across Canada. Findings revealed the necessity for a new essential condition that reflected support and leadership from the school district and/or provincial/territorial governing bodies. Modifications to the description of each of the essential conditions were also suggested to provide clarity. Results also indicated that an evaluative tool that was concise, meaningful, and provided immediate feedback would be useful to school communities to establish readiness, assess, and improve ongoing implementation of CSH approaches. Conclusions This research contributes to the evidence-base of CSH by providing school communities across Canada with a set of refined and understandable essential conditions that support successful implementation. Further, the development of an evaluation tool will support school health champions, researchers, and policymakers in the optimization and implementation of policies or programs which take a CSH approach, ultimately supporting healthier school communities across the country.
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Affiliation(s)
- Kacey C Neely
- Faculty of Health Sciences and Sport, J12 Pathfoot, University of Stirling, Stirling, FK9 4LA, UK.
| | - Genevieve R Montemurro
- School of Public Health, University of Alberta, 3-50 University Terrace, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Kate E Storey
- School of Public Health, University of Alberta, 3-50 University Terrace, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada
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Akiyama T, Njenga SM, Njomo DW, Takeuchi R, Kazama H, Mutua A, Walema B, Tomokawa S, Estrada CA, Henzan H, Asakura T, Shimada M, Ichinose Y, Kamiya Y, Kaneko S, Kobayashi J. Implementation of Kenyan comprehensive school health program: improvement and association with students' academic attainment. Health Promot Int 2020; 35:1441-1461. [PMID: 32125374 DOI: 10.1093/heapro/daaa005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There is growing evidence supporting the effectiveness of a comprehensive school health program. However, implementation in developing countries is a challenge. Furthermore, the available information on the association between a comprehensive school health program and students' academic attainment is limited. In Kenya, a project to verify the effects of a comprehensive school health program was carried out in Mbita sub-county, Homa Bay County from September 2012 to August 2017. This study aimed to clarify the improvement of school health during the project years and the association between school health and students' academic attainment. Primary schools in Mbita sub-county were selected as study sites. We assessed 44 schools' scores on a school health checklist developed from the Kenyan Comprehensive School Health Program, the students' mean score on the Kenya Certificate of Primary Education (KCPE), and absenteeism during the project years (2013-16). The mean school health checklist score (n = 44 schools) was 135.6 in 2013, 169.9 in 2014, 158.2 in 2015 and 181.3 in 2016. The difference of the mean score between 2013 and 2016 was significant. In addition, correlation analysis showed a significant association between mean KCPE score in the project years and school health checklist score (Pearson's coefficient was 0.43, p = 0.004). The results of this study suggest improvements of school health by the implementation of the Kenyan Comprehensive School Health Program and students' academic attainment.
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Affiliation(s)
- Takeshi Akiyama
- Department of Health Science, Nagano College of Nursing, 694 Akaho, Komagane, Nagano 399-4117, Japan.,Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Sammy M Njenga
- Kenya Medical Research Institute, PO Box 54840 00200, Off Mbagathi Road, Nairobi, Kenya
| | - Doris Wairimu Njomo
- Kenya Medical Research Institute, PO Box 54840 00200, Off Mbagathi Road, Nairobi, Kenya
| | - Rie Takeuchi
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Haruki Kazama
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Alex Mutua
- Ministry of Health, Afya House, Cathedral Road, PO Box 30016-00100, Nairobi, Kenya
| | - Barnett Walema
- State Department of Early Learning and Basic Education, Ministry of Education, PO Box 30040-00100, Nairobi, Kenya
| | - Sachi Tomokawa
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Sports and Health Sciences, Faculty of Education, Shinshu University, 6-Ro Nishi Nagano, Nagano City, Nagano 380-8544, Japan
| | - Crystal Amiel Estrada
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Hanae Henzan
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Takashi Asakura
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Education, Tokyo Gakugei University, 4-1-1 Nukuikita-machi, Koganei-shi, Tokyo 184-8501, Japan
| | - Masaaki Shimada
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Yoshio Ichinose
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Yasuhiko Kamiya
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Satoshi Kaneko
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Jun Kobayashi
- Japanese Consortium for Global School Health and Research, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.,Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
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Verjans-Janssen SRB, Gerards SMPL, Kremers SPJ, Vos SB, Jansen MWJ, Van Kann DHH. Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children. Int J Behav Nutr Phys Act 2020; 17:105. [PMID: 32807194 PMCID: PMC7433155 DOI: 10.1186/s12966-020-01012-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/10/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of the current study was to evaluate the one- and two-year effectiveness of the KEIGAAF intervention, a school-based mutual adaptation intervention, on the BMI z-score (primary outcome), and energy balance-related behaviors (secondary outcomes) of children aged 7-10 years.A quasi-experimental study was conducted including eight intervention schools and three control schools located in low socioeconomic neighborhoods in the Netherlands. Baseline measurements were conducted in March and April 2017 and repeated after one and 2 years. Data were collected on children's BMI z-score, sedentary behavior (SB), physical activity (PA) behavior, and nutrition behavior through the use of anthropometric measurements, accelerometers, and questionnaires, respectively. All data were supplemented with demographics, and weather conditions data was added to the PA data. Based on the comprehensiveness of implemented physical activities, intervention schools were divided into schools having a comprehensive PA approach and schools having a less comprehensive approach. Intervention effects on continuous outcomes were analyzed using multiple linear mixed models and on binary outcome measures using generalized estimating equations. Intervention and control schools were compared, as well as comprehensive PA schools, less comprehensive PA schools, and control schools. Effect sizes (Cohen's d) were calculated.In total, 523 children participated. Children were on average 8.5 years old and 54% were girls. After 2 years, intervention children's BMI z-score decreased (B = -0.05, 95% CI -0.11;0.01) significantly compared to the control group (B = 0.20, 95% CI 0.09;0.31). Additionally, the intervention prevented an age-related decline in moderate-to-vigorous PA (MVPA) (%MVPA: B = 0.95, 95% CI 0.13;1.76). Negative intervention effects were seen on sugar-sweetened beverages and water consumption at school, due to larger favorable changes in the control group compared to the intervention group. After 2 years, the comprehensive PA schools showed more favorable effects on BMI z-score, SB, and MVPA compared to the other two conditions.This study shows that the KEIGAAF intervention is effective in improving children's MVPA during school days and BMI z-score, especially in vulnerable children. Additionally, we advocate the implementation of a comprehensive approach to promote a healthy weight status, to stimulate children's PA levels, and to prevent children from spending excessive time on sedentary behaviors.Trial registrationNetherlands Trial Register, NTR6716 ( NL6528 ), Registered 27 June 2017 - retrospectively registered.
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Affiliation(s)
- Sacha R B Verjans-Janssen
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands.
| | - Sanne M P L Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands
| | - Steven B Vos
- Department of Industrial Design, Eindhoven University of Technology, 5612, AZ, Eindhoven, The Netherlands.,School of Sport Studies, Fontys University of Applied Sciences, 5644, HZ, Eindhoven, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health, Public Health Service South-Limburg, 6400, AA, Heerlen, The Netherlands.,Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, 6229, GT, Maastricht, The Netherlands
| | - Dave H H Van Kann
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands.,School of Sport Studies, Fontys University of Applied Sciences, 5644, HZ, Eindhoven, The Netherlands
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Kitching AE, van Rooyen B. Key aspects for the sustainable coordination of a process to facilitate holistic well-being in South African schools. Health Promot Int 2020; 35:692-701. [PMID: 31280310 DOI: 10.1093/heapro/daz060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A holistic well-being approach, understood as an approach that pays attention to the promotion of individual, relational and collective well-being in a particular context, is proposed as a way to address the fragmented nature in which mental health and well-being programmes are implemented in school communities in South Africa. The goal of this paper is to indicate key aspects for sustainable coordination of a process to facilitate holistic well-being in South African schools. Research was conducted in six South African schools with the aim of developing an integrated, multilevel process to facilitate holistic well-being in these contexts. A participatory action learning and action research approach was applied. As part of this research, key aspects that could contribute to the sustainable coordination of holistic well-being were identified. The research comprised a cross-case analysis of the data gathered, as well as a focus group that was held with the coordinators who facilitated the development of the process in each school. In addition, the school principals completed a semi-structured questionnaire, and Skype interviews were conducted with four international experts. The five aspects identified as key to the sustainable coordination of well-being are: that ownership and responsibility should reside in the school context; that there should be a clear vision for the promotion of holistic well-being; that the connections between all involved should be deepened; that all efforts to promote holistic well-being should be integrated, and that the complexity of the process should be acknowledged.
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Affiliation(s)
- Ansie Elizabeth Kitching
- COMBER (Community-Based Educational Research), Educational Psychology, Faculty of Education, North-West University, Potchefstroom, South Africa
| | - Bianke van Rooyen
- COMBER (Community-Based Educational Research), Educational Psychology, Faculty of Education, North-West University, Potchefstroom, South Africa
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Zozaya N, Vallejo L. The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020643. [PMID: 31963837 PMCID: PMC7013908 DOI: 10.3390/ijerph17020643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/22/2022]
Abstract
Background: Previous studies have analyzed the impact of economic crises on adult’s health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population. Methods: We used data from four waves (2002, 2006, 2010, 2014) of the Health Behavior in School-Aged Children (HBSC) survey in Spain. Separate multilevel logistic and linear regression models were applied for health complaints, self-rated health, life satisfaction, smoking, alcohol consumption, and breakfast skipping. Annual change in Spanish regional unemployment rates was used as a proxy of the economic crisis. An increasing set of control variables were included, consisting of individual, socioeconomic, and family and peer relationships indicators. Median odds ratios were estimated to quantify the cross-region and cross-school variation. Results: Increases in unemployment rates were linked to a higher risk of poorer health and bad habits in the simplest models. The effect was no longer statistically significant when indicators of family and peer relationships were included, suggesting a protective effect against the impact of the economic crisis. Our findings also show that schools had a larger effect on health and lifestyles than regions. Conclusion: The child’s social context—family, peers, school, and region—play an important role on the effects of the economic crisis on health and risk behaviors.
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Affiliation(s)
- Néboa Zozaya
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017 Las Palmas, Spain
- Weber Economía y Salud, Calle Moreto 17, 28014 Madrid, Spain
- Correspondence:
| | - Laura Vallejo
- Department of Quantitative Methods in Economics and Management, Universidad de Las Palmas de Gran Canaria, Calle Saulo Torón, 4 Las Palmas de Gran Canaria, 35017 Las Palmas, Spain
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25
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Bartelink NHM, van Assema P, Kremers SPJ, Savelberg HHCM, Oosterhoff M, Willeboordse M, van Schayck OCP, Winkens B, Jansen MWJ. Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study. BMJ Open 2019; 9:e030676. [PMID: 31676651 PMCID: PMC6830668 DOI: 10.1136/bmjopen-2019-030676] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/23/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Schools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The 'Healthy Primary School of the Future' (HPSF) aims to improve children's health and well-being by enhancing school health promotion. The current study aims to assess the effect of HPSF on children's body mass index (BMI) z-score after 1 and 2 years follow-up and to investigate whether HPSF has different effects within specific subgroups of children. DESIGN A longitudinal quasi-experimental design. SETTING Four intervention and four control schools participated; located in a low socioeconomic status region in the Netherlands. PARTICIPANTS 1676 children (aged 4-12 years). INTERVENTIONS HPSF uses a contextual systems approach and includes health-promoting changes in the school. Central to HPSF is the provision of a daily healthy lunch and structured physical activity sessions each day. Two intervention schools implemented both changes (full HPSF), two intervention schools implemented only the physical activity change (partial HPSF). MAIN OUTCOME MEASURES BMI z-score, determined by measurements of children's height and weight at baseline, after 1 and 2 years follow-up. RESULTS The intervention effect was significant after 1-year follow-up in the partial HPSF (standardised effect size (ES)=-0.05), not significant in the full HPSF (ES=-0.04). After 2 years follow-up, BMI z-score had significantly decreased in children of both the full HPSF (ES=-0.08) and the partial HPSF (ES=-0.07) compared with children of the control schools, whose mean BMI z-score increased from baseline to 2 years. None of the potential effect modifiers (gender, baseline study year, socioeconomic status and baseline weight status) were significant. CONCLUSIONS HPSF was effective after 1 and 2 years follow-up in lowering children's BMI z-scores. No specific subgroups of children could be identified who benefitted more from the intervention. TRIAL REGISTRATION NUMBER NCT02800616.
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Affiliation(s)
- Nina H M Bartelink
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Patricia van Assema
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marije Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Maartje Willeboordse
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Centre for Public Health Limburg, Heerlen, The Netherlands
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
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26
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Jain YK, Joshi NK, Bhardwaj P, Suthar P. Health-promoting school in India: Approaches and challenges. J Family Med Prim Care 2019; 8:3114-3119. [PMID: 31742128 PMCID: PMC6857387 DOI: 10.4103/jfmpc.jfmpc_673_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 08/23/2019] [Accepted: 08/31/2019] [Indexed: 11/05/2022] Open
Abstract
Interventions early in life are the need of the hour when it comes to controlling the rising incidence of communicable and non-communicable diseases (NCDs) globally. WHO has issued guidelines towards health promotional initiatives at schools as a part of Global School Health Initiative, and the Government of India has directed many policies and programs to integrate health deep within the school activities. School Health Promotion is an international need with programmes implementing across continents due to numerous documented benefits, to not just the individuals but to the community and country as a whole. Simple teachings like hand hygiene have shown to reduce the incidence diarrhea by more than 50% amongst children (a major cause of mortality in India), thus raising an urgent need of developing a model for health promotion at schools that is replicable, sustainable, and can be modified to the local needs as well. Though the existent programmes have a few documented challenges, a multisectorial involvement of government agencies, educational boards, and health sector along with the school is the way forward to address those challenges and covert the theory of health promoting schools (HPS) into a well-established fact. It presents a scope for the various established and newly emerging Schools of Public Health in the country to come forward and collaborate with these multiple sectors. These collaborations can be the only way to ensure sustainability and incorporation of health promotion into the core academic structure of schools in a diverse and highly populous country like India.
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Affiliation(s)
- Yogesh K Jain
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nitin K Joshi
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.,Community Medicine and Family Medicine, School of Public Health, AIIMS Jodhpur, Rajasthan, India
| | - Praveen Suthar
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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27
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Laxer RE, Dubin JA, Brownson RC, Cooke M, Chaurasia A, Leatherdale ST. Noncomprehensive and Intermittent Obesity-Related School Programs and Policies May Not Work: Evidence from the COMPASS Study. THE JOURNAL OF SCHOOL HEALTH 2019; 89:818-828. [PMID: 31364181 DOI: 10.1111/josh.12820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/22/2018] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The school environment has the potential to influence student body mass index (BMI) through programs and policies. Our objective was to examine the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. METHODS Obesity-related school policies and programs related to physical activity and healthy eating were collected from 41 schools across Ontario at baseline (2012-2013) and year 2 (2013-2014) of the COMPASS study. Self-reported height and weight were collected from the 4951 grades 9 and 10 students who attended those schools for 3 years. Linear mixed effects regression models examined the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. RESULTS Between Y1 and Y2 , 26 of the 41 schools implemented distinct new obesity-related programs or policies related to physical activity or healthy eating. Five of the interventions were associated with BMI trajectories of students attending those schools compared to students attending a pooled sample of control schools, predicting a higher BMI trajectory. CONCLUSIONS Isolated programs and policies may not successfully improve youths' BMI trajectories. Further research is required to test the implementation of policies and programs that follow a comprehensive school health (CSH) approach, targeting BMI and associated behaviors.
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Affiliation(s)
- Rachel E Laxer
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Joel A Dubin
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University, Campus Box 1196, One Brookings Drive, St. Louis, MO
| | - Martin Cooke
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
| | - Ashok Chaurasia
- 200 University Avenue W, University of Waterloo, Waterloo, ON N2L3G1
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28
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Bartelink N, van Assema P, Jansen M, Savelberg H, Kremers S. The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2432. [PMID: 31323922 PMCID: PMC6651395 DOI: 10.3390/ijerph16132432] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 01/05/2023]
Abstract
Background: The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children's health and health behaviors. Methods: The study used a mixed-methods design. The school context (n = 4) was assessed by the characteristics of the school population, teacher's health-promoting (HP) practices, implementers' perceived barriers, school's HP elements, and dominating organizational issues. Outcomes included objectively assessed BMI z-scores and physical activity (PA), and parent and child-reported dietary intake. Analyses included linear mixed models (four intervention schools versus four control schools), and qualitative comparisons between intervention schools with similar HP changes. Results: Effects on outcomes varied considerably across schools (e.g., range in effect size on light PA of 0.01-0.26). Potentially moderating contextual aspects were the child's socioeconomic background and baseline health behaviors; practices and perceived barriers of employees; and organizational issues at a school level. Conclusions: Similar HP changes lead to different outcomes across schools due to differences in the school context. The adoption of a complex adaptive systems perspective contributes to a better understanding of the variation in effects and it can provide insight on which contextual aspects to focus on or intervene in to optimize the effects of HP initiatives.
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Affiliation(s)
- Nina Bartelink
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
- Academic Collaborative Centre for Public Health Limburg, Public Health Services, P.O. Box 33, 6400 AA Heerlen, The Netherlands.
| | - Patricia van Assema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Maria Jansen
- Academic Collaborative Centre for Public Health Limburg, Public Health Services, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Hans Savelberg
- Department of Nutritional and Movement Sciences, Nutrition and Translational Research Institute Maastricht (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Stef Kremers
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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29
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Bartelink NHM, van Assema P, Jansen MWJ, Savelberg HHCM, Moore GF, Hawkins J, Kremers SPJ. Process evaluation of the healthy primary School of the Future: the key learning points. BMC Public Health 2019; 19:698. [PMID: 31170941 PMCID: PMC6554901 DOI: 10.1186/s12889-019-6947-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/07/2019] [Indexed: 11/23/2022] Open
Abstract
Background While schools have potential to contribute to children’s health and healthy behaviour, embedding health promotion within complex school systems is challenging. The ‘Healthy Primary School of the Future’ (HPSF) is an initiative that aims to integrate health and well-being into school systems. Central to HPSF are two top-down changes that are hypothesized as being positively disruptive to the Dutch school system: daily free healthy lunches and structured physical activity sessions. These changes are expected to create momentum for bottom-up processes leading to additional health-promoting changes. Using a programme theory, this paper explores the processes through which HPSF and the school context adapt to one another. The aim is to generate and share knowledge and experiences on how to implement changes in the complex school system to integrate school health promotion. Methods The current study involved a mixed methods process evaluation with a contextual action-oriented research approach. The processes of change were investigated in four Dutch primary schools during the development year (2014–2015) and the first two years of implementation (2015–2017) of HPSF. The schools (each with 15–26 teachers and 233–389 children) were in low socio-economic status areas. Measurements included interviews, questionnaires, observations, and analysis of minutes of meetings. Results Top-down advice, combined with bottom-up involvement and external practical support were key facilitators in embedding HPSF within the schools’ contexts. Sufficient coordination and communication at the school level, team cohesion, and feedback loops enhanced implementation of the changes. Implementation of the healthy lunch appeared to be disruptive and create momentum for additional health-promoting changes. Conclusions Initiating highly visible positive disruptions to improve school health can act as a catalyst for wider school health promotion efforts. Conditions to create a positive disruption are enough time, and sufficient bottom-up involvement, external support, team cohesion and coordination. The focus should be on each specific school, as each school has their own starting point and process of change. Trial registration The study was retrospectively registered in the ClinicalTrials.gov database on 14 June 2016 (NCT02800616). Electronic supplementary material The online version of this article (10.1186/s12889-019-6947-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- N H M Bartelink
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands. .,Public Health Services, Academic Collaborative Centre for Public Health Limburg, P.O. Box 33, 6400, AA, Heerlen, The Netherlands.
| | - P van Assema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - M W J Jansen
- Public Health Services, Academic Collaborative Centre for Public Health Limburg, P.O. Box 33, 6400, AA, Heerlen, The Netherlands.,Department of Health Services Research, CAPHRI, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - H H C M Savelberg
- Department of Nutrition and Movement Sciences, NUTRIM, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - G F Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales
| | - J Hawkins
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales
| | - S P J Kremers
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
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30
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Penney TL, McIsaac JLD, Storey K, Kontak JCH, Ata N, Kuhle S, Kirk SFL. A translational approach to characterization and measurement of health-promoting school ethos. Health Promot Int 2019; 33:980-989. [PMID: 28973145 DOI: 10.1093/heapro/dax039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A health promoting schools (HPS) approach is hypothesized to influence student health and wellbeing by promoting a 'school ethos' that reflects the physical environment, social relations, organisational structure, policies and practices within schools. This complex set of factors makes health promoting school ethos (HPSE) challenging to define and measure. This work sought to theorise, develop and pilot a measure of HPSE as the context for implementation of HPS initiatives. We used a multi-method, iterative process to identify relevant HPSE concepts through triangulation of conceptual literature, existing tools and the tacit knowledge of school stakeholders. The HPSE measurement tool was administered to 18 elementary schools through a principal and teacher survey and an environmental assessment, followed by the development of HPSE scores for each school. Testing for internal consistency of items was used to examine theorized concepts, and scores for each school are summarised. HPSE included eight conceptual dimensions with internal consistency ranging from α = 0.60 to α = 0.87. Total HPSE scores across schools (N = 18) ranged from 1 to 8 (mean = 3.94, SD = 2.1), with 28-65% of schools reporting 'high' on respective HPSE dimensions. Schools included a heterogeneous mixture of HPSE scores, particularly across different dimensions. Our novel approach to tool development allowed us to conceptualize HPSE using a flexible process comprising different types and sources of evidence. The HPSE tool holds potential for identification and measurement of critical components of different school context as it relates to HPS.
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Affiliation(s)
- Tarra L Penney
- Applied Research Collaborations for Health (ARCH), Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, Canada
| | - Jessie-Lee D McIsaac
- Applied Research Collaborations for Health (ARCH), Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Julia C H Kontak
- Applied Research Collaborations for Health (ARCH), Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, Canada
| | - Nicole Ata
- Applied Research Collaborations for Health (ARCH), Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, Canada
| | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynaecology and Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Sara F L Kirk
- Applied Research Collaborations for Health (ARCH), Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, Canada
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31
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Yazdi-Feyzabadi V, Omidvar N, Keshavarz Mohammadi N, Nedjat S, Karimi-Shahanjarini A, Rashidian A. Is an Iranian Health Promoting School status associated with improving school food environment and snacking behaviors in adolescents? Health Promot Int 2019; 33:1010-1021. [PMID: 28973644 DOI: 10.1093/heapro/dax045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Iranian Health Promoting Schools (IHPS) program was first piloted and then formally established in Iran in 2011 as a framework to promote healthy environment and behaviors such as proper dietary practice among adolescents. This study examined the role of IHPS in improving the school food environment and snacking behaviors among adolescents. In this cross-sectional study, 1320 eighth grade students from 40 middle schools with IHPS and non-IHPS program were selected using a proportional stratified random sampling method. A modified 55-item qualitative Food Frequency Questionnaire was used to assess the frequency of consumption of healthy and unhealthy snacks in the studied adolescents. Mixed effect negative binomial regression models were used to analyze the data. The association was also adjusted for individual variables, including gender, socio-economic status, pocket money, family structure and nutritional knowledge level. No significant difference was observed between the average of healthy and unhealthy snack items in IHPS and non-IHPS schools (p > 0.05). On the basis of adjusted analysis, being from/in IHPS was not associated with weekly frequency consumption of unhealthy [prevalence rate ratio (PRR) = 0.99; 95% CI: 0.85-1.16] and healthy (PRR = 1.08; 95% CI: 0.96-1.2) snacks among the adolescents. There was no difference regarding school food environment and snacking behaviors in IHPS and non-IHPS schools. This might indicate that there has been a weakness in institutionalizing the comprehensive concepts of the HPS approach in the studied schools. Addressing the proper understanding of HPS approach and the need for development of HPS through matching and adaptability with health promotion actions to reach defined standards, is necessary.
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Affiliation(s)
- Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Saharnaz Nedjat
- Epidemiology and Biostatistics Department, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Karimi-Shahanjarini
- Department of Public Health and Social Determinants of Health Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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32
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Bartelink NHM, van Assema P, Kremers SPJ, Savelberg HHCM, Oosterhoff M, Willeboordse M, van Schayck OCP, Winkens B, Jansen MWJ. One- and Two-Year Effects of the Healthy Primary School of the Future on Children's Dietary and Physical Activity Behaviours: A Quasi-Experimental Study. Nutrients 2019; 11:E689. [PMID: 30909515 PMCID: PMC6470547 DOI: 10.3390/nu11030689] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/13/2019] [Accepted: 03/18/2019] [Indexed: 02/08/2023] Open
Abstract
Schools can help to improve children's health. The 'Healthy Primary School of the Future' (HPSF) aims to sustainably integrate health and well-being into the school system. This study examined the effects of HPSF on children's dietary and physical activity (PA) behaviours after 1 and 2 years' follow-up. The study (n = 1676 children) has a quasi-experimental design with four intervention schools, i.e., two full HPSF (focus: nutrition and PA) and two partial HPSF (focus: PA), and four control schools. Accelerometers and child- and parent-reported questionnaires were used at baseline, after 1 (T1) and 2 (T2) years. Mixed-model analyses showed significant favourable effects for the full HPSF versus control schools for, among others, school water consumption (effect size (ES) = 1.03 (T1), 1.14 (T2)), lunch intake of vegetables (odds ratio (OR) = 3.17 (T1), 4.39 (T2)) and dairy products (OR = 4.43 (T1), 4.52 (T2)), sedentary time (ES = -0.23 (T2)) and light PA (ES = 0.22 (T2)). Almost no significant favourable effects were found for partial HPSF compared to control schools. We conclude that the full HPSF is effective in promoting children's health behaviours at T1 and T2 compared with control schools. Focusing on both nutrition and PA components seems to be more effective in promoting healthy behaviours than focusing exclusively on PA.
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Affiliation(s)
- Nina H M Bartelink
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616 6200 MD Maastricht, The Netherlands.
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
- Academic Collaborative Centre for Public Health Limburg, Public Health Services, P.O. Box 33, 6400 AA Heerlen, The Netherlands.
| | - Patricia van Assema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616 6200 MD Maastricht, The Netherlands.
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Stef P J Kremers
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Sciences, Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Marije Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre MUMC+/ Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - Maartje Willeboordse
- Department of Family Medicine, 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.
| | - 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.
| | - Maria W J Jansen
- Academic Collaborative Centre for Public Health Limburg, Public Health Services, P.O. Box 33, 6400 AA Heerlen, The Netherlands.
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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Haley SJ, Li S, Uner S, Arslan U, Konşuk Unlu H, Yardim MS, Bilir N, Araz OM, Ozcebe HH, Huang TTK. Perceptions of Obesity Prevention Policies: Socioeconomic Assessment in the Turkish Capital. J Pediatr Nurs 2019; 44:e20-e27. [PMID: 30413328 DOI: 10.1016/j.pedn.2018.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/25/2018] [Accepted: 10/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE The purpose of this study was to inform public policy opportunities to reduce childhood obesity by identifying parents' perceptions of factors contributing to childhood obesity, attribution of responsibility, and the extent of their support for public prevention policies with attention to socio-economic status. DESIGN AND METHODS In 2015, 2066 parent-child dyads across socio-economic strata from 43 randomly selected schools in Ankara completed surveys and measurements to examine perceptions, attribution, and prevention policies related to childhood obesity. RESULTS Parents across the socio-demographic spectrum recognized obesity as a serious problem. Unhealthy food availability was identified as the leading cause of while industry and media were credited with having the greatest responsibility for childhood obesity. There was strong public support for policy strategies targeting schools, marketing, and the built environment, though support tempered as socio-economic status and parental education decreased. CONCLUSIONS This survey provided insight into parents' knowledge and beliefs surrounding childhood obesity as well as their endorsement of related prevention strategies. Educational messages that address variations in SES to describe the causes of childhood obesity and connect those causes to actionable community prevention strategies may improve community support for enhanced policy actions within and beyond school settings.
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Affiliation(s)
- Sean J Haley
- City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA.
| | - Sheng Li
- City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA.
| | - Sarp Uner
- University of Hacettepe Institute of Public Health, Ankara, Turkey
| | - Umut Arslan
- University of Hacettepe Institute of Public Health, Ankara, Turkey
| | | | - Mahmut S Yardim
- University of Hacettepe Institute of Public Health, Ankara, Turkey.
| | - Nazmi Bilir
- University of Hacettepe Institute of Public Health, Ankara, Turkey
| | - Ozgur M Araz
- University of Nebraska Medical Center College of Public Health, Omaha, NE, USA; University of Nebraska - Lincoln College of Business Administration, Lincoln, NE, USA.
| | - Hilal H Ozcebe
- University of Hacettepe Institute of Public Health, Ankara, Turkey.
| | - Terry T-K Huang
- City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA.
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Kanyasan K, Nonaka D, Chatouphonexay A, Hernandez PM, Kounnavong S, Kobayashi J. Implementation of disaster risk reduction and management policies in a school setting in Lao PDR: a case study. Trop Med Health 2018; 46:42. [PMID: 30564055 PMCID: PMC6292101 DOI: 10.1186/s41182-018-0124-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background Lao People’s Democratic Republic (Lao PDR) formulated the National Strategic Plan for Disaster Risk Management to reduce risks to the communities. This plan was eventually integrated into the school curriculum, but its implementation has never been evaluated. This study aimed to clarify the present situation to inform better implementation strategies on disaster risk reduction and management in a school setting focused on fire disasters in Lao PDR. Methods A case study was conducted in Vientiane and five provinces in 2017. Key informant interviews were conducted among 52 policy implementers from the Disaster Management Committee (DMC), the education, and fire service sectors at national, provincial, district and school levels. Observations were done among eight secondary schools, and questionnaires were answered by 869 grade 7 students. Interview transcripts underwent content analysis using the 12 influential components of successful policy implementation and the 3 pillars of comprehensive school safety framework. The level of student knowledge on fire prevention and response was examined. Results Three themes emerged: policy content and dissemination, factors which affect policy implementation, and impacts of policy implementation facilitating factors include effective coordination and ownership among the national DMC members for scaling up disaster risk reduction (DRR) activities, and strong support from the central government. Barriers include unclear provisions in the national legislation, unclear mandates especially on leading the program, poor monitoring system, insufficient human resources, and lack of public-private partnerships. All the study schools conducted DRR classes and designated a disaster assembly point. More than 80% of the students correctly answered items on fire response. Conclusion The policy was widely disseminated and implemented in all levels across sectors among the study sites except for some rural areas. Although there is a lack of national legislation and clear mandates, strong leadership, and ownership of the implementers facilitated policy implementation. All the study schools conducted fire prevention activities. Most students knew how to appropriately respond to fire. A comprehensive school-based DRR program would be beneficial in improving student knowledge and practices on DRR.
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Affiliation(s)
- Kethsana Kanyasan
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa 903-0215 Japan.,2Faculty of Education, National University of Laos, North 13 Road, Dongdok Campus, 7322 Vientiane Capital, Lao People's Democratic Republic
| | - Daisuke Nonaka
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa 903-0215 Japan
| | - Athithouthay Chatouphonexay
- 2Faculty of Education, National University of Laos, North 13 Road, Dongdok Campus, 7322 Vientiane Capital, Lao People's Democratic Republic
| | - Paul Michael Hernandez
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa 903-0215 Japan.,3Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila, 625 Pedro Gil Street, Ermita, 1000 Manila, Philippines
| | - Sengchanh Kounnavong
- 4Lao Tropical and Public Health Institute, Ministry of Health, Ban Kaongot, Samsenthai Road, Sisattanak District, Vientiane Capital, Lao People's Democratic Republic
| | - Jun Kobayashi
- 1Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa 903-0215 Japan.,Japanese Consortium for Global School Health Research, Uehara 207, Nishihara-cho, Okinawa 903-0215 Japan
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Yun YH, Kim Y, Sim JA, Choi SH, Lim C, Kang JH. Development and Validity Testing of the School Health Score Card. THE JOURNAL OF SCHOOL HEALTH 2018; 88:569-575. [PMID: 29992601 DOI: 10.1111/josh.12645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/24/2017] [Accepted: 10/25/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND The objective of this study was to develop the School Health Score Card (SHSC) and validate its psychometric properties. METHODS The development of the SHSC questionnaire included 3 phases: item generation, construction of domains and items, and field testing with validation. To assess the instrument's reliability and validity, we recruited 15 middle schools and 15 high schools in the Republic of Korea. RESULTS We developed the SHSC questionnaire of 158 items categorized into 5 domains: (1) Governance and Infrastructure, (2) Need Assessment, (3) Planning, (4) Health Prevention and Promotion Program, and (5) Monitoring and Feedback. All SHSC domains and subdomains demonstrated acceptable reliability with good internal consistency. Each domain and subdomain except for "Planning" was associated significantly with students' health status. Most subdomains, including school health philosophy, school policy, communication, the evaluation system, and monitoring, were significantly and negatively associated with student absence. CONCLUSIONS The SHSC shows significant association with the overall student health and can be useful in assessing comprehensive school health programs.
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Affiliation(s)
- Young Ho Yun
- Department of Family Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, South Korea
| | - Yaeji Kim
- Department of Biomedical Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, South Korea
| | - Jin A Sim
- Department of Biomedical Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, South Korea
| | - Soo Hyuk Choi
- Korean Association of Secondary Education Principal, 27, Mokdongjungangnam-ro, Yangcheon-gu, Seoul 07958, South Korea
| | - Cheolil Lim
- Department of Education, Seoul National University College of Education, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea
| | - Joon-Ho Kang
- Department of kinesiology, Seoul National University College of Education, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea
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Baumann AA, Belle SH, James A, King AA. Specifying sickle cell disease interventions: a study protocol of the Sickle Cell Disease Implementation Consortium (SCDIC). BMC Health Serv Res 2018; 18:500. [PMID: 29945631 PMCID: PMC6020469 DOI: 10.1186/s12913-018-3297-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/13/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is an inherited blood disorder that results in a lifetime of anemia, severe pain, and end-organ damage that can lead to premature mortality. While the SCD field has made major medical advances, much needs to be done to improve the quality of care for people with SCD. This study capitalizes on the Sickle Cell Disease Implementation Consortium (SCDIC), a consortium of eight academic sites aiming to test implementation strategies that could lead to more accelerated application of the NHLBI guidelines for treating SCD. This report documents the process to support the consortium by specifying the interventions being developed. METHODS This study consists of three steps. The Principal Investigator of each site and two site representatives who are knowledgeable of the intervention (e.g., study coordinator or the person delivering the intervention) will answer an online survey aiming to capture components of the interventions. This survey will be completed by the site representatives three times during the study: during the development of the interventions, after one year of the interventions being implemented, and at the end of this study (after 2 years). A site visit and semi-structured interview (Step 2) in the first year of the process will capture the context of the sites. Step 3 comprises of the development of a framework with the details of the multi-component SCDIC interventions at the sites. DISCUSSION The outcome of this study, a framework of the SCDIC, will enable accurate replication and extension of published research, facilitating the translation of SCD studies to diverse populations and settings and allowing for theory testing of the effects of the intervention components across studies in different contexts and for different populations. TRIAL REGISTRATION ClinicalTrial.Gov (# NCT03380351 ). Registered December 21, 2017.
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Affiliation(s)
- Ana A. Baumann
- Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Steven H. Belle
- Graduate School of Public Health, University of Pittsburgh, Suite 605, 4420 Bayard St., Pittsburgh, PA 15260 USA
| | - Aimee James
- Division of Public Health Sciences, 660 South Euclid Ave. Box 8100, St Louis, MO 63110 USA
| | - Allison A. King
- Division of Public Health Sciences, 660 South Euclid Ave. Box 8100, St Louis, MO 63110 USA
- Program in Occupational Therapy; Department of Pediatrics, Division of Pediatric Hematology/Oncology; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63108 USA
| | - the Sickle Cell Disease Implementation Consortium
- Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
- Graduate School of Public Health, University of Pittsburgh, Suite 605, 4420 Bayard St., Pittsburgh, PA 15260 USA
- Division of Public Health Sciences, 660 South Euclid Ave. Box 8100, St Louis, MO 63110 USA
- Program in Occupational Therapy; Department of Pediatrics, Division of Pediatric Hematology/Oncology; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63108 USA
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Orava T, Manske S, Hanning R. Support for healthy eating at schools according to the comprehensive school health framework: evaluation during the early years of the Ontario School Food and Beverage Policy implementation. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:303-312. [PMID: 28902479 DOI: 10.24095/hpcdp.37.9.05] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Provincial, national and international public health agencies recognize the importance of school nutrition policies that help create healthful environments aligned with healthy eating recommendations for youth. School-wide support for healthy living within the pillars of the comprehensive school health (CSH) framework (social and physical environments; teaching and learning; healthy school policy; and partnerships and services) has been positively associated with fostering improvements to student health behaviours. This study used the CSH framework to classify, compare and describe school support for healthy eating during the implementation of the Ontario School Food and Beverage Policy (P/PM 150). METHODS We collected data from consenting elementary and secondary schools in a populous region of Ontario in Time I (2012/13) and Time II (2014). Representatives from the schools completed the Healthy School Planner survey and a food environmental scan (FES), which underwent scoring and content analyses. Each school's support for healthy eating was classified as either "initiation," "action" or "maintenance" along the Healthy School Continuum in both time periods, and as "high/increased," "moderate" or "low/decreased" within individual CSH pillars from Time I to Time II. RESULTS Twenty-five school representatives (8 elementary, 17 secondary) participated. Most schools remained in the "action" category (n = 20) across both time periods, with varying levels of support in the CSH pillars. The physical environment was best supported (100% high/increased support) and the social environment was the least (68% low/decreased support). Only two schools achieved the highest rating (maintenance) in Time II. Supports aligned with P/PM 150 were reportedly influenced by administration buy-in, stakeholder support and relevancy to local context. CONCLUSION Further assistance is required to sustain comprehensive support for healthy eating in Ontario school food environments.
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Affiliation(s)
- Taryn Orava
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Steve Manske
- Propel Centre for Population Health Impact, Waterloo, Ontario, Canada
| | - Rhona Hanning
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Tomokawa S, Kaewviset S, Saito J, Akiyama T, Waikugul J, Okada K, Kobayashi J, Jimba M. Key factors for school health policy implementation in Thailand. HEALTH EDUCATION RESEARCH 2018; 33:186-195. [PMID: 29509891 DOI: 10.1093/her/cyy008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
Thailand formulated a National School Health Policy (NSHP) in 1998, and it has been widely implemented but has not been evaluated. This case study aimed to identify factors that have influenced the implementation of NSHP in Thailand. For this purpose, we conducted a document review and key informant interviews. We selected key interviewees, from NSHP implementers at national, provincial and school levels in four geographical areas. We adopted a content analysis method, using a framework of 12 influential components of successful policy implementation and triangular policy framework. This study showed that NSHP was well-disseminated and implemented at whole country. We identified seven positive factors influencing NSHP implementation, namely matching with ongoing educational strategy, competition and encouragement by an awarding system, sustainable human capacity building at school level, participation of multiple stakeholders, sufficient understanding and acceptance of school health concepts, sharing information and collaboration among schools in the same clusters and functional fund raising activities. In addition, we identified three negative factors, namely lack of institutional sustainability, vague role of provincial officers and diverse health problems among Thai children. The government should clarify the role of provincial level and set up institutionalized capacity-building system as measures to strengthen monitoring and evaluation activities.
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Affiliation(s)
- S Tomokawa
- Department of Sports and Health Sciences, Faculty of Education, Shinshu University, 6-Ro Nishi Nagano, Nagano City, Nagano 380-8544, Japan
- Japanese Consortium for Global School Health and Research, Japan
| | - S Kaewviset
- Office of International Cooperation Faculty of Science, Mahidol University, 272 Rama 6 Road, Bangkok 10400, Thailand
| | - J Saito
- Japanese Consortium for Global School Health and Research, Japan
- Department of Health and Social Behavior/Health Education and Health Sociology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - T Akiyama
- Japanese Consortium for Global School Health and Research, Japan
- Department of Health Science, Nagano College of Nursing, 1694 Akaho, Komagane, Nagano 399-4117, Japan
| | - J Waikugul
- School Health Promotion Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand
| | - K Okada
- Japanese Consortium for Global School Health and Research, Japan
- Department of School Health Nursing, Faculty of Education, Chiba University, 1-33 Yayoi, Inage-ku, Chiba 263-8522, Japan
| | - J Kobayashi
- Japanese Consortium for Global School Health and Research, Japan
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - M Jimba
- Japanese Consortium for Global School Health and Research, Japan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Lindegaard Nordin L, Jourdan D, Simovska V. (Re)framing school as a setting for promoting health and well-being: a double translation process. CRITICAL PUBLIC HEALTH 2018. [DOI: 10.1080/09581596.2018.1449944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Lone Lindegaard Nordin
- Danish School of Education, Aarhus University, Campus Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Didier Jourdan
- Faculty of Education, Blaise Pascal University, Clermont-Ferrand, France
| | - Venka Simovska
- Danish School of Education, Aarhus University, Campus Copenhagen, Copenhagen, Denmark
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Brown KM, Elliott SJ, Robertson-Wilson J, Vine MM, Leatherdale ST. Can knowledge exchange support the implementation of a health-promoting schools approach? Perceived outcomes of knowledge exchange in the COMPASS study. BMC Public Health 2018. [PMID: 29534698 PMCID: PMC5851156 DOI: 10.1186/s12889-018-5229-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Despite the potential population-level impact of a health-promoting schools approach, schools face challenges in implementation, indicating a gap between school health research and practice. Knowledge exchange provides an opportunity to reduce this gap; however, there has been limited evaluation of these initiatives. This research explored researchers’ and knowledge users’ perceptions of outcomes associated with a knowledge exchange initiative within COMPASS, a longitudinal study of Canadian secondary students and schools. Schools received annual tailored summaries of their students’ health behaviours and suggestions for action and were linked with knowledge brokers to support them in taking action to improve student health. Methods Qualitative semi-structured interviews were conducted with COMPASS researchers (n = 13), school staff (n = 13), and public health stakeholders (n = 4) to explore their experiences with COMPASS knowledge exchange. Key issues included how knowledge users used school-specific findings, perceived outcomes of knowledge exchange, and suggestions for change. Results Outcomes for both knowledge users and researchers were identified; interestingly, knowledge users attributed more outcomes to using school-specific findings than knowledge brokering. School and public health participants indicated school-specific findings informed their programming and planning. Importantly, knowledge exchange provided a platform for partnerships between researchers, schools, and public health units. Knowledge brokering allowed researchers to gain feedback from knowledge users to enhance the study and a better understanding of the school environment. Interestingly, COMPASS knowledge exchange outcomes aligned with Samdal and Rowling’s eight theory-driven implementation components for health-promoting schools. Hence, knowledge exchange may provide a mechanism to help schools implement a health-promoting schools approach. Conclusions This research contributes to the limited literature regarding outcomes of knowledge brokering in public health and knowledge exchange in school health research. However, since not all schools engaged in knowledge brokering, and not all schools that engaged discussed these outcomes, further research is needed to determine the amount of engagement required for change and examine the process of COMPASS knowledge brokering to consider how to increase school engagement.
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Affiliation(s)
- Kristin M Brown
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Susan J Elliott
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Jennifer Robertson-Wilson
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario, N2L 3C5, Canada
| | - Michelle M Vine
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Scott T Leatherdale
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
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Darlington EJ, Violon N, Jourdan D. Implementation of health promotion programmes in schools: an approach to understand the influence of contextual factors on the process? BMC Public Health 2018; 18:163. [PMID: 29357922 PMCID: PMC5776776 DOI: 10.1186/s12889-017-5011-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implementing complex and multi-level public health programmes is challenging in school settings. Discrepancies between expected and actual programme outcomes are often reported. Such discrepancies are due to complex interactions between contextual factors. Contextual factors relate to the setting, the community, in which implementation occurs, the stakeholders involved, and the characteristics of the programme itself. This work uses realist evaluation to understand how contextual factors influence the implementation process, to result in variable programme outcomes. This study focuses on identifying contextual factors, pinpointing combinations of contextual factors, and understanding interactions and effects of such factors and combinations on programme outcomes on different levels of the implementation process. METHODS Schools which had participated in a school-based health promotion programme between 2012 and 2015 were included. Two sets of qualitative data were collected: semi-structured interviews with school staff and programme coordinators; and written documents about the actions implemented in a selection of four schools. Quantitative data included 1553 questionnaires targeting pupils aged 8 to 11 in 14 schools to describe the different school contexts. RESULTS The comparison between what was expected from the programme (programme theory) and the outcomes identified in the field data, showed that some of the mechanisms expected to support the implementation of the programme, did not operate as anticipated (e.g. inclusion of training, initiation by decision-maker). Key factors which influenced the implementation process included, amongst other factors, the mode of introduction of the programme, home/school relationship, leadership of the management team, and the level of delegated power. Five types of interactions between contextual factors were put forward: enabling, hindering, neutral, counterbalancing and moderating effects. Recurrent combinations of factors were identified. Implementation was more challenging in vulnerable schools where school climate was poor. CONCLUSION A single programme cannot be suited or introduced in the same manner in every context. However, key recurrent combinations of contextual factors could contribute to the design of implementation patterns, which could provide guidelines and recommendation for grass-root programme implementation.
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Wang T, Lurie M, Govindasamy D, Mathews C. The Effects of School-Based Condom Availability Programs (CAPs) on Condom Acquisition, Use and Sexual Behavior: A Systematic Review. AIDS Behav 2018; 22:308-320. [PMID: 28625012 PMCID: PMC5758683 DOI: 10.1007/s10461-017-1787-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
We conducted a systematic review to assess the impact of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior. We searched PubMed to identify English-language studies evaluating school-based CAPs that reported process (i.e. number of condoms distributed or used) and sexual behavior measures. We identified nine studies that met our inclusion criteria, with the majority conducted in the United States of America. We judged most studies to have medium risk of bias. Most studies showed that school-based CAPs increased the odds of students obtaining condoms (odds ratios (ORs) for individual studies ranged between 1.81 and 20.28), and reporting condom use (OR 1.36-3.2). Three studies showed that school-based CAPs positively influenced sexual behavior, while no studies reported increase in sexual activity. Findings suggest that school-based CAPs may be an effective strategy for improving condom coverage and promoting positive sexual behaviors.
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Affiliation(s)
- Timothy Wang
- Health Policy Research Department, The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Mark Lurie
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Darshini Govindasamy
- Health Systems Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, PO BOX 19070, Tygerberg, Western Cape, South Africa.
- Adolescent Health Research Unit, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, Western Cape, South Africa.
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, PO BOX 19070, Tygerberg, Western Cape, South Africa
- Adolescent Health Research Unit, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, Western Cape, South Africa
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Kontak JCH, McIsaac JLD, Penney TL, Kuhle S, Kirk SFL. The picture of health: examining school-based health environments through photographs. Health Promot Int 2017; 32:322-330. [PMID: 27107022 DOI: 10.1093/heapro/daw027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Health-promoting schools (HPS) is an effective approach to enhance the health and well-being of children and youth, but its measurement remains a challenge considering contextual differences across school environments. The purpose of this study was to qualitatively explore the physical features of the school environment through photographs of schools that had implemented an HPS approach compared with schools that had not. This study used a descriptive approach, wherein physical features of the school environment were distilled through visual images and qualitatively analyzed. School environment data were collected from 18 elementary schools (10 HPS, 8 comparison schools) from a school board in rural Nova Scotia (Canada). Evaluation assistants captured photographs of the physical school environment as part of a broader environment audit. Overarching themes included the promotion, access and availability of opportunities for healthy eating and physical activity, healthy school climate and safety and accessibility of the school. The photographs characterized diverse aspects of the school environment and revealed differences between schools that had implemented an HPS approach compared with schools that had not. There were increased visual cues to support healthy eating, physical activity and mental well-being, and indications of a holistic approach to health among schools that implemented an HPS approach. This research adds to understanding the environmental elements of HPS. The use of photographic data to understand school environments provided an innovative method to explore the physical features of schools that had implemented an HPS approach.
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Affiliation(s)
- Julia C H Kontak
- Applied Research Collaborations for Health, School of Health and Human Performance, Faculty of Health Professions, Dalhousie University, 1318 Robie Street, Halifax, NS, Canada B3H 3E2
| | - Jessie-Lee D McIsaac
- Applied Research Collaborations for Health, School of Health and Human Performance, Faculty of Health Professions, Dalhousie University, 1318 Robie Street, Halifax, NS, Canada B3H 3E2.,Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Tarra L Penney
- Applied Research Collaborations for Health, School of Health and Human Performance, Faculty of Health Professions, Dalhousie University, 1318 Robie Street, Halifax, NS, Canada B3H 3E2
| | - Stefan Kuhle
- Perinatal Epidemiology Research Unit, Departments of Pediatrics and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Sara F L Kirk
- Applied Research Collaborations for Health, School of Health and Human Performance, Faculty of Health Professions, Dalhousie University, 1318 Robie Street, Halifax, NS, Canada B3H 3E2.,Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
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Tooher R, Collins J, Braunack-Mayer A, Burgess T, Skinner SR, O'Keefe M, Watson M, Marshall HS. Intersectoral collaboration to implement school-based health programmes: Australian perspectives. Health Promot Int 2017; 32:312-321. [PMID: 26822033 DOI: 10.1093/heapro/dav120] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Understanding the processes and the factors influencing intersectoral collaboration is vital for the ongoing success of programmes that rely on effective partnerships between sectors, such as the school-based immunization programme, the school dental health programme and health promotion interventions delivered in school settings. We studied school-based health programmes delivered by partnerships between health, education and the local government sectors. We used purposive sampling to identify 19 people working in school-based health programmes and interviewed them about the barriers and enablers of successful collaboration. Data were analysed thematically. We found that collaboration between complex systems was a skilled endeavour which relied on a strong foundation of communication and interpersonal professional relationships. Understanding the core business, operational context and intersectoral point-of-view of collaborative partners was important both for establishing good intersectoral programmes and sustaining them as contexts and personnel changed. Aligning divergent sectoral agendas early in the collaborative process was essential for ensuring that all partners could meet their core business needs while also delivering the programme outcomes.
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Affiliation(s)
- Rebecca Tooher
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Joanne Collins
- Vaccinology and Immunology Trials Unit, Womens and Children's Hospital, Adelaide, SA, Australia
| | | | - Teresa Burgess
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - S Rachel Skinner
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Maree O'Keefe
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Maureen Watson
- Department of Health, SA Health, Adelaide, SA, Australia
| | - Helen S Marshall
- Vaccinology and Immunology Trials Unit, Womens and Children's Hospital, Adelaide, SA, Australia
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Abstract
This article presents results from the Cypriot experience of participation in a pan European health promotion project called 'Shape Up'. Implemented between September 2007 and June 2008, the aims of the overall programme reflect the primary concern of health promotion to facilitate healthy choices by creating the necessary conditions for their enactment. We describe the processes used in Shape Up before reporting findings from the evaluation undertaken by the University of Hull, UK. Findings from the Cypriot case studies demonstrate schools' potential to work in health promoting ways by enabling school communities to create environments conducive to health, where individuals are better able to take care of their health rather than simply implementing healthy activities at school. Participants in Shape Up Cyprus increased their access to healthier foods and opportunities to be active during and after school. Apart from visible environmental changes, participants were equipped with skills and critical knowledge to be healthier and more active citizens. They investigated the wider determinants of health and options for health improvement in specific contexts. They identified what needed changing within and around the school, developing visions of how changes could be enacted. They transferred visions into actions by writing letters, undertaking research, developing networks and accessing advice and financial support. We conclude that increasing awareness of the impact of structural factors upon health and the acquisition of skills in community action were central to Shape Up's success in Cyprus, and are therefore relevant for school-based health promotion.
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Affiliation(s)
- Jo Pike
- School of Education, University of Leeds, Leeds, UK
| | - Soula Ioannou
- Scientific Personnel, University of Cyprus, Nicosia, Cyprus.,Coordinating Committe of Health Education and Citizenship, Ministry of Education and Culture of Cyprus, Thoukididou and kimonos, Nicosia 1434, Cyprus
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Shahhosseini Z, Simbar M, Ramezankhani A. Characteristics of health-promoting schools from Iranian adolescents' point of view. Int J Adolesc Med Health 2017; 28:155-60. [PMID: 25910395 DOI: 10.1515/ijamh-2014-0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 03/03/2015] [Indexed: 11/15/2022]
Abstract
AIM Although characteristics of health-promoting schools are mentioned in the World Health Organization guidelines, different countries need to design more details of indicators for assessing these schools according to their social and cultural context. The aim of this study was to investigate characteristics of health-promoting schools from Iranian adolescent girls' point of view. MATERIALS AND METHODS In this cross-sectional study, 2010 middle school and high school female adolescents were selected from randomly selected schools in Mazandaran province, Iran. They completed a self-completion questionnaire around their views about characteristics of health- promoting schools. Data were analyzed using descriptive statistics and an independent t-test. RESULTS It is revealed that from Iranian adolescents' point of view the most important feature of health-promoting schools was the schools with no stressful exams and where notices are kindly given to students for their mistakes. CONCLUSION The results suggest that there is a need for more measurable standards of health-promoting schools based on the socio-cultural context of both developing and developed countries.
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Abstract
Purpose
Implementing health promotion programmes in schools is key to improving children’s health and well-being but difficulties in achieving expected results are often reported in the research literature. Discrepancies between expected and achieved outcomes can originate from differences in contexts. Understanding how interactions between contexts and programmes generate variable outcomes is, therefore, critical. The purpose of this paper is to explore the outputs of a programme implemented in different school contexts. The focus is to pinpoint outputs, understand the involvement of combinations of contextual factors and identify recurrences in these combinations.
Design/methodology/approach
This retrospective study covers a period from 2006 to 2016. Data collection includes two sets of data in eight high schools in the Rhône-Alpes Region in France: written documents and interviews with school staff. Realist evaluation is used to attempt to pinpoint outputs and relating contextual factors.
Findings
Results highlight the limited outputs of the programme. Differences between schools appear to originate from existing school policy prior to participation, existence of a project team, identification of the issue as priority and staff turnover. Analysis of contextual factors led to considering the implementation process as enabling health capacity building and enhanced the capacity of settings and communities to promote health.
Research limitations/implications
The data provided remain partial as there was high staff turnover, reluctance to participate due to failure to implement the project, and schools being over burdened with other requests.
Originality/value
Previous research suggests that top-down implementation of a standard programme is not an efficient strategy for all schools to engage in the development of suitable health promotion policies. A potential way forward is to base support for the local development of health promotion in schools on a better understanding of the contexts in which implementation occurs.
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Merianos AL, Barry AE. Examining the Impact of Alcohol and Other Drug Education Exposure on Student Alcohol Consumption. JOURNAL OF DRUG EDUCATION 2017; 47:3-20. [PMID: 29231038 DOI: 10.1177/0047237917744327] [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: 06/07/2023]
Abstract
This investigation examined the association between alcohol and other drug (AOD) prevention/education programs and drinking behaviors among students aged 12 to 17 years. We conducted a secondary analysis of the 2013 National Survey on Drug Use and Health ( N = 17,736). AOD prevention/education was assessed in three school settings: special class, regular class, and outside regular class. Outcome variables included past year alcohol use and current heavy episodic drinking. Associations were assessed via one-way analyses of variance and multiple regression models. There was a significant effect of program exposure on alcohol use ( p<.001) and heavy episodic drinking ( p = .002). Regression results found AOD prevention/education exposure ( p = .004) was significant, indicating that exposure decreased past year use. No difference was found based on heavy episodic drinking. Increasing exposure to AOD prevention/education programs is warranted and encouraged.
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Affiliation(s)
| | - Adam E Barry
- 2 Department of Health and Kinesiology, College of Education and Human Development, 14736 Texas A&M University , College Station, TX, USA
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McIsaac JLD, Penney TL, Ata N, Munro-Sigfridson L, Cunningham J, Veugelers PJ, Storey K, Ohinmaa A, Kirk SF, Kuhle S. Evaluation of a health promoting schools program in a school board in Nova Scotia, Canada. Prev Med Rep 2017; 5:279-284. [PMID: 28149709 PMCID: PMC5279859 DOI: 10.1016/j.pmedr.2017.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/10/2017] [Accepted: 01/22/2017] [Indexed: 11/30/2022] Open
Abstract
A Health promoting schools (HPS) approach aims to make schools a healthy place through a holistic approach that promotes a supportive 'school ethos' and emphasizes improvements in physical, social, and emotional well-being and educational outcomes. A HPS initiative in rural Nova Scotia (Canada) provided an opportunity for a population-level natural experiment. This study investigated student well-being and health behaviours between schools with and without HPS implementation and schools with high and low school ethos scores. Student well-being, nutrition, and physical activity were examined in a cross-sectional survey of elementary students in Nova Scotia, Canada in 2014. Multiple regression was used to assess the relationship with student well-being using the Quality of Life in School (QoLS) instrument and health behaviours. The main exposure was attending one of the 10 HPS schools; secondary exposure was the school ethos score. The overall QoLS score and its subdomain scores in the adjusted models were higher in students attending HPS schools compared to those in non-HPS schools, but the differences were not statistically significant and the effect sizes were small. Students in schools that scored high on school ethos score had higher scores for the QoLS and its subdomains, but the difference was only significant for the teacher-student relationship domain. Although this study did not find significant differences between HPS and non-HPS schools, our results highlight the complexity of evaluating HPS effects in the real world. The findings suggest a potential role of a supportive school ethos for student well-being in school.
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Affiliation(s)
- Jessie-Lee D. McIsaac
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Tarra L. Penney
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Nicole Ata
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | | | - Jane Cunningham
- Western Zone, Nova Scotia Health Authority, Yarmouth, NS, Canada
| | | | - Kate Storey
- School of Public Health, University of Alberta, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, AB, Canada
| | - Sara F.L. Kirk
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Stefan Kuhle
- Dept of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Dept of Obstetrics & Gynaecology, Dalhousie University, Halifax, NS, Canada
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Beck AJ, Reilly SM. What Can Secondary School Students Teach Educators and School Nurses About Student Engagement in Health Promotion? A Scoping Review. J Sch Nurs 2016; 33:30-42. [PMID: 27852826 DOI: 10.1177/1059840516677825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Student engagement represents a critical component of a comprehensive school health (CSH) approach to health promotion. Nevertheless, questions remain about its implementation. This scoping review updates the field of student engagement in health promotion. Of the 1,388 located articles, 14 qualify for inclusion in this study. An analysis reveals four themes. CSH programs that incorporate student engagement promote a sense of belonging to a community, encourage meaningful involvement, give voice to student concerns, and advance supportive relationships. This study finds a lack of research regarding student engagement in health promotion but confirms that student participation in CSH initiatives contributes to a sense of ownership. Consequently, we can infer that student ownership of health promotion takes place through their meaningful engagement and can effect social change.
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Affiliation(s)
- Amy J Beck
- 1 Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Sandra M Reilly
- 1 Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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