A qualitative investigation of school age children, their parents and school staff on their participation in the Digital Education to LImit Salt in the Home (DELISH) program

An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study

Background

High-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpose, a study was launched to support the development and scale-up of an mHealth-based system (EduSaltS) that integrated routine health education and salt reduction and was delivered through primary schools. This study aims to elaborate the framework, development process, features, and preliminary scaling-up of the EduSaltS system.

Methods

The EduSaltS system evolved from previously successfully tested interventions to reduce family salt intake by empowering schoolchildren through school health education. EduSaltS was designed by following the WHO's conceptual framework for developing a scaling-up strategy which accounted for the nature of the innovation, the capacity of the implementing organizations, the characteristics of the environment, the resources available, and type of scaling up. The system was then developed step by step from determination of online platform architecture, definition of component interventions and activities, development of specific educational materials and tools, to the development of the online/offline hybridized system. The system was tested and refined by a pilot in two schools and a preliminary scale-up in two cities in China.

Results

EduSaltS was developed as an innovative health education system, including an online WeChat-based education platform, a set of offline activities, and an actual administrative website showing the progress and setting the system. The WeChat platform could be installed on users' smartphones to automatically deliver 20 sessions of five-minute well-structured cartoon video classes, followed by other online interactive activities. It also helps support project implementation and real-time performance evaluation. As a first-stage roll-out, a one-year course has been successfully implemented among 54,538 children and their families from 209 schools in two cities, and the average course completion rate was 89.1%.

Conclusion

As an innovative mHealth-based health education system, EduSaltS was developed based on successfully tested interventions and an appropriate framework for scaling up. The early-stage roll-out has shown its preliminary scalability, and further evaluation is ongoing.

Parents' and teachers' views of the promotion of healthy eating in Australian primary schools

BACKGROUND

Primary schools have long been identified as appropriate settings for improving the healthy eating behaviours of children and helping them develop food skills. This qualitative study explored the views of Australian primary school parents and teachers about schools' strengths and weaknesses in promoting healthy eating and equipping children with food skills.

METHODS

Nineteen parents and 17 teachers from Victoria participated in semi-structured interviews. Audio recordings were transcribed and underwent thematic analysis using Nvivo.

RESULTS

This study demonstrated that parents and teachers believed that several facilitators helped promote children's healthy eating. These included food and nutrition education (FNE) programs, the community-based nature of schools, and teacher role modelling and the authority schools possess over children. Time scarcity, lack of teacher expertise, lack of leadership and funding were reported as barriers. School food environments such as canteens, lunch orders, fundraising events and school fairs were identified as both weaknesses and strengths by parents and teachers, which indicated inconsistent implementation of school nutrition policies across schools.

CONCLUSIONS

Australian primary schools demonstrate some useful efforts to promote healthy eating among children. However, there are numerous facilitators and barriers which impact on the promotion of healthy eating. These factors need to be addressed in order to develop healthy eating habits further among elementary students. These results provide directions for policymakers and school managers, as they point to the areas that need to be improved to assist the design of schools that better promote healthy eating among children.

Food and nutrition education in Australian primary schools: parents' views

Purpose

Primary schools provide continuous, intensive contact with large numbers of children starting from a young age, thus providing an appropriate setting for the promotion of healthy eating through food and nutrition education (FNE). This qualitative study explores the views of Australian primary school parents about FNE in primary schools.

Design/methodology/approach

In total, 19 parents of primary school children from Victoria participated in semi-structured interviews. Audio recordings were transcribed and underwent thematic analysis using Nvivo. A total of three themes emerged: FNE topics currently taught in primary schools, essential food skills and knowledge for primary school children and the importance of FNE.

Findings

Most parents thought that FNE is as important as the core subjects of primary school. Parental support for FNE, which is delivered over a prolonged period, and expanded by hands-on content such as cooking and gardening classes was evident. Parents viewed these classes as likely to improve children's food-related knowledge and healthy eating behaviours. Parents expressed appreciation for schools' emphasis on food sustainability and its alignment with school policies and practices. Parents were keen to see more sustainability included in the curriculum.

Practical implications

These results may have implications for curriculum developers and schools, as the findings can assist the design of food and nutrition curricula for primary schools which can empower children as well as their families to make better food-related decisions.

Originality/value

Australian parents' views of FNE in primary schools have been under examined.