Initial results from the European Network of Health Promoting Schools program on development of health education in Finland

The ASCD Healthy School Communities project: formative evaluation results

Purpose

– The purpose of this paper is to report the formative evaluation results from the Association for Supervision and Curriculum Development Healthy School Communities (HSC) pilot project.

Design/methodology/approach

– This study utilized 11 HSC pilot sites in the USA (eight sites) and Canada (three sites). The evaluation question was “What are the levers of change in a school community that allow for the initiation and implementation of best practice and policy for improving school health?” Pre- and post-site visits along with in-depth interviews with school teams, teachers, students, administrators, community stakeholders and other involved individuals, school site report reviews, Healthy School Report Card results and school improvement plans were used for evaluation purposes.

Findings

– This study identified nine levers of change: principal as leader of the HSC efforts; active and engaged leadership; distributive team leadership; effective use of data for continuous school improvement; integration of the HSC process with the school improvement process; ongoing and embedded professional development; authentic and mutually beneficial community collaborations; stakeholder support of the local HSC effort; and creation or modification of school policy related to HSC that increased the likelihood that school improvement via health promotion would be pursued and sustained.

Research limitations/implications

– Owing to the qualitative methods used in this study and the number of schools in the pilot project, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed evaluation question further.

Practical implications

– This study has implications for schools seeking to create sustainable, systemic integration of health and education for effective health-promoting schools and continuous school improvement.

Originality/value

– This study provides evidence that integration of health and education can become a sustainable and integral part of a school’s culture.

Do attitudes, intentions and actions of school food coordinators regarding public organic food procurement policy improve the eating environment at school? Results from the iPOPY study

OBJECTIVE

The present study investigates whether public organic food procurement policies have the potential to induce changes in the school food service environment.

DESIGN

A comparative cross-national survey was conducted in public primary and/or secondary schools in Finland, Germany and Italy. The school food coordinators completed a web-based questionnaire on their attitudes, intentions and actions towards organic school food provision.

SETTING

In Germany, 122 out of 2050 schools in the state of Hesse responded. In Finland, 250 out of 998 schools across the country responded. In Italy, 215 out of 940 schools from eight provinces responded.

SUBJECTS

School food coordinators in the sample of schools in the three countries.

RESULTS

The German and Finnish school food coordinators separately most agreed with the promotion of healthy eating habits (P < 0·001) and organic food (P < 0·001) by schools. The Finnish schools were most likely to adopt a food and nutrition policy (P < 0·001), a health-promoting school policy according to WHO principles (P < 0·001), to have a playground (P < 0·001), to involve physical activity themes in teaching (P = 0·012) and to have a canteen (P < 0·001). The Italian schools were most likely to involve the food and nutrition policy in pedagogical activities (P = 0·004), to serve nutritional school meals (P < 0·001) and to recommend children to eat healthily (P < 0·001). In the three countries, the non-organic schools were less likely to adopt a food and nutrition policy (P < 0·001), a WHO health-promoting policy (P < 0·001) and have a canteen (P = 0·017) than the organic schools.

CONCLUSIONS

The study suggests that there is a gap in the effects of public organic food procurement policy on building a healthier school food environment.

Facilitating the implementation and efficacy of health-promoting schools via an action-research approach in Taiwan

Taiwan launched its evidence-based health-promoting school (HPS) program via an action-research approach in 2010. The program featured a collaborative partnership between schools, local education authorities and university support networks. This study was focused on examining whether an HPS action-research approach was effective in advancing HPS implementation, perceived HPS impact and perceived HPS efficacy in Taiwan. In 2011, questionnaires were sent to 900 sample schools in Taiwan. A total of 621 schools returned the questionnaire, including 488 primary schools and 133 middle schools. The response rate was 69%. This study compared the difference in HPS implementation status, perceived HPS impact and perceived HPS efficacy between those schools that had implemented action-research HPS (138 schools) and those that had not (483 schools). The univariate analysis results indicated that the HPS implementation levels for components that included school health policies, physical environment, social environment, teaching activities and school-community relations were significantly higher in action-research schools than in non-action-research schools. Teachers in action-research schools reported significantly higher levels of HPS impact and HPS efficacy than non-action-research schools. The multivariate analysis results indicated that after controlling for school level and HPS funding, the HPS action-research approach was significantly positively related to greater levels of HPS implementation, perceived HPS impact and perceived HPS efficacy.

“Can There Be Such a Delightful Feeling as This?” Variations of Sexual Scripts in Finnish Girls’ Narratives

This study examined what kinds of sexual scripts were found in Finnish girls’ narratives, what elements those scripts included and how different scripts were associated with sexually risky behavior. The data were comprised of the narratives of 173 14 - 15-year-old girls regarding their experiences in sexually motivating situations. The narratives were analyzed using inductive content analysis. Besides the traditional romantic script, there are rational and experience-seeking scripts as well as the scripts of desire and postponing available to young girls to weigh and adapt in their lives. Implementation of emotion-based scripts often included risks of unprotected intercourse and losing self-control. The variety of these scripts is challenging in sex education, and is discussed in this paper.

Evaluación de las Escuelas Promotoras de Salud en Asturias (España)

n: Objetivo: Evaluar la situación de las escuelas en relación a la Promoción de la Salud, sus fortalezas y debilidades, a través de la incorporación de los principios de la Red Europea de Escuelas Promotoras de Salud y de las opiniones de alumnado y profesorado. Metodología: La población de estudio fueron 29 centros educativos. Se realizó una visita a cada centro y se recogió información por observación directa y entrevistas a equipo directivo, persona coordinadora del proyecto de salud y alumnado. Los criterios evaluados fueron: experiencia, compromiso, implicación del profesorado, metodología con alumnado, participación comunitaria, mejora del entorno, democracia y equidad, y otras acciones promotoras de salud. Cada criterio se valoró con una o varias variables. A cada criterio, se le dio 1 punto, de manera que cada centro podía obtener un total de 8 puntos. Juntos con éstas se recogieron otras variables cualitativas en relación a las fortalezas y debilidades de los centros en Promoción de la Salud. Resultados: La puntuación media de los centros fue 5,19 (DE: 1,16). Mayoritariamente, los centros tenían experiencia previa, incluía la Promoción en la Programación General Anual y en el Proyecto Educativo, y contaban con profesorado implicado, organizado y formado. Aproximadamente la mitad tenía una estética agradable y realizaba incorporación curricular, acciones de coeducación, de mejora del entorno, de alimentación saludable y actividades con comunidad. La participación del alumnado, de las familias y el uso organizado de espacios se dio en un porcentaje minoritario de centros. Conclusiones: Se constató un esfuerzo importante por incorporar la Promoción de la Salud, pero numerosas dificultades para ello. La principal limitación tiene que ver con la voluntariedad de estas acciones y la ausencia de políticas públicas para transformar los centros educativos. Destacar la aportación novedosa de esta investigación, en relación a la creación de un indicador global que permite evaluar la incorporación de la Promoción de la Salud en las escuelas utilizando los criterios de la Red Europea de Escuelas Promotoras de Salud. (Global Health Promotion, 2009; 16(3): pp. 96—106)

Significant effects of implementation of health-promoting schools on schoolteachers' nutrition knowledge and dietary intake in Taiwan

OBJECTIVE

Although teachers are the key participants in health-promoting schools (HPS) programme delivery, it is still unknown whether teachers are appropriate health information resources and role models for students with respect to healthy diets. The present study aimed to investigate the effects of implementing HPS programmes on teachers' nutrition knowledge and diets.

DESIGN

One HPS programme aiming at dietary intervention (HP-D) and one HPS not aiming at dietary intervention (HP-ND) were selected, along with two non-health-promoting (NHP) schools matched for school size and urbanization level with the two HPS. All 361 teachers in the four schools were invited to participate, yielding a 78.4 % overall valid response rate. A structured, self-reported questionnaire was administered, with regression models used for statistical analysis.

RESULTS

Teachers in the HP-D group had a mean score of 21.1 on a range of 0-30 for nutrition knowledge, which was significantly higher than the mean scores of 18.5 in the HP-ND group and 19.1 in the NHP group (P < 0.001). Better dietary behaviours were also observed among HP-D teachers. Further, being a 'health education' course instructor was associated with significantly higher scores on nutrition knowledge (beta = 2.6, P < 0.001) and vegetable and fruit consumption (beta = 1.4, P = 0.02) in the HP-D group than in the NHP group. The HP-ND and NHP groups exhibited similar patterns of non-significant differences compared with the HP-D group.

CONCLUSIONS

Implementation of a coordinated HPS framework on nutrition and diet was positively correlated with schoolteachers' nutrition knowledge and dietary intake.

Becoming a health promoting school: evaluating the process of effective implementation in Scotland

Increasingly, researchers are exploring alternative ways of assessing the impact of 'Health Promoting School' (HPS) initiatives, in recognition of the model's emphasis on achieving change that is both enduring and far-reaching. However, it is still assumed that initiatives will lead to immediate change at the individual level. This paper challenges that view and argues that potential markers of success associated with process need to be identified earlier as a means of supporting schools and teachers. Notwithstanding differences in the way the HPS is conceptualized and implemented, four themes are highlighted that have relevance beyond any one school or country. These were drawn from a process evaluation of a European Network of HPSs Project in Scotland. They highlight the ways in which schools were able to successfully adopt HPS principles and the conditions that need to be in place for the HPS concept to flourish. Such indicators need to be given greater recognition as HPS outcomes if schools are to progress beyond the early stages of project implementation.