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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 Unpublished data and grey literature were also searched.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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Wellman RJ, O'Loughlin EK, Maximova K, Kalubi J, Riglea T, O'Loughlin J. School- and intervention-related factors associated with institutionalization of health promotion interventions in elementary schools. Health Promot Chronic Dis Prev Can 2024; 44:166-178. [PMID: 38597805 PMCID: PMC11097743 DOI: 10.24095/hpcdp.44.4.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Long-term availability of health-promoting interventions (HPIs) in school settings can translate into health benefits for children. However, little is known about factors associated with HPI institutionalization in schools. In this study, we identified correlates of the institutionalization of HPIs offered in elementary schools in Quebec, Canada. METHODS In two-part, structured telephone interviews over three academic years (2016-2019), elementary school principals (or their designees) throughout Quebec identified an index HPI offered at least once in their school during the previous three years, and were asked whether it was institutionalized (i.e. explicitly written in the school's educational project, e.g. in the form of educational objectives and means of achieving them). We examined associations between institutionalization and 10 school-related and 16 HPI-related characteristics in univariable and multivariable logistic regression analyses. RESULTS School key informants (n = 163) reported on 147 different HPIs that had been available in their schools in the past three years, 56% of which were institutionalized. Three aspects of school culture-parent/community engagement with the school, school/teacher commitment to student health and school physical environment-were positively associated with HPI institutionalization. HPI-related characteristics positively associated with HPI institutionalization included number of competencies addressed by the HPI, number of teaching strategies employed, modifications made to the HPI prior to or during implementation and perceived success of the HPI. Inviting families or community groups to participate in the HPI was inversely associated with institutionalization. CONCLUSION Better understanding of factors associated with HPI institutionalization may inform the development of school-based HPIs that have the potential for sustainability.
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Affiliation(s)
- Robert J Wellman
- Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine, UMass Chan Medical School, Worcester, Massachusetts, United States
| | - Erin K O'Loughlin
- Centre de recherche du Centre hospitalier de l'Université de Montréal CRCHUM, Montréal, Quebec, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jodi Kalubi
- Centre de recherche du Centre hospitalier de l'Université de Montréal CRCHUM, Montréal, Quebec, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Quebec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal, and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Quebec, Canada
| | - Teodora Riglea
- Centre de recherche du Centre hospitalier de l'Université de Montréal CRCHUM, Montréal, Quebec, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Jennifer O'Loughlin
- Centre de recherche du Centre hospitalier de l'Université de Montréal CRCHUM, Montréal, Quebec, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Quebec, Canada
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Craig DW, Walker TJ, Cuccaro P, Sharma SV, Heredia NI, Robertson MC, Fernandez ME. Using the R = MC 2 heuristic to understand barriers to and facilitators of implementing school-based physical activity opportunities: a qualitative study. BMC Public Health 2024; 24:207. [PMID: 38233842 PMCID: PMC10792959 DOI: 10.1186/s12889-024-17744-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 01/11/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Schools are a key setting for supporting youth physical activity, given their broad reach and diverse student populations. Organizational readiness is a precursor to the successful implementation of school-based physical activity opportunities. The R = MC2 heuristic (Readiness = Motivation x Innovation-Specific Capacity x General Capacity) describes readiness as a function of an organization's motivation and capacity to implement an innovation and can be applied to better understand the implementation process. The purpose of this study was to explore the barriers to and facilitators of implementing school-based physical activity opportunities in the context of organizational readiness. METHODS We analyzed interview data from 15 elementary school staff (principals, assistant principals, physical education teachers, and classroom teachers) from a school district in Texas. We focused on factors related to adopting, implementing, and sustaining a variety of school-based physical activity opportunities. We used the Framework Method to guide the analysis and coded data using deductive (informed by the R = MC2 heuristic) and inductive approaches. Themes were generated using the frequency, depth, and richness of participant responses. RESULTS Four themes emerged from the data: (1) implementation is aided by the presence of internal and external relationships; (2) physical activity opportunities compete with other school priorities; (3) seeing the benefits of physical activity opportunities motivates school staff toward implementation; and (4) staff buy-in is critical to the implementation process. Themes 1-3 aligned with subcomponents of the R = MC2 heuristic (intra- and inter-organizational relationships, priority, and observability), whereas Theme 4 (staff buy-in) related to multiple subcomponents within the Motivation component but was ultimately viewed as a distinct construct. CONCLUSION Our results highlight and explain how key readiness constructs impact the implementation of school-based physical activity opportunities. They also highlight the importance of obtaining staff buy-in when implementing in the school setting. This information is critical to developing readiness-building strategies that help schools improve their capacity to deliver physical activity opportunities effectively. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Derek W Craig
- Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA.
| | - Timothy J Walker
- Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Paula Cuccaro
- Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics, & Environmental Sciences, Center for Health Equity, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Natalia I Heredia
- Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Michael C Robertson
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
- Department of Family and Preventive Medicine, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Maria E Fernandez
- Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
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Dabravolskaj J, Veugelers PJ, Mandour BA, Flynn J, Maximova K. Delivering health promotion during school closures in public health emergencies: building consensus among Canadian experts. Health Promot Int 2023; 38:daad172. [PMID: 38091618 PMCID: PMC10716908 DOI: 10.1093/heapro/daad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
School-based health promotion is drastically disrupted by school closures during public health emergencies or natural disasters. Climate change will likely accelerate the frequency of these events and hence school closures. We identified innovative health promotion practices delivered during COVID-19 school closures and sought consensus among education experts on their future utility. Fifteen health promotion practices delivered in 87 schools across Alberta, Canada during COVID-19 school closures in Spring 2020, were grouped into: 'awareness of healthy lifestyle behaviours and mental wellness', 'virtual events', 'tangible supports' and 'school-student-family connectedness'. Two expert panels (23 school-level practitioners and 20 decision-makers at the school board and provincial levels) rated practices on feasibility, acceptability, reach, effectiveness, cost-effectiveness and other criteria in three rounds of online Delphi surveys. Consensus was reached if 70% or more participants (strongly) agreed with a statement, (strongly) disagreed or neither. Participants agreed all practices require planning, preparation and training before implementation and additional staff time and most require external support or partnerships. Participants rated 'awareness of healthy lifestyle behaviours and mental wellness' and 'virtual events' as easy and quick to implement, effective and cost-effective, sustainable, easy to integrate into curriculum, well received by students and teachers, benefit school culture and require no additional funding/resources. 'Tangible supports' (equipment, food) and 'school-student-family connectedness' were rated as most likely to reach vulnerable students and families. Health promotion practices presented herein can inform emergency preparedness plans and are critical to ensuring health remains a priority during public health emergencies and natural disasters.
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Affiliation(s)
- Julia Dabravolskaj
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada
| | - Boshra A Mandour
- School of Public Health, University of Alberta, 3-50E University Terrace, 8303 112 Street NW, Edmonton, AB T6G 1K4, Canada
| | - Jenn Flynn
- APPLE Schools, 206-A, 12227 – 107 Ave NW, Edmonton, AB T5M 1Y9, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
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Bird M, Neely KC, Montemurro G, Mellon P, MacNeil M, Brown C, Sulz L, Storey K. Parental Perspectives of Sleep in the Home: Shaping Home-School Partnerships in School-Based Sleep Promotion Initiatives. Prev Chronic Dis 2023; 20:E38. [PMID: 37167552 DOI: 10.5888/pcd20.220395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Sleep is a critical component of child health and the prevention of chronic disease. Children may benefit from school-based sleep promotion; however, parents need to be involved for healthy sleep strategies learned at school to be translated to the home. The objective of this study was to explore parental perspectives on sleep behaviors and responsiveness to school-based sleep promotion. METHODS Twenty-five parents of school-aged children were purposively sampled for interviews from July 2019 through April 2020 in Alberta, Canada. Descriptive qualitative methodology was used, and data were generated through semistructured interviews and researcher field notes. Interviews were transcribed and themes were identified by using latent content analysis. RESULTS Three themes emerged from analysis: 1) sleep is valued and supported, 2) barriers to healthy sleep exist, and 3) schools are allies in promoting sleep. Parents perceived that sleep was essential for their child's health, facilitated healthy sleep practices in the home, and highlighted barriers (busy schedules and poor parental role models) that affected sleep. Parents supported and expressed value in school-based sleep promotion and noted factors that affected the success of school-based sleep promotion. CONCLUSION Parents are responsive to school-based sleep promotion. Promotion efforts should include resources that engage and involve parents in the school community. Throughout the development of resources to support school-based sleep promotion, additional consideration of parent-reported barriers to promoting healthy sleep in the home should be included.
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Affiliation(s)
- Melissa Bird
- Alberta Health Services, Calgary, Alberta, Canada
| | - Kacey C Neely
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | | | - Pamela Mellon
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Megan MacNeil
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Cary Brown
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lauren Sulz
- Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, 3-300 ECHA, 11405-87 Ave, Edmonton, AB Canada T6G 1C9
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Predicting the Presence of Active Schools: A National Survey of School Principals in the United States. J Phys Act Health 2022; 19:771-776. [PMID: 36170975 DOI: 10.1123/jpah.2021-0792] [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: 12/13/2021] [Revised: 06/29/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Principals are key to the promotion of physical activity (PA) in schools. The purpose of this study was to understand how school principals' PA values, behaviors, and individual and school characteristics were associated with the presence of an active school. METHODS A representative sample of 1019 school principals in the United States was surveyed. Survey items addressed principals' values and behaviors associated with PA, individual and school demographic factors, such as years of experience and school level, and a single item asking whether principals perceived their school to be an active school (ie, provides students with opportunities to be physically active before, during, and after the school day). Significant variables from a cross-tabulation and chi-square analysis were added to a hierarchical logistic regression model to assess the predictive properties of principal values and behaviors as they relate to the presence of an active school. RESULTS Approximately half of principals (47%) reported having an active school. The model significantly predicted the presence of an active school but accounted for only 6.6% of the total variance. Although values toward PA and more frequent personal PA behaviors were associated with the presence of an active school within the cross-tabulation and chi-square analysis, neither variable emerged as a significant predictor in the regression model. CONCLUSIONS Principals' personal PA values and behaviors contribute to the presence of an active school, but other variables, including years of experience and school contextual factors, are more powerful predictors.
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Kontak JC, Kirk SF. Process of youth engagement in school health promotion: a scoping review protocol. BMJ Open 2022; 12:e063889. [PMID: 36123089 PMCID: PMC9486345 DOI: 10.1136/bmjopen-2022-063889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION School environments are an essential setting to shape and influence the health and well-being of students. Health promoting school (HPS) is a whole-school approach that strengthens and builds a safe and healthy school environment for students to learn and develop. A core component of HPS is the meaningful participation of youth. Despite promising outcomes arising from youth engagement in school health promotion, there is less known on the process of how students are involved in school health promotion and in what form. This scoping review will explore and map the different components of the student engagement process in school health promotion with specific focus on whole-school approaches like HPS. METHODS AND ANALYSIS We will follow scoping review guidelines employed by the Joanna Briggs Institute and Arksey and O'Malley's framework. We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews to guide reporting. We will follow the PCC mnemonic (participant, concept and context) to develop eligibility criteria. Both published and unpublished literature will be included. Databases to be searched include: CINAHL, ERIC, MEDLINE, Scopus, ProQuest Dissertations & Theses Global databases and Google Scholar. Relevant organisational websites and sources identified by experts will also be reviewed. Two reviewers will screen the title, abstract and full text of the sourced articles. Data from included articles will be charted using a data charting tool. The socioecological model and Hart's Ladder of Participation will be used to guide charting. Descriptive analysis will be conducted for quantitative data, and thematic analysis will be employed for qualitative data. Data will be displayed through tables and narrative descriptions. ETHICS AND DISSEMINATION No ethical approval is required for this study. To disseminate our work, we plan to develop an open-access publication, accompanied by a conference presentation and other knowledge translation products.
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Affiliation(s)
- Julia C Kontak
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Healthy Populations Institute, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sara F Kirk
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- Healthy Populations Institute, Dalhousie University, Halifax, Nova Scotia, Canada
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
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Kontak JC, Caldwell HAT, Kay-Arora M, Hancock Friesen CL, Kirk SFL. Peering in: youth perspectives on Health Promoting Schools and youth engagement in Nova Scotia, Canada. Health Promot Int 2022; 37:6648071. [PMID: 35862775 PMCID: PMC9302890 DOI: 10.1093/heapro/daac081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Health Promoting Schools (HPS) is a whole-school approach that shapes the conditions necessary to support student health and well-being. Youth engagement is recognized as key to HPS implementation, yet research related to the involvement of youth voice in school health promotion initiatives is limited. The purpose of this study was to understand youth perspectives on HPS and school youth engagement. Ten youth (grades 9–10, ages 14–16) were trained as peer researchers using a Youth Participatory Action Research approach. The peer researchers interviewed 23 of their peers (grades 7–10, ages 12–16) on perspectives related to HPS and school youth engagement. All interviews were audio-recorded, transcribed and data were analysed using inductive ‘codebook’ thematic analysis. Themes related to a healthy school community were mapped onto the pillars of HPS: (i) Social and Physical Environment, (ii) Teaching and Learning, (iii) Partnerships and Services and (iv) School Policies. Participants placed more importance on the social and physical environment of the school including respect, inclusivity, supportive relationships and the design of spaces. Key factors for youth engagement were: (i) safe and supportive spaces, (ii) passion and interest, (iii) using their voice, (iv) power dynamics, (v) accessibility and (vi) awareness. With recognition that youth engagement is a crucial part of HPS, this work provides relevant and applicable information on areas of the healthy school community that are important to youth, and if/how they are meaningfully engaged in school decision-making.
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Affiliation(s)
- Julia C Kontak
- Faculty of Health, Dalhousie University, Dalhousie University, 5968 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada.,Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, NS B3H 3E2, Canada
| | - Hilary A T Caldwell
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, NS B3H 3E2, Canada
| | - Margaret Kay-Arora
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, NS B3H 3E2, Canada
| | - Camille L Hancock Friesen
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, NS B3H 3E2, Canada.,Division of Pediatric Cardiothoracic Surgery, Children's Health and Medical Centre, University of Nebraska Medical Center, 8200 Dodge Street, Omaha, NE 68114, USA
| | - Sara F L Kirk
- Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, NS B3H 3E2, Canada.,School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS B3H 4R2, Canada
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Klassen D, Champion C, Montemurro G, Flynn J, Raine K, Storey K. It takes a community: exploring APPLE Schools' impact within and beyond school walls in Canada. Health Promot Int 2022:6576067. [PMID: 35486099 DOI: 10.1093/heapro/daac050] [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: 11/12/2022] Open
Abstract
Childhood is a critical stage to develop healthy behaviours, and the school years are an important developmental period in which children are learning and growing. School-based health promotion interventions are increasingly using the comprehensive school health (CSH) approach that has been found effective at improving health behaviours, while adapting to the school and community context to create and sustain a healthy school culture. The interconnected environments of school, home and community are key to the CSH approach, however, there is minimal research that has been conducted to determine the impact at the community-level. This research used a qualitative multiple case study design to explore the influence of a school-based health promotion intervention, APPLE Schools, on the school and community environments from the perspectives of school staff in Alberta, Canada. Twenty-two participants participated in walking interviews in five schools. The walking interview approach combined interviewing and field observation and empowered participants to share their local expertise and knowledge within the context of school and community environments. Interviews were transcribed and analysed using an inductive thematic approach. Four themes were identified: APPLE schools look different, APPLE Schools build champions, APPLE Schools builds community partnerships and APPLE Schools honours community culture. Health promotion practice in schools was uniquely adapted based on strengths and needs of each school and was broadly influenced by the community outside of school walls. In sum, it was found that school-based health promotion reaches beyond school walls and can influence the broader community environment.
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Affiliation(s)
- Danielle Klassen
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB T6G 1C9, Canada
| | - Claudine Champion
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB T6G 1C9, Canada
| | - Genevieve Montemurro
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB T6G 1C9, Canada
| | - Jenn Flynn
- APPLE Schools Foundation, 3-50 University Terrace, 8303-112 Street, Edmonton, AB T6G 2T4, Canada
| | - Kim Raine
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB T6G 1C9, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB T6G 1C9, Canada
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Bailey R, Scheuer C. The COVID-19 pandemic as a fortuitous disruptor in physical education: the case of active homework. AIMS Public Health 2022; 9:423-439. [PMID: 35634024 PMCID: PMC9114789 DOI: 10.3934/publichealth.2022029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 11/18/2022] Open
Abstract
Measures devised to contain the COVID-19, including isolation, social distancing, and quarantine, have profoundly affected people's lives around the world. One of the consequences of these actions has been a general reduction in the habitual daily physical activity among children and young people for whom schools represent the major setting for the promotion of sports, physically active play, movement skills learning, and other activity supportive of healthy, active lifestyles. Whilst acknowledging the seriousness of these changes, and their concomitant health risks, we suggest that COVID-19 offers an opportunity to think again about important features of school-based activity promotion in light of new lessons learnt during lockdown, emerging technologies, and adapted pedagogies. In these specific cases, COVID-19 could be judged a "fortuitous disruptor" to the extent that it has opened a window of opportunity to schools and teachers to reflect on their assumptions about the scope, content, and delivery of their curricula, and on the new professional knowledge that has emerged. Active Homework, or physical activity-related tasks assigned to students by teachers that are meant to be carried out before, after and away from school, that students can do on their own or with family members, is not a new idea, but the enforced changes to school provision have made it considerably more common since the pandemic. Perhaps Active Homework is a concept worth retaining as schools start to return to "normal"? We offer a typology of Active Homework, and examine opportunities to expand, extend, and enhance physical education and physical activity opportunities by breaking down the presumed boundary between school and home. In conclusion, we suggest that Active Homework is worth exploring as a potentially valuable approach to enhancing the quantity and quality of students' school-based health-related physical activity. If so, considerably more research and curriculum development is needed.
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Affiliation(s)
- Richard Bailey
- Centre for Academic Partnerships and Engagement, University of Nottingham Malaysia, Semenyih, Selangor, Malaysia
| | - Claude Scheuer
- Institute for Teaching and Learning, Department of Education and Social Work, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Geda NR, Feng CX, Yu Y. Examining the association between work stress, life stress and obesity among working adult population in Canada: findings from a nationally representative data. Arch Public Health 2022; 80:97. [PMID: 35351179 PMCID: PMC8966340 DOI: 10.1186/s13690-022-00865-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background Obesity is a priority public health concern in Canada and other parts of the world. The study primarily aims at assessing the role of self-perceived work and life stress on obesity among working adults in Canada. Methods The study was conducted based on a total of 104,636 Canadian adults aged 18 and above, extracted from the 2017–2018 Canadian Community Health Survey (CCHS) data. We used a mixed-effect logistic regression model to determine the possible association between two stress variables and obesity, controlling for other variables in the model. The random effect term accounts for the correlation among the observations from the same health region. Results A total of 63,815 adult respondents (aged 18 and above) who were working during the 12 months prior to the survey were studied. Of those, 18.7% were obese based on their self-reported BMI > =30.0 kg/m2. More than two-thirds of the respondents reported that their stress level is a bit stressful to extremely stressful. The results of multivariable mixed-effect logistic regression showed that the odds of obesity were 1.432 times (95% CI: 1.248–1.644) among those who reported extremely work-related stress, compared to those who had no work-related stress. Perceived life stress was not significantly associated with obesity risk among working adult population, after adjusting other factors. Conclusion The study concluded that obesity among Canadian adults is 18.7% of the working adult population being obese. Given the reported high prevalence of stress and its effect on obesity, the findings suggested improving social support systems, individual/group counseling, and health education focusing on work environments to prevent and manage stressors and drivers to make significant program impacts. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00865-8.
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Affiliation(s)
- Nigatu Regassa Geda
- Center for Population Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Cindy Xin Feng
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Yamei Yu
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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The essential conditions needed to implement the Indigenous Youth Mentorship Program: a focused ethnography. BMC Public Health 2022; 22:213. [PMID: 35105323 PMCID: PMC8808991 DOI: 10.1186/s12889-021-12412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/08/2021] [Indexed: 11/15/2022] Open
Abstract
Background The Indigenous Youth Mentorship Program (IYMP) is a 20-week communal, relationship-based afterschool healthy living program for Indigenous youth in Canada. IYMP embraces the Anishnaabe/Nehiyawak concepts of Mino-Bimaadiziwin/miyo-pimâtisiwin (“living in a good way”) via its core components of physical activities/games, healthy snacks, and relationship-building. A strength of IYMP is that it values autonomy, adaptability, and the school community context. However, this presents challenges when evaluating its implementation, given that traditional implementation science methods tend to oversimplify the process. In response, essential conditions for the implementation of school-based healthy living programs across diverse contexts have been developed. The purpose of this research was to understand the applicability of these essential conditions within the context of IYMP. Methods 15 participants (n = 10 Young Adult Health Leaders; n = 5 coordinators) with experience implementing IYMP in the provinces of Alberta, Saskatchewan, Manitoba, and Quebec were purposefully sampled. Focused ethnography was the guiding method and one-on-one semi-structured interviews were used as the data generation strategy. The purpose of the interviews was to understand what conditions are needed to implement IYMP. The interview guide was based on previously established essential conditions developed by the research team. Interviews were audio-recorded and transcribed, and content analysis was used to identify patterns in the data. Results The overarching theme that emerged from the interviews was the applicability of the essential conditions when implementing IYMP. Participants felt the eight core conditions (students as change agents, school/community-specific autonomy, demonstrated administrative leadership, higher-level support, dedicated champion(s) to engage school community, community support, quality and use of evidence, and professional development) and four contextual conditions (time, funding and project support, readiness and understanding, and prior community connectivity) were necessary, but made suggestions to modify two conditions (youth led and learning opportunities) to better reflect their experiences implementing IYMP. In addition, a new core condition, rooted in relationship, emerged as necessary for implementation. Conclusions This research adds to the literature by identifying and describing what is needed in practice to implement a communal, relationship-based afterschool healthy living program. The essential conditions may support other researchers and communities interested in implementing and rippling similar programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12412-1.
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Gillies C, Blanchet R, Gokiert R, Farmer A, Willows ND. Comprehensive Nutrition Interventions in First Nation-Operated Schools in Canada. CAN J DIET PRACT RES 2022; 83:128-132. [PMID: 35014557 DOI: 10.3148/cjdpr-2021-039] [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: 11/10/2022]
Abstract
Comprehensive school-based nutrition interventions offer a promising strategy to support healthy eating for First Nations children. A targeted strategic review was performed to identify nutrition interventions in 514 First Nation-operated schools across Canada through their websites. Directed content analysis was used to describe if interventions used 1 or more of the 4 components of the Comprehensive School Health (CSH) framework. Sixty schools had interventions. Nearly all (n = 56, 93%) schools offered breakfast, snack, and (or) lunch programs (social and physical environment). About one-third provided opportunities for students to learn about traditional healthy Indigenous foods and food procurement methods (n = 18, 30%) (teaching and learning) or facilitated connections between the school and students' families or the community (n = 16, 27%) (partnerships and services). Few schools (n = 10, 17%) had a nutrition policy outlining permitted foods (school policy). Less than 1% (n = 3) of interventions included all 4 CSH components. Results suggest that most First Nation-operated schools provide children with food, but few have nutrition interventions that include multiple CSH components. First Nation-operated schools may require additional financial and (or) logistical support to implement comprehensive school-based nutrition interventions, which have greater potential to support long-term health outcomes for children than single approaches.
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Affiliation(s)
- Christina Gillies
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, AB.,Department of Social Sciences, Wageningen University & Research, Wageningen, The Netherlands
| | - Rosanne Blanchet
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, AB
| | - Rebecca Gokiert
- School of Public Health, University of Alberta, Edmonton, AB
| | - Anna Farmer
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, AB
| | - Noreen D Willows
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, AB
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Machado SS, Brewster AL, Shapiro VB, Ritchie LD, Magee KS, Madsen KA. Implementation Leadership in School Nutrition: A Qualitative Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:56-64. [PMID: 34728165 DOI: 10.1016/j.jneb.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This paper identifies implementation leadership characteristics in the school nutrition setting and places findings in the context of implementation leadership literature. METHODS Fourteen interviews were conducted with school district leadership/staff in an urban school district. Modified grounded theory was employed. RESULTS Four themes emerged: (1) understanding of technical/operational intervention details; (2) ability to proactively develop and communicate plans; (3) supervisory oversight; and (4) intervention framing. Themes were consistent with 4 of the 5 dimensions comprising the Implementation Leadership Scale: knowledgeable, proactive, perseverant, and distributed leadership. The supportive domain was not a major finding. An additional domain, how leaders message the intervention to staff, was identified. CONCLUSIONS AND IMPLICATIONS Implementation leadership in school nutrition appears similar, but not identical, to leader behaviors present in the Implementation Leadership Scale. School nutrition leaders might consider involving staff early in implementation planning, incorporating technical expertise, and clearly communicating the intervention purpose to support successful implementation. Future research might explore the interplay between leadership and implementation outcomes.
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Affiliation(s)
- Stephanie S Machado
- Department of Public Health and Health Services Administration, California State University, Chico, CA; Stephanie Machado was at UC Berkeley in the School of Public Health during the study..
| | - Amanda L Brewster
- School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Valerie B Shapiro
- School of Social Welfare, University of California Berkeley, Berkeley, CA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA
| | - Kiran S Magee
- School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Kristine A Madsen
- School of Public Health, University of California, Berkeley, Berkeley, CA
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Kazemitabar M, Garcia D, Chukwuorji JC, Sanmartín R, Lucchese F, Khoshnood K, Cloninger KM. Development and primary validation of the School Health Assessment Tool for Primary Schools (SHAT-PS). PeerJ 2021; 9:e12610. [PMID: 34993021 PMCID: PMC8675247 DOI: 10.7717/peerj.12610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/18/2021] [Indexed: 12/02/2022] Open
Abstract
Background School health programs need to target all aspects of physical, psychological, and social well-being. Using a slightly modified version of the COSMIN Risk of Bias checklist, we developed and conducted the first validation of the School Health Assessment Tool for Primary Schools (SHAT-PS). Method The exploratory sequential mixed method was used in this study. In the first phase, scientific databases were systematically searched to find school health models and instruments and 65 interviews were conducted with school stakeholders. The Colaizzi’s method was used to code the qualitative data into themes. Then, a pool of items was created for each theme, rechecked by psychometric experts and then validated for content (i.e., relevance, clarity, and comprehensiveness) by psychometric experts and individuals of the target population (i.e., school personnel). In the second phase, classical test theory was utilized to analyze the validity and reliability of the resulting items from phase 1 among 400 individuals working at primary schools. Results The coding of the interviews resulted in ten themes that we labeled based on the theoretical literature: school health policies, community connections, health education, physical activity, health services, nutrition, psychological services, physical environment, equipment and facilities, and school staff’s health. The items created for each theme ended up in an initial pool of 76 items. In the final stage of phase 1, 69 items remained after the content validity assessment by experts and school personnel. In phase 2, the SHAT-PS items were tested using maximum likelihood exploratory factor analysis and confirmatory factor analysis. Of the 69 items from phase 1, 22 items were removed due to low factor loadings. The results showed that the 8-factor model was the best solution (chi-square/df = 2.41, CFI = .98, TLI = .97, RMSEA = .06). The discriminant and convergent validity of the SHAT-PS were evaluated as satisfactory and the scale had high internal consistency (Cronbach’s alpha for all subscales > .93). The test-retest reliability was satisfactory—the intraclass correlation coefficient pooled was .95 (99% CI [.91–.98]). Moreover, the standard error of measurement resulted in an SEM pooled equal to 4.4. No discrepancy was found between subgroups of gender and subgroups of staffs’ positions at schools. Conclusion The SHAT-PS is a valid and reliable tool that may facilitate school staff, stakeholders and researchers to evaluate the presence of the factors that promote health at primary schools. Nevertheless, in the process of validation, many of the items related to staff’s health were eliminated due to poor factor loadings. Obviously, staff health is an important factor in the measurement of school health. Hence, we recommend that the validity and reliability of the SHAT-PS in other cultures should be done using the original 76-item version.
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Affiliation(s)
- Maryam Kazemitabar
- Department of Psychology, University of Tehran, Tehran, Iran
- Promotion of Health and Innovation (PHI), International Network for Well-Being, Iran
| | - Danilo Garcia
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
- Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Psychology, Lund University, Lund, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Promotion of Health and Innovation (PHI), International Network for Well-Being, Sweden
| | - JohnBosco C. Chukwuorji
- Department of Psychology, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Psychology, College of Sciences and the Health Professions, Cleveland State University, Cleveland, OH, United States of America
- Promotion of Health and Innovation Lab (PHI), International Network for Well-Being, Nigeria
| | - Ricardo Sanmartín
- Department of Developmental Psychology and Didactics, Faculty of Education, University of Alicante, Alicante, Spain
| | - Franco Lucchese
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
- Promotion of Health and Innovation (PHI), International Network for Well-Being, Italy
| | - Kaveh Khoshnood
- School of Public Health, Yale University, New Haven, CT, United States of America
| | - Kevin M. Cloninger
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Anthropedia Foundation, St. Louis, MO, United States of America
- College for Public Health and Justice, Saint Louis University, St. Louis, MO, United States of America
- Promotion of Health and Innovation Lab (PHI), International Network for Well-Being, United States of Amercia
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Lopresti S, Willows ND, Storey KE, McHugh TLF. Indigenous Youth Mentorship Program: key implementation characteristics of a school peer mentorship program in Canada. Health Promot Int 2021; 36:913-923. [PMID: 33166996 DOI: 10.1093/heapro/daaa090] [Citation(s) in RCA: 3] [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
The Indigenous Youth Mentorship Program (IYMP) is a peer-led health promotion program developed for elementary school students in Indigenous school communities in Canada. A local young adult health leader (YAHL) and high school mentors offer students healthy snacks, physical activity games, relationship building activities and cultural teachings. IYMP aims to improve children's health and wellbeing and empower Indigenous youth and communities. The purpose of this focused ethnography was to describe the key characteristics of successful IYMP delivery. Two focus groups were conducted with 16 participants (8 YAHLS and 8 youth mentors) from 7 schools followed by 4 individual interviews (3 YAHLs, 1 youth peer mentor). Transcripts were analyzed using content analysis. Findings were triangulated with IYMP program field observations and notes from IYMP national team meetings. The five characteristics identified as important for IYMP delivery were a sense of ownership by those delivering the program, inclusion of Indigenous Elders/knowledge keepers, establishing trusting relationships, open communication among all stakeholder groups, including community and academic partners, and adequate program supports in the form of program funding, manuals that described program activities, and local and national gatherings between academic and community partners for sharing ideas about the program and its components. This study indicates the importance of respectful partnerships between community and academic leads for program success and sustainability. As IYMP is implemented in more communities and becomes community autonomous, program sustainability may be ensured and implementation challenges mitigated by embedding the identified five essential characteristics within the fabric of IYMP.
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Affiliation(s)
- Sabrina Lopresti
- Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, Canada T6G 2P5
| | - Noreen D Willows
- Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, Canada T6G 2P5
| | - Kate E Storey
- School of Public Health, University of Alberta, 8303 - 112 Street, Edmonton, Alberta, Canada T6G 2P5
| | - Tara-Leigh F McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 1-111 University Hall, Edmonton, Alberta, Canada T6G 2P5
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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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"Sleep is healthy for your body and brain." Use of student-centered photovoice to explore the translation of sleep promotion at school to sleep behavior at home. Sleep Health 2021; 7:588-595. [PMID: 34301526 DOI: 10.1016/j.sleh.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/01/2021] [Accepted: 05/08/2021] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVES Schools are an important setting to teach and reinforce positive health behaviors such as sleep, however, research that incorporates the student perspective of school-based sleep promotion initiatives is limited. This study explored student's perceptions of sleep behavior (how they understood and valued positive and negative sleep behaviors) and determined if and how students translate school-based sleep promotion to the home. METHODS Forty-five grade 4 and 5 children (aged 9-11 years) were purposefully sampled from 3 schools participating in the Alberta Project Promoting healthy Living for Everyone in schools (APPLE) in Edmonton, Canada. Using focused ethnography as the method and photovoice as a data generating strategy, qualitative in-depth information was generated through photo-taking and one-on-one interviews. Data were analyzed in an iterative, cyclical process using latent content analysis techniques. RESULTS Four themes related to students' perception of sleep behavior within the context of a school-based sleep promotion initiative were identified: sleep is "healthy for your body and brain," sleep habits are rooted in the home environment, school experiences shape positive sleep habits at home, and students translate sleep promotion home if they think it is useful or would be acceptable to the family. CONCLUSION AND IMPLICATIONS School-based sleep promotion interventions that are grounded in the comprehensive school health (CSH) approach hold promise for successfully shaping student sleep behavior. To promote health and academic success in children, future interventions should include home-school partnerships that address child sleep across multiple critical learning environments.
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Storey KE, Stearns JA, McLeod N, Montemurro G. A social network analysis of interactions about physical activity and nutrition among APPLE schools staff. SSM Popul Health 2021; 14:100763. [PMID: 33748390 PMCID: PMC7966860 DOI: 10.1016/j.ssmph.2021.100763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/16/2021] [Accepted: 02/20/2021] [Indexed: 11/27/2022] Open
Abstract
Comprehensive school health (CSH) is a holistic approach to school-based health promotion that involves active participation and buy-in of school community members, including school staff (e.g., support staff, teachers, school health champions, principals). Implementation and sustainability of CSH builds on complex relationships within the school that support school-level health promoting changes and understanding the social relationships that exist in a school setting is critical. Thus, the purpose of this study was to conduct a social network analysis to examine adviceseeking networks of staff within three schools involved with a CSH program called APPLE Schools (A Project Promoting healthy Living for Everyone in Schools) project approach. The degree to which school staff were central in the network (i.e., gave or sought physical activity or nutrition advice, were connected or disconnected to others; indegree/outdegree centrality and betweenness centrality) and the overall structure of the networks were assessed (i.e., optimal levels of density and centralization). School health champions and several other individuals in the network were shown to be key sources of physical activity or nutrition advice and were identified as central players in the network. Whole networks across schools had low density and betweenness centralization, with optimal levels of out-centralization, and low to optimal levels of incentralization. This research allowed us to gain an understanding of network structures and relationship patterns in CSH schools, with specific attention to the coordinating role of school health champions, and other central players within the network. These findings increase our understanding of advice relationships that exist in a school setting and how these relationships may support CSH implementation and sustainability.
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Affiliation(s)
- Kate E. Storey
- School of Public Health, University of Alberta, 3-50 University Terrace, 8303-112 Street, Edmonton, Alberta, T6G 2T4, Canada
| | - Jodie A. Stearns
- School of Public Health, University of Alberta, 3-50 University Terrace, 8303-112 Street, Edmonton, Alberta, T6G 2T4, Canada
- Division of Preventive Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 1902 College Plaza, 8215 -112 St, Edmonton, AB, T6G 2C8, Canada
| | - Nicole McLeod
- School of Public Health, University of Alberta, 3-50 University Terrace, 8303-112 Street, Edmonton, Alberta, T6G 2T4, Canada
| | - Genevieve Montemurro
- School of Public Health, University of Alberta, 3-50 University Terrace, 8303-112 Street, Edmonton, Alberta, T6G 2T4, Canada
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Barcelona JM, Castelli DM, Duncan Cance J, Pitt Barnes S, Lee S. Presidential youth fitness program implementation: An antecedent to organizational change. EVALUATION AND PROGRAM PLANNING 2021; 86:101919. [PMID: 33601248 PMCID: PMC10495871 DOI: 10.1016/j.evalprogplan.2021.101919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 01/04/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Grounded in organizational change theory, the purpose of this study was to investigate the efficacy of the Presidential Youth Fitness Program (PYFP) and its association with healthy cultures within schools. METHODS Using a qualitative approach, data were collected through interviews, site visits and artifacts across 374 schools. An explanatory collective case study approach was used to identify key events related to implementation. RESULTS Pivotal antecedents to organizational change included prolonged, continual PD, direct support of PYFP implementation, and recognition. Further, three key themes of leveling of the playing field, strategically overcoming barriers, and recruiting teacher fitness champions were identified. CONCLUSIONS Creating a healthy school culture was an unexpected, but feasible outcome stemming from the implementation of the PYFP. A collective effort, led by physical education teachers and fitness champions and embraced by the administration, faculty, and community, is necessary for the school culture to unfreeze from its present status.
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Affiliation(s)
- Jeanne M Barcelona
- Wayne State University, Kinesiology, Health and Sport Studies, United States.
| | - Darla M Castelli
- The University of Texas at Austin, Department of Kinesiology and Health Education, United States
| | - Jessica Duncan Cance
- RTI International, Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, United States
| | - Seraphine Pitt Barnes
- Centers for Disease Control and Prevention, Division of Population Health, United States
| | - Sarah Lee
- Centers for Disease Control and Prevention, Division of Population Health, United States
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Graham-DeMello A, Yusuf J, Kay-Arora M, Hancock Friesen CL, Kirk SFL. Understanding the Environment for Health-Promoting Schools Policies in Nova Scotia: A Comprehensive Scan at the Provincial and Regional School Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073411. [PMID: 33806094 PMCID: PMC8037869 DOI: 10.3390/ijerph18073411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/13/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022]
Abstract
The World Health Organization has identified the school community as a key setting for health promotion efforts, laying out its priorities in the Health-Promoting Schools (HPS) framework. This framework offers a comprehensive approach that has been adopted in countries around the globe, with defining characteristics focused around the school curriculum and environment. Nova Scotia (NS) adopted the HPS framework at a provincial level in 2005, but it has been variably implemented. We aimed to identify, categorize, and broadly describe the environment for HPS policies in NS. Four iterative steps were employed: (1) a scan of government and regional school websites to identify publicly available policies; (2) consultations with provincial departments with respect to policy relevance and scope; (3) cross-comparison of policies by two reviewers; (4) compilation of policies into an online database. Seventy policies at the provincial level and 509 policies across eight public school regions were identified. Policies focusing on a ‘safe school environment’ were most common; those addressing mental health and well-being, physical activity, nutrition and healthy eating, and substance use were among those least commonly identified. This scan provides a comprehensive overview of HPS-relevant policies in NS, along with relative proportions and growth over time. Our findings suggest areas of policy action and inaction that may help or hinder the implementation of HPS principles and values.
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Affiliation(s)
- Anna Graham-DeMello
- Healthy Populations Institute, Dalhousie University, 1318 Robie St, P.O. Box 15000, Halifax, NS B3H 4R2, Canada; (J.Y.); (M.K.-A.); (S.F.L.K.)
- Correspondence: ; Tel.: +1-902-229-3803
| | - Joshua Yusuf
- Healthy Populations Institute, Dalhousie University, 1318 Robie St, P.O. Box 15000, Halifax, NS B3H 4R2, Canada; (J.Y.); (M.K.-A.); (S.F.L.K.)
- School of Health and Human Performance, Dalhousie University, 1318 Robie St, P.O. Box 15000, Halifax, NS B3H 4R2, Canada
| | - Margaret Kay-Arora
- Healthy Populations Institute, Dalhousie University, 1318 Robie St, P.O. Box 15000, Halifax, NS B3H 4R2, Canada; (J.Y.); (M.K.-A.); (S.F.L.K.)
| | - Camille L. Hancock Friesen
- UT Southwestern Medical Center, Children’s Medical Center Dallas, 1935 Medical District Drive, Dallas, TX 75235, USA;
| | - Sara F. L. Kirk
- Healthy Populations Institute, Dalhousie University, 1318 Robie St, P.O. Box 15000, Halifax, NS B3H 4R2, Canada; (J.Y.); (M.K.-A.); (S.F.L.K.)
- School of Health and Human Performance, Dalhousie University, 1318 Robie St, P.O. Box 15000, Halifax, NS B3H 4R2, Canada
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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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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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24
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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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25
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Webster CA, Glascoe G, Moore C, Dauenhauer B, Egan CA, Russ LB, Orendorff K, Buschmeier C. Recommendations for Administrators' Involvement in School-Based Health Promotion: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176249. [PMID: 32867355 PMCID: PMC7503319 DOI: 10.3390/ijerph17176249] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/16/2022]
Abstract
School administrator involvement is recognized as a key factor in the extent to which school health promotion programs and initiatives are successfully implemented. The aims of this scoping review are to: (a) Identify existing documents that contain recommendations regarding the involvement of school administrators in school-based health promotion; (b) distill and summarize the recommendations; (c) examine differences in the recommendations by targeted professional level, professional group, health promotion content focus, and by whether the recommendations are evidence-based or opinion-based; and (d) evaluate the research informing the recommendations. We drew upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines to conduct the review. Our team conducted a comprehensive literature search with no date or geographic restrictions from January 2018 through April 2018 using four electronic databases: Academic Search Complete, Google Scholar, Physical Education Index, and PubMed. Eligibility criteria included any online documents, in English, that contained recommendations targeting school administrators’ (e.g., principals, assistant principals, superintendents) involvement (e.g., support, endorsement, advocacy) in school health programming (e.g., physical activity, nutrition, wellness). The search yielded a total of 1225 records, which we screened by title, then by abstract, and finally by full text, resulting in 61 records that met inclusion criteria. Data (e.g., recommendations, targeted contexts, targeted administrators) from these records were extracted for a content analysis. Included records contained 80 distinct recommendations, which we summarized into three themes (Collaboration, Advocacy, and Support) using a content analysis. Separate content analyses revealed no qualitative differences in the recommendations by professional level, professional group, or content focus, or by whether the recommendations were evidence-based or opinion-based. Twenty-one of the included records were peer-reviewed research articles. Using the Mixed Methods Appraisal Tool (MMAT), we appraised qualitative research articles the highest and mixed methods research articles the lowest. This review provides a basis for future research and professional practice aiming to increase school administrators’ involvement in school-based health promotion.
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Affiliation(s)
- Collin A. Webster
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA
- Correspondence:
| | - Genee Glascoe
- Department of Educational Studies, University of South Carolina, Columbia, SC 29208, USA; (G.G.); (C.M.)
| | - Chanta Moore
- Department of Educational Studies, University of South Carolina, Columbia, SC 29208, USA; (G.G.); (C.M.)
| | - Brian Dauenhauer
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO 80639, USA; (B.D.); (C.B.)
| | - Cate A. Egan
- Department of Movement Sciences, University of Idaho, Moscow, ID 83844, USA;
| | | | - Karie Orendorff
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA;
| | - Cathy Buschmeier
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO 80639, USA; (B.D.); (C.B.)
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26
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Scott JJ, Johnston R, Blane S, Strickland M, Darby J, Gray E. Investigating primary preservice teachers' ultraviolet radiation awareness and perceived ability to teach sun safety. Health Promot J Austr 2020; 32 Suppl 2:178-184. [PMID: 32770684 PMCID: PMC8596547 DOI: 10.1002/hpja.401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 12/24/2022] Open
Abstract
Issue addressed Sun protection practices in Australian primary schools remain inconsistent. Therefore, this study investigates primary PSTs sun protective sun behaviours, ultraviolet (UV) radiation awareness and perceived ability to teach sun safety. Methods A convenience sample of undergraduate PSTs (N = 275; mean age = 23.13 years) enrolled at one Western Australian university completed an online survey. Descriptive analyses provided features of the data. Factors associated with sun protection behaviours and perceived knowledge and skill to teach sun safety were explored using multivariable logistic regression models. Results Lesser than 10% of participants reported using sun protective measures daily (midday shade use: 6.5%; sunscreen: 7.6%; hat: 4.4%). Only 56.3% reported they understand the UV index, with 68.0% rarely/never using it to aid sun protection. Under half the participants reported they felt they had the knowledge (38.5%) or skills (40%) to effectively teach sun safety in primary schools. Regression analysis revealed gender, undergraduate, year and skin sensitivity were not predictors of UV index use (P > .05) or perceived knowledge of sun safety (P > .05). Skin sensitivity was the strongest predictor for shade usage (P = .02), hat usage (P = .05) and perceived skill to teach sun safety (P = .02). Conclusions Survey data indicate UV radiation is inconsistently understood by PSTs. Many felt that they did not have the required knowledge or skill to teach sun safety effectively. So what? Improving PSTs UV radiation knowledge while at university is a potential opportunity to improve sun safety delivery in primary schools. A targeted intervention for PSTs is warranted.
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Affiliation(s)
- Joseph J Scott
- School of Education, Edith Cowan University, Joondalup, WA, Australia
| | - Robyn Johnston
- School of Education, Edith Cowan University, Joondalup, WA, Australia
| | - Sally Blane
- Cancer Council Western Australia, Subaico, WA, Australia
| | | | - Jill Darby
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Elin Gray
- Melanoma Research Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Abstract
PurposeObesity in children and adolescents is a significant public health concern. The World Health Organization Health Promoting Schools (HPS) framework promotes good nutrition and physical activity in school settings. While HPS is embraced globally, effective implementation and sustainable programmes are a continued challenge. This paper aims to report on the characteristics of current school interventions based on HPS and implementation barriers and enablers.Design/methodology/approachA literature search identified peer-reviewed studies of school health interventions reflective of the HPS framework focusing on obesity prevention. Studies from all countries were included, if conducted in primary and/or secondary schools; included a sufficient amount of qualitative implementation or process evaluation data to draw conclusions regarding key barriers and enablers to implementation; and were published in English.FindingsNine interventions (n = 9) from seven countries were included. Most were implemented in primary schools and focused on specific grade levels. Engaging parents, the home environment, teacher time constraints, fun interventions, student participation, teacher training, integration with the curriculum and stakeholder engagement all emerged as strong implementation themes. Teachers as role models, establishing community partnerships and policy support also emerged as common themes.Originality/valueFuture interventions may benefit from enhancing teacher and parent health promotion. Partnerships with initiatives focusing on environmental sustainability may simultaneously benefit human and planetary health while strengthening stakeholder engagement opportunities and consistent messaging throughout the community. More comprehensive evaluation data are needed, in particular, for long-term HPS initiatives.
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28
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Storey KE. Later school start times for supporting the education, health, and well-being of high school students. Paediatr Child Health 2020; 25:139-142. [PMID: 32296274 DOI: 10.1093/pch/pxz055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/05/2019] [Indexed: 01/27/2023] Open
Affiliation(s)
- Kate E Storey
- School of Public Health, University of Alberta, Edmonton, Alberta
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29
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Leung E, Wanner KJ, Senter L, Brown A, Middleton D. What will it take? Using an implementation research framework to identify facilitators and barriers in implementing a school-based referral system for sexual health services. BMC Health Serv Res 2020; 20:292. [PMID: 32264884 PMCID: PMC7140539 DOI: 10.1186/s12913-020-05147-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 03/24/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Across the United States, sexually transmitted infections and unintended pregnancy rates are alarmingly high among youth. Schools, due to their proximity and access to youth, can increase student access to sexual health services (SHS) by creating referral systems (RS) to link students to school- and community-based SHS. From 2013 to 2018, the Centers for Disease Control and Prevention's Division of Adolescent and School Health funded 17 Local Education Agencies (LEA) to partner with priority schools and stakeholders to develop and implement RS to increase student access to SHS. Cicatelli Associates Inc. (CAI) was funded to provide capacity-building to LEA. In 2016-2017, CAI conducted case studies at two LEA, both large and urban sites, but representing different geographical and political contexts, to elucidate factors that influence RS implementation. METHODS Nineteen LEA and community-based healthcare (CBH) staff were interviewed in the Southeastern (n = 9) and Western U.S. (n = 10). Key constructs (e.g., leadership engagement, resources, state and district policies) across the five domains of the Consolidated Framework for Implementation Research (CFIR) framework guided the methodology and analysis. Qualitative data was analyzed using the Framework Method and contextual factors and themes that led to RS implementation were identified. RESULTS Interviewees strongly believed that school-based RS can decrease STI, HIV and unintended pregnancy and increase students' educational attainment. We identified the following contextual key factors that facilitate successful implementation and integration of an RS: enforcing state and district policies, strong LEA and CBH collaboration, positive school culture towards adolescent health, knowledgeable and supportive staff, leveraging of existing resources and staffing structures, and influential district and school building-level leadership and champions. Notably, this case study challenged our initial assumptions that RS are easily implemented in states with comprehensive SHS policies. Rather, our conversations revealed how districts and local-level policies can have significant impact and influence to impede or promote those policies. CONCLUSIONS Through the use of the CFIR framework, the interviews identified important contextual factors and themes associated with LEAs' implementation barriers and facilitators. The study's results present key recommendations that other LEA can consider to optimize integration of RS-related evidence-based practices, systems, and policies in their districts.
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Affiliation(s)
- Emily Leung
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
| | - Kathryn J. Wanner
- Franklin and Marshall College, College Square 931 Harrisburg Ave. 1st Floor, Lancaster, PA 17603 USA
| | - Lindsay Senter
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
| | - Amanda Brown
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
| | - Dawn Middleton
- Cicatelli Associates, Inc. (CAI), 505 Eighth Ave. Suite 1900, New York, NY 10018 USA
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30
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Implementation of KEIGAAF in Primary Schools: A Mutual Adaptation Physical Activity and Nutrition Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030751. [PMID: 31991622 PMCID: PMC7037055 DOI: 10.3390/ijerph17030751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 01/19/2023]
Abstract
School health promotion is advocated. Implementation studies on school health promotion are less often conducted as effectiveness studies and are mainly conducted conventionally by assessing fidelity of "one size fits all" interventions. However, interventions that allow for local adaptation are more appropriate and require a different evaluation approach. We evaluated a mutual adaptation physical activity and nutrition intervention implemented in eight primary schools located in low socioeconomic neighborhoods in the Netherlands, namely the KEIGAAF intervention. A qualitative, multiple-case study design was used to evaluate implementation and contextual factors affecting implementation. We used several qualitative data collection tools and applied inductive content analysis for coding the transcribed data. Codes were linked to the domains of the Consolidated Framework for Implementation Research. NVivo was used to support data analysis. The implementation process varied greatly across schools. This was due to the high level of bottom-up design of the intervention and differing contextual factors influencing implementation, such as differing starting situations. The mutual adaptation between top-down and bottom-up influences was a key element of the intervention. Feedback loops and the health promotion advisors played a crucial role by navigating between top-down and bottom-up. Implementing a mutual adaptation intervention is time-consuming but feasible.
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Sahota P, Christian M, Day R, Cocks K. The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme. Pilot Feasibility Stud 2019; 5:152. [PMID: 31890264 PMCID: PMC6925414 DOI: 10.1186/s40814-019-0542-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 12/06/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study aims to evaluate the feasibility and acceptability of the PhunkyFoods Programme, a primary school-based intervention to promote healthy nutrition and physical activity knowledge and behaviours to assess outcomes to inform a phase 3 trial. Methods The cluster randomised feasibility trial recruited eight primary schools from the North of England. Elibility criteria included all primary schools in one town, excluding independent and special schools and schools that comprised of only key stage 2 pupils (years 3–6). Eight schools agreed to participate. Randomisation to intervention or control arms was in a 1:1 ratio. Intervention schools received PhunkyFoods over 17 months. Control schools continued with usual curriculum. Assessors were blinded to group assignment. Measures comprised of a Healthy Lifestyle Knowledge Questionnaire and Synchronised Nutrition and Activity Program to assess diet and physical activity, height, weight, and psychological wellbeing. Feasibility outcomes were recruitment, attrition rates, interviews with teaching staff, focus groups with pupils to explore the acceptability of outcome measures, implementation, intervention content, and programme fidelity. Results Three hundred fifty-eight pupils, aged 6–9 years from eight schools were recruited at baseline (control n = 170, intervention n = 188); 337 (94.1%) at 6 months (control n = 163, intervention n = 181); and 331 (92.5%) at 18 months (control n = 152, intervention n = 179), and 6 pupils opted out. Trends in increased knowledge of healthy lifestyle behaviours, healthier eating, and liking of fruit and vegetables were reported in the intervention compared to the control group. Year 4 intervention pupils had significantly higher healthy balanced diet knowledge scores compared to control pupils, mean difference 5.1 (95% CI 0.1 to 10.1, p=0.05). At 18 months, the mean percentage of vegetables liked was higher (intervention 53.9% vs. 43.0% control). Similarly, percentage of fruits liked was also higher (intervention 76.9% vs. 67.2% control). Qualitative data showed that delivery of the intervention was feasible and acceptable to teachers and pupils. Lessons were learned to inform the phase 3 trial around the dietary assessment measure and timing of recruitment. Conclusions Whilst the study was not powered to detect a definitive effect, results suggest a potential to increase knowledge of healthy lifestyle behaviours and dietary behaviours, suggesting that with minor changes, a phase 3 trial is likely to be deliverable. Trial registration ISRCTN, ISRCTN15641330. Registered 8 May 2015—retrospectively registered, 10.1186/ISRCTN15641330
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Affiliation(s)
- Pinki Sahota
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
| | - Meaghan Christian
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
| | - Rhiannon Day
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
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Lee JA, Welk GJ. Association Between Comprehensive School Physical Activity Program Implementation and Principal Support. Health Promot Pract 2019; 22:257-265. [PMID: 31315464 DOI: 10.1177/1524839919862767] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of Comprehensive School Physical Activity Program (CSPAP) has been recommended to help students achieve 60-minutes of physical activity each day. Implementing a CSPAP requires planning, coordination, and ongoing oversight, but an understudied factor is how principal support influences CSPAP implementation. The purpose of this study was to evaluate the impact of principal support on CSPAP implementation. Method. Schools in the Iowa FitnessGram Initiative (n = 84), a participatory network of schools committed to supporting physical education and wellness efforts, were invited to participate in the study. Physical education teachers from 42 schools completed a survey assessing CSPAP implementation and principal support for school wellness. Descriptive statistics and correlation analyses were used to report associations between the variables. A regression analysis was conducted to evaluate the impact of principal support on CSPAP implementation. Results. Almost half of the schools were reported to be fully implementing just one CSPAP component and no school was reported to be fully implementing all five. The CSPAP component with the highest reported level of implementation was quality physical education, while the lowest level of implementation was reported for family and community engagement and staff involvement. The regression analysis identified that principal support was a significant predictor of CSPAP implementation, b = 0.55, t(37) = 3.10, p < .004. Conclusions. Principal support is associated with implementation of CSPAP initiatives. Strategies that focus on how to attain principal support for CSPAP initiatives are needed and could have a significant impact on student physical activity and health.
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Affiliation(s)
- Joey A Lee
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
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McKernan C, Montemurro G, Chahal H, Veugelers PJ, Gleddie D, Storey KE. Translation of school-learned health behaviours into the home: student insights through photovoice. Canadian Journal of Public Health 2019; 110:821-830. [PMID: 31309443 DOI: 10.17269/s41997-019-00232-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 04/22/2019] [Accepted: 05/23/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Sedentary behaviours, physical inactivity, and poor diets in Canadian children are a major public health problem. Comprehensive school health (CSH) recognizes the importance of school and home collaboration; however, it is unknown how health behaviours promoted in school are adopted at home. The purpose of this research was to explore student perceptions of the translation of an intervention taking a CSH approach in Alberta, Canada, into the home environment. METHODS The guiding method was focused ethnography, using photovoice as the data generation strategy. Grades 5 and 6 students were purposively sampled (n = 25), and asked to take photos of what CSH looks like in their home environment. Subsequent one-on-one interviews were conducted as part of the photovoice process to gain a deeper understanding of student perceptions. RESULTS Two main themes emerged: students embraced the CSH philosophy, and students are driving change to create a healthy home culture. The underlying concept of leadership and independence was necessary for students to impact their health and the health of family members. Results demonstrated that students are catalyzing positive changes in the home environment by supporting changes in the home food environment, trying new things, facilitating improvements to healthy eating and active living, and monitoring unhealthy behaviours. CONCLUSION This study illustrates students' abilities to positively impact the home environment as a result of their involvement in CSH. Student leadership and independence should be promoted and emphasized in CSH to facilitate transition of health behaviours into the home environment.
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Affiliation(s)
- Christine McKernan
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Harneet Chahal
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Douglas Gleddie
- Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
| | - Kate E Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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Exploring the Relationship between School Gardens, Food Literacy and Mental Well-Being in Youths Using Photovoice. Nutrients 2019; 11:nu11061354. [PMID: 31208121 PMCID: PMC6627079 DOI: 10.3390/nu11061354] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/28/2019] [Accepted: 06/11/2019] [Indexed: 11/28/2022] Open
Abstract
The goal of the project was to gain an understanding of the relationships between secondary school youth experiences in school gardens and their mental well-being. Over the course of five months, sixteen youths participated in a photovoice research project in which they expressed their personal experiences about food and gardening through photography and writing. The aspects of secondary school youths’ life experiences affected by exposure to school gardens and their impact upon their well-being were identified. The youth explicitly associated relaxation with the themes of love and connectedness, growing food, garden as a place, cooking, and food choices. They were able to demonstrate and develop food literacy competency because of their engagement with the gardening and cooking activities. Youth clubs or groups were identified as a key enabler for connection with other youth and adults. Youth shared their food literacy experiences, observing that their engagement improved some aspect of their mental well-being. Through the photovoice process, the youth identified how their involvement in green spaces enabled connections with others, and highlighted aspects of personal health and personal growth, all of which contribute to their mental well-being.
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Woodruff SJ. Fruit and Vegetable Intake and Preferences Associated with the Northern Fruit and Vegetable Program (2014–2016). CAN J DIET PRACT RES 2019; 80:72-78. [DOI: 10.3148/cjdpr-2018-042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To examine overall usual fruit and vegetable (FV) intake and preferences among grade 5–8 students participating in the Northern Fruit and Vegetable Program (NFVP) over 3 years (2014–2016). Methods: In each year, a survey was administered 4 months into the NFVP in Northern Ontario, Canada. Results: A total of 4744 students participated (2014 = 1551; 2015 = 1617; 2016 = 1576). Overall usual FV intake did not change over the 3 years, yet preferences generally increased. FVs offered by the NFVP were rated higher on preference than those not offered (fruit P < 0.001; vegetables P < 0.005). In each year, participants were more likely to consume a higher overall usual fruit intake if they had higher preference for fruit as offered by the NFVP (all P < 0.05) as opposed to not offered by the NFVP (all P > 0.05). For vegetables, participants were more likely to consume higher overall usual vegetables if they had a higher preference for vegetables as offered (all P < 0.05) and not offered by the NFVP (all P < 0.05). Conclusions: This study documented that higher preferences for fruit (as offered) and vegetables (as offered and not offered) were associated with higher overall usual FV intakes within each of the 3 years.
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Affiliation(s)
- Sarah J. Woodruff
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, ON
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, ON
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36
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Gillies C, Farmer A, Maximova K, Willows ND. First Nations students' perceptions of school nutrition policy implementation: A mixed methods study. Nutr Diet 2018; 75:533-540. [PMID: 30537052 DOI: 10.1111/1747-0080.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/28/2022]
Abstract
AIM School nutrition policies can improve healthy food access for Indigenous First Nations children in Canada. This study explored First Nations students' perceptions of a school nutrition policy. METHODS The research was a process evaluation of school nutrition policy implementation using a mixed-methods design. Students in grades 4-12 (n = 94) completed a 17-question survey to capture their perceptions of the policy. Survey data informed an 11-question semi-structured interview guide. Transcripts from interviews with students (n = 20) were analysed using content analysis to identify barriers and facilitators to policy implementation. RESULTS Key facilitating factors to policy implementation were student support for the policy and taste preferences. Most students (87%) agreed that only healthy foods should be served at school and, in interviews, expressed a preference for healthy food choices. Barriers to policy implementation included foods available at school and lack of communication between students and their teachers and parents. Half (50%) of surveyed students reported that their eating habits at school were average; interviews explained that their diets could be improved by consuming more fruit and vegetables at school. Both surveys and interviews found that communication between students and their parents and teachers about what they ate and drank at school was low. CONCLUSIONS To support children's healthy eating at school, the school nutrition policy could provide clear guidelines on foods permissible in the school, while considering social and environmental barriers to healthy eating. The involvement of First Nations children in the implementation and evaluation of school nutrition policies is recommended.
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Affiliation(s)
- Christina Gillies
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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- Alexander First Nation Education, Morinville, Alberta, Canada
| | - Anna Farmer
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Katerina Maximova
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Noreen D Willows
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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37
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Green AE, Willging CE, Ramos MM, Shattuck D, Gunderson L. Factors Impacting Implementation of Evidence-Based Strategies to Create Safe and Supportive Schools for Sexual and Gender Minority Students. J Adolesc Health 2018; 63:643-648. [PMID: 30205932 PMCID: PMC6289584 DOI: 10.1016/j.jadohealth.2018.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/01/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The Centers for Disease Control and Prevention recommends six evidence-based strategies to improve safety and support for sexual and gender minority (SGM) youth in U.S. schools. However, only a small minority of schools implement all strategies. This study draws on implementation science to assess contextual challenges to strategy implementation. METHODS Semistructured interviews were conducted with at least two stakeholders at each of 42 high schools in New Mexico. Interviews consisted of open-ended questions centered on attitudes toward, access to, and availability of school and community supports for SGM youth, school policies, and practices, and organizational factors believed to impact implementation. Transcripts were imported into NVivo 11 for iterative coding and qualitative analysis. RESULTS We identified eleven overarching sets of factors related to the preparedness of schools to implement the evidence-based strategies: (1) political climate; (2) community context; (3) community resources; (4) policies and practices; (5) staff knowledge and exposure to SGM issues; (6) training deficits; (7) prevalence of neutrality discourses suggesting SGM students should not be singled out for "special treatment" or intervention; (8) student attitudes and support; (9) de facto safe spaces; (10) health education curricula; and (11) pragmatic considerations, such as time, staff turnover, and workloads. Key factors believed to hinder implementation included lack of resources, staffing concerns, and knowledge deficits. CONCLUSIONS These results can be used to inform the development of implementation strategies to modify school health systems from within to best support evidence-based practices for SGM youth and other stigmatized populations.
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Affiliation(s)
- Amy E Green
- Department of Psychiatry, University of California, La Jolla, California; Child and Adolescent Services Research Center, San Diego, California.
| | - Cathleen E Willging
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Mary M Ramos
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico, USA
| | - Daniel Shattuck
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Lara Gunderson
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
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38
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Verjans-Janssen SRB, Van Kann DHH, Gerards SMPL, Vos SB, Jansen MWJ, Kremers SPJ. Study protocol of the quasi-experimental evaluation of "KEIGAAF": a context-based physical activity and nutrition intervention for primary school children. BMC Public Health 2018; 18:842. [PMID: 29980235 PMCID: PMC6035437 DOI: 10.1186/s12889-018-5764-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background The environment affects children’s energy balance-related behaviors to a considerable extent. A context-based physical activity and nutrition school- and family-based intervention, named KEIGAAF, is being implemented in low socio-economic neighborhoods in Eindhoven, The Netherlands. The aim of this study was to investigate: 1) the effectiveness of the KEIGAAF intervention on BMI z-score, waist circumference, physical activity, sedentary behavior, nutrition behavior, and physical fitness of primary school children, and 2) the process related to the implementation of the intervention. Methods A quasi-experimental, controlled study with eight intervention schools and three control schools was conducted. The KEIGAAF intervention consists of a combined top-down and bottom-up school intervention: a steering committee developed the general KEIGAAF principles (top-down), and in accordance with these principles, KEIGAAF working groups subsequently develop and implement the intervention in their local context (bottom-up). Parents are also invited to participate in a family-based parenting program, i.e., Triple P Lifestyle. Children aged 7 to 10 years old (grades 4 to 6 in the Netherlands) are included in the study. Effect evaluation data is collected at baseline, after one year, and after two years by using a child questionnaire, accelerometers, anthropometry, a physical fitness test, and a parent questionnaire. A mixed methods approach is applied for the process evaluation: quantitative (checklists, questionnaires) and qualitative methods (observations, interviews) are used. To analyze intervention effectiveness, multilevel regression analyses will be conducted. Content analyses will be conducted on the qualitative process data. Discussion Two important environmental settings, the school environment and the family environment, are simultaneously targeted in the KEIGAAF intervention. The combined top-down and bottom-up approach is expected to make the intervention an effective and sustainable version of the Health Promoting Schools framework. An elaborate process evaluation will be conducted alongside an effect evaluation in which multiple data collection sources (both qualitative and quantitative) are used. Trial registration Dutch Trial Register NTR6716 (registration date 27/06/2017, retrospectively registered), METC163027, NL58554.068.16, Fonds NutsOhra project number 101.253. Electronic supplementary material The online version of this article (10.1186/s12889-018-5764-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S R B Verjans-Janssen
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, The Netherlands.
| | - Dave H H Van Kann
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Sanne M P L Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, The Netherlands
| | - Steven B Vos
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health, Public Health Service South-Limburg, Heerlen, The Netherlands.,Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, The Netherlands
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39
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Affiliation(s)
- Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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40
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Leeman J, Wiecha JL, Vu M, Blitstein JL, Allgood S, Lee S, Merlo C. School health implementation tools: a mixed methods evaluation of factors influencing their use. Implement Sci 2018; 13:48. [PMID: 29558964 PMCID: PMC5859635 DOI: 10.1186/s13012-018-0738-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/09/2018] [Indexed: 12/21/2022] Open
Abstract
Background The U.S. Centers for Disease Control and Prevention (CDC) develops tools to support implementation of evidence-based interventions for school health. To advance understanding of factors influencing the use of these implementation tools, we conducted an evaluation of state, school district, and local school staffs’ use of four CDC tools to support implementation of physical activity, nutrition, health education, and parent engagement. Two frameworks guided the evaluation: Interactive Systems Framework (ISF) for Dissemination and Implementation and Consolidated Framework for Implementation Research (CFIR). Methods The evaluation applied a mixed methods, cross-sectional design that included online surveys (n = 69 state staff from 43 states), phone interviews (n = 13 state staff from 6 states), and in-person interviews (n = 90 district and school staff from 8 districts in 5 states). Descriptive analyses were applied to surveys and content analysis to interviews. Results The survey found that the majority of state staff surveyed was aware of three of the CDC tools but most were knowledgeable and confident in their ability to use only two. These same two tools were the ones for which states were most likely to have provided training and technical assistance in the past year. Interviews provided insight into how tools were used and why use varied, with themes organized within the ISF domain “support strategies” (e.g., training, technical assistance) and four CFIR domains: (1) characteristics of tools, (2) inner setting, (3) outer setting, and (4) individuals. Overall, tools were valued for the credibility of their source (CDC) and evidence strength and quality. Respondents reported that tools were too complex for use by school staff. However, if tools were adaptable and compatible with inner and outer setting factors, state and district staff were willing and able to adapt tools for school use. Conclusions Implementation tools are essential to supporting broad-scale implementation of evidence-based interventions. This study illustrates how CFIR and ISF might be applied to evaluate factors influencing tools’ use and provides recommendations for designing tools to fit within the multi-tiered systems involved in promoting, supporting, and implementing evidence-based interventions in schools. Findings have relevance for the design of implementation tools for use by other multi-tiered systems.
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Affiliation(s)
- Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | | | - Maihan Vu
- Center for Health Promotion & Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | - Sallie Allgood
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Sarah Lee
- Division of Population Health, School Health Branch, Centers for Disease Control and Prevention, Atlanta, USA
| | - Caitlin Merlo
- Division of Population Health, School Health Branch, Centers for Disease Control and Prevention, Atlanta, USA
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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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Ramos Salas X, Alberga AS, Cameron E, Estey L, Forhan M, Kirk SFL, Russell-Mayhew S, Sharma AM. Addressing weight bias and discrimination: moving beyond raising awareness to creating change. Obes Rev 2017; 18:1323-1335. [PMID: 28994243 DOI: 10.1111/obr.12592] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/18/2017] [Accepted: 06/26/2017] [Indexed: 01/05/2023]
Abstract
Weight discrimination is the unjust treatment of individuals because of their weight. There have been very few interventions to address weight discrimination, due in part to the lack of consensus on key messages and strategies. The objective of the third Canadian Weight Bias Summit was to review current evidence and move towards consensus on key weight bias and obesity discrimination reduction messages and strategies. Using a modified brokered dialogue approach, participants, including researchers, health professionals, policy makers and people living with obesity, reviewed the evidence and moved towards consensus on key messages and strategies for future interventions. Participants agreed to these key messages: (1) Weight bias and obesity discrimination should not be tolerated in education, health care and public policy sectors; (2) obesity should be recognized and treated as a chronic disease in health care and policy sectors; and (3) in the education sector, weight and health need to be decoupled. Consensus on future strategies included (1) creating resources to support policy makers, (2) using personal narratives from people living with obesity to engage audiences and communicate anti-discrimination messages and (3) developing a better clinical definition for obesity. Messages and strategies should be implemented and evaluated using consistent theoretical frameworks and methodologies.
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Affiliation(s)
- X Ramos Salas
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Canadian Obesity Network, Edmonton, Alberta, Canada
| | - A S Alberga
- University of Calgary, Calgary, Alberta, Canada.,Department of Exercise Science, Concordia University, Montreal, Quebec, Canada
| | - E Cameron
- School of Human Kinetics and Recreation, Memorial University, St. John's, Newfoundland, Canada
| | - L Estey
- Canadian Obesity Network, Edmonton, Alberta, Canada
| | - M Forhan
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - S F L Kirk
- Dalhousie University, IWK Health Centre and Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - S Russell-Mayhew
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - A M Sharma
- Canadian Obesity Network, Edmonton, Alberta, Canada.,Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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