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Wiklund E, Vikman J, Wiklund M, Hedenborg S. Facilitators and barriers in interprofessional collaboration around physical activity on prescription-a focus group study in a Swedish school setting. Front Sports Act Living 2024; 6:1431786. [PMID: 39086852 PMCID: PMC11288834 DOI: 10.3389/fspor.2024.1431786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 07/04/2024] [Indexed: 08/02/2024] Open
Abstract
In Swedish school health services, local initiatives have been taken to use physical activity on prescription (PAP) to encourage physically inactive children to become more active. Previous research shows that interprofessional collaboration plays a crucial role in promoting physical activity in children, as well as in promoting health in schools. However, there is a lack of knowledge about PAP for children in the school setting, including how medical and educational staff can work together to encourage children who have been recommended PAP. Therefore, this study aims to explore the perceived facilitators and barriers concerning interprofessional collaboration regarding physical activity on prescription in the school setting, as viewed from the professionals' perspectives. Semi-structured interviews were conducted with 21 professionals who work with the method in school settings. The data were analyzed using Reflexive Thematic Analysis. The results reveal both barriers and facilitators for interprofessional collaboration on PAP in the school setting, as perceived by professionals. Organizational and structural obstacles within school institutions hinder collaboration, while a shared commitment to PAP, characterized by consensus-building, acts as a facilitating factor. PAP for children in a school setting is still an unexplored area and further research is required.
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Affiliation(s)
- Emelie Wiklund
- Department of Sports Sciences, Malmö University, Malmö, Sweden
| | - Jenny Vikman
- Department of Sports Sciences, Malmö University, Malmö, Sweden
| | - Maria Wiklund
- Physiotherapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Willow SA, Strnadová I, Danker J. Developing the self-determination of children and young people with intellectual disabilities in schools: A systematic review of the literature. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13247. [PMID: 38797718 DOI: 10.1111/jar.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Self-determination is associated with lifelong positive outcomes. Students with intellectual disabilities typically have lower self-determination than their peers. Universal basic education access offers schools the opportunity to rectify this disparity. This is the first systematic review investigating the school-based practices that target self-determination development for students with intellectual disabilities. METHOD The review follows the PRISMA guidelines, spanning five databases (ProQuest databases, EMBASE, Scopus, Sage Journals, Taylor and Francis Online) from 2006 to 2021. RESULTS Across the 18 studies, the most used practice is the SDLMI. Research focuses on United States-based transition-aged students with mild to moderate intellectual disabilities. Social validity tends to be assessed in summative and informal ways. Students are not generally involved in decision-making about practices and individualisation of support. CONCLUSIONS Self-determination development for this population can begin before puberty. Future research should critically investigate social validity and holistic integration of student self-determination learning opportunities throughout the pedagogical cycle.
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Affiliation(s)
- Sierra Angelina Willow
- School of Education, Faculty of Arts, Design and Architecture, UNSW, Sydney, New South Wales, Australia
| | - Iva Strnadová
- School of Education, Faculty of Arts, Design and Architecture, UNSW, Sydney, New South Wales, Australia
- Disability Innovation Institute, UNSW, Sydney, New South Wales, Australia
| | - Joanne Danker
- School of Education, Faculty of Arts, Design and Architecture, UNSW, Sydney, New South Wales, Australia
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Takens FE, Indyk I, Chinapaw MJM, Ujčič-Voortman JK, van Nassau F, Busch V. Qualitative multi-stakeholder evaluation of the adoption, implementation and sustainment of the school-based dietary intervention "Jump-in". BMC Public Health 2024; 24:1337. [PMID: 38760727 PMCID: PMC11102190 DOI: 10.1186/s12889-024-18814-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Comprehensive school-based programs applying the WHO Health Promoting School Model have the potential to initiate and sustain behavior change and impact health. However, since they often include intervention efforts on a school's policies, physical environment, curriculum, health care and involving parents and communities, they significantly 'intrude' on a complex system that is aimed primarily at education, not health promotion. More insights into and concrete strategies are therefore needed regarding their adoption, implementation, and sustainment processes to address the challenge to sustainable implementation of HPS initiatives in a primarily educational setting. This study consequently evaluates adoption, implementation and sustainment processes of Amsterdam's Jump-in healthy nutrition HPS intervention from a multi-stakeholder perspective. METHODS We conducted semi-structured interviews and focus groups with all involved stakeholders (n = 131), i.e., Jump-in health promotion professionals (n = 5), school principals (n = 7), at-school Jump-in coordinators (n = 7), teachers (n = 20), parents (n = 50, 9 groups) and children (n = 42, 7 groups) from 10 primary schools that enrolled in Jump-in in the school year 2016-2017. Included schools had a higher prevalence of overweight and/or obesity than the Dutch average and they were all located in Amsterdam's low-SEP neighborhoods. Data were analyzed using a directed content analysis, in which the Determinants of Innovation Model was used for obtaining theory-based predetermined codes, supplemented with new codes emerging from the data. RESULTS During intervention adoption, all stakeholders emphasized the importance of parental support, and accompanying workshops and promotional materials. Additionally, parents and teachers indicated that a shared responsibility for children's health and nuanced framing of health messages were important. During implementation, all stakeholders needed clear guidelines and support structures. Teachers and children highlighted the importance of peer influence, social norms, and uniform application of guidelines. School staff also found further tailoring of the intervention and dealing with financial constraints important. For long-term intervention sustainment, incorporating the intervention policies into the school statutes was crucial according to health promotion professionals. CONCLUSIONS This qualitative evaluation provides valuable insights into factors influencing the adoption, implementation, and sustainment processes of dietary interventions, such as the importance of transparent and consistent intervention guidelines, clear communication regarding the rationale behind intervention guidelines, and, stakeholders' involvement in decision-making.
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Affiliation(s)
- Froukje E Takens
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands.
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Indira Indyk
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Joanne K Ujčič-Voortman
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Vincent Busch
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
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Vaughan KL, Cade JE, Hetherington MM, Webster J, Evans CEL. The impact of school-based cooking classes on vegetable intake, cooking skills and food literacy of children aged 4-12 years: A systematic review of the evidence 2001-2021. Appetite 2024; 195:107238. [PMID: 38331100 DOI: 10.1016/j.appet.2024.107238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Many children consume a poor quality diet with only a third of children aged 6-9 years eating vegetables daily. A high quality diet is important for good health in childhood; however, the prevalence of children living with obesity has doubled from 10% to 23% during primary school in the UK. Cooking lessons have the potential to improve diet quality and reduce obesity prevalence in childhood, both of which are associated with improved cardiometabolic outcomes in adulthood. The aim of this systematic review is to investigate the impact of school-based cooking classes on cooking skills, food literacy and vegetable intake of children aged 4-12 years. METHODS We conducted a systematic review of OVID Medline, OVID Embase, EBSCO CINHAL and EBSCO ERIC for comparative studies that evaluated outcomes of children receiving cooking classes compared to a control group. Interventions included contained food preparation or a cooking activities and took place on school premises. Risk of bias was assessed using ROB2 and Robins-I. Outcomes were pooled in a meta-analysis using a random-effects model using standardised mean differences or reviewed using narrative synthesis. Certainty of evidence was assessed using GRADE. RESULTS We included 21 studies, (6 randomised). Meta-analysis showed a small positive effect on cooking self-efficacy of 0.39 units (95% CI 0.05 to 0.54), and a small positive effect on vegetable intake of 0.25 units (95% CI 0.05 to 0.45). Programmes with more than 6 h of cooking showed the greatest effects. CONCLUSIONS Children's cooking programmes result in small improvements in cooking efficacy and vegetable intake, particularly those with more than 6 h of classes. It is recommended that future interventions use consistent measurement for children's food literacy and cooking confidence.
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Craig DW, Walker TJ, Sharma SV, Cuccaro P, Heredia NI, Pavlovic A, DeFina LF, Kohl HW, Fernandez ME. Examining associations between school-level determinants and the implementation of physical activity opportunities. Transl Behav Med 2024; 14:89-97. [PMID: 37713255 PMCID: PMC10849171 DOI: 10.1093/tbm/ibad055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
School-based physical activity (PA) opportunities can help students engage in greater amounts of daily PA, meet PA guidelines, and lead to improved health and educational outcomes. However, we do not completely understand the organizational challenges to implementing these opportunities successfully. This exploratory study examined associations between school-level determinants and the implementation of school-based PA opportunities. We analyzed cross-sectional survey data from schools (n = 46) participating in the Healthy Zone School Program (HZSP) (Dallas, Texas, USA) during 2019-2020. Respondents completed an electronic survey that included measures of school-level determinants (e.g. culture, leadership, priority) and the implementation of school-based PA opportunities. We used linear regression models to examine associations between determinants and implementation outcomes (number of PA opportunities delivered, perceived overall success of each PA program/activity used). After adjusting for campus type (i.e. elementary, middle, high, K-12), student race/ethnicity, and percentage of economically disadvantaged students, no constructs were associated with the number of PA opportunities implemented. Linear regression models suggest access to knowledge and information (β = 0.39, P = .012, 95% CI = 0.24-1.44) and implementation climate (β = 0.34, P = .045, 95% CI = 0.02-1.59) were positively associated with the success of school-based PA opportunities. Our findings provide suggestive evidence that access to knowledge and information and a supportive school climate may improve the overall success of PA opportunities provided to students. Future research should examine additional school-level determinants to understand their importance to implementation and inform the development of strategies to improve schools' capacity for implementing PA opportunities successfully.
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Affiliation(s)
- Derek W Craig
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Timothy J Walker
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Natalia I Heredia
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
| | - Andjelka Pavlovic
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA
| | - Laura F DeFina
- Division of Youth Education, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230, USA
| | - Harold W Kohl
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Boulevard, Austin, TX 78712, USA
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, 1616 Guadalupe Street, Austin, TX 78701USA
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX 77030,USA
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Donin AS, Goldsmith LP, Sharp C, Wahlich C, Whincup PH, Ussher MH. Identifying barriers and facilitators to increase fibre intakes in UK primary school children and exploring the acceptability of intervention components: a UK qualitative study. Public Health Nutr 2024; 27:e59. [PMID: 38299336 PMCID: PMC10897578 DOI: 10.1017/s1368980024000089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/01/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVE Within the UK, dietary fibre intakes are well below recommended intakes and associated with increased risk of obesity. This study aimed to explore the views of parents and children on barriers and facilitators to increasing fibre intakes and improving diets, alongside investigating the appropriateness of intervention components to overcome modifiable barriers. DESIGN Qualitative study including semi-structured interviews and focus groups informed by the Theoretical Domains Framework (TDF) and the Capability-Opportunity-Motivation-Behaviour (COM-B) model. PARTICIPANTS Year 5 children (aged 9-10-years) and parents, recruited through London primary schools. RESULTS A total of twenty-four participants (eleven parents and thirteen children) took part. Five key themes were identified as barriers and facilitators, namely lack of (and improving) knowledge, social factors (including parent-child conflicts, limited time for food preparation, influence of peer and family members), current eating habits, influence of the school, community and home environment in shaping eating behaviours, and the importance of choice and variety in finding foods that are healthy and tasty. Parents strongly supported school-based dietary interventions to enable consistent messaging at home and school and help support dietary behaviour change. Practical sessions (such as workshops to strengthen knowledge, taste tests and food swap ideas) were supported by parents and children. CONCLUSIONS By using a theory-driven approach to explore the barriers and facilitators to increasing fibre intake, this research identified important themes and modifiable barriers to behaviour change and identifies acceptable intervention components to overcome barriers and bring about sustained dietary behaviour change in primary school children.
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Affiliation(s)
- Angela S Donin
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Lucy P Goldsmith
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Clare Sharp
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, UK
| | - Charlotte Wahlich
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Peter H Whincup
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
| | - Michael H Ussher
- Population Health Research Institute, St George’s, University of London, LondonSW17 0RE, England, UK
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, UK
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Wilcox H, Bishop S, Francis B, Lombard K, Beresford SAA, Ornelas IJ. Process evaluation of the Yéego! Program to increase healthy eating and gardening among American Indian elementary school children. BMC Public Health 2024; 24:232. [PMID: 38243203 PMCID: PMC10797868 DOI: 10.1186/s12889-024-17689-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/06/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND American Indian children are at increased risk for obesity and diabetes. School-based health promotion interventions are one approach to promoting healthy behaviors to reduce this risk, yet few studies have described their implementation and fidelity. We conducted a qualitative process evaluation of the Yéego! Healthy Eating and Gardening Program, a school-based intervention to promote healthy eating among Navajo elementary school children. The intervention included a yearlong integrated curriculum, as well as the construction and maintenance of a school-based garden. METHODS Our process evaluation included fidelity checklists completed by program staff and qualitative interviews with program staff and classroom teachers after the intervention was implemented. We used content analysis to identify themes. RESULTS We identified several themes related to evidence of delivery adherence, program satisfaction, and lessons learned about delivery. Intervention staff followed similar procedures to prepare for and deliver lessons, but timing, teaching styles, and school-level factors also impacted overall implementation fidelity. Teachers and students had positive perceptions of the program, especially lessons that were highly visual, experiential, and connected to Navajo culture and the surrounding community. Teachers and program staff identified ways to enhance the usability of the curriculum by narrowing the scope, relating content to student experiences, and aligning content with school curriculum standards. CONCLUSIONS The program was implemented with moderately high fidelity across contexts. We identified areas where modifications could improve engagement, acceptability, efficacy, and sustainability of the program. Our results have implications for the evaluation and dissemination of school-based health interventions to promote healthy eating among children, especially in American Indian communities.
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Affiliation(s)
- Heather Wilcox
- University of Washington, Box 351621, Seattle, WA, 98195, USA
| | - Sonia Bishop
- Fred Hutchinson Cancer Research Center, Seattle, USA
| | | | | | | | - India J Ornelas
- University of Washington, Box 351621, Seattle, WA, 98195, USA.
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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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Manzano-Sánchez D. Profile analysis through self-determination theory and intention to be physically active: differences according to gender and age. Front Psychol 2023; 14:1277532. [PMID: 37854139 PMCID: PMC10580080 DOI: 10.3389/fpsyg.2023.1277532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Physical Education in the current education system has various objectives,including educating students on the values of physical activity and increasing the physical activity levels of students. Objective The purpose of the present study is to analyze the motivational profiles of students, to understand which profiles have higher levels of responsibility, satisfaction of autonomy, competence, and social relationship needs; intention to be physically active; and perception of autonomy support. Methods A total of 752 students from Primary, Secondary, and Non-compulsory Education (M = 13.809; SD = 1.984, 47.9% boys and 52.1% girls), from different educational centers in Spain, participated in the study, to whom a series of questionnaires were administered to find out their values of the mentioned variables. The results established the existence of four profiles: "high quality," "low quality," "high quantity," and "low quantity" of motivation. Results The results reflect that the students of the "high quality" and "high quantity" profiles had higher values in all the variables in relation to the other two groups (except in amotivation and external regulation), discussing the differential analysis between the four groups. The group with the best results was the "high quantity" profile, as opposed to the "low quantity" profile. In turn, no differences were found according to gender, but according to the educational stage, the Primary Education stage was more related to the more self-determined profiles. Discussion and conclusion Therefore, it is necessary to look for more self-determined motivational profiles from an early age in order to improve levels of responsibility, perception of autonomy, satisfaction of basic psychological needs, and the intention to be physically active.
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Gallagher AL, Murphy R, Eochaidh CN, Fitzgerald J, Murphy CA, Law J. Implementation Science in School-Based, Universal-Level Intervention Research: A Scoping Review. Lang Speech Hear Serv Sch 2023; 54:1173-1194. [PMID: 37707419 DOI: 10.1044/2023_lshss-22-00181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
PURPOSE The aim of this study was to map the use of implementation science frameworks, models, and theories in intervention research targeting learning needs in the classroom. METHOD A scoping review was conducted. Electronic database and manual searches were conducted. Two reviewers independently completed screening, data extraction, and quality appraisal. Qualitative content analysis was undertaken using Nilsen's taxonomy and the domains of the Consolidated Framework for Implementation Research (CFIR). The data were further analyzed using the CFIR valence and strength rating scales. RESULTS Included papers (n = 22) used a diverse sample of implementation science frameworks and models. Most studies used determinant frameworks to guide data collection and analysis. Few studies used implementation science theory. Most studies were mixed methods (n = 11), published since 2019 (n = 20), and conducted in North America (n = 15). Over half of the interventions targeted social, emotional, and mental health (n = 13). A complex interplay of inner setting factors was identified as having a strong influence on implementation. Teachers' knowledge and beliefs, adaptability, and complexity of interventions were also identified as important considerations when conducting research in this context. CONCLUSIONS Early engagement with stakeholders in education is recommended when designing universal level speech, language, and communication interventions for use in the ordinary classroom. Adaptive, hybrid designs that test both implementation strategies and effectiveness of interventions may be warranted given the influence of inner setting factors on implementation outcomes.
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Affiliation(s)
- Aoife L Gallagher
- Health Research Institute, University of Limerick, Ireland
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | - Rachel Murphy
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | - Ciara Ni Eochaidh
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | | | - Carol-Anne Murphy
- Health Research Institute, University of Limerick, Ireland
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Ireland
| | - James Law
- Department of Speech Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Lekše R, Godec D, Prosen M. Determining the Impact of Lifestyle on the Health of Primary School Children in Slovenia Through Mixed Membership Focus Groups. J Community Health 2023; 48:857-869. [PMID: 37160527 PMCID: PMC10169174 DOI: 10.1007/s10900-023-01231-7] [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] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
Lifestyle choices made by children and adolescents can lead to a variety of health problems. It is therefore crucial to evaluate the state health-related lifestyles of primary school children's and identify areas for improvement. The aim of this study was to investigate the experiences and perspectives of those involved in educating current generations of primary school children about their lifestyle and the associated health implications of their behavior. Four focus groups were formed, comprising parents, primary school teachers, health professionals, and leisure activity teachers, with five participants in each group. Semi-structured interviews were conducted with each group as part of the qualitative research paradigm of the study. The study revealed three central themes, emphasizing the need to promote health and educate children about healthy behaviors, environmental influences, and health literacy. Community nurses need to take a proactive role in promoting school health. Although adults, peers, and the environment exert a strong influence on children's lifestyles, they often fail to live up to their responsibilities and allow harmful habits to form. To instill positive behaviors and an optimistic attitude towards a healthy lifestyle, all those involved in a child's education need to collaborate. Health-related topics should be included or reinforced in primary school curricula, and parents and school staff should receive appropriate training.
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Affiliation(s)
- Rebeka Lekše
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Polje 42, Izola, 6310 Slovenia
| | - Dijana Godec
- Health Promotion Centre, Gregorčičeva cesta 8, Ilirska Bistrica, 6250 Slovenia
| | - Mirko Prosen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Polje 42, Izola, 6310 Slovenia
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Almas A, Iqbal R, Ghani A, Samad Z, Sabir S, Kazmi K. School Health Education Program in Pakistan (SHEPP): findings from a feasibility trial in pre-adolescent school children from a lower middle-income country. Pilot Feasibility Stud 2023; 9:123. [PMID: 37461089 PMCID: PMC10351151 DOI: 10.1186/s40814-023-01344-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The school environment plays an essential role in promoting health education and physical activity for children and adolescents. We aim to assess the feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors including blood pressure, body mass index (BMI), and waist circumference. METHODS The SHEPP was a parallel group feasibility intervention trial conducted in two schools over 23 months. All children aged 9-11 years enrolled in the schools were included. The SHEPP intervention comprised of health education on healthy lifestyle and physical activity sessions for children, training of teachers, and awareness sessions for parents conducted over 10 months. One school received the intervention of SHEPP while the other school continued routine activity. The primary outcome was the feasibility of SHEPP in terms of recruitment, retention, and treatment fidelity. Secondary outcomes were physical activity levels, dietary intake (of fruits and vegetables), and cardiometabolic risk factors (blood pressure, BMI, and waist circumference (WC)). RESULTS A total of 1280 preadolescent children were assessed for eligibility and 1191 were found eligible. The overall recruitment n (%) was 982/1191(82.5%) with 505(51.4) from SHEPP intervention school and 477(48.6) in routine activity school. The overall retention rate n (%) at 10-month follow-up was 912/982(92.8), with 465/505(92) in SHEPP intervention school and 447/477(93.7) in routine activity school. In treatment fidelity, 132/144(92) %). Physical activity sessions and all (100%) health education sessions were conducted for each of the twelve classes. Mean (SD) Seven-day Physical activity increased by 134 (196) min in the SHEPP intervention school v 29.8(177) in the routine activity school (P value < 0.001) from baseline to follow-up. Overall, there was an increase in vegetable intake (> 3 serving /day) in SHEPP intervention school of 5.5 to 21.4% from baseline to follow-up compared to 7.5 to 14.9% in routine activity school. The mean change (SD) in systolic blood pressure was 1.3(12) mmHg, 2.2(19.0) mm Hg in in diastolic blood pressure, - 0.09(5.4) kg/m2 in BMI and 6.2 cm in waist circumference in the intervention arm versus - 3.4(11.1) mm Hg in SBP, - 4.3(9.9) mm Hg in DBP, - 0.04((4.6) kg/m2 in BMI, and 3.8 cm in WC in the control arm. CONCLUSION We found that intervention using SHEPP is feasible in schools and may help children to adopt a healthy lifestyle as they age by increasing physical activity. However, the potentially beneficial effect on diet, MI, and BP needs further exploration and a longer follow-up, more specifically at the juncture of teenage and adulthood. TRIAL REGISTRATION NCT03303287.
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Affiliation(s)
- Aysha Almas
- Department of Medicine, Aga Khan University, Karachi, Pakistan.
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Abdul Ghani
- Institute of Public Health, Quetta, Pakistan
| | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Sania Sabir
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Khawar Kazmi
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
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Devine LD, Gallagher AM, Briggs S, Hill AJ. Factors that influence food choices in secondary school canteens: a qualitative study of pupil and staff perspectives. Front Public Health 2023; 11:1227075. [PMID: 37522007 PMCID: PMC10375012 DOI: 10.3389/fpubh.2023.1227075] [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: 05/22/2023] [Accepted: 06/16/2023] [Indexed: 08/01/2023] Open
Abstract
Background Adolescence is recognised as a period of nutritional vulnerability, with evidence indicating that United Kingdom adolescents have suboptimal dietary intakes with many failing to meet dietary recommendations. Additionally, adolescence is a time of transition when they become more independent in their dietary choices and begin to develop their own sense of autonomy and are less reliant on their parent's guidance, which is reported to lead to less favourable dietary behaviours. Reducing the prevalence of poor dietary intakes and the associated negative health consequences among this population is a public health priority and schools represent an important setting to promote positive dietary behaviours. The aim of this school-based study was to explore the factors and barriers which influence food choices within the school canteen and to identify feasible strategies to promote positive dietary behaviours within this setting. Methods Thirteen focus groups with 86 pupils in Year 8 (n = 37; aged 11-12 years) and Year 9 (n = 49; aged 12-13 years) in six secondary schools across Northern Ireland, United Kingdom were conducted. Additionally, one-to-one virtual interviews were conducted with 29 school staff [principals/vice-principals (n = 4); teachers (n = 17); and caterers (n = 7)] across 17 secondary schools and an Education Authority (EA) senior staff member (n = 1). Focus groups and interviews were audio-recorded, transcribed, and analysed following an inductive thematic approach. Results Using the ecological framework, multiple factors were identified which influenced pupils' selection of food in the school canteen at the individual (e.g., time/convenience), social (e.g., peer influence), physical (e.g., food/beverage placement), and macro environment (e.g., food provision) level. Suggestions for improvement of food choices were also identified at each ecological level: individual (e.g., rewards), social (e.g., pupil-led initiatives), physical (e.g., labelling), and macro environment (e.g., whole-school approaches). Conclusion Low-cost and non-labour intensive practical strategies could be employed, including menu and labelling strategies, placement of foods, reviewing pricing policies and whole-school initiatives in developing future dietary interventions to positively enhance adolescents' food choices in secondary schools.
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Affiliation(s)
- Lauren D. Devine
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Alison M. Gallagher
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | | | - Alyson J. Hill
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
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Galván M, Hernández-Cabrera J, López-Rodríguez G, Bustos N, García-Cruz R, Guzmán-Saldaña R, Alzate-Yepes T, Galván-Valencia O. Perceptions of food environments in the school and at home during Covid-19: An online cross-sectional study of parents, teachers and experts from Latin America. PLoS One 2023; 18:e0287747. [PMID: 37384611 PMCID: PMC10309603 DOI: 10.1371/journal.pone.0287747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/13/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The high prevalence of overweight and obesity in children from Latin America (LA) have been related to obesogenic food environments. Besides, the negative effects of the Covid-19 pandemic should also be considered. The objective of this research was to describe and compare the perceptions of parents, teachers, and experts in LA of food environments at home and school that favor healthy habits in schoolchildren in pre Covid-19 stage and during the pandemic. METHODS This study used a survey self-reporting regarding conditions at home and the school favoring healthy habits, for three profiles: parents, primary school teachers, and experts. A fisher exact test was used to establish the difference between the response categories between countries and profiles. Logistic regression models were used to determine the probability of response in the levels of importance adjusted for sex and nationality. RESULTS Information from 954 questionnaires was reported: 48.4% experts, 32.0% teachers, and 19.6% parents. There were differences in the perception of food environments at school between profiles (p<0.001). In multivariate logistic regression models, experts and teachers were 20% more likely to give greater importance to elements of the food environment at school compared to parents (p<0.001). CONCLUSIONS Our findings showed that parents were less likely to perceive important elements of the school food environment compared to experts and teachers. Interventions are required to improve healthy eating environments that consider children's interpersonal mediators.
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Affiliation(s)
- Marcos Galván
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Jhazmín Hernández-Cabrera
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Guadalupe López-Rodríguez
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Nelly Bustos
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Nutrition and Food Technology Institute, University of Chile, Santiago, Chile
| | - Rubén García-Cruz
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Rebeca Guzmán-Saldaña
- Interdisciplinary Health Sciences Research Center, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Teresita Alzate-Yepes
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Oscar Galván-Valencia
- Interdisciplinary Network of Experts in School Environments in Latin America, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
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Imad N, Pearson N, Hall A, Shoesmith A, Nathan N, Giles L, Grady A, Yoong S. A Pilot Randomised Controlled Trial to Increase the Sustainment of an Indoor-Outdoor-Free-Play Program in Early Childhood Education and Care Services: A Study Protocol for the Sustaining Play, Sustaining Health (SPSH) Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5043. [PMID: 36981955 PMCID: PMC10048850 DOI: 10.3390/ijerph20065043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Early Childhood Education and Care (ECEC) settings are important environments to support children's physical activity (PA). In 2021, COVID-19 regulations recommended the provision of indoor-outdoor free-play programs in ECEC settings to reduce the transmission of COVID-19, resulting in an increased uptake of this practice. As the context has since changed, research suggests that ECEC services could cease the implementation of these practices. Therefore, this pilot randomised controlled trial (RCT) aims to examine the feasibility, acceptability, and impact of a sustainment strategy to ensure the ongoing implementation (sustainment) of ECEC-delivered indoor-outdoor free-play programs. Twenty ECEC services located in New South Wales, Australia that have implemented indoor-outdoor free-play programs since the release of COVID-19 guidelines will be recruited. The services will be randomly allocated either the sustainment strategy or usual care. The "Sustaining Play, Sustaining Health" program consists of eight strategies, developed to address key barriers against and facilitators of sustainment informed by the Integrated Sustainability Framework. The outcomes will be assessed via internal project records, staff surveys, and a self-reported measure of free play. This study will provide important data to support the performance of a fully powered trial within Australian ECEC settings and to inform the development of future sustainment strategies.
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Affiliation(s)
- Noor Imad
- School of Health Sciences, Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- Faculty of Health, School of Health and Social Development, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Alix Hall
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Adam Shoesmith
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Luke Giles
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
| | - Alice Grady
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Serene Yoong
- Faculty of Health, School of Health and Social Development, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
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Mpalampa L, Okoboi S, Nabaggala SM, Nanyonga RC. Factors associated with provision of physical activity in primary schools in Makindye Division in Kampala, Uganda: a cross-sectional study. BMC Public Health 2023; 23:314. [PMID: 36774479 PMCID: PMC9922171 DOI: 10.1186/s12889-023-15216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/06/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Globally, school-going children spend most of their days at school, sitting in lessons and unable to achieve the daily WHO recommendations for Physical Activity (PA) of at least 60 minutes per day. Limited studies have assessed the opportunities schools provide for PA to help the children achieve their daily recommended PA. We determined the level of and the factors associated with PA offered in primary schools in Makindye Division in Kampala during the school term. METHODS This cross-sectional study was conducted in 36 selected government and private primary schools in Makindye Division, Kampala. PA was defined as the amount of time in minutes available for PA as per WHO recommendations - sufficient (60 minutes or more of PA) or insufficient (less than 60 minutes of PA) and assessed for any factors associated with provision of time for PA in schools. Data were collected by interview administered questionnaires and analysed descriptively. Factors associated with PA were assessed using a logistic regression model. RESULTS Of the 36 schools, 3 were government and 33 were private schools. The proportion of schools offering sufficient time for PA among Primary schools in the Makindye Division was (8/36) 22%. The average time for PA for all schools per week was 197 minutes (SD 70.7). Sufficient PA was associated with the provision of PE lessons after a break or after lunch (p-value 0.038). Sufficient PA was more likely in schools that offered volleyball (OR 8.69), had space in the school for PA (OR 13.27), provided athletics (OR 2.26) and whose fees were Ushs 700,000 (USD 187) or more (OR 1.30). CONCLUSIONS Only 22% of sampled schools offered sufficient time for PA among Primary schools in Kampala per WHO guidelines. Provision of sufficient time for PA was associated with PE scheduled either after break or lunch. Sufficient PA was more likely with schools that had space for PA, schools which offered volleyball and athletics, and whose fees were 700,000/= or more. Schools should consider scheduling PE lessons after break or after lunch to increase the likelihood of meeting the targeted time for PA. Primary schools need to be supported to establish facilities and to increase diversity in available activities to ensure children achieve their recommended PA.
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Affiliation(s)
| | - Stephen Okoboi
- grid.11194.3c0000 0004 0620 0548Deputy Head of Research Department, Infectious Diseases Institute, Makerere University, P. O. Box 22418, Kampala, Uganda
| | - Sarah Maria Nabaggala
- grid.11194.3c0000 0004 0620 0548Infectious Diseases Institute, Makerere University, P. O. Box 22418, Kampala, Uganda
| | - Rose Clarke Nanyonga
- grid.442638.f0000 0004 0436 3538Clarke International University, P.O. Box 7782, Kampala, Uganda
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Implementation of four strategies in Dutch day-care centres to stimulate young children's fruit and vegetable consumption. Appetite 2023; 181:106378. [PMID: 36402413 DOI: 10.1016/j.appet.2022.106378] [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: 05/23/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022]
Abstract
The day-care setting is an ideal place to encourage children's fruit and vegetable (=F&V) eating. Whereas many studies have focused on the effectiveness to increase F&V consumption, little is known about how to successfully implement effective strategies in daily practice. This study aimed to investigate how day-care professionals evaluated the implementation of a self-chosen strategy to support children's F&V eating. Thirteen day-care locations chose one out of five promising strategies and implemented this strategy for 10-12 weeks. Before (N = 98) and after the study (N = 49), day-care professionals completed a questionnaire to assess their implementation experiences, the impact on children's F&V eating as well as their future intention to use the strategy (on a 5-point scale). Parents (N = 152) completed a short questionnaire at the end of the study to capture their experiences and potential transfer effects to the home situation. Results showed that acceptability, appropriateness, feasibility and sustainability of the strategies were generally satisfactory (scores ≥3.5 on a 5-point scale), but the strategy of cooking scored less favourable on appropriateness and sustained implementation. Children's willingness to taste F&V varieties (3.4 ± 0.7 vs. 2.8 ± 0.8; p < 0.001) and eating pleasure for vegetables (3.4 ± 0.6 vs. 3.1 ± 0.8; p = 0.01) increased, whereas children's F&V consumption did not change (p > 0.14). Parents valued the day-cares' efforts to encourage children's F&V consumption and a small group (∼20%) experienced positive effects at home. This study shows that implementing a self-chosen F&V strategy at the day-care is acceptable, appropriate and feasible for day-care professionals and has potential to positively impact children's F&V eating behaviour. Future research should investigate the effects of long-term implementation on children's eating behaviour and examine how structural implementation can be further supported.
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Almutairi N, Burns S, Portsmouth L. Barriers and enablers to the implementation of school-based obesity prevention strategies in Jeddah, KSA. Int J Qual Stud Health Well-being 2022; 17:2135197. [PMID: 36263729 PMCID: PMC9590444 DOI: 10.1080/17482631.2022.2135197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Despite schools' recognised role in mitigating childhood overweight, many schools fail to implement physical activity or nutrition strategies. The current study explored
the enablers and barriers to implementing obesity prevention strategies in
Jeddah, KSA. Methods This research is based on 14 semi-structured interviews with intermediate school principals and sports teachers to gain insight into their perception of barriers and enablers to implementing obesity prevention strategies. Themes were deductively generated from the data. Results Participants estimated the prevalence of overweight and obesity among their students to be between 3 and 15% with an increasing trend, particularly among female students. Participants identified five categories of barriers to implementation of obesity prevention intervention: curriculum; schools strategies promoting healthy weight; lack of resources; student’s lifstyle; and a lack of teachers in nutrition and sports. School regulations, staff and sufficient resources were the most frequently reported enablers. Participants also identified food services, awareness, and partnerships as barriers and enablers. Conclusion There is a need for better infrastructure and financial support for schools and professional development opportunities for teachers from the Saudi Ministry of Education. The Ministry also needs to support the development of multilevel health promotion strategies at school and home and reach out to the broader community.
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Affiliation(s)
- Naif Almutairi
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Department of Public Health, College of Health Sciences at Al-Leith, Umm Al-Qura University, Al-Leith, Kingdom of Saudi Arabia,CONTACT Naif Almutairi ; School of Population Health, Curtin University, GPO Box U1987, Perth6845, Australia
| | - Sharyn Burns
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Linda Portsmouth
- School of Population Health, Curtin University Bentley Campus, Perth, Australia,Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
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Camp-Spivey LJ, Newman SD, Stevens RN, Nichols M. Survey of South Carolina Public School Personnel Perspectives on Barriers and Facilitators to Regular Physical Activity and Healthy Eating Behaviors in Schools. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1062-1073. [PMID: 35962619 DOI: 10.1111/josh.13228] [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: 09/10/2021] [Revised: 05/06/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In South Carolina (SC), 42% of youth are overweight or obese. Two sets of modifiable behaviors contributing to obesity are physical activity (PA) and dietary habits. School-based interventions have successfully improved these behaviors. The purpose of this study was to identify SC public school personnel perspectives on the most common barriers and facilitators to regular PA and healthy eating behaviors in schools. METHODS A needs assessment survey was conducted with school personnel statewide. There were 17 questions on the survey that addressed: (1) demographic information about participants' educational backgrounds, (2) barriers to regular PA and healthy eating behaviors in schools, and (3) facilitators to regular PA and healthy eating behaviors in schools. Univariate and bivariate descriptive statistical analyses were performed using IBM SPSS Statistics 27. RESULTS Participants (N = 1311) indicated insufficient time for regular PA (n = 514, 39.2%) and limited access to healthy foods for healthy eating (n = 271, 20.7%) as main barriers. The primary facilitators were support from administrators for regular PA (n = 264, 20.1%) and support from cafeteria staff for healthy eating (n = 234, 17.8%). Further analyses explored how factors compared based on roles in schools, academic levels, and school district classifications. CONCLUSIONS Results suggest that overarching barriers and facilitators to school-based interventions addressing childhood obesity exist, so common strategies to mitigate challenges and maximize supports can be used in schools. Future studies are needed to examine how decreasing barriers and enhancing facilitators affect the implementation and outcomes of these school-based interventions.
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Affiliation(s)
- Logan J Camp-Spivey
- Mary Black College of Nursing, University of South Carolina Upstate, Spartanburg, SC, 29303
| | - Susan D Newman
- College of Nursing, Medical University of South Carolina, Charleston, SC, 29425
| | - Robert N Stevens
- South Carolina Clinical & Translational Research Institute, Medical University of South Carolina, Charleston, SC, 29425, USA; Co-Chair, Southeastern School Behavioral Health Conference, University of South Carolina, Columbia, SC, 29208, USA; Consultant, South Carolina Department of Education, Columbia, SC, 29211, USA; Consultant, South Carolina Department of Mental Health, Columbia, SC, 29202, USA; Investigator, STAR Clinical Research Network, Vanderbilt University, Nashville, TN, 37235, USA, Multiple
| | - Michelle Nichols
- College of Nursing, Medical University of South Carolina, Charleston, SC, 29425, USA; President, Mixed Methods International Research Association, Indianapolis, IN, 46230, USA, Multiple
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Qi Y, Rong S, Liao K, Huo J, Lin Q, Hamzah SH. School Gardening, Cooking and Sports Participation Intervention to Improve Fruits and Vegetables Intake and Moderate-to-Vigorous Physical Activity among Chinese Children: Study Protocol for a Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14096. [PMID: 36360973 PMCID: PMC9656511 DOI: 10.3390/ijerph192114096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Inadequate intake of fruits and vegetables (FV) and moderate-to-vigorous physical activity (MVPA) in children has become a global public health problem. Therefore, school-based gardening and cooking (SGC) and sports participation (SP) interventions may be effective in improving children's FV intake and MVPA. The aim of this study is to develop and evaluate the effectiveness of SGC and SP interventions on FV intake and MVPA among Chinese children. In this cluster randomized controlled trial study, 237 children in grades 4-5 from six public primary schools from Changsha, Hunan Province, China will be randomly assigned to: (1) a SGC and SP combined intervention group; (2) a SP intervention group; (3) a regular practice group. The intervention clusters will be implemented for a period of 6 months and follow up will be carried out after 12 months. The outcome will be collected using a combination of self-reported and objective measures. Primary outcomes will include children's FV intake and duration of MVPA per day, and secondary outcomes will included frequency and attitudes of FV intake and SP, in addition to other measures. Finally, a process evaluation will be used to analyze the facilitators and barriers to intervention implementation. Trial Registration: (Registration Number: ChiCTR2200064141).
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Affiliation(s)
- Yufei Qi
- Faculty of Sports and Exercise Science, University of Malaya, Kuala Lumpur 50603, Malaysia
- Department of Physical Education and Research, Central South University, 932 Lushan south Rd., Changsha 410083, China
| | - Siyu Rong
- Department of Physical Education and Research, Central South University, 932 Lushan south Rd., Changsha 410083, China
| | - Kunlong Liao
- Zhangshumen Primary School, Halfway Street, Taohualing Village, Changsha 430100, China
| | - Jiaqi Huo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
| | - Sareena Hanim Hamzah
- Faculty of Sports and Exercise Science, University of Malaya, Kuala Lumpur 50603, Malaysia
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van Kleef E, Dijkstra SC, Seidell J, Vingerhoeds MH, Polet IA, Zeinstra GG. Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands? JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:47. [PMID: 36243766 PMCID: PMC9569068 DOI: 10.1186/s41043-022-00328-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND A school provided healthy lunch might help to improve the nutritional quality of children's lunches. However, in the Netherlands, school lunch programs are not common. The aim of this study was to identify factors that promote or inhibit the implementation of a school lunch program at primary schools, from the viewpoint of school professionals. METHODS A cross-sectional online survey was conducted among 204 primary school professionals. The normalization process theory and its four constructs (i.e. coherence, cognitive participation, collective action, reflective monitoring) were used to develop questions and interpret findings. Descriptive statistics were used for 14 multiple choice questions (yes, no, don't know) and thematic content analysis for qualitative responses. RESULTS Participants had a shared understanding about how a lunch program differed from current practices. Most participants had the same view on the rationale for implementation (coherence), such as equality among children. Sixty percent expected that a healthy school lunch will contribute to healthier eating by the children. Participants showed different degrees of cognitive participation (46% indicated that healthy school lunch is good idea). Commitment depended on their belief whether providing a healthy lunch was part of their responsibility as school and 30% expected a large effect on their daily work (collective action). When appraising school lunch implementation (reflective monitoring), participants' concerns focused on feasibility and adaptability of a program in their own school. CONCLUSIONS The introduction of a school lunch program will require substantial effort, although there is considerable support and understanding about potential benefits. The findings point to a number of preconditions for large-scale introduction, including the need for support-both financially and organizationally-bottom-up involvement of teachers, children and parents and freedom to adapt the program.
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Affiliation(s)
- Ellen van Kleef
- Marketing and Consumer Behaviour Group, Wageningen University, Hollandseweg 1, 6706 KN Wageningen, The Netherlands
| | - S. Coosje Dijkstra
- Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1085, Amsterdam, The Netherlands
| | - Jaap Seidell
- Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1085, Amsterdam, The Netherlands
| | - Monique H. Vingerhoeds
- Food, Health and Consumer Research, Wageningen Food and Biobased Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Ilse A. Polet
- Food, Health and Consumer Research, Wageningen Food and Biobased Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Gertrude G. Zeinstra
- Food, Health and Consumer Research, Wageningen Food and Biobased Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
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Kovács K, Kovács KE, Bacskai K, Békési Z, Oláh ÁJ, Pusztai G. The Effects and Types of Parental Involvement in School-Based Sport and Health Programs Still Represent a Knowledge Gap: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912859. [PMID: 36232159 PMCID: PMC9565983 DOI: 10.3390/ijerph191912859] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/01/2022] [Accepted: 10/05/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND Health-related behaviours and attitudes acquired in childhood significantly shape health behaviours in adulthood and play an important role in preventing children from becoming overweight. Interventions incorporating parental involvement can provide outstanding support in shaping a child's health-related behaviour. However, parental involvement has not been investigated from the perspective of efficacy except for obesity. Therefore, this systematic review investigates school-based physical activity intervention programmes incorporating parental involvement. We aim to explore the impact of these programmes and the parental involvement they provide on behaviours that influence child health, which are essential for preventing children and adults from becoming overweight and promoting health-conscious lifestyles. METHODS This systematic literature review follows PRISMA guidelines. The EBSCO Discovery Service Search Engine was used for searching for literature. Papers included met the following inclusion criteria: (1) reported original, empirical research or systematic review published in a peer-reviewed journal; (2) primary or secondary school age (6-18 years) as the target population; (3) examined school-based sport or health prevention and intervention programs; (4) only healthy children and youth in the indicated age group; (5) school-based prevention or intervention program; (6) examines parental involvement; (7) in the English language, and (8) in disciplines of education, psychology, social work, sociology, social sciences and humanities. RESULTS An extremely limited number of interventions of sufficient quality address the role of parental involvement (N = 17). The forms of parental involvement show a huge variety, ranging from leaflets, home packs, sports organisations "forced" by the pandemic, parent meetings, programmes, courses, and school programmes with diverse children over several months (cooking together, gardening, playing sports together, etc.). Therefore, it is difficult to measure their effectiveness and impact. CONCLUSIONS The impact of parental involvement on children's health behaviour, especially physical activity and nutrition, as two of the most important factors in preventing them from becoming overweight, are unclear, and other correlations, e.g., academic achievement, are scarce.
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Affiliation(s)
- Klára Kovács
- MTA-DE-Parent-Teacher Cooperation Research Group, Institute of Educational Sciences and Cultural Management, University of Debrecen, 4032 Debrecen, Hungary
| | - Karolina Eszter Kovács
- MTA-DE-Parent-Teacher Cooperation Research Group, Institute of Psychology, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence:
| | - Katinka Bacskai
- MTA-DE-Parent-Teacher Cooperation Research Group, Institute of Educational Sciences and Cultural Management, University of Debrecen, 4032 Debrecen, Hungary
| | - Zsolt Békési
- MTA-DE-Parent-Teacher Cooperation Research Group, Institute of Educational Sciences and Cultural Management, University of Debrecen, 4032 Debrecen, Hungary
| | - Ádám József Oláh
- MTA-DE-Parent-Teacher Cooperation Research Group, Institute of Psychology, University of Debrecen, 4032 Debrecen, Hungary
| | - Gabriella Pusztai
- MTA-DE-Parent-Teacher Cooperation Research Group, Institute of Educational Sciences and Cultural Management, University of Debrecen, 4032 Debrecen, Hungary
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Hann M, Hayes CV, Lacroix-Hugues V, Lundgren PT, McNulty C, Syeda R, Eley C, Teixeira P, Gennimata D, Truninger M, Knøchel S, Münter L, Allison R, Fehér Á, Izsó T, Kunszabó A, Kasza G, Demirjian A. Evidence-based health interventions for the educational sector: Application and lessons learned from developing European food hygiene and safety teaching resources. Food Control 2022. [DOI: 10.1016/j.foodcont.2022.109219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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24
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Romaniuk P, Kaczmarek K, Brukało K, Grochowska-Niedworok E, Łobczowska K, Banik A, Luszczynska A, Poelman M, Harrington JM, Vandevijvere S. The Healthy Food Environment Policy Index in Poland: Implementation Gaps and Actions for Improvement. Foods 2022; 11:foods11111648. [PMID: 35681398 PMCID: PMC9180244 DOI: 10.3390/foods11111648] [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: 04/21/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Poland is facing the growing problem of overweight and obesity in the population, which makes it necessary to conduct a thorough assessment of the existing food environment policies. The aims of the study were: (1) to depict the strength of healthy food environment policies in Poland and identify implementation policies and infrastructure support gaps; (2) to identify and prioritise improvement policies, taking into account their importance, achievability and equity. Methods: We used the Healthy Food Environment Policy Index (Food-EPI). An experts’ panel rated Polish policies and infrastructure compared to international best practices and developed a list of recommended improvement actions addressing both components. Results: eight of the twenty-two policy and four of the twenty-two infrastructure indicators achieved the “no/very weak policy” result. Another four policy and five infrastructure indicators were considered “weak”. Another seven and eight indicators, respectively, were assessed as “moderate”. Among the identified actions, the highest priority was given to a food labelling system and training for persons involved in nutrition in schools. Conclusions: The Polish healthy food environment has been assessed as very weak or weak in most aspects. The infrastructure was assessed as slightly better compared to the policies domain, with more indicators receiving the “moderate” score.
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Affiliation(s)
- Piotr Romaniuk
- Department of Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska Street 18, 41-902 Bytom, Poland; (P.R.); (K.B.)
| | - Krzysztof Kaczmarek
- Department of Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska Street 18, 41-902 Bytom, Poland; (P.R.); (K.B.)
- Correspondence:
| | - Katarzyna Brukało
- Department of Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska Street 18, 41-902 Bytom, Poland; (P.R.); (K.B.)
| | - Elżbieta Grochowska-Niedworok
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Jordana Street 19, 41-808 Zabrze, Poland;
| | - Karolina Łobczowska
- Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, 53-238 Wroclaw, Poland; (K.Ł.); (A.B.); (A.L.)
| | - Anna Banik
- Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, 53-238 Wroclaw, Poland; (K.Ł.); (A.B.); (A.L.)
| | - Aleksandra Luszczynska
- Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, 53-238 Wroclaw, Poland; (K.Ł.); (A.B.); (A.L.)
- Lyda Hill Institute for Human Resilience, University of Colorado at Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80918, USA
| | - Maartje Poelman
- Consumption and Healthy Lifestyles, Wageningen University & Research, P.O. Box 8130, 6700 EW Wageningen, The Netherlands;
| | - Janas M. Harrington
- School of Public Health, University College Cork, T12 XF62 Cork City, Ireland;
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1142, New Zealand;
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Camp-Spivey LJ, Newman SD, Stevens RN, Nichols M. Describing South Carolina Public School Administrators' Perceptions and Experiences Related to School-Based Interventions and Strategies to Promote Healthy Physical Activity and Eating Behaviors: A Qualitative Study. THE JOURNAL OF SCHOOL HEALTH 2022; 92:581-593. [PMID: 35355265 DOI: 10.1111/josh.13164] [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: 07/30/2021] [Revised: 01/14/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND School-based interventions and strategies targeting physical activity (PA) and eating patterns have successfully addressed unhealthy behaviors contributing to excess weight in school-age children. The purpose of this study was to investigate South Carolina (SC) public school administrators' perceptions of and experiences with weight-related issues in schools and associated barriers and facilitators to awareness, selection, and implementation of school-based healthy PA and eating interventions and strategies. METHODS This qualitative descriptive study, guided by the Social Ecological Model and the Steps in Quality Intervention Development Model, involved semistructured interviews with SC public school administrators from all academic levels (N = 28). Data were analyzed using thematic analysis. RESULTS Four themes were identified from interviews (N = 28): weight-related terminology or stigma, experiences with school-based healthy PA and eating interventions and strategies, barriers to school-based healthy PA and eating interventions and strategies, and facilitators to school-based healthy PA and eating interventions and strategies. CONCLUSIONS Schools are well-positioned to provide interventions and strategies to improve PA and dietary habits leading to childhood obesity. School administrators, while knowledgeable and experienced with weight-related issues and school-based interventions and strategies, encounter barriers and facilitators that impact offerings and delivery. Understanding these challenges and supports is important in the development, adaptation, and implementation of school-based interventions and strategies focused on healthy PA and eating behaviors.
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Affiliation(s)
- Logan J Camp-Spivey
- Mary Black School of Nursing, University of South Carolina Upstate, Spartanburg, SC, 29303
| | - Susan D Newman
- College of Nursing, Medical University of South Carolina, Charleston, SC, 29425
| | - Robert N Stevens
- South Carolina Clinical & Translational Research Institute, Medical University of South Carolina, Charleston, SC, 29425
- Co-Chair, Southeastern School Behavioral Health Conference, University of South Carolina, Columbia, SC, 29208
- Consultant, South Carolina Department of Education, Columbia, SC, 29211
- Consultant, South Carolina Department of Mental Health, Columbia, SC, 29202
- Investigator, STAR Clinical Research Network, Vanderbilt University, Nashville, TN, 37235
| | - Michelle Nichols
- College of Nursing, Medical University of South Carolina, Charleston, SC, 29425
- President, Mixed Methods International Research Association, Indianapolis, IN, 46230
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Tohi M, Bay JL, Tu’akoi S, Vickers MH. The Developmental Origins of Health and Disease: Adolescence as a Critical Lifecourse Period to Break the Transgenerational Cycle of NCDs-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6024. [PMID: 35627561 PMCID: PMC9141771 DOI: 10.3390/ijerph19106024] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 02/06/2023]
Abstract
Noncommunicable diseases (NCDs), including type 2 diabetes and cardiovascular disease, represent a significant and growing global health burden. To date, a primary focus has been on treatment approaches to NCDs once manifested rather than strategies aimed at prevention. In this context, there is clear evidence that a range of adverse early life exposures can predispose individuals towards a greater risk of developing NCDs across the lifecourse. These risk factors can be passed to future generations, thus perpetuating a cycle of disease. This concept, preferentially termed "developmental programming", forms the basis of the Developmental Origins of Health and Disease (DOHaD) framework. To date, DOHaD has focused on preconception, pregnancy, lactation and, more recently, paternal health at the time of conception. However, it is becoming increasingly clear that investment in the window of adolescence is perhaps the most critical developmental window. Adolescence is a period where lifestyle behaviours become entrained. Therefore, a focus on adolescent behaviours, health literacy and emotional development may afford the best opportunity to break the cycle of NCDs. As the next generation of parents, adolescents should therefore be considered a priority group in advancing appropriate and informed actions aimed at reducing NCD risk factors across the lifecourse. This advancement requires a more comprehensive community understanding and uptake of DOHaD knowledge and concepts. NCD prevention strategies have typically entailed siloed (and often disease-specific) approaches with limited efficacy in curbing NCD prevalence and breaking the transgenerational transmission of disease traits. Recent findings across various disciplines have highlighted that a lifecourse systems approach is required to establish a comprehensive and sustainable framework for NCD intervention. A whole community approach with a particular focus on adolescents as potential agents of change is necessary to break the disease cycle.
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Affiliation(s)
- Melenaite Tohi
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand; (M.T.); (J.L.B.)
| | - Jacquie Lindsay Bay
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand; (M.T.); (J.L.B.)
| | - Siobhan Tu’akoi
- School of Population Health, The University of Auckland, Auckland 1023, New Zealand;
| | - Mark Hedley Vickers
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand; (M.T.); (J.L.B.)
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Nally S, Ridgers ND, Gallagher AM, Murphy MH, Salmon J, Carlin A. “When You Move You Have Fun”: Perceived Barriers, and Facilitators of Physical Activity From a Child's Perspective. Front Sports Act Living 2022; 4:789259. [PMID: 35321521 PMCID: PMC8937021 DOI: 10.3389/fspor.2022.789259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/01/2022] [Indexed: 11/14/2022] Open
Abstract
In Northern Ireland (NI), many children do not meet the recommended levels of physical activity (PA). To reduce the prevalence of physical inactivity and associated health conditions, it is important to understand the influences on children's PA, which in turn has the potential to inform future intervention design. The purpose of this formative study was to examine the current views, barriers, facilitators, experiences, and perceptions of children in relation to PA in the classroom, school, and home environments, and to assess the acceptability of components for a school-based intervention. Write and draw tasks and semi-structured focus groups (n = 10) were conducted with 50 children aged 7–9 years (22 boys, 28 girls) from six primary schools. Focus groups were recorded, transcribed, and analyzed thematically. Pen profiles were constructed from the transcripts in a deductive manner and represent key emergent themes. Results indicated that children's perception and knowledge of PA was mainly structured and sport-based, while some referred to fun, play and health. Fun, social support and outdoor activity were identified as key facilitators. Barriers included parental restrictions, lack of time and space in the different environments. The acceptability of intervention components was examined, children recognized the potential benefits of additional movement in the classroom, but opinions differed on the sit-to-stand desks. Findings contribute to a more detailed understanding of children's perceptions of context specific PA, the barriers they face, in addition to factors that support them to lead a physically active lifestyle, which may inform future PA promotion strategies.
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Affiliation(s)
- Sarah Nally
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
- *Correspondence: Sarah Nally
| | - Nicola D. Ridgers
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Alison M. Gallagher
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Sciences Research Institute, University of Ulster, Coleraine, United Kingdom
| | - Marie H. Murphy
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Angela Carlin
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster University, Newtownabbey, United Kingdom
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28
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Mazzucca S, Saliba LF, Smith R, Weno ER, Allen P, Padek M, Brownson RC. "It's good to feel like you're doing something": a qualitative study examining state health department employees' views on why ineffective programs continue to be implemented in the USA. Implement Sci Commun 2022; 3:4. [PMID: 35033206 PMCID: PMC8760784 DOI: 10.1186/s43058-021-00252-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Mis-implementation, the inappropriate continuation of programs or policies that are not evidence-based or the inappropriate termination of evidence-based programs and policies, can lead to the inefficient use of scarce resources in public health agencies and decrease the ability of these agencies to deliver effective programs and improve population health. Little is known about why mis-implementation occurs, which is needed to understand how to address it. This study sought to understand the state health department practitioners’ perspectives about what makes programs ineffective and the reasons why ineffective programs continue. Methods Eight state health departments (SHDs) were selected to participate in telephone-administered qualitative interviews about decision-making around ending or continuing programs. States were selected based on geographic representation and on their level of mis-implementation (low and high) categorized from our previous national survey. Forty-four SHD chronic disease staff participated in interviews, which were audio-recorded and transcribed verbatim. Transcripts were consensus coded, and themes were identified and summarized. This paper presents two sets of themes, related to (1) what makes a program ineffective and (2) why ineffective programs continue to be implemented according to SHD staff. Results Participants considered programs ineffective if they were not evidence-based or if they did not fit well within the population; could not be implemented well due to program restraints or a lack of staff time and resources; did not reach those who could most benefit from the program; or did not show the expected program outcomes through evaluation. Practitioners described several reasons why ineffective programs continued to be implemented, including concerns about damaging the relationships with partner organizations, the presence of program champions, agency capacity, and funding restrictions. Conclusions The continued implementation of ineffective programs occurs due to a number of interrelated organizational, relational, human resources, and economic factors. Efforts should focus on preventing mis-implementation since it limits public health agencies’ ability to conduct evidence-based public health, implement evidence-based programs effectively, and reduce the high burden of chronic diseases. The use of evidence-based decision-making in public health agencies and supporting adaptation of programs to improve their fit may prevent mis-implementation. Future work should identify effective strategies to reduce mis-implementation, which can optimize public health practice and improve population health. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00252-4.
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Affiliation(s)
- Stephanie Mazzucca
- Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA.
| | | | - Romario Smith
- Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA.,Heluna Health, City of Industry, CA, 91756, USA
| | - Emily Rodriguez Weno
- Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA.,Bayer Strategy and Business Consulting, St. Louis, MO, 63141, USA
| | - Peg Allen
- Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Margaret Padek
- Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Ross C Brownson
- Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA.,Department of Surgery, Division of Public Health Sciences, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, 63110, USA
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29
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Yadav A, Singh B, Kansara N, Bansal A, Teli P. Health profile and nutritional status of rural primary school children in Western Maharashtra. Is school absenteeism associated with undernutrition? MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_620_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Camp-Spivey LJ, Newman SD, Stevens RN, Nichols M. "We've Had to Build the Plane as We Flew It.": Impacts of the COVID-19 Pandemic on School-Based Weight Management Interventions. Child Obes 2021; 17:497-506. [PMID: 34197215 DOI: 10.1089/chi.2021.0037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: In response to the coronavirus disease 2019 (COVID-19) pandemic, elementary and secondary schools in the United States transitioned to remote learning to slow viral spread and protect students and school officials. This move interrupted academic education and school-based health interventions focused on physical activity (PA) and healthy eating behaviors to help combat childhood obesity. Little is known on how these interventions were affected by COVID-19. Methods: This concurrent multimethodological study incorporated two independent components: qualitative descriptive semistructured interviews with public school administrators and quantitative descriptive cross-sectional needs assessment survey of public school personnel. Results: Three themes were identified from interviews with school administrators (N = 28): changes in school-based interventions addressing PA and healthy eating behaviors, changes in academic delivery affecting PA and healthy eating behaviors, and needs of school administrators. From the survey (N = 1311), 635 (48.4%) participants indicated that schools' abilities to address PA and healthy eating behaviors were negatively impacted by COVID-19. The majority (n = 876, 66.8%) of participants strongly agreed or agreed that the pandemic would affect future school-based interventions related to PA and healthy eating behaviors. Conclusions: While schools are prime locations for delivering school-based weight management interventions related to childhood obesity, participants reported the pandemic had overall negative impacts on interventions addressing PA and healthy eating behaviors. Understanding these impacts is essential to adapting school-based interventions to changes from COVID-19 so students may receive health information and access health promotion interventions in remote learning environments and during social distancing.
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Affiliation(s)
- Logan J Camp-Spivey
- Medical University of South Carolina, College of Nursing, Charleston, SC, USA
| | - Susan D Newman
- Medical University of South Carolina, College of Nursing, Charleston, SC, USA
| | - Robert N Stevens
- South Carolina Department of Education and South Carolina Department of Mental Health, School Behavioral Health, Columbia, SC, USA
| | - Michelle Nichols
- Medical University of South Carolina, College of Nursing, Charleston, SC, USA
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Bennett AE, Mockler D, Cunningham C, Glennon-Slattery C, Johnston Molloy C. A Review of Experiential School-Based Culinary Interventions for 5–12-Year-Old Children. CHILDREN 2021; 8:children8121080. [PMID: 34943276 PMCID: PMC8699905 DOI: 10.3390/children8121080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 12/15/2022]
Abstract
Cooking is an essential skill and the acquisition of cooking skills at an early age is associated with higher diet quality. This review aimed to describe the characteristics of school-based experiential culinary interventions and to determine the value of these to child (5–12 years) health outcomes. Interventions were eligible for inclusion if they took place in school during school hours, included ≥3 classes, and had a control group. Interventions published up to May 2021 were included. The databases searched were PubMed, CINAHL, and EMBASE, and the grey literature was searched for published reports. The search strategy yielded 7222 articles. After screening, five published studies remained for analysis. Four studies targeted children aged 7–11 years, and one targeted children aged 5–12 years. The interventions included food tasting, food gardening, and/or nutrition education alongside experiential cooking opportunities. Improvements were evident in self-reported attitudes toward vegetables, fruits, and cooking, and two studies reported small objective increases in vegetable intake. School-based experiential cookery interventions have the potential to positively impact health-related aspects of the relationship children develop with food. However, a greater number of long-term methodologically rigorous interventions are needed to definitively quantify the benefits of such interventions.
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Affiliation(s)
- Annemarie E. Bennett
- Trinity Centre for Health Sciences, St James’ Healthcare Campus, D08 W9RT Dublin, Ireland;
- Correspondence:
| | - David Mockler
- Trinity Centre for Health Sciences, St James’ Healthcare Campus, D08 W9RT Dublin, Ireland;
| | - Cara Cunningham
- Community Nutrition and Dietetic Service, Health Service Executive, Clonbrusk, Athlone, N37 P8P8 Co Westmeath, Ireland;
| | - Corina Glennon-Slattery
- Primary Care Network 7, Health Service Executive, Primary Care Centre, Harbour Road, Mullingar, N91 V6R9 Co Westmeath, Ireland;
| | - Charlotte Johnston Molloy
- Community Nutrition and Dietetic Service, Health Service Executive, St Loman’s Healthcare Campus, Mullingar, N91 X36E Co Westmeath, Ireland;
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Bassi S, Bahl D, Harrell MB, Jain N, Kandasamy A, Salunke SR, Shah VG, Raghunathan P, Markandan S, Murthy P, Arora M. Knowledge, attitude, and behaviours on diet, physical activity, and tobacco use among school students: A cross-sectional study in two Indian states. F1000Res 2021; 10:544. [PMID: 34745560 PMCID: PMC8543165 DOI: 10.12688/f1000research.51136.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 04/04/2024] Open
Abstract
Background: Non-communicable diseases (NCDs) are escalating in India and can be attributed to behavioural risk factors such as unhealthy diet, physical inactivity and tobacco use that began in early years. Understanding adolescents' knowledge, attitudes and behaviours (KAB) related to NCD risk factors would inform the development of school-based health programmes to prevent NCDs. Methods: Sixth-grade students (n=1026) in 20 schools (10 private, 10 public) from two Indian cities (n=667 from Pune; n=359 from Bengaluru) participated in a KAB survey in 2019. Differences in KAB by gender, school type within cities were investigated. Results: Knowledge about the harms of tobacco use was higher than knowledge about a healthy diet and the importance of physical activity. Only a small proportion of students did not eat breakfast (8.7%) or fruits (11.3%) daily. Only 33.4% of students read nutrition labels before choosing their food. Moderate-to-vigorous physical activity of less than an hour per day was reported by 42.5% of students. Approximately one-third of students had ever tried smoking tobacco (30.1%), smokeless tobacco (30.5%), and e-cigarettes (32.4%). Differences in these behaviours by gender and school type showed that both boys, girls and students of private and public schools are vulnerable. Conclusions: The findings highlight that knowledge is low for thematic areas like diet and physical activity. Low knowledge can be attributed to unfavourable behaviours like lack of reading nutrition labels and indulgence in sedentary activities. To protect India's young population (adolescents), there is a need to amplify health education activities and context-specific health intervention materials for them by engaging parents and communities. Thus, these programmes should be incorporated into the curriculum as part of the regular teaching, as they may induce positive changes in their knowledge and behaviours. In India, school health programmes should dedicate significant time to health promotion and NCD risk prevention.
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Affiliation(s)
- Shalini Bassi
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Deepika Bahl
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Melissa Blythe Harrell
- School of Public Health, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, Austin, Texas, 78701, USA
| | - Neha Jain
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
| | - Arun Kandasamy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | | | | | - Prema Raghunathan
- Department of Paediatrics, Rajarajeswari Medical, College & Hospital, Bengaluru, Karnataka, 560074, India
| | - Selvarajan Markandan
- Department of Health and Family Welfare, Government of Karnataka, Bengaluru, Karnataka, 560008, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health And Neuro Sciences (NIMHANS), Bengaluru, Karnataka, 560029, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India (PHFI), Gurgaon, Haryana, 122002, India
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Shoesmith A, Hall A, Wolfenden L, Shelton RC, Powell BJ, Brown H, McCrabb S, Sutherland R, Yoong S, Lane C, Booth D, Nathan N. Barriers and facilitators influencing the sustainment of health behaviour interventions in schools and childcare services: a systematic review. Implement Sci 2021; 16:62. [PMID: 34118955 PMCID: PMC8199827 DOI: 10.1186/s13012-021-01134-y] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/03/2021] [Indexed: 12/14/2022] Open
Abstract
Background Sustainment has been defined as the sustained use or delivery of an intervention in practice following cessation of external implementation support. This review aimed to identify and synthesise factors (barriers and facilitators) that influence the sustainment of interventions (policies, practices, or programmes) in schools and childcare services that address the leading risk factors of chronic disease. Methods Seven electronic databases and relevant reference lists were searched for articles, of any design, published in English, from inception to March 2020. Articles were included if they qualitatively and/or quantitatively reported on school or childcare stakeholders’ (including teachers, principals, administrators, or managers) perceived barriers or facilitators to the sustainment of interventions addressing poor diet/nutrition, physical inactivity, obesity, tobacco smoking, or harmful alcohol use. Two independent reviewers screened texts, and extracted and coded data guided by the Integrated Sustainability Framework, an existing multi-level sustainability-specific framework that assesses factors of sustainment. Results Of the 13,158 articles identified, 31 articles met the inclusion criteria (8 quantitative, 12 qualitative, 10 mixed-methods, and 1 summary article). Overall, 29 articles were undertaken in schools (elementary n=17, middle n=3, secondary n=4, or a combination n=5) and two in childcare settings. The main health behaviours targeted included physical activity (n=9), diet (n=3), both diet and physical activity (n=15), and smoking (n=4), either independently (n=1) or combined with other health behaviours (n=3). Findings suggest that the majority of the 59 barriers and 74 facilitators identified to impact on intervention sustainment were similar across school and childcare settings. Factors predominantly relating to the ‘inner contextual factors’ of the organisation including: availability of facilities or equipment, continued executive or leadership support present, and team cohesion, support, or teamwork were perceived by stakeholders as influential to intervention sustainment. Conclusions Identifying strategies to improve the sustainment of health behaviour interventions in these settings requires a comprehensive understanding of factors that may impede or promote their ongoing delivery. This review identified multi-level factors that can be addressed by strategies to improve the sustainment of such interventions, and suggests how future research might address gaps in the evidence base. Trial registration This review was prospectively registered on PROSPERO: CRD42020127869, Jan. 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-021-01134-y.
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Affiliation(s)
- Adam Shoesmith
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia. .,Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia. .,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.
| | - Alix Hall
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, 2305, NSW, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, 2305, NSW, Australia
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Byron J Powell
- Brown School and School of Medicine, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Hannah Brown
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, 2305, NSW, Australia
| | - Serene Yoong
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, 2305, NSW, Australia
| | - Cassandra Lane
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia
| | - Debbie Booth
- University Library, Academic Division, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Nicole Nathan
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia.,Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, 2305, NSW, Australia
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Fernández CR, Lee J, Duroseau N, Vargas-Rodriguez I, Rieder J. Child Health Behaviour and Parent Priorities for a School-Based Healthy Lifestyle Programme. HEALTH EDUCATION JOURNAL 2021; 80:361-372. [PMID: 35747426 PMCID: PMC9217183 DOI: 10.1177/0017896920972152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The purpose of this study was to characterise parents' concerns for their children's health behaviours and perceptions of motivators and barriers to positive child health behaviour change, and to determine associations between motivators and barriers and parents' priorities for a school-based healthy lifestyle programme. DESIGN Cross-sectional study of 46 parents who had completed an un-validated survey distributed during school-wide events. SETTING School for children aged 5-14 years in The Bronx, New York City, USA. METHODS Wilcoxon Rank Sum tests compared motivators and barriers to positive child health behaviour change by heath behaviour concern; Spearman's correlation measured associations between motivators and barriers and programme priorities. RESULTS Parents concerned about child weight significantly ranked keeping up with others and decreasing clothing size as motivators, while parents concerned about child food choices significantly ranked improving food choices and decreasing BMI and clothing size as motivators. Food-, play-, and self-esteem-related motivators were associated with nutrition education (rs ≥ .41, p ≤ .01), physical activity classes (rs ≥ .29, p ≤ .04) and child involvement in programme decision-making (rs ≥ .43, p ≤ .01) priorities. Consistency-, child resistance-, and home rules-related barriers were associated with nutrition education (rs ≥ .37, p=.02), physical activity classes (rs ≥ .32, p = .02), and child involvement (rs ≥ .40, p ≤ .02) priorities. CONCLUSIONS Despite the study sample size, selection bias, and generalisability limitations, prioritising nutrition, physical activity and child involvement in programme decision-making may enhance parent support for school-based healthy lifestyle programmes.
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Affiliation(s)
- Cristina R Fernández
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Janet Lee
- Department of Pediatrics, Mount Sinai Health System, New York, NY, USA
| | - Nathalie Duroseau
- Adolescent Medicine Fellow, Department of Pediatrics, Mount Sinai Health System, New York, NY, USA
| | | | - Jessica Rieder
- Department of Pediatrics, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, NY, USA
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35
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Lai L, Cai L, Tan W, Zeng X, Sun F, Huang WY, Wong SHS, Chen Y. Adiposity Mediates the Association of Objectively Measured Physical Activity with Cardiorespiratory Fitness in Children. Child Obes 2020; 16:554-563. [PMID: 33185475 DOI: 10.1089/chi.2020.0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The relationship of physical activity (PA) to cardiorespiratory fitness (CRF) is well established in children. However, the extent to which adiposity affects this association remains unclear. Objective: The study aimed to explore whether the relationships of different PA intensities to CRF are explained by adiposity. Methods: Cross-sectional data were collected from 374 children (51.87% boys) aged 7-12 years. The time spent (min/day) in vigorous PA (VPA), moderate PA (MPA), light PA (LPA), and sedentary behavior was objectively measured using triaxial accelerometry. Height, weight, and waist circumference (WC) were objectively measured, from which the BMI was derived. The 20-meter shuttle run test was conducted to estimate maximal oxygen consumption [VO2max, mL/(kg·min)]. Linear mixed models and mediation analysis with bootstrapping were used to analyze data. Results: VO2max was positively associated with VPA [β = 0.143, 95% confidence interval (95% CI): 0.091 to 0.194], MPA (β = 0.051, 95% CI: 0.016 to 0.086), and moderate-to-vigorous PA (MVPA) (β = 0.052, 95% CI: 0.029 to 0.075), but not LPA or sedentary time. Both BMI and WC partially mediated the relationships of VPA and MVPA to VO2max, with the percentage of the total effect mediated by adiposity ranging from 18.0% to 19.6%. Similar results were also observed among boys but not among girls. Conclusions: Only moderate or vigorous intensity of PA is favorably correlated with CRF in children. BMI and WC play a pivotal mediating role in these associations, especially in boys, suggesting that promoting higher intensity of PA might benefit children's CRF through reducing adiposity.
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Affiliation(s)
- Lijuan Lai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiqing Tan
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Xia Zeng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Fenghua Sun
- Department of Health and Physical Education, Education University of Hong Kong, Hong Kong, China
| | - Wendy Yajun Huang
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Stephen Heung Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Verjans-Janssen SRB, Gerards SMPL, Kremers SPJ, Vos SB, Jansen MWJ, Van Kann DHH. Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children. Int J Behav Nutr Phys Act 2020; 17:105. [PMID: 32807194 PMCID: PMC7433155 DOI: 10.1186/s12966-020-01012-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/10/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of the current study was to evaluate the one- and two-year effectiveness of the KEIGAAF intervention, a school-based mutual adaptation intervention, on the BMI z-score (primary outcome), and energy balance-related behaviors (secondary outcomes) of children aged 7-10 years.A quasi-experimental study was conducted including eight intervention schools and three control schools located in low socioeconomic neighborhoods in the Netherlands. Baseline measurements were conducted in March and April 2017 and repeated after one and 2 years. Data were collected on children's BMI z-score, sedentary behavior (SB), physical activity (PA) behavior, and nutrition behavior through the use of anthropometric measurements, accelerometers, and questionnaires, respectively. All data were supplemented with demographics, and weather conditions data was added to the PA data. Based on the comprehensiveness of implemented physical activities, intervention schools were divided into schools having a comprehensive PA approach and schools having a less comprehensive approach. Intervention effects on continuous outcomes were analyzed using multiple linear mixed models and on binary outcome measures using generalized estimating equations. Intervention and control schools were compared, as well as comprehensive PA schools, less comprehensive PA schools, and control schools. Effect sizes (Cohen's d) were calculated.In total, 523 children participated. Children were on average 8.5 years old and 54% were girls. After 2 years, intervention children's BMI z-score decreased (B = -0.05, 95% CI -0.11;0.01) significantly compared to the control group (B = 0.20, 95% CI 0.09;0.31). Additionally, the intervention prevented an age-related decline in moderate-to-vigorous PA (MVPA) (%MVPA: B = 0.95, 95% CI 0.13;1.76). Negative intervention effects were seen on sugar-sweetened beverages and water consumption at school, due to larger favorable changes in the control group compared to the intervention group. After 2 years, the comprehensive PA schools showed more favorable effects on BMI z-score, SB, and MVPA compared to the other two conditions.This study shows that the KEIGAAF intervention is effective in improving children's MVPA during school days and BMI z-score, especially in vulnerable children. Additionally, we advocate the implementation of a comprehensive approach to promote a healthy weight status, to stimulate children's PA levels, and to prevent children from spending excessive time on sedentary behaviors.Trial registrationNetherlands Trial Register, NTR6716 ( NL6528 ), Registered 27 June 2017 - retrospectively registered.
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Affiliation(s)
- Sacha R B Verjans-Janssen
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands.
| | - Sanne M P L Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands
| | - Steven B Vos
- Department of Industrial Design, Eindhoven University of Technology, 5612, AZ, Eindhoven, The Netherlands.,School of Sport Studies, Fontys University of Applied Sciences, 5644, HZ, Eindhoven, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health, Public Health Service South-Limburg, 6400, AA, Heerlen, The Netherlands.,Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, 6229, GT, Maastricht, The Netherlands
| | - Dave H H Van Kann
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands.,School of Sport Studies, Fontys University of Applied Sciences, 5644, HZ, Eindhoven, The Netherlands
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Pan HJ, Hung LJ, Chen CY. Effect of class-based lifestyle intervention on the management of childhood obesity. Obes Res Clin Pract 2020; 14:184-190. [PMID: 32381350 DOI: 10.1016/j.orcp.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/31/2019] [Accepted: 03/24/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Childhood obesity is prevalent in southern Taiwan and lifestyle interventions for the management of childhood obesity are challenging. How to overcome the barriers of implementation programs is crucial. We offered lunchtime education and integrated it into education programs. Finally, we evaluated whether such an intervention could change unhealthy behaviors and reduce obesity tendency among elementary students. METHODS This was a prospective cohort study, conducted at an elementary school from September 2015 to July 2018. We distributed a lifestyle questionnaire to assess the students' dietary habits and physical activities before our intervention. We offered class-based interactive nutrition programs and record the behavior and weight change each semester. The body mass index (BMI) of the students were obtained each semester, and they were categorized as underweight, normal, overweight, and obese according to the age-specific BMI. RESULTS In total, 279 students were followed for 3 consecutive years. The most prevalent unhealthy dietary habit was the consumption of sweetened beverages in approximately 76% of the students. At the end of the study, the percentage of normal weight increased and the overall percentage of overweight/obesity decreased in both groups. At the end of the study, the BMI-time curve became flatter than that of Kaohsiung (regional) city and approached the national standard. It indicates that the increase in average BMI was effectively delayed with our intervention. CONCLUSIONS Lunchtime education is an innovative way to provide class-based education programs in school that yielded behavior changes and are effective approaches for delaying childhood obesity.
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Affiliation(s)
- Hsiang Ju Pan
- Department of Family Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan; Fooyin University, 151 Jinxue Rd., Daliao Dist., Kaohsiung City 83102, Taiwan.
| | - Li Ju Hung
- Department of Family Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan; National Kaohsiung University of Science and Technology, No. 415, Jiangong Rd., Sanmin Dist., Kaohsiung City 80778, Taiwan
| | - Chieh Yu Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan
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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: 6] [Impact Index Per Article: 1.5] [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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