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Dunn CG, Burgermaster M, Adams A, Koch P, Adintori PA, Stage VC. A Systematic Review and Content Analysis of Classroom Teacher Professional Development in Nutrition Education Programs. Adv Nutr 2019; 10:351-359. [PMID: 30668616 PMCID: PMC6416037 DOI: 10.1093/advances/nmy075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/23/2018] [Accepted: 10/03/2018] [Indexed: 11/14/2022] Open
Abstract
Many nutrition programs include classroom-based education. Schoolteachers are relied upon to deliver these programs despite gaps in nutrition education motivation, knowledge, and self-efficacy. Teacher professional development (PD) for these nutrition education programs has been identified as a strategy for improving program effectiveness, yet many interventions do not include a PD component and still fewer describe it. A literature search was conducted between January and February 2017; articles were collected from PubMed, ERIC, and EBSCOhost. Article inclusion criteria were as follows: 1) published in an English-language peer-reviewed or scholarly journal, 2) published after 2000, 3) empirical research, 4) research conducted in a K-12 classroom, 5) research included nutrition education component, and 6) program delivered by a classroom teacher. Twenty-seven interventions were identified. A team of 2 researchers performed content analysis based on an evidence-based set of 7 PD components to assess if and how these components were incorporated before, during, or after program implementation. Little information was provided that described the role of teacher PD in the course of delivering nutrition education in classroom-based programs. The most common elements of PD described in the literature were the time spent in PD and follow-up with instructors during or after program implementation. There was a notable lack of methodologic description of teacher PD, and this limited reporting may decrease researchers' ability to work with teachers in a consistent and effective manner.
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Affiliation(s)
- Caroline G Dunn
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
- Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, MA
| | - Marissa Burgermaster
- Nutritional Sciences, College of Natural Sciences, and
- Population Health, Dell Medical School, University of Texas at Austin, Austin, TX
| | - Alyson Adams
- School of Teaching and Learning, College of Education, University of Florida, Gainesville, FL
| | - Pamela Koch
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Peter A Adintori
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Virginia C Stage
- Department of Nutrition Science, College of Allied Health Sciences, East Carolina University, Gainesville, NC
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Measuring implementation fidelity of school-based obesity prevention programmes: a systematic review. Int J Behav Nutr Phys Act 2018; 15:75. [PMID: 30103764 PMCID: PMC6088402 DOI: 10.1186/s12966-018-0709-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/26/2018] [Indexed: 02/01/2023] Open
Abstract
Background Until now, there is no clear overview of how fidelity is assessed in school-based obesity prevention programmes. In order to move the field of obesity prevention programmes forward, the current review aimed to 1) identify which fidelity components have been measured in school-based obesity prevention programmes; 2) identify how fidelity components have been measured; and 3) score the quality of these methods. Methods Studies published between January 2001–October 2017 were selected from searches in PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library and ERIC. We included studies examining the fidelity of obesity prevention programmes (nutrition and/or physical activity and/or sitting) at school (children aged 4–18 year) measuring at least one component of implementation fidelity. A data extraction was performed to identify which and how fidelity components were measured. Thereafter, a quality assessment was performed to score the quality of these methods. We scored each fidelity component on 7 quality criteria. Each fidelity component was rated high (> 75% positive), moderate (50–75%) or low (< 50%). Results Of the 26,294 retrieved articles, 73 articles reporting on 63 different studies were included in this review. In 17 studies a process evaluation was based on a theoretical framework. In total, 120 fidelity components were measured across studies: dose was measured most often (N = 50), followed by responsiveness (N = 36), adherence (N = 26) and quality of delivery (N = 8). There was substantial variability in how fidelity components were defined as well as how they were measured. Most common methods were observations, logbooks and questionnaires targeting teachers. The quality assessment scores ranged from 0 to 86%; most fidelity components scored low quality (n = 77). Conclusions There is no consensus on the operationalisation of concepts and methods used for assessing fidelity in school-based obesity prevention programmes and the quality of methods used is weak. As a result, we call for more consensus on the concepts and clear reporting on the methods employed for measurements of fidelity to increase the quality of fidelity measurements. Moreover, researchers should focus on the relation between fidelity and programme outcomes and determine to what extent adaptations to programmes have been made, whilst still being effective. Electronic supplementary material The online version of this article (10.1186/s12966-018-0709-x) contains supplementary material, which is available to authorized users.
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Criss S, Tran A, Ganter C, Aftosmes-Tobio A, Gortmaker S, Viswanath K, Kwass JA, Davison KK. A Cascade of Champions: A Qualitative Study about the MA-CORD Media Competition Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:404. [PMID: 27058550 PMCID: PMC4847066 DOI: 10.3390/ijerph13040404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 03/15/2016] [Accepted: 03/23/2016] [Indexed: 11/16/2022]
Abstract
A media competition was part of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study. Criss et al., previously outlined the development and implementation of the competition, including variation in reach and adoption of the intervention across schools and afterschool programs. In this qualitative study, we examine community, provider, and organizational factors that explain the variation of media competition reach in school and afterschool programs, and describe the awareness of the media competition across other community sectors. Durlak and DuPre's ecological framework for understanding effective implementation provided the theoretical underpinnings for this study. Fifty-four key informant interviews were conducted, transcribed, and analyzed. Organizational capacity of committed teachers/staff and adaptability of the media competition seemed to be drivers for higher reach within school and afterschool programs. Salient themes that emerged as facilitators of effective implementation were having a cascade of champions and providing opportunity to participate in the media competition outside traditional class time. Clinics and coalitions were identified as additional sectors aware of the media competition. Specifically, our findings offer a new perspective on intervention design and a recommended direction for further study.
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Affiliation(s)
- Shaniece Criss
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA.
| | - Alvin Tran
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
| | - Claudia Ganter
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
| | - Alyssa Aftosmes-Tobio
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
| | - Steven Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA.
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA.
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
| | - Jo-Ann Kwass
- Massachusetts Department of Public Health, Bureau of Community Health and Prevention, 250 Washington Street, Boston, MA 02108, USA.
| | - Kirsten K Davison
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
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Shaw SR, Gomes P, Polotskaia A, Jankowska AM. The relationship between student health and academic performance: Implications for school psychologists. SCHOOL PSYCHOLOGY INTERNATIONAL 2015. [DOI: 10.1177/0143034314565425] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children who are unhealthy are at higher risk for school problems than students who are free from medical problems. Students with poor health have a higher probability of school failure, grade retention, and dropout. The relationship between student health and academic success is complex. Common manageable factors of student health are nutrition, maintaining healthy weight, and physical fitness. Through a comprehensive literature review the relationships among school achievement and nutrition, maintaining healthy weight, and physical fitness are examined. Furthermore, the efficacy of educational programs to improve nutrition, maintain healthy weight, and increase physical fitness is evaluated. The complexity of the relationship among variables is presented and areas for future research and practice for school psychologists are described.
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Langford R, Bonell CP, Jones HE, Pouliou T, Murphy SM, Waters E, Komro KA, Gibbs LF, Magnus D, Campbell R. The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane Database Syst Rev 2014; 2014:CD008958. [PMID: 24737131 PMCID: PMC11214127 DOI: 10.1002/14651858.cd008958.pub2] [Citation(s) in RCA: 272] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The World Health Organization's (WHO's) Health Promoting Schools (HPS) framework is an holistic, settings-based approach to promoting health and educational attainment in school. The effectiveness of this approach has not been previously rigorously reviewed. OBJECTIVES To assess the effectiveness of the Health Promoting Schools (HPS) framework in improving the health and well-being of students and their academic achievement. SEARCH METHODS We searched the following electronic databases in January 2011 and again in March and April 2013: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, Campbell Library, ASSIA, BiblioMap, CAB Abstracts, IBSS, Social Science Citation Index, Sociological Abstracts, TRoPHI, Global Health Database, SIGLE, Australian Education Index, British Education Index, Education Resources Information Centre, Database of Education Research, Dissertation Express, Index to Theses in Great Britain and Ireland, ClinicalTrials.gov, Current controlled trials, and WHO International Clinical Trials Registry Platform. We also searched relevant websites, handsearched reference lists, and used citation tracking to identify other relevant articles. SELECTION CRITERIA We included cluster-randomised controlled trials where randomisation took place at the level of school, district or other geographical area. Participants were children and young people aged four to 18 years, attending schools or colleges. In this review, we define HPS interventions as comprising the following three elements: input to the curriculum; changes to the school's ethos or environment or both; and engagement with families or communities, or both. We compared this intervention against schools that implemented either no intervention or continued with their usual practice, or any programme that included just one or two of the above mentioned HPS elements. DATA COLLECTION AND ANALYSIS At least two review authors identified relevant trials, extracted data, and assessed risk of bias in the trials. We grouped different types of interventions according to the health topic targeted or the approach used, or both. Where data permitted, we performed random-effects meta-analyses to provide a summary of results across studies. MAIN RESULTS We included 67 eligible cluster trials, randomising 1443 schools or districts. This is made up of 1345 schools and 98 districts. The studies tackled a range of health issues: physical activity (4), nutrition (12), physical activity and nutrition combined (18), bullying (7), tobacco (5), alcohol (2), sexual health (2), violence (2), mental health (2), hand-washing (2), multiple risk behaviours (7), cycle-helmet use (1), eating disorders (1), sun protection (1), and oral health (1). The quality of evidence overall was low to moderate as determined by the GRADE approach. 'Risk of bias' assessments identified methodological limitations, including heavy reliance on self-reported data and high attrition rates for some studies. In addition, there was a lack of long-term follow-up data for most studies.We found positive effects for some interventions for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small but have the potential to produce public health benefits at the population level. We found little evidence of effectiveness for standardised body mass index (zBMI) and no evidence of effectiveness for fat intake, alcohol use, drug use, mental health, violence and bullying others; however, only a small number of studies focused on these latter outcomes. It was not possible to meta-analyse data on other health outcomes due to lack of data. Few studies provided details on adverse events or outcomes related to the interventions. In addition, few studies included any academic, attendance or school-related outcomes. We therefore cannot draw any clear conclusions as to the effectiveness of this approach for improving academic achievement. AUTHORS' CONCLUSIONS The results of this review provide evidence for the effectiveness of some interventions based on the HPS framework for improving certain health outcomes but not others. More well-designed research is required to establish the effectiveness of this approach for other health topics and academic achievement.
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Affiliation(s)
- Rebecca Langford
- University of BristolSchool of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
| | - Christopher P Bonell
- Institute of Education, University of LondonSocial Science Research Unit18 Woburn SquareLondonLondonUKWC1H 0NR
| | - Hayley E Jones
- University of BristolSchool of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
| | - Theodora Pouliou
- University of BristolSchool of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
| | - Simon M Murphy
- Cardiff UniversityCardiff School of Social Sciences1‐3 Museum PlaceCardiffSouth GlamorganUKCF10 3BD
| | - Elizabeth Waters
- The University of MelbourneJack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global HealthLevel 5/207 Bouverie StParkvilleVICAustralia3052
| | - Kelli A Komro
- University of FloridaHealth Outcomes and Policy and Institute for Child Health PolicyPO Box 100177GainesvilleFloridaUSA32610‐0177
| | - Lisa F Gibbs
- The University of MelbourneJack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global HealthLevel 5/207 Bouverie StParkvilleVICAustralia3052
| | - Daniel Magnus
- University of BristolSchool of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
| | - Rona Campbell
- University of BristolSchool of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
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Peñalvo JL, Sotos-Prieto M, Santos-Beneit G, Pocock S, Redondo J, Fuster V. The Program SI! intervention for enhancing a healthy lifestyle in preschoolers: first results from a cluster randomized trial. BMC Public Health 2013; 13:1208. [PMID: 24359285 PMCID: PMC3901339 DOI: 10.1186/1471-2458-13-1208] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 12/16/2013] [Indexed: 11/20/2022] Open
Abstract
Background Unhealthy lifestyles contribute to the development of cardiovascular risk factors, whose incidence is increasing among children and adolescents. The Program SI! is a long-term, multi-target behavioral intervention to promote healthy lifestyle habits in children through the school environment. The objective of the study is to evaluate the efficacy of this intervention in its first phase, preschoolers. Methods Cluster-randomized controlled trial in public schools in the city of Madrid, Spain. A total 24 schools, including 2062 children (3–5 years), 1949 families, and 125 teachers participated in the study. Schools were assigned to their usual school curriculum or to engage in an additional multi-component intervention (Program SI!). The primary outcome of this trial is 1-school year changes from baseline in scores for children’s knowledge, attitudes and habits (KAH). Secondary outcomes are 1-school year changes from baseline in scores for knowledge, attitudes, and habits among parents, teachers, and the school environment. Results After 1-school year, our results indicate that the Program SI! intervention increases children’s KAH scores, both overall (3.45, 95% CI, 1.84-5.05) and component-specific (Diet: 0.93, 95% CI, 0.12-1.75; Physical activity: 1.93, 95% CI, 1.17-2.69; Human body: 0.65, 95% CI, 0.07-1.24) score. Conclusions The Program SI! is demonstrated as an effective and feasible strategy for increasing knowledge and improving lifestyle attitudes and habits among very young children. Trial registration NCT01579708, Evaluation of the Program SI! for Preschool Education: A School-Based Randomized Controlled Trial (Preschool-SI!).
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Affiliation(s)
- José L Peñalvo
- Area of Epidemiology and Populations Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fdez Almagro 3, Madrid 28029, Spain.
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Hoffman JA, Thompson DR, Franko DL, Power TJ, Leff SS, Stallings VA. Decaying behavioral effects in a randomized, multi-year fruit and vegetable intake intervention. Prev Med 2011; 52:370-5. [PMID: 21371499 PMCID: PMC3078952 DOI: 10.1016/j.ypmed.2011.02.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 02/15/2011] [Accepted: 02/21/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the effects of a multi-component, theory-based, 2.5-year intervention on children's fruit and vegetable consumption, preferences, knowledge and body mass index. METHODS Four inner city elementary schools in the Northeastern United States were randomized to an intervention (n=149) or control group (n=148) in 2005. Fruit and vegetable consumption during school lunch (measured by plate waste), preferences, and knowledge, as well as body mass index, were assessed five times across 3.5 years (pre-intervention, spring 2006, 2007, 2008 and 2009). Hierarchical linear modeling was used to analyze program outcomes. RESULTS At the first post-test assessment, children in the experimental group ate 0.28 more servings/lunch of fruit and vegetable relative to children in the control group and changes in fruit and vegetable consumption were found in each year throughout the program. However, this effect declined steadily across time so that by the delayed one-year follow-up period there was no difference between the groups in fruit and vegetable consumption. There were persistent intervention effects on children's knowledge. There were no effects on fruit and vegetable preferences and body mass index throughout the study. CONCLUSION Although there was initial fruit and vegetable behavior change, annual measurements indicated a gradual decay of behavioral effects. These data have implications for the design of school-based fruit and vegetable interventions.
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Hoffman JA, Franko DL, Thompson DR, Power TJ, Stallings VA. Longitudinal behavioral effects of a school-based fruit and vegetable promotion program. J Pediatr Psychol 2009; 35:61-71. [PMID: 19439567 DOI: 10.1093/jpepsy/jsp041] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE This study examined the longitudinal effects of a school-based program on kindergarten and first grade children's fruit and vegetable (F&V) consumption. METHODS The program included lunchroom, classroom, school-wide, and family components. The primary dependent variable, F&V consumed at lunch, was assessed using weighed plate waste. Hierarchical linear models were used to analyze the differences between intervention and control groups and to account for repeated measurements. RESULTS Children in the experimental group consumed more F&V (F = 29 g; V = 6 g; 0.43 portions/lunch; 0.28 servings/lunch) at the end of Year 1 compared with children in the control group. At the end of Year 2, children in the experimental group consumed more fruit (21 g; 0.23 portions/lunch; 0.15 servings/lunch), but not more vegetables compared with children in the control group. CONCLUSIONS The intervention resulted in increased F&V consumption, with more pronounced and enduring effects for fruits than vegetables.
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Blom-Hoffman J, Wilcox KR, Dunn L, Leff SS, Power TJ. Family Involvement in School-Based Health Promotion: Bringing Nutrition Information Home. SCHOOL PSYCHOLOGY REVIEW 2008; 37:567-577. [PMID: 19633724 PMCID: PMC2714582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Family-school collaboration related to children's physical development has become increasingly important as childhood obesity rates continue to rise. The present study described the development and implementation of a literacy-based, family component of a school-based health education program and investigated its viability, acceptability, and effectiveness. Interactive children's books were the mechanism by which students, parents, and teachers received consistent messages at home and school regarding nutrition information. The home-school intervention served to bridge home and school cultures in an urban population. Preliminary process evaluation results indicated that the interactive children's books were feasible to implement in the school context. Parents, children, and teachers had positive perceptions of the books. Parents who received the books demonstrated increased knowledge of 5 a Day, the primary nutrition message communicated in the program. Although not statistically significant, after the first and second years of intervention, parents in the experimental group reported that their children were eating 0.54 and 0.36 additional servings of fruit and vegetables per day compared with children in the control group. The program did not seem to impact the availability and accessibility of fruits and vegetables at home.
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Blom-Hoffman J, Leff SS, Franko DL, Weinstein E, Beakley K, Power TJ. Consent Procedures and Participation Rates in School-Based Intervention and Prevention Research: Using a Multi-Component, Partnership-Based Approach to Recruit Participants. SCHOOL MENTAL HEALTH 2008; 1:3-15. [PMID: 19834586 DOI: 10.1007/s12310-008-9000-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Evaluations of school-based interventions and prevention programs typically require parental consent for students to participate. In school-based efforts, program evaluators may have limited access to parents and considerable effort is required to obtain signed consent. This issue is particularly salient when conducting research in under-resourced, urban schools, where parent involvement in the school setting may be somewhat limited. The aims of this article were to (a) examine the published school-based prevention and intervention literature to assess the state of the field in terms of consent procedures and participation rates; and (b) describe two examples of health promotion studies that used multi-component, partnership-based strategies in urban schools to encourage communication among children, their parents, and researchers. The purpose of the case studies was to generate hypotheses to advance the science related to school-based participant recruitment for research studies. Of nearly 500 studies reviewed, only 11.5% reported both consent procedures and participation rates. Studies using active consent procedures had a mean participation rate of 65.5% (range: 11-100%). This article highlights the need for researchers to report consent procedures and participation rates and describes partnership-based strategies used to enroll students into two urban, school-based health promotion studies.
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Affiliation(s)
- Jessica Blom-Hoffman
- Department of Counseling and Applied Educational Psychology, Northeastern University, 203 Lake Hall, Boston, MA 02115, USA
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