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Carducci B, Dominguez G, Kidd E, Oh C, Jain R, Khan A, Bhutta ZA. Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs. Nutr Rev 2024:nuae030. [PMID: 38767979 DOI: 10.1093/nutrit/nuae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
CONTEXT The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. OBJECTIVE Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. DATA SOURCES A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. DATA EXTRACTION Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. DATA ANALYSIS A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. CONCLUSIONS This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022303255.
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Affiliation(s)
- Bianca Carducci
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Georgia Dominguez
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Emily Kidd
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Christina Oh
- Western University, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Reena Jain
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Amira Khan
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Centre of Excellence in Women, and Child Health, Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public, Health University of Toronto Health Sciences Building, Toronto, ON, Canada
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Wade L, Leahy AA, Babic MJ, Beauchamp MR, Smith JJ, Kennedy SG, Boyer J, Nathan N, Robinson K, Lubans DR. A systematic review and meta-analysis of the benefits of school-based, peer-led interventions for leaders. Sci Rep 2022; 12:21222. [PMID: 36481781 PMCID: PMC9732042 DOI: 10.1038/s41598-022-25662-9] [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: 05/10/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
The aim of our systematic review and meta-analysis was to quantitatively synthesise the effects of school-based peer-led interventions on leaders' academic, psychosocial, behavioural, and physical outcomes. Eligible studies were those that: (i) evaluated a school-based peer-led intervention using an experimental or quasi-experimental study design, (ii) included an age-matched control or comparison group, and (iii) evaluated the impact of the intervention on one or more leader outcomes. Medline, Sportdiscus, Psychinfo, Embase, and Scopus online databases were searched on the 24th of October, 2022 which yielded 13,572 results, with 31 included in the narrative synthesis and 12 in the meta-analysis. We found large positive effects for leaders' attitudes toward bullying (d = 1.02), small-to-medium positive effects for leaders' literacy (d = 0.39), and small positive effects for leaders' self-esteem (d = 0.18). There were mixed findings for behavioural outcomes and null effects for physical outcomes. Notable limitations of this research are the inclusion of a relatively small number of studies, and high heterogeneity in those included. Our findings have the potential to inform educational practice, but also highlight the need for further research examining the mechanisms that might account for the observed effects. Our systematic review was prospectively registered with PROSPERO (CRD42021273129).
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Affiliation(s)
- Levi Wade
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW 2308 Australia ,grid.413648.c Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Angus A. Leahy
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW 2308 Australia ,grid.413648.c Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Mark J. Babic
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW 2308 Australia ,grid.413648.c Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Mark R. Beauchamp
- grid.17091.3e0000 0001 2288 9830School of Kinesiology, University of British Columbia, Vancouver, BC Canada
| | - Jordan J. Smith
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW 2308 Australia ,grid.413648.c Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Sarah G. Kennedy
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Penrith, NSW Australia
| | - James Boyer
- grid.461941.f0000 0001 0703 8464New South Wales Department of Education, Sydney, NSW Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend, NSW Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, The University of Newcastle, Callaghan, NSW Australia ,grid.413648.c Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Katie Robinson
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW 2308 Australia ,grid.413648.c Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - David R. Lubans
- grid.266842.c0000 0000 8831 109XCentre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW 2308 Australia ,grid.413648.c Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia ,grid.9681.60000 0001 1013 7965 Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Robertson D, Carins J, Rundle‐Thiele S, Harris J. Evaluation of Social Impact Within Primary School Health Promotion: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:739-764. [PMID: 35365879 PMCID: PMC9544285 DOI: 10.1111/josh.13160] [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: 09/08/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Health promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions. METHOD A systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom. RESULTS A total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%). CONCLUSIONS This systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.
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Affiliation(s)
- Dianne Robertson
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Julia Carins
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Sharyn Rundle‐Thiele
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Jessica Harris
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
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Cotton W, Dudley D, Peralta L, Werkhoven T. The effect of teacher-delivered nutrition education programs on elementary-aged students: An updated systematic review and meta-analysis. Prev Med Rep 2020; 20:101178. [PMID: 32944494 PMCID: PMC7481566 DOI: 10.1016/j.pmedr.2020.101178] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/04/2020] [Accepted: 08/08/2020] [Indexed: 11/29/2022] Open
Abstract
Research shows that schools can make a positive impact on children’s nutritional outcomes. However, it is also reported that schools and teaching staff note many barriers, which may restrict nutritional education programming and delivery. This is concerning, considering the view that teachers are the key agents for promoting health and nutrition within schools. The purpose of the updated systematic review and meta-analysis was to ascertain the impact that nutrition education programs have on elementary-aged students’ energy intake, fruit, vegetable, sugar consumption and nutritional knowledge. A systematic literature search was conducted using electronic databases (The Cochrane Central Register of Controlled Trials (CENTRAL); A + Education; ERIC; PsycINFO; MEDLINE; ProQuest Central, Journals@Ovid and SAGE Health Sciences Full-Text Collection) from 1990 to 31st October 2018. This process yielded 34 studies for inclusion in this systematic review and meta-analysis. Of these studies, seven studies had a focus on energy intake, five had a focus on sugar consumption, 21 of the studies looked at fruit and vegetable consumption and 13 studies focused on nutritional knowledge. The results suggest that the teaching of nutrition education in elementary schools by qualified teachers can make an important contribution to the knowledge and dietary habits of children. The small and medium effect sizes indicate that prudent, evidence-based decisions need to be made by policy makers and pedagogues as to the teaching strategies employed when delivering nutrition education programs to elementary-aged students. The review is reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (van Sluijs et al., 2007).
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Affiliation(s)
- Wayne Cotton
- The University of Sydney, NSW 2006, Australia
- Corresponding author at: The University of Sydney, Room 337, Building A35, NSW 2006, Australia.
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Lepe S, Goodwin J, Mulligan KT, Balestracci K, Sebelia L, Greene G. Process Evaluation of a Policy, Systems, and Environmental Change Intervention in an Urban School District. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:307-317. [PMID: 30274727 DOI: 10.1016/j.jneb.2018.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 07/24/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To conduct a comprehensive process evaluation of a policy, systems, and environmental (PSE) change intervention. DESIGN Quasi-experimental, mixed methods. SETTING Low-income urban school district. PARTICIPANTS Fifth-grade students in 4 schools assigned to 2 intervention and 2 comparison schools (intervention, n = 142; comparison, n = 170). INTERVENTION Both groups received a nutrition curriculum delivered by classroom teachers. Intervention schools also received 10 PSE lessons taught by paraprofessional educators. MAIN OUTCOME MEASURES Quantitative data were obtained from fidelity and observation checklists, grading rubrics and self-reported student surveys. Focus group and interviews provided qualitative data. Quantitative measures included assessments of PSE and fruit and vegetable knowledge, as well as assessment of times fruits and vegetables (FV) were consumed yesterday. ANALYSES Qualitative data were analyzed using inductive content analysis. Quantitative data were analyzed using repeated measures analysis of variance and analysis of co-variance. RESULTS Fidelity, dose, reach, and acceptance of PSE intervention were high; students felt more empowered, although PSE lessons were considered lengthy and complicated. Intervention PSE and FV knowledge scores were significantly higher than comparison scores (F37.56, P < .001; and F3.94, P < .05, respectively). However, issues in communication were identified between school staff and researchers. CONCLUSIONS AND IMPLICATIONS Policy, systems, and environmental classroom interventions commented on the differences between quantitative and qualitative assessments, and this suggests the need for more sensitive quantitative assessments. Future research should look at long-term outcomes as this study only looked at short-term outcomes.
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Affiliation(s)
- Silvia Lepe
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Jennifer Goodwin
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Katie T Mulligan
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Kate Balestracci
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Linda Sebelia
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI.
| | - Geoffrey Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
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McIsaac JLD, Penney TL, Ata N, Munro-Sigfridson L, Cunningham J, Veugelers PJ, Storey K, Ohinmaa A, Kirk SF, Kuhle S. Evaluation of a health promoting schools program in a school board in Nova Scotia, Canada. Prev Med Rep 2017; 5:279-284. [PMID: 28149709 PMCID: PMC5279859 DOI: 10.1016/j.pmedr.2017.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/10/2017] [Accepted: 01/22/2017] [Indexed: 11/30/2022] Open
Abstract
A Health promoting schools (HPS) approach aims to make schools a healthy place through a holistic approach that promotes a supportive 'school ethos' and emphasizes improvements in physical, social, and emotional well-being and educational outcomes. A HPS initiative in rural Nova Scotia (Canada) provided an opportunity for a population-level natural experiment. This study investigated student well-being and health behaviours between schools with and without HPS implementation and schools with high and low school ethos scores. Student well-being, nutrition, and physical activity were examined in a cross-sectional survey of elementary students in Nova Scotia, Canada in 2014. Multiple regression was used to assess the relationship with student well-being using the Quality of Life in School (QoLS) instrument and health behaviours. The main exposure was attending one of the 10 HPS schools; secondary exposure was the school ethos score. The overall QoLS score and its subdomain scores in the adjusted models were higher in students attending HPS schools compared to those in non-HPS schools, but the differences were not statistically significant and the effect sizes were small. Students in schools that scored high on school ethos score had higher scores for the QoLS and its subdomains, but the difference was only significant for the teacher-student relationship domain. Although this study did not find significant differences between HPS and non-HPS schools, our results highlight the complexity of evaluating HPS effects in the real world. The findings suggest a potential role of a supportive school ethos for student well-being in school.
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Affiliation(s)
- Jessie-Lee D. McIsaac
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Tarra L. Penney
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Nicole Ata
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | | | - Jane Cunningham
- Western Zone, Nova Scotia Health Authority, Yarmouth, NS, Canada
| | | | - Kate Storey
- School of Public Health, University of Alberta, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, AB, Canada
| | - Sara F.L. Kirk
- Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Stefan Kuhle
- Dept of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Dept of Obstetrics & Gynaecology, Dalhousie University, Halifax, NS, Canada
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Sharif Ishak SIZ, Chin YS, Mohd Taib MN, Mohd Shariff Z. School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol. BMC Public Health 2016; 16:1101. [PMID: 27765023 PMCID: PMC5073924 DOI: 10.1186/s12889-016-3773-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/13/2016] [Indexed: 01/03/2023] Open
Abstract
Background Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13–14 years old. Methods/Design Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13–14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. Discussion It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. Trial registration UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).
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Affiliation(s)
- Sharifah Intan Zainun Sharif Ishak
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Yit Siew Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia. .,Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.
| | - Mohd Nasir Mohd Taib
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.,Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.,Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
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Yip C, Gates M, Gates A, Hanning RM. Peer-led nutrition education programs for school-aged youth: a systematic review of the literature. HEALTH EDUCATION RESEARCH 2016; 31:82-97. [PMID: 26661724 PMCID: PMC4883032 DOI: 10.1093/her/cyv063] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 11/06/2015] [Indexed: 06/05/2023]
Abstract
To date, the impacts of school-based, peer-led nutrition education initiatives have not been summarized or assessed collectively. This review presents the current evidence, identifies knowledge gaps, and provides recommendations for future research. PubMed, Scopus, ERIC and Google Scholar were searched for refereed Canadian and American primary studies published between January 2000 and November 2013, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventeen articles (11 programs) from Canada (24%) and the United States (76%) were identified. The results were summarized in terms of the study population, program design and main outcomes. Common outcome measures included healthy eating knowledge (n = 5), self-efficacy or attitudes towards healthy eating (n = 13), dietary measures (n = 9) and body mass index (n = 4), all of which tended to improve as a result of the programs. More research is needed to ascertain the effect of improvements in knowledge, self-efficacy and attitudes towards healthy eating on food behaviors. When evaluated, programs were generally well received, while the long-term maintenance of positive impacts was a challenge. Studies of sustainability and feasibility to promote long-term impact are a logical next step.
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Affiliation(s)
- Calvin Yip
- Department of Epidemiology and Biostatistics, Western University, 1151 Richmond Street, London, Ontario, N6A 3K1, Canada and
| | - Michelle Gates
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Allison Gates
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Rhona M Hanning
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
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Woodgate RL, Sigurdson CM. Building school-based cardiovascular health promotion capacity in youth: a mixed methods study. BMC Public Health 2015; 15:421. [PMID: 25909502 PMCID: PMC4416265 DOI: 10.1186/s12889-015-1759-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 04/21/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Essential to building cardiovascular health promotion capacity in youth, which extends into adulthood, are approaches that seek to empower, educate, and support. The Five Cs model of positive youth development (PYD) guided this study. This model represents the ability of youth to develop competence, confidence, connection, character, and caring when given the appropriate resources. The purpose of this two-year school-based feasibility study was to determine if providing a research intervention in the form of education, empowerment, and support build youth's capacity for cardiovascular health promotion. METHODS A mixed methods case study design was used to evaluate the process, and outcome of a youth-led cardiovascular health promotion program. Twenty-six youth aged 12-13 years from a Canadian middle school took part in the study. Youth participating in this study planned, implemented, and monitored cardiovascular health promotion activities in four areas: smoking, physical inactivity, nutrition and obesity. Qualitative data was collected from the youth participants using three focus groups and individual reflective journals. Quantitative data was collected with the PYD.2, a self-report questionnaire that assesses positive youth development and consists of 5 subscales: character, competence, caring, connection, and confidence. The participants completed the PYD before and after the program to determine if there were any changes in PYD scores after the intervention. The quantitative data was analyzed using paired samples t-tests, and the qualitative data was analyzed using constant comparative analysis. RESULTS While the PYD scores showed no significant changes, the qualitative findings confirmed that the youth acquired increased awareness and understanding of cardiovascular health promotion initiatives. Four themes emerged from the qualitative data, (1) doing the right thing, (2) wanting to make a change, but feeling constrained, (3) I get it, and (4) The project has changed me! The intervention was found to be acceptable and feasible for the youth participants and their school. CONCLUSIONS The contributions of this study were twofold. It generated evidence to support integrating positive youth development strategies into cardiovascular health promotion programs. Secondly, this study determined that the research intervention improved the participants' knowledge and attitudes about cardiovascular health and were suitable for further implementation and testing.
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Affiliation(s)
- Roberta L Woodgate
- Professor & Canadian Institutes of Health Research Applied Chair in Reproductive, Child and Youth Health Services and Policy Research, Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Corey M Sigurdson
- Ph.D. Candidate, Faculty of Graduate Studies, Applied Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
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Holsen I, Larsen T, Tjomsland HE, Servan AK. Exploring the importance of peers as leaders in the Dream School Program: from the perspectives of peer leaders, teachers and principals. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/1754730x.2014.978550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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