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Vieira M, Carvalho GS. The "Planning Health in School" Programme (PHS-pro) to Improve Healthy Eating and Physical Activity: Design, Methodology, and Process Evaluation. Nutrients 2023; 15:4543. [PMID: 37960196 PMCID: PMC10649764 DOI: 10.3390/nu15214543] [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: 09/20/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Few interventions have successfully promoted healthy eating and active living among children with effective changes in anthropometric health outcomes. Well-designed interventions involving multiple strategies to convert the knowledge already available into action are needed for preventing childhood obesity. In this study, an educational programme called "Planning Health in School" (PHS-pro) was designed, implemented and evaluated to contribute to the prevention of obesity in childhood. The PHS-pro aimed at improving the eating behaviours and lifestyles of Portuguese grade-6 children towards healthier nutritional status. This paper describes and evaluates the PHS-pro concerning: (i) the research design within the theoretical framework grounded on "The Transtheoretical Model" and the stages of change; (ii) the educational components and the application of the participatory methodology to engage children to meet their needs, as active participants in their change process; and (iii) the process evaluation of the intervention. The implementation of the PHS-pro took into account the views and inputs of the participants for evaluating the educational components that should be considered in the designing of interventions aiming to be effective strategies. From the health promotion perspective, this study is important because it examines new approaches and pathways to effectively prevent overweight and obesity in children.
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Affiliation(s)
- Margarida Vieira
- Research Centre on Child Studies, University of Minho, 4710-057 Braga, Portugal;
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Miller M, Barwood D, Devine A, Boston J, Smith S, Masek M. Rethinking Adolescent School Nutrition Education Through a Food Systems Lens. THE JOURNAL OF SCHOOL HEALTH 2023; 93:891-899. [PMID: 37254564 DOI: 10.1111/josh.13351] [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: 01/13/2022] [Revised: 03/24/2023] [Accepted: 05/21/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Obesity-driven nutrition education in schools does not appear to result in healthier adolescent food choices. This study explored food systems as an alternative pedagogical approach to engage students in nutrition education. METHODS After playing a food systems computer game, 250 13- to 16-year-old students in 5 Western Australian secondary schools, participated in group discussions to distinguish learning and interests in food systems. Discussion records were thematically coded using constant comparative analysis. RESULTS Students reported crop growth, food production and food waste, healthier food choices, and food systems as knowledge outcomes of game play. They requested additional content on food production, costing, handling, processing, and accessing local produce. Experiential activities were preferred pedagogical approaches. CONCLUSIONS Cross-curricular pedagogy which embraces human and planetary health through a food systems lens, can engage adolescents in nutrition education. Transformational computer games are effective to engage, educate and stimulate inquiry in food systems education.
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Affiliation(s)
- Margaret Miller
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Donna Barwood
- School of Education, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Amanda Devine
- Public Health and Occupational Health & Safety, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Julie Boston
- School of Education, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Sandra Smith
- School of Education, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
| | - Martin Masek
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia
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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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Crowe RK, Probst YC, Norman JA, Furber SE, Stanley RM, Ryan ST, Vuong C, Hammersley ML, Wardle K, Franco L, Beets MW, Weaver RG, Davis M, Innes-Hughes C, Okely AD. Foods and beverages provided in out of school hours care services: an observational study. BMC Public Health 2022; 22:277. [PMID: 35144567 PMCID: PMC8832650 DOI: 10.1186/s12889-022-12652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Out of school hours care (OSHC) is a fast-growing childcare setting in Australia, however the types of foods and beverages offered are relatively unknown. This study describes the food and beverages offered and investigates sector-level and setting-level factors which may impact OSHC in meeting the Australian Dietary Guidelines (ADG). Methods This cross-sectional, observational study was conducted in 89 OSHC services (between 2018 and 2019). Food and beverages offered, kitchen facilities and menus were captured via direct observation. Foods were categorised into five food groups or discretionary foods, based on the ADG, and frequencies determined. Short interviews with OSHC directors ascertained healthy eating policies, staff training, food quality assessment methods and food budgets. Fisher’s exact test explored the influence of sector-level and setting-level factors on food provision behaviours. Results Discretionary foods (1.5 ± 0.68) were offered more frequently than vegetables (0.82 ± 0.80) (p < .001), dairy (0.97 ± 0.81) (p = .013) and lean meats (0.22 ± 0.54) (p < .001). OSHC associated with long day care and reported using valid food quality assessment methods offered more lean meats (p= .002, and p= .004). Larger organisations offered more vegetables (p = .015) and discretionary foods (p= .007). Menus with clearly worded instructions to provide fruits and vegetables daily offered more fruit (p= .009), vegetables (p < .001) and whole grains (p= .003). No other sector or setting-level factors were associated with services aligning with the ADG. Conclusion Future interventions could benefit from trialling menu planning training and tools to assist OSHC services in NSW meet the ADG requirements.
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Affiliation(s)
- Ruth K Crowe
- School of Medicine, Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia. .,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.
| | - Yasmine C Probst
- School of Medicine, Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Jennifer A Norman
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia.,Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Susan E Furber
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - Rebecca M Stanley
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Sarah T Ryan
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Cecilia Vuong
- Health Promotion Service, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Megan L Hammersley
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Karen Wardle
- Health Promotion Service, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Lisa Franco
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - Michael W Beets
- Exercise Science, Arnold School of Public Health University of South Carolina, Columbia, SC, USA
| | - R Glenn Weaver
- Exercise Science, Arnold School of Public Health University of South Carolina, Columbia, SC, USA
| | - Marc Davis
- Centre for Population Health, St Leonards, NSW, Australia
| | | | - Anthony D Okely
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
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Wehner SK, Tjørnhøj-Thomsen T, Duus KS, Brautsch LAS, Jørgensen A, Bonnesen CT, Krølner RF. Adaptation, Student Participation and Gradual Withdrawal by Researchers as Sustainability Strategies in the High School-Based Young and Active Intervention: School Coordinators' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10557. [PMID: 34639854 PMCID: PMC8508229 DOI: 10.3390/ijerph181910557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/01/2021] [Accepted: 10/07/2021] [Indexed: 11/16/2022]
Abstract
Ensuring the sustainability of school-based public health intervention activities remains a challenge. The Young and Active (Y&A) intervention used peer-led workshops to promote movement and strengthen students' sense of community in 16 Danish high schools. Peer mentors inspired first-year students to implement movement activities. To support sustainability, we applied a three-year stepwise implementation strategy using university students as peer mentors in year 1 and senior high school students in the following two years. This study explores the sustainability potential of Y&A, focusing on school coordinators' reflections on the intervention's fit to their schools and the student-driven approach, and we assess the three-step implementation strategy. The study is based on telephone interviews with coordinators (n = 7) from schools that participated in all three years and participant observations of four workshops (a total of approximately 250 participating students). Results were generated through an abductive analysis. Seven schools continued the intervention throughout the three years and adapted it to fit their priorities. The student-driven approach was perceived to be valuable, but few student-driven activities were initiated. Teacher support seemed crucial to support students in starting up activities and acting as peer mentors in workshops. The three-step implementation strategy proved valuable due to the peer-approach and the possibility of gradual adaptation. In future similar initiatives, it is important to address how the adequate staff support of students can be facilitated.
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Affiliation(s)
- Stine Kjær Wehner
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark; (T.T.-T.); (K.S.D.); (L.A.S.B.); (A.J.); (C.T.B.); (R.F.K.)
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Almutairi NS, Burns S, Portsmouth L. Identifying factors associated with overweight and obesity among intermediate school students aged 12-15 years in school settings: mixed-methodology protocol. BMJ Open 2021; 11:e045877. [PMID: 34049915 PMCID: PMC8166636 DOI: 10.1136/bmjopen-2020-045877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Childhood obesity is a public health concern globally. In Arab countries, the prevalence of overweight and obesity has increased significantly over the last three decades. The level of childhood overweight and obesity in the Kingdom of Saudi Arabia (KSA) is high and continues to increase. This study will explore factors associated with overweight and obesity among adolescents and identify barriers and enablers to the implementation of comprehensive school-based obesity prevention interventions. METHODS AND ANALYSIS Socioecological model will inform this mixed-methods study. The study will include three phases: (1) a scoping review of the literature; (2) the development of a student survey instrument and (3) a mixed-method study comprising a cross-sectional survey targeting students aged 12-15 years with the collection of the students' height and weight measurements; one-on-one interviews with physical education teachers and school principals; and the administration of school climate audits using the Health Promoting School framework. Reliability and validity of the survey instrument will be examined during survey development. Descriptive, inferential and thematic analysis will be employed using appropriate statistical software. ETHICS AND DISSEMINATION Ethical approval has been granted from the Curtin University of Human Research Ethics Committee (HR2020-0337) and from the KSA Ministry of Education (4181827686). School principals will provide permission to conduct the study in individual schools. Individual consent/assent will be obtained from students and their parents, and teachers. Study findings will be disseminated via peer-review publications, reports and conferences.
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Affiliation(s)
- Naif Saleh Almutairi
- School of Population Health, Curtin University Bentley Campus, Perth, Western Australia, Australia
- Department of Public Health, College of Health Sciences at Al-Leith, Umm Al-Qura University, Al-Leith, Kingdom of Saudi Arabia
| | - Sharyn Burns
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Linda Portsmouth
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Western Australia, Australia
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