1
|
Ruiz-Hermosa A, Sánchez-López M, Castro-Piñero J, Grao-Cruces A, Camiletti-Moirón D, Martins J, Mota J, Ceciliani A, Murphy M, Vuillemin A, Sánchez-Oliva D. The Erasmus+ EUMOVE project-a school-based promotion of healthy lifestyles to prevent obesity in European children and adolescents. Eur J Public Health 2024; 34:955-961. [PMID: 39074353 PMCID: PMC11430908 DOI: 10.1093/eurpub/ckae113] [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] [Indexed: 07/31/2024] Open
Abstract
The aim of this study was to describe the goals, activities, and methods of EUMOVE project in developing a set of resources targeting both primary and secondary schools that allow the entire educational community to promote healthy lifestyles (HL). The EUMOVE project is an Erasmus+ program based in the Creating Active Schools (CAS) framework. The project lasted 3 years and was developed by 14 academic and non-governmental institutions from Spain, Portugal, France, Italy, and the UK. EUMOVE was divided into three phases. In the first phase, several work packages were carried out aimed to ensure the coordination/management of the project activities. In the second phase, seven educational resources strengthened by rigorous scientific research were developed to promote HL from schools. During the last phase, all the resources were disseminated through scientific seminars, workshops with families and teachers, and the online promotion by the non-governmental institutions of each country. The EUMOVE project developed and promoted a smartphone APP, video/activity repository of physically active lessons, active break virtual platform, learning units, and parent/teachers/school-leaders' guidelines to promote physical activity, active commuting, active school playgrounds, healthy diet, and sleep habits. To our knowledge, EUMOVE is the first European project to provide a set of practical tools based on scientific evidence to help schools or future school-wide interventions implement a paradigm shift based on the CAS framework for the promotion of HL. Future research will need to investigate the implementation, effectiveness, and scalability of this proposal.
Collapse
Affiliation(s)
- Abel Ruiz-Hermosa
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- ACAFYDE Research Group, Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Alberto Grao-Cruces
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Daniel Camiletti-Moirón
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - João Martins
- Pedagogical Laboratory, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Jorge Mota
- Centro de Investigação em Actividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Andrea Ceciliani
- Department for Life Quality Studies, University of Bologna, Bologna, Italy
| | - Marie Murphy
- Centre for Exercise, Physical Activity, Medicine and Health, Ulster University, Jordanstown, Northern Ireland, United Kingdom
| | - Anne Vuillemin
- Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS), Université Côte d'Azur, Nice, France
| | - David Sánchez-Oliva
- ACAFYDE Research Group, Faculty of Sports Sciences, University of Extremadura, Cáceres, Spain
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| |
Collapse
|
2
|
Zapata-Lamana R, Robles-Campos A, Reyes-Molina D, Rojas-Bravo J, Salcedo Lagos P, Chávez-Castillo Y, Gajardo-Aguayo J, Villalobos JV, Arias AM, Sanhueza-Campos C, Ibarra Mora J, Reyes-Amigo T, Cristi-Montero C, Sánchez-Oliva D, Ruiz-Hermosa A, Sánchez-López M, Poblete-Valderrama F, Celis-Morales C, Martorell M, Carrasco-Marín F, Albornoz-Guerrero J, Parra-Rizo MA, Cigarroa I. Effects of video-guided active breaks with curricular content on mental health and classroom climate in chilean schoolchildren aged 6 to 10: study protocol for a multicentre randomized controlled trial. Front Physiol 2024; 15:1438555. [PMID: 39328832 PMCID: PMC11424538 DOI: 10.3389/fphys.2024.1438555] [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: 05/26/2024] [Accepted: 08/09/2024] [Indexed: 09/28/2024] Open
Abstract
Background The incidence of mental health issues in children is increasing worldwide. In Chile, a recent surge in reports of deteriorating mental health among school populations and an increase in complaints related to poor school climate have been observed. Physical activity, specifically active breaks in the classroom, has shown positive effects on children's health. However, evidence regarding its impact on mental health and school climate in children is limited. Objective This work outlines the design, measurements, intervention program, and potential efficacy of the "Active Classes + School Climate and Mental Health" project. This project will assess a 12-week program of active breaks through guided videos with curricular content in the school classroom, and its effects on mental health and school climate as its primary indicators. Additionally, it will measure physical activity, physical fitness, motor competence, and academic performance in students aged 6-10 years in the Biobío province, Chile, as secondary indicators. Methodology: A multicenter randomized controlled trial involving 823 students from 1st to 4th grade (6-10 years old), six schools (three intervention and three control) will be conducted in the Biobío region, Chile. Participants belonging to the intervention group will implement video-guided active breaks through the "Active Classes" web platform, featuring curricular content, lasting 5-10 min and of moderate to vigorous intensity physical activity, twice a day, Monday to Friday, over a span of 12 weeks. Expected Results/Discussion: To our knowledge, this will be the first study in Chile to evaluate the effects of incorporating video-guided active breaks with curricular content on mental health variables and school climate in schoolchildren. Thus, this study contributes to the scarce evidence on the effects of video-guided active breaks on mental health variables and school climate in schoolchildren worldwide. Additionally, it will provide crucial information about active teaching methodologies that have the potential to positively contribute to the wellbeing of students, thus addressing the problems of mental health and climate in Chilean schools. ClinicalTrials.gov ID NCT06423404.
Collapse
Affiliation(s)
- Rafael Zapata-Lamana
- Escuela de kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles, Chile
- Escuela de Educación, Universidad de Concepción, Los Ángeles, Chile
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | | | - Daniel Reyes-Molina
- Escuela de kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles, Chile
- Doctorado en Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | | | | | - Yasna Chávez-Castillo
- Doctorado en Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
| | - Jorge Gajardo-Aguayo
- Doctorado en Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Concepción, Chile
- Facultad de Educación, Universidad de Concepción, Concepción, Chile
| | | | - Ana María Arias
- Escuela de Educación, Universidad de Concepción, Los Ángeles, Chile
| | | | - Jessica Ibarra Mora
- Departamento de Educación Física, Universidad Metropolitana de Ciencias de la Educación, Ñuñoa, Chile
| | - Tomás Reyes-Amigo
- Physical Activity Sciences Observatory (OCAF), Department of Physical Activity Sciences, Universidad de Playa Ancha, Valparaíso, Chile
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - David Sánchez-Oliva
- Facultad de Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
| | - Abel Ruiz-Hermosa
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Sports and Sciences, University of Extremadura, Cáceres, Spain
| | | | - Felipe Poblete-Valderrama
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Facultad de Educación, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Carlos Celis-Morales
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
- Centro de Investigación en Medicina de Altura (CEIMA), Universidad Arturo Prat, Iquique, Chile
| | - Miquel Martorell
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | | | | | - María Antonia Parra-Rizo
- Department of Health Psychology, Faculty of Social and Health Sciences, Campus of Elche, Miguel Hernandez University (UMH), Elche, Spain
- Faculty of Health Sciences, Valencian International University (VIU), Valencia, Spain
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica Silva Henríquez, Santiago, Chile
| |
Collapse
|
3
|
Schmittwilken L, Harding-Kuriger J, Carl J. Aligning extracurricular school activities with physical literacy: pilot evaluation through self-study of practice. Front Sports Act Living 2024; 6:1415689. [PMID: 39253624 PMCID: PMC11381300 DOI: 10.3389/fspor.2024.1415689] [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: 05/31/2024] [Accepted: 08/12/2024] [Indexed: 09/11/2024] Open
Abstract
Introduction Although several important documents of education and health promotion on the international level favor practices geared toward physical literacy (PL), not all countries have yet gained experience with this holistic concept. Therefore, numerous stakeholders and practitioners who intend to align their interventional activities with PL will soon face the situation that there are no recommendations for their specific culture and language for how to design such programs. Given that such recommendations are also lacking for Germany, the goal of the present study within the uncontrolled pilot cycles of the PLACE study was (a) to describe the process of a female pedagogue (27 years old, previously unexperienced with PL) initially familiarizing herself with the PL concept and its implementation opportunities for the school setting, and (b) to retrace the process of developing and refining a PL-driven intervention for extracurricular physical education (60-90 min) of children in grades three and four at primary schools in Bremen. Methods Adopting a self-study design, this endeavor emphasized continuous reflexivity involving: (a) session protocols; (b) biweekly discussions with another coach; (c) weekly discussions between scientists and stakeholders of youth development ("multi-perspective panel"); (d) weekly observations and impressions during field work; and (e) summative group interviews with children (n = 17, age range: 8-9 years, 17.6% boys). Written documents underwent qualitative content analysis with inductively generated categories. Results Despite explicit links between the theoretical PL domains and the intervention content, the character of how PL informed the intervention level was dominated by the stance and atmosphere implemented by the deliverer (e.g., participatory attitude, open mindset). Accordingly, the team revised the intervention primarily on the levels of organization (temporal schedule and sequences), instruction, and materials. After initial stages of didactically "surviving" within classes, the deliverer could increasingly integrate tasks of cognitive engagement and provide choice for students enabling individual autonomy for nurturing a person-centered approach. Discussion This study encourages teachers and stakeholders of physical education to seek exchange with scholars or other practitioners while simultaneously demonstrating patience in comprehensively internalizing PL and efficiently translating the concept into routines in line with individual's quality standards.
Collapse
Affiliation(s)
- Louisa Schmittwilken
- Institute of Sport Science, Oldenburg University, Oldenburg, Germany
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| |
Collapse
|
4
|
Mastorci F, Lazzeri MFL, Vassalle C, Pingitore A. The Transition from Childhood to Adolescence: Between Health and Vulnerability. CHILDREN (BASEL, SWITZERLAND) 2024; 11:989. [PMID: 39201923 PMCID: PMC11352511 DOI: 10.3390/children11080989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/31/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024]
Abstract
Transitioning from childhood into adolescence is an extraordinary time of life, associated with major physical, emotional, cognitive, and social changes and characterized by dynamic development in which interaction with the environment modulates the individual resources responsible for well-being and health. This sensitive period is the time when, in addition to hormonal, metabolic, and neural changes, certain behavioral strategies begin to take shape that will shortly go on to define the emotional, social, and cultural identity of the individual. This narrative review aimed to uncover the crucial processes underlying the transition by identifying processes that are responsible for cognitive, psychosocial, and emotional development, in the absence of disease. For this aim, we highlight (1) the physical, psychological, and social determinants during the transition from childhood to adolescence; (2) the role of health-related variables in resilience or vulnerability mechanisms; and (3) recent school-based strategies to promote health and well-being. Recognizing that health and well-being are the result of the interaction of many biological, psychological, social, cultural, and physical factors will lead to comprehensive health promotion involving all actors joining the growth process, from health professionals and the educational community to parents and community. Furthermore, it is important that psychosocial dimensions are strengthened already during childhood to prevent the onset of frailty and illness in adolescence.
Collapse
Affiliation(s)
- Francesca Mastorci
- Clinical Physiology Institute, CNR, 56124 Pisa, Italy; (M.F.L.L.); (A.P.)
| | | | | | | |
Collapse
|
5
|
Wu Y, Walsh K, White SLJ, L'Estrange L. Schools' readiness for child sexual abuse prevention education: Preliminary scale development using a Delphi method. CHILD ABUSE & NEGLECT 2024; 154:106884. [PMID: 38875868 DOI: 10.1016/j.chiabu.2024.106884] [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: 10/05/2023] [Revised: 04/28/2024] [Accepted: 05/31/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND This study employed a Delphi method with a panel of experts to collaboratively design a new instrument to assess schools' readiness for school-based child sexual abuse prevention education. METHODS An initial item pool was generated based on a review of existing empirical research and theoretical models. We invited researchers and stakeholders in the field of child sexual abuse prevention as experts to participate in a two-round online Delphi study in which they rated item importance and clarity, contributed their views on superfluous and/or missing items, gave rephrasing suggestions, and re-appraised revised items. Following the Delphi study, the instrument was pilot tested with a convenience sample of school staff. RESULTS The initial item pool comprised 81 items in five construct sub-scales congruent with Wiener's Organizational Readiness for Change theory: contextual factors, informational assessment, change valence, change commitment, and change efficacy. In the Delphi study, 24 experts participated in round 1, and 13 participated in round 2. Based on Delphi study responses, the instrument was reduced to 56 items in the five construct subscales: contextual factors (28 items), informational assessment (13 items), change valence (6 items), change commitment (3 items), and change efficacy (6 items). The Schools' Readiness for Child Sexual Abuse Prevention Education (SR-CSAPE) was successfully pilot tested with school staff (n = 19) and minor changes to demographic items were incorporated. CONCLUSIONS Informed by experts, the Schools' Readiness for Child Sexual Abuse Prevention Education (SR-CSAPE) is a newly-developed 56-item scale that identifies key organizational dimensions to schools' preparedness for CSA prevention education. Psychometric properties of the scale must be determined in future research.
Collapse
Affiliation(s)
- Yuejiao Wu
- Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059, Australia.
| | - Kerryann Walsh
- Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059, Australia
| | - Sonia L J White
- Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059, Australia
| | - Lyra L'Estrange
- Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059, Australia
| |
Collapse
|
6
|
Paakkari O, Kulmala M, Lyyra N, Saaranen T, Lindfors P, Tyrväinen H. The core competencies of a health education teacher. Health Promot Int 2024; 39:daae078. [PMID: 38984688 PMCID: PMC11234200 DOI: 10.1093/heapro/daae078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
Teachers play a crucial role in students' learning and in the development of health literacy. Hence, the aim of this study was to identify the core competencies needed for teachers of health education in supporting student learning. A three-round Delphi study was carried out over an 8-week period, through consultation with 25 Finnish experts in health education. An open-ended question was used to identify the core competencies for school health educators. The data were analysed using inductive content analysis. In subsequent rounds, experts were asked to assess the importance of the identified competencies on a 7-point Likert scale, and finally to rank the most important competencies. In total, 52 competencies were identified and categorized into eight core competence domains. Thereafter, 40 competencies were assessed and selected for the third round, in which the experts ranked the 15 most important competencies, encompassing four core domains, i.e. pedagogic and subject-specific didactic, social and emotional, content knowledge and continuous professional development. Other domains of competence identified in the present study were ethical competence, competence in school health promotion, contextual competence and professional well-being competence. The study defines health education teacher core competencies and domains, and the information can be used in teacher education programmes, for developing teaching and for teachers' self-evaluation.
Collapse
Affiliation(s)
- Olli Paakkari
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014, Finland
| | - Markus Kulmala
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014, Finland
| | - Nelli Lyyra
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014, Finland
| | - Terhi Saaranen
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Yliopistonrinne 3, 70211 Kuopio, Finland
| | - Pirjo Lindfors
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Arvo Ylpön katu 34, 33014, Finland
| | - Heli Tyrväinen
- Health Sciences, Open University, University of Jyväskylä, Alvar Aallon katu 9, 40014, Finland
| |
Collapse
|
7
|
Yin H, Omar Dev RD, Soh KG, Li F, Lian M. Assessment and development of physical education teachers' physical literacy: A systematic review. PLoS One 2024; 19:e0307505. [PMID: 39024325 PMCID: PMC11257255 DOI: 10.1371/journal.pone.0307505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 07/06/2024] [Indexed: 07/20/2024] Open
Abstract
In recent years, physical literacy (PL) has gained a great deal of attention in global academia. Children's physical activity (PA) participation is severely underrepresented today, and students' participation in PA and PL level development is strongly dependent on the PL levels of PE teachers. This study aims to offer information for PE teachers to improve their PL levels and for the future development of tools to assess the PL of PE teachers through a systematic review of studies assessing PL of PE teachers. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to conduct a comprehensive and systematic search in six databases-Web of Science, Scopus, ScienceDirect, PubMed, ProQuest; and SportDiscus, and a total of 671 papers were retrieved, but after removing duplicates, article identification, and screening only eight papers met the inclusion criteria. This study's results indicate a paucity of research related to PL among PE teachers, focusing on children, students, older adults, and children with disabilities. PE teachers performed poorly in the physical competence domain and better in the cognitive and affective domains, with a moderate level of overall PL. Only one instrument is currently available to assess PE teachers' (perceived) PL, and other studies have used instrument components. Therefore, it was concluded that the current PE teachers' PL level is not high. Also, because the concept of PL among PE teachers has not been standardized, no tool has been developed to evaluate the PL of PE teachers comprehensively and systematically. The CPD (continuing professional development) is considered an effective means of enhancing PL among PE teachers, and research should prioritize the development of CPD programs and tools that are specifically tailored to assess PL among PE teachers in the future.
Collapse
Affiliation(s)
- Hang Yin
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Roxana Dev Omar Dev
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Fangyi Li
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Menglong Lian
- Zhengzhou Vocational College of Automobile Engineering, Zhengzhou, Henan Province, China
| |
Collapse
|
8
|
Seekles ML, Mwita W, Andongolile A, Kihange A, Owen G, Hudda A, Mmbaga BT, Obasi AIN. "Alcohol will never run out": Socio-ecological drivers of adolescent boys' alcohol use in Kilimanjaro Region, Tanzania. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002443. [PMID: 38857241 PMCID: PMC11164390 DOI: 10.1371/journal.pgph.0002443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/06/2024] [Indexed: 06/12/2024]
Abstract
Heavy alcohol use amongst adolescent boys is a major public health concern in many countries. It is associated with a range of negative physical and mental health outcomes and predicts alcohol-related problems in adulthood. In Kilimanjaro Region, adolescent boys' alcohol use is widespread, and higher than other regions in Tanzania. An understanding of causal and contextual factors that influence the use of alcohol is needed to inform the development and implementation of effective alcohol prevention interventions. This study aimed to explore these socio-ecological factors in-depth amongst adolescent boys, young men and key stakeholders in Kilimanjaro Region, Tanzania. Between August 2022 and June 2023, multi-method, participatory, qualitative methods including: ethnographic observations (8 weeks), 37 in-depth interviews, 14 focus group discussions and participatory adolescent activities were used to elicit perceptions on factors driving adolescent boys' alcohol use in two (rural/urban) settings. Data were triangulated and deductively analysed, guided by Bronfenbrenner's socio-ecological framework. This study found many dynamic and inter-related factors linked to alcohol use within adolescents' social, cultural, economic, regulatory, and physical environments. In a context of widespread availability of alcohol, low enforcement of alcohol regulation and (mis)conceptions around the benefits of alcohol use (e.g. curative and/or nutritional properties), parental and cultural influences largely determined the initiation of use in childhood and younger adolescence; employment status, peers, lack of alternative recreational activity and social norms around independence appeared to drive continued and increased use in older adolescence. Factors and their impact varied between rural and urban settings. In conclusion, a wide range of determinants and drivers of alcohol use among ABYM work at multiple socio-ecological levels especially parental, cultural and socioeconomic factors. This suggests that effective prevention requires a systems approach intervening across these levels. For example, incorporating education/awareness raising, increased law enforcement, parent-child communication and problem-solving, and income generation activities.
Collapse
Affiliation(s)
- Maaike L. Seekles
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Winfrida Mwita
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | - Gilbert Owen
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Aliza Hudda
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Angela I. N. Obasi
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| |
Collapse
|
9
|
Junttila M, Kielinen M, Jussila K, Joskitt L, Mäntymaa M, Ebeling H, Mattila ML. The traits of Autism Spectrum Disorder and bullying victimization in an epidemiological population. Eur Child Adolesc Psychiatry 2024; 33:1067-1080. [PMID: 37219644 PMCID: PMC11032281 DOI: 10.1007/s00787-023-02228-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Abstract
Autistic children (Autism Spectrum Disorder, ASD) show an increased risk of bullying victimization and often face challenges in communication and peer relationships. However, it is unclear to what extent the amount and quality of ASD traits are associated with bullying victimization. This study examined the association of bullying victimization and ASD traits in an epidemiological population of 8-year-old children (n = 4408) using parent and teacher completed Autism Spectrum Screening Questionnaires (ASSQs), both separately and combined. The ASSQ items relating to loneliness and social isolation, lack of co-operating skills, clumsiness and lack of common sense were associated with victimization in the study population. The higher the ASSQ scores, the more the children were victimized: the ASSQ scores increased in parallel with victimization from 0 (0% victimized) to 45 (64% victimized). The victimization rate was 46% in ASD sample, 2% in the total population sample and 2% in the non-ASD population sample. The results enable more targeted means for recognizing potential victimization.
Collapse
Affiliation(s)
- Maria Junttila
- Clinic of Child Psychiatry, Faculty of Medicine, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland.
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland.
| | | | - K Jussila
- Clinic of Child Psychiatry, Faculty of Medicine, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
- Division of Psychology, VISE, Faculty of Education and Psychology, University of Oulu, Oulu, Finland
| | - L Joskitt
- Clinic of Child Psychiatry, Faculty of Medicine, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| | - M Mäntymaa
- Clinic of Child Psychiatry, Faculty of Medicine, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| | - H Ebeling
- Clinic of Child Psychiatry, Faculty of Medicine, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| | - M-L Mattila
- Clinic of Child Psychiatry, Faculty of Medicine, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| |
Collapse
|
10
|
Gaskin CJ, Venegas Hargous C, Stephens LD, Nyam G, Brown V, Lander N, Yoong S, Morrissey B, Allender S, Strugnell C. Sleep behavioral outcomes of school-based interventions for promoting sleep health in children and adolescents aged 5 to 18 years: a systematic review. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae019. [PMID: 38584765 PMCID: PMC10996385 DOI: 10.1093/sleepadvances/zpae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/24/2024] [Indexed: 04/09/2024]
Abstract
Study Objectives Insufficient sleep is common among children and adolescents, and can contribute to poor health. School-based interventions potentially could improve sleep behavior due to their broad reach, but their effectiveness is unclear. This systematic review focused on the effects of school-based interventions on sleep behavior among children and adolescents aged 5 to 18 years. Methods Five electronic databases were searched for randomized controlled trials of sleep health interventions initiated or conducted in school settings and in which behavioral sleep outcomes were measured. Cochrane risk of bias tools were used to assess study quality. Results From the 5303 database records and two papers from other sources, 21 studies (22 papers) met the inclusion criteria for this review. These studies involved 10 867 children and adolescents at baseline from 13 countries. Most studies (n = 15) were conducted in secondary schools. Sleep education was the most common intervention, either alone (n = 13 studies) or combined with other initiatives (stress management training, n = 2; bright light therapy, n = 1; health education, n = 1). Interventions were typically brief in terms of both the intervention period (median = 4 weeks) and exposure (median = 200 minutes). Behavioral outcomes included actigraphy-measured and self-reported sleep patterns, and sleep hygiene. All outcomes had high risk of bias or some concerns with bias. Sleep education interventions were typically ineffective. Later school start times promoted longer sleep duration over 1 week (1 study, high risk of bias). Conclusions Current evidence does not provide school-based solutions for improving sleep health, perhaps highlighting a need for complex, multi-component interventions (e.g. whole-of-school approaches) to be trialed.
Collapse
Affiliation(s)
- Cadeyrn J Gaskin
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | | | - Lena D Stephens
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Gunchmaa Nyam
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Victoria Brown
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Natalie Lander
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Serene Yoong
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | | | - Steven Allender
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | | |
Collapse
|
11
|
Shibuya F, Hattori-Uchima M, Dacanay P, Peter F, Ngirmang TT, Dacanay R, Takeuchi R, de Los Reyes C, Kobayashi J. Multi-country case study on school health policy and its implementation in relation to COVID-19 control in Micronesia Small Islands Developing States. Trop Med Health 2024; 52:27. [PMID: 38553741 PMCID: PMC10979614 DOI: 10.1186/s41182-024-00590-8] [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: 12/14/2023] [Accepted: 02/25/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic caused school closures and rises in mental illness and non-communicable disease among school children worldwide. The Pacific Small Islands Developing States (SIDS) were also affected, but school health activities, which can effectively reduce negative effects of COVID-19, were not widely implemented compared to other Asia-Pacific countries. This study examined current school health implementation and related policies at national, local, and school levels in the Micronesia SIDS according to phases of COVID-19 control. METHODS Multi-country case study targeted the Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), and Republic of Palau (ROP). These studies focused on school health implementation periods according to the PPR (Prevention, Preparedness, and Response) concept: Phase #1: prevention/preparedness, #2: early phase response, and #3: chronic phase response/recovery phase. Data were collected through policy document reviews that identified school health policies related to COVID-19 controls in the three phases and key informant interviews (KIIs) with 44 key informants (FSM, n = 14; RMI, n = 18; ROP, n = 12) whose work related to school health. The collected data were analyzed using content analysis methods according to the conceptual framework in this study. RESULTS This study identified three factors of school health implementation related to COVID-19 controls: promotion of decentralized education (FSM), implementation of COVID-19 controls in the school community (RMI), and disaster management for the protection of students including response to infectious disease (ROP). In Phase #1, no country had established a school health policy. In Phase #2, three enablers were identified in FSM and ROP, as reflected in COVID-19 controls by the education and health sectors. In Phase #3, RMI implemented COVID-19 controls in the school community. Documents on youth policy and disaster management in ROP were updated to reflect the chronic phase response and response to future public health crises. CONCLUSIONS A decentralized education was instrumental in immediately implementing COVID-19 control measures in schools at national and local levels for coordination between education and health sectors. Despite each county's multi-sectoral approach to engage COVID-19 controls in schools, local government organization requires strengthening and implementation of the formulated school health policy. In preparation for the next public health crisis, school health should be promoted that is integrated into both infection control and disaster management.
Collapse
Affiliation(s)
- Fumiko Shibuya
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
- Japanese Consortium for Global School Health Research, Nishihara, Japan.
| | | | - Paul Dacanay
- Division of Health Sciences, College of Micronesia-FSM, Palikir, Pohnpei, Federated States of Micronesia
| | - Florence Peter
- Women United Together Marshall Islands, Majuro, Marshall Islands
| | | | - Rudelyn Dacanay
- Division of Health Sciences, College of Micronesia-FSM, Palikir, Pohnpei, Federated States of Micronesia
| | - Rie Takeuchi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- Japanese Consortium for Global School Health Research, Nishihara, Japan
- Faculty of Medicine, International University of Health and Welfare, Narita, Japan
| | - Calvin de Los Reyes
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- Japanese Consortium for Global School Health Research, Nishihara, Japan
| |
Collapse
|
12
|
Barnes C, Jones J, Wolfenden L, Robertson K, Seidler AL, Norman J, Budgen P, Mattingly M, Piliskic C, Moorhouse L, Mozina J, Plaskett J, McDermott S, Darney S, Vuong C, Douglass N, McDonnell K, Sutherland R. A collaborative network trial to evaluate the effectiveness of implementation strategies to maximize adoption of a school-based healthy lunchbox program: a study protocol. Front Public Health 2024; 12:1367017. [PMID: 38601495 PMCID: PMC11004312 DOI: 10.3389/fpubh.2024.1367017] [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: 01/08/2024] [Accepted: 03/12/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction An important impediment to the large-scale adoption of evidence-based school nutrition interventions is the lack of evidence on effective strategies to implement them. This paper describes the protocol for a "Collaborative Network Trial" to support the simultaneous testing of different strategies undertaken by New South Wales Local Health Districts to facilitate the adoption of an effective school-based healthy lunchbox program ('SWAP IT'). The primary objective of this study is to assess the effectiveness of different implementation strategies to increase school adoption of the SWAP across New South Wales Local Health Districts. Methods Within a Master Protocol framework, a collaborative network trial will be undertaken. Independent randomized controlled trials to test implementation strategies to increase school adoption of SWAP IT within primary schools in 10 different New South Wales Local Health Districts will occur. Schools will be randomly allocated to either the intervention or control condition. Schools allocated to the intervention group will receive a combination of implementation strategies. Across the 10 participating Local Health Districts, six broad strategies were developed and combinations of these strategies will be executed over a 6 month period. In six districts an active comparison group (containing one or more implementation strategies) was selected. The primary outcome of the trial will be adoption of SWAP IT, assessed via electronic registration records captured automatically following online school registration to the program. The primary outcome will be assessed using logistic regression analyses for each trial. Individual participant data component network meta-analysis, under a Bayesian framework, will be used to explore strategy-covariate interactions; to model additive main effects (separate effects for each component of an implementation strategy); two way interactions (synergistic/antagonistic effects of components), and full interactions. Discussion The study will provide rigorous evidence of the effects of a variety of implementation strategies, employed in different contexts, on the adoption of a school-based healthy lunchbox program at scale. Importantly, it will also provide evidence as to whether health service-centered, collaborative research models can rapidly generate new knowledge and yield health service improvements. Clinical trial registration This trial is registered prospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12623000558628).
Collapse
Affiliation(s)
- Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Jannah Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Katie Robertson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Anna Lene Seidler
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Jennifer Norman
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Pip Budgen
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - Megan Mattingly
- Health Promotion, Murrumbidgee Local Health District, Albury, NSW, Australia
| | - Carla Piliskic
- Health Promotion Unit, Population Health, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia
| | - Lisa Moorhouse
- Health Equity, Promotion and Prevention Service, South Eastern Sydney Local Health District, Darlinghurst, NSW, Australia
| | - Jennifer Mozina
- Population Health, Southern NSW Local Health District, Queanbeyan, NSW, Australia
| | - Jennifer Plaskett
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Sarah McDermott
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Sara Darney
- Western NSW Health Promotion, Western NSW Local Health District, Dubbo, NSW, Australia
| | - Cecilia Vuong
- Health Promotion Service, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Nina Douglass
- Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia
| | - Kara McDonnell
- Population Health Promotion, Northern Sydney Local Health District, Brookvale, NSW, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
13
|
Devries K, Tanton C, Knight L, Nakuti J, Nanyunja B, Laruni Y, Amollo M, Apota J, Opobo T, Pearlman J, Allen E, Bonell C, Naker D. Good School Toolkit-Secondary Schools to prevent violence against students: protocol for a pilot cluster randomised controlled trial. BMJ Open 2024; 14:e077788. [PMID: 38346875 PMCID: PMC10862314 DOI: 10.1136/bmjopen-2023-077788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION No whole-school interventions which seek to reduce physical, sexual and emotional violence from peers, intimate partners and teachers have been trialled with adolescents. Here, we report a protocol for a pilot trial of the Good School Toolkit-Secondary Schools intervention, to be tested in Ugandan secondary schools. Our main objectives are to (1) refine the intervention, (2) to understand feasibility of delivery of the intervention and (3) to explore design parameters for a subsequent phase III trial. METHODS AND ANALYSIS We will conduct a pilot cluster randomised controlled trial, with two arms and parallel assignment. Eight schools will be randomly selected from a stratified list of all eligible schools in Kampala and Wakiso Districts. We will conduct a baseline survey and endline survey 18 months after the baseline, with 960 adolescents and 200 teachers. Qualitative data and mixed methods process data collection will be conducted throughout the intervention. Proportion of staff and students reporting acceptability, understanding and implementing with fidelity will be tabulated at endline for intervention schools. Proportions of schools consenting to participation, randomisation and proportions of schools and individual participants completing the baseline and endline surveys will be described in a Consolidated Standards of Reporting Trials diagram. ETHICS AND DISSEMINATION The ethical requirements of our project are complex. Full approvals have been received from the Mildmay Ethics Committee (0407-2019), the Uganda National Council for Science and Technology (SS 6020) and the London School of Hygiene & Tropical Medicine (16212). Results of this study will be published in peer-reviewed academic journals, and shared with public bodies, policy makers, study participants and the general public in Uganda. TRIAL REGISTRATION NUMBER PACTR202009826515511.
Collapse
Affiliation(s)
- Karen Devries
- London School of Hygiene & Tropical Medicine, London, UK
| | - Clare Tanton
- London School of Hygiene & Tropical Medicine, London, UK
| | - Louise Knight
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Mathew Amollo
- Africhild Centre, Makerere University, Kampala, Uganda
| | - John Apota
- Africhild Centre, Makerere University, Kampala, Uganda
| | - Timothy Opobo
- Africhild Centre, Makerere University, Kampala, Uganda
| | - Jodie Pearlman
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Chris Bonell
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | |
Collapse
|
14
|
Porter A, Walker R, House D, Salway R, Dawson S, Ijaz S, de Vocht F, Jago R. Physical activity interventions in European primary schools: a scoping review to create a framework for the design of tailored interventions in European countries. Front Public Health 2024; 12:1321167. [PMID: 38389941 PMCID: PMC10883314 DOI: 10.3389/fpubh.2024.1321167] [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: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction Schools provide a unique environment to facilitate physical activity for children. However, many school-based physical activity interventions have not been effective. We propose a new approach, which allows schools to tailor interventions to their specific context. This scoping review aimed to identify intervention components from previous school-based physical activity interventions to form the basis of a tailored approach in a European setting. Methods Joanna Briggs Institute guidelines for conducting scoping reviews were followed. European school-based intervention studies aimed at increasing physical activity in children aged 7-11 years published in English since 2015 were included. Databases searched were Ovid Medline, Embase, PsycINFO, Web of Science Social Sciences Citation Index, ERIC and British Education Index. Data was extracted on intervention components, context-related factors (geographical location, school size, child socioeconomic status and ethnicity), feasibility, acceptability and cost-effectiveness. A data-driven framework was developed to summarize the identified intervention components. Results 79 articles were included, constituting 45 intervention studies. We identified 177 intervention components, which were synthesized into a framework of 60 intervention component types across 11 activity opportunities: six within the school day, three within the extended school day and two within the wider school environment. Interventions most frequently targeted physical education (21%), active and outdoor learning (16%), active breaks (15%), and school-level environmewnt (12%). Of the intervention components, 41% were delivered by school staff, 31% by the research team, and 24% by external organizations. Only 19% of intervention studies reported geographical location and only 10% reported school size. Participant ethnicity and socioeconomic information was reported by 15% and 25%, respectively. Intervention acceptability was reported in 51% of studies, feasibility in 49%, and cost effectiveness in 2%. Discussion This review offers a first step in developing a future framework to help schools to develop context-specific, tailored interventions. However, there was a lack of reporting of contextual factors within the included studies, making it difficult to understand the role of context. Future research should seek to measure and report contextual factors, and to better understand the important aspects of context within school-based physical activity.
Collapse
Affiliation(s)
- Alice Porter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Robert Walker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Danielle House
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ruth Salway
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
| |
Collapse
|
15
|
Salam RA, Khan MH, Meerza SSA, Das JK, Lewis-Watts L, Bhutta ZA. An evidence gap map of interventions for noncommunicable diseases and risk factors among children and adolescents. Nat Med 2024; 30:290-301. [PMID: 38195753 DOI: 10.1038/s41591-023-02737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
Substance misuse, obesity, mental health conditions, type 1 diabetes, cancers, and cardiovascular and chronic respiratory diseases together account for 41% of disability-adjusted life years linked to noncommunicable diseases (NCDs) among children and adolescents worldwide. However, the evidence on risk factors and interventions for this age group is scarce. Here we searched four databases to generate an evidence gap map of existing interventions and research gaps for these risk factors and NCDs. We mapped 159 reviews with 2,611 primary studies; most (96.2%) were conducted in high-income countries, and only 100 studies (3.8%) were from low- and middle-income countries (LMICs). The efficacy of therapeutic interventions on biomarkers and adverse events for NCDs appears to be well evidenced. Interventions for mental health conditions appear to be moderately evidenced, while interventions for obesity and substance misuse appear to be moderate to very low evidenced. Priority areas for future research include evaluating digital health platforms to support primary NCD prevention and management, and evaluating the impact of policy changes on the prevalence of obesity and substance misuse. Our findings highlight the wide disparity of evidence between high-income countries and LMICs. There is an urgent need for increased, targeted financing to address the research gaps in LMICs.
Collapse
Affiliation(s)
- Rehana A Salam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Maryam Hameed Khan
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Saqlain Ali Meerza
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Laura Lewis-Watts
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
| |
Collapse
|
16
|
Aragoni da Silva J, Salmon J, Cordeiro Barbosa Filho V, da Silva Bandeira A, Dos Santos PC, Samara da Silva K. Psychosocial mediators and moderators of a school-based physical activity intervention among Brazilian adolescents. J Sports Sci 2024; 42:17-24. [PMID: 38466902 DOI: 10.1080/02640414.2024.2319455] [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: 06/02/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024]
Abstract
School-based interventions are needed due to the low levels of physical activity (PA) in adolescents. The aim is to examine the mediation effects of psychosocial factors (attitude, self-efficacy, social support from parents, friends, general teachers, and PE teachers, and environment school perception) and moderation by sex, school grade, and socioeconomic level of a school-based PA intervention on the PA practice among adolescents. The Movimente Programme is a randomised controlled trial at schools in southern Brazil (n = 921 adolescents). Strategies included teacher training, educational actions, and environmental changes. Adolescents self-reported their weekly PA. Potential psychosocial mediators and moderators were investigated through validated questionnaires in a Brazilian sample. The product of the coefficients with percentile bootstrapping 95% confidence interval was performed. The Movimente Programme was related to positive changes in adolescents' perception of the school environment and social support from general and physical education teachers. Most psychosocial variables (attitude, self-efficacy, social support from friends, and social support from teachers) were associated with PA, but none mediated the impact of the Movimente Programme on PA. Results varied according to sex and school grade. The Movimente Programme increased the adolescents' perception of the school environment and social support from teachers, but no mediators were confirmed.
Collapse
Affiliation(s)
- Jaqueline Aragoni da Silva
- Department of Physical Education, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Jo Salmon
- Institute of Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | | | | | | | - Kelly Samara da Silva
- Institute of Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| |
Collapse
|
17
|
Vennegoor G, van Assema P, Molleman GRM, van Empelen P, Dieleman J, Jansen MWJ. Fidelity, adaptation and integration of whole-school health promotion within Dutch schools: a cross-sectional survey study. Health Promot Int 2023; 38:daad173. [PMID: 38124497 PMCID: PMC10733658 DOI: 10.1093/heapro/daad173] [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: 12/23/2023] Open
Abstract
Implementing comprehensive health promotion programs in the school setting can be challenging, as schools can be considered complex adaptive systems. As a first step towards understanding what works in improving implementation for which schools and under which conditions, this study aimed to examine the degree of implementation of health promoting school (HPS) programs, in terms of five dimensions of fidelity (adherence, dose, participant responsiveness, quality of delivery and program differentiation), and the dimensions of adaptation and integration. The HPS Implementation Questionnaire was distributed among ± 2400 primary, secondary, secondary vocational and special needs schools in the Netherlands. Employees of 535 schools (22.3%) filled out the questionnaire. Data were analysed by descriptive statistics and ANOVA tests. The average degree of implementation was 2.55 (SD = 0.58, range = 0.68-3.90; scaled 0-4). The lowest scores were achieved for participant responsiveness and adherence, and the highest for integration and adaptation. Schools that identified as HPS reported significantly higher overall degree of implementation, adherence, dose, participant responsiveness, program differentiation and adaptation than schools that didn't. Primary schools achieved a significantly higher degree of implementation, dose, participant responsiveness, quality of delivery and integration than other school types. In conclusion, many schools work on student health and well-being to some extent, but the vast majority have much room for improvement. Higher implementation scores for schools that identified as HPS underline the value of HPS programs. A broader perspective on health and more insight into conditions for effectiveness and implementation in secondary and secondary vocational schools are needed.
Collapse
Affiliation(s)
- Gerjanne Vennegoor
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Patricia van Assema
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Promotion, Research Institute of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gerard R M Molleman
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Department of Healthy Living, Public Health Service Gelderland-Zuid, P.O. Box 1120, 6501 BC Nijmegen, The Netherlands
| | - Pepijn van Empelen
- Expertise Center Child Health, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 3005, 2301 DA Leiden, The Netherlands
| | - Joyce Dieleman
- Public Health Service Noord- en Oost Gelderland, Academic Collaborative Center AGORA, P.O. Box 3, 7200 AA Zutphen, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| |
Collapse
|
18
|
Ahmed KR, Kolbe-Alexander T, Khan A. Efficacy of a school-based education intervention on the consumption of fruits, vegetables and carbonated soft drinks among adolescents. Public Health Nutr 2023; 26:3112-3121. [PMID: 37781771 PMCID: PMC10755403 DOI: 10.1017/s1368980023002094] [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: 10/19/2022] [Revised: 07/21/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To evaluate the efficacy of a school-based education intervention on the consumption of fruit, vegetables and carbonated soft drinks among adolescents. DESIGN Cluster-randomised controlled trial. SETTING Eight secondary schools from Dhaka, Bangladesh, participated in this trial and were randomly allocated to intervention (n 160) and control groups (n 160). PARTICIPANTS A total of 320 students from 8th to 9th grades participated and completed the self-reported questionnaires at baseline, and at 8 and 12 weeks. The intervention included weekly classroom-based nutrition education sessions for students and healthy eating materials for students and parents. Repeated measures ANCOVA was used to assess the effects of the intervention. RESULTS Daily fresh fruit intake was more frequent in the intervention (26 %) compared to the control group (3 %) at 12 weeks (p = 0·006). Participants from the intervention group also reported a significantly (P < 0·001) higher (49 %) proportion of fresh vegetable intake compared to the control group (2 %) at 12 weeks. Frequency of daily carbonated soft drinks intake decreased (25 %) in the intervention group at 12 weeks compared to baseline, while it remained unchanged in the control group; the interaction effect was observed significant (P = 0·002). CONCLUSION Our school-based education intervention increased the daily frequency of fresh vegetables and fruit intake and decreased carbonated soft drink consumption among adolescents in the intervention group. There is a need for scaling up the intervention to engage students and empower them to develop healthy dietary habits.
Collapse
Affiliation(s)
- Kazi R Ahmed
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences, Darus Salam, Mirpur, Dhaka1216, Bangladesh
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tracy Kolbe-Alexander
- School of Health and Wellbeing, University of Southern Queensland, Toowoomba, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Australia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
| | - Asaduzzaman Khan
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
19
|
Nyoni T, Steiner JJ, Okumu M, Orwenyo E, Tonui BC, Lipsey K, Mengo C. The Use and Effectiveness of the Whole School Approach in School-Based Interventions Addressing Gender-Based Violence in Sub-Saharan Africa: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3615-3628. [PMID: 36458852 DOI: 10.1177/15248380221134296] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Adolescents and young people in sub-Saharan Africa (SSA) experience high rates of gender-based violence (GBV). The whole school approach (WSA) is an established benchmark of effective school-based interventions to address this issue. We conducted a systematic review of peer-reviewed literature using PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library, Clinicaltrials.gov, and Google Scholar (1) to determine the characteristics, measured outcomes, and effectiveness of school-based GBV interventions and (2) to examine each papers' alignment with WSA and methodological quality. We developed a comprehensive intervention characteristics form for data extraction and analyzed the selected studies' quality using the modified Methodological Quality Rating Scale. To measure alignment with WSA implementation standards, we expanded the application of the WSA by creating the Whole School Approach Rating Scale (WSARS) for assessing school-based GBV interventions. Most interventions (n = 14/16) we reviewed effectively addressed at least one of the three outcomes of interest (i.e., sexual violence, physical violence, and GBV-related knowledge/attitudes). Over half (n = 9/16) of the studies were rated high on the WSARS. However, we observed no significant differences in effectiveness between studies rated high and those rated low on the WSARS. Our results indicate that school-based GBV interventions could be an effective and sustainable strategy for addressing GBV in and around schools.
Collapse
Affiliation(s)
| | | | - Moses Okumu
- The University of Illinois Urbana-Champaign, USA
- Uganda Christian University, Mukono, Uganda
| | | | | | - Kim Lipsey
- Washington University in St. Louis, MO, USA
| | | |
Collapse
|
20
|
Ahmed KR, Horwood S, Khan A. Effects of a School-Based Physical Activity Intervention on Adolescents' Mental Health: A Cluster Randomized Controlled Trial. J Phys Act Health 2023; 20:1102-1108. [PMID: 37611913 DOI: 10.1123/jpah.2023-0062] [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: 02/18/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effectiveness of a school-based multicomponent physical activity intervention on mental health of adolescents. METHODS A clustered, randomized, controlled trial was employed in 8 high schools in Dhaka, Bangladesh, which were randomly assigned to either an intervention or control group; 40 students in grades 8 and 9 from each school took part in the trial (n = 160/group). Students in the intervention schools participated in a 12-week physical activity intervention with multiple components (eg, supervised circuits, lunchtime sports, health education, infographics), while control schools received no intervention. Participants completed baseline and postintervention surveys measuring depressive symptoms (Center for Epidemiologic Studies Depression Scale) and life satisfaction (Cantril Ladder), along with other sociodemographic and behavioral characteristics. Linear mixed-effects modeling was used to evaluate the intervention effects. RESULTS Depressive symptoms in the intervention group decreased at postintervention, but remained stable in the control group. There was an increase in life satisfaction in the intervention group and a decrease in the control group. Multivariable modeling showed that students in the intervention group had a significantly lower level of depressive symptoms (β = -4.60; 95% confidence interval, -5.76 to -3.46) and higher level of life satisfaction (β = 1.43; 95% confidence interval, 0.77 to 2.10) compared with their counterparts in the control group. Sensitivity analyses supported the positive effects of the intervention. CONCLUSIONS Our school-based, multicomponent physical activity intervention is effective in improving mental health indicators in adolescents. Future trials should be ramped up to include schools in rural and regional settings, using robust measures of mental well-being.
Collapse
Affiliation(s)
- Kazi Rumana Ahmed
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD,Australia
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences, Dhaka,Bangladesh
| | - Sharon Horwood
- School of Psychology, Deakin University, Geelong, VIC,Australia
| | - Asaduzzaman Khan
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD,Australia
| |
Collapse
|
21
|
Rongen FC, Coosje Dijkstra S, Hupkens TH, Vingerhoeds MH, Seidell JC, van Kleef E. A qualitative study exploring the perceptions of children, parents and school staff towards the development and implementation of school lunch provision within primary schools in the Netherlands. BMC Public Health 2023; 23:2367. [PMID: 38030987 PMCID: PMC10687776 DOI: 10.1186/s12889-023-17265-4] [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: 04/24/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND There is no tradition of serving school lunches in primary schools in the Netherlands. Most children tend to bring their own packed lunch, however these are often nutritionally suboptimal. While school lunch provision can aid healthy eating behavior amongst children, its introduction would constitute a profound change for children, parents and school staff. Therefore, this qualitative study aims to explore children's, parents and school staffs' perceptions of both the current lunch situation and the implementation of school lunch provision within primary schools in the Netherlands. METHODS In this qualitative study we conducted nine interviews with school principals, 98 interviews with children, and held six focus groups with teachers and six with parents at primary schools in two Dutch cities. The data was analysed via iterative coding. RESULTS The results showed that most children and parents are satisfied with the current lunch situation, although existing school food policies are not always put in place. Most teachers felt that children had insufficient time to consume their lunch in the current situation. The children were generally positive about the idea of a school lunch, and stressed that it was important to have the ability to choose. While both parents and school staff saw school lunch provision as an opportunity to educate families about healthy food options, they also expressed concern about who would be responsible, as well as the financial and organizational implications of its introduction. CONCLUSIONS Perceptions of children, parents and school staff about a school provided lunch are mixed. A complex intervention such as a new school lunch program is difficult to envisage for all parties involved and more research is needed regarding the effects, organization, logistics and the costs of school lunch provision in the Netherlands.
Collapse
Affiliation(s)
- Frédérique C Rongen
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, de Boelelaan 1085, Amsterdam, Netherlands
| | - S Coosje Dijkstra
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, de Boelelaan 1085, Amsterdam, Netherlands.
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
| | - Tobie H Hupkens
- Food Health & Consumer Research, Wageningen Food & Biobased Research, P.O. Box 17, Wageningen, 6700AA, Netherlands
| | - Monique H Vingerhoeds
- Food Health & Consumer Research, Wageningen Food & Biobased Research, P.O. Box 17, Wageningen, 6700AA, Netherlands
| | - Jacob C Seidell
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, de Boelelaan 1085, Amsterdam, Netherlands
| | - Ellen van Kleef
- Marketing and Consumer Behaviour Group, Wageningen University, Hollandseweg 1, Wageningen, 6706 KN, Netherlands
| |
Collapse
|
22
|
Mastorci F, Lazzeri MFL, Piaggi P, Doveri C, Casu A, Trivellini G, Marinaro I, Devine C, Vassalle C, Pingitore A. An Entangled Relationship between Bullying Perception and Psychosocial Dimensions in a Sample of Young Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1823. [PMID: 38002916 PMCID: PMC10670547 DOI: 10.3390/children10111823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/03/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Bullying is a hostile behavior repeated over a time period, affecting children and adolescents in different social settings, mainly small and stable ones like school, with negative effects on mental and physical health. In this study, we aimed to provide the degree of impairment of different variables related to health and well-being in bullying conditions, with attention to sex differences. METHODS Data were obtained from 5390 adolescents (mean age 13.08 ± 1.89; male 2729), and health-related quality of life (HRQoL) was assessed using the KIDSCREEN-52 questionnaire. RESULTS In all students, mood and emotion, self-perception, and parental relationships are the dimensions more compromised in bullying conditions, while lifestyle habit is the variable less involved. Bullied girls show a significant impairment of all HRQoL variables both with respect to the socially accepted counterpart and to the male population. CONCLUSIONS Our study highlights the strict association between bullying and emotional and social dimensions, suggesting that enhancing them preventively could facilitate earlier detection of problems, thereby reducing health risks.
Collapse
Affiliation(s)
- Francesca Mastorci
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| | - Maria Francesca Lodovica Lazzeri
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| | - Paolo Piaggi
- Department of Information Engineering, University of Pisa, 56126 Pisa, Italy;
| | - Cristina Doveri
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| | - Anselmo Casu
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| | - Gabriele Trivellini
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| | - Irene Marinaro
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| | - Caleb Devine
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| | | | - Alessandro Pingitore
- Clinical Physiology Institute, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy; (F.M.); (M.F.L.L.); (C.D.); (G.T.); (I.M.); (C.D.)
| |
Collapse
|
23
|
Fischer L, Liegmann K, Morgenstern M, Dadaczynski K. Effectiveness of the holistic primary school-based intervention MindMatters: study protocol for a cluster-randomised controlled trial. Trials 2023; 24:711. [PMID: 37941015 PMCID: PMC10631112 DOI: 10.1186/s13063-023-07731-0] [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: 08/15/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The prevalence of mental health problems in childhood and adolescence has increased significantly, not least due to the COVID-19 pandemic in Germany and other countries worldwide. Although holistic school interventions to promote mental health and prevent mental health problems are considered promising, there is currently uncertainty about their effectiveness due to evaluation studies with heterogeneous methodological quality. This paper presents the study protocol for the evaluation of the primary school module of MindMatters. METHODS As part of a universal mental health intervention, the MindMatters primary school module 'Learning Together with Emotions' aims to promote social-emotional learning (SEL) in the classroom across five skill areas. In addition to classroom activities, the intervention includes a school development module to help primary schools create structures and processes to maintain and promote mental health. To evaluate the effectiveness of the intervention, a two-arm cluster-randomised controlled trial will be conducted, including schools implementing MindMatters over a 12-month period and a control group with no access to the intervention. Data will be collected before and 18 months after initiation of the intervention. Controlled for baseline conditions, multilevel regression analysis will be used to examine primary intervention outcomes at the pupil level (i.e. reductions in mental and behavioural problems). Further mediation and moderation analyses will examine whether proximal outcomes predict changes in mental health outcomes and whether school-level factors influence the effectiveness of the intervention. DISCUSSION This study will contribute to strengthen the evidence base for holistic school (mental) health promotion interventions using a study design with high internal validity. Based on an intervention model, the results will not only provide insights into the relationship between proximal and distal outcomes, but will also allow conclusions to be drawn about how the implementation of the intervention affects its effectiveness. Finally, the findings also address the question of whether improved mental health has a positive effect on primary school pupils' academic performance. TRIAL REGISTRATION German Clinical Trials Register DRKS00023762. Registered on 5 January 2021.
Collapse
Affiliation(s)
- Lisa Fischer
- Department of Health Sciences, Fulda University of Applied Sciences, Fulda, Germany.
| | | | | | - Kevin Dadaczynski
- Department of Health Sciences, Fulda University of Applied Sciences, Fulda, Germany
- Center for Applied Health Sciences, Leuphana University Lueneburg, Lueneburg, Germany
| |
Collapse
|
24
|
van Dongen BM, Ridder MAM, Wolters L, Steenhuis IHM, Renders CM. Increasing community capacity to improve the implementation of Health Promoting Schools: barriers and facilitators from the FLASH intervention. Health Promot Int 2023; 38:daad115. [PMID: 37776534 PMCID: PMC10541852 DOI: 10.1093/heapro/daad115] [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: 10/02/2023] Open
Abstract
Building community capacity is important for the successful implementation of a Health Promoting School. To identify how capacity building can be encouraged in secondary schools, four schools engaged in the Fit Lifestyle at School and at Home (FLASH) intervention for 3 years. This study explores barriers and facilitators that school personnel, parents and pupils experienced in the capacity-building process. Thirty-one stakeholders were interviewed. Transcripts were analysed thematically based on the five actions of the intervention: (i) appoint a Healthy School coordinator and build a team, (ii) determine ambitions, (iii) design and (iv) implement the action plan and (v) evaluate and improve. The time and support allocated to coordinators helped them evolve their role from executors of health-promotion activities to coordinators, instigators and gatekeepers of the implementation process. Participatory tools helped identify shared values among stakeholders to determine context-specific ambitions and leverage points for interventions. Coordinators indicated that they lacked the skills and authority to engage pupils and parents and to reach the broader community. Coordinators struggled with translating promising ideas into action plans of coherent and mutually supportive activities and embedding them into policy. Strong leadership of Healthy School coordinators, who focus on the capacity-building process and foster collaborative relationships, is essential to build community capacity. In this process, more guidance is needed on how to involve the broader community in various phases. Furthermore, coordinators can benefit from professional development to align jointly designed activities into a comprehensive action plan embedded into Healthy School policies.
Collapse
Affiliation(s)
- Bonnie Maria van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Monica Antonia Maria Ridder
- Human Movement and Education Division, Windesheim University of Applied Sciences, Campus 2, 8017 CA Zwolle, The Netherlands
| | - Loïs Wolters
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Ingrid Hendrika Margaretha Steenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Carry Mira Renders
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Healthy Society, Windesheim University of Applied Sciences, Campus 2, 8017 CA Zwolle, The Netherlands
| |
Collapse
|
25
|
Whelan J, Fraser P, Bolton KA, Love P, Strugnell C, Boelsen-Robinson T, Blake MR, Martin E, Allender S, Bell C. Combining systems thinking approaches and implementation science constructs within community-based prevention: a systematic review. Health Res Policy Syst 2023; 21:85. [PMID: 37641151 PMCID: PMC10463953 DOI: 10.1186/s12961-023-01023-4] [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: 10/27/2022] [Accepted: 06/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Systems science offers methods for designing population health interventions while implementation science provides specific guidance for successful implementation. Integrating systems and implementation science may strengthen implementation and enhance and sustain systemic change to achieve system-level outcomes. Little is known about the extent to which these two approaches have been integrated to date. This review aimed to identify and synthesise the peer-reviewed literature that has reported the combined use of systems thinking approaches and implementation science constructs (within the same study), to deliver population health interventions. METHODS A systematic literature search of peer-reviewed original research was conducted across six databases from 2009 to 2021. Journal manuscripts were included if they: (1) reported on a population health study conducted in a community, (2) reported the use of a systems method in the design of the intervention, and (3) used an implementation science theory, framework or model in the delivery of the intervention. Data extracted related to the specific systems methods and definitions and implementation science constructs used. The Mixed Methods Appraisal Tool (MMAT) was used to assess study quality. RESULTS Of the 9086 manuscripts returned, 320 manuscripts were included for full-text review. Of these, 17 manuscripts that reported on 14 studies were included in the final extraction. The most frequently reported systems methods were a 'whole of community systems approach' (n = 4/14) and 'community-based system dynamics' (n = 2/14). Nineteen different implementation science theories, frameworks and models were used for intervention delivery, with RE-AIM being the only framework used in more than one study. CONCLUSION There are few published peer-reviewed studies using systems thinking and implementation science for designing and delivering population health interventions. An exploration of synergies is worthwhile to operationalise alignment and improve implementation of systems thinking approaches. Review protocol registration PROSPERO CRD42021250419.
Collapse
Affiliation(s)
- Jillian Whelan
- School of Medicine, Deakin University, Geelong, Australia.
- Institute for Health Transformation, Geelong, Australia.
- Global Centre for Preventive Health and Nutrition, Geelong, Australia.
| | - Penny Fraser
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Kristy A Bolton
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Penelope Love
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Claudia Strugnell
- School of Health and Social Development, Deakin University, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
- Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Tara Boelsen-Robinson
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Miranda R Blake
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Erik Martin
- School of Medicine, Deakin University, Geelong, Australia
| | - Steven Allender
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Colin Bell
- School of Medicine, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| |
Collapse
|
26
|
Farias L, Nyberg G, Helgadóttir B, Andermo S. Adolescents' experiences of a school-based health promotion intervention in socioeconomically advantaged and disadvantaged areas in Sweden: a qualitative process evaluation study. BMC Public Health 2023; 23:1631. [PMID: 37626379 PMCID: PMC10464358 DOI: 10.1186/s12889-023-16581-z] [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: 04/21/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Adolescence is a transition period in which positive experiences of physical activity have the potential to last into later adulthood. These experiences are influenced by socioeconomic determinants, leading to health inequalities. This study aims to explore adolescents' experiences and participation in a multi-component school-based intervention in schools located in socioeconomically advantaged and disadvantaged areas in Sweden. METHODS A qualitative design was used to evaluate how participants experienced the intervention. The intervention was a multi-component school-based intervention. It was conducted in six schools (four control and two intervention schools) with a total of 193 students and lasted one school year. It was teacher-led and consisted of three 60-minute group sessions per week: varied physical activities, homework support with activity breaks, and walks while listening to audiobooks. In total, 23 participant observations were conducted over eight months and 27 students participated in focus groups. A content analysis was conducted. RESULTS The results describe a main category 'Engaging in activities depending on socioeconomic status' and three generic categories: 1. Variations in participation in PA together with classmates and teachers; 2. Variations in engagement in PA after school; and 3. Differences in time and place allocated to do homework and listen to audiobooks. These categories illustrate how participants looked forward to the physical activities but used the time spent during the walks and homework support differently depending on how busy they were after school. Frequently, those who were busiest after school were also those from the advantaged area, and those who had little to do after school were from the disadvantaged area. CONCLUSION Socioeconomic factors influence participants' possibilities to engage in the intervention activities as well as how they use their time in the activities. This study showed that it is crucial to support adolescents' participation in physical activities by providing structure and engaging well-known teachers in the activities, especially in schools located in disadvantaged areas.
Collapse
Affiliation(s)
- Lisette Farias
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden.
| | - Gisela Nyberg
- Department of Sport Science, The Swedish School of Sport and Health Sciences, Lidingövägen 1, Stockholm, 114 33, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Björg Helgadóttir
- Department of Sport Science, The Swedish School of Sport and Health Sciences, Lidingövägen 1, Stockholm, 114 33, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Susanne Andermo
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden
- Department of Sport Science, The Swedish School of Sport and Health Sciences, Lidingövägen 1, Stockholm, 114 33, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden
| |
Collapse
|
27
|
Brandes B, Sell L, Buck C, Busse H, Zeeb H, Brandes M. Use of a toolbox of tailored evidence-based interventions to improve children's physical activity and cardiorespiratory fitness in primary schools: results of the ACTIPROS cluster-randomized feasibility trial. Int J Behav Nutr Phys Act 2023; 20:99. [PMID: 37596651 PMCID: PMC10439638 DOI: 10.1186/s12966-023-01497-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/23/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND School-based physical activity (PA) promotion is usually conducted by providing one specific intervention. In contrast, the ACTIvity PROmotion via Schools (ACTIPROS) toolbox provides a set of twelve evidence-based PA interventions serving different domains of the Health Promoting Schools framework that primary schools can select according to their requirements. In this study, we tested the feasibility of the toolbox approach in primary schools. METHODS A two-arm cluster-randomized feasibility trial at primary schools (n = 5 intervention schools [IS], n = 5 control schools) located in the Federal State of Bremen, Germany, was conducted. Children's habitual PA (GENEActiv, Activinsights Ltd.) and motor skills (Deutscher Motorik Test; DMT) were measured at the beginning (t0: Sept and Oct 2021) and at the end of the school year (t1: June and July 2022). Between Oct 2021 and July 2022, the ACTIPROS toolbox was implemented at IS. Teachers documented intervention choices and implementation within a short questionnaire (SIQ) at t1. RESULTS IS successfully implemented at least one intervention of the toolbox. In total, seven out of twelve possible interventions were selected. Two schools decided to replace an intervention with another during the trial. Results of the SIQ indicated that IS tended to choose similar interventions while implementation frequency was highly different. N = 429 students from two classes per school were recruited. The mean consent rate was 75.1% (n = 322). At t0 and t1, n = 304 (94.4%) and n = 256 (79.3%) of consented children took part in the DMT, respectively. The accelerometry sample included one class per participating school. At t0 and t1, n = 166 and n = 151 devices were handed out to students and n = 133 (80.1%) and n = 106 (70.2%) valid records could be retrieved, respectively. Linear mixed models showed an intervention effect of 15.5 min (95% CI: 4.5; 26.6) in children's daily MVPA at IS between t0 and t1 compared to controls. CONCLUSIONS All IS were able to implement at least one intervention from the toolbox, and unsuitable interventions were successfully replaced in a timely manner, highlighting the feasibility of implementing the ACTIPROS toolbox. Good consent rates for accelerometer and motor skills data were achieved. Results indicate a substantial increase in MVPA associated with the ACTIPROS toolbox and need to be tested in a larger sample. TRIAL REGISTRATION German Clinical Trials Register DRKS00025840.
Collapse
Affiliation(s)
- Berit Brandes
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Louisa Sell
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
- Faculty 11 – Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Christoph Buck
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Heide Busse
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
- Faculty 11 – Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Mirko Brandes
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| |
Collapse
|
28
|
Moore SE, Brennan SF, Lavelle F, Dean M, McKinley MC, Olgacher D, McCole P, Hunter RF, Dunne L, O’Connell NE, Elliott CT, McCarthy D, Woodside JV. Capturing the whole-school food environment in primary schools. Public Health Nutr 2023; 26:1671-1678. [PMID: 37272413 PMCID: PMC10410367 DOI: 10.1017/s1368980023001131] [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: 08/16/2022] [Revised: 01/23/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The school food environment (SFE) is an ideal setting for encouraging healthy dietary behaviour. We aimed to develop an instrument to assess whole-SFE, test the instrument in the school setting and demonstrate its use to make food environment recommendations. DESIGN SFE literature and UK school food guidance were searched to inform instrument items. The instrument consisted of (i) an observation proforma capturing canteen areas systems, food presentation and monitoring of food intake and (ii) a questionnaire assessing food policies, provision and activities. The instrument was tested in schools and used to develop SFE recommendations. Descriptive analyses enabled narrative discussion. SETTING Primary schools. PARTICIPANTS An observation was undertaken at schools in urban and rural geographical regions of Northern Ireland of varying socio-economic status (n 18). School senior management completed the questionnaire with input from school caterers (n 16). RESULTS The instrument captured desired detail and potential instrument modifications were identified. SFE varied. Differences existed between food policies and how policies were implemented and monitored. At many schools, there was scope to enhance physical eating environments (n 12, 67 %) and food presentation (n 15, 83 %); emphasise healthy eating through food activities (n 7, 78 %) and increase parental engagement in school food (n 9, 56 %). CONCLUSIONS The developed instrument can measure whole-SFE in primary schools and also enabled identification of recommendations to enhance SFE. Further assessment and adaptation of the instrument are required to enable future use as a research tool or for self-assessment use by schools.
Collapse
Affiliation(s)
- Sarah E Moore
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
| | - Sarah F Brennan
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
| | - Fiona Lavelle
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Moira Dean
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Michelle C McKinley
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Dilara Olgacher
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
| | - Patrick McCole
- Queen’s Management School, Queen’s University Belfast, BelfastBT9 5EE, United Kingdom of Great Britain and Northern Ireland
| | - Ruth F Hunter
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Laura Dunne
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Niamh E O’Connell
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Chris T Elliott
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Danielle McCarthy
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
| | - Jayne V Woodside
- Institute for Global Food Security, Queen’s University Belfast, BelfastBT9 5AG, United Kingdom of Great Britain and Northern Ireland
- Centre for Public Health, Queen’s University Belfast, BelfastBT12 6BA, United Kingdom of Great Britain and Northern Ireland
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
29
|
Guthold R, Kann L, Bhatti L, Abduvahobov P, Ansong J, Atkinson U, Baltag V, Caffe S, Caixeta R, Diallo CB, Fouad H, Haddad S, Hachri H, Jaggi JA, Joshi P, Karna P, Louazani SA, Mbola Mbassi S, Mehta R, Mudgal Y, Nigg CR, Okely AD, Ondarsuhu D, Ouaourir T, Trhari FZ, Riley LM. Effectiveness of a participatory approach to develop school health interventions in four low resource cities: study protocol of the 'empowering adolescents to lead change using health data' cluster randomised controlled trial. BMJ Open 2023; 13:e071353. [PMID: 37407059 PMCID: PMC10335517 DOI: 10.1136/bmjopen-2022-071353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION Comprehensive local data on adolescent health are often lacking, particularly in lower resource settings. Furthermore, there are knowledge gaps around which interventions are effective to support healthy behaviours. This study generates health information for students from cities in four middle-income countries to plan, implement and subsequently evaluate a package of interventions to improve health outcomes. METHODS AND ANALYSIS We will conduct a cluster randomised controlled trial in schools in Fez, Morocco; Jaipur, India; Saint Catherine Parish, Jamaica; and Sekondi-Takoradi, Ghana. In each city, approximately 30 schools will be randomly selected and assigned to the control or intervention arm. Baseline data collection includes three components. First, a Global School Health Policies and Practices Survey (G-SHPPS) to be completed by principals of all selected schools. Second, a Global School-based Student Health Survey (GSHS) to be administered to a target sample of n=3153 13-17 years old students of randomly selected classes of these schools, including questions on alcohol, tobacco and drug use, diet, hygiene, mental health, physical activity, protective factors, sexual behaviours, violence and injury. Third, a study validating the GSHS physical activity questions against wrist-worn accelerometry in one randomly selected class in each control school (n approximately 300 students per city). Intervention schools will develop a suite of interventions using a participatory approach driven by students and involving parents/guardians, teachers and community stakeholders. Interventions will aim to change existing structures and policies at schools to positively influence students' behaviour, using the collected data and guided by the framework for Making Every School a Health Promoting School. Outcomes will be assessed for differential change after a 2-year follow-up. ETHICS AND DISSEMINATION The study was approved by WHO's Research Ethics Review Committee; by the Jodhpur School of Public Health's Institutional Review Board for Jaipur, India; by the Noguchi Memorial Institute for Medical Research Institutional Review Board for Sekondi-Takoradi, Ghana; by the Ministry of Health and Wellness' Advisory Panel on Ethics and Medico-Legal Affairs for St Catherine Parish, Jamaica, and by the Comité d'éthique pour la recherche biomédicale of the Université Mohammed V of Rabat for Fez, Morocco. Findings will be shared through open access publications and conferences. TRIAL REGISTRATION NUMBER NCT04963426.
Collapse
Affiliation(s)
- Regina Guthold
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO, Geneva, Switzerland
| | - Laura Kann
- Noncommunicable Diseases Department, WHO, Geneva, Switzerland
| | - Lubna Bhatti
- Noncommunicable Diseases Department, WHO, Geneva, Switzerland
| | - Parviz Abduvahobov
- Health and Education Section, Division for Peace and Sustainable Development, Education Sector, UNESCO, Paris, France
| | | | - Uki Atkinson
- National Council on Drug Abuse, Kingston, Jamaica
| | - Valentina Baltag
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO, Geneva, Switzerland
| | - Sonja Caffe
- Family, Health Promotion and Life Course, PAHO, Washington, Columbia, USA
| | - Roberta Caixeta
- Noncommunicable Diseases and Mental Health Department, PAHO, Washington, Columbia, USA
| | - Cheick Bady Diallo
- Universal Health Coverage/Communicable and Noncommunicable Diseases, WHO Regional Office for Africa, Brazzaville, Congo
| | - Heba Fouad
- Noncommunicable Diseases and Mental Health Department, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Sally Haddad
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | | | - Jeannine A Jaggi
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | | | - Priya Karna
- WHO Country Office for India, New Delhi, India
| | | | - Symplice Mbola Mbassi
- Universal Health Coverage/Life Course, WHO Regional Office for Africa, Brazzaville, Congo
| | - Rajesh Mehta
- WHO Regional Office for South-East Asia, New Delhi, India
| | | | - Claudio R Nigg
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Anthony D Okely
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Dolores Ondarsuhu
- Noncommunicable Diseases and Mental Health Department, PAHO, Washington, Columbia, USA
| | - Tahar Ouaourir
- Population Department, Ministry of Health, Rabat, Morocco
| | | | - Leanne M Riley
- Noncommunicable Diseases Department, WHO, Geneva, Switzerland
| |
Collapse
|
30
|
Vonk L, Eekhout I, Huijts T, Levels M, Jansen MWJ. School health promotion and the consumption of water and sugar-sweetened beverages in secondary schools: a cross-sectional multilevel study. BMC Public Health 2023; 23:1296. [PMID: 37407939 DOI: 10.1186/s12889-023-16123-7] [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] [Received: 01/13/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Overweight among adolescents remains a serious concern worldwide and can have major health consequences in later life, such as cardiovascular diseases and cancer. Still, 33% of secondary school adolescents in the Netherlands consume sugar-sweetened beverages daily and over 26% do not consume water every day. The Dutch Healthy School program was developed to support schools in stimulating healthier lifestyles by focusing on health education, school environments, identifying students' health problems, and school policy. We examined the variation between secondary schools regarding the daily consumption of water and sugar-sweetened beverages and whether this variation can be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. METHODS We performed a cross-sectional multilevel study. We used data from the national Youth Health Monitor of 2019 on secondary schools (grades 8 and 10, age range about 12 to 18 years) of seven Public Health Services and combined these with information regarding Healthy School certification and general school- and school population characteristics. Our outcomes were daily consumption of water and sugar-sweetened beverages. In total, data from 51,901 adolescents from 191 schools were analysed. We calculated the intraclass correlation to examine the variation between schools regarding our outcomes. Thereafter, we examined whether we could explain this variation by the included characteristics. RESULTS The school-level explained 4.53% of the variation in the consumption of water and 2.33% of the variation in the consumption of sugar-sweetened beverages. This small variation in water and sugar-sweetened consumption could not be explained by Healthy School certification, yet some general school- and school population characteristics did: the proportion of the school population with at least one parent with high educational attainment, the educational track of the adolescents, urbanicity (only for water consumption) and school type (only for sugar-sweetened beverages consumption). CONCLUSIONS The low percentages of explained variation indicate that school-level characteristics in general (including Healthy School certification) do not matter substantially for the daily consumption of water and sugar-sweetened beverages. Future research should examine whether school health promotion can contribute to healthier lifestyles, and if so, under which level of implementation and school conditions.
Collapse
Affiliation(s)
- Lisanne Vonk
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, P.O. Box 33, 6400 AA, Heerlen, The Netherlands.
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Iris Eekhout
- Expertise Center Child Health, Netherlands Organisation for Applied Scientific Research (TNO), P.O. Box 3005, 2301 DA, Leiden, The Netherlands
| | - Tim Huijts
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands
- Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), P.O. Box 8900, NO-7491, Trondheim, Norway
| | - Mark Levels
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, P.O. Box 33, 6400 AA, Heerlen, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| |
Collapse
|
31
|
Sweeting H, Thomson H, Wells V, Flowers P. Evolution of 'whole institution' approaches to improving health in tertiary education settings: a critical scoping review. RESEARCH PAPERS IN EDUCATION 2023; 38:661-689. [PMID: 37424522 PMCID: PMC7614732 DOI: 10.1080/02671522.2021.1961302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/02/2021] [Indexed: 07/11/2023]
Abstract
In recent decades, 'whole school' approaches to improving health have gained traction, based on settings-based health promotion understandings which view a setting, its actors and processes as an integrated 'whole' system with multiple intervention opportunities. Much less is known about 'whole institution' approaches to improving health in tertiary education settings. We conducted a scoping review to describe both empirical and non-empirical (e.g. websites) publications relating to 'whole settings', 'complex systems' and 'participatory'/'action' approaches to improving the health of students and staff within tertiary education settings. English-language publications were identified by searching five academic and four grey literature databases and via the reference lists of studies read for eligibility. We identified 101 publications with marked UK overrepresentation. Since the 1970s, publications have increased, spanning a gradual shift in focus from 'aspirational' to 'conceptual' to 'evaluative'. Terminology is geographically siloed (e.g., 'healthy university' (UK), 'healthy campus' (USA)). Publications tend to focus on 'health' generally rather than specific health dimensions (e.g. diet). Policies, arguably crucial for cascading systemic change, were not the most frequently implemented intervention elements. We conclude that, despite the field's evolution, key questions (e.g., insights into who needs to do what, with whom, where and when; or efficacy) remain unanswered.
Collapse
Affiliation(s)
- Helen Sweeting
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Hilary Thomson
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Valerie Wells
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| |
Collapse
|
32
|
Shinde S, Raniti M, Sharma A, Sawyer SM. What happens when a whole-school health promotion research trial ends? a case study of the SEHER program in India. Front Psychiatry 2023; 14:1112710. [PMID: 37426112 PMCID: PMC10326627 DOI: 10.3389/fpsyt.2023.1112710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/26/2023] [Indexed: 07/11/2023] Open
Abstract
Background Health promotion interventions that are developed and evaluated by researchers and other external providers are at risk of not being sustained beyond the initial implementation period. When delivered by a lay school health worker, the SEHER study of a whole-school health promotion intervention in Bihar, India was found to be feasible, acceptable and effective in improving school climate and student health behaviors. The objective of this case study is to describe the decision-making processes, barriers, and enablers to continuing the SEHER intervention following its official closure. Methods For this exploratory qualitative case study, data were collected from four government-run secondary schools, two of which continued SEHER and two of which discontinued it after official closure. Thirteen school staff were interviewed, and 100 girls and boys (aged 15-18 years old) participated in eight focus groups discussing their experiences of the process of continuing the intervention (or discontinuing) following its official closure. Thematic analysis was conducted in NVivo 12 using grounded theory. Results No school sustained the intervention as originally delivered in the research trial. In two schools, the intervention was adapted by selecting sustainable components, whereas in two others it was discontinued altogether. We identified four interrelated themes that explained the complex decision-making process, barriers, and enablers related to program continuation: (1) understanding of the intervention philosophy among school staff; (2) school capabilities to continue with intervention activities; (3) school attitudes and motivation about implementing the intervention, and; (4) the education policy environment and governance structures. Suggestions for overcoming barriers included adequate resource allocation; training, supervision, and support from external providers and the Ministry of Education; and formal government approval to continue the intervention. Conclusion Sustaining this whole-school health promotion intervention in low-resource school settings in India depended on individual, school and government factors as well as external support. These findings suggest that health interventions will not necessarily become embedded in a school's operations merely because they are designed as a whole-school approach or because they are effective. Research should identify the resources and processes required to balance planning for future sustainability while awaiting trial results about an intervention's effectiveness.
Collapse
Affiliation(s)
- Sachin Shinde
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Center for Inquiry Into Mental Health, Pune, India
| | - Monika Raniti
- Centre for Adolescent Health, Murdoch Children’s Research Institute and Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | | | - Susan M. Sawyer
- Centre for Adolescent Health, Murdoch Children’s Research Institute and Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
33
|
Carl J, Schmittwilken L, Pöppel K. Development and evaluation of a school-based physical literacy intervention for children in Germany: protocol of the PLACE study. Front Sports Act Living 2023; 5:1155363. [PMID: 37325795 PMCID: PMC10264646 DOI: 10.3389/fspor.2023.1155363] [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: 01/31/2023] [Accepted: 05/12/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Fueled by the COVID-19 pandemic, the physical activity behavior of children has reached a concerning level nowadays. By empowering individuals to be physically active throughout the life course, the concept of physical literacy has recently gained increasing attention and adopts a holistic-integrative perspective on PA promotion. Although the field has successively attempted to translate the conceptual ideas of physical literacy into interventions, the theoretical base is heterogeneous and is often lacking within interventions. Furthermore, several countries, including Germany, have not equally adopted the concept yet. Therefore, the goal of the present study protocol is to describe the development and evaluation approach of a PL intervention ("PLACE") for children in grades three and four within the German all-day schooling system. Methods The physical literacy intervention cultivates explicit theory-content links and comprises 12 heterogeneous sessions (each 60-90 min in length). The study contains three different phases with two initial pilot studies and a subsequent main study. The two pilot studies take a mixed-methods character by drawing on quantitative pre-post-designs as well as interviews with children (in groups). In the main study, we will longitudinally compare the course of PL values (five outcome domains: physical, affective, cognitive, social, behavioral) between two study arms: school classes of children are either assigned to an intervention condition (regular physical education and health care plus PL intervention) or to a control condition (regular physical education and health care only). Discussion The findings of this study will provide evidence on how to structure a multicomponent intervention in Germany based on the PL concept. In summary, the results will report on the effectiveness of the intervention and, therefore, decide whether to scale-up the intervention.
Collapse
Affiliation(s)
- Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Louisa Schmittwilken
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- Institute of Sport Science, Oldenburg University, Oldenburg, Germany
| | - Katharina Pöppel
- Institute of Sport Science, Oldenburg University, Oldenburg, Germany
| |
Collapse
|
34
|
Roux F, Chih H, Hendriks J, Burns S. Mixed Method Evaluation of My Vital Cycles ®: A Holistic School-Based Ovulatory Menstrual Health Literacy Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5964. [PMID: 37297568 PMCID: PMC10252248 DOI: 10.3390/ijerph20115964] [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: 12/26/2022] [Revised: 04/18/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
There is a high prevalence of ovulatory menstrual (OM) dysfunctions among adolescents, and their menstrual health literacy is poor. The OM cycle can be used as a personal health monitor provided that the skills to understand it are correctly taught. My Vital Cycles®, a holistic school-based OM health literacy program, was trialed with a Grade 9 cohort in one single-sex school in Western Australia using the Health Promoting School framework. A validated OM health literacy questionnaire was administered pre- and post-program with 94 participants. Functional OM health literacy improved overall, with 15 out of 20 items showing improvement post-program (p < 0.05). In addition, 19 out of 53 items for interactive OM health literacy, and 18 out of 25 items for critical OM health literacy improved (p < 0.05). The improvement in mood concerns (p = 0.002) was unexpected. Thematic analysis of three focus groups of 18 girls revealed four themes of increasing comfort levels; finding the program informative; inclusion of non-teaching support such as healthcare professionals; and suggestions for future refinements. Overall, this Western Australian PhD project which developed and trialed My Vital Cycles® improved OM health literacy and was positively received. Future research possibilities include understanding the program's impact on mental health and further trials in co-educational settings; amongst different populations; and with extended post-program testing.
Collapse
Affiliation(s)
- Felicity Roux
- Curtin Medical School, Curtin University, Bentley, WA 6102, Australia
| | - HuiJun Chih
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | | | - Sharyn Burns
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| |
Collapse
|
35
|
Rachamin Y, Nerlich SE, Jäger L, De Gani SM, Favre O, Senn O. Adolescents' self-reported health status, behaviours and health issues addressed during routine school doctor consultations in Switzerland: an observational study. Swiss Med Wkly 2023; 153:40078. [PMID: 37243976 DOI: 10.57187/smw.2023.40078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND We aimed to investigate the self-reported health status and behaviours of 7th-grade adolescents, associations with gender and educational track, as well as health issues addressed during routine school doctor consultations in Switzerland. METHODS Data on health status and behaviours, specifically general well-being, stimulant and addictive substance use, bullying/violence, exercise, nutrition and health protection, and puberty/sexuality, were drawn from routinely collected self-assessment questionnaires from 1076 (of a total of 1126) students from 14 schools in the Swiss canton of Zug in 2020. Data on health issues addressed in school doctor consultations were collected by nine school doctors (for 595 individual consultations). Multilevel logistic regression analyses were used to investigate the association of gender and educational track with unfavourable health status or behaviours. RESULTS Although 92% (n = 989) of the students reported being happy or satisfied overall, 21% (n = 215) often or almost always felt sad, and 5-10% had repeatedly been seriously physically hurt (n = 67), sexually harassed with words (n = 88) or experienced uncomfortable physical contact (n = 60). Female gender and a lower educational track were associated with unfavourable health status. In 90% (n = 533) of the school doctor consultations, at least one topic of disease prevention or health promotion was addressed, whereby the topics addressed depended strongly on the individual school doctors. CONCLUSIONS Our findings revealed that unfavourable health status and behaviours were prevalent among adolescents but the health topics addressed in school doctor consultations were not tailored to students' self-reported health issues. A school-based approach that strengthens adolescents' health literacy and provides opportunities for patient-centred counselling has the potential to improve the current and future health of adolescents and, ultimately, adults. To realise this potential, it is essential for school doctors to be sensitised and trained to address students' health concerns. Emphasis should be placed on the importance of patient-centred counselling, the high prevalence of bullying, and gender and educational differences.
Collapse
Affiliation(s)
- Yael Rachamin
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Campus Stiftung Lindenhof Bern (SLB), Bern, Switzerland
| | - Sofia Elena Nerlich
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Levy Jäger
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | | | - Olivier Favre
- Department of Child and Adolescent Health, Office of Public Health, Canton of Zug, Zug, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
36
|
Sales D, da Silva Junior JP, Bergamo RR, de Oliveira LC, Ferrari G, Matsudo V. Association between school environment with sedentary behavior and physical activity intensity in children. Sci Rep 2023; 13:6995. [PMID: 37117328 PMCID: PMC10147915 DOI: 10.1038/s41598-023-33732-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/18/2023] [Indexed: 04/30/2023] Open
Abstract
We examined the association between indicators of the school environment with sedentary behavior and different intensities of physical activity in children. The study that included 515 children (265 boys) aged 9-11 years old from public and private schools in the city of São Caetano do Sul. Sedentary behavior and different intensities of physical activity were evaluated with an accelerometer. Inside school environment (policies, supervision committee, extracurricular activities, breaks, and access to school facilities) was evaluated using a questionnaire. Policies and practice (β: 8.49; 95% CI: 3.62-13.36), supervision committee (5.42; 0.64-10.19), inter-school competitions (2.40, 2.25-2.55), breaks of 15-29 min/day (6.87; 2.20-10.75), and outdoor sports field (5.40; 0.37-10.44), were positively associated with moderate-to-vigorous-intensity physical activity. Furthermore, crossing guards (7.65; 3.00-12.30) were positively associated with moderate-to-vigorous-intensity physical activity. We concluded that an association was found between school environment indicators with higher levels of physical activity and greater odds of meeting physical activity guidelines.
Collapse
Affiliation(s)
- Diego Sales
- Study Center of the Physical Fitness Laboratory of São Caetano Do Sul (CELAFISCS), Rua Santo Antonio, 50 - 5º andar - salas 504/505 - Centro, São Caetano Do Sul, SP, Brazil.
| | - João Pedro da Silva Junior
- Study Center of the Physical Fitness Laboratory of São Caetano Do Sul (CELAFISCS), Rua Santo Antonio, 50 - 5º andar - salas 504/505 - Centro, São Caetano Do Sul, SP, Brazil
| | - Raiany Rosa Bergamo
- Study Center of the Physical Fitness Laboratory of São Caetano Do Sul (CELAFISCS), Rua Santo Antonio, 50 - 5º andar - salas 504/505 - Centro, São Caetano Do Sul, SP, Brazil
| | - Luis Carlos de Oliveira
- Study Center of the Physical Fitness Laboratory of São Caetano Do Sul (CELAFISCS), Rua Santo Antonio, 50 - 5º andar - salas 504/505 - Centro, São Caetano Do Sul, SP, Brazil
| | - Gerson Ferrari
- Escuela de Ciencias de La Actividad Física, el Deporte Y La Salud, Universidad de Santiago de Chile, Santiago, Chile
- Facultad de Ciencias de La Salud, Universidad Autónoma de Chile, Providencia, Chile
| | - Victor Matsudo
- Study Center of the Physical Fitness Laboratory of São Caetano Do Sul (CELAFISCS), Rua Santo Antonio, 50 - 5º andar - salas 504/505 - Centro, São Caetano Do Sul, SP, Brazil
| |
Collapse
|
37
|
Widnall E, Albers PN, Hatch L, Hopkins G, Kidger J, Vocht FD, Kaner E, Sluijs EMV, Fairbrother H, Jago R, Campbell R. Using systems thinking to understand how the South West - School Health Research Network can improve adolescent health and well-being: A qualitative process evaluation. Health Place 2023; 82:103034. [PMID: 37120949 PMCID: PMC7614868 DOI: 10.1016/j.healthplace.2023.103034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
Schools offer a valuable setting to promote good health and mental well-being amongst young people. Schools are complex systems and therefore systems interventions are needed to improve pupil health and well-being. This paper presents a qualitative process evaluation of the South West- School Health Research Network, a systems level intervention. The evaluation is based on interviews with school staff, local authorities and wider stakeholders. Given the complexity of England's educational system there is a need to intervene and monitor health at multiple levels and to ensure close partnership working to effectively improve adolescent health through schools.
Collapse
Affiliation(s)
- Emily Widnall
- Population Health Sciences, University of Bristol, UK.
| | | | - Lorna Hatch
- Population Health Sciences, University of Bristol, UK
| | | | - Judi Kidger
- Population Health Sciences, University of Bristol, UK
| | | | - Eileen Kaner
- Faculty of Medical Sciences, Newcastle University, UK
| | | | | | - Russell Jago
- Population Health Sciences, University of Bristol, UK; Centre for Exercise Nutrition & Health Sciences, School for Policy Studies, University of Bristol, UK
| | - Rona Campbell
- Population Health Sciences, University of Bristol, UK
| |
Collapse
|
38
|
Widnall E, Hatch L, Albers PN, Hopkins G, Kidger J, de Vocht F, Kaner E, van Sluijs EM, Fairbrother H, Jago R, Campbell R. Implementing a regional school health research network in england to improve adolescent health and well-being, a qualitative process evaluation. BMC Public Health 2023; 23:745. [PMID: 37088825 PMCID: PMC10122722 DOI: 10.1186/s12889-023-15713-9] [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] [Received: 11/16/2022] [Accepted: 04/19/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND There is an increased need for prevention and early intervention surrounding young people's health and well-being. Schools offer a pivotal setting for this with evidence suggesting that focusing on health within schools improves educational attainment. One promising approach is the creation of School Health Research Networks which exist in Wales and Scotland, but are yet to be developed and evaluated in England. METHODS This qualitative process evaluation aimed to identify the main barriers and facilitators to implementing a pilot School Health Research Network in the South West of England (SW-SHRN). Semi-structured interviews were conducted with school staff, local authority members, and other key stakeholders. Interview data were analysed using the 7-stage framework analysis approach. RESULTS Four main themes were identified from the data: (1) 'Key barriers to SW-SHRN' (competing priorities of academic attainment and well-being, schools feeling overwhelmed with surveys and lack of school time and resource); (2) 'Key facilitators to SW-SHRN: providing evidence-based support to schools' (improved knowledge to facilitate change, feedback reports and benchmarking and data to inform interventions); (3) 'Effective dissemination of findings' (interpretation and implementation, embedding findings with existing evidence and policy, preferences for an online platform as well personalised communication and the importance of involving young people and families); and (4) 'Longer-term facilitators: ensuring sustainability' (keeping schools engaged, the use of repeat surveys to evaluate impact, informing school inspection frameworks and expanding reach of the network). CONCLUSION This study identifies several barriers to be addressed and facilitators to be enhanced in order to achieve successful implementation of School Health Research Networks in England which include providing a unique offering to schools that is not too burdensome, supporting schools to take meaningful action with their data and to work closely with existing organisations, services and providers to become meaningfully embedded in the system.
Collapse
Affiliation(s)
- Emily Widnall
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England.
| | - Lorna Hatch
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England
| | - Patricia N Albers
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England
| | - Georgina Hopkins
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England
| | - Judi Kidger
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England
| | - Eileen Kaner
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, England
| | | | | | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England
- Centre for Exercise Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, England
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, BS8 2PL, England
| |
Collapse
|
39
|
Ba-Break M, Bewick B, Huss R, Ensor T, Abahussin A, Alhakimi H, Elsey H. Systematic review of intervention functions, theoretical constructs and cultural adaptations of school-based smoking prevention interventions in low-income and middle-income countries. BMJ Open 2023; 13:e066613. [PMID: 36787979 PMCID: PMC9930567 DOI: 10.1136/bmjopen-2022-066613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/09/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To identify the approaches and strategies used for ensuring cultural appropriateness, intervention functions and theoretical constructs of the effective and ineffective school-based smoking prevention interventions that were implemented in low-income and middle-income countries (LMICs). DATA SOURCES Included MEDLINE, EMBASE, Global Health, PsycINFO, Web of Science and grey literature which were searched through August 2022 with no date limitations. ELIGIBILITY CRITERIA We included randomised controlled trials (RCTs) with ≥6 months follow-up assessing the effect of school-based interventions on keeping pupils never-smokers in LMICs; published in English or Arabic. DATA EXTRACTION AND SYNTHESIS Intervention data were coded according to the Theoretical Domains Framework, intervention functions of Behaviour Change Wheel and cultural appropriateness features. Using narrative synthesis we identified which cultural-adaptation features, theoretical constructs and intervention functions were associated with effectiveness. Findings were mapped against the capability-motivation and opportunity model to formulate the conclusion. Risk of bias was assessed using the Cochrane risk of bias tool. RESULTS We identified 11 RCTs (n=7712 never-smokers aged 11-15); of which five arms were effective and eight (four of the effective) arms had a low risk of bias in all criteria. Methodological heterogeneity in defining, measuring, assessing and presenting outcomes prohibited quantitative data synthesis. We identified nine components that characterised interventions that were effective in preventing pupils from smoking uptake. These include deep cultural adaptation; raising awareness of various smoking consequences; improving refusal skills of smoking offers and using never-smokers as role models and peer educators. CONCLUSION Interventions that had used deep cultural adaptation which incorporated cultural, environmental, psychological and social factors, were more likely to be effective. Effective interventions considered improving pupils' psychological capability to remain never-smokers and reducing their social and physical opportunities and reflective and automatic motivations to smoke. Future trials should use standardised measurements of smoking to allow meta-analysis in future reviews.
Collapse
Affiliation(s)
- Maryam Ba-Break
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Bridgette Bewick
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Tim Ensor
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Asma Abahussin
- Department of Biomedical Technology, King Saud University, Riyadh, Saudi Arabia
| | - Hamdi Alhakimi
- Head of MedGebra Centre for Research Consultations, Epidemiologist and Community Medicine Specialist, MedGebra Centre for Research Consultations, Utrecht, The Netherlands
| | - Helen Elsey
- Health Sciences, University of York, York, UK
| |
Collapse
|
40
|
Improving adolescents' dietary behaviours in the school-setting: challenges and opportunities. Proc Nutr Soc 2023:1-14. [PMID: 36916515 DOI: 10.1017/s0029665123002197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Adolescence is a critical time of physical, psychological and social development, and thus, optimal nutritional intakes are required during this life stage. Despite this, adolescence is recognised as a period of nutritional vulnerability, with many reportedly failing to meet current dietary guidelines. The school-setting presents a favourable environment to intervene and promote positive dietary behaviours and is also inclusive regardless of socio-economic status. However, a lack of consensus exists on how best to utilise schools to facilitate improvements in dietary behaviours among this age group. Whilst previous research has focused on identifying the factors motivating dietary choices within the school-setting, less is known on the optimum strategies to enhance these dietary choices which could positively contribute to the design of future interventions. It is reported that adolescents have good nutritional knowledge, although this does not appear to be a central consideration when making their dietary choices. Alternative factors at the individual (taste, visual appeal, familiarity, food quality, price, portion size, value for money, time/ convenience), social (peer influence), physical (product placement) and macro environment (food availability) levels have been frequently cited as important influences on adolescents' dietary choices in school. Although school-based interventions have shown potential in achieving positive dietary change among adolescents, more research is needed to determine the most effective methods in improving dietary behaviours in schools. This review summarises the key factors which influence adolescents' school-based dietary choices and the effectiveness of previously conducted interventions, identifying promising components for consideration when developing future dietary interventions within the school-setting.
Collapse
|
41
|
Alotaibi NM, Alshammari GM, Alabdulkarem KB, Alotaibi AA, Mohammed MA, Alotaibi A, Yahya MA. A Cross-Sectional Study of Gender Differences in Calorie Labeling Policy among Students: Dietary Habits, Nutritional Knowledge and Awareness. Nutrients 2023; 15:879. [PMID: 36839237 PMCID: PMC9958862 DOI: 10.3390/nu15040879] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Calorie labels may be the most important predictor of dietary choices among college students. The Saudi Food and Drug Authority (SFDA) has imposed calorie labels on the menus of restaurants and cafes. The current study looked at how the calorie labeling policy affects Saudi male and female students' dietary habits, nutritional knowledge, and awareness. The study included 802 students (360 males and 442 females) from Saudi Arabia's King Saud University, ranging between 18 and 35 years. Between December 2020 and October 2021, a cross-sectional, electronic, approved and validated survey was conducted to collect data on gender socio-demographic variables, food habits, and nutritional knowledge and awareness, in accordance with the food policy stated. The collected data were analyzed using descriptive statistical analysis. The Likert scale was used to determine the level of awareness and the food habit scores, and the Mann-Whitney U-test was used to determine the differences between the males and females. Spearman's correlation coefficient and simple regression analysis were performed to determine the association between the demographic factors and nutritional knowledge and the awareness of males and females. The results demonstrated that, with the exception of living situations, males and females differed significantly (p ≤ 0.01) in their socio-demographic characteristics. When asked about their food habits after the implementation of calorie labeling, the majority of respondents (>50%) gave negative responses, with a significant difference observed between maintaining body weight (p ≤ 0.05) and gaining weight (p ≤ 0.01). According to the Likert scale, there was a significant difference between males and females in terms of knowledge (p ≤ 0.01) and awareness (p ≤ 0.05). An average of 80.53% of males had very high knowledge (4.07) and 65.65% had medium level (3.24) awareness of calorie labeling, while 83.73% of females had very high knowledge (4.17) and 66.50% had medium level (3.32) awareness of calorie labeling. The socio-demographic and lifestyle variables were significantly and positively or negatively associated with calorie label utilization and varied between respondents, according to the Spearman correlation coefficients (r) and simple linear regression analysis. The number of factors that negatively impacted the males' knowledge and awareness was greater than that of the females. In conclusion, among college students, there were numerous gender differences in the demographic and social characteristics. The respondents' knowledge was insufficient, with females outperforming males.
Collapse
Affiliation(s)
- Naif M. Alotaibi
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
| | - Ghedeir M. Alshammari
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
| | - Kholoud B. Alabdulkarem
- Department of Social Studies, College of Arts, King Saud University, Riyadh 12372, Saudi Arabia
| | - Abdulaziz A. Alotaibi
- Public Administration Department, College of Business Administration, King Saud University, Riyadh 11543, Saudi Arabia
| | - Mohammed A. Mohammed
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
| | - Athoug Alotaibi
- Department of Social Studies, College of Arts, King Saud University, Riyadh 12372, Saudi Arabia
| | - Mohammed Abdo Yahya
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
| |
Collapse
|
42
|
Bae EJ, Yoon JY. Unhealthy weight control behaviors and related factors by gender and weight status: Results from a nationally representative sample of Korean adolescents. Arch Psychiatr Nurs 2023; 42:75-83. [PMID: 36842832 DOI: 10.1016/j.apnu.2022.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/26/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
Given the serious consequences of unhealthy weight control behaviors (UWCB) among adolescents, identifying factors contributing to it in this population is crucial. Although gender differences have been reported as UWCB-related factors, studies on weight status remain limited. Hence, using a nationally representative sample, we investigated the differences in UWCB-related factors by gender and weight status. Most sociodemographic, health-related behavior, psychosocial, and school factors were remarkably correlated with UWCB in the normal-weight female group; however, they demonstrated most inconsistent correlations in the overweight female group. Overall, this study suggests that UWCB-preventing interventions in adolescents should be customized by gender and weight status.
Collapse
Affiliation(s)
- Eun Jung Bae
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, Republic of Korea; Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea; Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
43
|
Collado-Soler R, Alférez-Pastor M, Torres FL, Trigueros R, Aguilar-Parra JM, Navarro N. A Systematic Review of Healthy Nutrition Intervention Programs in Kindergarten and Primary Education. Nutrients 2023; 15:nu15030541. [PMID: 36771248 PMCID: PMC9921877 DOI: 10.3390/nu15030541] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Childhood obesity and overweight rates are increasing in an exponential way. This type of diet-related health problem has consequences, not only at present but also for children's future lives. For these reasons, it is very important to find a solution, which could be nutrition intervention programs. The main objective of this article is to investigate the effectiveness of nutrition intervention programs in children aged 3-12 around the world. We used SCOPUS, Web of Science, and PubMed databases to carry out this systematic review and we followed the PRISMA statement. Two authors conducted literature searches independently, finding a total of 138 articles. Finally, after a thorough screening, a total of 19 articles were selected for detailed analysis. The results show that, in general, nutrition intervention programs are effective in improving knowledge and behaviors about healthy habits, and, consequently, that the body mass index value is reduced. However, it is true that we found differences between the incomes of families and geographical areas. In conclusion, we encourage school centers to consider including these types of programs in their educational program and bring awareness of the importance of families too.
Collapse
Affiliation(s)
- Rocio Collado-Soler
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Marina Alférez-Pastor
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Francisco L. Torres
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Rubén Trigueros
- Department of Language and Education, University of Antonio de Nebrija, 28015 Madrid, Spain
- Correspondence: (R.T.); (J.M.A.-P.)
| | - Jose M. Aguilar-Parra
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
- Correspondence: (R.T.); (J.M.A.-P.)
| | - Noelia Navarro
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| |
Collapse
|
44
|
Bilal S, Misra S, Hussain S, Tan SS, Priya E. Do Right, Be Bright: A Protocol on the Development of an Inter-Professional Health Intervention Model for Pre-School Children Through a Community-Based Service-Learning Initiative. J Multidiscip Healthc 2023; 16:1301-1310. [PMID: 37197578 PMCID: PMC10183355 DOI: 10.2147/jmdh.s405031] [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: 01/16/2023] [Accepted: 04/06/2023] [Indexed: 05/19/2023] Open
Abstract
An inter-professional project with a collaborative endeavor between the programs of Dentistry, Nutrition and Medicine was carried out with the aim to emphasise oral health maintenance, making the right nutritional choices and effective hand washing among pre-school children. The purpose of this paper is to share a detailed description of the design, development process, implementation, and planned evaluation of an interprofessional school-based health promotion intervention model "Do Right, Be Bright". This model is part of a quasi-experimental study, targeting pre-school children as the "Targets of Change" through the empowerment of school teachers as the "Agents of Change". The program design was based on Bartholomew's Intervention Mapping Approach, which proposes a direction for developing a theory-based health promotion intervention and on the most extensively applied theories of health behavior, the Health Belief Model. Therefore, based on a thorough literature review and needs assessment, three key areas of needs were identified for the targeted preschool children: oral hygiene, hand hygiene and nutrition. The efficacy of this model will be pilot tested in a preschool in Kuala Lumpur Malaysia.
Collapse
Affiliation(s)
- Sobia Bilal
- Division of Prevention and Public Health Sciences, Pediatric Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Snigdha Misra
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
- Correspondence: Snigdha Misra, Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia, Tel +603-2731 7608; +6016-617 9247, Fax +603-8656 7229, Email
| | - Sumaira Hussain
- Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Seok Shin Tan
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Ekta Priya
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| |
Collapse
|
45
|
AlZahrani SG. Healthy Schools Framework in Saudi Arabia: A Narrative Review. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2023. [DOI: 10.51847/lj2fbaa0vm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
46
|
Rasmussen IL, Ørjasæter KB, Schei J, Young S. Rise and shine: exploring self-esteem narratives of adolescents living with a diagnosis of attention-deficit/hyperactivity disorder. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2156297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Jorun Schei
- Child and Adolescent Psychiatrist, NTNU, St. Olavs University Hospital, Trondheim, Norway
| | - Susan Young
- Department of Psychology, Psychology Services Limited, London, UK
| |
Collapse
|
47
|
Jiménez-Parra JF, Belando-Pedreño N, Valero-Valenzuela A. The Effects of the ACTIVE VALUES Program on Psychosocial Aspects and Executive Functions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010595. [PMID: 36612915 PMCID: PMC9819049 DOI: 10.3390/ijerph20010595] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 05/27/2023]
Abstract
The main objective of this study was to implement an educational program named ACTIVE VALUES and to analyse the psychosocial and cognitive effects of its application. It is a quasi-experimental repeated measures research with a non-randomised experimental group (EG) and a control group (CG). The sample consisted of 102 students in the 6th grade of primary school, aged between 11 and 13 years (M = 11.59; SD = 0.60), and 4 teachers aged between 27 and 52 years (M = 38.5). The intervention program lasted 4 months, in which the EG implemented a teaching methodology based on the incorporation of classroom-based physical activity (CB-PA) in the structure of the Teaching for Personal and Social Responsibility (TPSR) model to develop personal and social values in students, as well as to reduce children's sedentary behaviour in the classroom in different educational areas (e.g., mathematics, Spanish language, social sciences and natural sciences), while the CG used a conventional methodology based on direct instruction. The main results found show significant improvements in intrinsic motivation variables (including intrinsic motivation for achievement, stimulating experiences and knowledge), self-determination index, autonomy, relatedness, psychological mediators index, personal and social responsibility, teacher climate, intention to be physically active and executive functions in the EG, while amotivation values increased in the CG. In conclusion, interdisciplinary educational programs based on the combination of pedagogical models and active methodologies are postulated as methodological alternatives to achieve an integral and multilateral development of children and adolescents, as well as to improve the different learning domains of physical education, such as cognitive, social and motor. It is recommended that future research should consider longitudinal designs with mixed methods and follow-up data to assess learning retention, as well as larger samples and the measurement of a greater number of executive functions (e.g., inhibitory control and attention).
Collapse
Affiliation(s)
| | - Noelia Belando-Pedreño
- Faculty of Sports Sciences, Department of Physical Activity and Sport, European University of Madrid, 28670 Madrid, Spain
| | - Alfonso Valero-Valenzuela
- Faculty of Sport Sciences, Department of Physical Activity and Sport, University of Murcia, 30720 Murcia, Spain
| |
Collapse
|
48
|
Bartelink N, van Dongen B, Kremers S, Renders C, van Vlokhoven B, van Koperen M, van Assema P. Supporting schools during the implementation of the health-promoting school approach: The roles of a healthy school advisor. Front Public Health 2022; 10:960873. [PMID: 36589979 PMCID: PMC9797735 DOI: 10.3389/fpubh.2022.960873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The health-promoting school (HPS) approach was developed by the World Health Organization to create health promotion changes in the whole school system. Implementing the approach can be challenging for schools because schools are dynamic organizations with each a unique context. Many countries worldwide have a health promotion system in place in which healthy school (HS) advisors support schools in the process of implementing the HPS approach. Even though these HS advisors can take on various roles to provide support in an adaptive and context-oriented manner, these roles have not yet been described. The current study aims to identify and describe the key roles of the HS advisor when supporting schools during the dynamic process of implementing the HPS approach. Methods The study was part of a project in which a capacity-building module was developed for and with HS advisors in the Netherlands. In the current study, a co-creation process enabled by participatory research was used in which researchers, HS advisors, national representatives, and coordinators of the Dutch HS program participated. Co-creation processes took place between October 2020 and November 2021 and consisted of four phases: (1) a narrative review of the literature, (2) interviews, (3) focus groups, and (4) a final check. Results Five roles were identified. The role of "navigator" as a more central one and four other roles: "linking pin," "expert in the field," "critical friend," and "ambassador of the HPS approach." The (final) description of the five roles was recognizable for the HS advisors that participated in the study, and they indicated that it provided a comprehensive overview of the work of an HS advisor in the Netherlands. Discussion The roles can provide guidance to all Dutch HS advisors and the regional public health organizations that employ them on what is needed to provide sufficient and context-oriented support to schools. These roles can inspire and guide people from other countries to adapt the roles to their own national context.
Collapse
Affiliation(s)
- Nina Bartelink
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands,School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, Netherlands,*Correspondence: Nina Bartelink
| | - Bonnie van Dongen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,Bonnie van Dongen
| | - Stef Kremers
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Carry Renders
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Boukje van Vlokhoven
- Sector Organization for Secondary Education (VO-raad), Utrecht, Netherlands,Programma Gezonde School (Healthy School Program), Utrecht, Netherlands
| | - Marije van Koperen
- Programma Gezonde School (Healthy School Program), Utrecht, Netherlands,Department of Public Health and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Patricia van Assema
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands,Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| |
Collapse
|
49
|
Implementation and Evaluation of a School-Based Educational Program Targeting Healthy Diet and Exercise (DIEX) for Greek High School Students. Sports (Basel) 2022; 10:sports10120196. [PMID: 36548493 PMCID: PMC9781068 DOI: 10.3390/sports10120196] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
The present study examined the effectiveness of a school-based health education program promoting healthy diet and exercise, named DIEX, implemented on adolescents. The program is based on the Theory of Planned Behavior (TPB) and is supported by life skills training. The recipients of the program were high school students (n = 367; 168 boys and 199 girls) from 14 schools in Greece who attended 10 1 h sessions implemented by their schoolteachers. Data were collected before and after the program implementation through online questionnaires for: a. attitude, intention, subjective norms, and PBC toward healthy eating; b. knowledge about healthy eating; c. exercise behavior and attitude toward the DIEX program; and d. satisfaction with the DIEX program (only post-program). The results showed that there were significant differences among the pre- and post-measures of students' knowledge and behavior about healthy diet, as well as attitudes and satisfaction toward the program's application. The results show that the DIEX program may have improved nutrition behavior variables. Conclusively, a theory-based behavioral intervention with skills training may result in positive behavioral changes for young students during health education in school settings with the assistance of new technologies.
Collapse
|
50
|
Blanquer-Genovart M, Manera-Bassols M, Salvador-Castell G, Cunillera-Puértolas O, Castell-Abat C, Cabezas-Peña C. School Menu Review Programme (PReME): evaluation of compliance with dietary recommendations during the period 2006-2020 in Catalonia. BMC Public Health 2022; 22:2173. [PMID: 36434578 PMCID: PMC9700995 DOI: 10.1186/s12889-022-14571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/16/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The School Menu Review Programme (PReME) has been offering complimentary revisions of meal plans to all schools in Catalonia since 2006. This study aims to assess the evolution of compliance with PReME's recommendations in the meals provided by school cafeterias in Catalonia during the period 2006-2020. METHODS Pre-post study with a sample of 6,387 meal plans from 2221 schools assessed during the period. The information was collected mainly by public health specialists within the annual technical and sanitary inspection of school kitchens and cafeterias. Meal plans were evaluated by Dietitian-Nutritionists team according to the criteria of the National Health System's "Consensus document on nutrition in schools" and the Public Health Agency of Catalonia's current guide "Healthy eating at school". Reports were sent to each participating school. A few months later, a new meal plan and another questionnaire were collected and evaluated in comparison with the first meal plan. Compliance with the recommendations was analysed based on the type of canteen management and the school category. RESULTS Compliance improved during the study period. The percentage of schools that complied with dietary recommendations in relation to the five PReME indicators (fresh fruit, pulses, daily vegetables, fresh food and olive oil for dressing) has steadily increased since PReME began, (over 70% in all indictors; p = < 0.001), with variations depending on school category and cafeteria management. Furthermore, an improvement in the levels of compliance with de recommended food frequencies was observed. with statistically significant differences for all items (p < 0.001), except for pulses whose compliance had been high since the beginning of the study (p = 0.216). CONCLUSIONS The positive evolution in compliance with PReME's recommendations provides evidence of the programme's effectiveness, with an improvement in the quality of school meals delivered in Catalonia.
Collapse
Affiliation(s)
- Maria Blanquer-Genovart
- Public Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005, Spain.
| | - Maria Manera-Bassols
- Public Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005, Spain
| | - Gemma Salvador-Castell
- Public Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005, Spain
| | - Oriol Cunillera-Puértolas
- Public Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005, Spain
| | - Conxa Castell-Abat
- Public Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005, Spain
| | - Carmen Cabezas-Peña
- Public Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005, Spain
| |
Collapse
|