[A participatory approach for the prevention of type 2 diabetes for francophone youth of New Brunswick]

The involvement of young people in school- and community-based noncommunicable disease prevention interventions: a scoping review of designs and outcomes

BACKGROUND

Since stakeholders' active engagement is essential for public health strategies to be effective, this review is focused on intervention designs and outcomes of school- and community-based noncommunicable disease (NCD) prevention interventions involving children and young people.

METHODS

The review process was based on the principles of scoping reviews. A systematic search was conducted in eight major databases in October 2015. Empirical studies published in English, French, Portuguese, and Spanish were considered. Five selection criteria were applied. Included in the review were (1) empirical studies describing (2) a health intervention focused on diet and/or physical activity, (3) based on children's and young people's involvement that included (4) a relationship between school and local community while (5) providing explicit information about the outcomes of the intervention. The search provided 3995 hits, of which 3253 were screened by title and abstract, leading to the full-text screening of 24 papers. Ultimately, 12 papers were included in the review. The included papers were analysed independently by at least two reviewers.

RESULTS

Few relevant papers were identified because interventions are often either based on children's involvement or are multi-setting, but rarely both. Children were involved through participation in needs assessments, health committees and advocacy. School-community collaboration ranged from shared activities, to joint interventions with common goals and activities. Most often, collaboration was school-initiated. Most papers provided a limited description of the outcomes. Positive effects were identified at the organisational level (policy, action plans, and healthy environments), in adult stakeholders (empowerment, healthy eating) and in children (knowledge, social norms, critical thinking, and health behaviour). Limitations related to the search and analytical methods are discussed.

CONCLUSION

There are very few published studies on the effectiveness of interventions based on children's involvement in school- and community-based NCD prevention programmes. However, interventions with these characteristics show potential benefits, and the merits of complex multi-setting approaches should be further explored through intervention-based studies assessing their effectiveness and identifying which components contribute to the observed outcomes.

Exploring adolescents' awareness of diabetes using the free association technique

PURPOSE

Healthy adolescents' awareness of diabetes was explored, and gender and grade-level differences in understanding were determined.

METHODS

Adolescents without diabetes in grades five, eight, and 10 (n=128) at four New Brunswick schools wrote down all words/expressions that came to mind when they heard the word "diabetes" (i.e., they used the free association technique). Answers were classified into categories using content analysis.

RESULTS

Eighty-eight girls and 40 boys completed the activity (n=44, 52, and 32 in grades five, eight, and 10, respectively). Nine principal categories were identified: 66% of the adolescents cited sugar (e.g., eating too much sugar, not enough sugar), 48% treatment (e.g., needles, injections), 45% the nature of diabetes (e.g., a disease, types of diabetes, heredity), 41% nutrition (e.g., diet, sugar-containing foods, other foods), 38% blood (e.g., too much/not enough sugar in blood), 18% complications (e.g., death), 11% physiological manifestations/symptoms (e.g., fainting), 6% obesity, and 6% physical activity. No differences were found in category citation frequency between boys and girls and grade levels, except that grade 10 students more frequently cited the categories of treatment, blood, and obesity (p=0.05).

CONCLUSIONS

Students thought of diabetes in terms of sugar and injections. Words related to obesity, prevention, and complications were cited infrequently.

Is children's choice in health care rhetoric or reality? A scoping review

AIM

This paper is a report of a scoping review examining children and young people's health services with respect to choice in order to inform future development of choice initiatives.

BACKGROUND

The importance of including children and young people in the choice agenda reflects the increasing acknowledgement that, individually and collectively, they are important consumers of health care in their own right. Data sources. A scoping review of all major health and medical research databases was undertaken using current guidelines to identify original relevant research papers and grey literature sources from 1990 to 2006.

REVIEW METHODS

Reference Manager software was used to collate, summarize, categorize, store and retrieve the search results. Papers meeting the inclusion criteria were read in full and descriptively summarized using a data extraction sheet. Each paper was repeatedly selected using a snowballing approach until saturation was reached. Results. Children and young people want more say in the planning and development of appropriate hospital and community health services. However, little evaluative research was found about whether these choices are acted upon and lead to more responsive services.

CONCLUSION

Choice for children and young people is viewed as a positive development in health care and many innovative examples of their involvement in decision-making were found. These illustrated that, given the opportunity, children and young people are willing and able to make decisions about their healthcare services. However, there is a long way to go before the rhetoric of the choice agenda is realized.