Subjective health literacy skills among Greek secondary school students: results from a national-wide survey.

Health literacy is a significant element of education and is inextricably linked to children's and adolescents' growth and prosperity. It is critical to monitor students' health literacy on a nationwide scale and identify the factors that influence it in order to create policies that advance it. The purpose of this study was to determine the health literacy level of Greek secondary school students and to correlate it with possible determinants such as personal and family characteristics, social support and personal and/or family illness experiences. A representative sample of 2749 seventh-, ninth-, and tenth-grade students was involved. Results showed that a higher motivation to learn about health topics and having positive social interactions and support were strongly associated with a higher level of health literacy. Gender, high academic achievement, absence of learning disabilities, gender, preference for biology and informatics and primary source of health information were also found to influence the skills' level. In order to enhance health literacy, the Greek educational system should take measures to include health literacy skills development goals in their curricula.

Following Darwin's footsteps: Evaluating the impact of an activity designed for elementary school students to link historically important evolution key concepts on their understanding of natural selection.

While several researchers have suggested that evolution should be explored from the initial years of schooling, little information is available on effective resources to enhance elementary school students' level of understanding of evolution by natural selection (LUENS). For the present study, we designed, implemented, and evaluated an educational activity planned for fourth graders (9 to 10 years old) to explore concepts and conceptual fields that were historically important for the discovery of natural selection. Observation field notes and students' productions were used to analyze how the students explored the proposed activity. Additionally, an evaluation framework consisting of a test, the evaluation criteria, and the scoring process was applied in two fourth-grade classes (N = 44) to estimate elementary school students' LUENS before and after engaging in the activity. Our results show that our activity allowed students to link the key concepts, resulting in a significant increase of their understanding of natural selection. They also reveal that additional activities and minor fine-tuning of the present activity are required to further support students' learning about the concept of differential reproduction.

Development and validation of a framework for the assessment of school curricula on the presence of evolutionary concepts (FACE).

Evolution is a key concept of biology, fundamental to understand the world and address important societal problems, but research studies show that it is still not widely understood and accepted. Several factors are known to influence evolution acceptance and understanding, but little information is available regarding the impacts of the curriculum on these aspects. Very few curricula have been examined to assess the coverage of biological evolution. The available studies do not allow comparative analyses, due to the different methodologies employed by the authors. However, such an analysis would be useful for research purposes and for the development of appropriate educational policies to address the problem of a lack of evolution acceptance in some countries. In this paper we describe the steps through which we developed a valid and reliable instrument for curricula analysis known as FACE: "Framework to Assess the Coverage of biological Evolution by school curricula." This framework was developed based on the "Understanding Evolution Conceptual Framework" (UECF). After an initial pilot study, our framework was reformulated based on identified issues and experts' opinions. To generate validity and reliability evidence in support of the framework, it was applied to four European countries' curricula. For each country, a team of a minimum of two national and two foreign coders worked independently to assess the curriculum using this framework for content analysis. Reliability evidence was estimated using Krippendorf's alpha and resulted in appropriate values for coding the examined curricula. Some issues that coders faced during the analysis were discussed and, to ensure better reliability for future researchers, additional guidelines and one extra category were included in the framework. The final version of the framework includes six categories and 34 subcategories. FACE is a useful tool for the analysis and the comparison of curricula and school textbooks regarding the coverage of evolution, and such results can guide curricula development.

Physical activity levels and self-efficacy of Greek children with congenital heart disease compared to their healthy peers.

OBJECTIVE: It remains a challenge for children with congenital heart disease (CHD) to develop healthy lifestyle behaviors. This study investigates the interrelationship of physical activity and self-efficacy levels in Greek children with corrected CHD and compares them with those of healthy controls. METHODS: A prospective cross-sectional study of 76 patients with operated CHD and 78 healthy volunteers (n = 154) was conducted. The Self Efficacy Scale and Previous Day Physical Activity Recall self-reporting questionnaires were used to assess self-efficacy and physical activity, respectively. Calculated metabolic equivalent of task (MET) provided an indication of participation in moderate and vigorous physical activities. RESULTS: Mean physical self-efficacy in children with CHD was 29.01 ± 7.28, while that in healthy volunteers was 29.04 ± 6.60 (p = 0.076). Average physical activity levels-METs in children with CHD (2.38 ± 0.85) were significantly lower than those in controls (3.1 ± 0.95). Physical self-efficacy and physical activity were positively correlated (r = 0.515, p = 0.001), thus indicating that children with higher self-efficacy engaged in more vigorous physical activities. In children with CHD, self-efficacy was quite important in predicting physical activity, thus explaining almost » of the variability in observed activities. CONCLUSION: The low physical activity levels exhibited by Greek children with corrected CHD can lead to a sedentary adult lifestyle. Improving physical self-efficacy may help encourage them and consequently increase their physical activity levels. School-based education initiatives and athletic programs can play an important role in improving this.

Greek adolescents and the Mediterranean diet: factors affecting quality and adherence.

OBJECTIVE: Evaluation of adolescents' adherence to the Mediterranean diet (AMD) and the connection to anthropometric, demographic, socioeconomic, and lifestyle characteristics. METHODS: In all, 525 adolescents aged 12 to 18 y from Athens and Heraklion, Greece, participated in this cross-sectional, school-based study, which took place during March and April 2012. The dependent variable was scored on the KIDMED test, with score >8 indicating an optimal Mediterranean diet (MD). Analysis included χ(2) test and Student's t test for the association between variables. Linear regression analysis was used to identify the determinants of AMD. A two-sided P-value < 0.05 was considered statistically significant. RESULTS: Of the participants, 21% had very good AMD. Positive predictors were mother's educational level (P < 0.01), living with both parents (P < 0.05), and residing in a smaller city (P < 0.01). Negative predictors were age (P < 0.05), >4-h computer use per day (P < 0.01), and lack of physical activity (P < 0.01). No correlation was found between AMD and body mass index (P > 0.05). CONCLUSIONS: Several anthropometric, demographic, socioeconomic, and lifestyle characteristics were significantly associated with AMD. It is highly important that children and adolescents adhere at a very young age to the MD as the healthier dietary choice. Further researchers might explore whether the economic recession in Greece has any effects on adolescents' dietary habits.