School-based physical education, physical activity and sports provision: A concept mapping framework for evaluation.

OBJECTIVE: Physical education, physical activity and sports provision are important factors in whole school health promotion, however, a standardised evaluation framework to evaluate the contribution of these components is lacking. A framework that accounts for the distinct structures and associated factors, that impact upon provision would facilitate a more coherent evaluation. METHODS: A concept mapping methodology, involving the generation of factors relevant to school physical education, physical activity and sports provision and their subsequent thematic and numeric rating and sorting was utilised. Concept mapping effectively gathers, integrates, and visually and numerically represents the composite thinking of a group of relevant and expert stakeholders around a complex social phenomenon. Following a review of the extant literature and synthesis among 20 expert stakeholders, a list of 95 factor statements relevant to school physical education, physical activity and sports provision were developed. RESULTS: Each factor statement was rated and sorted by 197 multi-disciplinary participants. An eight-cluster framework that demonstrated good validity (stress value: 0.266), was derived from the data based on: 1. Partnerships and Pupil Centered Physical Education; 2. Physical Activity and Sports; 3. School Demographics; 4. Equipment, Facilities and Budget; 5. Extra Costs; 6. Curriculum and Policy; 7. School Management and 8. Timetable. Statements within the cluster on school management received the highest mean importance and modifiability ratings while statements within the cluster on school demographics received the lowest mean importance and modifiability ratings. CONCLUSIONS: Eight overarching structures which account for school physical education, physical activity and sports provision have been identified. Within each of these, structures and overall factors of greatest importance and modifiability have been illuminated. Findings stemming from this rigorous methodology, provide the foundation for the development of a national provision evaluation index to inform both school-level and national policy and actions. It is recommended the current methodology is replicated in other nations to gain corresponding insights.

Test-Retest Reliability of a Physical Activity Behavior, Health and Wellbeing Questionnaire in Adolescents.

Background: The aim of this study was to examine the test-retest reliability of the physical activity behavior, health and wellbeing questionnaire, in adolescent populations, administered by teachers in school settings, in the Republic of Ireland. Methods: A cross-sectional, mixed sample of 55 participants (45.5% males: Age, 13.94 (±.40) years) were included. The participants completed the questionnaire on two occasions (T1 and T2), on the same day and time, one week apart following identical procedures. Variables for testing included physical activity behavior (n=13), health (n=11) and wellbeing (n=2). Test-retest reliability of the questionnaire's covariates, including family affluence and physical impairments were also examined. Results: Systematic error (Bland-Altman plots) was found to be near to zero for each of the physical activity behavior, health and wellbeing variables. The combined mean coefficient of variation was lower for females (10.19%) in comparison to males (13.01%). The combined mean intraclass correlation coefficients were higher for females (0.901) than males (0.822). Similarly, the combined mean Cronbach alpha coefficient were higher for girls (0.908) than boys (0.821). Conclusions: This study found the physical activity behavior, health and wellbeing questionnaire to be reliable for use in adolescent populations.

Overview of harm reduction in prisons in seven European countries.

While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.

Predictors of health of pre-registration nursing and midwifery students: Findings from a cross-sectional survey.

BACKGROUND: Student nurses/midwives evidence less than exemplary lifestyle habits and poor emotional health, despite exposure to health education/promotion during their educational preparation. Knowledge of the factors that predict nursing/midwifery students' health could inform strategies to enhance their health and increase their credibility as future health promoters/educators. OBJECTIVE: To establish the predictors of nursing/midwifery student emotional health. DESIGN: Cross-sectional survey. SETTING: The research took place at a university in Ireland. PARTICIPANTS: We involved a total sample (n=473) student nurses/midwives. METHODS: Participants completed the General Health Questionnaire, Lifestyle Behaviour Questionnaire and Ways of Coping Questionnaire to determine their self-reported emotional health, lifestyle behaviour and coping processes. Multivariate regression was performed to identify the predictors of student emotional health (dependent variable). The independent variables were demographics, coping, lifestyle behaviour and students' perceptions of determinants of their health. RESULTS: Many respondents reported significant emotional distress (48.71%) and unhealthy lifestyle behaviours including smoking (27.94%), physical inactivity (34.29%), alcohol consumption (91.7%) and unhealthy diet (28.05%). Multivariate regressions indicated that the predictors of emotional distress included gender, year of study, smoking, passive coping and beliefs that their student life was stressful or/and that worry stress and boredom adversely impacted their diet. CONCLUSIONS: Targeting student's beliefs regarding influences upon their health, promotion of positive lifestyles and adaptive coping is necessary to facilitate health gain of future health professionals.

Teacher Competencies in Health Education: Results of a Delphi Study.

OBJECTIVE: The aim of this research study was to identify the core competencies for health education teachers in supporting the development of health literacy among their students. METHOD/RESULTS: A three round Delphi method was employed. Experts in health education were asked to identify core competencies for school health educators. Twenty six participants from the academic field were invited to participate in the study. Twenty participants completed the first round of the Delphi, while eighteen took part in round two and fifteen participated in the final round. Data were collected using an electronic questionnaire. The first round contained an open ended question in which participants were asked to name and define all the competencies they perceived were important. Thematic analysis was undertaken on these data. A list of 36 competencies was created from this round. This list was then returned to the same participants and they were asked to rate each competency on a 7 point semantic differential scale in terms of importance. The resulting data were then analysed. For the final round, participants were presented with a list of 33 competencies and were asked to rank them again, in order of importance. CONCLUSION: Twelve core competencies emerged from the analysis and these competencies comprised of a mixture of knowledge, attitude and skills. The authors suggest that how these competencies are achieved and operationalised in the school context can be quite complex and multi-faceted. While the authors do not seek to generalise from the study they suggest that these competencies are an important input for all stakeholders, in order to question national and international teacher guidelines. In addition the competencies identified may provide a useful starting point for others to undertake deeper analysis of what it means to be an effective health educator in schools.

Psychological distress and coping amongst higher education students: a mixed method enquiry.

BACKGROUND: Psychological distress among higher education students is of global concern. Students on programmes with practicum components such as nursing and teacher education are exposed to additional stressors which may further increase their risk for psychological distress. The ways in which these students cope with distress has potential consequences for their health and academic performance. An in-depth understanding of how nursing/midwifery and teacher education students experience psychological distress and coping is necessary to enable higher education providers to adequately support these students. METHODS: This mixed method study was employed to establish self-reported psychological distress (General Health Questionnaire), coping processes (Ways of Coping Questionnaire) and lifestyle behaviour (Lifestyle Behaviour Questionnaire) of a total sample (n = 1557) of undergraduate nursing/midwifery and teacher education students in one university in Ireland. Individual interviews (n = 59) provided an in-depth understanding of students experiences of psychological distress and coping. RESULTS: A significant percentage (41.9%) of respondents was psychologically distressed. The factors which contributed to their distress, included study, financial, living and social pressures. Students used varied coping strategies including seeking social support, problem solving and escape avoidance. The positive relationship between elevated psychological distress and escape avoidance behaviours including substance use (alcohol, tobacco and cannabis) and unhealthy diet is of particular concern. Statistically significant relationships were identified between "escape-avoidance" and gender, age, marital status, place of residence, programme/year of study and lifestyle behaviours such as diet, substance use and physical inactivity. CONCLUSION: The paper adds to existing research by illuminating the psychological distress experienced by undergraduate nursing/midwifery and teacher education students. It also identifies their distress, maladaptive coping and the relationship to their lifestyle behaviours. The findings can inform strategies to minimise student distress and maladaptive coping during college and in future professional years.

Factors influencing the contribution of staff to health education in schools.

Understanding the contribution of the whole-school staff to health education (HE) is an important goal in HE research. This study aimed to identify the views of staff (principals; teachers; school nurses and doctors; counsellors and administrative, maintenance, canteen and cleaning staff) regarding the nature of their contribution to HE. The research is based on 207 semi-structured interviews of staff in a sample of five French middle schools (grade 6-9). Content analysis was performed using Bardin's method. The results showed that staff members have different views of their role, three main roles were identified: (i) as an educator in everyday life issues (72%); (ii) individual support, listening (14%) and (iii) taking part in collective projects and facilitation (14%). Professional status has a significant influence on the view they have of their contribution to HE. These results show that in order to facilitate consistent implementation of HE, schools need to be supported to build HE policy (need analysis, definition of priorities and partnerships) and also to develop the means by which an inclusive and real sharing of common culture among all staff can happen; this is not limited to teaching staff but includes non-teaching staff also.