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2.
BMC Public Health ; 21(1): 1630, 2021 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488691

RESUMEN

BACKGROUND: IMPROVE aims to conduct a hybrid type 3 evaluation design to test the effectiveness of bundled implementation strategies on intervention fidelity of the Healthy School Start (HSS) program, while simultaneously monitoring effects on health outcomes of children and parents. The HSS is a 4-component family support program for children starting school (5-7 years of age) promoting healthy dietary habits and physical activity in the home environment to prevent childhood obesity and parents' risk of developing type 2 diabetes. METHODS: IMPROVE is a cluster-randomized controlled trial with two arms to evaluate and compare the effects of two different bundles of implementation strategies on intervention fidelity expressed as adherence and responsiveness at 12 and 24 months (primary outcomes). Thirty schools in two municipalities will participate in the study reaching about 1400 families per school year. In stakeholder workshops, key implementation determinants were identified according to the domains of the Consolidated Framework for Implementation Research. Through a consensus process with stakeholders, two bundles of implementation strategies were tailored to address context-specific determinants. Schools randomly assigned to group 1 will receive bundle 1 (Basic) and group 2 will receive bundle 1 + 2 (Enhanced). Bundle 2 consists of external facilitation, fidelity monitoring and feedback strategies. Secondary outcomes will include change in acceptability, appropriateness, feasibility, and organisational readiness as perceived by school staff. In addition, child weight status and diet, and parents' feeding practices and risk of type 2 diabetes will be monitored. Linear and ordinal regression analysis will be used to test the effect on the primary and secondary outcomes, taking clustering and covariates into consideration where needed. Process evaluation will be conducted through key stakeholder interviews to investigate experiences of the program and perceptions on sustainability. DISCUSSION: This systematic approach to investigating the effectiveness of two different bundles of implementation strategies tailored to context-specific determinants on the fidelity of the HSS intervention will provide new insight into feasible implementation strategies and external support needed for the HSS to be effective and sustainable. Results will help inform how to bridge the gap between the research on school-based health programs and routine practice in schools. TRIAL REGISTRATION: Registered prospectively at ClinicalTrials.gov ID: NCT04984421 , registered July 30, 2021.


Asunto(s)
Diabetes Mellitus Tipo 2 , Obesidad Pediátrica , Niño , Salud del Niño , Promoción de la Salud , Humanos , Sobrepeso , Obesidad Pediátrica/prevención & control , Evaluación de Programas y Proyectos de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Servicios de Salud Escolar , Instituciones Académicas
4.
Rev Esp Salud Publica ; 952021 Sep 03.
Artículo en Español | MEDLINE | ID: mdl-34477180

RESUMEN

OBJECTIVE: Research has uncovered a global pandemic of physical inactivity and schools have been signaled as possible "agents" to modify these negative scores, since all children spend many hours a day there. The aim was to evaluate if it is possible to increase the physical activity levels of a whole school using a multifactorial, self-regulated intervention program during recess. METHODS: A cross-sectional study was conducted involving all the students (N=50) of a rural public school located in northern Spain (grades 1-6). The study followed an ABA case study research design (changes in the experimentation conditions and data collection after each one: week 1 no intervention, weeks 2-3 intervention, week 4 no intervention) and mixed quantitative-qualitative methodology which included the use of accelerometers (each participant wore one during the whole school day and the school week), field notes (researcher) and focus groups (teachers). Normality tests, descriptive and inferential statistics (ANOVAs) were conducted in the quantitative data obtained, while thematic content and constant comparison analyses in the qualitative data. RESULTS: Quantitative results showed that there was a significant increase to 67.15 ± 13.95 minutes/day of moderate-to-vigorous physical activity (MVPA) in week 2. Boys reached significantly higher scores than girls: 72.1 ± 12.12. Unfortunately, these scores went back to almost normal in the second week of implementation of the program (58.21 ± 12.88; boys= 62.75 ± 10.86). From the joined analysis of the researcher field notes and the teachers' focus groups 4 themes emerged: intensity change, dominance change, interactions change and self-regulation. CONCLUSIONS: It is possible to increase the physical activity levels of a whole school with a multifactorial, self-regulated program, but it is necessary to acknowledge that novelty "wears out" to avoid losing efficacy with time.


Asunto(s)
Ejercicio Físico , Servicios de Salud Escolar , Acelerometría , Niño , Estudios Transversales , Ejercicio Físico/fisiología , Ejercicio Físico/psicología , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Autocontrol , España
5.
Niger J Clin Pract ; 24(9): 1268-1276, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34531336

RESUMEN

Epidemiologic studies have reported increasing prevalence of childhood asthma in Nigeria and other developing countries where there are parallel increases in school enrolments. Children with asthma face lots of challenges in school which can affect their academic performance and quality of life. This narrative review highlights the challenges and the risks of schooling encountered by Nigerian children with asthma and the prospects of utilizing the School Health Programme (SHP) to overcome these challenges. An electronic search of relevant published articles from 2000 to 2020 was carried out using appropriate search engines for the following words: "schooling", "childhood asthma", "school health programme", "school environment," "health instructions", "school health services" and "asthma care in schools". The challenges and risks the school age asthmatics encounter in school include discrimination and victimization, exposure to triggers on the road and in the school environment, poor and non-existence asthma care services in schools, suboptimal knowledge of teachers and caregivers about childhood asthma hence poor asthma-related instructions and increased school absenteeism. The prospects of SHP as a tool to overcome these challenges are highlighted. These include the roles expected to be played by all stakeholders - the government and education authorities need to revise and more effectively implement the school health policy. The roles of asthma care professionals include the need to "adopt" schools to ensure optimal asthma care for the school population and the all-important enlightenment of teachers, school health workers, parents/caregivers and school children for overall improved asthma care delivery in Nigerian schools.


Asunto(s)
Asma , Calidad de Vida , Asma/epidemiología , Niño , Humanos , Nigeria/epidemiología , Servicios de Salud Escolar , Instituciones Académicas
6.
Int J Public Health ; 66: 1604025, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34531712

RESUMEN

Objectives: Rapid socioeconomic and nutrition transitions in Chinese populations have contributed to the growth in childhood obesity. This study presents a cost-effectiveness analysis of a school- and family-based childhood obesity prevention programme in China. Methods: A trial-based economic evaluation assessed cost-effectiveness at 12 months. Forty schools with 1,641 children were randomised to either receive the multi-component (diet and physical activity) intervention or to continue with usual activities. Both public sector and societal perspectives were adopted. Costs and benefits in the form of quality-adjusted life years (QALYs) were compared and uncertainty was assessed using established UK and US thresholds. Results: The intervention cost was 35.53 Yuan (£7.04/US$10.01) per child from a public sector perspective and 536.95 Yuan (£106/US$151) from a societal perspective. The incremental cost-effectiveness ratio (ICER) was 272.7 Yuan (£54/US$77)/BMI z-score change. The ICER was 8,888 Yuan (£1,760/US$2,502) and 73,831 Yuan (£14,620/US$20,796) per QALY from a public sector and societal perspective, respectively and was cost-effective using UK (£20,000) and US (US$50,000) per QALY thresholds. Conclusion: A multi-component school-based prevention programme is a cost-effective means of preventing childhood obesity in China.


Asunto(s)
Familia , Obesidad Pediátrica , Servicios de Salud Escolar , Niño , China/epidemiología , Análisis Costo-Beneficio , Humanos , Obesidad Pediátrica/epidemiología , Obesidad Pediátrica/prevención & control , Evaluación de Programas y Proyectos de Salud , Servicios de Salud Escolar/economía , Servicios de Salud Escolar/organización & administración
7.
Rev. bras. med. esporte ; 27(5): 494-497, July-Sept. 2021. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1288611

RESUMEN

ABSTRACT Introduction: It is not unusual that students do not like physical education. It has become a common educational phenomenon in current school physical education. Students have become less participative in physical education, serious and cold, less enjoyable, and stressed. The emergence of this series of changes is not entirely a matter of student attitudes. Objective: Aiming at school students who like sports but do not fall in love with physical education, participation quality continues to decline, students do not exercise themselves, and have no concept of exercise load. This research aims to learn and master the knowledge and skills of physical exercise through a digital fitness teaching system, effectively improve students' scientific exercise ability, mobilize students' hobbies to actively participate in physical exercise, improve the unscientific physical exercise habits of students in the past, promote students' physical and mental health, and lay the foundation for lifelong physical education. Methods: The methods studied in this article mainly include an experimental method, document method, expert interview method, questionnaire survey method, mathematical analysis method and other methods. Results: After two weeks of experimental preparation and ten weeks of teaching experiments to develop students' physical exercise ability, the students' aerobic exercise ability has been steadily improved. Through the digital fitness teaching system, students' interest in participating in physical exercise is strengthened and the cultivation of sports emotions and physical habits, improving the school's physical exercise environment and meeting students' physical exercise needs. Conclusions: The digital fitness teaching system is in the development and test stage. The first generation of digital fitness bikes has many problems with hardware and software. As an important supplementary form of school physical education under the new situation, this system greatly promotes students' lifelong physical education and learning scientific physical exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução: Não é incomum que os alunos não gostem de educação física. Tornou-se um fenômeno educacional comum na educação física escolar atual. Os alunos tornaram-se menos engajados na educação física, sérios e descolados, menos agradáveis e estressados. O surgimento dessa série de mudanças não é exclusivamente uma questão de atitudes dos alunos. Objetivo: Visando alunos que gostam de esportes, mas não se apaixonam por educação física, a qualidade da participação continua em declínio, os alunos não praticam exercícios e não têm noção de carga de exercícios. Esta pesquisa tem como objetivo aprender e dominar os conhecimentos e habilidades de exercício físico através de um sistema de ensino de fitness digital, efetivamente melhorar a capacidade de exercício científico dos alunos, mobilizar os hobbies dos alunos para participarem ativamente do exercício. Aptidão física, melhorar os hábitos de exercícios físicos não científicos dos alunos em passado, promover a saúde física e mental dos alunos e estabelecer as bases para a educação física ao longo da vida. Métodos: Os métodos estudados neste artigo incluem principalmente um método experimental, método de documento, método de entrevista com especialista, método de pesquisa por questionário, método de análise matemática e outros métodos. Resultados: Após duas semanas de preparação experimental e dez semanas de experimentos de ensino para desenvolver a capacidade de exercício físico dos alunos, a capacidade de exercício aeróbio dos alunos tem melhorado continuamente. Através do sistema de ensino de fitness digital, o interesse dos alunos em praticar exercícios físicos e o cultivo de emoções e hábitos de esportes físicos é potencializado, melhorando o ambiente de exercícios físicos da escola e satisfazendo as necessidades de exercícios físicos dos alunos. Conclusões: O sistema digital de ensino de fitness está em desenvolvimento e testes. A primeira geração de bicicletas de fitness digitais tem muitos problemas com hardware e software. Como uma importante forma complementar de educação física escolar na nova situação, esse sistema promove enormemente a educação física ao longo da vida dos alunos e o aprendizado de exercícios físicos científicos. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.


RESUMEN Introducción: No es raro que a los estudiantes no les guste la educación física. Se ha convertido en un fenómeno educativo común en la educación física escolar actual. Los estudiantes se han vuelto menos participativos en educación física, serios y fríos, menos agradables y estresados. El surgimiento de esta serie de cambios no es exclusivamente una cuestión de actitudes de los estudiantes. Objetivo: Apuntando a escolares a los que les guste el deporte pero no se enamoren de la educación física, la calidad de la participación sigue decayendo, los alumnos no se ejercitan y no tienen concepto de carga de ejercicio. Esta investigación tiene como objetivo aprender y dominar el conocimiento y las habilidades del ejercicio físico a través de un sistema de enseñanza de fitness digital, mejorar eficazmente la capacidad de ejercicio científico de los estudiantes, movilizar los pasatiempos de los estudiantes para participar activamente en el ejercicio físico, mejorar los hábitos de ejercicio físico no científicos de los estudiantes en el pasado, promover la salud física y mental de los estudiantes y sentar las bases para la educación física de por vida. Métodos: Los métodos estudiados en este artículo incluyen principalmente un método experimental, método de documento, método de entrevista a expertos, método de encuesta por cuestionario, método de análisis matemático y otros métodos. Resultados: Después de dos semanas de preparación experimental y diez semanas de experimentos de enseñanza para desarrollar la capacidad de ejercicio físico de los estudiantes, la capacidad de ejercicio aeróbico de los estudiantes ha mejorado de manera constante. A través del sistema de enseñanza digital de fitness se potencia el interés de los estudiantes por participar en el ejercicio físico y el cultivo de las emociones y hábitos físicos deportivos, mejorando el entorno de ejercicio físico del colegio y satisfaciendo las necesidades de ejercicio físico de los estudiantes. Conclusiones: El sistema de enseñanza de fitness digital se encuentra en etapa de desarrollo y prueba. La primera generación de bicicletas fitness digitales tiene muchos problemas con el hardware y el software. Como una forma complementaria importante de educación física escolar en la nueva situación, este sistema promueve en gran medida la educación física a lo largo de la vida de los estudiantes y el aprendizaje del ejercicio físico científico. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.


Asunto(s)
Humanos , Masculino , Femenino , Educación y Entrenamiento Físico/métodos , Estudiantes , Aptitud Física/fisiología , Realidad Virtual , Servicios de Salud Escolar , Modelos Teóricos
8.
Am J Respir Crit Care Med ; 204(5): 508-522, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34499024

RESUMEN

Rationale: For children with asthma, access to quick-relief medications is critical to minimizing morbidity and mortality. An innovative and practical approach to ensure access at school is to maintain a supply of stock albuterol that can be used by any student who experiences respiratory distress. To make this possible, state laws allowing for stock albuterol are needed to improve medication access.Objectives: To provide policy recommendations and outline steps for passing and implementing stock albuterol laws.Methods: We assembled a diverse stakeholder group and reviewed guidelines, literature, statutes, regulations, and implementation documents related to school-based medication access. Stakeholders were divided into two groups-legislation and implementation-on the basis of expertise. Each group met virtually to review documents and draft recommendations. Recommendations were compiled and revised in iterative remote meetings with all stakeholders.Main Results: We offer several recommendations for crafting state legislation and facilitating program implementation. 1) Create a coalition of stakeholders to champion legislation and implement stock albuterol programs. The coalition should include school administrators, school nurses and health personnel, parents, or caregivers of children with asthma, pediatric primary care and subspecialty providers (e.g., pulmonologists/allergists), pharmacists, health department staff, and local/regional/national advocacy organizations. 2) Legislative components critical for effective implementation of stock albuterol programs include specifying that medication can be administered in good faith to any child in respiratory distress, establishing training requirements for school staff, providing immunity from civil liability for staff and prescribers, ensuring pharmacy laws allow prescriptions to be dispensed to schools, and suggesting inhalers with valved holding chambers/spacers for administration. 3) Select an experienced and committed legislator to sponsor legislation and guide revisions as needed during passage and implementation. This person should be from the majority party and serve on the legislature's health or education committee. 4) Develop plans to disseminate legislation and regulations/policies to affected groups, including school administrators, school nurses, pharmacists, emergency responders, and primary/subspecialty clinicians. Periodically evaluate implementation effectiveness and need for adjustments.Conclusions: Stock albuterol in schools is a safe, practical, and potentially life-saving option for children with asthma, whether asthma is diagnosed or undiagnosed, who lack access to their personal quick-relief medication. Legislation is imperative for aiding in the adoption and implementation of school stock albuterol policies, and key policy inclusions can lay the groundwork for success. Future work should focus on passing legislation in all states, implementing policy in schools, and evaluating the impact of such programs on academic and health outcomes.


Asunto(s)
Albuterol/uso terapéutico , Asma/tratamiento farmacológico , Broncodilatadores/normas , Guías como Asunto , Política de Salud , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/normas , Servicios de Salud Escolar/normas , Adolescente , Broncodilatadores/uso terapéutico , Niño , Femenino , Humanos , Masculino , Estados Unidos
9.
Pediatr Clin North Am ; 68(5): 1119-1131, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34538303

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has caused severe economic and health impacts in the United States, and the impact is disproportionately more in socially disadvantages areas. The available data, albeit limited in children, suggest that the initial concerns of the potential of serious impact of COVID-19 illness in children with asthma are unproven so far. The reduction in asthma morbidities is due to improved adherence, COVID-19 control measures, school closures, and decreased exposure to allergens and viral infections in children. During the pandemic, asthma guidelines were updated to guide physicians in asthma care. In the face of unprecedented time, it is important to be vigilant, adhere to treatment guidelines, and implement preventive measures to eradicate the virus and improve outcomes in children with asthma.


Asunto(s)
Asma/enzimología , Asma/terapia , COVID-19/epidemiología , Educación del Paciente como Asunto/métodos , Servicios de Salud Escolar/organización & administración , COVID-19/terapia , Niño , Humanos , Cumplimiento de la Medicación , Instituciones Académicas/organización & administración , Telemedicina/estadística & datos numéricos , Estados Unidos
10.
BMC Pediatr ; 21(1): 346, 2021 08 16.
Artículo en Inglés | MEDLINE | ID: mdl-34399731

RESUMEN

BACKGROUND: In Finland, school doctors examine all children at predetermined ages in addition to annual health checks by school nurses. This study explored the association of study questionnaire-assessed need for and school doctor-evaluated benefit of routine health checks conducted by doctors. METHODS: Between August 2017 and August 2018, we recruited a random sample of 1341 children in grades 1 and 5 (aged seven and eleven years, respectively) from 21 elementary schools in four Finnish municipalities. Children mainly studying in special education groups or whose parents needed an interpreter were excluded. School nurses performed their health check as usual. Parents, nurses, and teachers then completed study questionnaires that assessed the concerns of parents, school nurses, and teachers regarding each child's physical, mental and social health. Doctors, blinded to the responses, routinely examined all the children. The primary outcome measures were (1) the need for a health check based on the study questionnaires and (2) the benefit/harm of the appointment as estimated by the doctors according to predetermined criteria, and (3) the patient-reported experience measures (PREMs) of benefit/harm of the appointment as estimated by the parents and children. We compared the need for a health check with the doctor-evaluated benefit using multilevel logistic regression. RESULTS: The participation rate was 75.5 %. According to all questionnaires, 20-25 % of the 1013 children had no need for a health check. The doctors regarded 410 (40.6 %) and the parents 812 (83.4 %) of the appointments as being beneficial. Respondents rarely reported harm. The children who were classified as needing a health check more often benefitted from the health check (assessed by the doctor) than children with no need for one (OR 3.53; 95 % CI 2.41-5.17). CONCLUSIONS: The need for a health check is an important predictor of school-doctor evaluated benefit of the health check. This approach could allow school doctors to allocate time for the children who need them most. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier NCT03178331, registration June 6th 2017.


Asunto(s)
Médicos , Instituciones Académicas , Técnicos Medios en Salud , Niño , Humanos , Padres , Servicios de Salud Escolar , Encuestas y Cuestionarios
11.
Medicine (Baltimore) ; 100(34): e27051, 2021 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-34449493

RESUMEN

ABSTRACT: School-based first aid interventions can contribute to the number of adults trained in first aid in the community over time but few studies have examined the effectiveness of teaching non-resuscitative first aid on knowledge, attitudes and skills. Currently, there is no consensus on the optimal content and duration of first aid training for junior secondary students. The aim of this study was to evaluated the effectiveness of a 2.5 hour introductory non-resuscitative first aid course for junior secondary students.This prospective, single-centre, pre-post study included 140 students (11-13 years old). Students completed a questionnaire on first aid knowledge, attitude towards first aid and self-confidence to perform first aid before and after a training session. Six emergency medicine physicians taught practical first aid skills training. A game-based formative assessment was undertaken where the instructors assessed small teams of students' role-playing injured classmates and first aid responders (and vice-versa) treating abrasions, ankle sprain, choking and a scald injury.Few students had prior first aid training (14%). After adjusting for student's age, sex, prior first aid training and format delivery, the course was associated with increased mean knowledge score (pre-training 53%, post-training 88%; mean difference [MD] 35%, 95% CI: 32% to 38%), positive attitudes and more confidence in performing first aid after training (all P < .001). All teams showed a good level of competency in treating simulated injuries with first aid kits.This brief non-resuscitative first aid course was associated with noticeable and valuable changes in knowledge score and self-confidence level in performing first aid. The game-based formative assessment facilitated a positive learning environment for skill competency evaluation.


Asunto(s)
Primeros Auxilios/métodos , Educación en Salud/organización & administración , Servicios de Salud Escolar/organización & administración , Adolescente , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Estudios Prospectivos
12.
Nutrients ; 13(8)2021 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-34444877

RESUMEN

Diet quality in the United States is improving over time but remains poor. Food outlets influence diet quality and represent the environments in which individuals make choices about food purchases and intake. The objective of this study was to use the Healthy Eating Index-2015 (HEI-2015) to evaluate the quality of foods consumed from the four major outlets where food is obtained-stores, full-service restaurants, quick-services restaurants, and schools-and to assess changes over time. This cross-sectional study used 24 h dietary recall data from eight cycles (2003-2004 to 2017-2018) of the National Health and Nutrition Examination Survey (NHANES). Linear trend estimation was used to test for changes in HEI scores over time, and balanced repeated replicate weighted linear regression was used to test for differences in total and component scores between types of food outlets. Overall, Americans are not consuming a mix of foods from any major category of food outlet that aligns with dietary guidelines. The total score for schools (65/100 points) and stores (62/100 points) was significantly higher than full-service (51/100 points) and quick-service (39/100 points) restaurants (p < 0.0001). HEI scores significantly improved over time for schools (p < 0.001), including an increase in whole grains from less than 1 point in 2003-2004 to 7 out of 10 points in 2017-2018. In 2017-2018, schools received the maximum score for total fruits, whole fruits, and dairy. Continued research on strategies for improving the quality of foods consumed from restaurants and stores is warranted.


Asunto(s)
Comportamiento del Consumidor/estadística & datos numéricos , Dieta Saludable/estadística & datos numéricos , Preferencias Alimentarias , Servicios de Alimentación/estadística & datos numéricos , Abastecimiento de Alimentos/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Conducta de Elección , Estudios Transversales , Femenino , Abastecimiento de Alimentos/métodos , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Política Nutricional , Encuestas Nutricionales , Valor Nutritivo , Restaurantes , Servicios de Salud Escolar/estadística & datos numéricos , Supermercados , Estados Unidos , Adulto Joven
13.
BMJ Open ; 11(8): e046940, 2021 08 13.
Artículo en Inglés | MEDLINE | ID: mdl-34389567

RESUMEN

INTRODUCTION: Preventive interventions to reduce overweight and obesity in childhood and adolescence are studied on their effectiveness worldwide. A number with positive results. However, long-term effects of these interventions and their potentially wider influence on well-being and health have been less studied. This study aims to evaluate the long-term effects of a multicomponent intervention in elementary school children targeting individual behaviour as well as environment (Lekker Fit!). The primary outcomeis body mass index and the secondary outcomes are waist circumference, weight status, physical fitness, lifestyle, psychosocial health and academic performance. METHODS AND ANALYSIS: In a naturalistic effect evaluation with a retrospective, controlled design adolescents in secondary schools, from intervention and non-intervention elementary schools, will be compared on a wide set of outcome variables. Data will be collected by questionnaires and through anthropometric and fitness measurements by trained physical education teachers and research assistants. Baseline data consist of measurements from the adolescents at the age of 5 years old and are gathered from preventive youth healthcare records, from before the intervention took place. Multilevel regression models will be used and adjusted for baseline measurements and potential confounding variables on the individual and environmental level. Furthermore, propensity scores will be applied. ETHICS AND DISSEMINATION: The study has been approved by the Medical Research Ethics Committee of the Erasmus Medical Centre, Rotterdam, The Netherlands (permission ID: MEC-2020-0644). Study findings will be disseminated in peer-reviewed journals and by conference presentations. TRIAL REGISTRATION NUMBER: NL8799. Pre-results.


Asunto(s)
Obesidad Pediátrica , Adolescente , Niño , Preescolar , Promoción de la Salud , Humanos , Sobrepeso/prevención & control , Obesidad Pediátrica/prevención & control , Evaluación de Programas y Proyectos de Salud , Estudios Retrospectivos , Servicios de Salud Escolar , Instituciones Académicas
14.
Artículo en Inglés | MEDLINE | ID: mdl-34360404

RESUMEN

(1) Background: The health behavior (HB) of adolescents develops in the school or family setting and plays an important role in their future health status. Health literacy (HL) has been identified as an important factor in modifying health behavior in addition to socioeconomic factors. health-promoting school (HPS) programs also have a significant role in providing students with the means of learning the importance of knowledge, behavior, and skills for a healthy lifestyle. (2) Method: This study aims to identify the association between HB, HL measured in comprehensive health literacy (CHL) and functional health literacy (FHL), HPS programs, and socioeconomic factors among high school students in Surabaya, Indonesia. A cross-sectional study was conducted, and 1066 students were evaluated as respondents. (3) Result: The results of multivariate analyses showed that following factors were associated with better health behavior: female, better academic performance, higher grade, higher father's education, lower allowance, and better CHL and FHL. The strongest association for HB was gender. CHL was especially associated with handwashing, physical activity, and drug abuse. FHL was associated with smoking and drug abuse. The implementation of HPS programs did not reach an optimum level and only influenced physical activity. (4) Conclusions: The findings confirm that CHL and FHL have a significant association with several HBs. HB intervention in the HPS program is recommended to incorporate the CHL and FHL for a better health impact.


Asunto(s)
Alfabetización en Salud , Adolescente , Estudios Transversales , Femenino , Conductas Relacionadas con la Salud , Humanos , Indonesia , Servicios de Salud Escolar , Instituciones Académicas , Estudiantes
15.
Cien Saude Colet ; 26(8): 3005-3018, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34378693

RESUMEN

The SHAHRP program was effective reducing drinking and alcohol - harms in Australia, but cross-cultural adaptation is required before replication. This study aimed at assessing the feasibility of SHAHRP in Brazil focused on implementation and acceptability. A mixed-methodsdesign was used: quantitative for implementing the program and evaluation and qualitative for acceptability. The quantitative design was a pilot of a randomized controlled trial. Private schools were randomly divided into four intervention (n=160) and four control (n=188) schools. Student's mean age was 12.7 years. The fidelity of implementation and likely outcome measures were assessed. Qualitative data on acceptability were provided by students and teachers. The percentage of implementation varied from 62.5% to 87.5%. Behaviours such as alcohol-harms requires a larger cohort and longer follow-up to be adequately evaluated. The risk reduction approach and activities had good acceptability from students and teachers. Quantitative and qualitative outcomes on knowledge and decision-making indicated possible improvement in SHAHRP schools. The program is feasible and well accepted in a Brazilian setting, opening the way for a more comprehensive evaluation and dissemination.


Asunto(s)
Instituciones Académicas , Estudiantes , Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/prevención & control , Brasil , Niño , Estudios de Factibilidad , Humanos , Evaluación de Programas y Proyectos de Salud , Servicios de Salud Escolar
16.
Artículo en Inglés | MEDLINE | ID: mdl-34360158

RESUMEN

In recent years, the nutritional pattern of the Dutch adolescent has cautiously improved. However, progress can be gained if more Dutch adolescents adhere to the nutritional guidelines. School-based initiatives offer opportunities to deal with the unhealthy eating behaviours of adolescents via nutrition educational interventions. In designing and/or re-designing school-based interventions, it is important to enhance optimal context-oriented implementation adaptation by involving the complex adaptive school system. This paper elaborates on the way of dealing with the dynamic implementation context of the educational programme "Krachtvoer" (ENG: "Power food") for prevocational schools, how the programme can be adapted to each unique implementation context, and how the programme can be progressively kept up to date. Following a co-creation-guided approach with various intersectoral stakeholders within and outside the school setting, action-oriented mixed research methods (i.e., observations, semi-structured interviews, focus group interviews, programme usage monitoring, and questionnaires) constantly provide input to develop the programme and its implementation strategy via continuous micro-process cycles. Successful co-creation of school-based health promotion seems to be dependent on proper intersectoral cooperation between research and practice communities, a national partner network that can provide project-relevant insights and establish capacity building aimed at improving contextual fit, and a time-investment balance in and between sectors.


Asunto(s)
Dieta Saludable , Instituciones Académicas , Adolescente , Promoción de la Salud , Investigación sobre Servicios de Salud , Humanos , Evaluación de Programas y Proyectos de Salud , Servicios de Salud Escolar
17.
Nutrients ; 13(8)2021 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-34444910

RESUMEN

Context-appropriate nutrition education interventions targeting middle school students have the potential to promote healthy dietary patters that may help prevent unnecessary weight gain at a point in childhood development when youth experience increasing agency over their food choices. The aim of this review was to identify and synthesize themes in train-the-trainer approaches, intervention content and delivery, and youth receptivity across teacher, mentor, and peer-led nutrition education interventions that targeted middle school-age youth in urban, primarily low-income settings. A systematic, electronic literature search was conducted in seven electronic databases, PubMed/Medline, CINAHL, ERIC, PsycINFO, Scopus, SPORTDiscus, and Cochrane CENTRAL, using fixed inclusion and exclusion criteria. A total of 53 papers representing 39 unique interventions were selected for data extraction and quality assessment. A framework synthesis approach was used to organize the interventions into six categories and identify themes according to whether the intervention was classroom-based or out-of-school-based and whether adults, cross-age peers or same-age peers delivered the intervention. Ten of the interventions contained multiple components such that they were included in two of the categories. The review findings indicated that trainings should be interactive, include opportunities to role-play intervention scenarios and provide follow-up support throughout intervention delivery. Interventions targeting middle school youth should include positive messaging and empower youth to make healthy choices within their specific food environment context.


Asunto(s)
Dieta Saludable/psicología , Educación en Salud/métodos , Terapia Nutricional/métodos , Servicios de Salud Escolar , Formación del Profesorado/métodos , Adolescente , Femenino , Humanos , Masculino , Pobreza/psicología , Estudiantes/psicología , Población Urbana
18.
BMJ Open ; 11(8): e046655, 2021 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-34341042

RESUMEN

OBJECTIVES: The aim of this study was to generate new evidence on how The Daily Mile (TDM), a popular school-based running programme in the UK, is implemented in a diverse and multiethnic city in the UK and also the barriers faced by non-implementer schools. DESIGN: Mixed method cross-sectional study (including survey data collection and qualitative interviews). SETTING: Primary schools in a multiethnic city in the East Midlands, UK. PARTICIPANTS: Forty-two schools in Leicester city completed an online survey, and five teaching staff from five schools took part in follow-up semistructured qualitative interviews. RESULTS: Overall, 40.5% of schools who completed the survey reported having never implemented TDM, and 96.0% of implementer schools reported delivering TDM on three or more days per week. Reported barriers included space limitations and safety issues, timetabling and curriculum pressures, and pupil and teacher attitudes. Facilitators of implementation were teacher engagement and school culture/ethos, communication of the initiative and substantial delivery adaptations. CONCLUSIONS: The findings from this study, based on data from schools in a multiethnic city in the UK, suggest that implementation of TDM is variable, and is influenced by a range of factors related to the school context, as well as the characteristics of TDM itself.


Asunto(s)
Carrera , Servicios de Salud Escolar , Estudios Transversales , Ejercicio Físico , Humanos , Instituciones Académicas , Reino Unido
19.
Front Public Health ; 9: 661119, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34434911

RESUMEN

Background: Despite a high rate of bicycle ownership, the prevalence of cycling to school among children and adolescents in Germany has been constantly low. Cycling to school can contribute to meeting the physical activity recommendations, which the majority of children and adolescents in Germany do not meet. Methods: By using intervention mapping, this study protocol describes the systematic planning process of a school-based intervention in Germany aimed to increase the number of days on which students cycle to school and to increase their physical activity levels. To make sure that the intervention will match the needs of students, we conducted a concept mapping study investigating what students need to cycle to school, as perceived by students, parents, and teachers. The logic model of change was based on an integration of the self-determination theory and the social-ecological model. We structured our intervention as two phases, a preparatory phase with weekly components for and a practical phase with a daily repeated component of the targeted behavior. In the 8-week preparatory phase, teachers, parents, and peers will be involved. The content of the 12-week practical phase will involve peers only and was considered promising based on the findings from a systematic review that we conducted to identify the effective strategies of school-based interventions to promote cycling to school among children and adolescents. Overall, our intervention includes 27 behavior change techniques. A researcher, student assistants, teachers, and other collaborators will implement the intervention; a whole-of-school approach with components performed before, during, and after school was chosen. As a study design, we decided to draft a two-arm three-level cluster randomized controlled trial. Both the effect and process evaluation were prepared. In the first instance, approximately 250 students of 12-15 years of age from grade 7 or 8, who attend a secondary school of intermediate or high educational level located in (sub)urban regions in Southern Germany, will pilot the intervention. Discussion: We expect to provide an effective and sustainable intervention for students, which gives insights into the mechanisms of change concerning the behavior of cycling to school and its influence on physical activity levels.


Asunto(s)
Servicios de Salud Escolar , Instituciones Académicas , Adolescente , Niño , Ejercicio Físico , Alemania , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudiantes , Revisiones Sistemáticas como Asunto
20.
Eur J Public Health ; 31(31 Suppl 1): i71-i79, 2021 07 07.
Artículo en Inglés | MEDLINE | ID: mdl-34240156

RESUMEN

BACKGROUND: Schools are key settings for delivering mental illness prevention in adolescents. Data on stakeholders' attitudes and factors relevant for the implementation of Internet-based prevention programmes are scarce. METHODS: Stakeholders in the school setting from Austria and Spain were consulted. Potential facilitators (e.g. teachers and school psychologists) completed an online questionnaire (N=50), policy makers (e.g. representatives of the ministry of education and health professional associations) participated in semi-structured interviews (N=9) and pupils (N=29, 14-19 years) participated in focus groups. Thematic analysis was used to identify experiences with, attitudes and needs towards Internet-based prevention programmes, underserved groups, as well as barriers and facilitators for reach, adoption, implementation and maintenance. RESULTS: Experiences with Internet-based prevention programmes were low across all stakeholder groups. Better reach of the target groups was seen as main advantage whereas lack of personal contact, privacy concerns, risk for misuse and potential stigmatization when implemented during school hours were regarded as disadvantages. Relevant needs towards Internet-based programmes involved attributes of the development process, general requirements for safety and performance, presentation of content, media/tools and contact options of online programmes. Positive attitudes of school staff, low effort for schools and compatibility to schools' curriculum were seen as key factors for successful adoption and implementation. A sound implementation of the programme in the school routine and continued improvement could facilitate maintenance of online prevention initiatives in schools. CONCLUSIONS: Attitudes towards Internet-based mental illness prevention programmes in school settings are positive across all stakeholder groups. However, especially safety concerns have to be considered.


Asunto(s)
Intervención basada en la Internet , Adolescente , Austria , Humanos , Salud Mental , Servicios de Salud Escolar , Instituciones Académicas , España
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