Health promotion intervention to prevent risk factors of chronic diseases: Protocol for a cluster randomized controlled trial among adolescents in school settings of Chandigarh (India).

BACKGROUND: Chronic diseases like diabetes, cardiovascular diseases and cancers are on the rise. Most of the risk factors of these diseases commence in Adolescence. Therefore, a cluster randomised controlled trial is designed to evaluate the effect of school-based health promotion intervention on the risk factors of chronic diseases. METHODOLOGY: Considering school as a cluster, twelve schools will be randomly selected from the public schools of Chandigarh, a city in India. After baseline assessment, six schools will be randomly allocated to intervention and six to the control arm. Study participants will be students of 8th grade (age 10-16 years), their parents and teachers. A sample of 360 students (12 clusters x 30 students) has been estimated to provide statistically valid inference. The PRECEDE PROCEED Model will be used to develop health promotion interventions to prevent the use of an unbalanced diet, physical inactivity, alcohol, and tobacco. Interventions will be implemented for six-months in the school setting. For students, the intervention will comprise interactive learning sessions of 30 minutes duration per week and physical activity sessions of 30 minutes duration four times every week. Educational sessions will be conducted for parents and teachers for 30 minutes, four times during the intervention period. Primary outcomes will be changes in the prevalence of behavioural risk factors from pre- to post-intervention. Changes in anthropometric, physiological, and biochemical measures will be the secondary outcomes. The difference-in-difference (DID) method will be used to measure the net change in the outcomes. DISCUSSION: It is essential to understand whether health promotion interventions implemented in the school setting simultaneously targeting adolescents, teachers, and parents are effective. Using the PRECEDE-PROCEED model for planning, implementing, and evaluating the intervention as part of a cluster Randomized Controlled Trial design with DID analysis, could objectively assess the impact.

Effectiveness of a Multifaceted Intervention for Prevention of Obesity in Primary School Children in China: A Cluster Randomized Clinical Trial.

Importance: A rapid nutritional transition has caused greater childhood obesity prevalence in many countries, but the repertoire of effective preventive interventions remains limited. Objective: To determine the effectiveness of a novel multifaceted intervention for obesity prevention in primary school children. Design, Setting, and Participants: A cluster randomized clinical trial was conducted during a single school year (from September 11, 2018, to June 30, 2019) across 3 socioeconomically distinct regions in China according to a prespecified trial protocol. Twenty-four schools were randomly allocated (1:1) to the intervention or the control group, with 1392 eligible children aged 8 to 10 years participating. Data from the intent-to-treat population were analyzed from October 1 to December 31, 2019. Interventions: A multifaceted intervention targeted both children (promoting healthy diet and physical activity) and their environment (engaging schools and families to support children's behavioral changes). The intervention was novel in its strengthening of family involvement with the assistance of a smartphone app. The control schools engaged in their usual practices. Main Outcomes and Measures: The primary outcome was the change in body mass index (BMI; calculated as weight in kilograms divided by height in square meters) from baseline to the end of the trial. Secondary outcomes included changes in adiposity outcomes (eg, BMI z score, prevalence of obesity), blood pressure, physical activity and dietary behaviors, obesity-related knowledge, and physical fitness. Generalized linear mixed models were used in the analyses. Results: Among the 1392 participants (mean [SD] age, 9.6 [0.4] years; 717 boys [51.5%]; mean [SD] BMI, 18.6 [3.7]), 1362 (97.8%) with follow-up data were included in the analyses. From baseline to the end of the trial, the mean BMI decreased in the intervention group, whereas it increased in the control group; the mean between-group difference in BMI change was -0.46 (95% CI, -0.67 to -0.25; P < .001), which showed no evidence of difference across different regions, sexes, maternal education levels, and primary caregivers (parents vs nonparents). The prevalence of obesity decreased by 27.0% of the baseline figure (a relative decrease) in the intervention group, compared with 5.6% in the control group. The intervention also improved other adiposity outcomes, dietary, sedentary, and physical activity behaviors, and obesity-related knowledge, but it did not change moderate- to vigorous-intensity physical activity, physical fitness, or blood pressure. No adverse events were observed during the intervention. Conclusions and Relevance: The multifaceted intervention effectively reduced the mean BMI and obesity prevalence in primary school children across socioeconomically distinct regions in China, suggesting its potential for national scaling. Trial Registration: ClinicalTrials.gov Identifier: NCT03665857.

Ensuring Access to Albuterol in Schools: From Policy to Implementation. An Official ATS/AANMA/ALA/NASN Policy Statement.

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.

Schools on the front lines: School based health centers amidst COVID-19.

School based health centers (SBHCs) are often at the front line of medical and mental health services for students in the schools they serve. Citywide school closures in New York City in March 2020 and ongoing social distancing procedures resulted in significant changes in SBHC services as well as access to these services. Furthermore, the combination of COVID-19 related stressors and the increased likelihood of adverse childhood events experienced by urban youth creates conditions for the exacerbation of mental health concerns among youth in metropolitan areas. The following article will explore the role of SBHCs as community agents focused on prevention and reduction of mental health concerns prior and during the current pandemic, as well as existing health disparities experienced by urban youth populations. The authors will also discuss research examining mental health concerns already present in global populations affected by COVID-19 as it may foreshadow the challenges to be faced by U.S. urban youth. Lastly, the authors describe recommendations, practice implications, and opportunities for preventative strategies and therapeutic interventions in school based health settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

School nutrition laws in the US: do they influence obesity among youth in a racially/ethnically diverse state?

BACKGROUND/OBJECTIVES: Little is known about the separate or combined effects of state and national nutrition policies regulating food and beverages in schools on child overweight/obesity (OV/OB) and related racial/ethnic disparities. We investigated the influence of school nutrition policies enacted in California, independently and in combination with the United States' national policy "Healthy Hunger Free Kids Act" (HHFKA) on childhood OV/OB and racial/ethnic disparities. SUBJECTS/METHODS: An interrupted time series design was used with data from 12,363,089 child-level records on 5th- and 7th-graders in California public schools to estimate sex- and racial/ethnic-specific time trends in OV/OB prevalence during three periods: before the California nutrition policies (2002-2004); when only California policies were in effect (2005-2012); and when they were in effect simultaneously with HHFKA (2013-2016). RESULTS: Before the state's policies, OV/OB prevalence increased annually among children in most subgroups. Improvements in OV/OB trends were observed for almost all groups after the California policies were in effect, with further improvements after the addition of HFFKA. The total change in annual log-odds of OV/OB, comparing the periods with both state and federal policies versus no policies, ranged from -0.08 to -0.01 and varied by grade, sex, and race/ethnicity. Within each sex and grade, the greatest changes were among African-American (-0.08 to -0.02, all p < 0.05) followed by Latino children (-0.06 to -0.01, all p < 0.05). Although disparities narrowed among these groups versus White children after the dual policy period, disparities remained large. CONCLUSIONS: State and national nutrition policies for schools may have contributed to containing the upward trend in childhood OV/OB and racial/ethnic OV/OB disparities within California. However, sizable OV/OB prevalence and disparities persist. To end the epidemic, promote healthy weight and increase health equity, future efforts should strengthen state and national policies to improve food quality in schools, particularly those serving populations with the highest OV/OB prevalence.

Analytical Assessment and Nutritional Adequacy of School Lunches in Sintra's Public Primary Schools.

School meals present several cost benefits overtime at the short, medium, and long term for individuals and society. This cross-sectional study aims to analyse the nutritional composition and evaluate the adequacy of school lunches. One hundred and fifty-eight samples were collected and analysed from 10 primary schools in Sintra's municipality, served during one week. On average, energy (27.7% daily energetic requirements) and carbohydrate (48.1%) contents did not reach the reference values, and the content of protein (19.5%) exceeded the reference value (p < 0.05). The mean total fat (28.8%) and saturated fatty acids (5.4%) content complied with the recommendations. The mean salt (1.7 g) and dietary fibre (8.3 g) content exceeded the reference value but did not differ significantly from the recommendations. Addressing school canteens is crucial, not only in a nutritional approach, but also as an opportunity to achieve healthier, sustainable, and accessible food systems, aligned with the Sustainable Development Goals 2030. We highlighted the importance of evaluating evidence-based practices and disseminated practice-based evidence regarding the adequacy of school lunches.

Infecção por SARS-CoV-2 na comunidade escolar / SARS-CoV-2 infection in the school community

Esta revisão rápida foi comissionada e subsidiada pelo Ministério da Saúde, no âmbito do projeto GEREB-010-FIO-20 e faz parte da Coleção "Rapid response for health promotion". Contexto: O contexto de pandemia com altas taxas de transmissão de SARS-CoV-2 necessitou que medidas de distanciamento social ao redor do mundo fossem realizadas, como o fechamento total ou parcial das escolas para o ensino remoto e híbrido. Os impactos relativos a estas medidas extrapolam o âmbito sanitário e precisam ser avaliados com cautela. A presente revisão rápida aborda a reabertura das escolas e apresenta os efeitos e as políticas realizadas para o enfrentamento desta problemática, de modo a compreender as condições e os efeitos de saúde em estudantes e trabalhadores e buscar as melhores condutas para a retomada das aulas em ambiente escolar. Pergunta: Quais taxas de infecção (incidência ou prevalência) de SARS-CoV-2 foram observadas entre estudantes e trabalhadores em escolas que se mantiveram abertas ou retomaram atividades presenciais durante a pandemia? Métodos: Duas bases eletrônicas e três repositórios da literatura foram buscadas em maio e junho de 2021 para identificar estudos que avaliaram as taxas de infecção por SARS-CoV-2 entre estudantes e trabalhadores de escolas da educação básica que se mantiveram abertas ou reabriram durante a pandemia de Covid-19. Utilizando atalhos de revisão rápida para simplificar o processo, foram realizadas seleção e extração dos dados com posterior avaliação da qualidade metodológica dos estudos. Em seguida, os resultados foram reunidos em síntese narrativa. Resultados: De 3.814 registros identificados nas buscas, 28 estudos foram incluídos após o processo de seleção. Os estudos incluídos utilizaram delineamentos transversais. Os relatos abrangeram 16 países, com resultados que envolveram desde uma única escola até o sistema educacional de todo o país. O período investigado variou de 3 a 278 dias, entre janeiro de 2020 a janeiro de 2021. De modo geral foram abordadas as duas grandes ondas de contágio de SARS-CoV-2 nos Estados Unidos e Europa, sobretudo frente ao contexto de reabertura das escolas. Os resultados de transmissão observados variaram substancialmente, considerando taxas de ataque secundárias, investigações de surtos e de prevalência de anticorpos na população. Considerações finais: A síntese das investigações sobre a transmissão de SARS-CoV-2 em escolas mostrou que foram registrados casos de Covid-19 quando as escolas se mantiveram abertas ou foram reabertas no período de pandemia. Os indivíduos infectados, estudantes e trabalhadores, foram responsáveis pela infecção de outras pessoas na escola, mas a maioria dos estudos indicou que as taxas de infecção e de soro-prevalência eram maiores na comunidade em geral.

This rapid review was commissioned and subsidized by the Ministry of Health, within the scope of the GEREB-010-FIO-20 project and is part of the "Rapid response for health promotion" Collection. Context: The context of a pandemic with high transmission rates of SARS-CoV-2 required social distancing measures around the world to be carried out, such as the total or partial closure of schools for remote and hybrid learning. The impacts related to these measures go beyond the health scope and need to be carefully evaluated. This rapid review addresses the reopening of schools and presents the effects and policies carried out to face this problem, in order to understand the conditions and health effects on students and workers and seek the best conduct for the resumption of classes in an environment school. Question: What infection rates (incidence or prevalence) of SARS-CoV-2 were observed among students and workers in schools that remained open or resumed face-to-face activities during the pandemic? Methods: Two electronic databases and three literature repositories were searched in May and June 2021 to identify studies that evaluated the rates of SARS-CoV-2 infection among students and workers in elementary schools that remained open or reopened during the period. Covid-19 pandemic. Using rapid review shortcuts to simplify the process, data selection and extraction were performed with subsequent evaluation of the methodological quality of the studies. Then, the results were gathered in narrative synthesis. Results: Of 3,814 records identified in the searches, 28 studies were included after the selection process. The included studies used cross-sectional designs. Reports spanned 16 countries, with results ranging from a single school to the entire country's education system. The period investigated ranged from 3 to 278 days, between January 2020 and January 2021. In general, the two major waves of SARS-CoV-2 contagion in the United States and Europe were addressed, especially in the context of reopening schools . The observed transmission results varied substantially, considering secondary attack rates, outbreak investigations, and the prevalence of antibodies in the population. Final considerations: The synthesis of investigations on the transmission of SARS-CoV-2 in schools showed that cases of Covid-19 were recorded when schools remained open or were reopened during the pandemic period. Infected individuals, students and workers, were responsible for infecting others at school, but most studies indicated that infection and seroprevalence rates were higher in the community at large.

Peer-to-Peer Sharing of Social Media Messages on Sexual Health in a School-Based Intervention: Opportunities and Challenges Identified in the STASH Feasibility Trial.

BACKGROUND: There is a strong interest in the use of social media to spread positive sexual health messages through social networks of young people. However, research suggests that this potential may be limited by a reluctance to be visibly associated with sexual health content on the web or social media and by the lack of trust in the veracity of peer sources. OBJECTIVE: The aim of this study was to investigate opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of STASH (Sexually Transmitted Infections and Sexual Health), a secondary school-based and peer-led sexual health intervention. METHODS: Following training, and as a part of their role, student-nominated peer supporters (aged 14-16 years) invited school friends to trainer-monitored, private Facebook groups. Peer supporters posted curated educational sex and relationship content within these groups. Data came from a feasibility study of the STASH intervention in 6 UK schools. To understand student experiences of the social media component, we used data from 11 semistructured paired and group interviews with peer supporters and their friends (collectively termed students; n=42, aged 14-16 years), a web-based postintervention questionnaire administered to peer supporters (n=88), and baseline and follow-up questionnaires administered to students in the intervention year group (n=680 and n=603, respectively). We carried out a thematic analysis of qualitative data and a descriptive analysis of quantitative data. RESULTS: Message sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends) and reassuring to peer supporters but led to engagement that ran parallel to-rather than embedded in-their routine social media use. The offline context of a school-based intervention helped legitimate and augment Facebook posts; however, even where friends were receptive to STASH messages, they did not necessarily engage visibly on social media. Preferences for content design varied; however, humor, color, and text brevity were important. Preferences for social media versus offline message sharing varied. CONCLUSIONS: Invitation-only social media groups formed around peer supporters' existing friendship networks hold potential for diffusing messages in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically and the need for adult oversight of activities for information accuracy and safeguarding.

School Nurse Perspectives on COVID-19.

Pennsylvania responded to the COVID-19 pandemic by closing schools and moving to online instruction in March 2020. We surveyed Pennsylvania school nurses (N = 350) in May 2020 to assess the impact of COVID-19 on nurses' concerns about returning to school and impact on practice. Data were analyzed using χ2 tests and regression analyses. Urban school nurses were more concerned about returning to the school building without a COVID-19 vaccine than rural nurses (OR = 1.58, 95% CI [1.05, 2.38]). Nurses in urban locales were more likely to report being asked for guidance on COVID-19 (OR = 1.69, 95% CI [1.06, 2.68]), modify communication practices (OR = 2.33, 95% CI [1.42, 3.82]), and be "very/extremely concerned" about their safety (OR = 2.16, 95% CI [1.35, 3.44]). Locale and student density are important factors to consider when resuming in-person instruction; however, schools should recognize school nurses for their vital role in health communication to assist in pandemic preparedness and response.

A Preliminary Study Examining the Validity of Brief Trauma Screening Tools for Young Adolescents in School-Based Health Centers.

BACKGROUND AND PURPOSE: There are very limited brief, validated, open access screening tools for trauma symptoms in adolescent populations. This study aimed to test two brief tools used with adults in primary care settings for use with adolescents. METHODS: Youth (n = 77) completed the Posttraumatic Stress Disorder (PTSD) Checklist (PCLC-2), the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV; PC-PTSD), and the PTSD Reaction Index for DSM-5 (reference tool). Sensitivities and specificities were analyzed. RESULTS: The PCLC-2 and PC-PTSD demonstrated high sensitivity and specificity with adolescents when using lower cutoff scores than those recommended for adults. CONCLUSIONS: The PC-PTSD and PCLC-2 have the potential to be used as brief screens with adolescents. Additional research is needed to further examine their validity with larger, diverse youth samples in primary care and school-based settings.

WHO guideline on school health services

Schools are essential for young people to acquire knowledge, socioemotional skills including selfregulation and resilience, and critical thinking skills that provide the foundation for a healthy future. Access to education and safe and supportive school environments have been linked to better health outcomes. In turn, good health is linked to reduced drop-out rates and greater educational attainment, educational performance, employment and productivity. WHO has long recognized the link between health and education and the potential for schools to play a central role in safeguarding student health and well-being. In 1995, WHO launched the Global School Health Initiative, which aimed to strengthen approaches to health promotion in schools. Among those approaches, pairing children with health services occupies an important place. Many health conditions can be better managed or prevented if detected early. The school environment and school health services provide an opportunity for timely interventions across a range of conditions, including anxiety and depression, behavioural disorders, diabetes, overweight, obesity and undernutrition. There are many reasons why school health services are uniquely placed to contribute to the health and well-being of school-age children. First, they operate where most children are, and they have access to families. Secondly, they are free at the point of use and overcome barriers such as transport issues, limited community services, and inconvenient location or appointment systems, and therefore have the potential to better serve underprivileged populations.

WHO guideline on school health services. Web Annex F. Systematic reviews of the effectiveness and acceptability of comprehensive school health services: GRADE evidence profiles and evidence-to-decision table

WHO guideline on school health services: Web Annex F. Systematic reviews of the effectiveness and acceptability of comprehensive school health services: GRADE evidence profiles and evidence-to-decision table In partnership with WHO guideline on school health services Web Annex F. Systematic reviews of the effectiveness and acceptability of comprehensive school health services: GRADE evidence profiles and evidence-to-decision tableIn partnership with WHO guideline on school health services Web Annex F. Systematic reviews of the effectiveness and acceptability of comprehensive school health services: GRADE evidence profiles and evidence-to-decision tableWHO guideline on school health services. Web Annex F. Systematic reviews of the effectiveness and acceptability of comprehensive school health.

School nurses' perceptions regarding barriers and facilitators in caring for children with chronic diseases in school settings: A mixed studies review.

This study aimed to understand school nurses' perceptions regarding barriers to and facilitators for health care services for children with chronic diseases in school settings. Using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Web of Science databases, a mixed studies review was conducted for literature published between January 2011 and June 2020. We performed a mixed-methods systematic review using a convergent integrated approach. A quality appraisal of the included studies was conducted using a mixed-methods appraisal tool. Twenty-seven articles (10 qualitative, 10 quantitative, and seven mixed-methods) that met the inclusion criteria were analyzed. Integrated findings that emerged from data synthesis were categorized into four levels (intrapersonal level, interpersonal level, institutional level, and community and public policy level) based on a socio-ecological model framework. This mixed systematic review provides a comprehensive understanding of school nurses' perceived barriers and facilitators when providing school health care for students with chronic diseases and how these barriers and facilitators interact across multiple systems. Further policies and strategies should be developed to provide effective school health services considering this study's findings.

Meal Quality of Entrées That Can Be Sold as Competitive Foods in Schools and Potential Impact of the Proposed USDA Rollbacks.

The Healthy, Hunger-Free Kids Act strengthened competitive food standards (i.e., Smart Snacks), but an exemption allows reimbursable meal entrées that do not meet Smart Snack standards to be sold as "competitive entrées" on the same day they are served in the reimbursable meal, and the following day. Proposed rollbacks would enable these competitive entrées to continue to be sold on a third day, increasing the availability of competitive foods exempt from Smart Snacks standards. This study compared the Healthy Eating Index (HEI) scores of potential competitive entrées alone versus full reimbursable school lunches, and examined the nutritional characteristics of potential competitive entrées. Data were from a national sample of 1108 schools from the School Nutrition and Meal Cost Study. Linear regression models, accounting for school-level and state and district policy characteristics, found that HEI scores of competitive entrées were an average of 30 points lower than HEI scores of reimbursable lunches, with greater differences in small and rural schools. Less than 1% of common potential competitive entrees met Smart Snack standards, primarily due to higher sodium and saturated fat levels. The proposed rollbacks are estimated to potentially add approximately 662 mg of sodium and 3 g of saturated fat over three days (1103 mg sodium and 5 g saturated fat over a week) on average relative to Smart Snacks limits. Instead of increasing opportunities to sell competitive entrées, their sales should be further limited.

A participação de jovens no Programa Saúde na Escola / The participation of young people in the School Health Program

Esta síntese rápida de evidências foi comissionada e subsidiada pelo Ministério da Saúde, no âmbito do projeto GEREB-010-FIO-20 e faz parte da Coleção "Rapid response for health promotion". O Programa Saúde na Escola (PSE) é uma estratégia para articulação entre as políticas e ações de educação e saúde, para alunos da rede pública de ensino: Creche, Pré-Escola, Ensino Fundamental, Ensino Médio, Rede Federal de Educação Profissional e Tecnológica, Educação de Jovens e Adultos (EJA). A integração da escola tanto aos programas de saúde quanto a outros espaços sociais é fundamental na formação dos estudantes, na percepção e construção da cidadania e no acesso às políticas públicas. Desse modo, são necessárias ações de PSE para promoção da saúde e do protagonismo juvenil. Nessa perspectiva, essa síntese rápida de evidência tem o intuito de verificar a participação de jovens no PSE. Pergunta: De que forma os jovens têm participado das ações do Programa de Saúde na Escola (PSE)? Métodos: As buscas por estudos que apresentam estratégias para a participação de jovens no PSE foram realizadas em seis bases de dados. Não houve restrição de ano de publicação, mas foram incluídos apenas estudos em português, inglês e espanhol. A avaliação da qualidade metodológica dos estudos qualitativos foi realizada por meio da ferramenta Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research e a qualidade dos relatos de experiência utilizando critérios de avaliação da Universidade Federal de Juiz de Fora. Nesta síntese rápida de evidências, produzida em 13 dias, foram utilizados atalhos metodológicos, de maneira que apenas o processo de seleção foi realizado em duplicidade e de forma independente. Resultados: De 1.264 publicações identificadas nas bases de dados, após o processo de seleção foram incluídas três pesquisas qualitativas e três relatos de experiência. Na avaliação da qualidade metodológica, os relatos atenderam aos itens mínimos sugeridos pelos checklists aplicados. Os estudos analisados trouxeram resultados sobre a formação de multiplicadores do PSE e oficinas de educação em saúde. As oficinas para formação de multiplicadores com base nos temas prioritários do PSE, a capacitação de estudantes para participação juvenil no PSE com produção de diagnóstico das escolas e seus territórios e, e o processo formativo de adolescentes realizado por acadêmicos de enfermagem tiveram resultados positivos no ambiente intra e extra escolar, onde evidenciaram a necessidade dos temas abordados estarem em conformidade com a necessidade dos adolescentes. Contudo, a formação de multiplicadores com apresentação pela gestão do PSE conforme cronograma anual e a formação de adolescentes para implementação de guia de educação em saúde nas escolas não apresentaram resultados tão satisfatórios. A primeira estratégia foi realizada de forma tradicional e assim obteve uma baixa participação dos adolescentes no processo formativo, já a formação de adolescentes para implementação de guia de educação em saúde nas escolas encontrou dificuldades na implementação dos guias em decorrência dos termos técnicos que constavam no guia, mas que foram supridas com a formação prévia dos dinamizadores foi fundamental para o alinhamento conceitual. Conclusão: Esta revisão identificou resultados promissores com as estratégias para aumento da participação dos jovens no PSE, embora muitas dessas atividades tenham que ser aprimoradas para melhores resultados. Dada a natureza dos estudos analisados não era de se esperar resultados sobre efetividade das ações, no entanto, os resultados trazem contribuições acerca dos desafios e possibilidades na implementação do programa. Nesse sentido, uma lacuna para ser abordada em pesquisas futuras é a comparação entre diferentes abordagens para promover a participação dos jovens no PSE.

This rapid synthesis of evidence was commissioned and subsidized by the Ministry of Health, within the scope of the GEREB-010-FIO-20 project and is part of the "Rapid response for health promotion" Collection. The School Health Program (PSE) is a strategy for articulating education and health policies and actions for students in the public school system: Daycare, Pre-School, Elementary School, High School, Federal Network of Professional and Technological Education , Youth and Adult Education (EJA). The school's integration with both health programs and other social spaces is fundamental in the formation of students, in the perception and construction of citizenship and in the access to public policies. Thus, PSE actions are necessary to promote health and youth protagonism. From this perspective, this quick synthesis of evidence is intended to verify the participation of young people in the PSE. Question: How have young people participated in the actions of the School Health Program (PSE)? Methods: The searches for studies that present strategies for the participation of young people in the PSE were carried out in six databases. There was no restriction on the year of publication, but only studies in Portuguese, English and Spanish were included. The evaluation of the methodological quality of qualitative studies was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research tool and the quality of experience reports using evaluation criteria from the Federal University of Juiz de Fora. In this quick synthesis of evidence, produced in 13 days, methodological shortcuts were used, so that only the selection process was carried out in duplicate and independently. Results: From 1,264 publications identified in the databases, after the selection process, three qualitative researches and three experience reports were included. In the assessment of methodological quality, the reports met the minimum items suggested by the checklists applied. The analyzed studies brought results on the training of PSE multipliers and health education workshops. The workshops for training multipliers based on the priority themes of the PSE, the training of students for youth participation in the PSE with the production of diagnoses in schools and their territories, and the training process for adolescents carried out by nursing students had positive results in the environment intra and extra-school, where they highlighted the need for the topics addressed to be in accordance with the needs of adolescents. However, the training of multipliers with presentation by the PSE management according to the annual schedule and the training of adolescents to implement a health education guide in schools did not show such satisfactory results. The first strategy was carried out in a traditional way and thus obtained a low participation of adolescents in the training process, while the training of adolescents to implement a health education guide in schools encountered difficulties in implementing the guides due to the technical terms contained in the guide , but which were supplied with the previous training of the promoters was fundamental for the conceptual alignment. Conclusion: This review identified promising results with strategies to increase youth participation in PSE, although many of these activities need to be improved for better results. Given the nature of the studies analyzed, results on the effectiveness of the actions were not to be expected, however, the results bring contributions about the challenges and possibilities in the implementation of the program. In this sense, a gap to be addressed in future research is the comparison between different approaches to promote youth participation in PSE.

Covid-19: documento sugere ações para a promoção da saúde no ambiente escolar

Tendo em vista que não há uma solução comum que se adeque a todas as escolas, e nem solução que atenda a todos os segmentos diferenciados de uma mesma escola, a Nota Técnica sugere a construção, em cada unidade escolar, de um Plano Integrado e Intersetorial Local de ações para o enfrentamento e convívio com a Covid-19, com ações sanitárias e educacionais, em sintonia com o planejamento de instâncias regionais e macrorregionais e respeitando a singularidade local.

Evaluation of a city-wide school-located influenza vaccination program in Oakland, California, with respect to vaccination coverage, school absences, and laboratory-confirmed influenza: A matched cohort study.

BACKGROUND: It is estimated that vaccinating 50%-70% of school-aged children for influenza can produce population-wide indirect effects. We evaluated a city-wide school-located influenza vaccination (SLIV) intervention that aimed to increase influenza vaccination coverage. The intervention was implemented in ≥95 preschools and elementary schools in northern California from 2014 to 2018. Using a matched cohort design, we estimated intervention impacts on student influenza vaccination coverage, school absenteeism, and community-wide indirect effects on laboratory-confirmed influenza hospitalizations. METHODS AND FINDINGS: We used a multivariate matching algorithm to identify a nearby comparison school district with pre-intervention characteristics similar to those of the intervention school district and matched schools in each district. To measure student influenza vaccination, we conducted cross-sectional surveys of student caregivers in 22 school pairs (2017 survey, N = 6,070; 2018 survey, N = 6,507). We estimated the incidence of laboratory-confirmed influenza hospitalization from 2011 to 2018 using surveillance data from school district zip codes. We analyzed student absenteeism data from 2011 to 2018 from each district (N = 42,487,816 student-days). To account for pre-intervention differences between districts, we estimated difference-in-differences (DID) in influenza hospitalization incidence and absenteeism rates using generalized linear and log-linear models with a population offset for incidence outcomes. Prior to the SLIV intervention, the median household income was $51,849 in the intervention site and $61,596 in the comparison site. The population in each site was predominately white (41% in the intervention site, 48% in the comparison site) and/or of Hispanic or Latino ethnicity (26% in the intervention site, 33% in the comparison site). The number of students vaccinated by the SLIV intervention ranged from 7,502 to 10,106 (22%-28% of eligible students) each year. During the intervention, influenza vaccination coverage among elementary students was 53%-66% in the comparison district. Coverage was similar between the intervention and comparison districts in influenza seasons 2014-2015 and 2015-2016 and was significantly higher in the intervention site in seasons 2016-2017 (7%; 95% CI 4, 11; p < 0.001) and 2017-2018 (11%; 95% CI 7, 15; p < 0.001). During seasons when vaccination coverage was higher among intervention schools and the vaccine was moderately effective, there was evidence of statistically significant indirect effects: The DID in the incidence of influenza hospitalization per 100,000 in the intervention versus comparison site was -17 (95% CI -30, -4; p = 0.008) in 2016-2017 and -37 (95% CI -54, -19; p < 0.001) in 2017-2018 among non-elementary-school-aged individuals and -73 (95% CI -147, 1; p = 0.054) in 2016-2017 and -160 (95% CI -267, -53; p = 0.004) in 2017-2018 among adults 65 years or older. The DID in illness-related school absences per 100 school days during the influenza season was -0.63 (95% CI -1.14, -0.13; p = 0.014) in 2016-2017 and -0.80 (95% CI -1.28, -0.31; p = 0.001) in 2017-2018. Limitations of this study include the use of an observational design, which may be subject to unmeasured confounding, and caregiver-reported vaccination status, which is subject to poor recall and low response rates. CONCLUSIONS: A city-wide SLIV intervention in a large, diverse urban population was associated with a decrease in the incidence of laboratory-confirmed influenza hospitalization in all age groups and a decrease in illness-specific school absence rate among students in 2016-2017 and 2017-2018, seasons when the vaccine was moderately effective, suggesting that the intervention produced indirect effects. Our findings suggest that in populations with moderately high background levels of influenza vaccination coverage, SLIV programs are associated with further increases in coverage and reduced influenza across the community.

The Effect of Supportive Implementation of Healthier Canteen Guidelines on Changes in Dutch School Canteens and Student Purchase Behaviour.

We developed an implementation plan including several components to support implementation of the "Guidelines for Healthier Canteens" in Dutch secondary schools. This study evaluated the effect of this plan on changes in the school canteen and on food and drink purchases of students. In a 6 month quasi-experimental study, ten intervention schools (IS) received support implementing the guidelines, and ten control schools (CS) received only the guidelines. Changes in the health level of the cafeteria and vending machines were assessed and described. Effects on self-reported purchase behaviour of students were analysed using mixed logistic regression analyses. IS scored higher on healthier availability in the cafeteria (77.2%) and accessibility (59.0%) compared to CS (60.1%, resp. 50.0%) after the intervention. IS also showed more changes in healthier offers in the cafeteria (range -3 to 57%, mean change 31.4%) and accessibility (range 0 to 50%, mean change 15%) compared to CS (range -9 to 46%, mean change 9.7%; range -30 to 20% mean change 7% resp.). Multi-level logistic regression analyses on the intervention/control and health level of the canteen in relation to purchase behaviour showed no relevant relations. In conclusion, the offered support resulted in healthier canteens. However, there was no direct effect on students' purchase behaviour during the intervention.