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3.
Presse Med ; 48(12): e369-e381, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31785940

RESUMO

BACKGROUND: In 2015, the vaccine against human Papillomavirus (hPV) was recommended in France for children from 11 to 14 years-old. This study assessed the knowledge of parents from Normandy about this vaccine and measured the impact of an information campaign on their intent to have their children vaccinated. METHODS: Parents from Normandy with children in sixth-grade class, aged 10 to 11, during the 2015-2016 school year were included. The secondary schools were selected in collaboration with academic institutions. The intent to have their child vaccinated was measured with a questionnaire distributed to children in April 2016 and collected from May to June 2016 by school nurses. RESULTS: Among the 16 selected secondary schools, 1428 questionnaires were distributed and 864 (60.5 %) were collected regardless of the gender of the child. Among the 439 girls, 85.9 % were not vaccinated against hPV. The intent to vaccinate was higher when the parent who responded was the mother (P<0.001). Among the parents who took note of the information booklet, 73.7 % found this information useful. There was a significant association between the knowledge about the vaccine against hPV and the intent to vaccinate (P<0.001). The percentage of vaccinated girls was significantly higher when their parents were informed (10.9 % versus 3.2 %). We noticed a significant rise of the intent to vaccinate children when information booklets were distributed (P<0.001). CONCLUSION: The vaccination rate after specific information about vaccination against hPV was significantly higher. The information campaign has thus a significant positive impact.


Assuntos
Intenção , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Pais , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Criança , Feminino , França/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , História do Século XXI , Humanos , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Pais/educação , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Serviços de Saúde Escolar/história , Instituições Acadêmicas/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários , Vacinação/psicologia
4.
J Ment Health Policy Econ ; 22(3): 109-120, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31811754

RESUMO

BACKGROUND: Recovery high schools (RHS) provide a supportive educational and therapeutic environment for students subsequent to treatment for substance use disorders (SUDs). Most students served by RHSs have concurrent mental health disorders and are at risk for school failure or dropout and substance use relapse. AIMS OF THE STUDY: The central question addressed is whether RHSs are economically efficient alternatives to other high school settings for students in recovery. The aim is to estimate the incremental cost-benefit of RHSs. METHODS: A quasi-experimental non-equivalent pretest-posttest comparison group design was used. We compared substance use and educational outcomes for adolescents who had received specialty SUD treatment; 143 who enrolled in an RHS were compared to 117 who enrolled in a non-RHS school. Groups were balanced by use of a propensity score to drop students who were not similar to those in the other group. The propensity score was also used as a covariate in multiple regression to estimate cost and outcome parameters and standard errors. To take account of uncertainties in impacts and shadow prices, we used Monte Carlo simulations to estimate the distribution of incremental benefits of RHS relative to non-RHS schooling. RESULTS: Two beneficial impacts of statistical and substantive importance were identified: increased probability of high school graduation and increased sobriety. RHS students had significantly (p<.05) less substance use during the study period -- at 12-month follow-up, 55% of RHS and 26% of comparison students reported 3 month abstinence from alcohol and drugs. Urinalysis confirmed abstinence from THC (cannabis) for 68% of RHS versus 37% of comparison students. RHS students' high school graduation rates were 21 to 25 percentage points higher than comparison students. Adopting a societal perspective, incremental benefits of RHSs were estimated by monetizing the increased probability of high school graduation and comparing it to incremental costs. Mean net benefits ranged from USD16.1 thousand to USD51.9 thousand per participant; benefit-to-cost ratios ranged from 3.0 to 7.2. DISCUSSION: Monetizing the benefits and the incremental costs of RHS relative to conventional schooling show substantial positive net benefits from RHS participation. Two factors lend credibility to the results. First, the RHS improvement in substance use indicates a mechanism through which the increased probability of high school graduation can plausibly occur. Second, the estimated increases in the probability of high school graduation were large and statistically significant. As the productivity gains from high school graduation are also large, the dominant benefit category is very plausible. Limitations include the non-randomized design; selection bias into the study conditions not fully controlled by the propensity scores; generalizability only to young people with treated behavioral health disorders; lack of estimates for direct monetization of reduced substance use among adolescents; possible attenuation of the value of education among individuals with behavioral health issues; and uncertainty in calculation of school costs. IMPLICATIONS FOR BEHAVIORAL HEALTH POLICIES: This research provides evidence that the recovery high school model provides cost beneficial support for high school students after primary SUD treatment. The students who enroll in RHSs typically have co-occurring mental health and substance use disorders, adding complexity to their continuing care. Funding policies recognizing the multiple systems of care (behavioral health, education, child and family services, juvenile justice) responsible for these young people are called for.


Assuntos
Sucesso Acadêmico , Serviços de Saúde Escolar/economia , Serviços de Saúde Escolar/estatística & dados numéricos , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Comportamento do Adolescente/psicologia , Criança , Doença Crônica , Análise Custo-Benefício , Humanos , Estudos Longitudinais , Estudos Prospectivos , Instituições Acadêmicas , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/reabilitação
6.
BMC Public Health ; 19(1): 1427, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666034

RESUMO

BACKGROUND: Malnutrition among school children may contribute to adverse health consequences such as non-communicable diseases, poor cognitive performance, psychological distress and poor quality of life that may persist into adulthood. In order to prevent childhood malnutrition, an intervention programme that integrates nutrition education and healthy school food environment is needed to provide nutrition information and reinforce the skills on healthy eating behaviours in schools. This paper describes a study protocol of a school-based intervention programme that integrates nutrition education and healthy school food environment, namely School Nutrition Programme (SNP). The SNP is a primary prevention programme that promotes healthy lifestyle among primary school children in light of the high prevalence of malnutrition in Malaysian children. METHODS/DESIGN: This quasi-experimental study aimed to evaluate the effectiveness of the SNP between intervention and comparison groups before and after the SNP, and after a 3-month follow-up. The SNP consisted of two main components, whereby three nutrition education sessions were implemented by trained teachers using three standardised modules, and healthy school food environment was implemented by the canteen food handlers with the provision of healthy menu to children during school recess times. Children from intervention group participated in the SNP, in addition to the standard Physical and Health Curriculum. The comparison group attended only the standardised Physical and Health Curriculum and the school canteen food handlers were reminded to follow the standard canteen guidelines from the Ministry of Education Malaysia. The assessment parameters in evaluating the effectiveness of the programme were knowledge, attitude and practice on nutrition, eating behaviours, physical activity, body composition, psychological distress, cognitive performance and health-related quality of life. Assessments were conducted at three time points: pre-intervention, post-intervention and 3-month follow-up. DISCUSSION: It was hypothesised that the SNP would be effective in promoting healthy lifestyle among school children, and further contributes in preventing malnutrition problem, enhancing cognitive performance and improving health-related quality of life among school children. Findings of the present study can be expanded to other schools in future on ways to improve nutrition education and healthy school food environment. TRIAL REGISTRATION: UMIN Clinical Trial Registration UMIN000032914 (Date of registration: 7th June 2018, retrospectively registered). PROTOCOL VERSION: 16th September 2019 & Version 4.


Assuntos
Currículo , Serviços de Alimentação , Educação em Saúde , Promoção da Saúde/métodos , Avaliação de Programas e Projetos de Saúde , Instituições Acadêmicas , Composição Corporal , Criança , Cognição , Exercício , Comportamento Alimentar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Malásia , Masculino , Estado Nutricional , Qualidade de Vida , Projetos de Pesquisa , Estudos Retrospectivos , Serviços de Saúde Escolar
7.
BMC Public Health ; 19(1): 1510, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718597

RESUMO

BACKGROUND: At a population level, small reductions in energy intake have the potential to contribute to a reduction in the prevalence of childhood obesity. In many school systems, there is the potential to achieve a reduction in energy intake through modest improvements in foods packed in children's school lunchboxes. This study will assess the effectiveness and cost-effectiveness of a multi-component intervention that uses an existing school-based communication application to reduce the kilojoule content from discretionary foods and drinks consumed by children from school lunchboxes whilst at school. METHODS: A Type I hybrid effectiveness-implementation cluster randomised controlled trial will be conducted in up to 36 primary schools in the Hunter New England, Central Coast and Mid North Coast regions of New South Wales, Australia. Designed using the Behaviour Change Wheel, schools will be randomly allocated to receive either a 5-month (1.5 school terms) multi-component intervention that includes: 1) school lunchbox nutrition guidelines; 2) curriculum lessons; 3) information pushed to parents via an existing school-based communication application and 4) additional parent resources to address common barriers to packing healthy lunchboxes or a control arm (standard school practices). The study will assess both child level dietary outcomes and school-level implementation outcomes. The primary trial outcome, mean energy (kJ) content of discretionary lunchbox foods packed in children's lunchboxes, will be assessed at baseline and immediately post intervention (5 months or 1.5 school terms). Analyses will be performed using intention to treat principles, assessing differences between groups via hierarchical linear regression models. DISCUSSION: This study will be the first fully powered randomised controlled trial internationally to examine the impact of an m-health intervention to reduce the mean energy from discretionary food and drinks packed in the school lunchbox. The intervention has been designed with scalability in mind and will address an important evidence gap which, if shown to be effective, has the potential to be applied at a population level. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN:12618001731280 registered on 17/10/2018. Protocol Version 1.


Assuntos
Dieta , Promoção da Saúde/métodos , Almoço , Obesidade Pediátrica/prevenção & controle , Serviços de Saúde Escolar , Instituições Acadêmicas , Telemedicina , Criança , Pré-Escolar , Comunicação , Análise Custo-Benefício , Currículo , Dieta/normas , Ingestão de Energia , Feminino , Humanos , Masculino , Aplicativos Móveis , New South Wales , Política Nutricional , Pais , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa
8.
BMC Public Health ; 19(1): 1514, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718611

RESUMO

BACKGROUND: Cervical cancer was the fourth most common cancer among women worldwide in 2012 and was the eighth most common cancer in 2014 and the eighth greatest cause of female cancer deaths in Hong Kong in 2015. Human papillomavirus (HPV) vaccination has been clinically documented to have a high efficacy in reducing HPV-related cervical intraepithelial neoplasia incidence. Therefore, receiving vaccination is a crucial public health measure to reduce disease burden. Significant others, such as schools and schoolteachers, have prominent influence in shaping adolescents' health perceptions and behavior. Therefore, the perspective of schools and schoolteachers regarding vaccination can significantly influence students' acceptance and accessibility of the vaccine. However, few studies have analyzed the perceptions of schoolteachers toward HPV vaccination, and even fewer have concerned how schoolteachers' perceptions influence their schools' motivation in implementing school-based HPV vaccination programs. This study was thus conducted to fill this literature gap. METHODS: With a Chinese community as the field site of this study, a qualitative approach of five focus group interviews was conducted with 35 schoolteachers from five primary and eight secondary schools in Hong Kong between July 2014 and January 2015. Thematic content analysis was used for data analysis. RESULTS: Perceptual, institutional, student and parental, and collaborator barriers interacted to discourage the sampled schoolteachers from organizing school-based HPV vaccination programs. Lack of knowledge regarding HPV vaccination, perception of HPV vaccination as inappropriate given the students' age, violation of traditional cultural values, lack of perceived needs and perceived risk, opposition from schools, low priority of HPV vaccination over other health education topics, lack of government support, lack of interest from parents and students, and lack of confidence in implementing organizations, all were the mentioned barriers. CONCLUSIONS: The sampled schoolteachers were demotivated to organize school-based HPV vaccination programs because of their perceptions and various social and cultural factors. As significant influencers of adolescent students, schoolteachers and schools should receive more support and information on organizing school-based HPV vaccination programs in the future.


Assuntos
Neoplasia Intraepitelial Cervical/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Papillomaviridae , Infecções por Papillomavirus/prevenção & controle , Professores Escolares , Instituições Acadêmicas , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Neoplasia Intraepitelial Cervical/virologia , Criança , Feminino , Educação em Saúde , Hong Kong/epidemiologia , Humanos , Programas de Imunização , Masculino , Motivação , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus , Pais , Aceitação pelo Paciente de Cuidados de Saúde , Pesquisa Qualitativa , Serviços de Saúde Escolar , Estudantes , Neoplasias do Colo do Útero/virologia , Vacinação , Adulto Jovem
9.
Lancet Psychiatry ; 6(12): 1011-1020, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31734106

RESUMO

BACKGROUND: Rates of anxiety and depression are increasing among children and young people. Recent policies have focused on primary prevention of mental disorders in children and young people, with schools at the forefront of implementation. There is limited information for the comparative effectiveness of the multiple interventions available. METHODS: We did a systematic review and network meta-analysis, searching MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled trials for published and unpublished, passive and active-controlled randomised and quasi-randomised trials. We included educational setting-based, universal, or targeted interventions in which the primary aim was the prevention of anxiety and depression in children and young people aged 4-18 years. Primary outcomes were post-intervention self-report anxiety and depression, wellbeing, suicidal ideation, or self-harm. We assessed risk of bias following the Cochrane Handbook for Systematic Reviews of Interventions. We estimated standardised mean differences (SMD) using random effects network meta-analysis in a Bayesian framework. The study is registered with PROPSERO, number CRD42016048184. FINDINGS: 1512 full-text articles were independently screened for inclusion by two reviewers, from which 137 studies of 56 620 participants were included. 20 studies were assessed as being at low risk of bias for both random sequence generation and allocation concealment. There was weak evidence to suggest that cognitive behavioural interventions might reduce anxiety in primary and secondary settings. In universal secondary settings, mindfulness and relaxation-based interventions showed a reduction in anxiety symptoms relative to usual curriculum (SMD -0·65, 95% credible interval -1·14 to -0·19). There was a lack of evidence to support any one type of intervention being effective to prevent depression in universal or targeted primary or secondary settings. Comparison-adjusted funnel plots suggest the presence of small-study effects for the universal secondary anxiety analysis. Network meta-analysis was not feasible for wellbeing or suicidal ideation or self-harm outcomes, and results are reported narratively. INTERPRETATION: Considering unclear risk of bias and probable small study effects for anxiety, we conclude there is little evidence that educational setting-based interventions focused solely on the prevention of depression or anxiety are effective. Future research could consider multilevel, systems-based interventions as an alternative to the downstream interventions considered here. FUNDING: UK National Institute for Health Research.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Meta-Análise em Rede , Serviços de Saúde Escolar , Adolescente , Ansiedade/terapia , Criança , Pré-Escolar , Terapia Cognitivo-Comportamental , Depressão/terapia , Humanos , Ideação Suicida
10.
Community Dent Health ; 36(4): 286-292, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31724837

RESUMO

OBJECTIVES: This systematic review examines elementary school-aged children's involvement in oral health interventions. METHODS: A systematic review of randomised controlled studies was carried out according to the PRISMA guidelines. PubMed, CINAHL, Embase, and Scopus databases were searched for publications listed between 2008-2018. The review was focused on randomised controlled studies investigating educational oral health interventions for elementary school-age children ages 6-12 years. Data were analysed using deductive content analysis using the Typology of Youth Participation and Empowerment model. The quality of reporting was assessed using the CONSORT checklist for randomised trials. The Cochrane risk of bias assessment tool was used to assess the risk of bias. RESULTS: Eight studies were reviewed involving a total of 3232 children. The studies mostly represented the Vessel type of participation. Interventions usually consisted of researcher-designed tasks and assignments given to the children. No mentions of collaboration or consultation with children during the intervention design, implementation of the design, analysis or study process were found. CONCLUSION: Children's views of oral health education and their potential role as active participants in the overall research process should be examined using qualitative methods prior to any intervention design. The use of participatory research methodology when planning pre-intervention studies and developing interventions, including ones with a randomised controlled trial design, is, therefore, recommended.


Assuntos
Educação em Saúde Bucal , Saúde Bucal , Adolescente , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Serviços de Saúde Escolar , Instituições Acadêmicas
11.
BMC Public Health ; 19(1): 1455, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694590

RESUMO

BACKGROUND: The development of school-based programs for preventing adolescent sexual harassment often lacks an evidence-based approach and use of proper theories. Appropriate stakeholders are often not involved in the development process. To help improve this process, we used the Intervention Mapping framework to retrospectively evaluate the development of two school-based programs, Benzies & Batchies and Boys, each of which was intended to prevent sexual harassment among adolescent students of a lower educational level in the Netherlands. The two interventions were among the first school-based programs targeting sexual harassment, and were implemented in Dutch secondary schools. METHODS: As well as doing desk research into the context and content of the interventions, we used semi-structured focused interviews with the initial developers to gather their opinions on and experiences with the development process, whereby the topics were based on the six steps of the IM framework. To better suit the needs of the respondents, we had adapted the language of our topics and had used open-ended questions The data we had gathered from the desk research and face-to-face consultations were checked against a planning tool that was based on 19 tasks within the six steps of IM. RESULTS: Although both programs had been developed in practice and lacked a thorough theoretical foundation, the methods and materials used represented aspects of behavior-change theories. The developers of Benzies & Batchies completed slightly more planning criteria within the six steps of the planning process, and used more change methods than the developers of Boys did. CONCLUSIONS: We recommend that parents should also be involved in the development of sex and relationship education programs, and should be allowed to participate in the program itself. To meet the needs of intervention developers, greater insight is needed into the importance of the individual steps in the Intervention Mapping framework. In our view, the development of practice-based interventions will improve if future intervention developers combine evidence-based theories with their practice-based experience. This will increase the success and effectiveness of their interventions.


Assuntos
Terapia Comportamental/métodos , Implementação de Plano de Saúde/organização & administração , Serviços de Saúde Escolar/organização & administração , Assédio Sexual/prevenção & controle , Adolescente , Feminino , Humanos , Masculino , Países Baixos , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Estudantes/psicologia
12.
Rev Saude Publica ; 53: 93, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644772

RESUMO

OBJECTIVE: To evaluate the potential support of schools for oral health promotion and associated factors in Brazilian capitals. METHODS: Data from 1,339 public and private schools of the 27 Brazilian capitals were obtained from the National Survey of School Health (PeNSE) 2015. Data from the capitals were obtained from the United Nations Development Program and the Department of Informatics of the Brazilian Unified Health System (Datasus). The indicator " ambiente escolar promotor de saúde bucal " (AEPSB - oral health promoting school environment) was designed from 21 variables of the school environment with possible influence on students' oral health employing the categorical principal components analysis (CATPCA). Associations between the AEPSB and characteristics of schools, capitals and regions were tested (bivariate analysis). RESULTS: Ten variables comprised CAPTCA, after excluding those with low correlation or high multicollinearity. The analysis resulted in a model with three dimensions: D1. Within-school aspects (sales of food with added sugar in the canteen and health promotion actions), D2. Aspects of the area around the school (sales of food with added sugar in alternative points) and D3. prohibitive policies at school (prohibition of alcohol and tobacco consumption). The sum of the scores of the dimensions generated the AEPSB indicator, dichotomized by the median. From the total of schools studied, 51.2% (95%CI 48.5-53.8) presented a more favorable environment for oral health (higher AEPSB). In the capitals, this percentage ranged from 36.6% (95%CI 23.4-52.2) in Rio Branco to 80.4% (95%CI 67.2-89.1) in Florianópolis. Among the Brazilian regions, it ranged from 45.5% (95%CI 40.0-51.2) in the North to 67.6% (95%CI 59.4-74.9) in the South. Higher percentages of schools with higher AEPSB were found in public schools [58.1% (95%CI 54.9-61.2)] and in capitals and regions with higher Human Development Index [61.0% (95%IC 55.8-66.0) and 57.4% (95%CI 53.2-61.4), respectively] and lower Gini index [55.7% (95%CI 51.2-60.0) and 52.8 (95%CI 49.8-55.8), respectively]. CONCLUSIONS: The potential to support oral health promotion in schools in Brazilian capitals, assessed by the AEPSB indicator, was associated with contextual factors of schools, capitals and Brazilian regions.


Assuntos
Inquéritos de Saúde Bucal/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Serviços de Saúde Escolar/estatística & dados numéricos , Meio Social , Adolescente , Brasil/epidemiologia , Estudos Transversais , Comportamento Alimentar , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Geografia , Humanos , Masculino , Valores de Referência , Fatores de Risco , Instituições Acadêmicas/estatística & dados numéricos , Fatores Socioeconômicos , Análise Espacial
13.
BMC Public Health ; 19(1): 1393, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660918

RESUMO

BACKGROUND: Limited research has been conducted on the effectiveness of sexuality education for very young adolescents (VYAs) ages 10-14 years in Sub-Saharan Africa. Furthermore, evaluations of sexuality education programs often report outcomes of risky sexual practices, yet positive aspects of sexuality are hardly studied and rarely reported. This study evaluates the effectiveness of a Comprehensive Sexuality Education (CSE) intervention for VYAs in Uganda, analyzing both positive and negative outcome indicators. METHODS: We conducted a mixed methods study, incorporating a cluster randomized trial (NCT03669913) among pupils in 33 randomly selected primary schools in Mbarara district. This was followed by a qualitative evaluation of the intervention in 4 schools that included 14 in-depth interviews and 3 focus group discussions distributed among pupils, teachers and parents. Quantitative data were analyzed using ordered logistic regression to compare differences in the change from baseline to endline between the intervention and control arms. We conducted bivariate analysis and multiple regression analysis controlling for key covariates, including age, gender, school location (rural vs urban), truancy, and orphanhood. Qualitative data were analyzed by thematic approach using ATLAS TI. RESULTS: Between July 2016 and August 2017, 1096 pupils were recruited. Outcomes were studied among 380 pupils in the intervention arm and 484 pupils in the control arm. The proportion of pupils who ever had sex increased from 9 to 12.1% in intervention compared to 5.2 to 7.4% in the control group between baseline and endline, however the differences between groups were not statistically significant. We found greater improvements in sexual and reproductive health (SRH) knowledge among intervention schools (AOR: 2.18, 95% CI: 1.66-2.86) and no significant differences in self-esteem, body image or gender equitable norms. Qualitative evidence echoes perceived SRH knowledge acquisition, increased their perception of SRH related risks, and intentions to delay sexual intercourse to prevent unwanted pregnancy, HIV and other STIs. CONCLUSION: This study demonstrates that CSE can improve SRH knowledge and behavioral intentions among VYAs in Uganda. These results further emphasize the importance of initiating sexuality education before most adolescents have started engaging in sexual activity, enabling them to make informed decisions in the future. TRIAL REGISTRATION: NCT03669913 , registered retrospectively on September 13th, 2018.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , População Rural , Serviços de Saúde Escolar , Educação Sexual , Estudantes/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino , Gravidez , Avaliação de Programas e Projetos de Saúde , População Rural/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Uganda
14.
BMC Public Health ; 19(1): 1413, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664974

RESUMO

BACKGROUND: Adolescence is crucial period for laying the foundations for healthy development and mental well-being. The increasing prevalence of mental disorders amongst adolescents makes promotion of mental well-being and prevention interventions at schools important. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is designed as a whole school approach (school community, students and families) to promote a culture of mental well-being and prevent mental disorders by enhancing resilience capacities. The present article aims at describing the rationale, conceptual framework, as well as methodology of implementation and evaluation of the UPRIGHT intervention. METHODS: UPRIGHT project is a research and innovation project funded by the European Union's Horizon 2020 Research and Innovation programme under grant agreement No. 754919 (Duration: 48 months). The theoretical framework has been developed by an innovative and multidisciplinary approach using a co-creation process inside the UPRIGHT Consortium (involving seven institutions from Spain, Italy, Poland, Norway, Denmark, and Iceland). Resulted is the UPRIGHT programme with 18 skills related to 4 components: Mindfulness, Coping, Efficacy and Social and Emotional Learning. Among the five Pan-European regions, 34 schools have been currently involved (17 control; 17 intervention) and around 6000 adolescents and their families are foreseen to participate along a 3-year period of evaluation. Effectiveness of the intervention will be evaluated as a randomized controlled trial including quantitative and qualitative analysis in the five Pan-European regions representative of the cultural and socioeconomic diversity. The cost-effectiveness assessment will be performed by simulation modelling methods. DISCUSSION: We expect a short- to medium-term improvement of mental well-being in adolescents by enhancing resilience capacities. The study may provide robust evidence on intrapersonal, familiar and social environmental resilience factors promoting positive mental well-being. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03951376 . Registered 15 May 2019.


Assuntos
Saúde Mental , Resiliência Psicológica , Serviços de Saúde Escolar , Estudantes/psicologia , Adolescente , Criança , Europa (Continente) , Humanos , Projetos de Pesquisa , Estudantes/estatística & dados numéricos
15.
BMC Public Health ; 19(1): 1406, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664976

RESUMO

BACKGROUND: Cost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique's school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program. METHODS: We collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods-identification and measurement of resource quantities and valuation by application of unit costs, and gross costing-for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program. RESULTS: The total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15-$23) in year two, and $24 (CI: $22-$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively. CONCLUSION: National adaptation and scale-up of Mozambique's school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/economia , Serviços de Saúde Escolar/economia , Serviços de Saúde Escolar/organização & administração , Criança , Custos e Análise de Custo , Feminino , Humanos , Esquemas de Imunização , Moçambique/epidemiologia , Infecções por Papillomavirus/epidemiologia , Avaliação de Programas e Projetos de Saúde
16.
Rev Lat Am Enfermagem ; 27: e3174, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596409

RESUMO

OBJECTIVE: to analyze the contributions of the in situ simulation in the self-confidence of early childhood and elementary education teachers regarding the initial management of health complications in school. METHOD: this is a pre-post testing quasi-experimental study. Two pre and post in situ simulation instruments were applied to 76 teachers, namely: visual analogue scale of teachers' self-confidence in the management of health complications at school, and a questionnaire to assess their knowledge on the subject. The educational activity was composed of four scenarios of in situ simulation. The data were analyzed by descriptive and analytical statistics using univariate and multivariate linear regression. RESULTS: the comparison of results of pre and post in situ simulation self-confidence identified promotion of self-confidence (p<0.001), especially for those teachers with less professional experience (p=0.008), without previous similar experience (p=0.003) and who actively participated in the simulation (p=0.009). CONCLUSION: the teachers feel uncomfortable to handle health complications. The in situ simulation elevated the perception of self-confidence among teachers.


Assuntos
Serviços de Saúde Escolar , Professores Escolares , Autoimagem , Treinamento por Simulação , Adulto , Brasil , Educação Profissionalizante/métodos , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Tempo
17.
Artigo em Inglês | MEDLINE | ID: mdl-31540214

RESUMO

Health literacy as a set of competencies to promote and sustain health has received significant research attention, particularly in studies on adults. Improving health literacy at an early age is crucial to personal health and development, so there is a need to investigate the health literacy of school-aged children. The aims of this study were to determine the level of subjective health literacy among adolescents in Lithuania and to examine the association between health literacy, school achievement, health education in schools, and family affluence. Health literacy was assessed using a brief Health Literacy for School-Aged Children instrument on a representative sample of 2369 subjects (from the 7th to 10th grades). Overall, 12.1% of all respondents had low, 70.5% moderate, and 17.4% a high level of health literacy. School achievements were found to be a significant predictor of health literacy, as were the number of school-based health promotion events. Family affluence also predicted an increased level of health literacy. This study was the first nationally representative examination of this topic in Lithuania and it highlighted the alarming finding that less than one-fifth of adolescents had high health literacy.


Assuntos
Alfabetização em Saúde , Sucesso Acadêmico , Adolescente , Feminino , Humanos , Lituânia , Masculino , Serviços de Saúde Escolar , Instituições Acadêmicas , Autorrelato
18.
BMC Public Health ; 19(1): 1239, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500603

RESUMO

BACKGROUND: Primary schools are valuable settings to implement healthy lifestyle (healthy eating and physical activity) interventions, aimed at targeting childhood obesity. This study explored school staff perceptions of factors that hinder and enable successful implementation and sustainability of healthy lifestyle interventions in primary schools. Qualitative data was pooled and analysed from two evaluations carried out in primary schools in North England: a feasibility study of a nutrition and physical activity educational programme (PhunkyFoods Feasibility Study), and an evaluation of a healthy eating programme (The Food Dudes Evaluation). METHODS: Sixty-five qualitative semi-structured interviews were conducted with head teachers, teachers, catering managers, designated school-based programme coordinators and programme staff supporting schools with programme delivery, at 14 schools involved in both evaluations. Thematic analysis was undertaken and emergent themes categorised using a framework for successful implementation by Durlak and Dupre (2008). RESULTS: Overall, all schools were delivering a range of healthy lifestyle programmes, often with overlapping content. Perceived challenges to implementation of individual programmes included: limited time, timing of implementation, limited training and support, insufficient resources, capacity and facilities, staff perceptions of intervention and perceived skill-proficiency (for cooking and physical activities). Short-term funding, lack of external and internal support were perceived to hinder sustainability. Staff recommendations for successful implementation of future programmes included: extended training and planning time, sufficient capacity, external support for delivery, good resources (interactive, practical and adaptable), and facilities for cooking, healthy eating, gardening and physical activities. Head teachers need to prioritise delivery of a few key healthy lifestyle programmes, in an overcrowded curriculum. Schools need to employ strategies to engage participation of staff, pupils and parents long term. CONCLUSIONS: Effective implementation of school-based healthy lifestyle programmes was thought to be aided by flexible and adaptable programmes, enabling good contextual fit, well-resourced programmes and effective leadership at multiple levels, pupil (pupils support delivery) and parent involvement. To facilitate sustainability, it was perceived that programmes need to be integrated within the curriculum and school policies long term, with sustained support from head teachers and staff. These findings are relevant to programme developers, policy makers and those involved in delivering interventions.


Assuntos
Obesidade Pediátrica/prevenção & controle , Serviços de Saúde Escolar/organização & administração , Professores Escolares/psicologia , Instituições Acadêmicas/organização & administração , Criança , Inglaterra , Exercício , Humanos , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa
19.
BMC Public Health ; 19(1): 1203, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477088

RESUMO

BACKGROUND: Few adolescent girls engage in enough physical activity (PA) to meet recommendations and there is a need for new interventions to increase girls PA. We have previously published the results of the PLAN-A cluster randomised feasibility trial which was a peer-led school-based PA intervention, showing that the intervention was feasible and held promise to increase the PA of girls aged 12-13 years. In PLAN-A, pupils nominated by their peers as influential attend training to teach them how to influence, promote and normalise physical activity amongst their peer-group. This paper reports the results of the process evaluation of the PLAN-A feasibility study, specifically focussing on acceptability to key stakeholders, intervention fidelity, receipt/experiences and perceived effect and suggested intervention refinements before proceeding to a definitive RCT. METHODS: A mixed-methods process evaluation triangulated data from qualitative focus groups and interviews with peer-supporter and non peer-supporter pupils (N = 52), parents (N = 12), teachers (N = 6) and intervention training deliverers (N = 5), quantitative questionnaires, and observations of intervention delivery. Quantitative data were analysed descriptively, and qualitative data were analysed with the Framework Method. RESULTS: The duration, timings, content and delivery of the peer-supporter training were acceptable. There was good fidelity to the intervention manual and its underpinning theory including high fulfilment of session objectives and use of an autonomy-supportive motivational style. Peer-supporters engaged with and enjoyed the training and retained key peer-supporter messages (what counts as PA, encouragement, empathy and subtlety). Parents and teachers were supportive of the intervention and reported perceived effects including increased PA and awareness of it, improved peer relationships, and confidence. Suggested intervention refinements included increasing participatory learning, reducing technical jargon, and providing more support to overcome challenges to giving peer support. CONCLUSIONS: PLAN-A can be delivered as planned, is well-received, and appears to be effective in empowering adolescent girls to support their peer group to become more active. The refinements identified can be made within the original intervention structure, before proceeding to a definitive trial. TRIAL REGISTRATION: ISCTRN, ISRCTN12543546 , Registered on 28/7/2015.


Assuntos
Exercício/psicologia , Infuência dos Pares , Serviços de Saúde Escolar/organização & administração , Adolescente , Criança , Estudos de Viabilidade , Feminino , Grupos Focais , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Inquéritos e Questionários
20.
Bull Soc Pathol Exot ; 112(2): 90-95, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31478618

RESUMO

Schools are considered as one of the most effective vectors for education on sexually transmitted diseases among young people. We report here the results of a study of HIV infection as presented in school textbooks in Ivory Coast, conducted in June 2018 as part of the development of a communication strategy to increase demand for HIV infection testing, especially among young people. Surprisingly, even though the textbooks studied were published between 2007 and 2017, almost all of them stated that HIV infection leads to death, with no mention of the existence of treatments that make it possible to live in good health. Some textbooks even stated that no treatment is available. These findings highlight one cause - perhaps major - for the reluctance of young people to get tested. The misrepresentation of HIV infection, reinforced by education, hampers incentive campaigns for HIV testing, for which the best argument is that awareness of a positive HIV status makes it possible to benefit from treatment. The present study included textbooks from the French educational program, used throughout French-speaking Africa, and from the Ivory Coast program. It would be interesting to conduct a similar study in other French-speaking and English-speaking African countries. Adapting the presentation of HIV in school textbooks to reflect the current situation in the fight against HIV infection should be a priority.


Assuntos
Comunicação , Infecções por HIV , Serviços de Saúde Escolar , Livros de Texto como Assunto , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/transmissão , Atitude Frente a Saúde , Costa do Marfim/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , HIV-1/fisiologia , HIV-2/fisiologia , Promoção da Saúde/métodos , Promoção da Saúde/normas , Humanos , Conhecimento , Linguagem , Programas de Rastreamento/psicologia , Serviços de Saúde Escolar/normas , Serviços de Saúde Escolar/estatística & dados numéricos , Educação Sexual/normas , Educação Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Doenças Sexualmente Transmissíveis/transmissão , Livros de Texto como Assunto/normas
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