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1.
BMC Public Health ; 19(1): 813, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234822

RESUMO

BACKGROUND: Tobacco is the main cause of non-communicable disease and premature death globally. Implementing restrictive school tobacco policies such as smoke-free-school-hours (SFSH) may have the potential to reduce smoking among Vocational Education and Training (VET) school students. To be effective, school tobacco policies that largely involve strict and consistent enforcement by both managers and teaching teaching staff must be implemented. This study investigated the attitudes towards the implementation of SFSH among the managers and teaching staff at Danish VET schools. METHODS: The analyses were based on cross-sectional survey data collected with an online survey among managers and teaching staff at Danish VET schools. The data was collected from March to June 2017. RESULTS: Managers and teaching staff (n = 571) from 71 out of 87 Danish VET schools (81.6%) took part in the survey. In the adjusted analysis, teaching staff were twice as likely as managers to have a favourable attitude towards SFSH. Furthermore, being female and of increasing age correlated with having a favourable attitude. A trend towards schools in favour of SFSH having more health promotion facilities, policy and practice, was identified. CONCLUSION AND IMPLICATIONS: Existing health promotion facilities and activities at the schools were associated with a favorable attitude among the management towards implementing SFSH. Thus, implementing other health promotion activities and policies might be an important first step to establish readiness to implement SFSH.


Assuntos
Promoção da Saúde/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Professores Escolares/psicologia , Política Antifumo , Educação Vocacional/legislação & jurisprudência , Adulto , Estudos Transversais , Dinamarca , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
3.
Pediatrics ; 143(6)2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31113831

RESUMO

BACKGROUND AND OBJECTIVES: California implemented Senate Bill 277 (SB277) in 2016, becoming the first state in nearly 30 years to eliminate nonmedical exemptions from immunization requirements for schoolchildren. Our objectives were to determine (1) the impacts of SB277 on the percentage of kindergarteners entering school not up-to-date on vaccinations and (2) if geographic patterns of vaccine refusal persisted after the implementation of the new law. METHODS: At the state level, we analyzed the magnitude and composition of the population of kindergarteners not up-to-date on vaccinations before and after the implementation of SB277. We assessed correlations between previous geographic patterns of nonmedical exemptions and patterns of the remaining entry mechanisms for kindergarteners not up-to-date after the law's implementation. RESULTS: In the first year after SB277 was implemented, the percentage of kindergartners entering school not up-to-date on vaccinations decreased from 7.15% to 4.42%. The conditional entrance rate fell from 4.43% to 1.91%, accounting for much of this decrease. Other entry mechanisms for students not up-to-date, including medical exemptions and exemptions for independent study or homeschooled students, largely replaced the decrease in the personal belief exemption rate from 2.37% to 0.56%. In the second year, the percentage of kindergartners not up-to-date increased by 0.45%, despite additional reductions in conditional entrants and personal belief exemptions. The correlational analysis revealed that previous geographic patterns of vaccine refusal persisted after the law's implementation. CONCLUSIONS: Although the percentage of incoming kindergarteners up-to-date on vaccinations in California increased after the implementation of SB277, we found evidence for a replacement effect.


Assuntos
Política de Saúde/legislação & jurisprudência , Imunização/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Recusa de Vacinação/legislação & jurisprudência , Vacinação/legislação & jurisprudência , California/epidemiologia , Criança , Pré-Escolar , Feminino , Política de Saúde/tendências , Humanos , Imunização/tendências , Masculino , Serviços de Saúde Escolar/tendências , Instituições Acadêmicas/legislação & jurisprudência , Instituições Acadêmicas/tendências , Vacinação/tendências , Recusa de Vacinação/tendências , Vacinas/uso terapêutico
5.
Curationis ; 42(1): e1-e8, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30843403

RESUMO

BACKGROUND:  Implementation of the Integrated School Health Policy (ISHP) requires strong intersectoral collaboration on the part of key role players such as the Department of Health, Department of Basic Education and Department of Social Development. These departments and educational structures such as school governing bodies, teacher unions and learner organisations, academic institutions, civil society and development partner organisations are also expected to contribute to the development of sustainable and comprehensive school health programmes. OBJECTIVES:  The objective of this study was to describe the compliance of the schools in the City of Tshwane to the ISHP in 2015. METHOD:  A quantitative, explorative and descriptive study was conducted in the City of Tshwane using a questionnaire to determine the extent of compliance to the application of the ISHP in selected schools. RESULTS:  The results indicated a widespread non-compliance to ISHP programmes. There was insufficient stakeholder integration in the school health programmes at schools in the City of Tshwane. CONCLUSION:  The lack of collaboration with relevant stakeholders in school health service delivery will lead to a fragmented, uncoordinated and unsustainable approach to the execution of ISHP programmes. This might result in delayed or no detection and intervention in cases of, among others, mental, psychosocial and health challenges to learning, as well as development of nutrition-related conditions.


Assuntos
Acreditação/métodos , Política de Saúde/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Acreditação/tendências , Estudos Transversais , Promoção da Saúde/métodos , Humanos , Avaliação de Programas e Projetos de Saúde/métodos , Serviços de Saúde Escolar/tendências , África do Sul , Inquéritos e Questionários
6.
Artigo em Inglês | MEDLINE | ID: mdl-30717312

RESUMO

Health and education are interrelated, and it is for this reason that we studied the education of migrant children. The Thai Government has ratified 'rights' to education for all children in Thailand since 2005. However, there are gaps in knowledge concerning the implementation of education policy for migrants, such as whether and to what extent migrant children receive education services according to policy intentions. The objective of this study is to explore the implementation of education policy for migrants and the factors that determine education choices among them. A cross-sectional qualitative design was applied. The main data collection technique was in-depth interviews with 34 key informants. Thematic analysis with an intersectionality approach was used. Ranong province was selected as the main study site. Results found that Migrant Learning Centers (MLCs) were the preferable choice for most migrant children instead of Thai Public Schools (TPSs), even though MLCs were not recognized as formal education sites. The main reason for choosing MLCs was because MLCs provided a more culturally sensitive service. Teaching in MLCs was done in Myanmar's language and the MLCs offer a better chance to pursue higher education in Myanmar if migrants migrate back to their homeland. However, MLCs still face budget and human resources inadequacies. School health promotion was underserviced in MLCs compared to TPSs. Dental service was underserviced in most MLCs and TPSs. Implicit discrimination against migrant children was noted. The Thai Government should view MLCs as allies in expanding education coverage to all children in the Thai territory. A participatory public policy process that engages all stakeholders, including education officials, health care providers, Non-Governmental Organizations (NGOs), MLCs' representatives, and migrants themselves is needed to improve the education standards of MLCs, keeping their culturally-sensitive strengths.


Assuntos
Educação Especial/legislação & jurisprudência , Educação Especial/organização & administração , Migrantes/educação , Adulto , Criança , Estudos Transversais , Educação Especial/economia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar/etnologia , Serviços de Saúde Escolar/legislação & jurisprudência , Serviços de Saúde Escolar/provisão & distribução , Ensino , Tailândia
7.
Health Promot J Austr ; 30(2): 276-280, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29577478

RESUMO

ISSUE ADDRESSED: Whole-of-setting initiatives have been recommended as an equitable approach to health promotion. However, there has been little analysis of differences in uptake of such approaches according to indicators of socioeconomic position. In Victoria, Australia, the Achievement Program is a state government health promotion initiative that uses a whole-of-setting approach in early childhood services, schools and workplaces. We conducted an exploratory comparison of uptake of and progression through the programme by schools and early childhood services in one local area, according to area-level socioeconomic position. METHODS: Approximately 3 years after programme initiation, we linked data on the progress of 89 early childhood services and 67 primary schools to an area-level index of relative socioeconomic disadvantage. We compared uptake of and progression through the programme by setting (service or school) and quartiles of socioeconomic position. RESULTS: About 89% of early childhood services and 70% of primary schools had registered for the programme, with 18% and 15%, respectively, attaining the goal of completing the final stage. A greater proportion of settings in areas in the most disadvantaged quartile had registered for the programme and completed the final stage of the programme, compared with settings in areas in the least disadvantaged quartile. However, variation by socioeconomic position was not linear across quartiles. CONCLUSION: The Achievement Program did not appear to be inequitable in its uptake. Research into uptake in other local areas and outcomes achieved would be beneficial. SO WHAT?: This demonstrates that whole-of-setting approaches can potentially be an equity-enhancing approach to health promotion.


Assuntos
/legislação & jurisprudência , Promoção da Saúde/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Fatores Socioeconômicos , /métodos , Promoção da Saúde/métodos , Humanos , Vitória
8.
Transl Behav Med ; 9(2): 246-255, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29800423

RESUMO

The Daily Physical Activity (DPA) policy in British Columbia requires elementary schools to help students achieve 30 min of physical activity during instructional and noninstructional time on school days. The purpose of this study was to determine how elementary teachers implement the DPA policy, and examine differences in children's light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) at school, based on how the teacher implemented the DPA policy during the school day (provision of DPA during instructional time or only noninstructional time). In this observational mixed-methods study, 12 teachers were interviewed on their implementation approaches. Teachers provided DPA opportunities during instructional time (i.e., prescriptive implementers, n = 9) or relied on students to be active during noninstructional times (i.e., nonprescriptive, n = 3). Next, 10 students from each interviewed teacher's classroom were randomly selected to wear accelerometers for one school week. Hierarchical linear modeling was used to examine the contribution of teacher's implementation strategy on student's activity levels. t-Tests examined differences in students' activity levels between implementation groups. Teacher's DPA implementation strategy accounted for a significant proportion of variance in student's activity throughout the school day (p's < .05). The prescriptive group (n = 88) was more active (LPA and MVPA) and spent a greater proportion of their school days in MVPA during instructional time than the nonprescriptive group (n = 23). Heterogeneity in policy implementation creates variations in policy effectiveness. Students provided with opportunities to be active during instructional time may accumulate more MVPA compared with those who are not given these opportunities. Registration: Not applicable.


Assuntos
Exercício , Promoção da Saúde/legislação & jurisprudência , Instituições Acadêmicas , Acelerometria , Colúmbia Britânica , Criança , Feminino , Política de Saúde , Promoção da Saúde/métodos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Serviços de Saúde Escolar/legislação & jurisprudência , Professores Escolares , Ensino/legislação & jurisprudência , Fatores de Tempo , Dispositivos Eletrônicos Vestíveis
9.
NASN Sch Nurse ; 34(2): 113-116, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30222037

RESUMO

Nurses are familiar with policy at the federal, state, local, and institutional levels, but drafting a policy memo might be new to some. School nurses may have an interest in writing a health policy memo on their own, with colleagues, as part of a nursing organization, or with students who are interested in learning about policy development, school health, and safety. The intention of writing a policy memo is to offer a concisely written analysis of an issue, including background, landscape, and available options, along with recommendations for action to persons in authority, such as congressmen, senators, local officials, or school boards. The first section of this article serves as an exemplar of a policy memo, using the public health topic of asthma. Next, the article focuses on barriers to policy development for this condition in schools and offers selected strategies to address those barriers. While a discourse concerning barriers is not a typical component of a policy memo, this section shows how school nurses can draw on evidence to consider the best way to make positive change. To construct a sturdy argument for change, school nurses need to appreciate potential counterarguments, which is why this exemplar is included.


Assuntos
Asma/prevenção & controle , Defesa da Criança e do Adolescente , Política de Saúde , Serviços de Enfermagem Escolar , Asma/enfermagem , Criança , Humanos , Serviços de Saúde Escolar/legislação & jurisprudência , Estados Unidos
10.
J Acad Nutr Diet ; 119(3): 490-499, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30473488

RESUMO

BACKGROUND: The Healthy, Hunger-Free Kids Act (HHFKA) 2010 updated standards to increase the nutritional quality of school meals. Studies of HHFKA outcomes have focused primarily on fruit and vegetables, nutrient quality of whole meals, and plate waste. OBJECTIVE: To examine changes in school lunch entrée nutrient quality and student selections after HHFKA implementation. DESIGN: Descriptive, longitudinal study analyzing 1.7 million student-selected lunch entrées in eight entrée categories. PARTICIPANTS/SETTING: Three middle schools and three high schools in an urban school district in Washington State, from January 2011 to January 2014 (16 months before and 15 months after HHFKA implementation). MAIN OUTCOME MEASURES: Nutritional quality of each entrée category was assessed by analyzing mean adequacy ratio, energy density, and energy per serving. Selection was determined by analyzing number of entrées in each category selected by students. STATISTICAL ANALYSES PERFORMED: Comparison of indices of pre- and postimplementation nutritional quality using a combination of Wilcoxon two-sample test with t approximation and a two-sided alternative t test assuming equal variances and t test assuming unequal variances using Satterthwaite approximation. Quantity of entrée categories selected was also determined by Satterthwaite approximation. RESULTS: After implementation, there was significant improvement in mean adequacy ratio and energy per serving overall for all entrées combined. There were significant improvements in both mean adequacy ratio and energy per serving for salads, burritos, and pizza in middle schools and for hot sandwiches and burritos in high schools. For energy density, middle schools also had significant decreases for casseroles and salads, with no significant changes found in high schools. The variety of entrées decreased by 44%, and there were significant changes in the proportions of entrées selected from specific food categories. CONCLUSION: Nutritional quality of lunch entrées, variety of entrées available, and student entrée selections changed after implementation of HHFKA policy in one urban school district in Washington State.


Assuntos
Serviços de Alimentação/estatística & dados numéricos , Implementação de Plano de Saúde/estatística & dados numéricos , Política Nutricional/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Estudantes/estatística & dados numéricos , Adolescente , Criança , Feminino , Preferências Alimentares/psicologia , Serviços de Alimentação/legislação & jurisprudência , Humanos , Fome , Estudos Longitudinais , Almoço , Masculino , Valor Nutritivo , Estudantes/psicologia , Washington
11.
JAMA Pediatr ; 173(2): 169-175, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30575857

RESUMO

Importance: Children experiencing anaphylaxis at school may lack access to a personal epinephrine device, prompting recent legislation permitting undesignated (eg, non-student specific) stock epinephrine autoinjector units at school. However, epinephrine device costs vary, and the cost-effectiveness of undesignated school stock epinephrine is uncharacterized to date. Objective: To define value-based strategies for undesignated school stock epinephrine programs. Design, Setting, and Participants: Markov simulations of the Chicago Public Schools system were used over extended time horizons to model 2 school stock epinephrine autoinjector policies to provide access for at-risk students. The dates of the data used in the analysis were September 2017 to June 2018 (the 2017-2018 school year). Main Outcomes and Measures: This study compared the following 3 strategies: no school undesignated epinephrine supply, school undesignated supplemental epinephrine supply (supplemental model), and school undesignated universal epinephrine supply (universal model). The base-case model assumed a 10-fold reduced fatality risk with having undesignated stock epinephrine units available vs not having undesignated stock epinephrine units available. Costs of school stock epinephrine units available for acquisition by schools were evaluated from a societal perspective. Quality-adjusted life-years (QALYs) and total epinephrine acquisition expenses were calculated. Results: Based on Markov simulations of the Chicago Public Schools system (371 382 students), the cost was $107 816 (95% CI, $107 382-$108 250) for no school undesignated epinephrine supply compared with $108 160 (95% CI, $107 725-$108 595) for the supplemental model and $100 397 (95% CI, $99 979-$100 815) for the universal model. Undesignated stock epinephrine improved outcomes, with 26.869 (95% CI, 26.841-26.897) QALYs accrued as the model concluded compared with 26.867 (95% CI, 26.839-26.896) QALYs for the strategy without undesignated stock epinephrine. When comparing supplemental model stock epinephrine to the strategy without undesignated devices, the incremental cost-effectiveness ratio was high at $268 811 per QALY in the base-case simulation. However, the cost of the supplemental model fell below $100 000 per QALY when the annual undesignated epinephrine acquisition costs did not exceed $338 per school (compared with stock epinephrine unavailability). The universal model dominated all others and was associated with significant cost savings ($7419 per student at risk who would otherwise be prescribed an individual school epinephrine supply). Conclusions and Relevance: Undesignated school stock epinephrine is cost-effective at device acquisition costs not exceeding $338 per school per year, although a universal model vs a supplemental model is associated with superior health and economic outcomes.


Assuntos
Anafilaxia/tratamento farmacológico , Análise Custo-Benefício , Epinefrina/administração & dosagem , Custos de Cuidados de Saúde/estatística & dados numéricos , Hipersensibilidade a Amendoim/tratamento farmacológico , Serviços de Saúde Escolar/economia , Simpatomiméticos/administração & dosagem , Adolescente , Anafilaxia/economia , Chicago , Criança , Redução de Custos/estatística & dados numéricos , Epinefrina/economia , Epinefrina/uso terapêutico , Política de Saúde , Humanos , Injeções Intramusculares , Cadeias de Markov , Modelos Econômicos , Hipersensibilidade a Amendoim/economia , Anos de Vida Ajustados por Qualidade de Vida , Serviços de Saúde Escolar/legislação & jurisprudência , Simpatomiméticos/economia , Simpatomiméticos/uso terapêutico
12.
Lang Speech Hear Serv Sch ; 49(4): 810-816, 2018 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-30458542

RESUMO

Purpose: The purpose of this article is to provide an overview of recent dyslexia legislation and guidelines pertaining to services for students with dyslexia in public school settings and to describe possible implications for speech-language pathologists (SLPs). Method: In recent years, there has been increased attention focused on effectively meeting the needs of students with dyslexia nationwide. The Decoding Dyslexia organization has chapters in all 50 states in the nation, and they have been instrumental in promoting public awareness of the importance of improving services for students with dyslexia. As a result, new legislation, policies and guidelines have been introduced and developed in many states. California is an example of 1 state that has recently passed legislation in this area and released guidelines that serve as recommendations related to this law. This article provides a broad overview of recent dyslexia legislation, with more specific information pertaining to recent legislation and guidelines in the state of California. Clinical implications for SLPs who serve this population in school settings are also discussed. Conclusion: The information discussed in this article may serve as a useful model for states that are in the process of developing or revising their own policies or guidelines for meeting the needs of students with dyslexia.


Assuntos
Dislexia/reabilitação , Terapia da Linguagem/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Patologia da Fala e Linguagem/legislação & jurisprudência , Adolescente , Criança , Política de Saúde , Humanos , Terapia da Linguagem/métodos , Guias de Prática Clínica como Assunto , Estados Unidos
13.
J Athl Train ; 53(9): 873-879, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30284457

RESUMO

CONTEXT: : All 50 states and the District of Columbia have enacted laws governing concussion management and education. These concussion laws, featuring common tenets regarding removal from play, return to play, and concussion education, have shaped school and district policies. OBJECTIVE: : To evaluate the strategies commonly used to implement concussion laws at the school and district levels, as reported by certified athletic trainers (ATs). DESIGN: : Qualitative study. SETTING: : High schools. PATIENTS OR OTHER PARTICIPANTS: : We interviewed 64 ATs from high schools (1 per school) participating in High School Reporting Information Online. DATA COLLECTION AND ANALYSIS: : Interviews were conducted with participants between April and October 2015 regarding implementation of the 3 core tenets of concussion laws. Research team members independently evaluated the interview transcripts and field notes to identify common themes in implementation strategies. RESULTS: : Of the 64 schools represented, 90.6% were public schools, 89.1% sponsored more than 15 sports, and all schools employed at least 1 AT and had a written concussion policy. Four commonly used strategies to implement removal from play were reliance on coaches, immediate response, referral and guidance after injury, and notification of key individuals. Use of assessment or baseline tests, communication among parties involved, reliance on AT assessments, and return-to-learn policies were 4 frequent strategies to implement return to play. Finally, 3 major implementation strategies to effectuate concussion education were use of existing educational tools, timing of education, and concussion training for school professionals. CONCLUSIONS: : Although concussion laws were passed at different times and varied in content across states, common themes in implementation strategies emerged across jurisdictions. The identification of strategic approaches to implementation will help ensure proper concussion management and education, reducing negative health outcomes among youths with concussions.


Assuntos
Traumatismos em Atletas/terapia , Concussão Encefálica/terapia , Serviços de Saúde Escolar/legislação & jurisprudência , Instituições Acadêmicas , Esportes Juvenis/legislação & jurisprudência , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Humanos , Pesquisa Qualitativa , Volta ao Esporte , Medicina Esportiva
14.
J Sch Health ; 88(10): 776-784, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30203483

RESUMO

BACKGROUND: Asthma has no known cure, and though manageable, it disrupts the everyday lives of over 6 million US children. Because children spend more than half of their waking hours in school, students must be able to carry and administer their inhaler at school to manage their asthma. METHODS: This policy paper is a comprehensive review of all 50 states and the District of Columbia's laws and policies for the self-carry and administration of quick-relief asthma inhalers among children in prekindergarten through 12th grade. RESULTS: All states permit students to carry and administer their inhalers at school, although each state differs in their development and implementation of policies for asthma self-management at school. This review examines how states regulate self-carry policies by looking at policy development, regulated school systems, relevant stakeholders, required medical records, and school liability. CONCLUSIONS: Each state's laws have nuances that create gray areas, increasing the potential of misinterpreted or incorrectly implemented policies for asthma self-management at school. As a result, children may not have immediate access to their inhaler for symptom management or in an emergency. State policymakers should reform current laws to remove barriers for students to carry and use inhalers at school.


Assuntos
Asma/prevenção & controle , Asma/terapia , Crianças com Deficiência/legislação & jurisprudência , Direitos do Paciente/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Estudantes/legislação & jurisprudência , Criança , Bem-Estar da Criança/legislação & jurisprudência , Política de Saúde , Humanos , Nebulizadores e Vaporizadores/estatística & dados numéricos , Serviços de Saúde Escolar/estatística & dados numéricos , Autoadministração/métodos , Estados Unidos
15.
Cad Saude Publica ; 34(5): e00104217, 2018 05 10.
Artigo em Português | MEDLINE | ID: mdl-29768585

RESUMO

This study evaluated the implementation of the School Health Program (PSE in Portuguese) in the city of Belo Horizonte, Minas Gerais State, Brazil, the mechanisms favoring inter-sector action, and municipal administrators' perceptions concerning inter-sector collaboration. A case study was developed with document search and the application of an online questionnaire. The document search analyzed federal and municipal legislation on the PSE published in the Federal Register and Municipal Register and news on the program published in the Municipal Register. A semi-structured online questionnaire was completed by 30 municipal administrators. Content analysis was used on the qualitative data from the document search and questionnaire. The quantitative data were interpreted by descriptive analysis using Stata v. 13. Integrative mechanisms were identified in the federal and municipal provisions and in the unique PSE model adopted by the city. These mechanisms can potentially promote permanent linkage between health and education. However, the study with municipal administrators showed limited use of these mechanisms and the predominance of a sector-based logic in the program. There was evident difficulty in developing inter-sector collaboration in the program's activities. The potentialities of inter-sector action identified in the official documents and described in the institutional news failed to reverberate in either the administrators' practices or the impact on the schools' territories.


Assuntos
Colaboração Intersetorial , Avaliação de Programas e Projetos de Saúde , Serviços de Saúde Escolar/organização & administração , Pessoal Administrativo/psicologia , Brasil , Comportamento Cooperativo , Publicações Governamentais como Assunto , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Relações Interinstitucionais , Percepção , Pesquisa Qualitativa , Serviços de Saúde Escolar/legislação & jurisprudência , Inquéritos e Questionários
17.
J Acad Nutr Diet ; 118(3): 455-463, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29111088

RESUMO

BACKGROUND: The changes in school meal programs stemming from the Healthy, Hunger-Free Kids Act of 2010 have expanded interest in strategies that increase student participation in school lunch and reduce plate waste. However, it remains unclear what factors are associated with schools' use of such strategies. OBJECTIVE: This study examines whether state laws are associated with two types of school meal-related practices: (a) using promotional strategies (ie, taste tests, using posters or announcements) and (b) duration of lunch periods. DESIGN: This cross-sectional study utilized the nationally representative 2014 School Health Policies and Practices Study, combined with corresponding state laws gathered by the National Wellness Policy Study. School data were available from 414 public schools in 43 states. MAIN OUTCOME MEASURES: Outcome measures included 16 strategies to promote school meals and the amount of time students had to eat lunch after being seated. STATISTICAL ANALYSES PERFORMED: Multivariate logistic regression and Poisson regression were used to examine associations between state laws and school practices, after accounting for school demographic characteristics. RESULTS: Compared to schools in states with no law about engaging stakeholders in meal programs, schools in states with a law were more likely to conduct taste tests (64% vs 44%, P=0.016), collect suggestions from students (67% vs 50%, P=0.017), and invite family members to a school meal (71% vs 53%, P=0.015). Schools used more promotion strategies in states with a law than in states without a law (mean=10.4 vs 8.8, P=0.003). Schools were more likely to provide students at least 30 minutes to eat lunch after being seated in states with laws that addressed a minimum amount of time for lunch duration (43% vs 27%, P=0.042). CONCLUSIONS: State-level policy provisions are associated with school practices. Policy development in more states may support school practices that promote lunch participation and consumption.


Assuntos
Serviços de Alimentação/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Política Nutricional/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Governo Estadual , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Almoço , Masculino , Análise Multivariada , Fatores de Tempo , Estados Unidos
19.
Glob Health Promot ; 25(1): 54-62, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27380769

RESUMO

BACKGROUND: In the lives of women, puberty is marked by the onset of menarche. From this stage onwards until menopause, reproductive health and menstrual hygiene are important aspects of women's lives. In Zambia's Western Province, the natural process of menstruation is a taboo and dealt with secretly. Information and knowledge about menstruation and menstrual hygiene among adolescent girls is inadequate. This paper explores the factors influencing the understanding, experiences and practices of menstrual hygiene among adolescent girls in Mongu District, Western Province of Zambia. METHODS: An explorative study design was used by means of six focus group discussions conducted with 51 respondents, aged 13-20 years, from three secondary schools. Their age at menarche was 11-15. For data analysis thematic content analysis was used. RESULTS: The paper shows that the girls suffer from poor menstrual hygiene, originating from lack of knowledge, culture and tradition, and socio-economic and environmental constraints, leading to inconveniences, humiliation and stress. This leads to reduced school attendance and poor academic performance, or even drop outs, and ultimately infringes upon the girls' human rights. CONCLUSION: To address these shortcomings, a 'super setting approach' is recommended, in which a Health Promoting School could improve the girls' individual and group needs, and a community setting which would address the broader socio-economic, cultural and environmental conditions. This would enable creating a supportive environment for the girls to manage their periods. To successfully utilize the approach, all stakeholders (parents, teachers, children, governments and communities) should cooperate to generate context-specific solutions for creating safe menstrual care, and better and dignified conditions for adolescent girls. Therefore, this calls for comprehensive, strident advocacy for policy changes at national level, and mediation and involvement at community level.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Higiene , Menstruação , Adolescente , Feminino , Promoção da Saúde , Humanos , Menarca , Pesquisa Qualitativa , Saúde Reprodutiva/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Instituições Acadêmicas , Fatores Socioeconômicos , Adulto Jovem , Zâmbia
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