scholarly journals Process evaluation of the Healthy Primary School of the Future: the key learning points

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
N. H. M. Bartelink ◽  
P. van Assema ◽  
M. W. J. Jansen ◽  
H. H. C. M. Savelberg ◽  
G. F. Moore ◽  
...  
Keyword(s):  
Health Promotion ◽  
Primary School ◽  
Process Evaluation ◽  
School System ◽  
School Health ◽  
Team Cohesion ◽  
School Health Promotion ◽  
Top Down ◽  
Bottom Up ◽  
Health Promoting

Abstract Background While schools have potential to contribute to children’s health and healthy behaviour, embedding health promotion within complex school systems is challenging. The ‘Healthy Primary School of the Future’ (HPSF) is an initiative that aims to integrate health and well-being into school systems. Central to HPSF are two top-down changes that are hypothesized as being positively disruptive to the Dutch school system: daily free healthy lunches and structured physical activity sessions. These changes are expected to create momentum for bottom-up processes leading to additional health-promoting changes. Using a programme theory, this paper explores the processes through which HPSF and the school context adapt to one another. The aim is to generate and share knowledge and experiences on how to implement changes in the complex school system to integrate school health promotion. Methods The current study involved a mixed methods process evaluation with a contextual action-oriented research approach. The processes of change were investigated in four Dutch primary schools during the development year (2014–2015) and the first two years of implementation (2015–2017) of HPSF. The schools (each with 15–26 teachers and 233–389 children) were in low socio-economic status areas. Measurements included interviews, questionnaires, observations, and analysis of minutes of meetings. Results Top-down advice, combined with bottom-up involvement and external practical support were key facilitators in embedding HPSF within the schools’ contexts. Sufficient coordination and communication at the school level, team cohesion, and feedback loops enhanced implementation of the changes. Implementation of the healthy lunch appeared to be disruptive and create momentum for additional health-promoting changes. Conclusions Initiating highly visible positive disruptions to improve school health can act as a catalyst for wider school health promotion efforts. Conditions to create a positive disruption are enough time, and sufficient bottom-up involvement, external support, team cohesion and coordination. The focus should be on each specific school, as each school has their own starting point and process of change. Trial registration The study was retrospectively registered in the ClinicalTrials.gov database on 14 June 2016 (NCT02800616).

scholarly journals Implementation of KEIGAAF in Primary Schools: A Mutual Adaptation Physical Activity and Nutrition Intervention

2020 ◽  
Vol 17 (3) ◽  
pp. 751 ◽  
Author(s):  
Sacha R.B. Verjans-Janssen ◽  
Sanne M.P.L. Gerards ◽  
Anke H. Verhees ◽  
Stef P.J. Kremers ◽  
Steven B. Vos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Primary Schools ◽  
School Health ◽  
Contextual Factors ◽  
Nutrition Intervention ◽  
School Health Promotion ◽  
Top Down ◽  
Bottom Up ◽  
Mutual Adaptation

School health promotion is advocated. Implementation studies on school health promotion are less often conducted as effectiveness studies and are mainly conducted conventionally by assessing fidelity of “one size fits all” interventions. However, interventions that allow for local adaptation are more appropriate and require a different evaluation approach. We evaluated a mutual adaptation physical activity and nutrition intervention implemented in eight primary schools located in low socioeconomic neighborhoods in the Netherlands, namely the KEIGAAF intervention. A qualitative, multiple-case study design was used to evaluate implementation and contextual factors affecting implementation. We used several qualitative data collection tools and applied inductive content analysis for coding the transcribed data. Codes were linked to the domains of the Consolidated Framework for Implementation Research. NVivo was used to support data analysis. The implementation process varied greatly across schools. This was due to the high level of bottom-up design of the intervention and differing contextual factors influencing implementation, such as differing starting situations. The mutual adaptation between top-down and bottom-up influences was a key element of the intervention. Feedback loops and the health promotion advisors played a crucial role by navigating between top-down and bottom-up. Implementing a mutual adaptation intervention is time-consuming but feasible.

What does co-creation mean? An attempt at definition informed by the perspectives of school health promoters in France

2021 ◽  
pp. 001789692110135
Author(s):  
Emily Darlington ◽  
Julien Masson
Keyword(s):  
Decision Making ◽  
Health Promotion ◽  
Creative Thinking ◽  
School Health ◽  
Added Value ◽  
School Health Promotion ◽  
Screening Process ◽  
School Settings ◽  
School Based ◽  
Health Promoting

Background: Capacity building and community-level participation are important to enhance the efficiency and sustainability of health promotion programmes, as well as to promote empowerment and decision-making power. However, stakeholders’ participation in the design and implementation of health promotion projects often involves the provision of information and consultation rather than partnership or citizen control, especially in school settings. Co-creation could be a means to support higher levels of participation, yet its definition remains unclear. A further challenge relates to the methods needed to promote participation. Examining what co-creation represents for health promoters could help in both of these respects. Objectives and goals: This study explored how school health promotion professionals perceived and defined co-creation to gain insight into how to encourage co-creation processes in school-based health promotion. Methods: Qualitative data including documents and illustrations were collected during creative thinking activities undertaken with school health promotion professionals. All data collected were transcribed and analysed using a three-stage screening process. Results: Co-creation is a multi-dimensional construct. Based on our findings, it is a voluntary-based process of bottom-up collaboration informed by values of diversity, mutual trust, openness, autonomy, freedom, respect and shared expertise, responsibility and decision-making. Co-creation can result in out-of-the-box, new or improved tailored health-promoting practices and projects, which address a co-defined need, for the benefit of all members of the group. Conclusion: Co-creation is timely and key in school health promotion practices. Further research is needed into the specific competences needed to promote co-creation, as well as the methods used to evaluate achievements and added value of co-creation at different levels of implementation.

Socio-ecological school environments and children’s health and wellbeing outcomes

2015 ◽  
Vol 115 (3/4) ◽  
pp. 420-434 ◽  
Author(s):  
Yetunde O. John-Akinola ◽  
Saoirse Nic Gabhainn
Keyword(s):  
Health Promotion ◽  
School Environment ◽  
Primary Schools ◽  
School Health ◽  
School Policy ◽  
Ecological Environment ◽  
School Health Promotion ◽  
Content Type ◽  
Health And Wellbeing ◽  
Health Promoting

Purpose – Attention to improving the school environment is a common activity in school health promotion. The role of the school environment in supporting improved health and wellbeing has a theoretical base, but has rarely been directly investigated empirically. The purpose of this paper is to investigate the associations between school socio-ecological environment and health and wellbeing outcomes. Design/methodology/approach – Questionnaire data were collected from 231 pupils in nine primary schools: urban and rural; single and mixed gender; disadvantaged and non-disadvantaged; and health promoting schools (HPS) and non-HPS. Questionnaire items included perceptions of the school socio- ecological environment (school perception, class relationships, teacher relationships, school policy and parental participation) and health and wellbeing outcomes. Findings – Reported school perception (OR 1.21, 95 per cent CI 1.12-1.30), class relationships (OR 1.13, 95 per cent CI 1.06-1.21), relationship with teacher (OR 1.20, 95 per cent CI 1.11-1.29), perception of school policy (OR 1.25, 95 per cent CI 1.13-1.37) and parents’ participation in school life (OR 1.32, 95 per cent CI 1.15-1.51) were all significantly associated with health and wellbeing outcomes for all groups of pupils. Very few differences emerged between different school types on the measures of either school socio-ecological environment or measures of health and wellbeing. Originality/value – The socio-ecological environment is clearly related to general health and wellbeing outcomes, which underlines its relevance to school health promotion. The lack of discernable differences between HPS and non-HPS demonstrate the lack of clarity in definitions of the health promoting status of schools.

scholarly journals Children as messengers of health knowledge? Impact of health promotion and water infrastructure in schools on facial cleanliness and trachoma in the community

2021 ◽  
Vol 15 (2) ◽  
pp. e0009119
Author(s):  
Xinyi Chen ◽  
Beatriz Munoz ◽  
Harran Mkocha ◽  
Meraf A. Wolle ◽  
Sheila K. West
Keyword(s):  
Health Promotion ◽  
Primary School ◽  
Random Sample ◽  
Primary Schools ◽  
School Health ◽  
Health Messages ◽  
Water Infrastructure ◽  
School Health Promotion ◽  
Educational Materials ◽  
The Impact

Background Health promotion is essential to the SAFE strategy for trachoma elimination. Schools are a valuable venue for health promotion. However, there is little literature about the impact of health education and water infrastructure in schools on facial cleanliness and trachoma in the community. Our study aimed to describe the current state of school health promotion in Kongwa, Tanzania, and to examine the transferability of health messages from schools to the community at large. Methodology/Findings A cross-sectional survey was carried out in all 92 villages in Kongwa district, which included 85 primary schools. Data were collected on health messages and water infrastructure in the schools. A random sample of 3084 children aged 0–5 were examined for facial cleanliness in all villages. In 50 villages, a random sample of 50 children aged 1–9 per village were examined for follicular trachoma (TF). Thirty-seven (44.6%) schools had educational materials on face-washing. Fifty (60.2%) schools had a washing station. The presence of a health teacher was correlated with having posters on face washing in classrooms. The presence of face-washing materials was correlated with the availability of washing stations. Neither teachers mentioning face-washing in health curricula nor educational materials in classrooms were associated with clean faces or trachoma in the community. Having a washing station in the school was associated with lower community rates of trachoma. Conclusions Primary school health messages and materials on trachoma were not associated with clean faces or lower rates of trachoma in the community. The target audience for primary school health promotion is likely the students themselves, without immediate rippling effects in the community. A long-term perspective should be considered during the implementation of health promotion in schools. The goal of school health promotion should be training the next generation of parents and community health leaders in combatting trachoma.

scholarly journals Associations between Perceived Child-Parent Relationships and School Engagement among 9–11 Aged Children

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 595
Author(s):  
Pirita Markkula ◽  
Anja Rantanen ◽  
Anna-Maija Koivisto ◽  
Katja Joronen
Keyword(s):  
Health Promotion ◽  
Confidence Intervals ◽  
School Engagement ◽  
School Health ◽  
Multivariate Analyses ◽  
Dropping Out ◽  
School Health Promotion ◽  
Parent Relationships ◽  
School Burnout ◽  
Finnish Study

School engagement has been shown to protect students from dropping out of education, depression and school burnout. The aim of this Finnish study was to explore the association between child-parent relationships and how much 99,686 children aged 9–11 years liked school. The data were based on the 2019 School Health Promotion Study, conducted by the Finnish Institute for Health and Welfare. This asked children whether they liked school or not and about their child-parent relationships. Univariate and multivariate analyses were used to examine the data separately for boys and girls and the results are presented as odds ratios (OR) and 95% confidence intervals (CI). According to the results, girls showed more school engagement than boys (81.9% versus 74.0%), and it was more common in children who felt that their parents communicated with them in a supportive way. This association was slightly stronger for girls than boys (OR 2.46 95% CI 2.33–2.59 versus OR 2.10 95% CI 2.02–2.20). It is important that child-parent relationships and communication are considered during school health examinations, so that children who have lower support at home can be identified.

The role of principals in school health promotion in South Africa: a qualitative study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Siphokazi Kwatubana ◽  
Velaphi Aaron Nhlapo ◽  
Nomsa Moteetee
Keyword(s):  
Health Promotion ◽  
Teacher Development ◽  
School Health ◽  
School Principals ◽  
Development Programme ◽  
Health Improvement ◽  
School Health Promotion ◽  
Content Type ◽  
Professional Teacher

PurposeSchool principals are presumed to be pillars of school health promotion implementation. Their understanding of their role could enhance school health promotion. This study aims to investigate how principals understood their role in school health promotion.Design/methodology/approachIn this study, semi-structured interviews were conducted with six school principals who participated and completed the first cycle of the Continuous Professional Teacher Development programme that was offered by the South African Council of Educators. Snowball sampling was used to sample participants.FindingsThe findings of this study showed that principals did not differentiate between concepts of health-promoting schools and school health promotion, the meaning was the same for them. They focused on any health improvement within the schools, regardless of its conceptual nature. The second finding pertains to the role of the principal as a manager, while the third was on expedition of collaborations and partnerships.Research limitations/implicationsThis research was limited to school principals who completed the Continuous Professional Teacher Development programme. It, therefore, does not include perceptions of other principals.Originality/valueThe study findings suggest that despite inability of schools in poor communities to implement effective school health programmes, the principals of the sampled schools were aware of their roles. This is positive, as the efforts to enhance health promotion initiatives would focus on developing and empowering principals to improve their performance.

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