Examining adolescent maltreatment and connections to school engagement

This article examines how maltreatment experienced by adolescents is related to school engagement. Maltreatment includes physical, mental, and sexual violence along with sexual harassment, neglect, and witnessing domestic violence. School engagement refers to the students’ relationship to all activities in the school. It describes students’ thoughts, activities and participation as well as their emotions in relation to school. Analysis is based on the Finnish School Health Promotion data ( N = 155,299) and analyzed by linear regression analysis. Results indicate that adolescents’ maltreatment experiences are related to school engagement, regardless of gender, age, family structure, or immigrant background. Maltreatment increases functional engagement and decreases emotional and cognitive engagement. These results thus confirm that maltreatment can also cause immersion in schoolwork. The results can be used to prevent lower school engagement and maltreatment of adolescents.

Self-Reported School Difficulties and the Use of the School Nurse Services by Adolescent Students

Adolescents are increasingly finding school difficult and physical, mental and social problems increase the risk of exclusion. School health services help to identify problems and prevent them from escalating and the school nurse should be consulted when children are struggling academically. This study explored associations between school difficulties and the use of school health nurse services by 73,680 comprehensive school students with median age of 15.3. The study was based on nationally representative data from the 2017 Finnish School Health Promotion study and analyzed by gender. Difficulties in schooling were common and ranged from 9.9–32.7%. Girls reported difficulties more frequently than boys. Having self-reported difficulties was associated with greater use of school health nurse services, with girls seeking help more often than boys with similar issues and more boys saying they had no need for services. In addition, more self-reported difficulties with schooling were associated with unmet need for school health nurse services. School difficulties were associated with greater use of the school health nurse service use when the data were controlled for background factors. This study highlights shortcomings in access to school health nurse services by children with self-reported school difficulties and that girls were more likely report problems and seek help.

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

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.

Open letters about health dialogues reveal school staff and students' expectations of school health promotion leadership

PurposeThis study explores to what extent health promotion policy in practice and leadership engagement is reflected in school actors' experiences of health dialogues (HDs) and their ideas about promoting health and learning in schools.Design/methodology/approachThe 93 participants consisted of 44 school nurses, 37 students in grades 4, 7 or the first year of high school and 12 teachers, who shared their experiences with HDs by writing open letters.FindingsThe qualitative content analysis resulted in four themes: Putting health on the agenda, Finding a common goal, Walking side by side and Pointing out a healthy direction. The participants' expectations of school health promotion leadership are revealed in suggestions on how the HDs can fulfill both the educational assignment and promote student health.Practical implicationsBased on the findings, we argue that for successful school health promotion leaders need to acknowledge the field of tension where leadership has to take place, anchor health promotion policy and administer “a Sandwich approach” – a top-down and bottom-up leadership simultaneously that facilitates school-based health promotion.Originality/valueWhen different school actors (school nurses, teachers and students) are given a voice, a collective picture of HDs can emerge and help develop health promotion practices.

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

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.

Clustering Lifestyle Risk Behaviors among Vietnamese Adolescents and Roles of School: A Bayesian Multilevel Analysis of Global School-Based Student Health Survey 2019

Background: Adolescence is a vulnerable period for many lifestyle risk behaviors. In this study, we investigated the clustering of risk behaviors and role of the school health promotion programs among adolescents in Vietnam. Methods: We analyzed data of 7,541 adolescents aged 13-17y from the 2019 nationally representative Global School-based Student Health Survey, conducted in 20 provinces and cities in Vietnam. We applied the latent class analysis to identify groups of clustering and used Bayesian 2-level logistic regressions to evaluate the effects of school health promotion programs on these clusters. We reassessed the school effect size by incorporating different informative priors to the Bayesian models. Findings: The most frequent lifestyle risk behavior among Vietnamese adolescents was unhealthy diet (~67%), followed by sedentary behavior (37% in boys and 48% in girls) and low fruit/vegetable intake (~31%). More than half of students had a cluster of at least two risk factors and a quarter with three risk factors. Latent class analysis detected 18% boys and 15% girls being at high-risk of lifestyle behaviors. Consistent through different priors, high quality of health promotion programs associated with lower the odds of lifestyle risk behaviors (highest quality schools vs. lowest quality schools; boys: Odds ratio (OR) = 0.69, 95% Highest Density Interval (HDI): 0.49 - 0.99; girls: OR = 0.62, 95% HDI: 0.42 - 0.92). Interpretation: Our findings demonstrated the clustering of specific lifestyle risk behaviors among Vietnamese adolescents, suggesting a special need for required courses in schools and join interventions that target sex-specific multiple risk behaviors.

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

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.

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

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.