The Differences in Physical Activity Preferences and Practices among High versus Low Active Adolescents in Secondary Schools

This study aimed to (a) identify the differences in the preferred, practiced, and organized physical activity (PA) between high and low physically active Czech and Polish boys and girls and to (b) identify which types of PA are likely to be recommended by low active boys and girls. The research was carried out between 2010 and 2019 in the Czech Republic and Poland and included 6619 participants aged 15 to 19 years. The preferences and practices of the different types of PA and participation in organized PA were identified using a PA preference questionnaire and weekly PA was identified using the International Physical Activity Questionnaire-long form. Czech and Polish boys and girls who were low active preferred less physically demanding and more health-oriented PA compared with high active individuals. Power exercises and participation in organized PA are the most significant predictors of achieving at least 3 × 20 min of vigorous PA per week among low active individuals in both countries. Monitoring the trends in the preferred and practiced types of PA among boys and girls is crucial for the effective promotion of PA to low active boys and girls and positive changes in physical education and school health policy.

Development of a School Health Policy Implementation Survey: A Delphi Study

Data on school health policy implementation are limited due to the absence of a validated measurement tool. The purpose of this study was to create and pilot a school health policy implementation survey. A modified, four-round Delphi process was used to achieve consensus on content and format of the survey. The final 76-item survey was piloted in 655 schools with a return rate of 57.1% (n = 378). Seven schools participated in environmental audits. Based on the audits, survey responses represented an accurate description of school practices for 84.2% (n = 64) of questions. The remaining 15.8% (n = 12) of survey items were eliminated or revised. This measurement tool begins to fill the research gap between the evaluation of written school health policy and implementation. Further, this tool may be used by school nurses in alignment with the Framework for 21st Century School Nursing Practice.

A vibrant reflection of the revised integrated school health policy with a lens on substance use

Substance use is rife amongst adolescents, including learners. Learners are easily exposed to substances with onset as early as 10 years and average age of drug experimentation is 12 years in South Africa. This results in many negative health and social outcomes, a challenge as far as the achievement of global, regional and national goals such as quality education. The revised Integrated School Health Policy (ISHP) is a policy operating within the school environment aiming to address health and social barriers of learners and improve optimal health, comprising a vague action component on substance use prevention. This article is an opinion piece, which uses the Walt and Gilson model as an operational framework to analyse the revised ISHP within the lens of substance use. It assesses the four interrelated aspects: policy context, policy content, policy actors, and the policy process. The ISHP is placed within schools where adolescents are found and has the potential to reduce many health challenges such as substance use amongst learners. However, some issues are left to chance, such as health education on substance use prevention stated to only begin at Grade 4 (10 years), little mention of parental involvement, limited interplay amongst actors, limited investment in upskilling educators on dealing with substance use, scarce resources for implementation in all developmental phases and provinces to address substance use. Intervention can be more comprehensive with an intersectoral political approach needed to ensure that implementation addresses all multiple levels of influence of substance use amongst learners and the numerous health and social barriers.

Exploring the views of Heads of Schools on School Health Services in Public Primary Schools in Enugu Metropolis, Nigeria: A Qualitative Study

Background: School health services offer a great opportunity for many children to access primary health care, especially in developing countries. This study assessed the status of health services in public primary schools in Enugu Metropolis, Enugu State, Nigeria from the perspectives of the school heads.Methods: This was a qualitative study conducted among 24 public primary school head masters/mistresses in the three Local Government Areas making up Enugu metropolis. They were purposively selected from the 117 public primary schools in the metropolis. Data were collected through the use of Key Informant Interview (KII) guide, and analyzed using thematic approach.Results: Only one of the participants knew about the school health policy, while others expressed surprise at its existence. All the schools had a first aid box, but most of the boxes were not sufficiently stocked. None of the schools had a trained first aider. De-worming was carried out once in a while in all the schools. Majority of the schools did not document health services provided. The schools rarely referred pupils to health facilities as needed, but rather informed parents if their children became ill while in school.Conclusion: The implementation of health services in public primary schools in Enugu Metropolis leaves much to be desired. Health services, including health appraisal were generally poor. Basic resources necessary for school health services were lacking in the schools. There is need for stakeholders to take urgent steps in order to redress the situation.

A systematic review of school health policy measurement tools: implementation determinants and outcomes

Background Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed. The purposes of the present systematic review of quantitative measures of school policy implementation were to (1) identify quantitative school health policy measurement tools developed to measure implementation at the school, district, or state/provincial levels; (2) describe the policy implementation outcomes and determinants assessed and identify the trends in measurement; and (3) assess pragmatic and psychometric properties of identified implementation measures to understand their quality and suitability for broader application. Methods Peer-reviewed journal articles published 1995–2020 were included if they (1) had multiple-item quantitative measures of school policy implementation and (2) addressed overall wellness, tobacco, physical activity, nutrition, obesity prevention, or mental health/bullying/social-emotional learning. The final sample comprised 86 measurement tools from 67 peer-review articles. We extracted study characteristics, such as psychometric and pragmatic measure properties, from included articles based on three frameworks: (1) Implementation Outcomes Framework, (2) Consolidated Framework for Implementation Research, and (3) Policy Implementation Determinants Framework. Results Most implementation tools were developed to measure overall wellness policies which combined multiple policy topics (n = 35, 40%) and were in survey form (n = 75, 87%). Fidelity was the most frequently prevalent implementation outcome (n = 70, 81%), followed by adoption (n = 32, 81%). The implementation determinants most assessed were readiness for implementation, including resources (n = 43, 50%), leadership (n = 42, 49%), and policy communication (n = 41, 48%). Overall, measures were low-cost and had easy readability. However, lengthy tools and lack of reported validity/reliability data indicate low transferability. Conclusions Implementation science can contribute to more complete and rigorous assessment of school health policy implementation processes, which can improve implementation strategies and ultimately the intended health benefits. Several high-quality measures of implementation determinants and implementation outcomes can be applied to school health policy implementation assessment. Dissemination and implementation science researchers can also benefit from measurement experiences of school health researchers.

A systematic review of school health policy measurement tools: Implementation determinants and outcomes

Background Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students, and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed. The purposes of the present systematic review of quantitative measures of school policy implementation are to identify quantitative measures of implementation determinants and Proctor model implementation outcomes and assess pragmatic and psychometric properties of such measures. Methods Peer-reviewed journal articles published 1995–2020 were included if they: 1) had multiple-item quantitative measures of school policy implementation; and 2) addressed overall wellness, tobacco, physical activity, nutrition, obesity prevention, and mental health/bullying/social-emotional learning. The final sample comprised 86 measurement tools from 67 peer-review articles. We extracted study characteristics, such as psychometric and pragmatic measure properties, from included articles based on three frameworks: Implementation Outcomes Framework, 2) Consolidated Framework for Implementation Research, and 3) Policy Implementation Determinants Framework. Results Most implementation tools were developed to measure overall wellness policies which combined multiple policy topics (n = 35, 40%) and were in survey form (n = 75, 87%). Fidelity was the most frequently prevalent implementation outcome (n = 70, 81%), followed by adoption (n = 32, 81%). The implementation determinants most assessed were readiness for implementation, including resources (n = 43, 50%), leadership (n = 42, 49%), and policy communication (n = 41, 48%). Overall, measures were low-cost and had easy readability. However, lengthy tools and lack of reported validity/reliability data indicate low transferability. Conclusions Implementation science can contribute to more complete and rigorous assessment of school health policy implementation processes, which can improve implementation strategies and ultimately the intended health benefits. Several high-quality measures of implementation determinants and implementation outcomes can be applied to school health policy implementation assessment. D&I researchers can also benefit from measurement experiences of school health researchers.

A Systematic Review of School Health Policy Measurement Tools: Implementation Determinants and Outcomes

Background: Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students, and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed. The purposes of the present systematic review of quantitative measures of school policy implementation are to identify quantitative measures of implementation determinants and Proctor model implementation outcomes and assess pragmatic and psychometric properties of such measures.Methods: Peer-reviewed journal articles published 1995-2020 were included if they: 1) had multiple-item quantitative measures of school policy implementation; and 2) addressed overall wellness, tobacco, physical activity, nutrition, obesity prevention, and mental health/bullying/social-emotional learning. The final sample comprised 86 measurement tools from 67 peer-review articles. We extracted study characteristics, such as psychometric and pragmatic measure properties, from included articles based on three frameworks: Implementation Outcomes Framework, 2) Consolidated Framework for Implementation Research, and 3) Policy Implementation Determinants Framework.Results: Most implementation tools were developed to measure overall wellness policies which combined multiple policy topics (n=35, 40%) and were in survey form (n=75, 87%). Fidelity was the most frequently prevalent implementation outcome (n=70, 81%), followed by adoption (n=32, 81%). The implementation determinants most assessed were readiness for implementation, including resources (n=43, 50%), leadership (n=42, 49%), and policy communication (n=41, 48%). Overall, measures were low-cost and had easy readability. However, lengthy tools and lack of reported validity/reliability data indicate low transferability.Conclusions: Implementation science can contribute to more complete and rigorous assessment of school health policy implementation processes, which can improve implementation strategies and ultimately the intended health benefits. Several high-quality measures of implementation determinants and implementation outcomes can be applied to school health policy implementation assessment. D&I researchers can also benefit from measurement experiences of school health researchers.

Prioritizing Training Needs of School Health Staff: The Example of Vietnam

Competencies of school health staff (SHS) members, including school nurses, are crucial to improving child and adolescent health. In Vietnam, although SHS members are dispatched to schools, they have limited training opportunities. This study identified SHS members’ training needs in a province of Vietnam. A cross-sectional, online survey was conducted with 204 SHS members. The performance and importance of SHS members’ competencies were measured using 59-items and rated by a 5-point Likert scale. SHS members’ training priorities were analyzed using the Borich Needs Assessment and the Locus for Focus model. Controlling infectious disease was the highest training priority while implementing health promotion programs was of relatively low priority. The high-priority training needs identified could be rendered mandatory in policy for continuing education of SHS members. Awareness of the importance of health promotion, which has been emphasized globally, should also be promoted via school health policy. These findings could guide development of future training programs for SHS members.

Factors that Influence the Dissemination and Implementation of a School Health Policy

The policy on school health is ineffectively disseminated and poorly implemented in many contexts. The purpose of this study was to explore and describe the factors that influence the dissemination and implementation of a policy on school health in Bayelsa state in southern Nigeria. A qualitative approach (using an exploratory, descriptive and contextual research design) was used to achieve the aim of the study. Non-probability purposive sampling was used to select 24 participants for the study. Semi-structured individual interviews and an Olympus VN-7800 audio tape were used to collect data. The data were analysed concurrently using line-by-line the six inductive steps of a thematic analysis as well as Atlas ti version 8.0 to ensure consistency of the findings. The results show that bureaucracy, ineffective monitoring and evaluation, insufficient financial support, political interference, lack of equity of service delivery, poor working conditions, ineffective communication, and lack of knowledge and awareness are perceived as barriers to such a policy. Accessibility to policy documents, collaborative partnership, existing school health programmes, and competent and willing personnel are perceived as positive factors for the dissemination and implementation of such a policy. This study would contribute towards the improvement of school health and educational practices if the findings and recommendations are implemented appropriately.