Peter K. Smith
Full Text Available Following some background studies on the nature of school bullying, its prevalence, and the negative consequences it can have, this article reviews the history of anti-bullying interventions over the last 30 years. It considers several major programmes in detail, such as the Olweus Bullying Prevention Program, KiVa, Steps to Respect, and Friendly Schools. The nature and evaluation of the interventions is discussed, followed by a review of meta-analyses of the programmes effectiveness. Issues considered are the effect at different ages; components of interventions; work with peers; disciplinary methods, non-punitive and restorative approaches; challenges regarding cyberbullying; the role of parents; the role of teachers and teacher training; set menu versus à la carte approaches; sustainability of interventions and societal context. Conclusions show that interventions have had some success, with traditional bullying. However, further progress is needed in strengthening theoretical underpinnings to interventions, and in tackling cyberbullying.
Mampane, Ruth; Huddle, Christelle
This study reports on the outcomes of educational psychology school-based intervention. The aim was to determine whether the intervention served as an educational pathway to resilience. Through a concurrent mixed-methods research design interpreted through a pragmatic lens, academic school performance of students in a rural school was used as an…
Martin, Michael J.; Henry, Anna
The purpose of this study was to develop a substantive theory for community development by school-based agriculture programs through grounded theory methodology. Data for the study included in-depth interviews and field observations from three school-based agriculture programs in three non-metropolitan counties across a Midwestern state. The…
Ickes, Melinda J; McMullen, Jennifer; Haider, Taj; Sharma, Manoj
The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.
Melinda J. Ickes
Full Text Available Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1 primary research; (2 overweight or obesity prevention interventions; (3 school-based; (4 studies published between 1 January 2002 through 31 December 2013; (5 published in the English language; (6 child-based interventions, which could include parents; and (7 studies that reported outcome data. Results: A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Discussion: Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.
Sundborn, G; Ni Mhurchu, C; Ness, C; Latu, H; Jackson, R
The Kelston Beverages Study was designed to increase awareness of the sugar content of sugary drinks, the poor health consequences that high intake of these drinks have, and inform on ways to reduce intake of students. The aims of this pilot study were to refine interventions and processes designed to raise awareness of the harms that sugar sweetened beverages (SSBs) have on health, and to reduce their consumption among the youth of a small West Auckland suburb. There were three arms to this interventional study, one in schools, another in community organisations (churches, sports clubs and community groups), and the final arm is in the local retail sector. The school arm was the most extensive component and initially involved a survey of children's knowledge and consumption of sugar sweetened beverages (SSBs) using a brief questionnaire. The study evaluated any SSB policies in schools and for schools that did not have policies, opportunities were scoped to develop and implement them; a canteen AUDIT focussed particularly on beverages was carried out; and finally a student partnered social marketing exercise was undertaken that comprised 2 competitions, one to design a poster, and another to write and perform a rap. Children were re-surveyed at the completion of the intervention (7 months later) to determine change in knowledge and self-reported consumption of SSBs. Both the community organisations and retail arms of this study focussed on raising awareness into the harmful effects of SSBs and establishing healthy beverage policy in the respective organisations. Promising results with regards to acceptability, feasibility, and recruitment as well as valuable learnings with regard to process support the development of a proposal to conduct a cluster randomised trial of the interventions successfully tested in this pilot study.
Piana, Natalia; Ranucci, Claudia; Buratta, Livia; Foglia, Elena; Fabi, Marta; Novelli, Francesca; Casucci, Simone; Reginato, Elisa; Pippi, Roberto; Aiello, Cristina; Leonardi, Alessia; Romani, Giannermete; De Feo, Pierpaolo; Mazzeschi, Claudia
Objective: To describe an innovative school-based intervention to promote healthy lifestyles. To evaluate its effects on children's food habits and to highlight the key components which contribute most to the beneficial effects obtained from children's, teachers' and parents' perspectives. Design: An educational tool to improve personal awareness,…
Naylor, Patti-Jean; Nettlefold, Lindsay; Race, Douglas; Hoy, Christa; Ashe, Maureen C; Wharf Higgins, Joan; McKay, Heather A
Implementation science is an emerging area in physical activity (PA) research. We sought to establish the current state of the evidence related to implementation of school-based PA models to explore 1) the relationship between implementation and health outcomes, and 2) factors that influence implementation. We searched 7 electronic databases (1995-2014) and included controlled studies of school-based PA programmes for healthy youth (6-18 y) measuring at least one physical health-related outcome. For objective 1, studies linked implementation level to student-level health outcome(s). For objective 2, studies reported factors associated with implementation. There was substantial variability in how health outcomes and implementation were assessed. Few studies linked implementation and health outcomes (n=15 interventions). Most (11/15) reported a positive relationship between implementation and at least one health outcome. Implementation factors were reported in 29 interventions. Of 22 unique categories, time was the most prevalent influencing factor followed by resource availability/quality and supportive school climate. Implementation evaluation supports scale-up of effective school-based PA interventions and thus population-level change. Our review serves as a call to action to 1) address the link between implementation and outcome within the school-based PA literature and 2) improve and standardize definitions and measurement of implementation. Copyright © 2015 Elsevier Inc. All rights reserved.
Velsor-Friedrich, Barbara; Richards, Maryse; Militello, Lisa K.; Dean, Kyle C.; Scott, Darrick; Gross, Israel M.; Romeo, Edna
Research conducted on youth exposure to violence has generally focused on documenting the prevalence of community violence and its emotional and behavioral implications. However, there is a dearth of information related to the impact of violence on the implementation and evaluation of community and school-based programs. This commentary examines…
Butler, Helen; Bowes, Glenn; Drew, Sarah; Glover, Sara; Godfrey, Celia; Patton, George; Trafford, Lea; Bond, Lyndal
Schools and school systems are increasingly asked to use evidence-based strategies to promote the health and well-being of students. The dissemination of school-based health promotion research, however, offers particular challenges to conventional approaches to dissemination. Schools and education systems are multifaceted organizations that sit within constantly shifting broader contexts. This article argues that health promotion dissemination needs to be rethought for school communities as complex systems and that this requires understanding and harnessing the dynamic ecology of the sociopolitical context. In developing this argument, the authors draw on their experience of the dissemination process of a multilevel school-based intervention in a complex educational context. Building on this experience, they argue for the need to move beyond conventional dissemination strategies to a focus on active partnerships between developers and users of school-based intervention research and offer a conceptual tool for planning dissemination.
Public health professionals and educators have developed effective school-based interventions to reduce prejudice and stigma against lesbian, gay, bisexual, and transgender (LGBT) students. Such interventions can reduce the harm caused to sexual minority youths by stigma and can improve health outcomes. However, critics have warned that these interventions attempt to control speech and religious beliefs protected by the First Amendment. We review this critique and assess the legal and ethical arguments. We conclude that, both legally and ethically, there is great leeway for schools to implement LGBT-affirmative interventions. Still, we recommend that interventionists attend critics’ concerns using principles of community-based participatory research (CBPR). Using CBPR approaches, interventionists can achieve better community acceptance and cooperation and more successful interventions. PMID:23948002
Gould, Laura Feagans; Dariotis, Jacinda K.; Mendelson, Tamar; Greenberg, Mark. T.
This study examines gender, grade-level, and baseline depressive symptoms as potential moderators of a school-based mindfulness intervention's impact on the self-regulatory outcomes of urban youth. Ninety-seven participants from four urban public schools were randomly assigned to an intervention or wait-list control condition. Fourth and fifth…
Oosterhoff, Marije; Bosma, Hans; van Schayck, Onno C P; Joore, Manuela A
A uniform approach for costing school-based lifestyle interventions is currently lacking. The objective of this study was to develop a template for costing primary school-based lifestyle interventions and apply this to the costing of the "Healthy Primary School of the Future" (HPSF) and the "Physical Activity School" (PAS), which aim to improve physical activity and dietary behaviors. Cost-effectiveness studies were reviewed to identify the cost items. Societal costs were reflected by summing up the education, household and leisure, labor and social security, and health perspectives. Cost inputs for HPSF and PAS were obtained for the first year after implementation. In a scenario analysis, the costs were explored for a hypothetical steady state. From a societal perspective, the per child costs were €2.7/$3.3 (HPSF) and €- 0.3/$- 0.4 (PAS) per day during the first year after implementation, and €1.0/$1.2 and €- 1.3/$- 1.6 in a steady state, respectively (2016 prices). The highest costs were incurred by the education perspective (first year: €8.7/$10.6 (HPSF) and €4.0/$4.9 (PAS); steady state: €6.1/$7.4 (HPSF) and €2.1/$2.6 (PAS)), whereas most of the cost offsets were received by the household and leisure perspective (first year: €- 6.0/$- 7.3 (HPSF) and €- 4.4/$- 5.4 (PAS); steady state: €- 5.0/$- 6.1 (HPSF) and €- 3.4/$- 4.1 (PAS)). The template proved helpful for costing HPSF and PAS from various stakeholder perspectives. The costs for the education sector were fully (PAS) and almost fully (HPSF) compensated by the savings within the household sector. Whether the additional costs of HPSF over PAS represent value for money will depend on their relative effectiveness.
Kleijn, M.J.J. de; Farmer, M.M.; Booth, M.; Motala, A.; Smith, A.; Sherman, S.; Assendelft, W.J.J.; Shekelle, P.
BACKGROUND: The purpose of this review is to study the effect of school-based interventions on smoking prevention for girls. METHODS: We performed a systematic review of articles published since 1992 on school-based tobacco-control interventions in controlled trials for smoking prevention among
Shackleton, Nichola; Jamal, Farah; Viner, Russell M; Dickson, Kelly; Patton, George; Bonell, Christopher
Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches. We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively. We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective. There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Lima-Serrano, Marta; Lima-Rodríguez, Joaquín S
Given that lifestyleshave similar determinants and that school-based interventions are usually targeted at all the risks that affect adolescents, the objective of this systematic review was to summarize the characteristics and effects of school-based interventions acting on different behavioral domains of adolescent health promotion. The review process was conducted by two independent reviewers who searched PubMed, Scopus, PsycINFO, and ERIC databases for experimental or observational studies with at least two measures of results published from 2007 to 2011, given that the research information available doubles every 5 years. Methodological quality was assessed with a standardized tool. Information was extracted from 35 studies aiming to prevent risk behaviors and promote healthy nutrition, physical activity, and mental and holistic health. Activities were based on theoretical models and were classified into interactive lessons, peer mediation, environmental changes, parents' and community activities, and tailored messages by computer-assisted training or other resources, usually including multiple components. In some cases, we identified some moderate to large, short- and long-term effects on behavioral and intermediate variable. This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Lopez, Laureen M; Bernholc, Alissa; Chen, Mario; Tolley, Elizabeth E
Young women, especially adolescents, often lack access to modern contraception. Reasons vary by geography and regional politics and culture. The projected 2015 birth rate in 'developing' regions was 56 per 1000 compared with 17 per 1000 for 'developed' regions. To identify school-based interventions that improved contraceptive use among adolescents Until 6 June 2016, we searched for eligible trials in PubMed, CENTRAL, ERIC, Web of Science, POPLINE, ClinicalTrials.gov and ICTRP. We considered randomized controlled trials (RCTs) that assigned individuals or clusters. The majority of participants must have been 19 years old or younger.The educational strategy must have occurred primarily in a middle school or high school. The intervention had to emphasize one or more effective methods of contraception. Our primary outcomes were pregnancy and contraceptive use. We assessed titles and abstracts identified during the searches. One author extracted and entered the data into RevMan; a second author verified accuracy. We examined studies for methodological quality.For unadjusted dichotomous outcomes, we calculated the Mantel-Haenszel odds ratio (OR) with 95% confidence interval (CI). For cluster randomized trials, we used adjusted measures, e.g. OR, risk ratio, or difference in proportions. For continuous outcomes, we used the adjusted mean difference (MD) or other measures from the models. We did not conduct meta-analysis due to varied interventions and outcome measures. The 11 trials included 10 cluster RCTs and an individually randomized trial. The cluster RCTs had sample sizes from 816 to 10,954; the median number of clusters was 24. Most trials were conducted in the USA and UK; one was from Mexico and one from South Africa.We focus here on the trials with moderate quality evidence and an intervention effect. Three addressed preventing pregnancy and HIV/STI through interactive sessions. One trial provided a multifaceted two-year program. Immediately after year one and
Augustyniak, Kristine M.; Brooks, Morgan; Rinaldo, Vincent J.; Bogner, Roselind; Hodges, Shannon
School-based professionals have entered the 21st century with a heightened call to address the emotional and behavioral concerns of youth. While cognitive-behavioral therapies and psychoeducational groups have demonstrated moderate effects with children and adolescents, there is little available research to assist clinicians in refining treatments…
Dinkmeyer, Don, Jr.; Carlson, Jon
Decades after consultation has become a mandated function of school counselors, consultants still seek effective ways to deliver this essential role. This book, geared towards mental health professionals, provides a set of skills for working with the school-based population. The ideas, based on Adlerian psychology, present a theory of consultation…
Fairchild, Thomas N., Ed.
School-based helpers are helping professionals who work within educational settings and whose training and primary responsibility is to promote the mental health of students. Few resource materials provide these helpers with needed information and practical strategies--this text tries to meet that need. The 12 chapters here cover a wide range of…
Olsson, Tina M.; Ferrer-Wreder, Laura; Eninger, Lilianne
Commentators interested in school-based prevention programs point to the importance of economic issues for the future of prevention efforts. Many of the processes and aims of prevention science are dependent upon prevention resources. Although economic analysis is an essential tool for assessing resource use, the attention given economic analysis…
Roseman, Mary G.; Riddell, Martha C.; Haynes, Jessica N.
Objective: To review the literature, identifying proposed recommendations for school-based nutrition interventions, and evaluate kindergarten through 12th grade school-based nutrition interventions conducted from 2000-2008. Design: Proposed recommendations from school-based intervention reviews were developed and used in conducting a content…
Morris, Matthew C; Kouros, Chrystyna D; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy
Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Lastprogramcomparedtoawaitlistcontrolcondition.(*) Knowledge gains from pre- to post-intervention were assessed in 5 domains: safe versus unsafe people; safe choices; problem-solving; clear disclosure; and assertiveness. Participants were 1177 students (46% White, 26% African American, 15% Hispanic, 4% Asian American, 6% Other) in grades 1 through 6 from 14 public schools in Tennessee. Multilevel models accounting for the nesting of children within schools revealed large effect sizes for the intervention versus control across all knowledge domains (d's ranged from 1.56 to 2.13). The effectiveness of the program was moderated by mean per capita income and rates of substantiated cases of child abuse and neglect in the community. Intervention effects were stronger for youth living in lower as compared to higher income counties, and for youth attending schools in counties with lower as compared to higher abuse/neglect rates. Child characteristics (sex, race) did not moderate intervention effects. This research identified two community-level factors that predicted the effectiveness of a CSA education and prevention program designed to improve children's knowledge of personal safety skills. School-based CSA prevention programs may require modification for communities with higher rates of child abuse and neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.
Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B
In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of Kickin' Asthma, a school-based asthma curriculum designed by health educators and local students, which teaches asthma physiology and asthma self-management techniques to middle and high school students in Oakland, CA. Eligible students were identified through an in-class asthma case identification survey. Approximately 10-15 students identified as asthmatic were recruited for each series of the Kickin' Asthma intervention. The curriculum was delivered by an asthma nurse in a series of four 50-minute sessions. Students completed a baseline and a 3-month follow-up survey that compared symptom frequency, health care utilization, activity limitations, and medication use. Of the 8488 students surveyed during the first 3 years of the intervention (2003-2006), 15.4% (n = 1309) were identified as asthmatic; approximately 76% of eligible students (n = 990) from 15 middle schools and 3 high schools participated in the program. Comparison of baseline to follow-up data indicated that students experienced significantly fewer days with activity limitations and significantly fewer nights of sleep disturbance after participation in the intervention. For health care utilization, students reported significantly less frequent emergency department visits or hospitalizations between the baseline and follow-up surveys. A school-based asthma curriculum designed specifically for urban students has been shown to reduce symptoms, activity limitations, and health care utilization for intervention participants.
Haque, S.E.; Rahman, M.; Itsuko, K.; Mutahara, M.; Sakisaka, K.
Objectives: To assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents. Design: Intervention study. Setting: Araihazar area, Bangladesh. Participants:
Pérez-Rodrigo, Carmen; Wind, Marianne; Hildonen, Christina; Bjelland, Mona; Aranceta, Javier; Klepp, Knut-Inge; Brug, Johannes
The importance of careful theory-based intervention planning is recognized for fruit and vegetable promotion. This paper describes the application of the Intervention Mapping (IM) protocol to develop the Pro Children intervention to promote consumption of fruit and vegetable among 10- to 13-year-old schoolchildren. Based on a needs assessment, promotion of intake of fruit and vegetable was split into performance objectives and related personal, social and environmental determinants. Crossing the performance objectives with related important and changeable determinants resulted in a matrix of learning and change objectives for which appropriate educational strategies were identified. Theoretically similar but culturally relevant interventions were designed, implemented and evaluated in Norway, the Netherlands and Spain during 2 school years. Programme activities included provision of fruits and vegetables in the schools, guided classroom activities, computer-tailored feedback and advice for children, and activities to be completed at home with the family. Additionally, optional intervention components for community reinforcement included incorporation of mass media, school health services or grocery stores. School project committees were supported. The Pro Children intervention was carefully developed based on the IM protocol that resulted in a comprehensive school-based fruit and vegetable promotion programme, but culturally sensible and locally relevant. (c) 2005 S. Karger AG, Basel
Pennington, Brittany; Pokorski, Elizabeth A.; Kumm, Skip; Sterrett, Brittany I.
The National Center for Leadership in Intensive Intervention (NCLII), a consortium funded by the Office of Special Education Programs (OSEP), prepares special education leaders to become experts in research on intensive intervention for students with disabilities who have persistent and severe academic (e.g., reading and math) and behavioral…
Reinaerts, E.; De Nooijer, J.; De Vries, N. K.
Purpose: The purpose of this paper is to show how the intervention mapping (IM) protocol could be applied to the development of two school-based interventions. It provides an extensive description of the development, implementation and evaluation of two interventions which aimed to increase fruit and vegetable (F&V) consumption among primary…
Objectives. Non-communicable diseases and limited participation in school physical education have become increasing concerns in South Africa. In response to these concerns, a schoolbased physical activity intervention, Healthnutz, was implemented in three primary schools in Alexandra Township, Johannesburg.
Objective: Parental divorce affects approximately 30 000 South African children annually. This pilot study aimed to evaluate the effectiveness of the Children of Divorce Intervention Programme (CODIP) at two South African schools. CODIP is a preventively oriented group programme which was developed to foster resilience ...
Everhart, D. Erik
The effects of sleep disturbance on children are wide ranging and include alterations in behavior, mood, cognition, and academic performance. Screening and intervention for pediatric sleep disorders within the schools are not widely implemented, and the concept of integrating school personnel into the multidisciplinary sleep team has yet to be…
Johnson, Teresa; Weed, L. Diane; Touger-Decker, Riva
The prevalence of childhood overweight and obesity in the United States has resulted in a number of school-based health interventions. This article provides a review of research that addressed childhood overweight and obesity in minority, U.S. elementary schools. All studies reported some benefits in health behaviors and/or anthropometric…
Carpenter, Laurie M.; Lachance, Laurie; Wilkin, Margaret; Clark, Noreen M.
Background: Schools are an ideal setting for implementation of asthma interventions for children; however, sustaining school-based programs can be challenging. This study illustrates policy and practice changes brought about through the Childhood Asthma Linkages in Missouri (CALM) program to sustain such programs. Methods: Researchers analyzed…
Daigneault, Susan Dahlgren
Describes a school-based group intervention designed to address issues of body image, self-esteem, weight, and eating disturbances. This 10-session group provides female high school students with opportunities to explore their concerns about relationships, appearance, and what it means to be female. Provides descriptions of narrative techniques…
Polanin, Joshua R.; Espelage, Dorothy L.; Pigott, Therese D.
This meta-analysis synthesized bullying prevention programs' effectiveness at increasing bystander intervention in bullying situations. Evidence from 12 school-based programs, involving 12,874 students, indicated that overall the programs were successful (Hedges's g = 0.20, 95% confidence interval [CI] = 0.11 to 0.29, p = 0.001), with larger…
Wilson, Kaitlyn P.
Purpose: Video modeling is an intervention strategy that has been shown to be effective in improving the social and communication skills of students with autism spectrum disorders, or ASDs. The purpose of this tutorial is to outline empirically supported, step-by-step instructions for the use of video modeling by school-based speech-language…
Hester, Laura L.; Wilce, Maureen A.; Gill, Sarah A.; Disler, Sheri L.; Collins, Pamela; Crawford, Gregory
Background: Asthma is a leading chronic childhood disease in the United States and a major contributor to school absenteeism. Evidence suggests that multicomponent, school-based asthma interventions are a strategic way to address asthma among school-aged children. The Centers for Disease Control and Prevention (CDC) encourages the 36 health…
Abood, Doris A.; Black, David R.; Coster, Daniel C.
Objective: A school-based nutrition education minimal intervention (MI) was evaluated. Design: The design was experimental, with random assignment at the school level. Setting: Seven schools were randomly assigned as experimental, and 7 as delayed-treatment. Participants: The experimental group included 551 teens, and the delayed treatment group…
Johnson, Ashleigh B; Montgomery, Chelsea M; Dillard, Wesley A; Morrill, Kenneth; Hoesli, Coral; Gillette, Wesley M; Johnson, Brandon K; Nathaniel, Thomas I
Community stroke awareness initiatives have traditionally been used to expand knowledge of stroke signs and risk factors to high-risk adult populations. Here, we use a novel unfettered, visual art-based approach for an elementary school initiative to raise stroke awareness. Seventh graders in a middle school art class received stroke awareness training during the course of the 2015 to 2016 school year through their teacher in the visual arts class. In turn, they used this training to develop their own artistic interpretations of key stroke awareness concepts via project-based learning and then present their projects to raise awareness about stroke. We evaluated our predata and postdata to determine whether the visual art school-based stroke intervention was effective in both educating students about stroke and enabling them to effectively disseminate this information to parents and other adults in their community. The pretest evaluation indicates a fair or good knowledge about stroke, and no student indicated an "outstanding" or "excellent" knowledge. The posttest evaluation indicated a higher degree of stroke awareness because students were rated as having an "outstanding," "excellent," or "very good" performance especially in the ability to translate knowledge of stroke awareness lessons learned in their art class into a well-articulated stroke-related project and presentation. Pearson χ test reveals significant difference (P art teacher to lead the educational component in the intervention indicates that expertise in neurology or stroke is not necessary to facilitate understanding of stroke and highlights the importance of creativeness in stroke education for children.
Barkoukis, Vassilis; Lazuras, Lambros; Ourda, Despoina; Tsorbatzoudis, Haralambos
Cyberbullying is an emerging form of bullying that takes place through contemporary information and communication technologies. Building on past research on the psychosocial risk factors for cyberbullying in this age group, the present study assessed a theory-driven, school-based preventive intervention that targeted moral disengagement, empathy and social cognitive predictors of cyberbullying. Adolescents (N = 355) aged between 16 and 18 years were randomly assigned into the intervention and the control group. Both groups completed anonymous structured questionnaires about demographics, empathy, moral disengagement and cyberbullying-related social cognitive variables (attitudes, actor prototypes, social norms, and behavioral expectations) before the intervention, post-intervention and 6 months after the intervention. The intervention included awareness-raising and interactive discussions about cyberbullying with intervention group students. Analysis of covariance (ANCOVA) showed that, after controlling for baseline measurements, there were significant differences at post-intervention measures in moral disengagement scores, and in favorability of actor prototypes. Further analysis on the specific mechanisms of moral disengagement showed that significant differences were observed in distortion of consequences and attribution of blame. The implications of the intervention are discussed, and guidelines for future school-based interventions against cyberbullying are provided. © 2015 Wiley Periodicals, Inc.
Scherr, Rachel E; Linnell, Jessica D; Smith, Martin H; Briggs, Marilyn; Bergman, Jacqueline; Brian, Kelley M; Dharmar, Madan; Feenstra, Gail; Hillhouse, Carol; Keen, Carl L; Nguyen, Lori M; Nicholson, Yvonne; Ontai, Lenna; Schaefer, Sara E; Spezzano, Theresa; Steinberg, Francene M; Sutter, Carolyn; Wright, Janel E; Young, Heather M; Zidenberg-Cherr, Sheri
To provide a framework for implementation of multicomponent, school-based nutrition interventions. This article describes the research methods for the Shaping Healthy Choices Program, a model to improve nutrition and health-related knowledge and behaviors among school-aged children. Longitudinal, pretest/posttest, randomized, controlled intervention. Four elementary schools in California. Fourth-grade students at intervention (n = 252) and control (n = 238) schools and their parents and teachers. Power analyses demonstrate that a minimum of 159 students per group will be needed to achieve sufficient power. The sample size was determined using the variables of nutrition knowledge, vegetable preference score, and body mass index percentile. A multicomponent school-based nutrition education intervention over 1 academic year, followed by activities to support sustainability of the program. Dietary and nutrition knowledge and behavior, critical thinking skills, healthy food preferences and consumption, and physical activity will be measured using a nutrition knowledge questionnaire, a food frequency questionnaire, a vegetable preferences assessment tool, the Test of Basic Science Process Skills, digital photography of plate waste, PolarActive accelerometers, anthropometrics, a parent questionnaire, and the School and Community Actions for Nutrition survey. Evaluation will include quantitative and qualitative measures. Quantitative data will use paired t, chi-square, and Mann-Whitney U tests and regression modeling using P = .05 to determine statistical significance. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Full Text Available High school students are a common target group in initiatives addressing discriminatory attitudes towards people with mental illness. However, these initiatives are rarely evaluated and documented. The aim of our paper is to evaluate the effectiveness of a school-based educational intervention for improving adolescents’ attitudes and reducing the desire for social distance from people with mental illness living in their community. A total of 161 students aged 16-18 years old were questioned at baseline assessment and 86 of them received a three-workshop educational intervention while 75 students comprised the control group. A follow-up assessment 1 month post intervention evaluated its impact. Attitudes and the social distance were assessed through the Community Attitudes towards the Mentally Ill scale and a 10-statement questionnaire based on the Self-report Inventory of Fear and Behavioural Intentions, respectively. Data from 140 subjects were analyzed. All attitude dimensions and half of the measured social distance statements were significantly improved in the intervention group at follow up assessment compared to controls. However, the statements measuring more intimate types of social relationships did not change significantly post intervention. In conclusion, short educational interventions can be effective to some extent in reducing discriminatory attitudes towards people with mental illness. However, effective interventions to address deeply held negative stereotypes will require further research.
Ruff, R R; Niederman, R
The school and community context can contribute to inequity in child oral health. Whether the school and community affect the effectiveness of school-based caries prevention is unknown. The association between the school and community environment and dental caries, as well as their moderating effects with school-based caries prevention, was assessed using multilevel mixed-effects regression. Data were derived from a 6-y prospective cohort study of children participating in a school-based caries prevention program. For the school and community, living in a dental-shortage area and the proportion of children receiving free or reduced lunch were significantly related to an increased risk of dental caries at baseline. Caries prevention was associated with a significant per-visit decrease in the risk of untreated caries, but the rate of total caries experience increased over time. Caries prevention was more effective in children who had prior dental care at baseline and in schools with a higher proportion of low socioeconomic status students. There was significant variation across schools in the baseline prevalence of dental caries and the effect of prevention over time, although effects were modest. The school and community environment have a direct impact on oral health and moderate the association between school-based caries prevention and dental caries. Knowledge Transfer Statement: School-based caries prevention can be an effective means to reduce oral health inequity by embedding dental care within schools. However, the socioeconomic makeup of schools and characteristics of the surrounding community can affect the impact of school-based care.
Liber, J.M.; de Boo, G.M.; Huizenga, H.; Prins, P.J.M.
Objective: In this randomized controlled trial, we investigated the effectiveness of a school-based targeted intervention program for disruptive behavior. A child-focused cognitive behavioral therapy (CBT) program was introduced at schools in disadvantaged settings and with active teacher support
Holly, Cheryl; Porter, Sallie; Kamienski, Mary; Lim, Aubrianne
Nearly 1,300 children in the United States die because of firearm-related injury each year and another 5,790 survive gunshot wounds, making the prevention of firearm-related unintentional injury to children of vital importance to families, health professionals, and policy makers. To systematically review the evidence on school-based and community-based gun safety programs for children aged 3 to 18 years. Systematic review. Twelve databases were searched from their earliest records to December 2016. Interventional and analytic studies were sought, including randomized controlled trials, quasi-experimental studies, as well as before-and-after studies or cohort studies with or without a control that involved an intervention. The low level of evidence, heterogeneity of studies, and lack of consistent outcome measures precluded a pooled estimate of results. A best evidence synthesis was performed. Results support the premise that programs using either knowledge-based or active learning strategies or a combination of these may be insufficient for teaching gun safety skills to children. Gun safety programs do not improve the likelihood that children will not handle firearms in an unsupervised situation. Stronger research designs with larger samples are needed to determine the most effective way to transfer the use of the gun safety skills outside the training session and enable stronger conclusions to be drawn.
Results: Eating the uncooked food as a cause for soil transmitted infections constituted 27.16% (63) followed by 16.38% (38) not using latrines, 15.95% (37) eating left ... The study also found out that the community perception towards the de-worming programme was good because the de-worming programme improved the ...
Painter, Julia E.; Sales, Jessica M.; Pazol, Karen; Wingood, Gina M.; Windle, Michael; Orenstein, Walter A.; DiClemente, Ralph J.
Background: School-based vaccination programs may provide an effective strategy to immunize adolescents against influenza. This study examined whether adolescent attitudes toward influenza vaccination mediated the relationship between receipt of a school-based influenza vaccination intervention and vaccine uptake. Methods: Participants were…
Dunn, Michael S.; Thompson, Sharon H.; M'Cormack, Fredanna A. D.; Yannessa, John F.; Duffy, Jennifer L.
The purpose of this study was to assess community attitudes toward school-based abstinence-plus sexuality education. A dual sampling approach of landlines and cell phones resulted in 988 adults from two counties completing "The South Carolina Survey of Public Opinion on Pregnancy Prevention." Among respondents, 87.1% supported…
Fox, Patricia G; Rossetti, Jeanette; Burns, Kenneth R; Popovich, Judith
One particular focus of refugee studies in the United States has been the violence experience of Southeast Asian (S.E.A.) refugee children and its impact on mental health and school adaptation. Although virtually all researchers have found that the children have high rates of depression and/or post-traumatic stress disorder, findings concerning successful school adaptation have been inconclusive. Even so, concern has been generated on how to best meet the children's mental health needs. The purpose of our study was to provide an eight-week school-based program that was designed to reduce depression symptoms of S.E.A. refugee children. Specifically, this collaborative program addressed refugee adaptation issues, children's culture and the development of coping skills. All of the children were screened for depression using the Children's Depression Inventory (CDI). Analysis of CDI data revealed that children's depression scores had a significant decrease between screening times 1 (approximately one month before the intervention) and 2 (fourth week of the intervention), 1 and 3 (eighth week of the intervention) and 1 and 4 (one month following the intervention). Globally, culturally sensitive mental health school-based programs may be an appropriate intervention to assist immigrant and refugee children in making a successful adaptation to host countries.
Serafini, Kelly; Shipley, Leandra; Stewart, David G
The stages of change (Precontemplation, Contemplation, Preparation, Action, and Maintenance) have been well studied in adult populations. However, fewer studies have examined how the stages of change are related to adolescent substance use. Furthermore, there have been no studies that have examined how the stages of change relate to outcomes in a school-based intervention. To better capture adolescent motivation, we added an additional group to the Transtheoretical Model of Change, which we titled Coerced Action, to represent adolescents that made changes to their substance use despite low problem recognition (representing the internal motivation of Precontemplation and the change behaviors of the Action group). We then examined how the stages of change were related to a thorough assessment of substance use at baseline and corresponding treatment outcomes. Our sample consisted of 264 adolescents (mean age: 16.1, 44.5% Caucasian, 37.5% female) who participated in an 8-week, school-based Motivational Enhancement intervention. Results indicated significant group differences across the stages of change in substance use patterns (alcohol use, negative consequences, affective dysregulation), as well as treatment outcomes (alcohol use and negative consequences). For instance, adolescents in the Action group demonstrated more negative consequences at 16weeks follow-up than those in Precontemplation and Coerced Action, F(1, 3)=8.23, pmotivation among adolescent substance users within school-based settings. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fredriksen, Per Morten; Hjelle, Ole Petter; Mamen, Asgeir; Meza, Trine J; Westerberg, Ane C
The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance. HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 ) as of June 20 th - 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
Per Morten Fredriksen
Full Text Available Abstract Background The prevalence of non-communicable diseases (NCDs is increasing worldwide, also among children. Information about primary prevention of NCD’s is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. Methods The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545 with two control schools (n = 752; all aged 6–11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL, non-HDL, micro C-reactive protein (mCRP and long-term blood sugar (HbA1c. In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL, mental health, executive functions, diet and academic performance. Discussion HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. Trial registration The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 as of June 20th – 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
Andersen, Anette; Krølner, Rikker; Bast, Lotus Sofie; Thygesen, Lau Caspar; Due, Pernille
Uptake of smoking in adolescence is still of major public health concern. Evaluations of school-based programmes for smoking prevention show mixed results. The aim of this study was to examine the effect of X:IT, a multi-component school-based programme to prevent adolescent smoking. Data from a Danish cluster randomized trial included 4041 year-7 students (mean age: 12.5) from 51 intervention and 43 control schools. Outcome measure 'current smoking' was dichotomized into smoking daily, weekly, monthly or more seldom vs do not smoke. Analyses were adjusted for baseline covariates: sex, family socioeconomic position (SEP), best friend's smoking and parental smoking. We performed multilevel, logistic regression analyses of available cases and intention-to-treat (ITT) analyses, replacing missing outcome values by multiple imputation. At baseline, 4.7% and 6.8% of the students at the intervention and the control schools smoked, respectively. After 1 year of the intervention, the prevalence was 7.9% and 10.7%, respectively. At follow-up, 553 students (13.7%) did not answer the question on smoking. Available case analyses: crude odds ratios (OR) for smoking at intervention schools compared with control schools: 0.65 (0.48-0.88) and adjusted: 0.70 (0.47-1.04). ITT analyses: crude OR for smoking at intervention schools compared with control schools: 0.67 (0.50-0.89) and adjusted: 0.61 (0.45-0.82). Students at intervention schools had a lower risk of smoking after a year of intervention in year 7. This multi-component intervention involving educational, parental and context-related intervention components seems to be efficient in lowering or postponing smoking uptake in Danish adolescents. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.
Morris, Matthew C.; Kouros, Chrystyna D.; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy
Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Last program compared to a waitlist control condition. Knowledge gains from pre- to post-interv...
Andrew L. Sussman
Full Text Available Purpose. From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR approach was conducted toward the development of a nutritional and physical activity (DVD and clinician toolkit for a school-based health center (SBHC weight management intervention. Methods. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Results. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Conclusions. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334.
Mauricio, Anne M.; Gonzales, Nancy A.; Millsap, Roger E.; Meza, Connie M.; Dumka, Larry E.; Germán, Miguelina; Genalo, M. Toni
This study describes a culturally sensitive approach to engage Mexican origin families in a school-based, family-focused preventive intervention trial. The approach was evaluated via assessing study enrollment and intervention program participation, as well as examining predictors of engagement at each stage. Incorporating traditional cultural values into all aspects of engagement resulted in participation rates higher than reported rates of minority-focused trials not emphasizing cultural sensitivity. Family preferred language (English or Spanish) or acculturation status predicted engagement at all levels, with less acculturated families participating at higher rates. Spanish-language families with less acculturated adolescents participated at higher rates than Spanish-language families with more acculturated adolescents. Other findings included two-way interactions between family language and the target child’s familism values, family single- vs. dual-parent status, and number of hours the primary parent worked in predicting intervention participation. Editors’ Strategic Implications: The authors present a promising approach—which requires replication—to engaging and retaining Mexican American families in a school-based prevention program. The research also highlights the importance of considering acculturation status when implementing and studying culturally tailored aspects of prevention models. PMID:18004659
Full Text Available Abstract Stigmatizing, or discriminatory, perspectives and behaviour, which target individuals on the basis of their mental health, are observed in even the youngest school children. We conducted a systematic review of the published and unpublished, scientific literature concerning the benefits and harms of school-based interventions, which were directed at students 18 years of age or younger to prevent or eliminate such stigmatization. Forty relevant studies were identified, yet only a qualitative synthesis was deemed appropriate. Five limitations within the evidence base constituted barriers to drawing conclusive inferences about the effectiveness and harms of school-based interventions: poor reporting quality, a dearth of randomized controlled trial evidence, poor methods quality for all research designs, considerable clinical heterogeneity, and inconsistent or null results. Nevertheless, certain suggestive evidence derived both from within and beyond our evidence base has allowed us to recommend the development, implementation and evaluation of a curriculum, which fosters the development of empathy and, in turn, an orientation toward social inclusion and inclusiveness. These effects may be achieved largely by bringing especially but not exclusively the youngest children into direct, structured contact with an infant, and likely only the oldest children and youth into direct contact with individuals experiencing mental health difficulties. The possible value of using educational activities, materials and contents to enhance hypothesized benefits accruing to direct contact also requires investigation. Overall, the curriculum might serve as primary prevention for some students and as secondary prevention for others.
Miovský, Michal; Voňková, Hana; Gabrhelík, Roman; Šťastná, Lenka
This study aims to examine the effect of school-based preventive intervention on cannabis use in Czech adolescents with different levels of risk factors and provide evidence of its universality. A randomized controlled prevention trial with six waves was conducted over a period of 33 months. We used a two-level logistic random-intercept model for panel data; we first looked at the statistical significance of the effect of the intervention on cannabis use, controlling for the characteristics of the children and time dummies. Then we analyzed the effects of the interactions between the intervention and the characteristics of the children on cannabis use and related it to the definition of universal preventive interventions. The setting for the study was in basic schools in the Czech Republic in the years 2007-2010. A total of 1,874 sixth-graders (mean age 11.82 years) who completed the baseline testing. According to our results, the prevention intervention was effective. We found all the selected characteristics of the children to be relevant in relation to cannabis use, except their relationships with their friends. We showed empirically that the intervention is universal in two dimensions for the selected characteristics of the children. First, all adolescents who undergo the intervention are expected to benefit. Second, with respect to the effect of the intervention on cannabis use, the total level of individual risk of cannabis use is superior to the composition of the risk factors in the individual risk profile. We present indicative evidence that the drug prevention intervention may be considered a true universal preventive intervention.
Roy M Anderson
Full Text Available The London Declaration on neglected tropical diseases was based in part on a new World Health Organization roadmap to "sustain, expand and extend drug access programmes to ensure the necessary supply of drugs and other interventions to help control by 2020". Large drug donations from the pharmaceutical industry form the backbone to this aim, especially for soil-transmitted helminths (STHs raising the question of how best to use these resources. Deworming for STHs is often targeted at school children because they are at greatest risk of morbidity and because it is remarkably cost-effective. However, the impact of school-based deworming on transmission in the wider community remains unclear.We first estimate the proportion of parasites targeted by school-based deworming using demography, school enrolment, and data from a small number of example settings where age-specific intensity of infection (either worms or eggs has been measured for all ages. We also use transmission models to investigate the potential impact of this coverage on transmission for different mixing scenarios.In the example settings <30% of the population are 5 to <15 years old. Combining this demography with the infection age-intensity profile we estimate that in one setting school children output as little as 15% of hookworm eggs, whereas in another setting they harbour up to 50% of Ascaris lumbricoides worms (the highest proportion of parasites for our examples. In addition, it is estimated that from 40-70% of these children are enrolled at school.These estimates suggest that, whilst school-based programmes have many important benefits, the proportion of infective stages targeted by school-based deworming may be limited, particularly where hookworm predominates. We discuss the consequences for transmission for a range of scenarios, including when infective stages deposited by children are more likely to contribute to transmission than those from adults.
Haugland, Bente Storm Mowatt; Raknes, Solfrid; Haaland, Aashild Tellefsen; Wergeland, Gro Janne; Bjaastad, Jon Fauskanger; Baste, Valborg; Himle, Joe; Rapee, Ron; Hoffart, Asle
Anxiety disorders are prevalent among adolescents and may have long-lasting negative consequences for the individual, the family and society. Cognitive behavioral therapy (CBT) is an effective treatment. However, many anxious youth do not seek treatment. Low-intensity CBT in schools may improve access to evidence-based services. We aim to investigate the efficacy of two CBT youth anxiety programs with different intensities (i.e., number and length of sessions), both group-based and administered as early interventions in a school setting. The objectives of the study are to examine the effects of school-based interventions for youth anxiety and to determine whether a less intensive intervention is non-inferior to a more intensive intervention. The present study is a randomized controlled trial comparing two CBT interventions to a waitlist control group. A total of 18 schools participate and we aim to recruit 323 adolescents (12-16 years). Youth who score above a cutoff on an anxiety symptom scale will be included in the study. School nurses recruit participants and deliver the interventions, with mental health workers as co-therapists and/or supervisors. Primary outcomes are level of anxiety symptoms and anxiety-related functional impairments. Secondary outcomes are level of depressive symptoms, quality of life and general psychosocial functioning. Non-inferiority between the two active interventions will be declared if a difference of 1.4 or less is found on the anxiety symptom measure post-intervention and a difference of 0.8 on the interference scale. Effects will be analyzed by mixed effect models, applying an intention to treat procedure. The present study extends previous research by comparing two programs with different intensity. A brief intervention, if effective, could more easily be subject to large-scale implementation in school health services. ClinicalTrials.gov, NCT02279251 . Registered on 15 October 2014. Retrospectively registered.
Fair, Kayla N; Solari Williams, Kayce D; Warren, Judith; McKyer, E Lisako Jones; Ory, Marcia G
Although the influence of organizational culture has been examined on a variety of student outcomes, few studies consider the influence that culture may have on school-based obesity prevention interventions. We present a systematic review of the literature to examine how elements of organizational culture may affect the adoption, implementation, and sustainability of school-based obesity prevention interventions. Fourteen studies examining the impact of organizational-level characteristics on school-based obesity prevention interventions were identified through the online databases EBSCO (CINAHL, ERIC, Agricola), Web of Science, Medline (PubMed), and Scopus. Five themes were identified as elements of organizational culture that influence the adoption, implementation, and sustainability of school-based obesity prevention interventions: organizational response to limited resources, value placed on staff training and professional development, internal support, organizational values, and school climate. Organizational culture can greatly influence the success of school-based obesity interventions. The collection of data related to organizational-level factors may be used to identify strategies for creating and sustaining a supportive environment for obesity prevention interventions in the school setting. © 2018, American School Health Association.
Shetgiri, Rashmi; Kataoka, Sheryl; Lin, Hua; Flores, Glenn
Few studies have rigorously evaluated school-based interventions to reduce violence and substance use in high school students, especially Latinos. This study assessed the effects of a school-based program on reducing violence and substance use among primarily Latino high school students. Ninth-grade students at risk for violence and substance use were randomized to intervention or control groups. The intervention was based on an existing program developed for white and African American youth. Data on smoking, alcohol and drug use, fighting, and grades were collected at baseline and 4 and 8 months post enrollment. There were 55 students in the control and 53 in the intervention group; 74% of controls and 78% of intervention students were Latino. There were no significant changes in fighting, smoking, or alcohol or drug use, from baseline to 8-month follow-up, between the intervention and control group. Pre and post grade point average (GPA) decreased from 2.3 at baseline to 1.8 at follow-up (pschool-based program showed no reduction in violence or substance use. The findings suggest that a program targeting non-Latino youth may not be optimal for reducing violence and substance use in Latinos; greater attention to cultural appropriateness and racial/ethnic differences may be needed. There was a decrease in intervention-group GPA but no significant change compared with controls. Further studies of the impact of school-based substance use and violence prevention programs on academics, and the effectiveness of afterschool or community-based programs compared to school-based programs are needed.
Full Text Available Children aged 10-11 years pass through a dynamic developmental period marked by rapid changes in body size, shape, and composition, all of which are sexually dimorphic. The purpose of this study was to analyze the effects of gender on a school-based intervention in the prepubertal growth spurt. One hundred twenty-five healthy children (58 boys, 67 girls, fifth and sixth grade students from an urban public elementary school in Portugal (10.8 ± 0.4 years, were randomly assigned into two experimental groups: a strength training group (19 boys, 22 girls, and an endurance training group (21 boys, 24 girls; and a control group (18 boys, 21 girls; no training program. Training program for the two experimental groups was conducted twice a week for 8 weeks. Compared with the values at the beginning of the protocol, both strength and endurance training programs produced significant improvements (p 0.05, ƞ_p^2= 0.16, Power= 0.29 and aerobic (p> 0.05, ƞ_p^2= 0.05, Power= 0.28 capacity. The results of the present study should be taken into consideration in order to optimize strength training school-based programs.
Bickham, David S; Hswen, Yulin; Slaby, Ronald G; Rich, Michael
While media education and reduction programs have been proposed to prevent adverse health and academic outcomes related to heavy electronic media use among school-aged children, few have been formally piloted and evaluated. We used a quasi-experimental design to evaluate the effectiveness of Take the Challenge (TtC), a school-based media education/reduction program for the primary prevention of sleep deprivation, dysfunctional social-emotional behaviors, and poor academic performance. Sixth- to eighth-grade students at a rural Midwestern U.S. middle school received the TtC program, while a similar school in the same district served as the comparison group. Health-related and academic measures were collected from students and teachers at both schools before and after the intervention. The primary outcome measure was student-reported electronic media use (television, video games, Internet). Secondary measures included student health behaviors (student-reported sleep, exercise, and outdoor play) and academic activities (teacher-reported homework and classroom performance). Compared to the comparison group, students receiving TtC slept more and reduced television viewing, background television time, after-school video gaming, and weekend Internet use. Teachers reported increases in the extent to which TtC students completed homework assignments and stayed on task in the classroom. Well-designed school-based programs such as TtC can reduce electronic media use among middle-school children and improve related health and academic outcomes.
Full Text Available School-based mindfulness interventions have been shown to be effective in reducing mental health symptoms. However, comparatively little research has investigated the acceptability of these programs from the perspective of the children. Program acceptability underpins engagement, and more engaging programs are also more efficacious (Cowan & Sheridan, 2003; Mautone et al., 2009 yet there is little literature which has considered the acceptability of school-based mindfulness programs. To address this gap, semi-structured interviews were conducted with upper primary aged children (N = 30 who had participated in a six week mindfulness program in four Australian primary schools. Thematic analysis of interviews revealed children found the program to be acceptable. Children reported that they enjoyed doing the mindfulness program, would recommend it to others, and learned about relaxing as well as felt relaxed while doing the program. Children also highlighted the use of culturally appropriate teaching materials and possible stigmatisation as threats to the acceptability of the program. The results of the study support the acceptability of mindfulness programs in school settings, grounded in the unique perspective of the child.
Greaves Colin J
Full Text Available Abstract Background Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. Methods This paper describes the development of the Healthy Lifestyles Programme (HeLP, a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM. The intervention focuses on the following health behaviours, i reduction of the consumption of sweetened fizzy drinks, ii increase in the proportion of healthy snacks consumed and iii reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Results Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives - establish motivation, take action and stay motivated - in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. Conclusion The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their
Background Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. Methods This paper describes the development of the Healthy Lifestyles Programme (HeLP), a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM). The intervention focuses on the following health behaviours, i) reduction of the consumption of sweetened fizzy drinks, ii) increase in the proportion of healthy snacks consumed and iii) reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Results Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives - establish motivation, take action and stay motivated - in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. Conclusion The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their eating and activity
Lloyd, Jennifer J; Logan, Stuart; Greaves, Colin J; Wyatt, Katrina M
Only limited data are available on the development and feasibility piloting of school-based interventions to prevent and reduce obesity in children. Clear documentation of the rationale, process of development and content of such interventions is essential to enable other researchers to understand why interventions succeed or fail. This paper describes the development of the Healthy Lifestyles Programme (HeLP), a school-based intervention to prevent obesity in children, through the first 4 steps of the Intervention Mapping protocol (IM). The intervention focuses on the following health behaviours, i) reduction of the consumption of sweetened fizzy drinks, ii) increase in the proportion of healthy snacks consumed and iii) reduction of TV viewing and other screen-based activities, within the context of a wider attempt to improve diet and increase physical activity. Two phases of pilot work demonstrated that the intervention was acceptable and feasible for schools, children and their families and suggested areas for further refinement. Feedback from the first pilot phase suggested that the 9-10 year olds were both receptive to the messages and more able and willing to translate them into possible behaviour changes than older or younger children and engaged their families to the greatest extent. Performance objectives were mapped onto 3 three broad domains of behaviour change objectives--establish motivation, take action and stay motivated--in order to create an intervention that supports and enables behaviour change. Activities include whole school assemblies, parents evenings, sport/dance workshops, classroom based education lessons, interactive drama workshops and goal setting and runs over three school terms. The Intervention Mapping protocol was a useful tool in developing a feasible, theory based intervention aimed at motivating children and their families to make small sustainable changes to their eating and activity behaviours. Although the process was time
Hynynen, S-T; van Stralen, M M; Sniehotta, F F; Araújo-Soares, V; Hardeman, W; Chinapaw, Mai J M; Vasankari, T.; Hankonen, N.
Lack of physical activity (PA) and high levels of sedentary behaviour (SB) have been associated with health problems. This systematic review evaluates the effectiveness of school-based interventions to increase PA and decrease SB among 15-19-year-old adolescents, and examines whether intervention
González-Cutre, David; Sierra, Ana C.; Beltrán-Carrillo, Vicente J.; Peláez-Pérez, Manuel; Cervelló, Eduardo
The authors analyzed the effects of a multidimensional intervention to promote physical activity (PA) in school, based on self-determination theory. The study involved 88 students, between 14 and 17 years old, who were divided into a control group (n = 59) and an experimental group (n = 29). In the experimental group, a 6-month intervention was…
Blake, Holly; Dawett, Bhupinder; Leighton, Paul; Rose-Brady, Laura; Deery, Chris
To evaluate a brief oral health promotion intervention delivered in schools by a primary care dental practice, aimed at changing oral health care knowledge and oral health-related behaviors in children. Cohort study with pretest-posttest design. Three primary schools. One hundred and fifty children (aged 9-12 years). Children received a 60-minute theory-driven classroom-based interactive educational session delivered by a dental care professional and received take-home literature on oral health. All children completed a questionnaire on oral health-related knowledge and self-reported oral health-related behaviors before, immediately after, and 6 weeks following the intervention. Children's dental knowledge significantly improved following the intervention, with improvement evident at immediate follow-up and maintained 6 weeks later. Significantly more children reported using dental floss 6 weeks after the intervention compared with baseline. No significant differences were detected in toothbrushing or dietary behaviors. School-based preventative oral health education delivered by primary care dental practices can generate short-term improvements in children's knowledge of oral health and some aspects of oral hygiene behavior. Future research should engage parents/carers and include objective clinical and behavioral outcomes in controlled study designs. © 2014 Society for Public Health Education.
Haque, Syed Emdadul; Rahman, Mosiur; Itsuko, Kawashima; Mutahara, Mahmuda; Sakisaka, Kayako
To assess the impact of a school-based menstrual education programme on: (1) menstrual knowledge, beliefs and practices, (2) menstrual disorders experienced, and (3) restrictions on menstruating adolescents. Intervention study. Araihazar area, Bangladesh. 416 adolescent female students aged 11-16 years, in grade 6-8, and living with their parents. A school-based health education study conducted from April 2012 to April 2013. We randomly selected 3 of 26 high schools in the study area. We delivered 6 months of educational intervention by trained (by an obstetrician and gynaecologist) research assistants (RAs) on menstrual hygiene among school girls. RAs read the questionnaire and participants answered. The changes in knowledge, beliefs and practices regarding menstruation, menstrual disorders experienced, and the restrictions and behaviours practiced by menstruating adolescents were compared between the baseline and the follow-up assessments. After health education, participants reported a significant improvement (pmenstruation (78.6% vs 59.6%). The programme produced significant changes in the knowledge, beliefs and practices of menstrual hygiene, complications from lack of hygiene, and the behaviour and restrictions of the menstruating adolescents. These results demonstrate the feasibility of implementing a health education programme for adolescents on menstrual hygiene in secondary schools serving rural Bangladesh. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Clinton-Sherrod, A Monique; Morgan-Lopez, Antonio A; Gibbs, Deborah; Hawkins, Stephanie R; Hart, Laurie; Ball, Barbara; Irvin, Neil; Littler, Nicole
This study extends past research by examining factors associated with changes in attitudes, knowledge, and intended behaviors related to sexual assault. This study included 1,182 participants from four unique multiple-session school-based sexual violence interventions. Implementation and participant factors examined include single- versus mixed-gender groups, group setting versus classroom lecture setting, and participant gender. Participants completed self-administered, paper-and-pencil pre- and postsurveys. A significant desired overall effect was found on participants' reports of positive attitudes, beliefs, and behavior regarding sexual harassment and personal boundaries and positive dating relationship norms (from pretest to posttest). There were steeper increases over time in both measures, with larger mixed-gender/single-gender differences among boys than among girls. Differences in the impact of participating in mixed- versus single-gender groups depended on classroom versus small group settings. The implications of these findings are discussed for sexual assault prevention programs.
Kawabata, Masato; Chua, Khai Leng; Chatzisarantis, Nikos L D
Regular participation in moderate-to-vigorous physical activity (MVPA) is important to manage obesity. Physical education (PE) is considered to play an important role in promoting lifelong participation in physical activity (PA) because it provides an existing network where cost-effective interventions can be implemented to produce sustainable change in health behavior. However, the association between compulsory school PA (e.g., PE lessons) and body composition levels has received mixed support in the literature. Therefore, the present study aimed to investigate whether a school-based intervention targeting salient PA benefits and barriers grounded on the theory of planned behavior would promote young people's participation in MVPA during leisure time and reduce body mass index (BMI) of overweight students. A total of 171 students from 3 secondary schools in Singapore underwent the control condition followed by the intervention condition. Both the conditions consisted of PE lessons twice per week over 4 weeks. In the control condition, PE teachers encouraged students to participate in PA during leisure time without providing persuasive message. While in the intervention condition, PE teachers delivered persuasive messages that targeted the salient benefits and barriers associated with PA to the students at the last 5 to 10 min of each PE lesson. PA levels over a week were measured objectively with wrist-mounted GENEActiv Original accelerometers and subjectively with self-reporting questionnaires three times (Baseline, Post 1, and Post 2) in each condition. Student's self-reported PA level was measured using the Leisure-Time Physical Activity Participation Questionnaire and the International Physical Activity Questionnaire, and their attitudes, intentions, subjective norms and perceived behavior control towards leisure-time PA were measured with a questionnaire based on the theory of planned behavior. Furthermore, students' intention, determination and
Wagaman, M. Alex; Geiger, Jennifer Mullins; Bermudez-Parsai, Monica; Hedberg, E. C.
Although schools have been trying to address bulling by utilizing different approaches that stop or reduce the incidence of bullying, little remains known about what specific intervention strategies are most successful in reducing bullying in the school setting. Using the social-ecological framework, this paper examines school-based disciplinary interventions often used to deliver consequences to deter the reoccurrence of bullying and aggressive behaviors among school-aged children. Data for this study are drawn from the School-Wide Information System (SWIS) with the final analytic sample consisting of 1,221 students in grades K – 12 who received an office disciplinary referral for bullying during the first semester. Using Kaplan-Meier Failure Functions and Multi-level discrete time hazard models, determinants of the probability of a student receiving a second referral over time were examined. Of the seven interventions tested, only Parent-Teacher Conference (AOR=0.65, pbullying and aggressive behaviors. By using a social-ecological framework, schools can develop strategies that deter the reoccurrence of bullying by identifying key factors that enhance a sense of connection between the students’ mesosystems as well as utilizing disciplinary strategies that take into consideration student’s microsystem roles. PMID:22878779
Browne, Christi L.
The challenge of school-based science curriculum change and educational reform is often presented to science teachers and departments who are not necessarily prepared for the complexity of considerations that change movements require. The development of a Professional Learning Community (PLC) focused on a science department's curriculum change efforts, may provide the necessary tools to foster sustainable school-based curriculum science changes. This research presents a case study of an evolving science department PLC consisting of 10 middle school science teachers from the same middle school and their efforts of school-based science curriculum change. A transformative mixed model case study with qualitative data and deepened by quantitative analysis, was chosen to guide the investigation. Collected data worked to document the essential developmental steps, the occurrence and frequency of the five essential dimensions of successful PLCs, and the influences the science department PLC had on the middle school science department's progression through school-based science curriculum change, and the barriers, struggles and inhibiting actions of the science department PLC. Findings indicated that a science department PLC was unique in that it allowed for a focal science departmental lens of science curriculum change to be applied to the structure and function of the PLC and therefore the process, proceedings, and results were directly aligned to and driven by the science department. The science PLC, while logically difficult to set-up and maintain, became a professional science forum where the middle school science teachers were exposed to new science teaching and learning knowledge, explored new science standards, discussed effects on student science learning, designed and critically analyzed science curriculum change application. Conclusions resulted in the science department PLC as an identified tool providing the ability for science departmental actions to lead to
Full Text Available Obesity in childhood is increasing worldwide. To combat overweight and obesity in childhood, the school-based Children's Health InterventionaL Trial (CHILT project combines health education and physical activity. This paper examines the effect of intervention on the body mass index (BMI and motor abilities after 20.8 ± 1.0 months in 12 randomly selected primary schools compared with 5 randomly selected control schools. The anthropometric data were assessed, BMI was calculated. Coordination was determined by lateral jumping and endurance performance by a 6-minute run. No difference in the prevalence of overweight and obesity was found between the intervention (IS and control schools (CS either at baseline or following intervention (each p > 0.05. The increase in the number of lateral jumps was significantly higher in the IS than in the CS (p < 0.001. For the 6-minute run the increase in distance run was significantly improved in IS (p = 0.020. All variables were controlled for gender and age. Overweight and obese children in both IS and CS produced significantly lower scores in coordination and endurance tasks than normal and underweight children during both examinations (each p < 0.001, adjusted for gender and age. Preventive intervention in primary schools offers an effective means to improve motor skills in childhood and to break through the vicious circle of physical inactivity - motor deficits - frustration - increasing inactivity possibly combined with an excess energy intake and weight gain. To prevent overweight and obesity these measures have to be intensified
Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl
sub-Saharan Africa (Malawi, South Africa, Tanzania, Zimbabwe, and Kenya), one in Latin America (Chile), and two in Europe (England and Scotland). Sexual and reproductive health educational programmes Six trials evaluated school-based educational interventions. In these trials, the educational programmes evaluated had no demonstrable effect on the prevalence of HIV (RR 1.03, 95% CI 0.80 to 1.32, three trials; 14,163 participants; low certainty evidence), or other STIs (herpes simplex virus prevalence: RR 1.04, 95% CI 0.94 to 1.15; three trials, 17,445 participants; moderate certainty evidence; syphilis prevalence: RR 0.81, 95% CI 0.47 to 1.39; one trial, 6977 participants; low certainty evidence). There was also no apparent effect on the number of young women who were pregnant at the end of the trial (RR 0.99, 95% CI 0.84 to 1.16; three trials, 8280 participants; moderate certainty evidence). Material or monetary incentive-based programmes to promote school attendance Two trials evaluated incentive-based programmes to promote school attendance. In these two trials, the incentives used had no demonstrable effect on HIV prevalence (RR 1.23, 95% CI 0.51 to 2.96; two trials, 3805 participants; low certainty evidence). Compared to controls, the prevalence of herpes simplex virus infection was lower in young women receiving a monthly cash incentive to stay in school (RR 0.30, 95% CI 0.11 to 0.85), but not in young people given free school uniforms (Data not pooled, two trials, 7229 participants; very low certainty evidence). One trial evaluated the effects on syphilis and the prevalence was too low to detect or exclude effects confidently (RR 0.41, 95% CI 0.05 to 3.27; one trial, 1291 participants; very low certainty evidence). However, the number of young women who were pregnant at the end of the trial was lower among those who received incentives (RR 0.76, 95% CI 0.58 to 0.99; two trials, 4200 participants; low certainty evidence). Combined educational and incentive
Rickert, Vaughn I; Auslander, Beth A; Cox, Dena S; Rosenthal, Susan L; Rupp, Richard E; Zimet, Gregory D
Adolescent immunization rates for human papillomavirus (HPV) are low and interventions within school-based health centers (SBHCs) may increase HPV uptake and series completion. We examined the effect of a parent health message intervention on HPV vaccination intent, first dose uptake and series completion among adolescents who received care at SBHCs. Via computer-assisted telephone interviews (CATI), 445 parents of young adolescents were randomly assigned to 2 two-level interventions using a 2 × 2 design (rhetorical question (RQ) or no-RQ and one-sided or two-sided message). The RQ intervention involved asking the parent a question they were likely to endorse (e.g., "Do you want to protect your daughter from cervical cancer?") with the expectation that they would then behave in a manner consistent with their endorsement (i.e., agree to vaccinate). For the one-sided message, parents were given information that emphasized the safety and effectiveness of HPV vaccine, whereas the two-sided message acknowledged that some parents might have concerns about the vaccine, followed by reassurance regarding the safety and effectiveness. At CATI conclusion, parents indicated intentions to have their adolescents vaccinated. Parents who endorsed any intent were sent a consent form to return and all adolescents with signed returned consents were vaccinated at SBHCs. Medical records were reviewed for uptake/completion. Parents were 87% female; adolescents were 66% male and racially/ethnically diverse. 42.5% of parents indicated some intention to immunize, 51.4% were unsure, and 6.1% were not interested. 34% (n = 151) of adolescents received their first dose with series completion rates of 67% (n = 101). The RQ component of the intervention increased intention to vaccinate (RR = 1.45; 95%CI 1.16,1.81), but not first dose uptake or series completion. The 1-sided and 2-sided messages had no effect. This brief, RQ health intervention enhanced intent, but did not impact vaccination
Sowden, A; Arblaster, L; Stead, L
Decisions to smoke are made within a broad social context. Community interventions use co-ordinated, widespread, multi-component programmes to try and influence behaviour. To determine the effectiveness of community interventions in preventing the uptake of smoking in young people. The Tobacco Addiction group specialised register, Medline and other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and contact was made with content area specialists. Searches were updated in September 2002. Randomised and non randomised controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years. Information relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined using qualitative narrative synthesis. Seventeen studies were included in the review, 46 studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with six using random allocation of schools or communities. Of thirteen studies which compared community interventions to no intervention controls, two, which were part of cardiovascular disease prevention programmes, reported lower smoking prevalence. Of three studies comparing community interventions to school-based programmes only, one found differences in reported smoking prevalence. One study reported a lower rate of increase in prevalence in a community receiving a multi-component intervention compared to a community exposed to a mass media campaign alone. One study reported a significant difference in smoking prevalence between a group receiving a media, school and homework intervention compared to a group
Stoltz, S.E.M.J.; Londen, M. van; Dekovic, M.; Orobio de Castro, B.; Prinzie, P.; Lochman, J.E.
BACKGROUND: For elementary school-children with aggressive behaviour problems, there is a strong need for effective preventive interventions to interrupt the developmental trajectory towards more serious behaviour problems. AIM: The aim of this RCT-study was to evaluate a school-based individual
Lien, N.; Haerens, L.; te Velde, S.J.; Mercken, L.; Klepp, K.I.; Moore, L.; de Bourdeaudhuij, I.; Faggiano, F.; Lenthe, F.J.
Objectives: The aim of this study was to explore subgroup effects by high and low socioeconomic position (SEP) of three previously conducted, effective European interventions. Methods: Reanalyses stratified by SEP were conducted by the research groups of each study. All studies were school-based:
Wallén, Eva Flygare; Müllersdorf, Maria; Christensson, Kyllike; Marcus, Claude
This study evaluates a multifactorial school-based intervention with the aim of decreasing cardiometabolic risk factors by means of a healthy lifestyle, primarily with daily physical activity and healthy food during school hours, at an upper secondary school for students with intellectual disabilities. The outcome is measured in terms of…
Stichter, Janine P.; Herzog, Melissa J.; Owens, Sarah A.; Malugen, Emily
Despite the movement toward identification of evidence-based practices (EBPs), there is a discrepancy in the availability of school-based EBPs targeting the unique needs of students with high functioning forms of autism and related social needs. Based on calls for systematic intervention development and evaluation processes, the current study…
Moreno-Maldonado, Concepción; Ramos, Pilar; Moreno, Carmen; Rivera, Francisco
Psychologists in schools can play an important role in developing policies and programs to promote healthy eating habits. This study analyses the contributions of family socioeconomic status, peer influence (schoolmates' food consumption), and school-based nutrition interventions to explain adolescent eating behaviors. Data were obtained from the…
Tol, W.A.; Komproe, I.H.; Jordans, M.J.D.; Ndayisaba, A.; Ntamatumba, P.; Sipsma, H.; Smallegange, E.S.; Macy, R.D.; de Jong, J.T.V.M.
Background: Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving
Dockrell, Sara; Earle, Deirdre; Galvin, Rose
This study investigated the effect of a school-based ergonomic intervention on childrens' posture and discomfort while using computers using a pre/post test study design. The sample comprised 23 children age 9 and 10 years. Posture was assessed with Rapid Upper Limb Assessment (RULA) and a workstation assessment was completed using a Visual…
Tol, Wietse A.; Komproe, Ivan H.; Jordans, Mark J D; Ndayisaba, Aline; Ntamutumba, Prudence; Sipsma, Heather; Smallegange, Eva S.; Macy, Robert D.; de Jong, Joop T V M; Komproe, J
Background: Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving
Painter, Kirstin; Phelan, Jo C; DuPont-Reyes, Melissa J; Barkin, Kay F; Villatoro, Alice P; Link, Bruce G
School-based interventions for preadolescents provide the opportunity, in a ubiquitous institutional setting, to attack stigmatizing attitudes before they are firmly entrenched, and thus they may reduce mental illness stigma in the overall population. This study evaluated the effectiveness of classroom-based interventions in reducing stigma and increasing understanding of mental illness and positive attitudes toward treatment seeking among sixth-grade students. In an ethnically and racially diverse sample (N=721), 40% of participants were Latino, 26% were white, and 24% were African American; the mean age was 11.5. In a fully crossed design, classrooms from a school district in Texas were randomly assigned to receive all three, two, one, or none of the following interventions: a PowerPoint- and discussion-based curriculum, contact with two college students who described their experiences with mental illness, and exposure to antistigma printed materials. Standard and vignette-based quantitative measures of mental health knowledge and attitudes, social distance, and help-seeking attitudes were assessed pre- and postintervention. Printed materials had no significant effects on outcomes and were grouped with the control condition for analysis. For eight of 13 outcomes, the curriculum-only group reported significantly more positive outcomes than the control group; the largest between-group differences were for stigma awareness and action, recognition of mental illness in the vignettes, and positive orientation to treatment. The contact-alone group reported significantly more positive outcomes on three vignette-based measures. Results were most promising for a classroom-based curriculum that can be relatively easily disseminated to and delivered by teachers, offering the potential for broad application in the population.
Khun, Sokrin; Manderson, Lenore
Dengue fever continues to be a major public health problem in Cambodia, with significant impact on children. Health education is a major means for prevention and control of the National Dengue Control Program (NDCP), and is delivered to communities and in schools. Drawing on data collected in 2003-2004 as part of an ethnographic study conducted in eastern Cambodia, we explore the approaches used in health education and their effectiveness to control dengue. Community health education is provided through health centre outreach activities and campaigns of the NDCP, but is not systematically evaluated, is under-funded and delivered irregularly; school-based education is restricted in terms of time and lacks follow-up in terms of practical activities for prevention and control. As a result, adherence is partial. We suggest the need for sustained routine education for dengue prevention and control, and the need for approaches to ensure the translation of knowledge into practice.
Full Text Available Dengue fever continues to be a major public health problem in Cambodia, with significant impact on children. Health education is a major means for prevention and control of the National Dengue Control Program (NDCP, and is delivered to communities and in schools. Drawing on data collected in 2003-2004 as part of an ethnographic study conducted in eastern Cambodia, we explore the approaches used in health education and their effectiveness to control dengue. Community health education is provided through health centre outreach activities and campaigns of the NDCP, but is not systematically evaluated, is under-funded and delivered irregularly; school-based education is restricted in terms of time and lacks follow-up in terms of practical activities for prevention and control. As a result, adherence is partial. We suggest the need for sustained routine education for dengue prevention and control, and the need for approaches to ensure the translation of knowledge into practice.
Parker, Donna R; Assaf, Annlouise R
Review of the community-based CVD intervention programs suggests that a number of components have been successful using varying methods and materials for CVD risk reduction. It should be noted, however, that in multi-intervention programs it is often difficult to determine which components of the intervention were responsible for the overall success of the study. The community-based approach to CVD prevention is generalizable, cost-effective (because of the use of mass communication methods), and has the potential for modifying the environment and influencing health policies. Based on the experiences and successes of a number of community projects, recommendations have been proposed for developing future programs. Although they are not totally comprehensive, it has been suggested that a community-based intervention program should consider the following recommendations: 1) An understanding of the community: the needs and priorities of the community should be assessed, and close collaboration with individuals from the community, including community leaders, opinion leaders, community health care providers, and community organizations from various sectors of the community, should be consulted. Efforts should be focused on underserved and vulnerable populations. 2) Inclusion of community activities: these activities should be integrated within the context of the community environment, including primary health care services, voluntary organizations, grocery stores, restaurants, work sites, schools, and local media. 3) Inclusion mass media messages: the mass media can provide information and reinforcement of the behavior change. 4) Develop cost-effective interventions to assure that the community is exposed to an effective dose of the intervention. 5) Work with community organizations to help change social and physical environments to make them more conducive to health and healthy life-styles changes. 6) Develop a reliable monitoring and evaluation system: monitor the
Service-learning (SL) is an experiential teaching method that combines instruction with community service, with the aim of enriching students' academic learning, interpersonal skills and sense of responsibility while making meaningful contributions to the community. However, measuring outcomes of service-learning projects is difficult. This article reports on the perceptions of 18 third-year undergraduate nursing students who took part in a pilot service-learning project targeting tobacco use in a local elementary school. Faculty members evaluated the program's outcomes by engaging students in structured reflection on the program about its relevance to their future careers as practicing professionals, especially in community-based settings. The students' perceptions were elicited through three sets of reflective assignments following the project. Findings from the reflective assignments suggest that the pilot program was successful in enhancing the students' academic, social, and personal development while building a partnership between the school of nursing and key players in the community, including school-based nurses, teachers, administrators, families, and community leaders. The author suggests that service-learning projects can help nursing students accomplish key developmental tasks of the college years (such as building their competence, autonomy, and integrity), while helping impart the skills and values they will need as they graduate and seek professional nursing roles.
Chawla, Nattapon; Panza, Alessio; Sirikulchayanonta, Chutima; Kumar, Ramesh; Taneepanichskul, Surasak
Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adults and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thais is the 5th highest in Asia. The present study objective was to evaluate the effectiveness of a life-skills, multicomponent, school-based intervention on child nutritional status. A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The interventions included education, diet, physical activity (PA), food-environment, school builtenvironment, and life-skills components. Subjects were measured at baseline and at 6 months post-treatment. The intervention group had significant differences in overall healthy practices (+1.5 mean difference, p=0.048), dietary habits, physical activity, lower total cholesterol (TC) levels (-2.43 mean, p=0.019) and higher high density lipoprotein cholesterol (HDL-C) levels (+4.06 p=0.028) as compared to the control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetables increased while consumption of high-caloric snacks and fast foods decreased in children after the intervention. This study indicated that a multidisciplinary approach in school-based interventions is most likely to be effective in preventing children from becoming overweight in the long term. More research should be conducted on school-based interventions with longer intervention periods and higher sustainability.
Chawla, N.; Panza, A.; Kumar, R.
Childhood obesity has become a major public health issue today. The prevalence of obesity and overweight is increasing in both adult and children. Childhood obesity in Thailand has more than doubled since the 1960s and a recent study reported that overweight and obesity in Thai is the 5th highest in Asia. The present study objective is to evaluate the effectiveness of a life skills multicomponent school-based intervention on children's nutritional status. Methods: A quasi-experimental design was conducted in two-groups (control and intervention schools) on 453 students attending grade levels 4-5 in Bangkok. Two schools were selected for control, and two schools for intervention groups. The intervention included education, dietary, physical activity, food-environment, school built-environment, and life skills components. Outcomes were measured at baseline and post-treatment measured after 6 months. Results: The intervention group had significant improvements in healthier practice (+1.5 mean difference, p=0.048) on dietary habits and physical activity, lowered cholesterol levels (-2.43 mean, p=0.019), and higher HDL levels (+4.06 p=0.028) as compared to control. A higher reduction of overweight individuals among the intervention group over the intervention period was observed. Physical activity and consumption of vegetable increased while consumption of high-caloric snacks and fasts food decreased in children after the intervention. Conclusion: Childhood overweight and obesity is a serious public health problem based on its increasing rates and the associated health risks. This study indicated that multidisciplinary approach on school-based interventions is likely most effective to prevent children becoming overweight in long term. More research should be conducted on school-based intervention with longer intervention periods with higher sustainability. (author)
Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl
(Chile), and two in Europe (England and Scotland). Sexual and reproductive health educational programmesSix trials evaluated school-based educational interventions.In these trials, the educational programmes evaluated had no demonstrable effect on the prevalence of HIV (RR 1.03, 95% CI 0.80 to 1.32, three trials; 14,163 participants; low certainty evidence), or other STIs (herpes simplex virus prevalence: RR 1.04, 95% CI 0.94 to 1.15; three trials, 17,445 participants; moderate certainty evidence; syphilis prevalence: RR 0.81, 95% CI 0.47 to 1.39; one trial, 6977 participants; low certainty evidence). There was also no apparent effect on the number of young women who were pregnant at the end of the trial (RR 0.99, 95% CI 0.84 to 1.16; three trials, 8280 participants; moderate certainty evidence). Material or monetary incentive-based programmes to promote school attendanceTwo trials evaluated incentive-based programmes to promote school attendance.In these two trials, the incentives used had no demonstrable effect on HIV prevalence (RR 1.23, 95% CI 0.51 to 2.96; two trials, 3805 participants; low certainty evidence). Compared to controls, the prevalence of herpes simplex virus infection was lower in young women receiving a monthly cash incentive to stay in school (RR 0.30, 95% CI 0.11 to 0.85), but not in young people given free school uniforms (Data not pooled, two trials, 7229 participants; very low certainty evidence). One trial evaluated the effects on syphilis and the prevalence was too low to detect or exclude effects confidently (RR 0.41, 95% CI 0.05 to 3.27; one trial, 1291 participants; very low certainty evidence). However, the number of young women who were pregnant at the end of the trial was lower among those who received incentives (RR 0.76, 95% CI 0.58 to 0.99; two trials, 4200 participants; low certainty evidence). Combined educational and incentive-based programmesThe single trial that evaluated free school uniforms also included a trial arm in which
Evans, Charlotte E L; Albar, Salwa Ali; Vargas-Garcia, Elisa J; Xu, Fei
School-based interventions are relatively new and were first introduced in the United States in the 1990s. Early programs were mainly education based with many of the findings now embedded in school policy in the form of a healthy eating curriculum. More recent school programs have taken education outside the classroom and attempted to engage parents as well as teachers. Environmental changes such as improving the quality of foods available at lunchtime and at other times during the school day are now common. Reviews of evaluations of school-based programs have demonstrated that they are effective and successfully improve dietary quality such as increasing fruit and vegetable intake and decreasing sweet and savory snacks and sweetened drinks; not just in school but over the whole day and particularly in younger school children. School-based interventions are also effective at reducing obesity if components to increase physical activity and reduce sedentary behaviors are also targeted but not if only dietary behaviors are tackled. Most of the high-quality evaluation studies using randomized controlled trials have been carried out in high-income countries as they are costly to run. However, middle-income countries have benefitted from the information available from these evaluation studies and many are now starting to fund and evaluate school-based programs themselves, resulting in unique problems such as concomitant under- and overnutrition being addressed. Action for the future demands more focus on populations most at risk of poor dietary quality and obesity in order to reduce inequalities in health and on adolescents who have not benefited as much as younger children from school-based interventions. This will involve innovative solutions within schools as well as targeting the food environment outside schools such as reducing the density of fast-food outlets and marketing of sweet and savory snacks and drinks. © 2015 Elsevier Inc. All rights reserved.
Morrow, S A; Bates, P E
This study examined the effectiveness of three sets of school-based instructional materials and community training on acquisition and generalization of a community laundry skill by nine students with severe handicaps. School-based instruction involved artificial materials (pictures), simulated materials (cardboard replica of a community washing machine), and natural materials (modified home model washing machine). Generalization assessments were conducted at two different community laundromats, on two machines represented fully by the school-based instructional materials and two machines not represented fully by these materials. After three phases of school-based instruction, the students were provided ten community training trials in one laundromat setting and a final assessment was conducted in both the trained and untrained community settings. A multiple probe design across students was used to evaluate the effectiveness of the three types of school instruction and community training. After systematic training, most of the students increased their laundry performance with all three sets of school-based materials; however, generalization of these acquired skills was limited in the two community settings. Direct training in one of the community settings resulted in more efficient acquisition of the laundry skills and enhanced generalization to the untrained laundromat setting for most of the students. Results of this study are discussed in regard to the issue of school versus community-based instruction and recommendations are made for future research in this area.
Full Text Available Abstract Background The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. Methods A total of 300 children (grade 3; 8-9 years of age from six schools in Granada (Spain will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school or a control group (no intervention school; 50 children. Outcomes will include physical activity (measured by accelerometry, physical fitness (assessed using the ALPHA fitness battery, and anthropometry (height, weight and waist circumference. Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires, academic achievement (grades from the official school’s records, and health-related quality of life (child and parental questionnaires. To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. Discussion The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.
Tercedor, Pablo; Villa-González, Emilio; Ávila-García, Manuel; Díaz-Piedra, Carolina; Martínez-Baena, Alejandro; Soriano-Maldonado, Alberto; Pérez-López, Isaac José; García-Rodríguez, Inmaculada; Mandic, Sandra; Palomares-Cuadros, Juan; Segura-Jiménez, Víctor; Huertas-Delgado, Francisco Javier
The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions) to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. A total of 300 children (grade 3; 8-9 years of age) from six schools in Granada (Spain) will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school) or a control group (no intervention school; 50 children). Outcomes will include physical activity (measured by accelerometry), physical fitness (assessed using the ALPHA fitness battery), and anthropometry (height, weight and waist circumference). Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires), academic achievement (grades from the official school's records), and health-related quality of life (child and parental questionnaires). To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.
Tol, Wietse A; Komproe, Ivan H; Jordans, Mark J D; Ndayisaba, Aline; Ntamutumba, Prudence; Sipsma, Heather; Smallegange, Eva S; Macy, Robert D; de Jong, Joop T V M
Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim). We conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention. No main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes. Given inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are
Adam G. Cole
Full Text Available School-based programs and policies can reduce student smoking rates. However, their impact on never-smoking students has not been investigated despite the clear transition between non-susceptible, susceptible, and ever tried smoking statuses. The objective of this paper was to examine the longitudinal student-level impact of six changes in school-based tobacco control programs and policies on student transitions in susceptibility to smoking over one year. Two multinomial logistic regression models identified the relative risk of a change in self-reported susceptibility to smoking or in trying a cigarette among never-smoking students in each of the six intervention schools compared to the relative risk among never-smoking students in control schools. Model 1 identified the relative risk of a change in smoking susceptibility status among baseline non-susceptible never smoking students, while Model 2 identified the relative risk of a change in smoking susceptibility status among baseline susceptible never smoking students. Students at some intervention schools were at increased risk of becoming susceptible to or trying a cigarette at one year follow-up. Intervention studies should examine changes to susceptibility to future smoking when evaluating impact to ensure that school-based tobacco control programs and policies do not negatively change the risk status of never-smoking students.
Bagherniya, Mohammad; Sharma, Manoj; Mostafavi Darani, Firoozeh; Maracy, Mohammad Reza; Safarian, Mohammad; Allipour Birgani, Ramesh; Bitarafan, Vida; Keshavarz, Seyed Ali
Background Nowadays childhood obesity has become one the most challenging issue which is considered as a principle public health problem all around the world. This study was conducted with the aim of evaluating the impact of a 7-month school-based nutrition education intervention using social cognitive theory (SCT) to prevent obesity among overweight and obese adolescent girls. Method In this cluster randomized community trial after choosing schools, a total of 172 overweight and obese girl students participated in the study (87 in the intervention and 85 in the control group). A 7-month intervention based on SCT for students, their parents, and teachers was conducted. At baseline and end of the study, body mass index (BMI), waist circumstances (WCs), dietary intake, and psychological questionnaires regarding the SCT constructs were obtained. Results After 7 months, the mean of BMI and WCs reduced in the intervention group from 29.47 (4.05) to 28.5 (4.35) and from 89.65 (8.15) to 86.54 (9.76), respectively, but in comparison to the control group, they were not statistically significant ( p values .127 and .504, respectively). In the intervention group, nutritional behaviors and most of the psychological variables (self-efficacy, social support, intention, and situation) were improved in favor of the study and they were significant in comparison to the control group ( p < .05). Conclusion Although school-based nutrition education intervention using SCT did not change significantly BMI and WCs among the targeted population in this study, dietary habits as well as psychological factors improved significantly in the intervention group. This trial was registered in Iranian Registry of Clinical Trials, www.irct.ir (IRCT2013103115211N1).
Adhikari, Ramesh P; Upadhaya, Nawaraj; Satinsky, Emily N; Burkey, Matthew D; Kohrt, Brandon A; Jordans, Mark J D
This study evaluates the feasibility, acceptability, and outcomes of a combined school- and family-based intervention, delivered by psychosocial counselors, for children with behavior problems in rural Nepal. Forty-one children participated at baseline. Two students moved to another district, meaning 39 children, ages 6-15, participated at both baseline and follow-up. Pre-post evaluation was used to assess behavioral changes over a 4-month follow-up period (n = 39). The primary outcome measure was the Disruptive Behavior International Scale-Nepal version (DBIS-N). The secondary outcome scales included the Child Functional Impairment Scale and the Eyberg Child Behavior Inventory (ECBI). Twelve key informant interviews were conducted with community stakeholders, including teachers, parents, and community members, to assess stakeholders' perceptions of the intervention. The study found that children's behavior problems as assessed on the DBIS-N were significantly lower at follow-up (M = 13.0, SD = 6.4) than at baseline (M = 20.5, SD = 3.8), p behaviors among children and the implementation of new behavior management techniques both at home and in the classroom. Significant change in child outcome measures in this uncontrolled evaluation, alongside qualitative findings suggesting feasibility and acceptability, support moving toward a controlled trial to determine effectiveness.
Jaycox, Lisa H; Stein, Bradley D; Wong, Marleen
Schools are well positioned to facilitate recovery for students exposed to community or school violence or other traumatic life events affecting populations of youth. This article describes how schools can circumvent several key barriers to mental health service provision, outcomes that school interventions target, and the role of the family in school-based services. It includes a description of the history of schools in facilitating recovery for students exposed to traumatic events, particularly related to crisis intervention, and the current status of early intervention and strategies for long-term recovery in the school setting. Challenges and future directions are also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.
Torrente, Catalina; Nathanson, Lori; Rivers, Susan; Brackett, Marc
Children's social-emotional skills, such as conflict resolution and emotion regulation, have been linked to a number of highly regarded academic and social outcomes. The current study presents preliminary results from a causal test of the theory of change of RULER, a universal school-based approach to social and emotional learning (SEL).…
Blackman, Kate F.; Powers, Joelle D.; Edwards, Jeffrey D.; Wegmann, Kate M.; Lechner, Ethan; Swick, Danielle C.
Mental health needs among children in the United States have significant consequences for children and their families, as well as the schools that serve them. This qualitative study evaluated the second year of an innovative school-based mental health project that created a multi-system partnership between an urban school district, a public mental…
Patino-Fernandez, Anna M.; Hernandez, Jennifer; Villa, Manuela; Delamater, Alan
Background: The prevalence of childhood obesity is high, particularly among minority youth. The objective of this article was to evaluate parent and school staff perspectives of childhood health and weight qualitatively to guide the development of a school-based obesity prevention program for minority youth. Methods: Hispanic parents (N?=?9) of…
Brown, Kelly J.; Block, Audrey J.
Evaluated a school-based program that served female adolescents with histories of physical, sexual, or emotional abuse. Found that participation produced healthier beliefs and attitudes about alcohol and other drug use and reduced initiation of tobacco and marijuana use. Findings support enrolling younger girls before they develop negative…
Huong, Le Thi Thanh; Long, Tran Khanh; Anh, Le Vu; Cook, Margaret; Capra, Mike
It is indicated that children are involuntarily exposed to secondhand smoke from adults, mainly at their home environment. This study aimed at describing the effectiveness of the school-based intervention to decrease the in-home smoking situation of adults so as to decrease children's exposure to secondhand smoke at home during the year 2011-2012 in a rural district in Hanoi, Viet Nam. This school-based intervention program (intervention and control group) involved 804 children aged 8 to 11 years from August 2011 to May 2012 in a rural district of Hanoi, Viet Nam. Children were taught in class about the harmful effects of secondhand smoke and about how to negotiate with fathers not to smoke in-home. Then children applied what they learnt, including staying away from secondhand smoke and persuading fathers not to smoke in-home in order to decrease children's exposure to secondhand smoke. Chi square test, t-test and multinominal logistic regression were applied in data analysis. The results showed that children's reported their father's in-home smoking decreased from 83.0% pre-intervention to 59.8% post-intervention ( p Viet Nam to increase children's awareness on the adverse health effects of secondhand smoke and to help them to be able to avoid their exposure to secondhand smoke at their home environment.
Full Text Available Abstract Background Physical activity levels decline markedly among girls during adolescence. School-based interventions that are multi-component in nature, simultaneously targeting curricular, school environment and policy, and community links, are a promising approach for promoting physical activity. This report describes the rationale, design and baseline data from the Girls in Sport group randomised trial, which aims to prevent the decline in moderate-to-vigorous intensity physical activity (MVPA among adolescent girls. Methods/Design A community-based participatory research approach and action learning framework are used with measurements at baseline and 18-month follow-up. Within each intervention school, a committee develops an action plan aimed at meeting the primary objective (preventing the decline in accelerometer-derived MVPA. Academic partners and the State Department of Education and Training act as critical friends. Control schools continue with their usual school programming. 24 schools were matched then randomized into intervention (n = 12 and control (n = 12 groups. A total of 1518 girls (771 intervention and 747 control completed baseline assessments (86% response rate. Useable accelerometer data (≥10 hrs/day on at least 3 days were obtained from 79% of this sample (n = 1199. Randomisation resulted in no differences between intervention and control groups on any of the outcomes. The mean age (SE of the sample was 13.6 (± 0.02 years and they spent less than 5% of their waking hours in MVPA (4.85 ± 0.06. Discussion Girls in Sport will test the effectiveness of schools working towards the same goal, but developing individual, targeted interventions that bring about changes in curriculum, school environment and policy, and community links. By using community-based participatory research and an action learning framework in a secondary school setting, it aims to add to the body of literature on effective school-based
Kriemler, S; Meyer, U; Martin, E
School-based interventions are thought to be the most universally applicable and effective way to counteract low physical activity (PA) and fitness although there is controversy about the optimal strategy to intervene.......School-based interventions are thought to be the most universally applicable and effective way to counteract low physical activity (PA) and fitness although there is controversy about the optimal strategy to intervene....
Resaland, G K; Anderssen, S A; Holme, I M
at the I-school carried out 60 min of PA daily. The PA lessons were planned, organized and led by expert physical education (PE) teachers. In the C-school, children were offered the normal 45 min of PE twice weekly. The intervention resulted in a greater beneficial development in systolic (P=0......The aim of this study was to investigate the effect of a 2-year school-based physical activity (PA) intervention in 9-year-old children on cardiovascular disease (CVD) risk factors. One intervention school (I-school) (n=125) and one control school (C-school) (n=131) were included. The children...
Le Thi Thanh Huong
Full Text Available It is indicated that children are involuntarily exposed to secondhand smoke from adults, mainly at their home environment. This study aimed at describing the effectiveness of the school-based intervention to decrease the in-home smoking situation of adults so as to decrease children’s exposure to secondhand smoke at home during the year 2011–2012 in a rural district in Hanoi, Viet Nam. This school-based intervention program (intervention and control group involved 804 children aged 8 to 11 years from August 2011 to May 2012 in a rural district of Hanoi, Viet Nam. Children were taught in class about the harmful effects of secondhand smoke and about how to negotiate with fathers not to smoke in-home. Then children applied what they learnt, including staying away from secondhand smoke and persuading fathers not to smoke in-home in order to decrease children’s exposure to secondhand smoke. Chi square test, t-test and multinominal logistic regression were applied in data analysis. The results showed that children’s reported their father’s in-home smoking decreased from 83.0% pre-intervention to 59.8% post-intervention (p < 0.001 in the intervention school while no change happened in the control school. The study found that the better changed smoking location of adult smokers as reported by children associated with the school who received intervention activities (adjusted OR = 2.04; 95% CI: 1.28–3.24. Poorer changed attitudes towards secondhand smoke of children associated with a lower percentage of better change in smoking location of their fathers/other adult smokers (aOR = 0.51, 95% CI: 0.28–0.96. Children’s poorer changed knowledge towards secondhand smoke also associated with poorer changed smoking location of adult smokers (aOR = 2.88, 95% CI: 1.07–7.76. It is recommended by this study that similar school based intervention approaches should be applied in primary schools in Viet Nam to increase children’s awareness on the
Lena V Nordheim
Full Text Available Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims.We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation to assess the certainty of the evidence.Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low.Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health
Nordheim, Lena V; Gundersen, Malene W; Espehaug, Birgitte; Guttersrud, Øystein; Flottorp, Signe
Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims. We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) to assess the certainty of the evidence. Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low. Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health claims. The small
Njomo, D W; Masaku, J; Mwende, F; Odhiambo, G; Musuva, R; Matey, E; Thuita, I G; Kihara, J H
In Kenya, the National School-Based Deworming Programme (NSBDP) for soil-transmitted helminthes and schistosomiasis in prioritized areas has been going on since the year 2012. By the year 2013 over 6 million School Age Children (SAC) had been treated. A community sensitization supplement containing key messages and answers to frequently asked questions was developed as a guiding tool. Awareness creation methods used include county sensitization meetings, stakeholder forums, town criers and posters. To assess the local stakeholders' perceptions of community sensitization for programme implementation, a qualitative cross-sectional survey was conducted in four-sub-counties of coastal region. In-depth interviews (IDIs) were administered to 40 purposively selected opinion leaders so as to explore their perceptions of awareness creation sources, adequacy of information given, length of period of awareness creation and period between which information is given and drugs are administered. Separate IDIs were administered to pre-school teachers (41), community health extension workers (34) and primary school teachers (38). To elicit more information, 20 focus group discussions (FGDs) categorized by gender and age were conducted among parents of school-age children. Data was audio recorded, transcribed, coded and analyzed manually by study themes. The most commonly reported source of information was school pupils. Due to low literacy levels, use of posters was regarded as ineffective and religious institutions, town criers and vernacular radio stations considered more effective. The information given during programme implementation was considered inadequate and use of complementary methods to reach all targeted children including the non-enrolled, and relay adequate information reported as important. Use of school and chief's meetings with health personnel being present was mentioned as a useful method that would allow for interaction with participants indicating that they
Miller, David N.
Meeting a crucial need, this book distills the best current knowledge on child and adolescent suicide prevention into comprehensive guidelines for school-based practitioners. The author draws on extensive research and clinical experience to provide best-practice recommendations for developing schoolwide prevention programs, conducting risk…
Todd, Charlotte; Christian, Danielle; Davies, Helen; Rance, Jaynie; Stratton, Gareth; Rapport, Frances; Brophy, Sinead
Schools play an important role in promoting the health of children. However, little consideration is often given to the influence that headteachers' and school staff's prior beliefs have on the implementation of public health interventions. This study examined primary school headteachers' and school health co-ordinators' views regarding child health in order to provide greater insights on the school's perspective for those designing future school-based health interventions. A qualitative study was conducted using 19 semi-structured interviews with headteachers, deputy headteachers and school health co-ordinators in the primary school setting. All transcripts were analysed using thematic analysis. Whilst many participants in this study believed good health was vital for learning, wide variance was evident regarding the perceived health of school pupils and the magnitude of responsibility schools should take in addressing child health behaviours. Although staff in this study acknowledged the importance of their role, many believed the responsibility placed upon schools for health promotion was becoming too much; suggesting health interventions need to better integrate school, parental and societal components. With mental health highlighted as an increasing priority in many schools, incorporating wellbeing outcomes into future school based health interventions is advocated to ensure a more holistic understanding of child health is gained. Understanding the health beliefs of school staff when designing interventions is crucial as there appears to be a greater likelihood of interventions being successfully adopted if staff perceive a health issue as important among their pupils. An increased dependability on schools for addressing health was expressed by headteachers in this study, highlighting a need for better understanding of parental, child and key stakeholder perspectives on responsibility for child health. Without this understanding, there is potential for certain
Full Text Available Abstract Background Active commuting to school has declined over time, and interventions are needed to reverse this trend. The main objective was to investigate the effects of a school-based intervention on active commuting to school and health-related fitness in school-age children of Southern Spain. Methods A total of 494 children aged 8 to 11 years were invited to participate in the study. The schools were non-randomly allocated (i.e., school level allocation into the experimental group (EG or the control group (CG. The EG received an intervention program for 6 months (a monthly activity focused on increasing the level of active commuting to school and mainly targeting children’s perceptions and attitudes. Active commuting to school and health-related fitness (i.e., cardiorespiratory fitness, muscular fitness and speed-agility, were measured at baseline and at the end of the intervention. Children with valid data on commuting to school at baseline and follow-up, sex, age and distance from home to school were included in the final analysis (n = 251. Data was analyzed through a factorial ANOVA and the Bonferroni post-hoc test. Results At follow up, the EG had higher rates of cycling to school than CG for boys only (p = 0.04, but not for walking to school for boys or girls. The EG avoided increases in the rates of passive commuting at follow up, which increased in the CG among girls for car (MD = 1.77; SE = 0.714; p = 0.010 and bus (MD = 1.77; SE = 0.714; p = 0.010 modes. Moreover, we observed significant interactions and main effects between independent variables (study group, sex and assessment time point on health-related fitness (p < 0.05 over the 6-month period between groups, with higher values in the control group (mainly in boys. Conclusion A school-based intervention focused on increasing active commuting to school was associated with increases in rates of cycling to school among boys, but not for
Full Text Available Bilingual learning can be integrated in any subjects in school. One of the subject is Guidance and Couseling subject that provides opportunities for students to develop their social skills and communication. Today, the phenomenon of bullying often occurs in every aspect of life, and one of them is in educational institutions such as schools. School should be a place to establish a positive attitude and character, but the fact the school becomes the scene of bullying practices. The research question is how the bilingual learning of school-based anti bullying intervension integrated with Guidance and Counseling materials by using English for Academic Purposes settings is. This qualitative study used descriptive qualitative method that aims to understand the process and the outcome of bilingual learning process from the viewpoint or perspective of the participants. This research takes the view that since people are instruments, the objects of the research together with the researcher herself, their active involvement in the process is the key to any sustainable efforts. This research is aslo supposed to identify the students‘ understanding of the school-based anti bullying materials that are implemented in EAP settings. The impact of thus program implementation is certainly expected as the strategies to minimize the impacts that will occur in bullying behavior by the integration of anti-bullying bilingual learning model through guidance and counseling materials.
Full Text Available The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development. However, no information on the cost-effectiveness of interventions in China is available. The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity. We hypothesized the integrated intervention which combined nutrition education and physical activity (PA is more cost-effective than the same intensity of single intervention.And Findings: A multi-center randomized controlled trial conducted in six large cities during 2009-2010. A total of 8301 primary school students were categorized into five groups and followed one academic year. Nutrition intervention, PA intervention and their shared common control group were located in Beijing. The combined intervention and its' control group were located in other 5 cities. In nutrition education group, 'nutrition and health classes' were given 6 times for the students, 2 times for the parents and 4 times for the teachers and health workers. "Happy 10" was carried out twice per day in PA group. The comprehensive intervention was a combination of nutrition and PA interventions. BMI and BAZ increment was 0.65 kg/m(2 (SE 0.09 and 0.01 (SE 0.11 in the combined intervention, respectively, significantly lower than that in its' control group (0.82 ± 0.09 for BMI, 0.10 ± 0.11 for BAZ. No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its' control, which is the same case in the nutrition intervention. The single intervention has a relative lower intervention costs compared with the combined intervention. Labor costs in Guangzhou, Shanghai and Jinan was higher compared to other cities. The cost-effectiveness ratio was $120.3 for BMI and $249.3 for BAZ in combined intervention, respectively.The school-based integrated obesity intervention program was cost
Resaland, G K; Andersen, Lars Bo; Mamen, A
The aim of this study was to describe changes in children's cardiorespiratory fitness (CRF) following a school-based physical activity (PA) intervention. In total, 259 children (age 9.3+/-0.3 years) were invited to participate, of whom 256 participated. The children from the intervention school (63...... boys, 62 girls) carried out 60-min PA over 2 school years. The children from the control school (62 boys, 69 girls) had the regular curriculum-defined amount of physical education in school, i.e. 45 min twice weekly. One hundred and eighty-eight children (73.4%) successfully completed both the baseline...
Fisher, Paige H; Masia-Warner, Carrie; Klein, Rachel G
This paper describes Skills for Academic and Social Success (SASS), a cognitive-behavioral, school-based intervention for adolescents with social anxiety disorder. Clinic-based treatment studies for socially anxious youth are reviewed, and a strong rationale for transporting empirically-based interventions into schools, such as SASS, is provided. The SASS program consists of 12, 40-min group sessions that emphasize social skills and in-vivo exposure. In addition to group sessions, students are seen individually at least twice and participate in 4 weekend social events with prosocial peers from their high schools. Meetings with teachers provide information about social anxiety and facilitate classroom exposures for socially anxious participants. Parents attend 2 psychoeducational meetings about social anxiety, its treatment, and approaches for managing their child's anxiety. Initial findings regarding the program's effectiveness are presented. We conclude by discussing the challenges involved in implementing treatment protocols in schools and provide suggestions to address these issues.
Kelishadi, Roya; Lajevardi, Bahareh; Bahreynian, Maryam; Omid-Ghaemi, Vahid; Movahedian, Mahsa
Snacks play an important role in child health and nutritional status. Schools are considered as the preferred place to encourage healthy eating among children. The aim of this study was to evaluate the effect of buffet school-based intervention on acceptance and satisfaction of parents and students in Iran. Primary school students (n = 1120, 68.83% girls) from first to third grade, with one of their parents, participated in this prospective field trial study conducted in Isfahan, Iran. The study was consisted of three phases; schools selection, kitchen selection, implementation including two different parts, getting order and distribution. We provided hot snacks as traditional and healthy fast food according to taste and food preferences of children. Acceptance and satisfaction of parents and students were evaluated via a researcher made questionnaire before and after the intervention in one-third of participants as a representative sample of students who ordered the snacks. Most of the students usually ate snack in the break-time at school, the eagerness of provided snacks was 98.8% and 63.6% in girls and boys, respectively. The most interesting tastes were Ashe Reshteh and Tahchin, (45.1% girls vs. 36.8% boys), while bean (among girls) and Ashe Jo (among boys) were ranked as the lowest. More than half of parents (66.7%) evaluated the price of snacks as "acceptable," showing their satisfaction. Results of this study indicate that school-based interventions accompanied with parental and principals' support is considered as a practical approach to promote healthful eating at an early age. Developing effective interventions for youth might, therefore, help to prevent unhealthy dietary choices becoming habitual.
Irwin, Lynn G; Fortune, Dónal G
The purpose of this study was to determine the effectiveness of contact versus education interventions for adolescents in reducing stigmatizing attitudes toward people with acquired brain injury (ABI), and whether visibility of ABI affects the intervention outcome. 408 students (age range = 14-17 years) from 13 schools in the Mid-West of Ireland were randomly allocated to one of the three interventions: Education only, Contact (Visible Disability), or Contact ("Invisible" Disability). Stigmatizing attitudes were measured before and after intervention. Results suggest that a Contact intervention was more effective in reducing stigmatizing attitudes in terms of social restrictiveness, benevolence, and community mental health beliefs than education alone. Visibility of ABI impacted the effectiveness of the contact intervention on Community Mental Health beliefs only. Contact with a person with ABI is thus more effective in promoting positive attitudes than ABI education alone, while the presence of visible impairment was not found to increase this intervention effect.
Larsen, Andrew L.; Liao, Yue; Alberts, Janel; Huh, Jimi; Robertson, Trina; Dunton, Genevieve F.
Background: Few nutrition interventions in kindergarten classes have been evaluated, and none has been tested for program effectiveness, implementation, and dissemination. Building a Healthy Me (BHM) is a nutrition intervention for kindergarteners that is classroom-based and includes a family component. This study evaluated the public health…
Crone, M.R.; Reijneveld, S.A.; Willemsen, M.C.; Leerdam, F.J.M. van; Spruijt, R.D.; Hira Sing, R.A.
Objective: To assess the effect of an antismoking intervention focusing on adolescents in lower education. Students with lower education smoke more often and perceive more positive norms, and social pressure to smoke, than higher educated students. An intervention based on peer group pressure and
Full Text Available Objective. To evaluate the effectiveness of a 12-month multicomponent obesity prevention intervention. Setting. 9 elementary schools in Santiago, Chile. Subjects. 6–8 y old low-income children (N=1474. Design. Randomized controlled study; 5 intervention/4 control schools. We trained teachers to deliver nutrition contents and improve the quality of PE classes. We determined % healthy snacks brought from home, children’s nutrition knowledge, nutritional status, duration of PE classes, and % time in moderate/vigorous activity (MVA. Effectiveness was determined by comparing Δ BMI Z between intervention and control children using PROCMIXED. Results. % obesity increased in boys from both types of schools and in girls from control schools, while decreasing in girls from intervention schools (all nonsignificant. % class time in MVA declined (24.5–16.2 while remaining unchanged (24.8–23.7% in classes conducted by untrained and trained teachers, respectively. In boys, BMI Z declined (1.33–1.24 and increased (1.22–1.35 in intervention and control schools, respectively. In girls, BMI Z remained unchanged in intervention schools, while increasing significantly in control schools (0.91–1.06, P=0.024. Interaction group * time was significant for boys (P<0.0001 and girls (P=0.004. Conclusions. This intervention was effective in controlling obesity, but not preventing it. Even though impact was small, results showed that when no intervention is implemented, obesity increases.
Wise, Nancy; D'Angelo, Nadia; Chen, Xi
The current intervention study investigated the sustained effectiveness of phonological awareness training on the reading development of 16 children in French immersion who were identified as at-risk readers based on grade 1 English measures. The intervention program provided children from three cohorts with supplemental reading in small groups on…
Nayak, Baby S; Bhat, Vinod H
Childhood obesity and overweight is a global epidemics and has been increasing in the developing countries. Childhood obesity is linked with increased mortality and morbidity independent of adult obesity. Declining physical activity, access to junk food and parenting style are the major determinants of overweight in children. Thus, there is a need for increasing the physical activity of children, educating the parents as well as the children on lifestyle modification. This can be achieved through implementation of multicomponent intervention. To evaluate the effectiveness of multicomponent intervention on improving the lifestyle practices, reducing the body fat and improving the self esteem of obese children from selected schools of Udupi District, South India. A sample of 120 obese children were enrolled for multicomponent intervention. The components of multicomponent intervention were: education provided to the obese children on lifestyle modification, education of the parents and increasing the physical education activity of these children in the form of aerobics under the supervision of physical education teacher. There was an attrition of 25% in the intervention group. Thus the final sample in the intervention group was 90. Total sample of 131 overweight/ obese children enrolled as controls. There was an attrition of 20.61% in the control group. Thus, the final sample in the control group was 104. Intervention group received the multicomponent intervention for six month. Mixed Method Repeated measures Ananlysis of Variance (ANOVA) was applied for analysis of data. Results indicated that the intervention was effective in reducing the Body Mass Index (BMI), triceps, biceps, subscapular skin fold thickness of obese children. The intervention was also effective in improving the lifestyle practices and self-esteem of obese children. Overweight/obese children need to control diet and perform vigorous exercise at least for 20 minutes a day to reduce the excess fat
Gerald, Lynn B; Gerald, Joe K; McClure, Leslie A; Harrington, Kathy; Erwin, Sue; Bailey, William C
Background Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. Purpose To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. Methods The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer’s active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. Results The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. Limitations The changed design does not allow us to
Gerald, Lynn B; Gerald, Joe K; McClure, Leslie A; Harrington, Kathy; Erwin, Sue; Bailey, William C
Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer's active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. The changed design does not allow us to directly measure the effectiveness of hand
W. Jansen (Wilma); H. Raat (Hein); E. Joosten-van Zwanenburg (Evelien); I. Reuvers (Ivo); R. Walsem, van (Ron); J. Brug (Hans)
textabstractBackground Effective interventions to prevent overweight and obesity in children are urgently needed especially in inner-city neighbourhoods where prevalence of overweight and inactivity among primary school children is high. A school based intervention was developed aiming at the
Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K; Nagle, Brian J; Arredondo, Elva M; Barquera, Simón; Elder, John P
Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be gathered from such interventions. We performed a systematic review of papers published between 1965 and December 2010. Interventions were considered eligible if they had a school-based component, were done in Latin America, evaluated an obesity related outcome (body mass index [BMI], weight, %body fat, waist circumference, BMI z-score), and compared youth exposed vs not exposed. Ten studies were identified as having a school-based component. Most interventions had a sample of normal and overweight children. The most successful interventions focused on prevention rather than treatment, had longer follow-ups, a multidisciplinary team, and fewer limitations in execution. Three prevention and 2 treatment interventions found sufficient improvements in obesity-related outcomes. We found sufficient evidence to recommend school-based interventions to prevent obesity among youth in Latin America. Evidence-based interventions in the school setting should be promoted as an important component for integrated programs, policies, and monitoring frameworks designed to reverse the childhood obesity in the region. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
van Nassau, Femke; Singh, Amika S.; van Mechelen, Willem; Brug, Johannes; Chin A. Paw, Mai J. M.
Background: The school-based Dutch Obesity Intervention in Teenagers (DOiT) program is an evidence-based obesity prevention program. In preparation for dissemination throughout the Netherlands, this study aimed to adapt the initial program and to develop an implementation strategy and materials. Methods: We revisited the Intervention Mapping (IM)…
Kamali, Khosrow; Yoosefi Looyeh, Majid
This article describes a group narrative intervention for improving the behavior of 8- to 11-year-old children with attention-deficit/hyperactivity disorder at home and school. (Contains 2 tables and 1 note.)
Conclusions: This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed.
Full Text Available The purpose of this pilot study is to determine the feasibility of monitoring the progress of children with an autism spectrum disorder (ASD both in school and at home to promote a school-based integrated care model between parents, teachers, and medical providers. This is a prospective cohort study. To monitor progress, outcome measures were administered via an online platform developed for caregivers and teachers of children (n = 30 attending a school specializing in neurodevelopmental disorders and using an integrated medical and education program. Longitudinal analysis showed improvements in a novel scale, the Teacher Autism Progress Scale (TAPS, which was designed to measure key autism-related gains in a school environment (2.1-point improvement, p = 0.004, ES = 0.324. The TAPS showed a strong and statistically significant correlation, with improvement in aberrant behavior (r = −0.50; p = 0.008 and social responsiveness (r = −0.70; p < 0.001. The results also showed non-statistically significant improvements in aberrant behavior, social responsiveness, and quality of life over time at both school and home. To assess feasibility of ongoing progress measurement, we assessed missing data, which showed caregivers were more likely to miss surveys during summer. Results demonstrate the value and feasibility of online, longitudinal data collection in school to assist with individualized education planning and collaborative care for children with ASD. Lessons learned in this pilot will support school outcomes researchers in developing more efficacious, collaborative treatment plans between clinicians, caregivers, and teachers.
Christiansen, Lars B.; Lund-Cramer, Pernille; Brondeel, Ruben
Purpose Physical activity at school can improve the mental health of all children – especially if it targets children's developmental needs and is carried out in a positive social climate. The purpose of the present study was to examine the effect of a 9-month school intervention focusing......) PE lessons, 2) in-class activity outside PE, and 3) physical activity during break-time. It used a cluster-randomized design to select 24 Danish schools either for intervention or for control. Survey data on self-perception variables, socio-demographics and physical activity was collected prior...... on physical self-worth, self-perceived sport competence, body attractiveness, social competences and global self-worth in children aged 10–13 years. Methods Taking self-determination theory as its starting point, the intervention was developed and pilot-tested in close co-operation with schools. It targeted 1...
Chisholm, Katharine Elizabeth; Patterson, Paul; Torgerson, Carole; Turner, Erin; Birchwood, Max
With the burden of mental illness estimated to be costing the English economy alone around £22.5 billion a year 1, coupled with growing evidence that many mental disorders have their origins in adolescence, there is increasing pressure for schools to address the emotional well-being of their students, alongside the stigma and discrimination of mental illness. A number of prior educational interventions have been developed and evaluated for this purpose, but inconsistency of findings, reporting standards, and methodologies have led the majority of reviewers to conclude that the evidence for the efficacy of these programmes remains inconclusive. A cluster randomised controlled trial design has been employed to enable a feasibility study of 'SchoolSpace', an intervention in 7 UK secondary schools addressing stigma of mental illness, mental health literacy, and promotion of mental health. A central aspect of the intervention involves students in the experimental condition interacting with a young person with lived experience of mental illness, a stigma reducing technique designed to facilitate students' engagement in the project. The primary outcome is the level of stigma related to mental illness. Secondary outcomes include mental health literacy, resilience to mental illness, and emotional well-being. Outcomes will be measured pre and post intervention, as well as at 6 month follow-up. The proposed intervention presents the potential for increased engagement due to its combination of education and contact with a young person with lived experience of mental illness. Contact as a technique to reduce discrimination has been evaluated previously in research with adults, but has been employed in only a minority of research trials investigating the impact on youth. Prior to this study, the effect of contact on mental health literacy, resilience, and emotional well-being has not been evaluated to the authors' knowledge. If efficacious the intervention could provide a
Ong Ken K
Full Text Available Abstract Background Improving nutrition knowledge among children may help them to make healthier food choices. The aim of this study was to assess the effectiveness and acceptability of a novel educational intervention to increase nutrition knowledge among primary school children. Methods We developed a card game 'Top Grub' and a 'healthy eating' curriculum for use in primary schools. Thirty-eight state primary schools comprising 2519 children in years 5 and 6 (aged 9-11 years were recruited in a pragmatic cluster randomised controlled trial. The main outcome measures were change in nutrition knowledge scores, attitudes to healthy eating and acceptability of the intervention by children and teachers. Results Twelve intervention and 13 control schools (comprising 1133 children completed the trial. The main reason for non-completion was time pressure of the school curriculum. Mean total nutrition knowledge score increased by 1.1 in intervention (baseline to follow-up: 28.3 to 29.2 and 0.3 in control schools (27.3 to 27.6. Total nutrition knowledge score at follow-up, adjusted for baseline score, deprivation, and school size, was higher in intervention than in control schools (mean difference = 1.1; 95% CI: 0.05 to 2.16; p = 0.042. At follow-up, more children in the intervention schools said they 'are currently eating a healthy diet' (39.6% or 'would try to eat a healthy diet' (35.7% than in control schools (34.4% and 31.7% respectively; chi-square test p Conclusions The 'Top Grub' card game facilitated the enjoyable delivery of nutrition education in a sample of UK primary school age children. Further studies should determine whether improvements in nutrition knowledge are sustained and lead to changes in dietary behaviour.
Macdonald, Heather M; Kontulainen, Saija A; Khan, Karim M; McKay, Heather A
This 16-month randomized, controlled school-based study compared change in tibial bone strength between 281 boys and girls participating in a daily program of physical activity (Action Schools! BC) and 129 same-sex controls. The simple, pragmatic intervention increased distal tibia bone strength in prepubertal boys; it had no effect in early pubertal boys or pre or early pubertal girls. Numerous school-based exercise interventions have proven effective for enhancing BMC, but none have used pQCT to evaluate the effects of increased loading on bone strength during growth. Thus, our aim was to determine whether a daily program of physical activity, Action Schools! BC (AS! BC) would improve tibial bone strength in boys and girls who were pre- (Tanner stage 1) or early pubertal (Tanner stage 2 or 3) at baseline. Ten schools were randomized to intervention (INT, 7 schools) or control (CON, 3 schools). The bone-loading component of AS! BC included a daily jumping program (Bounce at the Bell) plus 15 minutes/day of classroom physical activity in addition to regular physical education. We used pQCT to compare 16-month change in bone strength index (BSI, mg2/mm4) at the distal tibia (8% site) and polar strength strain index (SSIp, mm3) at the tibial midshaft (50% site) in 281 boys and girls participating in AS! BC and 129 same-sex controls. We used a linear mixed effects model to analyze our data. Children were 10.2+/-0.6 years at baseline. Intervention boys tended to have a greater increase in BSI (+774.6 mg2/mm4; 95% CI: 672.7, 876.4) than CON boys (+650.9 mg2/mm4; 95% CI: 496.4, 805.4), but the difference was only significant in prepubertal boys (p=0.03 for group x maturity interaction). Intervention boys also tended to have a greater increase in SSIp (+198.6 mm3; 95% CI: 182.9, 214.3) than CON boys (+177.1 mm3; 95% CI: 153.5, 200.7). Change in BSI and SSIp was similar between CON and INT girls. Our findings suggest that a simple, pragmatic program of daily activity
Lee, Albert; Ho, Mandy; Keung, Vera M W; Kwong, Amy C M
Home and school environments conducive for unhealthy eating and physical inactivity are precursors of obesity. The aim of this study is evaluation of the effectiveness of a multi-component school-based weight management programme for overweight and obese primary school children via a home-school joint venture. This study made use of variety of behavioural modification strategies integrating into the Health Promoting School approach to promote healthy lifestyles. The participants were overweight and obese students aged between 8 and 12 from six participating schools. The interventions involved students attending ten 75 minutes after-school sessions and one 3-hour week-end session of practical interactive and fun activities on healthy eating and exercise, and meal plan together with parents and printed tailor-made management advices. Parents received an introductory seminar with 2 sets of specially designed exercise for their overweight children. The tools to measure bodyweight and fat percentage and standing height were bio-impedance body fat scale and a portable stadiometer. Self-administered questionnaire was used to measure knowledge, attitudes and behaviours. McNemar test was utilized to compare the proportions of behaviour changes within the same group to assess for the trends of changes. BMI z-score and body fat percentage of intervention participants at baseline, 4 month and 8 month were compared pair-wisely using tests of within subject contrasts in repeated measures ANOVA to assess for programme sustainability. Those students in the intervention group reduced their BMI z-score (-0.21, 95% CI -0.34 to -0.07, P = 0.003) and body fat (-2.67%, 95% CI -5.12 to -0.22, P = 0.033) compared to wait list control group with statistical significant, and the intervention group also had a significant reduction in BMI z-score (-0.06, 95% CI -0.11, -0.007, P = 0.028) and body fat (-1.71%, 95% CI, -3.44 to 0.02, P = 0.052) after a 4 month maintenance period. Improvement of
Botha, Cornelius J; Wild, Lauren G
Parental divorce affects approximately 30 000 South African children annually. This pilot study aimed to evaluate the effectiveness of the Children of Divorce Intervention Programme (CODIP) at two South African schools. CODIP is a preventively oriented group programme which was developed to foster resilience by helping children cope more effectively with possible academic, behavioural, and emotional problems brought about by their parents' divorce. Twenty-five 10- to 14-year-old boys from two primary schools were randomly assigned to 2 experimental groups and 1 delayed intervention control group. The experimental groups attended 12 one-hour weekly sessions; the control group received no intervention until after the study was completed. Children's understanding of divorce related events and social, emotional and behavioural adjustment was assessed one week before the intervention and three months thereafter using a battery of self-rated, teacher-rated and parent-rated questionnaires. One-way ANOVAs indicated no statistically significant decline in children's self-reported problematic beliefs about divorce or total difficulties. However, teachers' and parents' ratings indicated that compared to the control group, the combined experimental groups showed significant improvement in their general behavioural, emotional and social adjustment after programme participation. The results suggest that South African children who experience parental divorce may benefit from participation in CODIP.
Background: Children and adolescents are among the most vulnerable groups affected by natural and man-made disaster. To better understand research and practice concerning mental health and psychosocial support efforts in humanitarian settings, the authors conducted a comprehensive review of all intervention ...
Charafeddine, Lama; El Rafei, Rym; Azizi, Sophie; Sinno, Durriyah; Alamiddine, Kawthar; Howson, Christopher P; Walani, Salimah R; Ammar, Walid; Nassar, Anwar; Yunis, Khalid
Maternal behavior before and after conception affects maternal and child health. Limited awareness of adolescents in preconception health may be addressed through school education. The aim of this intervention is to assess preconception health awareness among adolescents in Lebanese high schools and to test the effectiveness of a one-time educational session in improving preconception knowledge. The intervention consisted of a 30-minute educational session about good practices in preconception health, developed by the National Collaborative Perinatal Neonatal Network's (NCPNN) research team. A convenience sample of high school Lebanese students in grades 10 to 12, aged 14 to 26 years old, from 70 private and public schools in all six Lebanese provinces, participated in the intervention in 2011 and 2012. A multiple-choice questionnaire administered prior to and 2 months after the session was used to assess knowledge improvement among the students. A total of 7,290 students were enrolled. After the session, mean scores of correct answers increased from 4.36 to 6.42 out of 10, representing a 47.2% improvement (p improvement was observed for questions about Trisomy 21, folic acid intake and toxoplasmosis with percentages improvement of 96%, 172% and 83% respectively. Being female or in private school was a significant predictor of higher scores in both pre-test and post-test (p students. We recommend expanding the scope of this intervention into universities in Lebanon.
Vassilopoulos, Stephanos P.; Brouzos, Andreas; Damer, Diana E.; Mellou, Angeliki; Mitropoulou, Alexandra
This study investigated the impact of a psychoeducational group for social anxiety aimed at elementary children. An 8-week psychoeducational program based on empirically validated risk factors was designed. Interventions included cognitive restructuring, anxiety management techniques, and social skills training. Pre-and posttest data from 3 groups…
Full Text Available Studies have shown preventive effects of an active lifestyle during childhood on later life; therefore, health promotion has to start early. The programme “Join the Healthy Boat” promotes a healthy lifestyle in primary school children. In order to evaluate it, children’s behaviours in respect of increased physical activity (PA, a decrease in screen media use (SMU, more regular breakfast, and a reduction of the consumption of soft drinks (SDC were investigated. 1943 children (7.1 ± 0.6 years participated in the cluster-randomised study and were assessed at baseline and 1736 of them at follow-up. Teachers delivered lessons, which included behavioural contracting and budgeting of SMU and SDC. Daily SMU, PA behaviours, SDC, and breakfast patterns were assessed via parental questionnaire. After one-year intervention, significant effects were found in the intervention group for SMU of girls, children without migration background, and children with parents having a low education level. In the control group, second grade children skipped breakfast significantly more often. Tendencies but no significant differences were found for PA and SDC. This intervention seems to affect groups, which are usually hard to reach, such as children of parents with low education levels, which shows that active parental involvement is vital for successful interventions.
Whitley, Jessica; Smith, J. David; Vaillancourt, Tracy
Teachers and other school staff play key roles as partners in the prevention, identification, and intervention of mental health difficulties among children and youth. However, it is essential that teachers are equipped with sufficient mental health literacy to engender effective practices in these areas. This article reviews the literature related…
Peck, Heather L.; Bray, Melissa A.; Kehle, Thomas J.
This investigation analyzed the effect of relaxation and guided imagery on lung function and anxiety by employing a multiple baseline design across four middle school students with asthma. With the introduction of the intervention, it was found that lung function improved and anxiety decreased in all students. (Contains 63 references, 1 table, and…
Barnett, David; Hawkins, Renee; McCoy, Dacia; Wahl, Elaine; Shier, Ashley; Denune, Hilary; Kimener, Lauren
There has been a paucity of guidance on the methodological details needed for measuring and sampling the independent variable or actual intervention occurrences in research and practice. Furthermore, the planning and support necessary to document the independent variable in both circumstances may be considerable. The current study extends prior…
Bush, Joshua L.; Bush, Heather M.; Coker, Ann L.; Brancato, Candace J.; Clear, Emily R.; Recktenwald, Eileen A.
Costs of providing the Green Dot bystander-based intervention, shown to be effective in the reduction of sexual violence among Kentucky high school students, were estimated based on data from a large cluster-randomized clinical trial. Rape Crisis Center Educators were trained to provide Green Dot curriculum to students. Implementing Green Dot in…
Rosário, R; Araújo, A; Padrão, P; Lopes, O; Moreira, A; Abreu, S; Vale, S; Pereira, B; Moreira, P
There is evidence that fruit consumption among school children is below the recommended levels. This study aims to examine the effects of a dietary education intervention program me, held by teachers previously trained in nutrition, on the consumption of fruit as a dessert at lunch and dinner, among children 6-12 years old. This is a randomized trial with the schools as the unit of randomisation. A total of 464 children (239 female, 6-12years) from seven elementary schools participated in this cluster randomized controlled trial. Three schools were allocated to the intervention and four to the control group. For the intervention schools, we delivered professional development training to school teachers (12 sessions of 3 h each). The training provided information about nutrition, healthy eating, the importance of drinking water and healthy cooking activities. After each session, teachers were encouraged to develop classroom activities focused on the learned topics. Sociodemographic was assessed at baseline and anthropometric, dietary intake and physical activity assessments were performed at baseline and at the end of the intervention. Dietary intake was evaluated by a 24-h dietary recall and fruit consumption as a dessert was gathered at lunch and dinner. Intervened children reported a significant higher intake in the consumption of fruit compared to the controlled children at lunch (P = 0.001) and at dinner (P = 0.012), after adjusting for confounders. Our study provides further support for the success of intervention programmes aimed at improving the consumption of fruit as a dessert in children. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Mendelson, Tamar; Greenberg, Mark T.; Dariotis, Jacinda K.; Gould, Laura Feagans; Rhoades, Brittany L.; Leaf, Philip J.
Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper…
Rausch, John C.; Berger-Jenkins, Evelyn; Nieto, Andres R.; McCord, Mary; Meyer, Dodi
Background: Parents exert a significant effect on children's eating behaviors and physical activity levels, so it is imperative to find successful obesity prevention programs that target whole families in underserved communities. Purpose: To investigate the effects of a Coordinated School Health Program (CSHP) on parents in the program over a…
Full Text Available Abstract Background With the burden of mental illness estimated to be costing the English economy alone around £22.5 billion a year 1, coupled with growing evidence that many mental disorders have their origins in adolescence, there is increasing pressure for schools to address the emotional well-being of their students, alongside the stigma and discrimination of mental illness. A number of prior educational interventions have been developed and evaluated for this purpose, but inconsistency of findings, reporting standards, and methodologies have led the majority of reviewers to conclude that the evidence for the efficacy of these programmes remains inconclusive. Methods/Design A cluster randomised controlled trial design has been employed to enable a feasibility study of 'SchoolSpace', an intervention in 7 UK secondary schools addressing stigma of mental illness, mental health literacy, and promotion of mental health. A central aspect of the intervention involves students in the experimental condition interacting with a young person with lived experience of mental illness, a stigma reducing technique designed to facilitate students' engagement in the project. The primary outcome is the level of stigma related to mental illness. Secondary outcomes include mental health literacy, resilience to mental illness, and emotional well-being. Outcomes will be measured pre and post intervention, as well as at 6 month follow-up. Discussion The proposed intervention presents the potential for increased engagement due to its combination of education and contact with a young person with lived experience of mental illness. Contact as a technique to reduce discrimination has been evaluated previously in research with adults, but has been employed in only a minority of research trials investigating the impact on youth. Prior to this study, the effect of contact on mental health literacy, resilience, and emotional well-being has not been evaluated to the authors
Caldwell, Linda L; Bradley, Stephanie; Coffman, Donna
This manuscript focuses on how individualized components may be embedded within a universal preventive intervention (TimeWise: Taking Charge of Leisure Time) to make program delivery more effective. Leisure related variables (motivation, boredom/interest and peer and parental influence) were used to suggest ways to individualize the program. Latent Class Analysis was used to develop individualized risk and strength profiles of adolescents (N = 617). Comparisons were made between a treatment and control group. Four classes were identified: undifferentiated high, intrinsic motivation, extrinsic motivation/amotivation, undifferentiated low. These classes were related to substance use. Membership in the intrinsic class was associated with intervention group while the extrinsic class was related to the control group. Results were useful in suggesting ways to tailor a universal prevention program.
Adom, Theodosia; Puoane, Thandi; De Villiers, Anniza; Kengne, André Pascal
The increasing prevalence of obesity and overweight in childhood in developing countries is a public health concern to many governments. Schools play a significant role in the obesity epidemic as well as provide favourable environments for change in behaviours in childhood which can be carried on into adulthood. There is dearth of information on intervention studies in poor-resource settings. This review will summarise the available evidence on school-based interventions that focused on promoting healthy eating and physical activity among learners aged 6-15 years in Africa and to identify factors that lead to successful interventions or potential barriers to success of these programmes within the African context. This protocol is developed following the guidelines of PRIMSA-P 2015. Relevant search terms and keywords generated from the subject headings and the African search filter will be used to conduct a comprehensive search of MEDLINE (PubMed), MEDLINE (EbscoHost), CINAHL (EbscoHost), Register Academic Search Complete (EbscoHost) and ISI Web of Science (Science Citation Index) for published literature on school-based interventions to prevent and control obesity in learners in Africa. Grey literature will be also be obtained. The searches will cover 1 January 2000 to 30 June 2016. No language limitations will be applied. Full-text articles of eligible studies will be screened. Risk of bias and quality of reporting will be assessed. Data will be extracted, synthesised and presented by country and major regional groupings. Meta-analysis will be conducted for identical variables across studies, where data allow. This protocol is developed following the guidelines of PRISMA-P 2015. No primary data will be collected hence ethics is not a requirement. The findings will be submitted for publication in peer-reviewed journals, in conferences and in policy documents for decision-making, where needed. Published by the BMJ Publishing Group Limited. For permission to use
Stanley, Nicky; Ellis, Jane; Farrelly, Nicola; Hollinghurst, Sandra; Downe, Soo
Schools provide the setting in which interventions aimed at preventing intimate partner violence and abuse (IPVA) are delivered to young people in the general population and a range of programmes have been designed and evaluated. To date, most rigorous studies have been undertaken in North America and the extent to which programmes are transferable to other settings and cultures is uncertain. This paper reports on a mixed methods review, aimed at informing UK practise and policy, which included a systematic review of the international literature, a review of the UK grey literature and consultation with young people as well as experts to address the question of what works for whom in what circumstances. The context in which an intervention was delivered was found to be crucial. Context included: the wider policy setting; the national or regional level, where the local culture shaped understandings of IPVA, and the readiness of an individual school. The programmes included in the systematic review provided stronger evidence for changing knowledge and attitudes than for behavioural change and those young people who were at higher risk at baseline may have exerted a strong influence on study outcomes. Shifting social norms in the peer group emerged as a key mechanism of change and the young people consulted emphasised the importance of authenticity which could be achieved through the use of drama and which required those delivering programmes to have relevant expertise. While the consultation identified increasing interest in targeting interventions on boys, there was an identified lack of materials designed for minority groups of young people, especially Lesbian, Gay, Bisexual and Transgender young people. Increased responsivity to the local context can be achieved by involving those who will deliver and receive these preventive programmes in their development. Schools need to be better prepared and supported in the task of delivering these interventions and this is
Full Text Available Type 1 diabetes is one of the most common chronic childhood diseases, while type 2 diabetes in children is increasing at alarming rates globally. Against this backdrop, the school is a critical environment for children with diabetes. They continue to face barriers to education that may lead to depression, poor academic performance, and poor quality of life. To address these challenges, diabetes interventions have been implemented in school and the goal was to systematically review these interventions and their outcomes between 2000 and 2013. Fifteen studies were included in the narrative synthesis. Education of school personnel was the main focus before 2006. Studies reported gains in knowledge and perceived confidence of school staff. Since 2006, more comprehensive interventions have been developed to promote better care coordination and create a safe school environment. These studies reported improved diabetes management and quality of life of students. Assessment tools varied and study design included randomized controlled trials, quantitative and qualitative methods. Although many of the studies reported a significant difference in the parameters measured, it was not possible to determine optimal ways to improve the health, quality of life and academic performance of children with diabetes, given the disparity in scope, assessment tools and measured outcomes. Experimental designs, longer follow-up studies, larger sample sizes, and a higher number of participating schools are critical issues to consider in future studies. Most of the research was conducted in North America and further research is needed in other parts of the world.
Conner, Matthew David
Background: The prevalence of both obesity and type 2 diabetes in the United States has increased over the past two decades and rates remain high. The latest data from the National Center for Health Statistics estimates that 36% of adults and 17% of children and adolescents in the US are obese (CDC Adult Obesity, CDC Childhood Obesity). Being overweight or obese greatly increases one's risk of developing several chronic diseases, such as type 2 diabetes. Approximately 8% of adults in the US have diabetes, type 2 diabetes accounts for 90-95% of these cases. Type 2 diabetes in children and adolescents is still rare, however clinical reports suggest an increase in the frequency of diagnosis (CDC Diabetes Fact Sheet, 2011). Results from the Diabetes Prevention Program show that the incidence of type 2 diabetes can be reduced through the adoption of a healthier lifestyle among high-risk individuals (DPP, 2002). Objectives: This classroom-based intervention included scientific coverage of energy balance, diabetes, diabetes prevention strategies, and diabetes management. Coverage of diabetes management topics were included in lesson content to further the students' understanding of the disease. Measurable short-term goals of the intervention included increases in: general diabetes knowledge, diabetes management knowledge, and awareness of type 2 diabetes prevention strategies. Methods: A total of 66 sixth grade students at Tavelli Elementary School in Fort Collins, CO completed the intervention. The program consisted of nine classroom-based lessons; students participated in one lesson every two weeks. The lessons were delivered from November of 2005 to May of 2006. Each bi-weekly lesson included a presentation and interactive group activities. Participants completed two diabetes knowledge questionnaires at baseline and post intervention. A diabetes survey developed by Program ENERGY measured general diabetes knowledge and awareness of type 2 diabetes prevention strategies
Abel, Eileen Mazur; Chung-Canine, Unju; Broussard, Karen
Despite the fact that children are negatively impacted by family separation and divorce (Amato, 2001 ; Dreman & Shemi, 2004 ; Kelly, 2000 ) there is a paucity of information regarding evidence-based social work practice with children coping with family disruption. In order to address this gap, the authors describe the process and outcomes of a quasi-experimental evaluation (N = 79) designed to reduce the behavioral, emotional, and academic problems that children often face when experiencing divorce or parental separation. Results of data analysis (paired t-tests, independent t-tests, and analysis of variance) suggest (p < .05) that the intervention is effective in helping children cope with family disruption.
Stewart, David G; Felleman, Benjamin I; Arger, Christopher A
This study examined whether adolescents receiving Motivational Interviewing (MI) intervention have different outcomes compared to those receiving Motivational Incentives (Motivational Interviewing combined with Contingency Management; MI+CM). A total of 136 adolescents (from a parent study of 220 adolescents) with problematic substance use were recruited from 8 high schools in Washington State, where they completed either 8-weeks of MI or MI+CM. Frequency of marijuana use was assessed at baseline, at the end-of-treatment, and at 16-week follow-up. A balanced and matched sample was created using propensity scores, then analyzed using Hierarchical Linear Modeling (HLM). Multilevel regression analyses revealed that adolescents who received MI+CM exhibited a greater reduction in use across time (pmotivation and school attendance were not found. Use of coping strategies at the end-of-treatment had a significant indirect effect on the relationship between the intervention condition and marijuana use at the end-of-treatment (F3, 121=10.20, R2=.20, p<.01). These results suggest that the inclusion of contingencies into adolescent marijuana treatment decreases the end-of-treatment frequency of marijuana use and related consequences while increasing the use of coping strategies and the pursuit of additional treatment. Copyright © 2015 Elsevier Inc. All rights reserved.
Stensel David J
Full Text Available Abstract Background Physical inactivity is recognised as a public health concern within children and interventions to increase physical activity are needed. The purpose of this research was to evaluate the effect of a school-based healthy lifestyles intervention on physical activity, fruit and vegetable consumption, body composition, knowledge, and psychological variables. Method A non-randomised controlled study involving 8 primary schools (4 intervention, 4 control. Participants were 589 children aged 7–11 years. The intervention lasted 10 months and comprised a CD-rom learning and teaching resource for teachers; an interactive website for pupils, teachers and parents; two highlight physical activity events (1 mile school runs/walks; a local media campaign; and a summer activity wall planner and record. Primary outcome measures were objectively measured physical activity (pedometers and accelerometers and fruit and vegetable consumption. Secondary outcomes included body mass index, waist circumference, estimated percent body fat, knowledge, psychological variables. Multi-level modelling was employed for the data analysis. Results Relative to children in control schools, those in intervention schools significantly increased their total time in moderate-to-vigorous physical activity (MVPA (by 9 minutes/day vs a decrease of 10 minutes/day, their time in MVPA bouts lasting at least one minute (10 minutes/day increase vs no change and increased daily steps (3059 steps per day increase vs 1527 steps per day increase. A similar pattern of results was seen in a subset of the least active participants at baseline. Older participants in intervention schools showed a significant slowing in the rate of increase in estimated percent body fat, BMI, and waist circumference. There were no differences between groups in fruit and vegetable intake. Extrinsic motivation decreased more in the intervention group. Conclusion The intervention produced positive
Drapeau, Vicky; Savard, Mathieu; Gallant, Annette; Nadeau, Luc; Gagnon, Jocelyn
Most Canadian children do not meet daily recommendations for consumption of vegetables and fruits (V/F) and dairy products (DP). The aim of this study was to evaluate the impact of Team Nutriathlon on V/F and DP consumption of children. Participants were 404 children from grades 5 and 6 (intervention group [IG] N = 242, control group [CG] N = 162). Teams of children were guided to increase their consumption and variety of V/F and DP over an 8-week period. Daily servings of V/F and DP were compared between groups at 4 time points: baseline (week 0), during (week 6), immediately after (week 9 or 10), and a follow-up 10 weeks after (week 20) the intervention. During and after the program and at follow-up, children in the IG consumed more servings of V/F and DP compared to the CG (group × time, p .05). Team Nutriathlon is an innovative school-based nutrition program that can help to increase the V/F and DP consumption of children. © 2016, American School Health Association.
Full Text Available Abstract Background The benefits of physical activity for the mental health and well-being of children and young people are well-established. Increased physical activity during school hours is associated with better physical, psychological and social health and well‐being. Unfortunately many children and young people exercise insufficiently to benefit from positive factors like well-being. The main aim of this study is to develop, implement and evaluate a multi-component, school-based, physical activity intervention to improve psychosocial well-being among school-aged children and youths from the 4th to the 6th grade (10–13 years. Methods A four-phased intervention – design, pilot, RCT, evaluation - is carried out for the development, implementation and evaluation of the intervention which are guided by The Medical Research Council framework for the development of complex interventions. 24 schools have been randomized and the total study population consists of 3124 children (baseline, who are followed over a period of 9 months. Outcome measure data at the pupil level are collected using an online questionnaire at baseline and at follow-up, 9 months later with instruments for measuring primary (general physical self-worth and secondary outcomes (self-perceived sport competences, body attractiveness, scholastic competences, social competences and global self-worth; enjoyment of PA; self-efficacy; and general well-being that are both valid and manageable in setting-based research. The RE-AIM framework is applied as an overall instrument to guide the evaluation. Discussion The intervention focuses on the mental benefits of physical activity at school, which has been a rather neglected theme in health promotion research during recent decades. This is unfortunate as mental health has been proclaimed as one of the most important health concerns of the 21st century. Applying a cluster RCT study design, evaluating the real-world effectiveness of
Smedegaard, Søren; Christiansen, Lars Breum; Lund-Cramer, Pernille; Bredahl, Thomas; Skovgaard, Thomas
The benefits of physical activity for the mental health and well-being of children and young people are well-established. Increased physical activity during school hours is associated with better physical, psychological and social health and well-being. Unfortunately many children and young people exercise insufficiently to benefit from positive factors like well-being. The main aim of this study is to develop, implement and evaluate a multi-component, school-based, physical activity intervention to improve psychosocial well-being among school-aged children and youths from the 4 th to the 6 th grade (10-13 years). A four-phased intervention - design, pilot, RCT, evaluation - is carried out for the development, implementation and evaluation of the intervention which are guided by The Medical Research Council framework for the development of complex interventions. 24 schools have been randomized and the total study population consists of 3124 children (baseline), who are followed over a period of 9 months. Outcome measure data at the pupil level are collected using an online questionnaire at baseline and at follow-up, 9 months later with instruments for measuring primary (general physical self-worth) and secondary outcomes (self-perceived sport competences, body attractiveness, scholastic competences, social competences and global self-worth; enjoyment of PA; self-efficacy; and general well-being) that are both valid and manageable in setting-based research. The RE-AIM framework is applied as an overall instrument to guide the evaluation. The intervention focuses on the mental benefits of physical activity at school, which has been a rather neglected theme in health promotion research during recent decades. This is unfortunate as mental health has been proclaimed as one of the most important health concerns of the 21 st century. Applying a cluster RCT study design, evaluating the real-world effectiveness of the intervention, this study is one of the largest
Pellecchia, Melanie; Connell, James E; Kerns, Connor M; Xie, Ming; Marcus, Steven C; Mandell, David S
This study examined the extent to which clinical and demographic characteristics predicted outcome for children with autism spectrum disorder. Participants included 152 students with autism spectrum disorder in 53 kindergarten-through-second-grade autism support classrooms in a large urban public school district. Associations between child characteristics (including age, language ability, autism severity, social skills, adaptive behavior, co-occurring psychological symptoms, and restrictive and repetitive behavior) and outcome, as measured by changes in cognitive ability following one academic year of an intervention standardized across the sample were evaluated using linear regression with random effects for classroom. While several scales and subscales had statistically significant bivariate associations with outcome, in adjusted analysis, only age and the presence of symptoms associated with social anxiety, such as social avoidance and social fearfulness, as measured through the Child Symptom Inventory-4, were associated with differences in outcome. The findings regarding the role of social anxiety are new and have important implications for treatment. Disentangling the construct of social anxiety to differentiate between social fearfulness and social motivation has important implications for shifting the focus of early treatment for children with autism spectrum disorder. © The Author(s) 2015.
Annette Quinto Romani
Full Text Available AbstractChildhood obesity and inactivity is a significant public health problem that also has economic consequences. Therefore, economists have a role to play in determining the causal impacts. The influences of childhood background on outcomes can, usefully, be broken down into the effect of family, school and peer. To combat the raising childhood obesity, schools have been advocated as a potential area. This paper analyses whether increasing physical activity in a school context can contribute to health improvement using multiple outcomes. We address the issue by using a unique longitudinal data set of, respectively, 1087 (BMI and 1047 (fitness schoolchildren attending 37 state schools in the Municipality of Aalborg, Denmark. The effect is identified by using a randomized experiment that creates an exogenous increase in physical activity. Surprisingly, we find that the intervention did not have the expected impact on schoolchildren’s health, and the scant evidence we have points towards a negative effect. A plausible explanation is that the results mask important heterogeneity. Another plausible explanation is that the results also capture any compensating behaviour that schoolchildren engage in by being less active out of school. From a public-policy perspective, increasing physical activity in a school context seems to increase the ‘gap’ in child health and ‘crowd-out’ outside-school physical activity. Consequently, a supportive cost-benefit case might exist if parental behaviour is assumed to be affected by school resources and endogenous.
Liber, J.M.; de Boo, G.M.; Huizenga, H.; Prins, P.J.M.
Objective: In this randomized controlled trial, we investigated the effectiveness of a school-based targeted intervention program for disruptive behavior. A child-focused cognitive behavioral therapy (CBT) program was introduced at schools in disadvantaged settings and with active teacher support
Dalma, A.; Veloudaki, A.; Petralias, A.; Mitraka, K.; Zota, D.; Kastorini, C.-M.; Yannakoulia, M.; Linos, A.
Introduction: Aiming at reducing the rates of food insecurity and promoting healthy diet for children and adolescents, we designed and implemented the Program on Food Aid and Promotion of Healthy Nutrition-DIATROFI, a school-based intervention program including the daily provision of a free healthy mid-day meal in disadvantaged areas across…
van Nassau, F.; Singh, A.S.; van Mechelen, W.; Brug, J.; Chin A Paw, M.J.M.
BACKGROUND: The school-based Dutch Obesity Intervention in Teenagers (DOiT) program is an evidence-based obesity prevention program. In preparation for dissemination throughout the Netherlands, this study aimed to adapt the initial program and to develop an implementation strategy and materials.
Wang, Dongxu; Stewart, Donald; Chang, Chun
Purpose: The purpose of this paper is to assess whether the school-based nutrition programme using the health-promoting school (HPS) framework was effective to improve parents' knowledge, attitudes and behaviour (KAB) in relation to nutrition in rural Mi Yun County, Beijing. Design/methodology/approach: A cluster-randomised intervention trial…
Lobelo, Felipe; Garcia de Quevedo, Isabel; Holub, Christina K.; Nagle, Brian J.; Arredondo, Elva M.; Barquera, Simon; Elder, John P.
Background: Rapidly rising childhood obesity rates constitute a public health priority in Latin America which makes it imperative to develop evidence-based strategies. Schools are a promising setting but to date it is unclear how many school-based obesity interventions have been documented in Latin America and what level of evidence can be…
Walther, Birte; Hanewinkel, Reiner; Morgenstern, Matthis
The aim of this study was to evaluate the effects of a four-session school-based media literacy curriculum on adolescent computer gaming and Internet use behavior. The study comprised a cluster randomized controlled trial with three assessments (baseline, posttest, and 12-month follow-up). At baseline, a total of 2,303 sixth and seventh grade adolescents from 27 secondary schools were assessed. Of these, 1,843 (80%) could be reached at all three assessments (Mage=12.0 years; SD=0.83). Students of the intervention group received the media literacy program Vernetzte www.Welten ("Connected www.Worlds ") implemented by trained teachers during class time. The control group attended regular class. Main outcome measures were adolescents' computer gaming and Internet use: days per month, hours per day, and addictive use patterns. Parental media monitoring and rules at home were assessed as secondary outcomes. Results of multilevel growth-curve models revealed a significant intervention effect in terms of a lower increase in self-reported gaming frequency (β = -1.10 [95% CI -2.06, -0.13]), gaming time (β = -0.27 [95% CI -0.40, -0.14]), and proportion of excessive gamers (AOR=0.21 [95% CI 0.08, 0.57]) in the intervention group. There were also significant group-time interactions for the addictive gaming scale (β=-0.08 [95% CI -0.12, -0.04]), and the Internet Addiction Scale (β = -0.06 [95% CI -0.10, -0.01]). No effect was found for days and hours of Internet use or parental media behavior. The study shows that the program Vernetzte www.Welten can influence adolescents' media use behavior. Future research should address mediating and moderating variables of program effects.
studies are needed to evaluate more precisely the effectiveness of school-based interventions.
de León, O A
A political conflict forced banks to close down in Panama during March 1988. Thus, thousand of families were unable to meet their most basic needs during that lapse of time. This paper describes a community intervention program that was set up in the midst of such an economic disaster. That program emphasized mental health consultation techniques to help devising an effective organizational action as well as developing standards to determine needs, and a clear-cut two-way communication with the affected families. The incidence of emotional disorder was assessed with the Self Report Questionnaire, and crisis intervention was offered to any people who should apply for it. Cognitive responses, coping behaviors, and social supports were also assessed. Results showed that those individuals excluded from a full participation in their culture were much more likely to develop emotional disorders. Finding that affected people showed a scarce self-help behavior was interpreted as a feature of the transcultural transaction between affected people, and professionals.
Karczewski, Sabrina A.; Carter, Jocelyn S.; DeCator, Draycen D.
Background: Rates of obesity have risen disproportionately for ethnic minority youth in the United States. School-based programs may be the most comprehensive and cost-effective way to implement primary prevention in children. In this study we evaluated the effect of a school-based obesity prevention on the outcome of body mass index percentile…
Huang, Keng-Yen; Nakigudde, Janet; Calzada, Esther; Boivin, Michael J; Ogedegbe, Gbenga; Brotman, Laurie Miller
Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students. The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions. The
Freeman, Matthew C.; Clasen, Thomas; Brooker, Simon J.; Akoko, Daniel O.; Rheingans, Richard
We conducted a cluster-randomized trial to assess the impact of a school-based water treatment, hygiene, and sanitation program on reducing infection with soil-transmitted helminths (STHs) after school-based deworming. We assessed infection with STHs at baseline and then at two follow-up rounds 8 and 10 months after deworming. Forty government primary schools in Nyanza Province, Kenya were randomly selected and assigned to intervention or control arms. The intervention reduced reinfection prevalence (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.31–1.00) and egg count (rate ratio [RR] 0.34, CI 0.15–0.75) of Ascaris lumbricoides. We found no evidence of significant intervention effects on the overall prevalence and intensity of Trichuris trichiura, hookworm, or Schistosoma mansoni reinfection. Provision of school-based sanitation, water quality, and hygiene improvements may reduce reinfection of STHs after school-based deworming, but the magnitude of the effects may be sex- and helminth species-specific. PMID:24019429
Johnston, Stephen S; Salkever, David S; Ialongo, Nicholas S; Slade, Eric P; Stuart, Elizabeth A
When candidates for school-based preventive interventions are heterogeneous in their risk of poor outcomes, an intervention's expected economic net benefits may be maximized by targeting candidates for whom the intervention is most likely to yield benefits, such as those at high risk of poor outcomes. Although increasing amounts of information about candidates may facilitate more accurate targeting, collecting information can be costly. We present an illustrative example to show how cost-benefit analysis results from effective intervention demonstrations can help us to assess whether improved targeting accuracy justifies the cost of collecting additional information needed to make this improvement.
Nakkash, Rima T; Al Mulla, Ahmad; Torossian, Lena; Karhily, Roubina; Shuayb, Lama; Mahfoud, Ziyad R; Janahi, Ibrahim; Al Ansari, Al Anoud; Afifi, Rema A
Involving children in research studies requires obtaining parental permission. A school-based intervention to delay/prevent waterpipe use for 7th and 8th graders in Qatar was developed, and parental permission requested. Fifty three percent (2308/4314) of the parents returned permission forms; of those 19.5% of the total (840/4314) granted permission. This paper describes the challenges to obtaining parental permission. No research to date has described such challenges in the Arab world. A random sample of 40 schools in Doha, Qatar was selected for inclusion in the original intervention. Permission forms were distributed to parents for approval of their child's participation. The permission forms requested that parents indicate their reasons for non-permission if they declined. These were categorized into themes. In order to understand reasons for non-permission, interviews with parents were conducted. Phone numbers of parents were requested from the school administration; 12 of the 40 schools (30%) agreed to provide the contact information. A random sample of 28 parents from 12 schools was interviewed to reach data saturation. Thematic analysis was used to analyze their responses. Reasons for non-permission documented in both the forms and interviews included: poor timing; lack of interest; the child not wanting to participate; and the child living in a smoke-free environment. Interviews provided information on important topics to include in the consent forms, parents' decision-making processes regarding their child's participation, and considerations for communicating with parents. Many parents also indicated that this was the first time they had been asked to give an informed consent for their child's participation in a study. Results indicate that more attention needs to be given to the informed parental consent process. Researchers should consider enhancing both the methods of communicating information as well the specific information provided. Before
Li, Shenghui; Arguelles, Lester; Jiang, Fan; Chen, Wenjuan; Jin, Xingming; Yan, Chonghuai; Tian, Ying; Hong, Xiumei; Qian, Ceng; Zhang, Jun; Wang, Xiaobin; Shen, Xiaoming
Background Sufficient sleep during childhood is essential to ensure a transition into a healthy adulthood. However, chronic sleep loss continues to increase worldwide. In this context, it is imperative to make sleep a high-priority and take action to promote sleep health among children. The present series of studies aimed to shed light on sleep patterns, on the longitudinal association of sleep with school performance, and on practical intervention strategy for Chinese school-aged children. Methods and Findings A serial sleep researches, including a national cross-sectional survey, a prospective cohort study, and a school-based sleep intervention, were conducted in China from November 2005 through December 2009. The national cross-sectional survey was conducted in 8 cities and a random sample of 20,778 children aged 9.0±1.61 years participated in the survey. The five-year prospective cohort study included 612 children aged 6.8±0.31 years. The comparative cross-sectional study (baseline: n = 525, aged 10.80±0.41; post-intervention follow-up: n = 553, aged 10.81±0.33) was undertaken in 6 primary schools in Shanghai. A battery of parent and teacher reported questionnaires were used to collect information on children’s sleep behaviors, school performance, and sociodemographic characteristics. The mean sleep duration was 9.35±0.77 hours. The prevalence of daytime sleepiness was 64.4% (sometimes: 37.50%; frequently: 26.94%). Daytime sleepiness was significantly associated with impaired attention, learning motivation, and particularly, academic achievement. By contrast, short sleep duration only related to impaired academic achievement. After delaying school start time 30 minutes and 60 minutes, respectively, sleep duration correspondingly increased by 15.6 minutes and 22.8 minutes, respectively. Moreover, intervention significantly improved the sleep duration and daytime sleepiness. Conclusions Insufficient sleep and daytime sleepiness commonly existed and
Li, Shenghui; Arguelles, Lester; Jiang, Fan; Chen, Wenjuan; Jin, Xingming; Yan, Chonghuai; Tian, Ying; Hong, Xiumei; Qian, Ceng; Zhang, Jun; Wang, Xiaobin; Shen, Xiaoming
Sufficient sleep during childhood is essential to ensure a transition into a healthy adulthood. However, chronic sleep loss continues to increase worldwide. In this context, it is imperative to make sleep a high-priority and take action to promote sleep health among children. The present series of studies aimed to shed light on sleep patterns, on the longitudinal association of sleep with school performance, and on practical intervention strategy for Chinese school-aged children. A serial sleep researches, including a national cross-sectional survey, a prospective cohort study, and a school-based sleep intervention, were conducted in China from November 2005 through December 2009. The national cross-sectional survey was conducted in 8 cities and a random sample of 20,778 children aged 9.0±1.61 years participated in the survey. The five-year prospective cohort study included 612 children aged 6.8±0.31 years. The comparative cross-sectional study (baseline: n = 525, aged 10.80±0.41; post-intervention follow-up: n = 553, aged 10.81±0.33) was undertaken in 6 primary schools in Shanghai. A battery of parent and teacher reported questionnaires were used to collect information on children's sleep behaviors, school performance, and sociodemographic characteristics. The mean sleep duration was 9.35±0.77 hours. The prevalence of daytime sleepiness was 64.4% (sometimes: 37.50%; frequently: 26.94%). Daytime sleepiness was significantly associated with impaired attention, learning motivation, and particularly, academic achievement. By contrast, short sleep duration only related to impaired academic achievement. After delaying school start time 30 minutes and 60 minutes, respectively, sleep duration correspondingly increased by 15.6 minutes and 22.8 minutes, respectively. Moreover, intervention significantly improved the sleep duration and daytime sleepiness. Insufficient sleep and daytime sleepiness commonly existed and positively associated with the impairment of
Full Text Available BACKGROUND: Sufficient sleep during childhood is essential to ensure a transition into a healthy adulthood. However, chronic sleep loss continues to increase worldwide. In this context, it is imperative to make sleep a high-priority and take action to promote sleep health among children. The present series of studies aimed to shed light on sleep patterns, on the longitudinal association of sleep with school performance, and on practical intervention strategy for Chinese school-aged children. METHODS AND FINDINGS: A serial sleep researches, including a national cross-sectional survey, a prospective cohort study, and a school-based sleep intervention, were conducted in China from November 2005 through December 2009. The national cross-sectional survey was conducted in 8 cities and a random sample of 20,778 children aged 9.0±1.61 years participated in the survey. The five-year prospective cohort study included 612 children aged 6.8±0.31 years. The comparative cross-sectional study (baseline: n = 525, aged 10.80±0.41; post-intervention follow-up: n = 553, aged 10.81±0.33 was undertaken in 6 primary schools in Shanghai. A battery of parent and teacher reported questionnaires were used to collect information on children's sleep behaviors, school performance, and sociodemographic characteristics. The mean sleep duration was 9.35±0.77 hours. The prevalence of daytime sleepiness was 64.4% (sometimes: 37.50%; frequently: 26.94%. Daytime sleepiness was significantly associated with impaired attention, learning motivation, and particularly, academic achievement. By contrast, short sleep duration only related to impaired academic achievement. After delaying school start time 30 minutes and 60 minutes, respectively, sleep duration correspondingly increased by 15.6 minutes and 22.8 minutes, respectively. Moreover, intervention significantly improved the sleep duration and daytime sleepiness. CONCLUSIONS: Insufficient sleep and daytime sleepiness
Lander, Natalie; Eather, Narelle; Morgan, Philip J; Salmon, Jo; Barnett, Lisa M
Fundamental movement skill (FMS) competence is positively associated with physical activity (PA). However, levels of both FMS and PA are lower than expected. Current reviews of interventions to improve FMS and PA have shown that many school-based programs have achieved positive outcomes, yet the maintenance of these interventions is variable. Teachers play a central role in the success and longevity of school-based interventions. Despite the importance of teacher engagement, research into the nature and quality of teacher training in school-based PA and FMS interventions has received little attention. The aim of this systematic review was to investigate the type and quantity of teacher training in school-based physical education PA and/or FMS interventions, and to identify what role teacher training had on the intervention outcome. A systematic search of eight electronic databases was conducted. Publication date restrictions were not implemented in any database, and the last search was performed on 1 March 2015. School physical education-based interventions facilitated by a school teacher, and that included a quantitative assessment of FMS competence and/or PA levels were included in the review. The search identified 39 articles. Eleven of the studies measured FMS, 25 studies measured PA and three measured both FMS and PA. Nine of the studies did not report on any aspect of the teacher training conducted. Of the 30 studies that reported on teacher training, 25 reported statistically significant intervention results for FMS and/or PA. It appears that teacher training programs: are ≥ 1 day; provide comprehensive subject and pedagogy content; are framed by a theory or model; provide follow-up or ongoing support; and measure teacher satisfaction of the training, are more effective at improving student outcomes in FMS and/or PA. However, the provision of information regarding the characteristics of the teacher training was largely inadequate. Therefore, it was
Iatarola, Patrice; Stiefel, Leanna
Summarizes results of surveys and interviews of community members from 29 New York City schools involved in school-level budgeting during 1995-96. Analyzes respondents' knowledge about school budgets, ideas about resource decision making, perceptions of budgetary power, and suggestions. Fully 80% of respondents supported a participatory process.…
Buys, Laurie; Miller, Evonne
This exploratory pilot study investigates the extent to which participating in a community cultural development (CCD) initiative builds social capital among children. An independent youth arts organisation implemented two cultural activities, developing a compact disc of original music and designing mosaic artworks for a library courtyard, in two…
Diana Barbosa Cunha
Full Text Available OBJECTIVE: To investigate the influence of the stage of readiness for changes in food consumption variation among adolescents participating in school-based community trial in Duque de Caxias (RJ, Brazil.METHODS: It is a secondary analysis of a one-year randomized community trial to prevent excessive weight gain in students attending the 5thgrade in 20 public schools in the municipality of Duque de Caxias. The activities conducted discouraged the consumption of sweetened beverages and cookies and encouraged the consumption of fruits and beans. A food frequency questionnaire was applied at the beginning and at the end of the study. The stages of readiness for behavioral change vary in a scale from (1 "I don't think of changing diet" to (5 "I'm already changing my diet successfully". For the longitudinal analyses, we used generalized linear mixed models.RESULTS: There was a greater change in the consumption of fruit and soft drinks among participants in the intervention group who were in the action stage, compared to participants who did not think about changing their diet.CONCLUSION: The proposed strategy may be used to identify population groups with motivation for changes in dietary behavior.
Cunha, Diana Barbosa; de Souza, Bárbara da Silva Nalin; da Veiga, Glória Valéria; Pereira, Rosangela Alves; Sichieri, Rosely
To investigate the influence of the stage of readiness for changes in food consumption variation among adolescents participating in school-based community trial in Duque de Caxias (RJ), Brazil. It is a secondary analysis of a one-year randomized community trial to prevent excessive weight gain in students attending the 5th grade in 20 public schools in the municipality of Duque de Caxias. The activities conducted discouraged the consumption of sweetened beverages and cookies and encouraged the consumption of fruits and beans. A food frequency questionnaire was applied at the beginning and at the end of the study. The stages of readiness for behavioral change vary in a scale from (1) "I don't think of changing diet" to (5) "I'm already changing my diet successfully". For the longitudinal analyses, we used generalized linear mixed models. There was a greater change in the consumption of fruit and soft drinks among participants in the intervention group who were in the action stage, compared to participants who did not think about changing their diet. The proposed strategy may be used to identify population groups with motivation for changes in dietary behavior.
Sharifah Intan Zainun Sharif Ishak
Full Text Available Abstract Background Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL, a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13–14 years old. Methods/Design Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13–14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity, body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. Discussion It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. Trial registration UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016
Sharif Ishak, Sharifah Intan Zainun; Chin, Yit Siew; Mohd Taib, Mohd Nasir; Mohd Shariff, Zalilah
Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely 'Eat Right, Be Positive About Your Body and Live Actively' (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordered eating among secondary school adolescents aged 13-14 years old. Following quasi-experimental design, the intervention is conducted in two secondary schools located in the district of Hulu Langat, Selangor, Malaysia. Adolescents aged 13-14 years will be included in the study. A peer-education strategy is adopted to convey knowledge and teach skills relevant to achieving a healthy lifestyle. The intervention mainly promoted: healthy eating, positive body image and active lifestyle. The following parameters will be assessed: body weight, disordered eating status, stages of change (for healthy diet, breakfast, food portion size, screen viewing and physical activity), body image, health-related quality of life, self-esteem, eating and physical activity behaviours; and knowledge, attitude and practice towards a healthy lifestyle. Assessment will be conducted at three time points: baseline, post-intervention and 3-month follow-up. It is hypothesized that EPaL intervention will contribute in preventing overweight and disordered eating by giving the positive effects on body weight status, healthy lifestyle behaviour, as well as health-related quality of life of peer educators and participants. It may serve as a model for similar future interventions designed for the Malaysian community, specifically adolescents. UMIN Clinical Trial Registration UMIN000024349 (Date of registration: 11th. October 2016, retrospectively registered).
Sani, A Sadiq; Abraham, Charles; Denford, Sarah; Ball, Susan
School-based sexual health education has the potential to provide an inclusive and comprehensive approach to promoting sexual health among young people. We reviewed evaluations of school-based sexual health education interventions in sub-Saharan Africa to assess effectiveness in reducing sexually transmitted infections and promoting condom use. We searched ten electronic databases, hand-searched key journals, and reference lists of included articles for potential studies. Data were extracted on outcomes, intervention characteristics, methods and study characteristics indicative of methodological quality. Where possible, data were synthesized using random effect meta-analysis. Intervention features found predominantly in effective interventions were noted. The initial search retrieved 21634 potentially relevant citations. Of these, 51 papers reporting on 31 interventions were included. No evaluation reported statistically significant effects on the incidence or prevalence of Human Immunodeficiency Virus and Herpes Simplex Virus 2 infections. However, intervention participants reported statistically significant greater condom use in both randomised controlled trials and non-randomised trials for short (less than 6 months) follow-up periods (OR = 1.62, 95 % CI = 1.03-2.55 and OR = 2.88, 95 % CI = 1.41-5.90 respectively). For intermediate (6-10 months) and long-term (more than 10 months) follow-up periods, the effect was statistically significant (OR = 1.40, 95 % CI = 1.16-1.68) and marginally significant (OR = 1.22, 95 % CI = 0.99-1.50) among the randomised trials respectively. Only 12 of the 31 interventions reported implementation details, out of which seven reported on fidelity. School-based sexual health education has the potential to promote condom use among young people in sub-Saharan Africa. However, further work is needed to develop and evaluate interventions that have measurable effects on sexually transmitted infections.
De Henauw, Stefaan; Verbestel, Vera; Mårild, Staffan
to develop new pathways for sustainable health-promoting communities. Against this background, the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study developed and implemented innovative community-oriented intervention programmes for obesity....... The sphere of action encompassed both children and their (grand) parents, schools, local public authorities and influential stakeholders in the community. All materials for the interventions were centrally developed and culturally adapted. Results: So far, the following has been achieved: focus group...... research, literature review and expert consultations were done in an early phase as a basis for the development of the intervention modules. The intervention mapping protocol was followed as guide for structuring the intervention research. The overall intervention programme's duration was 2 years...
Walker, Sharon L; Smith, Donald J
Violence impacts the lives of children on a daily basis. In their communities, they witness drive-by shootings, drug deals, and violence in their schools while many endure abuse, neglect, and violent behavior in their homes. Because the traumatizing impact of such exposure disrupts a child's ability to concentrate and learn, the Dallas Independent School District (ISD) sought content expertise to develop a training vehicle for school district professionals. The program aimed to raise the awareness of educators to problems related to domestic violence and the myriad of circumstances at home and in the community that lead to exposure to violence. Approximately 15,000 faculty and staff of Dallas ISD were educated in the identification, intervention, and prevention of exposure to violence. Referrals and inquiries related to abuse have increased (approximately 70%) while the city of Dallas has witnessed a drop in the number of domestic violence and child abuse offenses.
Champion, Katrina E; Newton, Nicola C; Spring, Bonnie; Wafford, Q Eileen; Parmenter, Belinda J; Teesson, Maree
Six key behavioural risk factors (risky alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and unhealthy sleep patterns) have been identified as strong determinants of chronic disease, such as cardiovascular disease, diabetes and cancers. School-based interventions targeting these multiple health risk behaviours among adolescents have the potential to halt the trajectory towards later disease, whilst online and mobile technology interventions offer advantages in terms of student engagement, reach and scalability. Despite this, the efficacy of eHealth school-based interventions targeting these six health risk behaviours among adolescents has not been evaluated. The proposed systematic review aims to address this by determining the nature and efficacy of existing eHealth school-based interventions targeting multiple health risk behaviours among adolescents. A systematic search of the MEDLINE, Embase, PsycINFO and Cochrane Library databases will be conducted to identify eligible published papers. Eligible studies will be randomised controlled trials, including cluster randomised controlled trials, of interventions targeting two or more of the following lifestyle risk behaviours: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and sleep. Eligible studies will be those evaluating interventions delivered in a secondary school setting among participants 11-18 years of age, via an eHealth platform (Internet, computers of mobile technology). Two reviewers will independently screen studies for eligibility, extract data and assess the risk of bias. Study outcomes will be summarised in a narrative synthesis, and meta-analyses will be conducted where it is appropriate to combine studies. It is anticipated that the results from this review will serve to inform the development of future eHealth multiple health behaviour interventions for adolescents by identifying common characteristics of effective programs and highlighting
Somerset, Shawn; Markwell, Katherine
To determine changes in ability to identify specific vegetables and fruits, and attitudes towards vegetables and fruit, associated with the introduction of a school-based food garden. A 12-month intervention trial using a historical control (control n 132, intervention n 120), class-based, self-administered questionnaires requiring one-word answers and 3-point Likert scale responses. A state primary school (grades 4 to 7) in a low socio-economic area of Brisbane, Australia. The introduction of a school-based food garden, including the funding of a teacher coordinator for 11 h/week to facilitate integration of garden activities into the curriculum. Ability to identify a series of vegetables and fruits, attitudes towards vegetables and fruit. Frequency distributions for each item were generated and chi2 analyses were used to determine statistical significance. Exploratory factor analysis was employed to detect major trends in data. The intervention led to enhanced ability to identify individual vegetables and fruits, greater attention to origins of produce (garden-grown and fresh), changes to perceived consumption of vegetables and fruits, and enhanced confidence in preparing fruit and vegetable snacks, but decreased interest in trying new fruits. The introduction of this school-based food garden was associated with skill and attitudinal changes conducive to enhancing vegetable and fruit consumption. The ways in which such changes might impact on dietary behaviours and intake require further analysis.
Torres-Harding, Susan; Baber, Ashley; Hilvers, Julie; Hobbs, Nakisha; Maly, Michael
School-based social activism projects have much potential to foster civic engagement, self-efficacy, and positive youth development. Social activism projects may also be a means by which children, a group that is disempowered due to their age and dependence on adults, might seek to positively impact social and community problems. The current study…
Full Text Available Screening, Brief Intervention, and Referral to Treatment (SBIRT is an evidence-based approach to reducing substance use in adolescents. An emerging literature shows the promise of school-based SBIRT. However, most school-based SBIRT has only targeted substance-using adolescents and used school-based health clinics, which most schools lack. This project aimed to describe the following: a model for implementing universal SBIRT in high schools without school-based clinics, reasons students most commonly endorsed for reducing or avoiding substance use, students’ perceptions of SBIRT, and students’ intentions to change substance use or remain abstinent following SBIRT. Participants were N = 2513, 9th to 10th grade students in 10 high schools. Students rated SBIRT positively and indicated substantial intentions to reduce or delay substance use following SBIRT. Results support SBIRT’s potential to delay substance use among current abstainers in addition to reducing substance use among current users. This project demonstrates SBIRT’s feasibility as a universal method in high schools without in-school clinics.
Kutcher, Stan; Wei, Yifeng; Behzadi, Pegah
Suicide in young people is a significant health concern, with numerous community- and school-based interventions promising to prevent suicide currently being applied across Canada. Before widespread application of any one of these, it is essential to determine its effectiveness and safety. We systematically reviewed the global literature on one of the most common community suicide prevention interventions in Canada and summarized data on 2 commonly applied school-based suicide prevention programmes. None of these has demonstrated effectiveness in preventing youth suicide or safety in application. Concurrently with their widespread distribution in Canada, the suicide rate in young women has increased-the first time in over 3 decades. Policy and regulatory implications of these findings are discussed.
Bisset, Sherri L; Potvin, Louise; Daniel, Mark; Paquette, Manon
This study sought to provide an intermediate impact assessment of the nutrition intervention Petits cuistots--parents en réseaux (Little Cooks--Parental Networks) on: 1) knowledge, attitude, capacity and experience with regard to nutrition, diet and cookery, and 2) parental and/or family participation in school. A total of 388 students from grades 5 (participants) and 6 (non-participants). The evaluation of the nutrition intervention took place in each of the seven participating elementary schools, all of which are located in Montreal's most disadvantaged neighbourhoods. The program component "Little Cooks" is a nutrition workshop run by community dieticians. Each of the eight annual workshops features a food item and nutrition theme with a recipe for a collective food preparation and tasting experience. Classroom teachers participate to provide classroom management and program support. The "Parental Networks" component of the program invites parents to assist with the nutrition workshop, and offers additional parent and family activities which link to nutrition workshop themes (e.g., dinners or visits to local food producers). The program had some impact on knowledge of the nutrient content of food, food produce and cooking; attitude and experience with tasting of new or less common foods; and perceived cooking capacity. Families with students participating in the program participated more in school activities than did families of students not in the program. Our assessment indicates a potential program impact upon several intermediate impact measures, and in so doing highlights a promising nutrition capacity-promoting intervention.
Millar, Golden M.; Lean, Debra; Sweet, Susan D.; Moraes, Sabrina C.; Nelson, Victoria
Evidence suggests that schools have, by default, become the primary mental health system for students in Canada. The goal of the present study was to design, implement, and evaluate the Psychology School Mental Health Initiative (PSMHI). The PSMHI is an innovative attempt to increase the capacity of school-based psychology staff to deliver…
Singh, A.S.; Chin A Paw, J.M.M.; Brug, J.; Mechelen, van W.
Health promotion programs benefit from an accompanying process evaluation since it can provide more insight in the strengths and weaknesses of a program. A process evaluation was conducted to assess the reach, implementation, satisfaction and maintenance of a school-based program aimed at the
McIntyre, Laura Lee; Gresham, Frank M.; DiGennaro, Florence D.; Reed, Derek D.
We reviewed all school-based experimental studies with individuals 0 to 18 years published in the "Journal of Applied Behavior Analysis" (JABA) between 1991 and 2005. A total of 142 articles (152 studies) that met review criteria were included. Nearly all (95%) of these experiments provided an operational definition of the independent variable,…
De La Rue, Lisa; Polanin, Joshua R.; Espelage, Dorothy L.; Pigott, Terri D.
The incidence of violence in dating relationships has a significant impact on young people, including decreased mental and physical health. This review is the first to provide a quantitative synthesis of empirical evaluations of school-based programs implemented in middle and high schools that sought to prevent or reduce incidents of dating…
Taborda Zapata, Eliana María; Montoya González, Laura Elisa; Gómez Sierra, Natalia María; Arteaga Morales, Laura María; Correa Rico, Oscar Andrés
Schizophrenia is a complex disease for which pharmacological management is an insufficient therapeutic measure to ensure adaptation to the community and restoring the quality of life of the patient, with a multidimensional management and community interventions being necessary. Case report. This case report illustrates a multidisciplinary treatment response, based on a community care model for mental health from Envigado, Colombia. The management of schizophrenia requires multimodal interventions that include community screening, psychoeducation of individuals, their families and society, addressing different areas of operation that allow adaptation of the subject to his social environment. A integrated intervention that can be provided on a Community scale, with the implementation of policies that allow it to be applied. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Full Text Available Background: Obesity in adolescence is the strongest risk factor for obesity in adulthood. This study aimed to evaluate the effects of a comprehensive lifestyle intervention on different anthropometric indices in 12–16-year-old boy adolescents after 12 Weeks of Intervention. Methods: A total of 96 male adolescents from two schools participated in this study. The schools were randomly assigned to intervention (53 students and control school (43 students. Height and weight of students were measured and their body mass index (BMI was calculated. Body fat percent (BF and body muscle percent (BM was assessed using a bioimpedance analyzer considering the age, gender, and height of students at baseline and after intervention. The obesity reduction intervention was implemented in the intervention school based on the Ottawa charter for health promotion. Results: Twelve weeks of intervention decreased BF percent in the intervention group in comparison with the control group (decreased by 1.81% in the intervention group and increased by 0.39% in the control group, P < 0.01. However, weight, BMI, and BM did not change significantly. Conclusions: The result of this study showed that a comprehensive lifestyle intervention decreased the body fat percent in obese adolescents, although these changes was not reflected in the BMI. It is possible that BMI is not a good indicator in assessment of the success of obesity management intervention.
Quaresma, A M; Palmeira, A L; Martins, S S; Minderico, C S; Sardinha, L B
The aim of this study was to explore the effects of social support and behavioral regulation of exercise on physical activity (PA) and quality of life (QoL), in a Portuguese school-based intervention. We hypothesized that serial mediation effects would be present leading to greater levels of PA and QoL. The sample comprised 1042 students (549 boys), aged 10-16 years, BMI = 19.31 ± 3.51, allocated to two groups of schools: control (n = 207) and intervention (n = 835). This study will report the 24 months results of the program, which aimed to develop healthy lifestyles. Questionnaires were used to measure PA, QoL, motivation to exercise and social support. There was no direct impact of the intervention on QoL or PA. Serial mediation analyses were conducted. Social support (P motivation (P = 0.085) increased more on intervention group. Indirect effects were observed in all serial mediation models. The positive indirect effects on PA and QoL were explained by the increase on peer/parent support in serial with the increase in intrinsic motivation (P motivation (P school-based intervention promoted the development of social support and motivational mechanisms that explained higher levels of PA and QoL. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Full Text Available Early social and economic deprivation, associated with poor nutrition and physical inactivity, may lead to adverse health trajectories. A cluster-randomized controlled-trial examining the effect of a school-based comprehensive intervention on nutrition knowledge, eating habits, and behaviors among low socioeconomic status (LSES school-aged children was performed. LSES school-aged children (4–7 years and their mothers were recruited from 11 schools, located in one town. The intervention was implemented on three levels: children, mothers, and teachers. The intervention (IArm included nutrition classes for children, mothers, and teachers and physical activity (PA classes for children; the control (CArm received PA only. Interventions were conducted by professional personnel, who were trained during in a two-day session to deliver the specific program in schools. Family data were obtained by parental interviews. Food knowledge observations, packed lunch records, and anthropometric measurements were obtained in school at baseline, six months, and at the end of the school year. Of 258 children enrolled, 220 (87.6% completed the six-month program. Only children in the IArm improved their nutrition knowledge and eating-habits and increased food variety and fruit and vegetable consumption, quality score of packed lunches (p < 0.001 for all, habitual water drinking increased (p = 0.02, and decreased sweet-drink consumption (p = 0.05. A school-based comprehensive nutrition intervention targeting LSES population improved eating habits, nutritional knowledge, and healthier packed lunches.
Diana B Cunha
Full Text Available To evaluate the effectiveness of a school-based intervention involving the families and teachers that aimed to promote healthy eating habits in adolescents; the ultimate aim of the intervention was to reduce the increase in body mass index (BMI of the students.Paired cluster randomized school-based trial conducted with a sample of fifth graders.Twenty classes were randomly assigned into either an intervention group or a control group.From a total of 574 eligible students, 559 students participated in the study (intervention: 10 classes with 277 participants; control: 10 classes with 282 participants. The mean age of students was 11 years.Students attended 9 nutritional education sessions during the 2010 academic year. Parents/guardians and teachers received information on the same subjects.Changes in BMI and percentage of body fat.Intention-to-treat analysis showed that changes in BMI were not significantly different between the 2 groups (β = 0.003; p = 0.75. There was a major reduction in the consumption of sugar-sweetened beverages and cookies in the intervention group; students in this group also consumed more fruits.Encouraging the adoption of healthy eating habits promoted important changes in the adolescent diet, but this did not lead to a reduction in BMI gain. Strategies based exclusively on the quality of diet may not reduce weight gain among adolescents.Clinicaltrials.gov NCT01046474.
Van Lippevelde Wendy
Full Text Available Abstract Background Overweight and obesity in youth has increased dramatically. Therefore, overweight prevention initiatives should start early in life and target modifiable energy balance-related behaviours. Parental participation is often advocated as important for school-based interventions, however, getting parents involved in school-based interventions appears to be challenging based on earlier intervention experiences. The purpose of this study was to get insight into the determinants of and perspectives on parental participation in school-interventions on energy balance-related behaviours (physical activity, healthy eating, sedentary behaviours in parents of ten- to twelve-year olds in order to develop an effective parental module for school-based interventions concerning energy balance-related behaviours. Methods Four countries (Belgium, Hungary, Norway and Spain conducted the focus group research based on a standardised protocol and a semi-structured questioning route. A variation in parental socio-economic status (SES and parental school involvement was taken into account when recruiting the parents. The audio taped interviews were transcribed, and a qualitative content analysis of the transcripts was conducted in each country. Results Seventeen focus group interviews were conducted with a total of 92 parents (12 men, 80 women. Physical activity was considered to be a joint responsibility of school and parents, nutrition as parent's responsibility but supported by the school, and prevention of sedentary behaviours as parent's sole responsibility. Parents proposed interactive and practical activities together with their child as the best way to involve them such as cooking, food tasting, nutrition workshops, walking or cycling tours, sport initiations together with their child. Activities should be cheap, on a convenient moment, focused on their children and not on themselves, not tutoring, not theoretical, and school-or home
Background Overweight and obesity in youth has increased dramatically. Therefore, overweight prevention initiatives should start early in life and target modifiable energy balance-related behaviours. Parental participation is often advocated as important for school-based interventions, however, getting parents involved in school-based interventions appears to be challenging based on earlier intervention experiences. The purpose of this study was to get insight into the determinants of and perspectives on parental participation in school-interventions on energy balance-related behaviours (physical activity, healthy eating, sedentary behaviours) in parents of ten- to twelve-year olds in order to develop an effective parental module for school-based interventions concerning energy balance-related behaviours. Methods Four countries (Belgium, Hungary, Norway and Spain) conducted the focus group research based on a standardised protocol and a semi-structured questioning route. A variation in parental socio-economic status (SES) and parental school involvement was taken into account when recruiting the parents. The audio taped interviews were transcribed, and a qualitative content analysis of the transcripts was conducted in each country. Results Seventeen focus group interviews were conducted with a total of 92 parents (12 men, 80 women). Physical activity was considered to be a joint responsibility of school and parents, nutrition as parent's responsibility but supported by the school, and prevention of sedentary behaviours as parent's sole responsibility. Parents proposed interactive and practical activities together with their child as the best way to involve them such as cooking, food tasting, nutrition workshops, walking or cycling tours, sport initiations together with their child. Activities should be cheap, on a convenient moment, focused on their children and not on themselves, not tutoring, not theoretical, and school-or home-based. Conclusions Parents want to
Kong, Kaimeng; Liu, Jie; Tao, Yexuan
School-based nutrition education has been widely implemented in recent years to fight the increasing prevalence of childhood obesity in China. A comprehensive literature search was performed using six databases to identify studies of school-based nutrition education interventions in China. The methodological quality and the risk of bias of selected literature were evaluated. Stratified analysis was performed to identify whether different methodologies influenced the estimated effect of the intervention. Seventeen articles were included in the analysis. Several of the included studies had inadequate intervention duration, inappropriate randomization methods, selection bias, unbalanced baseline characteristics between control and intervention groups, and absent sample size calculation. Overall, the studies showed no significant impact of nutrition education on obesity (OR=0.76; 95% CI=0.55-1.05; p=0.09). This can be compared with an OR of 0.68 for interventions aimed at preventing malnutrition and an OR of 0.49 for interventions aimed at preventing iron-deficiency anemia. When studies with unbalanced baseline characteristics between groups and selection bias in the study subjects were excluded, the impact of nutrition education on obesity was significant (OR=0.73; 95% CI=0.55-0.98; p=0.003). An analysis stratified according to the duration of intervention revealed that the intervention was effective only when it lasted for more than 2 years (OR=0.49, 95% CI=0.42-0.58; pnutrition education programs in China have some important limitations that might affect the estimated effectiveness of the intervention.
Al-Mekhlafi, Abdulsalam M; Abdul-Ghani, Rashad; Al-Eryani, Samira M; Saif-Ali, Reyadh; Mahdy, Mohammed A K
Yemen is a developing country overwhelmed with a triad of poverty, diseases and social conflicts. Moreover, the majority of its population live in rural communities and suffer from intestinal parasitic infections (IPIs). Therefore, the present school-based, cross-sectional survey aimed to detect the prevalence of such infections and associated risk factors among schoolchildren in the rural communities of Bani Alharith, Hamdan and Bani Hushaysh districts of Sana'a, north of Yemen. Socio-demographic data and certain behavioral risk factors as well as stool samples were collected from 1218 schoolchildren from ten randomly schools in the study area. Fresh stool samples were examined for parasites by direct saline and iodine preparations and after concentration with formol-ether technique. The overall prevalence of IPIs was 54.8%, with a higher frequency of protozoal than helminthic infections (37.6 vs. 17.2%, respectively). Parasite species recovered were Entameba histolytica (21.5%), Giardia lamblia (16.1%), Ascaris lumbricoides (8.3%), Hymenolepis nana (5.3%), Schistosoma mansoni (2.6%), Trichuris trichiura (0.5%) and Enterobius vermicularis (0.4%). Univariate analysis showed that the male gender and illiteracy of fathers and/or mothers were the socio-demographic factors significantly associated with higher infection rates. The illiteracy of mothers was also confirmed as an independent risk factor by multivariable analysis. On the other hand, not washing hands before eating, not washing fruits and vegetables before consumption, eating uncovered food and not clipping fingernails were the risk behaviors significantly associated with higher infection rates, with the last three ones being confirmed as independent risk factors. Therefore, control measures should include regular treatment of protozoal infections and deworming of schoolchildren, promotion of hygiene in rural schools through health education programs, regular inspection of schoolchildren for personal hygiene
Rens, Lezahn; Joosten, Annette
A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.
Full Text Available Abstract Background The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. Methods/design We designed a cluster randomized controlled trial in 8 randomly selected urban primary schools between May 2010 and December 2013. Each school was randomly assigned to either the intervention or control group (four schools in each group. Participants were the 4th graders in each participating school. The multi-component program was implemented within the intervention group, while students in the control group followed their usual health and physical education curriculum with no additional intervention program. The intervention consisted of four components: a classroom curriculum, (including physical education and healthy diet education, b school environment support, c family involvement, and d fun programs/events. The primary study outcome was body composition, and secondary outcomes were behaviour and behavioural determinants. Discussion The intervention was designed with due consideration of Chinese cultural and familial tradition, social convention, and current primary education and exam system in Mainland China. We did our best to gain good support from educational authorities, school administrators, teachers and parents, and to integrate intervention components into schools’ regular academic programs. The results of and lesson learned from this study will help guide future school-based childhood obesity prevention programs in Mainland China. Trial registration Registration number: ChiCTR-ERC-11001819
Van Cauwenberghe, Eveline; Maes, Lea; Spittaels, Heleen; van Lenthe, Frank J; Brug, Johannes; Oppert, Jean-Michel; De Bourdeaudhuij, Ilse
The objective of the present review was to summarise the existing European published and 'grey' literature on the effectiveness of school-based interventions to promote a healthy diet in children (6-12 years old) and adolescents (13-18 years old). Eight electronic databases, websites and contents of key journals were systematically searched, reference lists were screened, and authors and experts in the field were contacted for studies evaluating school-based interventions promoting a healthy diet and aiming at primary prevention of obesity. The studies were included if they were published between 1 January 1990 and 31 December 2007 and reported effects on dietary behaviour or on anthropometrics. Finally, forty-two studies met the inclusion criteria: twenty-nine in children and thirteen in adolescents. In children, strong evidence of effect was found for multicomponent interventions on fruit and vegetable intakes. Limited evidence of effect was found for educational interventions on behaviour, and for environmental interventions on fruit and vegetable intakes. Interventions that specifically targeted children from lower socio-economic status groups showed limited evidence of effect on behaviour. In adolescents, moderate evidence of effect was found for educational interventions on behaviour and limited evidence of effect for multicomponent programmes on behaviour. In children and adolescents, effects on anthropometrics were often not measured, and therefore evidence was lacking or delivered inconclusive evidence. To conclude, evidence was found for the effectiveness of especially multicomponent interventions promoting a healthy diet in school-aged children in European Union countries on self-reported dietary behaviour. Evidence for effectiveness on anthropometrical obesity-related measures is lacking.
Stewart, David G; Moise-Campbell, Claudine; Chapman, Meredith K; Varma, Malini; Lehinger, Elizabeth
Ethnic minority youth are disproportionately affected by substance use-related consequences, which may be best understood through a social ecological lens. Differences in psychosocial consequences between ethnic majority and minority groups are likely due to underlying social and environmental factors. The current longitudinal study examined the outcomes of a school-based motivational enhancement treatment intervention in reducing disparities in substance use consequences experienced by some ethnic minority groups with both between and within-subjects differences. Students were referred to the intervention through school personnel and participated in a four-session intervention targeting alcohol and drug use. Participants included 122 youth aged 13-19 years. Participants were grouped by ethnicity and likelihood of disparate negative consequences of substance use. African American/Hispanic/Multiethnic youth formed one group, and youth identifying as White or Asian formed a second group. We hypothesized that (1) there would be significant disparities in psychosocial, serious problem behavior, and school-based consequences of substance use between White/Asian students compared to African American/Hispanic/Multiethnic students at baseline; (2) physical dependence consequences would not be disparate at baseline; and (3) overall disparities would be reduced at post-treatment follow-up. Results indicated that African American/Hispanic/Multiethnic adolescents demonstrated statistically significant disparate consequences at baseline, except for physical dependency consequences. Lastly, significant reductions in disparities were evidenced between groups over time. Our findings highlight the efficacy of utilizing school-based substance use interventions in decreasing ethnic health disparities in substance use consequences.
Alcazar, Lani; Raber, Margaret; Lopez, Kimberly; Markham, Christine; Sharma, Shreela
Hispanic families are at elevated risk for certain diet related illnesses including obesity and diabetes. Brighter Bites is a 16-week school-based program that delivers produce and nutrition education to high-need areas. The purpose of this study was to explore the adoption of Brighter Bites healthy eating strategies in low-income Spanish-speaking families as well as barriers to the sustainability of improved dietary behaviors using Photovoice. Two researchers worked with a predominately Hispanic, low-income public school to conduct the project. Spanish speaking parents participating in Brighter Bites were recruited and five mothers completed the study. Participants developed research questions, took documentary photos, attended group analysis sessions, and organized a community event. Photos from participants were gathered at two time points: i) during the Brighter Bites produce distributions, and ii) when the distributions were no longer in session. Participants organized resulting photos into themes during discussion groups that proceeded each photo-taking period. Themes that emerged during the produce distribution period included: cost savings, increased variety and accessibility of fresh produce, and ability to practice healthy eating. Themes that emerged when the weekly produce distributions were no longer in session included: increased costs, lack of variety, the continued effect of Brighter Bites, and innovative ways to cook with produce. Overall, participants were enthusiastic about the benefits they experienced with the program, but noted hardships in accessing nutritious food without the produce distributions in session. Innovative approaches are needed to create sustainable pathways to healthful food access after community nutrition interventions are complete. Copyright © 2017 Elsevier Ltd. All rights reserved.
Schutte, Lisette; van den Borne, Marieke; Kok, Gerjo; Meijer, Suzanne; Mevissen, Fraukje Ef
Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. Teacher's implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher's actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching intervention was developed based on a concept
Domazet, Sidsel Louise; Froberg, Karsten; Hillman, Charles H.; Andersen, Lars Bo; Bugge, Anna
Background Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12–14 years old adolescents. Methods A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD) age: 12.9 (0.6) years) completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects). The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. Results No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p’s>0.05) or mathematics skills (p>0.05). An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4–38.6) and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39–0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0–9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p’s>0.05). Conclusions No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing
Full Text Available Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12-14 years old adolescents.A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD age: 12.9 (0.6 years completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects. The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness.No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p's>0.05 or mathematics skills (p>0.05. An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4-38.6 and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39-0.05. Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0-9. Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p's>0.05.No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared
Tarp, Jakob; Domazet, Sidsel Louise; Froberg, Karsten; Hillman, Charles H; Andersen, Lars Bo; Bugge, Anna
Physical activity is associated not only with health-related parameters, but also with cognitive and academic performance. However, no large scale school-based physical activity interventions have investigated effects on cognitive performance in adolescents. The aim of this study was to describe the effectiveness of a school-based physical activity intervention in enhancing cognitive performance in 12-14 years old adolescents. A 20 week cluster randomized controlled trial was conducted including seven intervention and seven control schools. A total of 632 students (mean (SD) age: 12.9 (0.6) years) completed the trial with baseline and follow-up data on primary or secondary outcomes (74% of randomized subjects). The intervention targeted physical activity during academic subjects, recess, school transportation and leisure-time. Cognitive performance was assessed using an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. No significant difference in change, comparing the intervention group to the control group, was observed on the primary outcomes (p's>0.05) or mathematics skills (p>0.05). An intervention effect was found for cardiorespiratory fitness in girls (21 meters (95% CI: 4.4-38.6) and body-mass index in boys (-0.22 kg/m2 (95% CI: -0.39-0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0-9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between groups (all p's>0.05). No evidence was found for effectiveness of a 20-week multi-faceted school-based physical activity intervention for enhancing executive functioning or mathematics skills compared to a
Kok, Gerjo; Meijer, Suzanne; Mevissen, Fraukje EF
Background Full program implementation is crucial for effectiveness but is often overlooked or insufficiently considered during development of behavioral change interventions. For school-based health promotion programs, teachers are key players in program implementation, but teacher support in this phase is mostly limited to technical support and information. To ensure optimal implementation of the Dutch school-based sexual health program Long Live Love, a Web-based coaching website was developed to support teachers in completeness and fidelity of program implementation. Objective The aim of this paper is to provide insight into the process of systematic development of a Web-based coaching intervention to support teachers in their implementation of a school-based sexual health program. Methods The intervention mapping (IM) protocol was applied for the development of a theory- and evidence-based intervention. The IM process begins with (1) a needs assessment, followed by (2) the formulation of change objectives, (3) the selection of theory-based intervention methods and practical applications that take the parameters for effectiveness into consideration, (4) integration of practical applications into an organized program, (5) planning for adoption, implementation, and sustainability of the program, and finally, (6) generating an evaluation plan to measure program effectiveness. Results Teacher’s implementation behavior was characterized by inconsistently selecting parts of the program and not delivering (all) lessons as intended by program developers. Teachers, however, did not perceive this behavior as problematic, revealing the discrepancy between teacher’s actual and perceived need for support in delivering Long Live Love lessons with completeness and fidelity. Teachers did, however, acknowledge different difficulties they encountered which could potentially negatively influence the quality of implementation. With the IM protocol, this Web-based coaching
Full Text Available Abstract Background Depression is common and can have devastating effects on the life of adolescents. Psychological interventions are the first-line for treating or preventing depression among adolescents. This proposal aims to evaluate a school-based, universal psychological intervention to reduce depressive symptoms among student's aged 13-14 attending municipal state secondary schools in Santiago, Chile. Study design This is a cluster randomised controlled trial with schools as the main clusters. We compared this intervention with a control group in a study involving 22 schools, 66 classes and approximately 2,600 students. Students in the active schools attended 11 weekly and 3 booster sessions of an intervention based on cognitive-behavioural models. The control schools received their usual but enhanced counselling sessions currently included in their curriculum. Mean depression scores and indicators of levels of functioning were assessed at 3 and 12 months after the completion of the intervention in order to assess the effectiveness of the intervention. Direct and indirect costs were measured in both groups to assess the cost-effectiveness of this intervention. Discussion As far as we are aware this is the first cluster randomised controlled trial of a school intervention for depression among adolescents outside the Western world. Trial Registration ISRCTN19466209
Namisi, Francis; Aarø, Leif Edvard; Kaaya, Sylvia; Kajula, Lusajo J; Kilonzo, Gad P; Onya, Hans; Wubs, Annegreet; Mathews, Catherine
Cluster-randomized controlled trials were carried out to examine effects on sexual practices of school-based interventions among adolescents in three sites in sub-Saharan Africa. In this publication, effects on communication about sexuality with significant adults (including parents) and such communication as a mediator of other outcomes were examined. Belonging to the intervention group was significantly associated with fewer reported sexual debuts in Dar es Salaam only (OR 0.648). Effects on communication with adults about sexuality issues were stronger for Dar es Salaam than for the other sites. In Dar, increase in communication with adults proved to partially mediate associations between intervention and a number of social cognition outcomes. The hypothesized mediational effect of communication on sexual debut was not confirmed. Promoting intergenerational communication on sexuality issues is associated with several positive outcomes and therefore important. Future research should search for mediating factors influencing behavior beyond those examined in the present study.
‘Let’s Move It’ – a school-based multilevel intervention to increase physical activity and reduce sedentary behaviour among older adolescents in vocational secondary schools: a study protocol for a cluster-randomised trial
Full Text Available Abstract Background Physical activity (PA has been shown to decline during adolescence, and those with lower education have lower levels of activity already at this age, calling for targeted efforts for them. No previous study has demonstrated lasting effects of school-based PA interventions among older adolescents. Furthermore, these interventions have rarely targeted sedentary behaviour (SB despite its relevance to health. The Let’s Move It trial aims to evaluate the effectiveness and the cost-effectiveness of a school-based, multi-level intervention, on PA and SB, among vocational school students. We hypothesise that the intervention is effective in increasing moderate-to-vigorous-intensity physical activity (MVPA, particularly among those with low or moderate baseline levels, and decreasing SB among all students. Methods The design is a cluster-randomised parallel group trial with an internal pilot study. The trial is conducted in six vocational schools in the Helsinki Metropolitan area, Finland. The intervention is carried out in 30 intervention classes, and 27 control classes retain the standard curriculum. The randomisation occurs at school-level to avoid contamination and to aid delivery. Three of the six schools, randomly allocated, receive the ‘Let’s Move It’ intervention which consists of 1 group sessions and poster campaign targeting students’ autonomous PA motivation and self-regulation skills, 2 sitting reduction in classrooms via alterations in choice architecture and teacher behaviour, and 3 enhancement of PA opportunities in school, home and community environments. At baseline, student participants are blind to group allocation. The trial is carried out in six batches in 2015–2017, with main measurements at pre-intervention baseline, and 2-month and 14-month follow-ups. Primary outcomes are for PA, MVPA measured by accelerometry and self-report, and for SB, sedentary time and breaks in sedentary time (accelerometry
Tsimtsiou, Zoi; Drosos, Evangelos; Drontsos, Anastasios; Haidich, Anna-Bettina; Dantsi, Fotini; Sekeri, Zafiria; Dardavesis, Theodoros; Nanos, Panagiotis; Arvanitidou, Malamatenia
Purpose Although safe Internet use is an emerging public health issue, there is a scarcity of published work describing relevant school-based interventions. The objective of this study was to explore the impact of a health professional-led, school-based intervention in raising awareness on cyber-safety in adolescents, Therefore, the aim of this study was to investigate adolescents' evaluation of this school-based intervention, 6 months after its implementation, as well as the impact of adolescents' school class and gender on their evaluation. Methods A student sample was selected using a multistage stratified random sampling technique, according to the location and school grade level (middle, high school). The students - aged from 12 to 18 years old experienced an interactive presentation in their classrooms on the amount of time spent online, the use of social networks and the available support services. An evaluation tool was completed anonymously and voluntarily 6 months after the intervention. Results Four hundred and sixty-two students (response rate 90.7%, 246 middle, 216 high school) completed the evaluation tool. Younger students, especially the ones in the first year of middle school, scored significantly higher in all six parameters used in the evaluation of this intervention compared with all the older participants: (a) they had kept the presented information on Safeline and Saferinternet websites and the helpline Ypostirizo (70.2% vs. 33.7%, p < 0.001) (b) they had already used it (32.5% vs. 12.3%, p < 0.001), (c) they had learned new information on cyber safety (66.4% vs. 34%, p < 0.001), (d) they rated the intervention as more interesting (median 8 vs. 7, p < 0.05), (e) they had reconsidered the way they use Internet (median 7 vs. 6, p < 0.05) and (f) they had changed their cyber behavior (median 7 vs. 5, p < 0.05). Conclusion The active involvement of students in a discussion on cyber-safety based on their experiences was highly evaluated. The impact
Lau, Patrick Wing Chung; Wang, Jing Jing; Maddison, Ralph
Active videogames (AVGs) that require body movements to play offer a novel opportunity to turn a traditionally sedentary behavior into a physically active one. We sought to determine the effect of a school-based AVG intervention on Chinese children's aerobic fitness, physical activity (PA) level, and PA-related psychological correlates. Eighty 8-11-year-old Chinese children (55 males) were recruited from one Hong Kong primary school and were allocated at random to either an AVG intervention or control group. Children in the intervention group played an AVG, Xbox 360, twice per week during after-school hours, each for 60 minutes over 12 weeks in duration. The control group received no intervention. Children's body-mass index (BMI), objective PA, aerobic fitness (maximum oxygen consumption [VO 2max ]), PA task efficacy, barrier efficacy, and enjoyment were assessed. Compared with the control group, significant increases were found in the intervention group in VO 2max [mean and 95% confidence interval (CI): 1.58 (0.74, 2.42) mL/(kg·min)], objective moderate-to-vigorous PA [6.73 (1.70, 11.76) min/day], and total PA [27.19 (9.33, 45.04) min/day], but not for BMI. No significant differences in PA task efficacy, barrier efficacy, and enjoyment were observed. A 12-week (60 minutes × twice per week) school-based AVG intervention can improve Chinese children's aerobic fitness and PA level. These findings indicated that AVGs could be used as an alternative means to engage Chinese children in PA in school setting. However, the treatment effects of AVGs on PA-related psychological correlates and body composition need more investigation.
Grassi, Elena; Evans, Alexandra; Ranjit, Nalini; Pria, Simona Dalla; Messina, Laura
The purpose of the present study was to investigate the impact of a school-based nutrition and media education intervention on the promotion of fruit and vegetable consumption to help prevent childhood obesity. The 10-week-long intervention included sessions on nutrition education and media literacy. It also included a health communication media-based campaign workshop during which the children created posters, newsletters and video commercials related to fruits and vegetables targeted to their parents. For evaluation purposes, the study utilized a mixed-methods approach, including a quasi-experimental study (with one intervention group and one control group) and a focus group study. Four different elementary schools in Treviso (Veneto Region of Italy) agreed to participate in the research. The target population for the study included 10-year-old Italian children and their parents. Data indicate that this intervention was effective for children but not for parents. Evaluation results show that the intervention was effective in significantly increasing children's fruit and vegetable intake (Pmedia education intervention to address the children's obesity issue and, in particular, to increase children's fruit and vegetable intake. The study also opens a new perspective on the theoretical constructs investigated, because the development of 'ability of expression' could be considered one of the most important factors to determine the efficacy of the intervention.
Wikman, Johan Michael; Ryom, Knud; Stelter, Reinhard
group (n = 58) did not. A Danish version of the Recovery-Stress Questionnaire for Athletes measured recovery levels in the participants, at baseline and at the end of intervention. Qualitative interviews were conducted with four of the participants. Quantitative results did not show an improvement...... in recovery and stress levels. Qualitative results showed that the intervention had an effect on the participants, and also revealed areas, in which the intervention could be improved. Suggestions for future interventions are given....
Dray, Julia; Bowman, Jenny; Campbell, Elizabeth; Freund, Megan; Hodder, Rebecca; Wolfenden, Luke; Richards, Jody; Leane, Catherine; Green, Sue; Lecathelinais, Christophe; Oldmeadow, Christopher; Attia, John; Gillham, Karen; Wiggers, John
Worldwide, 10-20% of adolescents experience mental health problems. Strategies aimed at strengthening resilience protective factors provide a potential approach for reducing mental health problems in adolescents. This study evaluated the effectiveness of a universal, school-based intervention targeting resilience protective factors in reducing mental health problems in adolescents. A cluster randomised controlled trial was conducted in 20 intervention and 12 control secondary schools located in socio-economically disadvantaged areas of NSW, Australia. Data were collected from 3115 students at baseline (Grade 7, 2011), of whom 2149 provided data at follow up (Grade 10, 2014; enrolments in Grades 7 to 10 typically aged 12-16 years; 50% male; 69.0% retention). There were no significant differences between groups at follow-up for three mental health outcomes: total SDQ, internalising problems, and prosocial behaviour. A small statistically significant difference in favour of the control group was found for externalising problems. Findings highlight the continued difficulties in developing effective, school-based prevention programs for mental health problems in adolescents. ANZCTR (Ref no: ACTRN12611000606987). Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available Abstract Aims: Cardiovascular disease risk factors occur more frequently in children with obesity. Project PANK is a multidisciplinary school-based intervention lasting 6 months to improve BMI z-score, waist circumference (WC, waist-to-height ratio (WHtR, blood pressure (BP, nutrition, physical activity (PA, sedentary behaviour (SB, cardiorespiratory fitness (CRF, glucose, cholesterol, and triglycerides (TG. Methods/DesignA total of 77 children (7-10 years were recruited from an urban school. The protocol includes PA and SB individual meetings for children/parents; increasing school exercise; PA and SB lessons for children; A goal in the number of steps/day to accomplish in and after school. In nutrition, the protocol includes three individual meetings for children/parents and six lessons for children. ResultsPositive associations were found between the BMI Z-score, WC, and WHtR with TG; the BMI Z-score and WHtR with glucose; the light PA time and HDL-C; the vigorous and moderate-to-vigorous PA with CRF; the caloric intake and lipids with LDL-C, BMI z-score, WC, and WHtR. A negative association was found between CRF and TG. ConclusionBaseline results stress the importance of multidisciplinary school-based interventions. We hypothesized that PANK will improve blood variables, anthropometric measures, and BP, by changing food intake, enhancing PA and CRF, and decreasing SB.
Full Text Available Abstract Background Childhood obesity is not only associated with adult obesity but also with increased risk of adult onset of type 2 diabetes and subsequent coronary heart disease. The potential effects of school-based health intervention programmes on cardiovascular risk and surrogate markers are unclear, as only few studies have attempted to investigate a complete risk profile including a detailed laboratory analysis or micro- and macrovascular function. In this study a comprehensive school-based randomized intervention programme will be investigated in 10-14-year old children addressing the influence of lifestyle intervention on inactivity, cardiometabolic risk factors and early signs of vascular disease. Methods/Design 15 secondary schools in Southern Germany are randomly assigned to intervention or control schools. Children in the fifth grade (10-11 years will be observed over four years. The study combines a school-based with a home-based approach, aiming at children, teachers and parents. The main components are weekly lifestyle-lessons for children, taught by regular classroom teachers to increase physical activity in- and outside of school, to improve eating patterns at school and at home, to reduce media consumption and to amplify well-being. In 4-6 annual meetings, teachers receive information about health-related topics with worksheets for children and supporting equipment, accounting for school-specific needs and strategies. Parents' trainings are provided on a regular basis. All examinations are performed at the beginning and at the end of every school year. Anthropometry includes measurements of BMI, waist and upper arm circumferences, skinfold thickness as well as peripheral blood pressure. Blood sampling includes lipid parameters, insulin, glucose, hsCRP, adiponectin, and IL-6 as well as testosteron and estrogen to determine maturation status. Vascular function is non-invasively assessed by measuring arterial stiffness in large
Jeanette M. Johnstone
Full Text Available Adolescents are in a high-risk period developmentally, in terms of susceptibility to stress. A mindfulness intervention represents a potentially useful strategy for developing cognitive and emotion regulation skills associated with successful stress coping. Mindfulness strategies have been used successfully for emotional coping in adults, but are not as well studied in youth. This article details a novel proposal for the design of an 8-week randomized study to evaluate a high school-based mindfulness curriculum delivered as part of a two semester health class. A wellness education intervention is proposed as an active control, along with a waitlist control condition. All students enrolled in a sophomore (10th grade health class at a private suburban high school will be invited to participate (n = 300. Pre-test assessments will be obtained by youth report, parent ratings, and on-site behavioral testing. The assessments will evaluate baseline stress, mood, emotional coping, controlled attention, and working memory. Participants, divided into 13 classrooms, will be randomized into one of three conditions, by classroom: A mindfulness intervention, an active control (wellness education, and a passive control (waitlist. Waitlisted participants will receive one of the interventions in the following term. Intervention groups will meet weekly for 8 weeks during regularly scheduled health classes. Immediate post-tests will be conducted, followed by a 60-day post-test. It is hypothesized that the mindfulness intervention will outperform the other conditions with regard to the adolescents' mood, attention and response to stress.
Agha, Sohail; Van Rossem, Ronan
To determine whether adolescents' normative beliefs about abstinence and condoms, their personal risk perception, and safer sex practices changed after the implementation of a peer sexual health education intervention implemented in Zambian secondary schools. The peer intervention was implemented during the first week of September 2000 in Lusaka, Zambia. A quasi-experimental, longitudinal panel design was used to evaluate its impact. Three schools were randomly assigned to the intervention condition and two to the control condition. Three rounds of data from male and female adolescents in grades 10 and 11 were collected at baseline in July 2000, at first follow-up in the second half of September 2000, and at second follow-up in early April 2001. A total of 416 respondents aged 14-23 (at baseline) were interviewed in all three survey rounds. A mixed-effects logistic regression growth curve analysis was used to calculate adjusted odds ratios to compare intervention and control groups on the outcome variables. Student self-reports showed positive changes in normative beliefs about abstinence immediately after the intervention, and these improvements were largely sustained until 6 months after the intervention. Students became more likely to approve of condom use and to intend using condoms immediately after the intervention, but these positive outcomes could not be sustained during the 6 months that followed the intervention. Normative beliefs regarding condom use took longer to develop: these were only observed at 6 months follow-up. Students reported reductions in multiple regular partnerships. There was no change in condom use. A single session school-based peer sexual health intervention resulted in the development of normative beliefs about abstinence that were sustained over a 6-month period. Normative beliefs about condoms took longer to develop. More regular efforts may be required to sustain the approval of, and the intention to use, condoms. The intervention
Durlak, Joseph A; Weissberg, Roger P; Dymnicki, Allison B; Taylor, Rebecca D; Schellinger, Kriston B
This article presents findings from a meta-analysis of 213 school-based, universal social and emotional learning (SEL) programs involving 270,034 kindergarten through high school students. Compared to controls, SEL participants demonstrated significantly improved social and emotional skills, attitudes, behavior, and academic performance that reflected an 11-percentile-point gain in achievement. School teaching staff successfully conducted SEL programs. The use of 4 recommended practices for developing skills and the presence of implementation problems moderated program outcomes. The findings add to the growing empirical evidence regarding the positive impact of SEL programs. Policy makers, educators, and the public can contribute to healthy development of children by supporting the incorporation of evidence-based SEL programming into standard educational practice. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.
Kong, Alberta S; Farnsworth, Seth; Canaca, Jose A; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L
In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles to conduct formative research in identifying acceptable and potentially sustainable obesity intervention strategies in 8 New Mexico school communities. We collected formative data from 8 high schools on areas of community interest for school health improvement through collaboration with local School Health Advisory Councils (SHACs) and interviews with students and parents. A survey based on formative results was created to assess acceptability of specific intervention strategies and was provided to SHACs. Quantitative data were analyzed using descriptive statistics while qualitative data were evaluated using an iterative analytic process for thematic identification. Key themes identified through the formative process included lack of healthy food options, infrequent curricular/extracurricular physical activity opportunities, and inadequate exposure to health/nutritional information. Key strategies identified as most acceptable by SHAC members included healthier food options and preparation, a healthy foods marketing campaign, yearly taste tests, an after-school noncompetitive physical activity program, and community linkages to physical activity opportunities. An adaptive CBPR approach for formative assessment can be used to identify obesity intervention strategies that address community school health concerns. Eight high school SHACs identified 6 school-based strategies to address parental and student concerns related to obesity. © 2012, American School Health Association.
Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Moreno-García, Carlos Francisco; Trujillo Escobar, Tamy Goretty; Solà, Rosa; Giralt, Montse
The use of social marketing to modify lifestyle choices could be helpful in reducing youth obesity. Some or all of the 8 domains of the National Social Marketing Centre's social marketing benchmark criteria (SMBC) are often used but not always defined in intervention studies. The aim of this review is to assess the effectiveness of European school-based interventions to prevent obesity relative to the inclusion of SMBC domains in the intervention. The PubMed, Cochrane, and ERIC databases were used. Nonrandomized and randomized controlled trials conducted from 1990 to April 2014 in participants aged 5 to 17 years were included. After the study selection, the 8 domains of the SMBC were assessed in each included study. Thirty-eight publications were included in the systematic review. For the meta-analysis, randomized controlled trials (RCTs) reporting body mass index or prevalence of overweight and obesity were considered. Eighteen RCTs with a total of 8681 participants included at least 5 SMBC. The meta-analysis showed a small standardized mean difference in body mass index of -0.25 (95%CI, -0.45 to -0.04) and a prevalence of overweight and obesity odds ratio of 0.72 (95%CI, 0.5-0.97). Current evidence indicates that the inclusion of at least 5 SMBC domains in school-based interventions could benefit efforts to prevent obesity in young people. PROSPERO registration number: CRD42014007297. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute.
Evans, Rhiannon; Murphy, Simon; Scourfield, Jonathan
Sporadic and inconsistent implementation remains a significant challenge for social and emotional learning (SEL) interventions. This may be partly explained by the dearth of flexible, causative models that capture the multifarious determinants of implementation practices within complex systems. This paper draws upon Rogers (2003) Diffusion of Innovations Theory to explain the adoption, implementation and discontinuance of a SEL intervention. A pragmatic, formative process evaluation was conducted in alignment with phase 1 of the UK Medical Research Council's framework for Developing and Evaluating Complex Interventions. Employing case-study methodology, qualitative data were generated with four socio-economically and academically contrasting secondary schools in Wales implementing the Student Assistance Programme. Semi-structured interviews were conducted with 15 programme stakeholders. Data suggested that variation in implementation activity could be largely attributed to four key intervention reinvention points, which contributed to the transformation of the programme as it interacted with contextual features and individual needs. These reinvention points comprise the following: intervention training, which captures the process through which adopters acquire knowledge about a programme and delivery expertise; intervention assessment, which reflects adopters' evaluation of an intervention in relation to contextual needs; intervention clarification, which comprises the cascading of knowledge through an organisation in order to secure support in delivery; and intervention responsibility, which refers to the process of assigning accountability for sustainable delivery. Taken together, these points identify opportunities to predict and intervene with potential implementation problems. Further research would benefit from exploring additional reinvention activity.
Hubbard, Gill; Stoddart, Iona; Forbat, Liz; Neal, Richard D; O'Carroll, Ronan E; Haw, Sally; Rauchhaus, Petra; Kyle, Richard G
Raising cancer awareness and addressing barriers to help-seeking may improve early diagnosis. The aim was to assess whether a psycho-educational intervention increased adolescents' cancer awareness and addressed help-seeking barriers. This was a cluster randomised controlled trial involving 2173 adolescents in 20 schools. The intervention was a 50-min presentation delivered by a member of Teenage Cancer Trust's (UK charity) education team. Schools were stratified by deprivation and roll size and randomly allocated to intervention/control conditions within these strata. Outcome measures were the number of cancer warning signs and cancer risk factors recognised, help-seeking barriers endorsed and cancer communication. Communication self-efficacy and intervention fidelity were also assessed. Regression models showed significant differences in the number of cancer warning signs and risk factors recognised between intervention and control groups. In intervention schools, the greatest increases in recognition of cancer warning signs at 6-month follow-up were for unexplained weight loss (from 44.2% to 62.0%) and change in the appearance of a mole (from 46.3% to 70.7%), up by 17.8% and 24.4%, respectively. Greatest increases in recognition of cancer risk factors were for getting sunburnt more than once as a child (from 41.0% to 57.6%) and being overweight (from 42.7% to 55.5%), up by 16.6% and 12.8%, respectively. Regression models showed that adolescents in intervention schools were 2.7 times more likely to discuss cancer at 2-week follow-up compared with the control group. No differences in endorsement of barriers to help-seeking were observed. School-based brief psycho-educational interventions are easy to deliver, require little resource and improve cancer awareness. © 2015 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd. © 2015 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
Sacchetti, R; Dallolio, L; Musti, M A; Guberti, E; Garulli, A; Beltrami, P; Castellazzi, F; Centis, E; Zenesini, C; Coppini, C; Rizzoli, C; Sardocardalano, M; Leoni, E
A school based health promotion intervention was performed with the aim of increasing physical activity and improving the dietary habits of primary school pupils, using integrated educational strategies involving schools, families, public bodies, sports associations and public health operators. The intervention concerned 11 classes during 3 school years from 2009-10 (231 third-year school children) to 2011-12 (234 fifth-year school children). Information was collected both before and after the intervention about the dietary habits and the physical activities practised by the children, using the questionnaires of the project !OKkio alla Salute! which were administered to both children and parents. At the same time anthropometric measurements were taken (height, weight, BMI) and motor skills were assessed using standardized tests: Sit & Reach, medicine-ball forward throw, standing long jump, 20 m running speed, and forward roll. At the end of the intervention 12 different expected outcomes were assessed (5 about dietary habits, 5 about motor habits, 1 about anthropometric characteristics, 1 about motor skills). At baseline, 35.8% of the children show excess weight (23.4% overweight; 12.4% obese); this percentage falls to 29.3% (25.3% overweight; 4% obese) after the intervention (p habits improve from the pre- to the post-intervention: there is a rise in the percentage of children who receive an adequate mid-morning snack (p habits do not improve in the same way, since there is the increasing tendency with age to skip from a regular daily practice of physical exercise to favour of the occasional practice of a sport. The motor performances, compared after normalization for modifications due to the process of growth, improve between the third and fifth years of primary school, but with no significant differences. To achieve this objective more focused measures are necessary in the administration of moderate to intense physical exercise. The results point to a positive
Baker, Philip R A; Francis, Daniel P; Soares, Jesus; Weightman, Alison L; Foster, Charles
Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. We searched the Cochrane Public Health Group Segment of the Cochrane Register of Studies,The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, the British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORT Discus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.org; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA); the US Centre for Disease Control and Prevention (CDC) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were searched and we contacted experts in the field. The searches were updated to 16 January 2014, unrestricted by language or publication status. Cluster randomised controlled trials, randomised controlled trials, quasi-experimental designs which used a control population for comparison, interrupted time-series studies, and prospective controlled cohort studies were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised individuals from the same community were excluded. At least two review authors independently extracted the data and assessed the risk of bias. Each study was assessed for the setting, the number of included components
Marquis, Grace S; Colecraft, Esi K
Background. Low caregiver income and poor nutrition knowledge and skills are important barriers to achieving optimal child feeding in rural Ghana. An integrated microcredit and nutrition education intervention was implemented to address these barriers. Using a quasi-experimental design, 134 caregivers of children 2 to 5 years of age in six intervention communities were enrolled into self-selected savings and loan groups. They received small individual loans over four 16-week cycles to support their income-generating activities. Nutrition and entrepreneurial education was provided during weekly loan repayment meetings. Another 261 caregivers in six comparison communities did not receive the intervention. Data on household sociodemographic and economic characteristics, perception of income-generating activity profits, and children's consumption of animal-source foods in the previous week were collected at baseline and at four additional time points. Differences according to group (intervention vs. control) and time (baseline vs. endline) were analyzed with chi-square and Student's t-tests. The intervention and comparison groups did not differ by caregivers' age and formal education; few (35) had previous experience with microcredit loans. At endline, more intervention than comparison caregivers perceived that their business profits had increased (59% vs. 23%, p < .001). In contrast to comparison children, after 16 months of intervention children consumed more livestock meat (p =.001), organ meat (p = .04), eggs (p = .001), and milk and milk products (p < .0001) in the previous week in comparison with baseline. Integrated food-centered strategies can improve children's diets, which will enhance their nutritional status, health, and cognitive outcomes.
Jennissen, Charles A; Peck, Jeffrey; Wetjen, Kristel; Hoogerwerf, Pam; Harland, Karisa K; Denning, Gerene M
Since 1985, one-third of all US all-terrain vehicle (ATV)-related injuries and one-quarter of deaths involved victims safety education of youth could help reduce these tragedies. To assess the efficacy of the Safety Tips for ATV Riders (STARs) school-based programme targeting adolescents. A survey was anonymously administered before and after the programme to determine demographics, knowledge and reported likelihood of using the information learned. Over 4600 students in 30 Iowa schools participated from November 2010 to April 2013. Initially, 52% knew most ATVs are designed for one rider, 25% knew the recommended vehicle size for their age range and 42% knew riding on Iowa's roads was legal only for agricultural purposes. After the programme, this increased to 92%, 82% and 76%, respectively (psafety information learned, respectively; younger students, females and infrequent riders reported higher likelihoods. STARs increased short-term ATV safety knowledge and almost half the participants reported they would use the safety information presented. Males and frequent riders seemed more resistant, but some groups that may be more vulnerable to potential ATV crash and injury appeared amenable to the training with higher increases in postprogramme scores and greater intention of improving safety behaviours. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Full Text Available Abstract Background Emotional problems such as anxiety and low mood in children are common, impair everyday functioning and increase the risk of severe mental health disorders in adulthood. Relatively few children with emotional health problems are identified and referred for treatment indicating the need to investigate preventive approaches. Methods/Design The study is designed to be a pragmatic cluster randomized controlled trial evaluating the effectiveness of an efficacious school-based cognitive behavior therapy (CBT prevention program (FRIENDS on symptoms of anxiety and low mood in children 9 to 10 years of age. The unit of allocation is schools which are assigned to one of three conditions: school-led FRIENDS, health-led FRIENDS or treatment as usual. Assessments will be undertaken at baseline, 6 months and 12 months. The primary outcome measure is change on the Revised Child Anxiety and Depression Scale. Secondary outcome measures assess changes in self-esteem, worries, bullying and life satisfaction. An economic evaluation will be undertaken. Discussion As of September 2011, 41 schools have been recruited and randomized. Final 12-month assessments are scheduled to be completed by May 2013. Trial Registration ISRCTN23563048
Dobbie, Fiona; Angus, Kathryn; Littlecott, Hannah; Allum, Karen; Wells, Valerie; Amos, Amanda; Haw, Sally; Bauld, Linda
Despite a decline in child and adult smoking prevalence, young people who smoke (even occasionally) can rapidly become addicted to nicotine, with most adult smokers initiating smoking before they are 18. Schools have long been a popular setting to deliver youth smoking prevention interventions, but evidence of the effectiveness of school-based prevention programmes is mixed, and outcomes vary by the type of programme delivered. Existing systematic reviews that explore the factors contributing to the success or failure of school-based smoking prevention programmes often exclude qualitative studies, due to a focus on intervention effectiveness which qualitative research cannot answer. Instead, qualitative research is focussed on the experiences and perceptions of those involved in the programmes. This systematic review will address this gap by updating a 2009 review to examine qualitative studies. The aim is to generate deeper insight to help target resources which have the potential to save lives by preventing smoking initiation among children and young people. This systematic review will be searching the following databases: the Cochrane Library, MEDLINE, EMBASE, PsycINFO, HMIC, ERIC, ASSIA, Web of Science and CINAHL. In order to identify additional references, we will consult the reference lists of a sample of systematic reviews and search relevant organizational websites in order to identify appropriate grey literature. The search strategy will include key words and database-specific subject headings relating to smoking, children and young people, health promotion and school. Authors will independently screen, assess data quality and extract data for synthesis. Study findings will be synthesised thematically using 'best-fit framework syntheses'. This allows for an existing set of themes to be used as a starting point to map or code included studies. These themes are then adapted as coding takes place to accommodate new emerging themes. This review will focus on
Waters, Allison M; Groth, Trisha A; Sanders, Mary; O'Brien, Rosanne; Zimmer-Gembeck, Melanie J
Clinical scientists are calling for strong partnerships in the provision of evidence-based treatments for child mental health problems in real-world contexts. In the present study, we describe the implementation of a cognitive-behavioral intervention (CBI) to address grade 5 children's anxiety symptoms. The CBI arose from a long-standing partnership between University and Education Department stakeholders. The partnership integrates school-based, evidence-informed treatment delivery with clinical education, and also supports a school-based psychology clinic to provide assessment and treatment services to children attending schools within the catchment area and clinical training for university graduate students. Children in the active condition (N=74) completed the CBI during regular class time, while children in the control condition (N=77) received the standard classroom curriculum. Children's anxiety and depressive symptoms, threat interpretation biases (perceived danger and coping ability), and perceptions of their social skills were assessed before and after condition. Children in the active condition reported significant improvements in self-reported anxiety symptoms, and perceptions of their social skills and coping ability, whereas no significant differences were observed for children in the control condition from pre- to post-assessment. For a subset of children assessed 12 months after the CBI (n=76), symptom improvement remained stable over time and estimates of danger and coping ability showed even greater improvement. Results demonstrate the value of strong stakeholder partnerships in innovative youth mental health services, positive child outcomes, and clinical education. Copyright © 2015. Published by Elsevier Ltd.
Sharif Ishak, Sharifah Intan Zainun; Chin, Yit Siew; Mohd. Taib, Mohd. Nasir; Mohd. Shariff, Zalilah
Abstract Background Obesity, eating disorders and unhealthy weight-loss practices have been associated with diminished growth in adolescents worldwide. Interventions that address relevant behavioural dimensions have been lacking in Malaysia. This paper describes the protocol of an integrated health education intervention namely ‘Eat Right, Be Positive About Your Body and Live Actively’ (EPaL), a primary prevention which aimed to promote healthy lifestyle in preventing overweight and disordere...
Muellmann, S; Landgraf-Rauf, K; Brand, T; Zeeb, H; Pischke, C R
Objective: To summarize the current evidence on the effectiveness of school-based interventions for the maintenance of mental health and the prevention of psychosocial problems among pupils. Methods: A systematic literature search of reviews published between 2007 and 2015 was carried out. Databases searched included Medline, PsycINFO, Campbell Library, Cochrane Library, NICE, ERIC, and Web of Science. Study selection, data extraction, and quality assessment (using AMSTAR criteria) were performed by 2 independent reviewers. Results: 6 reviews covering 331 primary studies were included in this review of reviews. Findings of three reviews with a focus on the maintenance and/or promotion of mental health and general well-being suggested that interventions aimed at changes in the social and the school environment were more effective than those that only targeted individual behavior change among pupils. Interventions for the reduction of mobbing/bullying were most effective if they comprised organizational changes at schools, such as playground and schoolyard supervision, and disciplinary measures. One review suggested strong evidence for the effectiveness of classroom management to reduce violent behavior among pupils. Conclusions: Participation in interventions promoting changes in the school environment, in addition to individual behavior change, appears to be associated with improved mental health among pupils and reductions in mobbing/bullying and violent behavior at schools. © Georg Thieme Verlag KG Stuttgart · New York.
Jones, Stephanie M; Brown, Joshua L; Lawrence Aber, J
This study contributes to ongoing scholarship at the nexus of translational research, education reform, and the developmental and prevention sciences. It reports 2-year experimental impacts of a universal, integrated school-based intervention in social-emotional learning and literacy development on children's social-emotional, behavioral, and academic functioning. The study employed a school-randomized, experimental design with 1,184 children in 18 elementary schools. Children in the intervention schools showed improvements across several domains: self-reports of hostile attributional bias, aggressive interpersonal negotiation strategies, and depression, and teacher reports of attention skills, and aggressive and socially competent behavior. In addition, there were effects of the intervention on children's math and reading achievement for those identified by teachers at baseline at highest behavioral risk. These findings are interpreted in light of developmental cascades theory and lend support to the value of universal, integrated interventions in the elementary school period for promoting children's social-emotional and academic skills. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.
Laureati, Monica; Bergamaschi, Valentina; Pagliarini, Ella
This study investigated the effectiveness of the 'Food Dudes' school-based intervention consisting of rewards, peer-modeling and food exposure on food neophobia and the liking of fruits and vegetables (FV) in a large cohort of children. Five-hundred sixty children recruited from three schools were assigned to the experimental or control group. For 16 days, children in the experimental group watched motivational videos, were read letters to encourage them to eat FV and received a small reward for eating one portion of both a fruit and a vegetable. The control group was only provided with FV for the same time period. Food neophobia and liking were measured in both groups of children before and after the intervention, and a follow-up measurement was carried out 6 months later. The intervention was effective in reducing food neophobia and, most importantly, a persistent effect was observed 6 months after the intervention as children of the experimental group showed significantly lower neophobia scores than the control group. Additionally, the program was effective in increasing liking for both FV; however, this effect was maintained only for fruit after 6 months. Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available Background: Bullying perpetration and victimization is associated with significant academic, psychosocial and health related problems among adolescents. There is a need to develop effective interventions to prevent bullying among adolescents, especially in low and middle income countries. This paper presents the study protocol to develop, and evaluate the effect of multi-component school based prevention program for bullying in India. Design: Quasi-experimental study. Methods: The study will be conducted among 846 students of grade 7th and 8th in the intervention and control schools in Chandigarh, Union Territory, North India. A government and a private school will be selected purposively in each of the intervention and control arm. The intervention is based on socio-ecological model, and will be administered at individual, relationship (parents and teachers and school level. The primary study outcome will be the proportion of students experiencing any kind of bullying (bullying, victimization, or both, in each study arm. The effectiveness of the intervention will be measured by performing difference in difference analysis and generalized estimating equations. Expected impact for public health: Bullying is an aggressive behaviour with significant morbidities, including psychological or physical trauma, affecting individuals not only in their adolescence, but also later in their adulthood. This quasi-experimental study is expected to provide evidence on whether multi-component bullying prevention intervention program, can reduce the burden of bullying perpetration and victimization among school adolescents in India. The results of the study will add in the exiting literature on bullying intervention program, especially, from the low middle-income countries, as there are limited studies available on this topic in these countries.
Morales, Eduardo S
Translation from research to practice faces numerous problems that include replicating effectiveness, fidelity to the protocol and processes, and adaptations to different types of target populations. Working collaboratively with existing service providers can speed up the time for development and can ease the implementation of empirical randomized trials. Contextual community prevention theory is an innovative approach that focuses on changing behaviors of community members by creating a visible institutional presence that draws and pulls the targeted population into the organization's activities and interventions. The result is an institution or organization within the community that provides a new active and dynamic context, engaging its community members into its activities, interventions, and functions. An HIV prevention program developed collaboratively from the ground up for Latino gay/bisexual men is presented. Results from the program evaluation efforts across the years suggest promise for testing its efficacy through a randomized trial. HIV prevention efforts need to develop dynamic support systems within communities where these men have ownership, have control, and feel safe; otherwise HIV infection rates in this population will increase. Copyright 2009 by the American Psychological Association
Bremer, Emily; Lloyd, Meghann
The purpose of this pilot study was to demonstrate the impact of a fundamental-motor-skill (FMS) intervention on the motor skills of 3- to 7-year-old children with autism-like characteristics in an early intervention classroom. A secondary purpose was to qualitatively assess the impact of the program as described by the classroom's special education teacher. All children in the classroom (N = 5) took part in an FMS intervention for two 6-wk blocks (fall 2013 and winter 2014). Motor-skill proficiency and social skills were assessed at 3 times: baseline, after Block 1 of the intervention, and after Block 2 of the intervention. In addition, an interview was conducted with the classroom teacher after Assessment 3 to draw further insights into the relative success and impact of the program. Results were analyzed through a visual analysis and presented individually. They indicated improvements in the participants' individual FMS and social-skill scores, possible improvements in declarative knowledge, and an increase in the special education teacher's readiness to teach FMS; further research with larger, controlled samples is warranted.
Mesheriakova, Veronika V; Tebb, Kathleen P
The use of effective contraception can decrease the incidence of unplanned pregnancy among adolescents. This study aims to examine the effectiveness of an iPad-based application (app) on improving adolescent girls' sexual health knowledge and on its ability to influence their intentions to use effective contraception. This was a prospective study of girls aged 12 to 18 years recruited from 3 school-based health centers in California. A total of 120 racially/ethnically diverse participants used the iPad app; 54% were sexually active, with only 26% using effective contraception at baseline. The average score on baseline sexual health knowledge assessment was 58%. After using the app, 68% of the sexually active participants reported intention to use effective contraception in the future, and sexual health knowledge improved significantly to 79% ( P iPad-based app is a promising intervention to educate adolescents about sexual health and support them in selecting an effective contraception method.
Full Text Available Abstract Background Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Methods Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. Results The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of
Hetherington, Erin; Eggers, Matthijs; Wamoyi, Joyce; Hatfield, Jennifer; Manyama, Mange; Kutz, Susan; Bastien, Sheri
Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Based in rural and remote Tanzania, this pilot study engaged pastoralist high-school students and communities in the development and evaluation of culturally and contextually relevant strategies to improve sanitation and hygiene. Using a train-the-trainer approach, key activities included teacher workshops, school-based lessons, extra-curricular activities, community events and a One Health sanitation science fair which showcased projects related to water, sanitation and hygiene in relation to human and animal health. The process and outcome of the study were evaluated through qualitative interviews and focus group discussions with diverse project participants, as well as pre- and post- questionnaires completed by students on knowledge, attitudes and practices concerning sanitation and hygiene. The questionnaire results at baseline and follow-up showed statistically significant improvements on key measures including a decrease in unhygienic behaviors, an increase in the perceived importance of handwashing and intention to use the toilet, and increased communication in the social network about the importance of clean water and improved sanitation and hygiene practices, however there were no significant changes in sanitation related knowledge. Qualitative data highlighted strong leadership emerging from youth and enthusiasm from teachers and students concerning the overall approach in the project, including the use of participatory methods. There was a high degree of community engagement with hundreds of community members participating in school-based events
Liber, Juliette M; De Boo, Gerly M; Huizenga, Hilde; Prins, Pier J M
In this randomized controlled trial, we investigated the effectiveness of a school-based targeted intervention program for disruptive behavior. A child-focused cognitive behavioral therapy (CBT) program was introduced at schools in disadvantaged settings and with active teacher support (ATS) versus educational teacher support (ETS) (CBT + ATS vs. CBT + ETS). Screening (n = 1,929) and assessment (n = 224) led to the inclusion of 173 children ages 8-12 years from 17 elementary schools. Most of the children were boys (n = 136, 79%) of low or low-to-middle class socioeconomic status (87%); the sample was ethnically diverse (63% of non-Western origin). Children received CBT + ATS (n = 29) or CBT + ETS (n = 41) or were entered into a waitlist control condition (n = 103) to be treated afterward (CBT + ATS, n = 39, and CBT + ETS, n = 64). Effect sizes (ES), clinical significance (reliable change), and the results of multilevel modeling are reported. Ninety-seven percent of children completed treatment. Teachers and parents reported positive posttreatment effects (mean ES = .31) for CBT compared with the waitlist control condition on disruptive behavior. Multilevel modeling showed similar results. Clinical significance was modest. Changes had remained stable or had increased at 3-months follow-up (mean ES = .39). No consistent effect of teacher condition was found at posttreatment; however, at follow-up, children who received ETS fared significantly better. This study shows that a school-based CBT program is beneficial for difficult-to-reach children with disruptive behavior: The completion rate was remarkably high, ESs (mean ES = .31) matched those of previous studies with targeted intervention, and effects were maintained or had increased at follow-up.
Kesztyüs, Dorothea; Schreiber, Anja; Wirt, Tamara; Wiedom, Martina; Dreyhaupt, Jens; Brandstetter, Susanne; Koch, Benjamin; Wartha, Olivia; Muche, Rainer; Wabitsch, Martin; Kilian, Reinhold; Steinacker, Jürgen M
Measuring the impact of the URMEL-ICE school-based overweight prevention programme on anthropometric measures in primary-school children, computing incremental cost-effectiveness relation (ICER) and net monetary benefit (NMB). This is an intervention study with historical control. Propensity score method is applied to account for group differences. One-year teacher-driven classroom implementation is used, which is based on especially developed teaching material including health education, physical activity breaks and parent involvement. 354 children in the control and 365 children in the intervention group at baseline and follow-up were analysed. Effectiveness is measured as cm waist circumference (WC) and unit (0.01) waist-to-height ratio (WHtR) increase prevented in intervention vs. control group using an adjusted two-level model. Standard cost-effectiveness analysis methods, net benefit regression and a societal perspective for a 1-year time horizon are applied. WC gain was 1.61 cm and WHtR gain was 0.014 significantly less in intervention vs. control group. Intervention costs were euro24.09 per child. ICER was euro11.11 (95% confidence interval (CI) [8.78; 15.02]) per cm WC and euro18.55 (95% CI [14.04; 26.86]) per unit WHtR gain prevented. At a maximum willingness to pay (MWTP) of euro35, both values of the CIs for NMB regarding WC and WHtR are located in the positive range. The study gives new information about the cost-effectiveness of structured health promotion embedded in daily routine at primary schools. Assuming a MWTP of euro35 the intervention is cost-effective with a positive NMB. This result may help decision makers in implementing programmes to prevent childhood overweight in school settings.
Dart, Evan H.; Radley, Keith C.; Mason, Benjamin A.; Allen, Justin P.
Students with developmental disabilities have been found to exhibit higher rates of problem behavior in the classroom than their typically developing peers. Effectively addressing these students' behavior concerns requires the identification of interventions that can be implemented in an educational setting. Furthermore, matching intervention…
De La Rue, Lisa; Polanin, Joshua R.; Espelage, Dorothy L.; Pigott, Terri D.
Background: The incidence of psychological, physical, and sexual violence in intimate dating relationships has a significant impact on young people. These issues are of great concern to researchers, educators, and administrators who strive to help youth be happy and healthy. This review focused on prevention and intervention efforts implemented in…
Sullivan, Amanda L.; Long, Lori
As Response to Intervention (RtI) approaches become more common in educational systems throughout the country, it is increasingly important to identify how practitioners perceive these changes and how they obtain the skills necessary to face emergent roles and responsibilities. In this exploratory study, a national sample of 557 school…
Moore, Darren A.; Whittaker, Sarah; Ford, Tamsin J.
This paper describes daily report cards and the evidence relating to their use in schools for children with attention-deficit/hyperactivity disorder (ADHD). This intervention typically involves teachers evaluating a student's behaviour at school against pre-determined targets and parents subsequently providing reinforcement at home for positive…
de Bruin, Catriona L.; Deppeler, Joanne M.; Moore, Dennis W.; Diamond, Neil T.
This article reviews research on the effectiveness of four categories of intervention when implemented in public schools with adolescents and young adults diagnosed with an autism spectrum disorder. The study's inclusionary criteria include a setting of public schools, participants aged between 12 and 22 years, and the investigation of an…
Ruocco, Sylvia; Gordon, Jocelynne; McLean, Louise A.
Early manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the "Get Lost Mr. Scary" programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5-7 years. Participants were 134 children (65 males and 69 females) drawn…
Botting, Nicola; Gaynor, Marguerite; Tucker, Katie; Orchard-Lisle, Ginnie
Some reports suggest that there is an increase in the number of children identified as having developmental language impairment (Bercow, 2008). yet resource issues have meant that many speech and language therapy services have compromised provision in some way. Thus, efficient ways of identifying need and prioritizing intervention are required.…
Mevissen, F.E.F.; Empelen, P. van; Watzeels, A.; Duin, G. van; Meijer, S.; Lieshout, S. van; Kok, G.
This paper describes the development of a Dutch online programme called Long Live Love+ focusing on positive, coercion-free relationships, contraception use, and the prevention of STIs, using the Intervention Mapping (IM) approach. All six steps of the approach were followed. Step 1 confirmed the
Reports on a primary preventive intervention that prevents future chemical dependency in children (N=57). Results indicate substantial increases in internal locus of control, frustration tolerance, and assertive social skills, along with decreases in acting-out behavior. Findings suggest that school social workers can provide effective…
Reubsaet, A.; Brug, J.; Kitslaar, J.; Van Hooff, J. P.; van den Borne, H. W.
The present paper describes the impact and evaluation of two intervention components--a video with group discussion and an interactive computer-tailored program--in order to encourage adolescents to register their organ donation preference. Studies were conducted in school during regular school hours. The video with group discussion in class had a…
Mevissen, Fraukje E. F.; van Empelen, Pepijn; Watzeels, Anita; van Duin, Gee; Meijer, Suzanne; van Lieshout, Sanne; Kok, Gerjo
This paper describes the development of a Dutch online programme called "Long Live Love+" focusing on positive, coercion-free relationships, contraception use, and the prevention of STIs, using the Intervention Mapping (IM) approach. All six steps of the approach were followed. Step 1 confirmed the need for a sexual health programme…
Martínez-Vizcaíno, Vicente; Sánchez-López, Mairena; Notario-Pacheco, Blanca; Salcedo-Aguilar, Fernando; Solera-Martínez, Montserrat; Franquelo-Morales, Pablo; López-Martínez, Sara; García-Prieto, Jorge C; Arias-Palencia, Natalia; Torrijos-Niño, Coral; Mora-Rodríguez, Ricardo; Rodríguez-Artalejo, Fernando
Studies that have examined the impact of a physical activity intervention on cardiometabolic risk factors have yielded conflicting results. The objective of this study was to assess the impact of a standardized physical activity program on adiposity and cardiometabolic risk factors in schoolchildren. Cluster randomized trial study of 712 schoolchildren, 8-10 years, from 20 public schools in the Province of Cuenca, Spain. The intervention (MOVI-2) consisted of play-based and non-competitive activities. MOVI-2 was conducted during two 90-minute sessions on weekdays and one 150-minute session on Saturday mornings every week between September 2010 and May 2011. We measured changes in adiposity (overweight/obesity prevalence, body mass index [BMI], triceps skinfold thickness [TST], body fat %, fat-free mass, waist circumference) and other cardiometabolic risk factors (LDL-cholesterol, triglycerides/HDL-cholesterol ratio, insulin, C-reactive protein and blood pressure). The analyses used mixed regression models to adjust for baseline covariates under cluster randomization. Among girls, we found a reduction of adiposity in intervention versus control schools, with a decrease in TST (-1.1 mm; 95% confidence interval [CI] -2.3 to -0.7), body fat % (-0.9%; 95% CI -1.3 to -0.4), waist circumference (-2.7 cm; 95% CI -4.5 to -0.9), and an increase in fat-free mass (0.3 kg; 95% CI 0.01 to 0.6). The intervention also led to lower serum LDL-cholesterol and insulin levels. Among boys, a reduction in waist circumference (-1.4 cm; 95% CI -2.6 to -0.1; P = 0.03), and an increase in fat-free mass (0.5 kg; 95% CI 0.2 to 0.9; P = 0.003) was associated with the intervention versus control schools. The prevalence of overweight/obesity or underweight, BMI, and other cardiometabolic risk factors was not modified by the intervention. No important adverse events were registered. An extracurricular intervention of non-competitive physical activity during an academic year, targeting all
Andrade, Susana; Verloigne, Maïté; Cardon, Greet; Kolsteren, Patrick; Ochoa-Avilés, Angelica; Verstraeten, Roosmarijn; Donoso, Silvana; Lachat, Carl
Effective interventions on screen-time behaviours (television, video games and computer time) are needed to prevent non-communicable diseases in low- and middle-income countries. The present manuscript investigates the effect of a school-based health promotion intervention on screen-time behaviour among 12- to 15-year-old adolescents. We report the effect of the trial on screen-time after two stages of implementation. We performed a cluster-randomised pair matched trial in urban schools in Cuenca-Ecuador. Participants were adolescents of grade eight and nine (mean age 12.8 ± 0.8 years, n = 1370, control group n = 684) from 20 schools (control group n = 10). The intervention included an individual and environmental component tailored to the local context and resources. The first intervention stage focused on diet, physical activity and screen-time behaviour, while the second stage focused only on diet and physical activity. Screen-time behaviours, primary outcome, were assessed at baseline, after the first (18 months) and second stage (28 months). Mixed linear models were used to analyse the data. After the first stage (data from n = 1224 adolescents; control group n = 608), the intervention group had a lower increase in TV-time on a week day (β = -15.7 min; P = 0.003) and weekend day (β = -18.9 min; P = 0.005), in total screen-time on a weekday (β = -25.9 min; P = 0.03) and in the proportion of adolescents that did not meet the screen-time recommendation (β = -4 percentage point; P = 0.01), compared to the control group. After the second stage (data from n = 1078 adolescents; control group n = 531), the TV-time on a weekday (β = 13.1 min; P = 0.02), and total screen-time on a weekday (β = 21.4 min; P = 0.03) increased more in adolescents from the intervention group. No adverse effects were reported. A multicomponent school-based intervention was only able to mitigate the increase
Kitchen, Meaghan S; Ransley, Joan K; Greenwood, Darren C; Clarke, Graham P; Conner, Mark T; Jupp, Jennifer; Cade, Janet E
The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Medical Research Council Registry code G0501297.
Kitchen, Meaghan S; Ransley, Joan K; Greenwood, Darren C; Clarke, Graham P; Conner, Mark T; Jupp, Jennifer; Cade, Janet E
Background The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. Method This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. Discussion A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Trial registration Medical Research Council Registry code G0501297 PMID:19531246
Conner Mark T
Full Text Available Abstract Background The School Fruit and Vegetable Scheme (SFVS is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3 their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. Method This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group, consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET, and height and weight measurements collected, at baseline (Year 2 and 18 month follow-up (Year 4. The primary outcome will be the ability of the intervention (Project Tomato to maintain consumption of fruit and vegetable portions compared to the control group. Discussion A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Trial registration Medical Research Council Registry code G0501297
de Meij, Judith S B; van der Wal, Marcel F; van Mechelen, Willem; Chinapaw, Mai J M
The aim of the present study was to investigate factors influencing the adoption, implementation, and institutionalization process of JUMP-in-a multilevel school-based physical activity promotion program-to optimize the dissemination of the intervention and improve its effectiveness. The process evaluation concerned the constraints and success and failure factors at sociopolitical, organizational, user, and intervention levels. A mixed methods approach including qualitative and quantitative data was conducted during two school years (2006-2008). JUMP-in was successfully embedded in the Amsterdam municipal policy and in the organizational structure and daily practices of the sectors involved. A general impeding factor was the complexity of the multilevel programme requiring multidisciplinary collaboration between organizations. In addition, there was a discrepancy between the recommendation to standardize and simplify the innovation and the need to tailor the strategies to local environmental, social, and cultural aspects. This process evaluation provides challenges and remedies for managing discrepancies between prerequisites for an effective innovation and demands of daily implementation practice. The main recommendations are (a) standardized, simplified guidelines; (b) stepwise implementation; (c) formalized coalitions, integration of policy, and synchronization of tasks and protocols; and (d) smart planning and control by clear communication and feedback instruments. If these recommendations are incorporated into the JUMP-in intervention and organization, increased effectiveness and long-term effects can be expected.
Winther, Jo; Carlsson, Anthony; Vance, Alasdair
Oppositional defiant disorder (ODD) or conduct disorder (CD) occurs when children's disruptive and antisocial behaviours start to interfere with their academic, emotional and/or social development. Recently, there has been a considerable investment to implement national school-based early intervention programs to help prevent the onset of ODD/CD. This paper describes the delivery of the Royal Children's Hospital, Child and Adolescent Mental Health Service and Schools Early Action Program: a whole school, multi-level, multidisciplinary approach to address emerging ODD/CD and pre- versus post-delivery assessment in 40 schools over a 4-year period (2007-2010). All children from preparatory to grade 3 (ages 4-10 years) were screened for conduct problems (n = 8546) using the Strengths and Difficulties Questionnaire. Universal, targeted and indicated interventions were delivered in school settings. In total, 304 children participated in the targeted group program where the Child Behaviour Checklist was used as a pre- and post-intervention measure. Cohen's d effect sizes and a reliability change index were calculated to determine clinical significance. Significant reductions in both parent- and teacher-reported internalizing and externalizing symptoms were noted. Parent, teacher and child feedback were very positive. A future randomized controlled trial of the program would address potential placebo and selection bias effects. © 2013 Wiley Publishing Asia Pty Ltd.
Full Text Available Introduction & Objective: Participation in regular physical activity is associated with a variety of positive outcomes for young people. Physical activity (PA rates decline precipitously during the high school years and are consistently lower among adolescent girls than among adolescent boys. In order to stop or diverse this negative trend, there are necessary interventions based on various theories and models to promote physical activity in girls. Materials & Methods: This randomized control study evaluated the effectiveness of a 24-week exercise education program based on Pender’s Health Promotion model to improve cognitive and psychosocial factors associated with physical activity and to promote physical activity in adolescent girls (n =106. The program included educational sessions and tailored counseling. Results: There was an increase of 45 minutes for daily physical activity in the experimental group compared to their baseline. After intervention, the training group had a positive significant progression in stages along with significant improvements in self efficacy, enjoyment of physical activity, interpersonal influences, planning for physical activity, and also a decrease in perceived barriers to physical activity and competing preferences (p ≤ .0001-0.04. Conclusion: Findings of this study showed the positive effect of program on stage of change and potential determinants of the behavior of physical activity. The high proportion of the people in action and maintenance in experimental group compared to the baseline and the attainment of recommend criteria for physical activity are promising findings of school-based intervention based on Pender’s health promotion model.
Gunawardena, Nalika; Kurotani, Kayo; Indrawansa, Susantha; Nonaka, Daisuke; Mizoue, Tetsuya; Samarasinghe, Diyanath
School health promotion has been shown to improve the lifestyle of students, but it remains unclear whether school-based programs can influence family health. We developed an innovative program that enables school children to act as change agents in promoting healthy lifestyles of their mothers. The objective of this study was to examine the effect of the child-initiated intervention on weight, physical activity and dietary habit of their mothers. A 12-month cluster randomized trial was conducted, with school as a cluster. Participants were mothers with grade 8 students, aged around 13 years, of 20 schools in Homagama, Sri Lanka. Students of the intervention group were trained by facilitators to acquire the ability to assess noncommunicable disease risk factors in their homes and take action to address them, whereas those of the comparison group received no intervention. Body weight, step count and lifestyle of their mothers were assessed at baseline and post-intervention. Multi-level multivariable linear regression and logistic regression were used to assess the effects of intervention on continuous and binary outcomes, respectively. Of 308 study participants, 261 completed the final assessment at 12 month. There was a significantly greater decrease of weight and increase of physical activity in the intervention group. The mean (95% confidence interval) difference comparing the intervention group with the control group was -2.49 (-3.38 to -1.60) kg for weight and -0.99 (-1.40 to -0.58) kg/m(2) for body mass index. The intervention group had a 3.25 (95% confidence interval 1.87-5.62) times higher odds of engaging in adequate physical activity than the control group, and the former showed a greater number of steps than the latter after intervention. The intervention group showed a greater reduction of household purchase of biscuits and ice cream. A program to motivate students to act as change agents of family's lifestyle was effective in decreasing weight and
Stoolmiller, M; Eddy, J M; Reid, J B
This study examined theoretical, methodological, and statistical problems involved in evaluating the outcome of aggression on the playground for a universal preventive intervention for conduct disorder. Moderately aggressive children were hypothesized most likely to benefit. Aggression was measured on the playground using observers blind to the group status of the children. Behavior was micro-coded in real time to minimize potential expectancy biases. The effectiveness of the intervention was strongly related to initial levels of aggressiveness. The most aggressive children improved the most. Models that incorporated corrections for low reliability (the ratio of variance due to true time-stable individual differences to total variance) and censoring (a floor effect in the rate data due to short periods of observation) obtained effect sizes 5 times larger than models without such corrections with respect to children who were initially 2 SDs above the mean on aggressiveness.
Boscarino, Joseph A
The current issue of International Journal of Emergency Mental Health and Human Resilience is focused on community disasters, the impact of trauma exposure, and crisis intervention. The articles incorporated include studies ranging from the World Trade Center disaster to Hurricane Sandy. These studies are related to public attitudes and beliefs about disease outbreaks, the impact of volunteerism following the World Trade Center attacks, alcohol misuse among police officers after Hurricane Katrina, posttraumatic stress disorder after Hurricane Sandy among those exposed to the Trade Center disaster, compassion fatigue and burnout among trauma workers, crisis interventions in Eastern Europe, and police officers' use of stress intervention services. While this scope is broad, it reflects the knowledge that has emerged since the Buffalo Creek and Chernobyl catastrophes, to the more recent Hurricane Katrina and Sandy disasters. Given the current threat environment, psychologists, social workers, and other providers need to be aware of these developments and be prepared to mitigate the impact of psychological trauma following community disasters, whether natural or man-made.
Salmoirago-Blotcher, Elena; Druker, Sue; Meyer, Florence; Bock, Beth; Crawford, Sybil; Pbert, Lori
Cardiovascular prevention is more effective if started early in life, but available interventions to promote healthy lifestyle habits among youth have been ineffective. Impulsivity in particular has proven to be an important barrier to the adoption of healthy behaviors in youth. Observational evidence suggests that mindfulness interventions may reduce impulsivity and improve diet and physical activity. We hypothesize that mindfulness training in adjunct to traditional health education will improve dietary habits and physical activity among teenagers by reducing impulsive behavior and improving planning skills. The Commit to Get Fit study is a pilot cluster randomized controlled trial examining the feasibility, acceptability and preliminary efficacy of school-based mindfulness training in adjunct to traditional health education for promotion of a healthy diet and physical activity among adolescents. Two schools in central Massachusetts (30 students per school) will be randomized to receive mindfulness training plus standard health education (HE-M) or an attention-control intervention plus standard health education (HE-AC). Assessments will be conducted at baseline, intervention completion (2 months), and 8 months. Primary outcomes are feasibility and acceptability. Secondary outcomes include physical activity, diet, impulsivity, mood, body mass index, and quality of life. This study will provide important information about feasibility and preliminary estimates of efficacy of a school-delivered mindfulness and health education intervention to promote healthy dietary and physical activity behaviors among adolescents. Our findings will provide important insights about the possible mechanisms by which mindfulness training may contribute to behavioral change and inform future research in this important area. Copyright © 2015 Elsevier Inc. All rights reserved.
Burges Watson, Duika; Adams, Jean; Azevedo, Liane B; Haighton, Catherine
Physical activity is critical to improving health and well-being in children. Quantitative studies have found a decline in activity in the transition from primary to secondary education. Exergames (active video games) might increase physical activity in adolescents. In January 2011 exergame dance mat systems were introduced in to all secondary schools across two local authority districts in the UK. We performed a quasi-experimental evaluation of a natural experiment using a mixed methods design. The quantitative findings from this work have been previously published. The aim of this linked qualitative study was to explore the implementation of the dance mat scheme and offer insights into its uptake as a physical activity intervention. Embedded qualitative interviews at baseline and 12 month follow-up with purposively selected physical education teachers (n = 20) and 25 focus groups with a convenience sample of pupils (n = 120) from five intervention schools were conducted. Analysis was informed by sociology of translation approach. At baseline, participants (both teachers and pupils) reported different expectations about the dance mats and how they could be employed. Variation in use was seen at follow-up. In some settings they were frequently used to engage hard to reach groups of pupils. Overall, the dance mats were not used routinely to increase physical activity. However there were other unanticipated benefits to pupils such as improved reaction time, co-ordination and mathematic skills. The use of dance mats was limited in routine physical education classes because of contextual issues (school/government policy) technological failures (batteries/updates) and because of expectations about how and where they could be used. Our linked quantitative study (previously published) suggested that the dance mats were not particularly effective in increasing physical activity, but the qualitative results (reported here) show that the dance mats were not used
Full Text Available The aim of the study was to evaluate the effectiveness of a media literacy intervention targeting, for the first time, the specific topic of Performance and Appearance Enhancing Substances (PAESs use in high-school students. Overall, 389 students (52% male aged between 13 and 19 years (mean = 16.56 year; SD = 1.26 participated to a media literacy intervention (i.e., “intervention group” while 103 students aged between 14 and 19 year (mean = 16.10 year; SD = 1.38 were considered as the control group (i.e., “control group”. In two separate occasions over the course of six consecutive months, students in both groups filled out a set of questionnaires which included measures of social-cognitive beliefs (i.e., attitudes, subjective norms, intentions and a self-reported measure of retrospective use of doping (Yes/No and supplements (Yes/No. Compared to students in the control group (Mean(time1 = 1.96; SD(time1 = 0.85; and Mean(time2 = 2.09; SD(time2 = 0.94, intervention students on average expressed relatively stronger attitudes against doping use over time (Mean(time1 = 2.2; SD(time1 = 0.85; and Mean(time2 = 2.05; SD(time2 = 0.82. Students in the latter group also showed a statistically significant decrease in self-reported supplement use (Use(time1 = 6.7%; Use(time2 = 3.8%; p = 0.05, McNemar Test. Interestingly, albeit marginally significant, students in the control group showed a relative increment in the self-reported use of supplements over time (Use(time1 = 4.9%; Use(time2 = 8.7%; p = 0.22, McNemar Test. Overall, the media literacy intervention investigated in the present study was effective in decreasing adolescent student’s positive attitudes toward doping use and in reducing the use of legal PAES. These findings supported the generalizability and the usefulness of a media literacy approach in the specific field of PAES.
Duika Burges Watson
Full Text Available Abstract Background Physical activity is critical to improving health and well-being in children. Quantitative studies have found a decline in activity in the transition from primary to secondary education. Exergames (active video games might increase physical activity in adolescents. In January 2011 exergame dance mat systems were introduced in to all secondary schools across two local authority districts in the UK. We performed a quasi-experimental evaluation of a natural experiment using a mixed methods design. The quantitative findings from this work have been previously published. The aim of this linked qualitative study was to explore the implementation of the dance mat scheme and offer insights into its uptake as a physical activity intervention. Methods Embedded qualitative interviews at baseline and 12 month follow-up with purposively selected physical education teachers (n = 20 and 25 focus groups with a convenience sample of pupils (n = 120 from five intervention schools were conducted. Analysis was informed by sociology of translation approach. Results At baseline, participants (both teachers and pupils reported different expectations about the dance mats and how they could be employed. Variation in use was seen at follow-up. In some settings they were frequently used to engage hard to reach groups of pupils. Overall, the dance mats were not used routinely to increase physical activity. However there were other unanticipated benefits to pupils such as improved reaction time, co-ordination and mathematic skills. The use of dance mats was limited in routine physical education classes because of contextual issues (school/government policy technological failures (batteries/updates and because of expectations about how and where they could be used. Conclusions Our linked quantitative study (previously published suggested that the dance mats were not particularly effective in increasing physical activity, but the qualitative
Full Text Available BACKGROUND: In 2004 Niger established a large scale schistosomiasis and soil-transmitted helminths control programme targeting children aged 5-14 years and adults. In two years 4.3 million treatments were delivered in 40 districts using school based and community distribution. METHOD AND FINDINGS: Four districts were surveyed in 2006 to estimate the economic cost per district, per treatment and per schistosomiasis infection averted. The study compares the costs of treatment at start up and in a subsequent year, identifies the allocation of costs by activity, input and organisation, and assesses the cost of treatment. The cost of delivery provided by teachers is compared to cost of delivery by community distributers (CDD. The total economic cost of the programme including programmatic, national and local government costs and international support in four study districts, over two years, was US$ 456,718; an economic cost/treatment of $0.58. The full economic delivery cost of school based treatment in 2005/06 was $0.76, and for community distribution was $0.46. Including only the programme costs the figures are $0.47 and $0.41 respectively. Differences at sub-district are more marked. This is partly explained by the fact that a CDD treats 5.8 people for every one treated in school. The range in cost effectiveness for both direct and direct and indirect treatments is quantified and the need to develop and refine such estimates is emphasised. CONCLUSIONS: The relative cost effectiveness of school and community delivery differs by country according to the composition of the population treated, the numbers targeted and treated at school and in the community, the cost and frequency of training teachers and CDDs. Options analysis of technical and implementation alternatives including a financial analysis should form part of the programme design process.
Nobles, JD; Staniford, LJ; Gately, P
Introduction: Interventions are often developed without the guidance of the target group to be worked with. Action research (programme development with the input of researchers and clients) has been highlighted as a useful method for increasing programme engagement and achieving programme outcomes . Hearty Lives Renfrewshire (HLR), is a British Heart Foundation a community-based intervention aiming to increase knowledge and awareness of CVD risk factors in young people, adopted an action r...
Stahl, S M; Lawrie, T; Neill, P; Kelley, C
To evaluate different techniques intended to motivate community residents to have their blood pressures taken, five inner-city target areas with comparable, predominantly Black, populations were selected. A sample of about 200 households in each of four areas were subjected to different motivational interventions; in one of these four areas, households were approached in a series of four sequential steps. The fifth target area served as a control. Findings establish that home visits by community members trained to take blood pressure measurements (BPMs) in the home produces much larger yields of new (previously unknown) hypertensives than more passive techniques such as invitational letters and gift offers. Prior informational letters, including letters specifying time of visit, do not affect refusals or increase the yield. More "passive" motivational techniques yield a higher proportion of previously known hypertensives than the more "active" outreach efforts.
Hallfors, Denise D.; Cho, Hyunsan; Mbai, Isabella; Milimo, Benson; Itindi, Janet
We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area in rural western Kenya to test whether providing young orphan adolescents with uniforms, school fees, and community visitors improves school retention and reduces HIV risk factors. The trial was a community intervention, limited to one community. In this paper, we examined intervention implementation and its association with outcomes using longitudinal data. We used both quantitative and qualitative methods to evaluate the community-based model for orphan HIV prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE analyses showed null effects after 2 years. Volunteer community visitors, a key element of the intervention, showed little of the expected effect although qualitative reports documented active assistance to prevent orphans' school absence. For future research, we recommend capturing the transition to high school, a larger sample size, and biomarker data to add strength to the research design. We also recommend a school-based intervention approach to improve implementation and reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving school attendance and preventing dropout because of their unique ability to address critical biopsychosocial problems. PMID:22350730
Hallfors, Denise D; Cho, Hyunsan; Mbai, Isabella; Milimo, Benson; Itindi, Janet
We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area in rural western Kenya to test whether providing young orphan adolescents with uniforms, school fees, and community visitors improves school retention and reduces HIV risk factors. The trial was a community intervention, limited to one community. In this paper, we examined intervention implementation and its association with outcomes using longitudinal data. We used both quantitative and qualitative methods to evaluate the community-based model for orphan HIV prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE analyses showed null effects after 2 years. Volunteer community visitors, a key element of the intervention, showed little of the expected effect although qualitative reports documented active assistance to prevent orphans' school absence. For future research, we recommend capturing the transition to high school, a larger sample size, and biomarker data to add strength to the research design. We also recommend a school-based intervention approach to improve implementation and reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving school attendance and preventing dropout because of their unique ability to address critical biopsychosocial problems.
Gullan, Rebecca L.; Power, Thomas J.; Leff, Stephen S.
Despite considerable fiscal and structural support for youth service programs, research has not demonstrated consistent outcomes across participants or programs, suggesting the need to identify critical program processes. The present study addresses this need through preliminary examination of the role of program empowerment in promoting positive identity development in inner-city, African American youth participating in a pilot school-based service program. Results suggest that participants who experienced the program as empowering experienced increases in self-efficacy, sense of civic responsibility, and ethnic identity, over and above general engagement and enjoyment of the program. Preliminary exploration of differences based on participant gender suggests that some results may be stronger and more consistent for males than females. These findings provide preliminary support for the importance of theoretically grounded program processes in producing positive outcomes for youth service participants. PMID:25104875
Boddy Lynne M
Full Text Available Abstract Background Childhood obesity is a significant public health concern. Many intervention studies have attempted to combat childhood obesity, often in the absence of formative or preparatory work. This study describes the healthy eating component of the formative phase of the Children’s Health Activity and Nutrition: Get Educated! (CHANGE! project. The aim of the present study was to gather qualitative focus group and interview data regarding healthy eating particularly in relation to enabling and influencing factors, barriers and knowledge in children and adults (parents and teachers from schools within the CHANGE! programme to provide population-specific evidence to inform the subsequent intervention design. Methods Semi-structured focus group interviews were conducted with children, parents and teachers across 11 primary schools in the Wigan borough of North West England. Sixty children (N = 24 boys, 33 parents (N = 4 male and 10 teachers (N = 4 male participated in the study. Interview questions were structured around the PRECEDE phases of the PRECEDE-PROCEED model. Interviews were transcribed verbatim and analysed using the pen-profiling technique. Results The pen-profiles revealed that children’s knowledge of healthy eating was generally good, specifically many children were aware that fruit and vegetable consumption was ‘healthy’ (N = 46. Adults’ knowledge was also good, including restricting fatty foods, promoting fruit and vegetable intake, and maintaining a balanced diet. The important role parents play in children’s eating behaviours and food intake was evident. The emerging themes relating to barriers to healthy eating showed that external drivers such as advertising, the preferred sensory experience of “unhealthy” foods, and food being used as a reward may play a role in preventing healthy eating. Conclusions Data suggest that; knowledge related to diet composition was not a barrier per se to
Baker, Philip Ra; Francis, Daniel P; Soares, Jesus; Weightman, Alison L; Foster, Charles
Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. We searched the Cochrane Public Health Group Specialised Register, The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, The British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORTDiscus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.ca; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were followed up. We contacted experts in the field from the National Obesity Observatory Oxford, Oxford University; Queensland Health, Queensland University of Technology, the University of Central Queensland; the University of Tennessee and Washington University; and handsearched six relevant journals. The searches were last updated to the end of November 2009 and were not restricted by language or publication status. Cluster randomised controlled trials, randomised controlled trials (RCT), quasi-experimental designs which used a control population for comparison, interrupted time-series (ITS) studies, and prospective controlled cohort studies (PCCS) were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised
Leerlooijer, Joanne N; Ruiter, Robert A C; Reinders, Jo; Darwisyah, Wati; Kok, Gerjo; Bartholomew, L Kay
Evidence-based health promotion programmes, including HIV/AIDS prevention and sexuality education programmes, are often transferred to other cultures, priority groups and implementation settings. Challenges in this process include the identification of retaining core elements that relate to the programme's effectiveness while making changes that enhances acceptance in the new context and for the new priority group. This paper describes the use of a systematic approach to programme adaptation using a case study as an example. Intervention Mapping, a protocol for the development of evidence-based behaviour change interventions, was used to adapt the comprehensive school-based sexuality education programme 'The World Starts With Me'. The programme was developed for a priority population in Uganda and adapted to a programme for Indonesian secondary school students. The approach helped to systematically address the complexity and challenges of programme adaptation and to find a balance between preservation of essential programme elements (i.e. logic models) that may be crucial to the programme's effectiveness, including key objectives and theoretical behaviour change methods, and the adaptation of the programme to be acceptable to the new priority group and the programme implementers.
Full Text Available Abstract Background Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Relatively few adolescents with depression are identified and referred for treatment indicating the need to investigate alternative preventive approaches. Study Design A pragmatic cluster randomised controlled trial evaluating the effectiveness of a school based prevention programme on symptoms of depression in "high risk" adolescents (aged 12-16. The unit of allocation is year groups (n = 28 which are assigned to one of three conditions: an active intervention based upon cognitive behaviour therapy, attention control or treatment as usual. Assessments will be undertaken at screening, baseline, 6 months and 12 months. The primary outcome measure is change on the Short Mood and Feeling Questionnaire at 12 months. Secondary outcome measures will assess changes in negative thoughts, self esteem, anxiety, school connectedness, peer attachment, alcohol and substance misuse, bullying and self harm. Discussion As of August 2010, all 28 year groups (n = 5023 had been recruited and the assigned interventions delivered. Final 12 month assessments are scheduled to be completed by March 2011. Trial Registration ISRCTN19083628
Towle, Angela; Godolphin, William; Van Staalduinen, Samantha
To develop, implement and evaluate a workshop to help adolescents develop independent and active relationships with their physicians. A needs-assessment survey informed the development of a workshop delivered by medical student volunteers and incorporated into the career and personal planning curriculum of high schools in Vancouver, Canada. Over a 6-year period, 64 workshops were delivered by 181 medical students to 1651 high school students in six schools. The workshop is acceptable, do-able, effective and sustainable, characteristics that arise from the mutual benefits to all the groups involved: the medical school, the school board, the medical students, the high school teachers and students. The workshop provides a model for providing health care education to adolescents in the community. Teaching adolescents the importance of good doctor-patient communication encourages them to take ongoing responsibility for their health care and is an alternative route to direct health care education.
Koporc, Kimberly M; Strunz, Eric; Holloway, Cassandra; Addiss, David G; Lin, William
Between 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007-2012. Data from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA. Of the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%. To continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled.
Bilińska, Inez; Kryst, Łukasz
The epidemic of obesity, which is one of the most important public health problems, appeared paradoxically as a result of improving living conditions. The aim of this study was to determine the effects on overweight/obesity prevalence of the primary-school-based intervention program. The group of 5,293 children (7-11 year-olds) from Poznań (Poland) was divided into two subgroups: experimental and control one. The research group was participating in extra physical activities. Measurements (height and weight) were taken twice: at baseline and after 1-year follow-up. The estimations of the prevalence of overweight/obesity were based on the cut-off points of the IOTF values. To estimate the risk the odds ratio (OR) were calculated. There were no differences in BMI for both boys and girls. Also there were no significant differences in prevalence of overweight and obesity, for both sexes. The risk of being overweight/obese was not reduced in children in the experimental group - OR for boys was 0.93 (0.80, 1.08), and for girls OR = 0.88 (0.76, 1.03). In conclusion, the risk of overweight/obesity has not changed after one year of extra physical activities and engagement in health-oriented education program. This study shows that in case of such programs it is necessary to apply more intense interventions, probably also during longer period of time. It is possible that other adverse factors have a stronger influence on the body mass, which would suggest that the theoretical part of intervention concerning pro-health-related behaviors was not implemented in practice.
Hino, Tenyu; Yokota, Chiaki; Nishimura, Kunihiro; Nakai, Michikazu; Kato, Suzuka; Kuwabara, Kazuyo; Takekawa, Hidehiro; Arimizu, Takuro; Tomari, Shinya; Wada, Shinichi; Ohnishi, Hideyuki; Toyoda, Kazunori; Okamura, Tomonori; Minematsu, Kazuo
Advancing school-based education is a promising means to spread knowledge pertaining to stroke. The aim of the current study was to clarify whether stroke lessons provided by schoolteachers could deliver stroke knowledge to children (aged 9-11 years) and their parents, at a similar level to when taught by medical staff. Schoolteachers conducted lessons on stroke for school children using the educational materials we prepared (i.e., the teacher group; 1051 children and 719 parents). This was compared with our previous data from Akashi city and Tochigi prefecture, in which the stroke lessons were conducted by medical staff (i.e., the medical group; 1031 children and 756 parents). Three campaigns were conducted between September 2014 and May 2016. Each child was given education materials to take home to discuss stroke with their parents. The children and their parents answered questionnaires on stroke knowledge, at baseline, immediately after the lesson, and at 3 months after the lesson. Compared with the time point before the lesson, both children and parents instructed by the teacher group showed significant increases in the scores about stroke symptoms and risk factors, immediately and at 3 months after the lesson (P educational material, adequately delivered knowledge of stroke to children and parents, in a manner that was similar to when medical staff delivered this information. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Chile has suffered a fast increase in childhood obesity in the last 10 years. As a result, several school programmes have been implemented, however the effectiveness of these needs to be evaluated to identify and prioritize strategies to curve this trend. Methods Cluster randomized controlled trial. Twelve primary public schools chosen at random over three regions of the country will take part in this study. The sample size consisted of a total of 1,655 children. For each region one school will be selected for each of the three nutritional intervention modes and one school will be selected as the control group. The intervention modes consist of the following: Healthy Kiosk and nutritional education (KSEAN; Optimized physical activity (AFSO; Healthy Kiosk and nutritional education (KSEAN + optimized physical activity (AFSO; Control group. The effectiveness of each intervention will be evaluated by determining the nutritional condition of each child by measuring percentage of body fat, BMI and the z-score of the BMI. This study will also identify the eating behaviours, nutritional knowledge and fitness of each child, along with the effective time of moderate activity during physical education classes. Discussion A protocol to evaluate the effectiveness of a school based intervention to control and/or reduce the rates of childhood obesity for children between 6 and 10 years of age was developed. The protocol was developed in line with the Declaration of Helsinski, the Nüremberg Code and the University of Chile Guidelines for ethical committees, and was approved by the INTA, Universidad de Chile ethical committee on Wednesday 12 March 2014. There is consensus among researchers and health and education personnel that schools are a favourable environment for actions to prevent and/or control childhood obesity. However a lack of evidence on the effectiveness of interventions to date has led some to question the wisdom of
Bustos, Nelly; Olivares, Sonia; Leyton, Bárbara; Cano, Marcelo; Albala, Cecilia
Chile has suffered a fast increase in childhood obesity in the last 10 years. As a result, several school programmes have been implemented, however the effectiveness of these needs to be evaluated to identify and prioritize strategies to curve this trend. Cluster randomized controlled trial. Twelve primary public schools chosen at random over three regions of the country will take part in this study. The sample size consisted of a total of 1,655 children. For each region one school will be selected for each of the three nutritional intervention modes and one school will be selected as the control group. The intervention modes consist of the following: Healthy Kiosk and nutritional education (KSEAN); Optimized physical activity (AFSO); Healthy Kiosk and nutritional education (KSEAN) + optimized physical activity (AFSO); Control group. The effectiveness of each intervention will be evaluated by determining the nutritional condition of each child by measuring percentage of body fat, BMI and the z-score of the BMI. This study will also identify the eating behaviours, nutritional knowledge and fitness of each child, along with the effective time of moderate activity during physical education classes. A protocol to evaluate the effectiveness of a school based intervention to control and/or reduce the rates of childhood obesity for children between 6 and 10 years of age was developed. The protocol was developed in line with the Declaration of Helsinski, the Nüremberg Code and the University of Chile Guidelines for ethical committees, and was approved by the INTA, Universidad de Chile ethical committee on Wednesday 12 March 2014. There is consensus among researchers and health and education personnel that schools are a favourable environment for actions to prevent and/or control childhood obesity. However a lack of evidence on the effectiveness of interventions to date has led some to question the wisdom of allocating resources to programmes. This is the first study
Elbe, Anne-Marie; Wikman, Johan Michael; Zheng, Miky
This study investigates the enjoyment and cohesion of school children participating in a school-based high-intensity physical activity (PA) intervention. Both enjoyment and cohesion have been found to be important factors for adherence to regular physical and sport activity, an important outcome...... of PA interventions. The sample consisted of 300 pupils (mean age: 9.3 years; 52.7% female) assigned to a team sport intervention, an individual sport intervention, or a control group for 10 months. The Physical Activity Enjoyment Scale and Youth Sport Environment Questionnaire were used to measure...
Berger, U; Schaefer, J-M; Wick, K; Brix, C; Bormann, B; Sowa, M; Schwartze, D; Strauss, B
Representative surveys indicate that eating disorders are an increasing problem, especially among (pre)adolescents. We assessed the effects of a German school-based primary prevention program ("Torera") for seventh graders. Torera especially relates to pathological eating behavior in the realm of bulimia nervosa or binge eating disorder. The program is built upon two previously evaluated modules for sixth graders with a gender-specific adaption. The coeducational intervention involves nine manual-guided lessons touching a wide range of eating-related problems. Twenty-two Thuringian secondary schools (n = 256 boys and 277 girls, aged 11-13 years at baseline) participated in a trial with 2 control groups (untreated and pretreated) with pre-post assessment. Primary outcomes were conspicuous eating behavior and body self-esteem, measured by standardized questionnaires (SCOFF, EAT-26D, and FBeK). Girls and students at risk showed significant improvement with small (d = 0.35) to medium (d = 0.66) effect sizes on eating behavior, significantly mediated by body self-esteem. Boys only improved with respect to eating attitudes, revealing a small effect size (d = 0.35). With relatively low implementation costs (about 2.50 per student), Torera provides an efficient model for reducing risky eating behavior and strengthening body self-esteem without negative side effects. To improve the effectiveness of the intervention, further research efforts focusing on at-risk groups (secondary prevention) and structural actions for prevention (e.g., offering healthy school catering) are needed.
Beehler, Sarah; Deutsch, Charles; Green, Lawrence W.; Hawe, Penelope; McLeroy, Kenneth; Miller, Robin Lin; Rapkin, Bruce D.; Schensul, Jean J.; Schulz, Amy J.; Trimble, Joseph E.
Community interventions are complex social processes that need to move beyond single interventions and outcomes at individual levels of short-term change. A scientific paradigm is emerging that supports collaborative, multilevel, culturally situated community interventions aimed at creating sustainable community-level impact. This paradigm is rooted in a deep history of ecological and collaborative thinking across public health, psychology, anthropology, and other fields of social science. The new paradigm makes a number of primary assertions that affect conceptualization of health issues, intervention design, and intervention evaluation. To elaborate the paradigm and advance the science of community intervention, we offer suggestions for promoting a scientific agenda, developing collaborations among professionals and communities, and examining the culture of science. PMID:21680923
McKay, Michael; Agus, Ashley; Cole, Jonathan; Doherty, Paul; Foxcroft, David; Harvey, Séamus; Murphy, Lynn; Percy, Andrew; Sumnall, Harry
To assess the effectiveness of a combined classroom curriculum and parental intervention (the Steps Towards Alcohol Misuse Prevention Programme (STAMPP)), compared with alcohol education as normal (EAN), in reducing self-reported heavy episodic drinking (HED) and alcohol-related harms (ARHs) in adolescents. 105 high schools in Northern Ireland (NI) and in Scotland. Schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational). Eligible students were in school year 8/S1 (aged 11-12 years) at baseline (June 2012). A classroom-based alcohol education intervention, coupled with a brief alcohol intervention for parents/carers. PRIMARY OUTCOMES: (1) The prevalence of self-reported HED in the previous 30 days and (2) the number of self-reported ARHs in the previous 6 months. Outcomes were assessed using two-level random intercepts models (logistic regression for HED and negative binomial for number of ARHs). At 33 months, data were available for 5160 intervention and 5073 control students (HED outcome), and 5234 and 5146 students (ARH outcome), respectively. Of those who completed a questionnaire at either baseline or 12 months (n=12 738), 10 405 also completed the questionnaire at 33 months (81.7%). Fewer students in the intervention group reported HED compared with EAN (17%vs26%; OR=0.60, 95% CI 0.49 to 0.73), with no significant difference in the number of self-reported ARHs (incident rate ratio=0.92, 95% CI 0.78 to 1.05). Although the classroom component was largely delivered as intended, there was low uptake of the parental component. There were no reported adverse effects. Results suggest that STAMPP could be an effective programme to reduce HED prevalence. While there was no significant reduction in ARH, it is plausible that effects on harms would manifest later. ISRCTN47028486; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article
Schaechter, Judy; Uhlhorn, Susan B
Motor vehicle crashes are the leading cause of death for U.S. Latinos aged 1 to 35 years. Restraint use is an effective means of prevention of motor vehicle crash injury. Effective interventions to raise restraint use include the following: legislation, law enforcement, education, and equipment distribution. The effects of law enforcement interventions in Latino immigrant communities are understudied. We measured the community-level effect of a combined intervention that included warnings and citations phase enforcement in Latino communities. We designed and implemented in two of three Latino-majority communities a multicomponent intervention consisting of a community awareness campaign, restraint use education with equipment distribution, and a two-staged law enforcement intervention. Restraint use observations were conducted in all three communities at baseline, after the warnings phase and again after the citations phase of the intervention were completed. The combined intervention of community awareness, education, child passenger restraint distribution, and law enforcement focused on educational traffic stops with incentives and warnings was associated with a significant increase in both driver and child passenger restraint use in one intervention community, but only driver restraint increased to a level of significance in the other intervention community; significant increase was also noted among nonintervention drivers. The citations phase of the intervention did not result in a significant increase in restraint use and was complicated by interruptions due to unlicensed drivers. The combined effort of community awareness, education, equipment distribution and law enforcement intervention that included incentives and warnings may be effective at increasing seat belt use in Latino communities without the need for citations.
E. Whitney Evans
Full Text Available Background. Less than half of American children meet national physical activity (PA recommendations. This study tested the feasibility, acceptability, and preliminary effectiveness of using wearable PA monitors to increase PA in school-age children. Methods. In Phase 1 of this study, conducted in 2014, 32 fifth-grade students enrolled in a low-resource middle school were given a waist-worn Fitbit Zip monitor for 4 weeks to test its feasibility (adherence and acceptability. Adherence, wear time of ≥8 hours per day, was examined. Feedback was solicited from parents through structured interviews. In Phase 2, conducted in 2015, 42 sixth-grade students were assigned, by classroom, to one of three conditions (Fitbit + goal and incentive-based intervention, Fitbit only, or control to test the feasibility of the wrist-worn Fitbit Charge and its preliminary effectiveness in increasing PA over 6 weeks. Results. In Phase 1, average adherence was 64.1%. In Phase 2, it was 73.4% and 80.2% for participants in the Fitbit + intervention and Fitbit only groups, respectively (p=.07. After controlling for baseline values, weight status, and sex, there were no significant group differences in changes in MVPA or steps from baseline to follow-up. Conclusions. While moderately acceptable, wearable PA monitors did not increase PA levels in this sample. They may be more effective within a coordinated school-based physical activity program.
Mwidunda, Sylvester A.; Carabin, Hélène; Matuja, William B. M.; Winkler, Andrea S.; Ngowi, Helena A.
Taenia solium causes significant economic and public health impacts in endemic countries. This study determined effectiveness of a health education intervention at improving school children’s knowledge and attitudes related to T. solium cysticercosis and taeniasis in Tanzania. A cluster randomised controlled health education intervention trial was conducted in 60 schools (30 primary, 30 secondary) in Mbulu district. Baseline data were collected using a structured questionnaire in the 60 schools and group discussions in three other schools. The 60 schools stratified by baseline knowledge were randomised to receive the intervention or serve as control. The health education consisted of an address by a trained teacher, a video show and a leaflet given to each pupil. Two post-intervention re-assessments (immediately and 6 months post-intervention) were conducted in all schools and the third (12 months post-intervention) was conducted in 28 secondary schools. Data were analysed using Bayesian hierarchical log-binomial models for individual knowledge and attitude questions and Bayesian hierarchical linear regression models for scores. The overall score (percentage of correct answers) improved by about 10% in all schools after 6 months, but was slightly lower among secondary schools. Monitoring alone was associated with improvement in scores by about 6%. The intervention was linked to improvements in knowledge regarding taeniasis, porcine cysticercosis, human cysticercosis, epilepsy, the attitude of condemning infected meat but it reduced the attitude of contacting a veterinarian if a pig was found to be infected with cysticercosis. Monitoring alone was linked to an improvement in how best to raise pigs. This study demonstrates the potential value of school children as targets for health messages to control T. solium cysticercosis and taeniasis in endemic areas. Studies are needed to assess effectiveness of message transmission from children to parents and the general
Mwidunda, Sylvester A; Carabin, Hélène; Matuja, William B M; Winkler, Andrea S; Ngowi, Helena A
Taenia solium causes significant economic and public health impacts in endemic countries. This study determined effectiveness of a health education intervention at improving school children's knowledge and attitudes related to T. solium cysticercosis and taeniasis in Tanzania. A cluster randomised controlled health education intervention trial was conducted in 60 schools (30 primary, 30 secondary) in Mbulu district. Baseline data were collected using a structured questionnaire in the 60 schools and group discussions in three other schools. The 60 schools stratified by baseline knowledge were randomised to receive the intervention or serve as control. The health education consisted of an address by a trained teacher, a video show and a leaflet given to each pupil. Two post-intervention re-assessments (immediately and 6 months post-intervention) were conducted in all schools and the third (12 months post-intervention) was conducted in 28 secondary schools. Data were analysed using Bayesian hierarchical log-binomial models for individual knowledge and attitude questions and Bayesian hierarchical linear regression models for scores. The overall score (percentage of correct answers) improved by about 10% in all schools after 6 months, but was slightly lower among secondary schools. Monitoring alone was associated with improvement in scores by about 6%. The intervention was linked to improvements in knowledge regarding taeniasis, porcine cysticercosis, human cysticercosis, epilepsy, the attitude of condemning infected meat but it reduced the attitude of contacting a veterinarian if a pig was found to be infected with cysticercosis. Monitoring alone was linked to an improvement in how best to raise pigs. This study demonstrates the potential value of school children as targets for health messages to control T. solium cysticercosis and taeniasis in endemic areas. Studies are needed to assess effectiveness of message transmission from children to parents and the general
Sylvester A Mwidunda
Full Text Available Taenia solium causes significant economic and public health impacts in endemic countries. This study determined effectiveness of a health education intervention at improving school children's knowledge and attitudes related to T. solium cysticercosis and taeniasis in Tanzania. A cluster randomised controlled health education intervention trial was conducted in 60 schools (30 primary, 30 secondary in Mbulu district. Baseline data were collected using a structured questionnaire in the 60 schools and group discussions in three other schools. The 60 schools stratified by baseline knowledge were randomised to receive the intervention or serve as control. The health education consisted of an address by a trained teacher, a video show and a leaflet given to each pupil. Two post-intervention re-assessments (immediately and 6 months post-intervention were conducted in all schools and the third (12 months post-intervention was conducted in 28 secondary schools. Data were analysed using Bayesian hierarchical log-binomial models for individual knowledge and attitude questions and Bayesian hierarchical linear regression models for scores. The overall score (percentage of correct answers improved by about 10% in all schools after 6 months, but was slightly lower among secondary schools. Monitoring alone was associated with improvement in scores by about 6%. The intervention was linked to improvements in knowledge regarding taeniasis, porcine cysticercosis, human cysticercosis, epilepsy, the attitude of condemning infected meat but it reduced the attitude of contacting a veterinarian if a pig was found to be infected with cysticercosis. Monitoring alone was linked to an improvement in how best to raise pigs. This study demonstrates the potential value of school children as targets for health messages to control T. solium cysticercosis and taeniasis in endemic areas. Studies are needed to assess effectiveness of message transmission from children to parents and
Research demonstrates that addressing mental health issues in children can yield both increased academic performance and better social-emotional skills. In the past, school-based mental health services for students have been implemented inconsistently and usually in combination with community partners. When school mental health interventions are…
Community perceptions on the community-directed treatment and school-based approaches for the control of schistosomiasis and soil-transmitted helminthiasis among school-age children in Lushoto District, Tanzania.
Massa, K; Magnussen, P; Sheshe, A; Ntakamulenga, R; Ndawi, B; Olsen, A
The success of the Community-Directed Treatment (ComDT) approach in the control of onchocerciasis and filariasis has caught the attention of other disease control programmes. In this study the ComDT approach was implemented and compared with the school-based approach for control of schistosomiasis and soil-transmitted helminthiasis among school-age children in Lushoto District, Tanzania. This was a qualitative study, consisting of in-depth interviews with village leaders, community drug distributors (CDDs) and schoolteachers, as well as focus group discussions with separate groups of mothers and fathers to assess the perceptions and experiences of the villagers on the implementation of the two approaches. It was found that the villagers accepted the ComDT approach and took the responsibility of selecting the CDDs, organizing and implementing their own method of distributing drugs to the school-age children in their villages. The ComDT approach was well received and was successfully implemented in the villages. Although the villagers pointed out the limitation in reaching the non-enrolled children in the school-based approach, they also expressed satisfaction with this approach. This study suggests that the ComDT approach is well accepted and can be implemented effectively to ensure better coverage of especially non-enrolled school-age children.
Drmic, Irene E.; Aljunied, Mariam; Reaven, Judy
Adolescents with autism spectrum disorder (ASD) are at high risk for anxiety difficulties and disorders. Clinic-based cognitive behavioral therapy (CBT) is effective; however, few published school-based CBT programs for youth with ASD exist. In this study, the Facing Your Fears CBT protocol was adapted for delivery and piloted within a school…
Lyon, Aaron R.; Bruns, Eric J.; Weathers, Ericka S.; Canavas, Nick; Ludwig, Kristy; Vander Stoep, Ann; Cheney, Douglas; McCauley, Elizabeth
School-based mental health services offer unparalleled opportunities for providing accessible care to children and adolescents. Research indicates that services available in schools are rarely based on evidence of effectiveness and are typically disconnected from the larger school context. To address these issues, the current paper presents…
Belur, Vinetha; Dennis, Michael L.; Ives, Melissa L.; Vincent, Robert; Muck, Randolph
The expansion of behavioral health services to school-based health centers under the Affordable Care Act (Public Law 111-148) presents an opportunity to improve access to substance use disorders treatment for youth and reduce their substance use, and emotional, health, and school problems. We explore the feasibility of implementing five to seven…
Alben, Sr., Timothy P
.... Community mitigations and interventions such as school closures, event cancellations, limited travel, quarantine and work at home plans are traditional responses to slowing the spread of a virus...
Alder, Stephen; Wuthrich, Amy; Haddadin, Bassam; Donnelly, Sharon; Hannah, Elizabeth Lyon; Stoddard, Greg; Benuzillo, Jose; Bateman, Kim; Samore, Matthew
Background: The Inter-Mountain Project on Antibiotic Resistance and Therapy (IMPART) is an intervention that addresses emerging antimicrobial resistance and the reduction of unnecessary antimicrobial use. Purpose: This study assesses the design and implementation of the community intervention component of IMPART. Methods: The study was conducted…
Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth
As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.
Pisani, Anthony R; Wyman, Peter A; Gurditta, Kunali; Schmeelk-Cone, Karen; Anderson, Carolyn L; Judd, Emily
Suicide is a leading cause of death among 10- to 19-year-olds in the United States, with 5% to 8% attempting suicide each year. Suicide risk rises significantly during early adolescence and is higher in rural and underserved communities. School-based universal prevention programs offer a promising way of reducing suicide by providing strategies for emotion regulation and encouraging help-seeking behaviors and youth-adult connectedness. However, such programs frequently run into difficulties in trying to engage a broad range of students. Text messaging is a dominant medium of communication among youths, and studies show both efficacy and uptake in text messaging interventions aimed at adolescents. Text-based interventions may, thus, offer a means for school-based universal prevention programs to engage adolescents who would otherwise be difficult to reach. We field tested Text4Strength, an automated, interactive text messaging intervention that seeks to reach a broad range of early adolescents in rural communities. Text4Strength extends Sources of Strength, a peer-led school suicide prevention program, by encouraging emotion regulation, help-seeking behaviors, and youth-adult connectedness in adolescents. The study tested the appeal and feasibility of Text4Strength and its potential to extend universal school-based suicide prevention. We field tested Text4Strength with 42 ninth-grade students. Over 9 weeks, students received 28 interactive message sequences across 9 categories (Sources of Strength introduction, positive friend, mentors, family support, healthy activities, generosity, spirituality, medical access, and emotion regulation strategies). The message sequences included games, requests for advice, questions about students' own experiences, and peer testimonial videos. We measured baseline mental health characteristics, frequency of replies, completion of sequences and video viewing, appeal to students, and their perception of having benefited from the
Bergh, I.H.; van Stralen, M.M.; Bjelland, M.; Grydeland, M.; Lien, N.; Klepp, K.I.; Anderssen, S.A.; Ommundsen, Y.
Background: To improve effectiveness of future screen behaviour interventions, one needs to know whether an intervention works via the proposed mediating mechanisms and whether the intervention is equally effective among subgroups. Parental regulation is identified as a consistent correlate of
Zhang, Donglan; Wang, Guijing; Joo, Heesoo
Effective community-based interventions are available to control hypertension. It is important to determine the economics of these interventions. Peer-reviewed studies from January 1995 through December 2015 were screened. Interventions were categorized into educational interventions, self-monitoring interventions, and screening interventions. Incremental cost-effectiveness ratios were summarized by types of interventions. The review was conducted in 2016. Thirty-four articles were included in the review (16 from the U.S., 18 from other countries), including 25 on educational interventions, three on self-monitoring interventions, and six on screening interventions. In the U.S., five (31.3%) studies on educational interventions were cost saving. Among the studies that found the interventions cost effective, the median incremental costs were $62 (range, $40-$114) for 1-mmHg reduction in systolic blood pressure (SBP) and $13,986 (range, $6,683-$58,610) for 1 life-year gained. Outside the U.S., educational interventions cost from $0.62 (China) to $29 (Pakistan) for 1-mmHg reduction in SBP. Self-monitoring interventions, evaluated in the U.S. only, cost $727 for 1-mmHg reduction in SBP and $41,927 for 1 life-year gained. For 1 quality-adjusted life-year, screening interventions cost from $21,734 to $56,750 in the U.S., $613 to $5,637 in Australia, and $7,000 to $18,000 in China. Intervention costs to reduce 1 mmHg blood pressure or 1 quality-adjusted life-year were higher in the U.S. than in other countries. Most studies found that the three types of interventions were either cost effective or cost saving. Quality of economic studies should be improved to confirm the findings. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.
Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig
Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.
Full Text Available Abstract Background Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. Methods Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000. Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. Results The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000 were calculated to be about €900,000. €555,000 was spent on interventions to change people's exercise patterns, €250,000 on improving nutrition, €50,000 on smoking cessation, and €45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. Conclusion The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very
Kim, J; Arrandale, V H; Kudla, I; Mardell, K; Lougheed, D; Holness, D L
Farmers are at increased risk of developing work-related respiratory diseases including asthma, but little is known about their occupational health and safety (OHS) knowledge and exposure prevention practices. Educational interventions may improve knowledge and practice related to prevention. To determine the feasibility of an educational intervention for farmers in a community health centre setting. This was a pilot study. Farmers were recruited by the community health centre and completed a questionnaire on symptoms, OHS knowledge and exposure prevention practices. The intervention group received education on work-related asthma and exposure control strategies, and was offered spirometry and respirator fit testing. All subjects were asked to repeat the questionnaire 6 months later. There were 68 study participants of whom 38 formed the intervention group. At baseline, almost 60% of farmers reported having received OHS training and were familiar with material safety data sheets (MSDSs); fewer (approximately 40%) reported knowledge of OHS legislation and availability of MSDSs. Approximately, two-thirds of subjects reported using respiratory protection. The response rate for repeating the questionnaire was 76% in the intervention group and 77% in the controls. Among the intervention subjects, statistically significant increases were observed in reported safety training, familiarity and availability of MSDSs and knowledge of OHS legislation. Gaps in OHS knowledge were observed. The educational intervention on OHS knowledge and exposure prevention practices in the community health centre setting was feasible. Larger, more-controlled studies should be undertaken as this study suggests a positive effect on OHS knowledge and prevention practices.
Elbe, Anne-Marie; Wikman, Johan Michael; Zheng, Miky; Larsen, Malte Nejst; Nielsen, Glen; Krustrup, Peter
This study investigates the enjoyment and cohesion of school children participating in a school-based high-intensity physical activity (PA) intervention. Both enjoyment and cohesion have been found to be important factors for adherence to regular physical and sport activity, an important outcome of PA interventions. The sample consisted of 300 pupils (mean age: 9.3 years; 52.7% female) assigned to a team sport intervention, an individual sport intervention, or a control group for 10 months. The Physical Activity Enjoyment Scale and Youth Sport Environment Questionnaire were used to measure enjoyment and cohesion. The Yo-Yo IR1C test determined fitness improvements. Results showed that enjoyment and cohesion (social) measured at the beginning of the intervention significantly predict fitness improvements achieved after 10 months. No differing developmental effects over time could be found in the intervention groups with regard to cohesion and enjoyment when comparing them to the control group. However, enjoyment and cohesion (social) significantly decreased in the groups that performed individual sports. Team sports seem to be more advantageous for the development of enjoyment and cohesion, which are both factors that positively impact the health outcomes of the intervention.
Salam, Rehana A; Haroon, Sarah; Ahmed, Hashim H; Das, Jai K; Bhutta, Zulfiqar A
In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women's groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge, attitudes, and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS (SMD: 0.66, 95% CI: 0.25, 1.07), protected sexual encounters (RR: 1.19, 95% CI: 1.13, 1.25), condom use (SMD: 0.96, 95% CI: 0.03, 1.58), and decreased frequency of sexual intercourse (RR: 0.76, 95% CI: 0.61, 0.96). Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication. We found very limited evidence on community-based management for HIV infected population and prevention of mother- to-child transmission (MTCT) for HIV-infected pregnant women. Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement. School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group. Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT, and various emerging models of care to improve morbidity and mortality outcomes.
Karacabeyli, D; Allender, S; Pinkney, S; Amed, S
Multi-setting, multi-component community-based interventions have shown promise in preventing childhood obesity; however, evaluation of these complex interventions remains a challenge. The objective of the study is to systematically review published methodological approaches to outcome evaluation for multi-setting community-based childhood obesity prevention interventions and synthesize a set of pragmatic recommendations. MEDLINE, CINAHL and PsycINFO were searched from inception to 6 July 2017. Papers were included if the intervention targeted children ≤18 years, engaged at least two community sectors and described their outcome evaluation methodology. A single reviewer conducted title and abstract scans, full article review and data abstraction. Directed content analysis was performed by three reviewers to identify prevailing themes. Thirty-three studies were included, and of these, 26 employed a quasi-experimental design; the remaining were randomized control trials. Body mass index was the most commonly measured outcome, followed by health behaviour change and psychosocial outcomes. Six themes emerged, highlighting advantages and disadvantages of active vs. passive consent, quasi-experimental vs. randomized control trials, longitudinal vs. repeat cross-sectional designs and the roles of process evaluation and methodological flexibility in evaluating complex interventions. Selection of study designs and outcome measures compatible with community infrastructure, accompanied by process evaluation, may facilitate successful outcome evaluation. © 2018 World Obesity Federation.
Pfefferbaum, Rose L; Pfefferbaum, Betty; Van Horn, Richard L; Klomp, Richard W; Norris, Fran H; Reissman, Dori B
Community resilience has emerged as a construct to support and foster healthy individual, family, and community adaptation to mass casualty incidents. The Communities Advancing Resilience Toolkit (CART) is a publicly available theory-based and evidence-informed community intervention designed to enhance community resilience by bringing stakeholders together to address community issues in a process that includes assessment, feedback, planning, and action. Tools include a field-tested community resilience survey and other assessment and analytical instruments. The CART process encourages public engagement in problem solving and the development and use of local assets to address community needs. CART recognizes 4 interrelated domains that contribute to community resilience: connection and caring, resources, transformative potential, and disaster management. The primary value of CART is its contribution to community participation, communication, self-awareness, cooperation, and critical reflection and its ability to stimulate analysis, collaboration, skill building, resource sharing, and purposeful action.
Children's Aid Society, 2012
School Based Health Centers (SBHC) are considered by experts as one of the most effective and efficient ways to provide preventive health care to children. Few programs are as successful in delivering health care to children at no cost to the patient, and where they are: in school. For many underserved children, The Children's Aid Society's…
Dietrichson, Jens; Bøg, Martin; Filges, Trine
This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in grades 7 to 12 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer-assisted in......This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in grades 7 to 12 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer...
McCammon, Susan; And Others
Post-tornado support groups were organized by the Greene County, North Carolina disaster coordinators and the Pitt County outreach workers from the Community Mental Health Center sponsored tornado follow-up project. The most significant intervention used was the emphasis on creating a climate of group support by establishing a forum for…
Adams, Alexandra K.; LaRowe, Tara L.; Cronin, Kate A.; Prince, Ronald J.; Wubben, Deborah P.; Parker, Tassy; Jobe, Jared B.
Healthy Children, Strong Families (HCSF) is a 2-year, community-driven, family-based randomized controlled trial of a healthy lifestyles intervention conducted in partnership with four Wisconsin American Indian tribes. HCSF is composed of 1 year of targeted home visits to deliver nutritional and physical activity curricula. During Year 1, trained…
LeBron, Alana M; Schulz, Amy J; Bernal, Cristina; Gamboa, Cindy; Wright, Conja; Sand, Sharon; Valerio, Melissa; Caver, Deanna
Contextually and culturally congruent interventions are urgently needed to reduce racial, ethnic, and socioeconomic inequities in physical activity and cardiovascular disease. To examine a community-based participatory research (CBPR) process that incorporated storytelling into a physical activity intervention, and consider implications for reducing health inequities. We used a CBPR process to incorporate storytelling in an existing walking group intervention. Stories conveyed social support and problem-solving intervention themes designed to maintain increases in physical activity over time, and were adapted to the walking group context, group dynamics, challenges, and traditions. After describing of the CBPR process used to adapt stories to walking group sites, we discuss challenges and lessons learned regarding the adaptation and implementation of stories to convey key intervention themes. A CBPR approach to incorporating storytelling to convey intervention themes offers an innovative and flexible strategy to promote health toward the elimination of health inequities.
Murray, Christopher; Doren, Bonnie
The current investigation was designed to evaluate the effects of the Working at Gaining Employment Skills (WAGES) curriculum on the social and occupational skills of adolescents with disabilities. Adolescents with disabilities were assigned to either an intervention or control condition. Youth in the intervention group were exposed to the WAGES…
Dietrichson, Jens; Bøg, Martin; Eiberg, Misja
This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in Kindergarten to grade 6 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer...
Mendez, Linda Raffaele; Ogg, Julia; Loker, Troy; Fefer, Sarah
In this study, the authors reviewed journal articles published between 1995 and 2010 that described student mental health interventions involving parents delivered in school settings. Their review identified 100 articles describing 39 interventions. On the basis of participant selection criteria provided by the authors of the reviewed articles,…
Garnham-Lee, Katy; Trigwell, Joanne; McGee, Ciara E.; Knowles, Zoe; Foweather, Lawrence
This study evaluated the impact and acceptability of a three-hour bespoke training workshop for sports coaches and teachers to subsequently deliver a sport-for-health smoking prevention intervention in primary schools. Questionnaires were completed pre- and post-training by both teachers (N = 24) and coaches (N = 8), and post-intervention by…
Al-Delaimy, W K; Webb, M
The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.
Do school-based interventions focusing on physical activity, fitness, or fundamental movement skill competency produce a sustained impact in these outcomes in children and adolescents? A systematic review of follow-up studies.
Lai, Samuel K; Costigan, Sarah A; Morgan, Philip J; Lubans, David R; Stodden, David F; Salmon, Jo; Barnett, Lisa M
The aim of this systematic review was to determine whether typically developing children and adolescents (aged 3-18 years) who have participated in school-based interventions have sustained outcomes in PA, fitness, and/or FMS. A systematic search of six electronic databases (CINAHL® Plus with Full Text, Ovid MEDLINE®, SPORTDiscus™, Scopus, PsycINFO® and ERIC) was conducted from 1995 to 26 July 2012. Included studies were school-based studies (including randomized controlled trials, longitudinal cohort, quasi-experimental, and experimental) that had a positive effect at post intervention in at least one variable and had a follow-up PA, fitness, or FMS assessment at least 6 months after the post-intervention assessment. Risk of bias assessment was guided by the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" statement. The search identified 14 articles, and some studies addressed multiple outcomes: 13 articles assessed PA; three assessed fitness; and two assessed FMS. No study in this review met four key methodological criteria that have been shown to influence results, i.e., clarity on the randomization process, assessor blinding, analyzing participants in their original groups, and retaining sufficient participants through the entire study. Three-quarters (ten of 13) of the studies addressing PA, reported PA behavior change maintenance. The length of follow-up ranged from 6 months to 20 years, and the degree of PA difference reported was between 3 and 14 min per day. Only one of the three studies assessing fitness reported a sustained impact, whilst both studies that assessed FMS reported maintenance of effects. It is likely that PA is a sustainable outcome from interventions in children and adolescents, and there is reasonable evidence that interventions of longer than 1 year and interventions that utilize a theoretical model or framework are effective in producing this sustained impact. It would seem probable that FMS are a sustainable
During the 60s and the 70s strategies for decreasing initiation or quitting have been developed, in order to find those with high success rates. Unfortunately, interventions with an individual approach involved few smokers, so their impact in decreasing smoking prevalence was limited. The socio-ecological model offers a theoretical framework to community interventions for smoking cessation developed during the 80s, in which smoking was considered not only an individual, but also a social problem. In the 80s and the 90s smoking cessation community trials were developed, such as the Community Intervention Trial for Smoking Cessation (COMMIT). Afterwards, policy interventions (price policy; smoking bans in public places; advertising bans; bans of sales to minors) were developed, such as the American Stop Smoking Intervention Study for Cancer Prevention (ASSIST). California has been the first State all over the world to develop a comprehensive Tobacco Control Program in 1988, becoming the place for an ever-conducted natural experiment. All policy interventions in tobacco control have been finally grouped together in the World Health Organization - Framework Convention on Tobacco Control (WHO-FCTC), the first Public Health Treaty. Study designs have changed, according to the individual, community, or regulatory approaches: the classical randomized controlled trials (RCTs), in which the sampling unit is the individual, have been carried out for the evaluation of smoking cessation treatments, whereas cluster RCTs, in which the sampling unit is the community, have been conducted for evaluating community interventions, such as COMMIT. Finally, quasi-experimental studies (before/after study; prospective cohorts, both with a control group), in which the observational unit is a State, have been used for evaluating tobacco control policies, such as ASSIST and the International Tobacco Control Policy Evaluation Project. Although the successes of the last 20 years, tobacco
Brooks Lyndon O
Full Text Available Abstract Background The purpose of this paper was to evaluate the long-term impact of a childhood motor skill intervention on adolescent motor skills and physical activity. Methods In 2006, we undertook a follow-up of motor skill proficiency (catch, kick, throw, vertical jump, side gallop and physical activity in adolescents who had participated in a one-year primary school intervention Move It Groove It (MIGI in 2000. Logistic regression models were analysed for each skill to determine whether the probability of children in the intervention group achieving mastery or near mastery was either maintained or had increased in subsequent years, relative to controls. In these models the main predictor variable was intervention status, with adjustment for gender, grade, and skill level in 2000. A general linear model, controlling for gender and grade, examined whether former intervention students spent more time in moderate-to-vigorous physical activity at follow-up than control students. Results Half (52%, n = 481 of the 928 MIGI participants were located in 28 schools, with 276 (57% assessed. 52% were female, 58% in Grade 10, 40% in Grade 11 and 54% were former intervention students. At follow-up, intervention students had improved their catch ability relative to controls and were five times more likely to be able to catch: ORcatch = 5.51, CI (1.95 – 15.55, but had lost their advantage in the throw and kick: ORthrow = .43, CI (.23 – .82, ORkick = .39, CI (.20 – .78. For the other skills, intervention students appeared to maintain their advantage: ORjump = 1.14, CI (.56 – 2.34, ORgallop = 1.24, CI (.55 – 2.79. Intervention students were no more active at follow-up. Conclusion Six years after the 12-month MIGI intervention, whilst intervention students had increased their advantage relative to controls in one skill, and appeared to maintain their advantage in two, they lost their advantage in two skills and were no more active than controls
Bergh, Ingunn H; Bjelland, Mona; Grydeland, May; Lien, Nanna; Andersen, Lene F; Klepp, Knut-Inge; Anderssen, Sigmund A; Ommundsen, Yngvar
There is limited knowledge as to whether obesity prevention interventions are able to produce change in the determinants hypothesized to precede change in energy balance-related behaviors in young people. The aim of this study was to evaluate the effect of a multi-component intervention on a wide range of theoretically informed determinants of physical activity (PA) and sedentary behavior (SB). Moderation effects of gender, weight status and parental education level and whether the perceived intervention dose received influenced the effects were also explored. The HEIA study was a 20-month school-based, randomized controlled trial to promote healthy weight development. In total, 1418 11-year-olds participated at baseline and post-intervention assessment. Enjoyment, self-efficacy, perceived social support from parents, teachers and friends related to PA, perceived parental regulation of TV-viewing and computer/game-use and perceived social inclusion at schools were examined by covariance analyses to assess overall effects and moderation by gender, weight status and parental education, mid-way and post-intervention. Covariance analyses were also used to examine the role of intervention dose received on change in the determinants. At mid-way enjoyment (p = .03), perceived social support from teachers (p = .003) and self-efficacy (p = .05) were higher in the intervention group. Weight status moderated the effect on self-efficacy, with a positive effect observed among the normal weight only. At post-intervention results were sustained for social support from teachers (p = .001), while a negative effect was found for self-efficacy (p = .02). Weight status moderated the effect on enjoyment, with reduced enjoyment observed among the overweight. Moderation effects for parental education level were detected for perceived social support from parents and teachers. Finally, positive effects on several determinants were observed among those receiving a high
Bergh Ingunn H
Full Text Available Abstract Background There is limited knowledge as to whether obesity prevention interventions are able to produce change in the determinants hypothesized to precede change in energy balance-related behaviors in young people. The aim of this study was to evaluate the effect of a multi-component intervention on a wide range of theoretically informed determinants of physical activity (PA and sedentary behavior (SB. Moderation effects of gender, weight status and parental education level and whether the perceived intervention dose received influenced the effects were also explored. Methods The HEIA study was a 20-month school-based, randomized controlled trial to promote healthy weight development. In total, 1418 11-year-olds participated at baseline and post-intervention assessment. Enjoyment, self-efficacy, perceived social support from parents, teachers and friends related to PA, perceived parental regulation of TV-viewing and computer/game-use and perceived social inclusion at schools were examined by covariance analyses to assess overall effects and moderation by gender, weight status and parental education, mid-way and post-intervention. Covariance analyses were also used to examine the role of intervention dose received on change in the determinants. Results At mid-way enjoyment (p = .03, perceived social support from teachers (p = .003 and self-efficacy (p = .05 were higher in the intervention group. Weight status moderated the effect on self-efficacy, with a positive effect observed among the normal weight only. At post-intervention results were sustained for social support from teachers (p = .001, while a negative effect was found for self-efficacy (p = .02. Weight status moderated the effect on enjoyment, with reduced enjoyment observed among the overweight. Moderation effects for parental education level were detected for perceived social support from parents and teachers. Finally, positive effects on several
Clark, Mary Kristen; Flynn, Perry
Purpose: We reflect on Alan Kamhi's (2011) prologue on balancing certainty and uncertainty as it pertains to school-based practice. Method: In schools, rational thinking depends on effective team processes, much like professional learning communities. We consider the conditions that are required for rational thinking and how rational team dialogue…
Minnaert, Alexander; Prince, Arnout; Opdenakker, Marie
Studies show a decrease in students’ motivation in secondary education. Hence, it was investigated whether training of teachers could stop this decline. Two interventions were implemented in prevocational secondary education, being self-regulated strategy instruction and behavioral consultation
Freeman, Matthew C; Clasen, Thomas
We assessed a pilot project by UNICEF and Hindustan Unilever Limited to improve the quality of drinking water for children in schools through adoption of improved drinking water practices among households in southern India. The intervention consisted of providing classrooms of 200 schools a commercial water purifier, and providing basic hygiene and water treatment information to students, parents, and teachers. We found no evidence that the intervention was effective in improving awareness or uptake of effective water treatment practices at home. A similar proportion of household members in the intervention and control groups boiled their water (P = 0.60), used a ceramic filtration system (P = 0.33), and used a cloth filter (P = 0.89). One year after the launch of the campaign, household ownership of the commercial purifier promoted at schools was higher in the intervention group (26%) than the control group (19%), but this difference was not statistically significant (P = 0.53).
Norris, Shane A; Ho, Julius Cheah Chee; Rashed, Aswir Abd; Vinding, Vibeke; Skau, Jutta K H; Biesma, Regien; Aagaard-Hansen, Jens; Hanson, Mark; Matzen, Priya
Malaysia is experiencing a nutrition transition with burgeoning obesity, particularly in women, and a growing prevalence of non-communicable disease. These health burdens have severe implications not only for adult health but also across generations. Pre-conception health promotion could address the intergenerational risk of metabolic disease. This paper describes the development of the "Jom Mama" intervention using Intervention Mapping (IM). The Jom Mama intervention aims to improve the health of young adult couples in Malaysia prior to conception. IM comprises of five steps prior to the last one, which involves the evaluation of the intervention. We used the five steps to develop the Jom Mama intervention. Both the process and evidence is documented providing the rationale to the selection of the key objectives of the intervention: (i) increasing healthy dietary practice; (ii) increasing physical activity levels, (iii) reducing sedentary activity; and (iv) improving social support to offset stressful lifestyles. From the IM process, Jom Mama will be health-system centred approach that uniquely combines both community health promoters and an electronic-health platform to deliver the complex intervention. IM is an iterative process that systematically gathers "best" evidence, selects appropriate theories of behaviour change, and facilitates formative research so as to develop a complex intervention. Though the IM process is time consuming, complex, and costly, it has enriched the Jom Mama intervention with a number of notable advantages: (i) intervention fashioned on formative work with stakeholders and in the target group; (ii) intervention combines research evidence with theory; (iii) intervention acknowledges multiple dynamics of influence; and (iv) intervention is embedded within health service priorities in Malaysia for greater scale-up possibility.
Shane A. Norris
Full Text Available Abstract Background Malaysia is experiencing a nutrition transition with burgeoning obesity, particularly in women, and a growing prevalence of non-communicable disease. These health burdens have severe implications not only for adult health but also across generations. Pre-conception health promotion could address the intergenerational risk of metabolic disease. This paper describes the development of the “Jom Mama” intervention using Intervention Mapping (IM. The Jom Mama intervention aims to improve the health of young adult couples in Malaysia prior to conception. Methods IM comprises of five steps prior to the last one, which involves the evaluation of the intervention. We used the five steps to develop the Jom Mama intervention. Results Both the process and evidence is documented providing the rationale to the selection of the key objectives of the intervention: (i increasing healthy dietary practice; (ii increasing physical activity levels, (iii reducing sedentary activity; and (iv improving social support to offset stressful lifestyles. From the IM process, Jom Mama will be health-system centred approach that uniquely combines both community health promoters and an electronic-health platform to deliver the complex intervention. Conclusion IM is an iterative process that systematically gathers “best” evidence, selects appropriate theories of behaviour change, and facilitates formative research so as to develop a complex intervention. Though the IM process is time consuming, complex, and costly, it has enriched the Jom Mama intervention with a number of notable advantages: (i intervention fashioned on formative work with stakeholders and in the target group; (ii intervention combines research evidence with theory; (iii intervention acknowledges multiple dynamics of influence; and (iv intervention is embedded within health service priorities in Malaysia for greater scale-up possibility.
Tucker, Sharon; Lanningham-Foster, Lorraine M.
School-based childhood obesity prevention programs have grown in response to reductions in child physical activity (PA), increased sedentariness, poor diet, and soaring child obesity rates. Multiple systematic reviews indicate school-based obesity prevention/treatment interventions are effective, yet few studies have examined the school nurse role…
Anna N. Chard
Full Text Available Evidence of the impact of water, sanitation, and hygiene (WASH in schools (WinS interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS study was a randomized controlled trial designed to measure the impact of the United Nations Children’s Fund (UNICEF Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils’ school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times.
McNamara, K. P.; O'Reilly, S. L.; George, J.; Peterson, G. M.; Jackson, S. L.; Duncan, G.; Howarth, H.; Dunbar, J. A.
Background: Delivery of cardiovascular disease (CVD) prevention programs by community pharmacists appears effective and enhances health service access. However, their capacity to implement complex behavioural change processes during patient counselling remains largely unexplored. This study aims to determine intervention fidelity by pharmacists…
Paynter, Jessica M.; Keen, Deb
This study investigated staff attitudes, knowledge and use of evidence-based practices (EBP) and links to organisational culture in a community-based autism early intervention service. An EBP questionnaire was completed by 99 metropolitan and regionally-based professional and paraprofessional staff. Participants reported greater knowledge and use…
McIlfatrick, Sonja; Connolly, Michael; Collins, Rita; Murphy, Tara; Johnston, Bridget; Larkin, Philip
To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions. Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. A mixed methods study using online survey and focus group interviews and thematic analysis to examine data. Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015. The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared. Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care. Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care. © 2017 John Wiley & Sons Ltd.
Duncan, Michael J; Eyre, Emma; Bryant, Elizabeth; Clarke, Neil; Birch, Samantha; Staples, Victoria; Sheffield, David
A total of 77 children (34 boys, 43 girls, mean age ± standard deviation = 9 ± 1 years) participated in this study; 46 children (intervention) undertook a 12-week school gardening programme and 31 children acted as controls. Measures of the Theory of Planned Behaviour and fruit and vegetable consumption were taken pre- and post-intervention. Repeated measures analysis of variance and hierarchical regression analysis indicated that the intervention group increased daily consumption of fruits and vegetables and increased intentions, attitudes, norms, and perceived behavioural control related to fruit and vegetable consumption. Attitudes, norms and perceived behavioural control significantly predicted changes in fruit and vegetable consumption. © The Author(s) 2015.
Bugge, Anna; Tarp, Jakob; Østergaard, Lars; Domazet, Sidsel Louise; Andersen, Lars Bo; Froberg, Karsten
The aim of the study; LCoMotion - Learning, Cognition and Motion was to develop, document, and evaluate a multi-component physical activity (PA) intervention in public schools in Denmark. The primary outcome was cognitive function. Secondary outcomes were academic skills, body composition, aerobic fitness and PA. The primary aim of the present paper was to describe the rationale, design and methods of the LCoMotion study. LCoMotion was designed as a cluster-randomized controlled study. Fourteen schools from all five regions in Denmark participated. All students from 6th and 7th grades were invited to participate (n = 869) and consent was obtained for 87% (n = 759). Baseline measurements were obtained in November/December 2013 and follow-up measurements in May/June 2014. The intervention lasted five months and consisted of a "package" of three main components: PA during academic lessons, PA during recess and PA homework. Furthermore a cycling campaign was conducted during the intervention period. Intervention schools should endeavor to ensure that students were physically active for at least 60 min every school day. Cognitive function was measured by a modified Eriksen flanker task and academic skills by a custom made mathematics test. PA was objectively measured by accelerometers (ActiGraph, GT3X and GT3X+) and aerobic fitness assessed by an intermittent shuttle-run test (the Andersen intermittent running test). Furthermore, compliance with the intervention was assessed by short message service (SMS)-tracking and questionnaires were delivered to students, parents and teachers. LCoMotion has ability to provide new insights on the effectiveness of a multicomponent intervention on cognitive function and academic skills in 6th and 7th grade students. Clinicaltrials.gov: NCT02012881 (10/10/2013).
Mobley, Connie C; Stadler, Diane D; Staten, Myrlene A; El Ghormli, Laure; Gillis, Bonnie; Hartstein, Jill; Siega-Riz, Anna Maria; Virus, Amy
The HEALTHY primary prevention trial developed an integrated multicomponent intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program (NSLP), and à la carte venues are compared to the experience of control schools. The intervention was implemented in 21 middle schools from winter 2007 through spring 2009 (following a cohort of students from sixth through eighth grades); 21 schools acted as observed controls. The nutrition component targeted school food service environmental change. Data identifying foods and nutrients served (selected by students for consumption) were collected over a 20-day period at baseline and end of study. Analysis compared end of study values for intervention versus control schools. Intervention schools more successfully limited dessert and snack food portion size in NSLP and à la carte and lowered fat content of foods served. Servings of high-fiber grain-based foods and/or legumes were improved in SBP but not NSLP. Intervention and control schools eliminated >1% fat milk and added-sugar beverages in SBP, but intervention schools were more successful in NSLP and à la carte. The HEALTHY program demonstrated significant changes in the nutritional quality of foods and beverages served in the SBP, NSLP, and à la carte venues, as part of an effort to decrease childhood obesity and support beneficial effects in some secondary HEALTHY study outcomes. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.
Xu, Fei; Wang, Xiaorong; Ware, Robert S; Tse, Lap Ah; Wang, Zhiyong; Hong, Xin; Chan, Emily Ying Yang; Li, Jiequan; Wang, Youfa
urgent development of effective interventions to prevent rapidly rising childhood obesity in China is needed. Between May 2010 and December 2013, a cluster randomized controlled trial was conducted among 4th graders in eight urban primary schools randomly assigned to intervention or control groups in Nanjing, China. A multi-component intervention program was implemented within the treatment group, while students in the control group followed their usual health education curriculum without additional intervention. At baseline, 638 and 544 students were enrolled in the intervention and control group, respectively. The prevalence of excess body weight was 26.8%, with 27.4% in the intervention group and 26.1% in the control group (p=0.61). The mean (SD) BMI and WC was 18.7 (3.0) and 63.0 (9.2) for participants in intervention schools, and 18.5 (2.9) and 63.6 (8.7) for students in control group, separately (p=0.24 and 0.41, respectively). Compared to those who were not aware of what lifestyle/behavior factors were unhealthy, students who were aware of the unhealthy lifestyle/ behavior factors consumed fewer fried snacks (0.46±0.76 serves/week vs 0.65±0.91 serves/week; p<0.01), soft drinks (160±194 ml/week vs 199±227 ml/week; p<0.01), but larger amount of meat (502±429 g/week vs 449±344 g/week; p=0.03), and reported less screen time (214±232 minutes/week vs 252±264 minutes/week; p<0.01). Moreover, there was no difference within physical activity time between these two groups (257±341 minutes/week vs 218±324 minutes/week; p=0.13). Main characteristics of participants were balanced at baseline within intervention and control schools, but a gap existed between healthy lifestyle knowledge and actual healthy behavior in students. ChiCTR-ERC-11001819.
Effectiveness of a 16-month multi-component and environmental school-based intervention for recovery of poor income overweight/obese children and adolescents: study protocol of the health multipliers program
Pollyanna Fernandes Patriota
Full Text Available Abstract Background Excess of weight is a serious public health concern in almost all countries, afflicting people of different ages and socioeconomic backgrounds. Studies have indicated the need for developing treatment strategies that intervene directly in the obesogenic environment. This study aims to evaluate the effectiveness of a multi-component and environmental school-based intervention, lasting 16 months, on the recovery of the nutritional status of low-income children and adolescents with overweight/ obesity. Methods/study design The study was conducted by the Center for Recovery and Nutritional Education (CREN in São Paulo, Brazil. Two schools located in poor neighborhoods were selected for the intervention, between March 2016 and June 2017. The participants were all students aged 8 to 12 years from the two participating schools. At the beginning of the intervention, anthropometric measurements were carried out to assess the nutritional status of the students. For convenience, students from one of the schools were considered as the control group, while those from the other school formed the experimental group. The intervention in the experimental group (n = 438 consists of the following weekly activities at school: psychological counseling in groups, theoretical/practical nutrition workshops, and supervised physical education classes. In addition, theoretical and practical educational activities are held regularly for parents, teachers, and cooks. Students with excess of weight (≥1 body mass index [BMI] –for-age Z score, n = 138 received clinical and nutritional care periodically at the outpatient care at CREN. Students enrolled in the control group (n = 353 participated in psychological counseling groups and theoretical/practical nutrition workshops for 6 months held in the school environment to provide motivation to entire classrooms. In the following 10 months, students with excess of weight from the control group (n
Effectiveness of a 16-month multi-component and environmental school-based intervention for recovery of poor income overweight/obese children and adolescents: study protocol of the health multipliers program.
Patriota, Pollyanna Fernandes; Filgueiras, Andrea Rocha; de Almeida, Viviane Belucci Pires; Alexmovitz, Guilherme Aparecido Costa; da Silva, Carlos Eduardo; de Carvalho, Vivian Fortuna Feres; Carvalho, Natália; de Albuquerque, Maria Paula; Domene, Semiramis Martins Alvares; do Prado, Wagner Luiz; Torres, Gustavo Enrique Salazar; de Oliveira, Ana Paula Reis; Sesso, Ricardo; Sawaya, Ana Lydia
Excess of weight is a serious public health concern in almost all countries, afflicting people of different ages and socioeconomic backgrounds. Studies have indicated the need for developing treatment strategies that intervene directly in the obesogenic environment. This study aims to evaluate the effectiveness of a multi-component and environmental school-based intervention, lasting 16 months, on the recovery of the nutritional status of low-income children and adolescents with overweight/ obesity. The study was conducted by the Center for Recovery and Nutritional Education (CREN) in São Paulo, Brazil. Two schools located in poor neighborhoods were selected for the intervention, between March 2016 and June 2017. The participants were all students aged 8 to 12 years from the two participating schools. At the beginning of the intervention, anthropometric measurements were carried out to assess the nutritional status of the students. For convenience, students from one of the schools were considered as the control group, while those from the other school formed the experimental group. The intervention in the experimental group (n = 438) consists of the following weekly activities at school: psychological counseling in groups, theoretical/practical nutrition workshops, and supervised physical education classes. In addition, theoretical and practical educational activities are held regularly for parents, teachers, and cooks. Students with excess of weight (≥1 body mass index [BMI] -for-age Z score, n = 138) received clinical and nutritional care periodically at the outpatient care at CREN. Students enrolled in the control group (n = 353) participated in psychological counseling groups and theoretical/practical nutrition workshops for 6 months held in the school environment to provide motivation to entire classrooms. In the following 10 months, students with excess of weight from the control group (n = 125) were invited to attend the routine outpatient
Aceves-Martins, Magaly; Llauradó, Elisabet; Tarro, Lucia; Moriña, David; Papell-Garcia, Ignasi; Prades-Tena, Jordi; Kettner-Høeberg, Helle; Puiggròs, Francesc; Arola, Lluís; Davies, Amy; Giralt, Montse; Solà, Rosa
Encouraging adolescents to adopt healthy lifestyles can be challenging. The aim of the "Som la Pera" study was to engage adolescents by applying new strategies to increase both their fruit and vegetable consumption and their physical activity (PA) while reducing their sedentary behavior. In disadvantaged neighborhoods of Reus (Spain), two high schools were randomly assigned to the intervention (n = 170 adolescents 13- to 16-year-olds) and two were assigned to the control group (n = 223 adolescents 13- to 16-year-olds). The intervention, which lasted 12 months and spanned 2 academic years (2013-2015), used social marketing (SM) to improve healthy choices. The peer-led strategy involved 5 adolescents who designed and implemented 10 activities as challenges for their 165 school-aged peers. The control group received no intervention. To assess self-reported lifestyles in both groups, the Health Behavior in School-Aged Children Survey was used at baseline and end of study. After 12 months, intervention adolescents showed an increase of 28.9% in ≥1 fruit/day (p < 0.01) and of 18.5% in ≥6 hours/week of PA (p < 0.01) compared with controls. Additionally, intervention group males had an increase of 28.8% in ≥1 vegetable/day (p < 0.01) and of 15.6% in ≤2 hours/day of sedentary activity (p = 0.01) compared with controls. A school-based, peer-led, SM intervention developed by adolescents attending high schools in low-income neighborhoods effectively improved the healthy choices of their school-aged peers, leading to increased fruit consumption and PA in adolescents of both genders. Furthermore, adolescent males were more sensitive to improvements in healthy choices, showing increased vegetable consumption and decreased sedentary behavior.
McElearney, Aisling; Adamson, Gary; Shevlin, Mark; Bunting, Brendan
Bullying remains a significant issue in the lives of many children and young people at school and can have serious negative implications for emotional health and well-being in the short and longer term. This paper reports on an impact evaluation of the effectiveness of a school counselling intervention in promoting positive change in the peer…
Bugge, Anna; Tarp, Jakob; Ostergaard, Lars
BACKGROUND: The aim of the study; LCoMotion - Learning, Cognition and Motion was to develop, document, and evaluate a multi-component physical activity (PA) intervention in public schools in Denmark. The primary outcome was cognitive function. Secondary outcomes were academic skills, body composi...
Mobley, Connie C.; Stadler, Diane D.; Staten, Myrlene A.; El Ghormli, Laure; Gillis, Bonnie; Hartstein, Jill; Siega-Riz, Anna Maria; Virus, Amy
Background: The HEALTHY primary prevention trial developed an integrated multicomponent intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program…
The study examined community participation in the School-Based Management Committees (SBMC), the challenges hindering participation, and strategies for fostering efficacy of the School Based Management Committee. The number 340 schools were selected from the population of 2543 public primary schools in ...
Sebire, Simon J; Edwards, Mark J; Campbell, Rona; Jago, Russell; Kipping, Ruth; Banfield, Kathryn; Tomkinson, Keeley; Garfield, Kirsty; Lyons, Ronan A; Simon, Joanne; Blair, Peter S; Hollingworth, William
Physical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls' physical activity levels. A two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n = 4; control n = 2) with year 8 (12-13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer-supporters. Approximately 15 % of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer-supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer-supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully-powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be largely descriptive and focus on recruitment, attendance and data provision rates. The findings will inform the sample size required for a
Caxaj, Claudia Susana; Parroquia de San Miguel Ixtahuacan, Kolol Qnan Tx'otx'
The presence of large-scale mining operations poses many threats to communities. In a rural community in Guatemala, community leaders were motivated to address divisiveness and local conflict that have been exacerbated since the arrival of a mining company in the region. Prior research by our team identified spiritual and cultural strengths as important sources of strength and resilience in the community. We piloted a community-based intervention centred on spiritual and cultural practices in the region, to address divisiveness and build community harmony. One hundred and seventeen participants from over 18 villages in the municipality participated in the workshops and follow-up focus groups. Community leaders facilitated the intervention and partnered with the academic researcher throughout the research process. Overall, community members and facilitators expressed satisfaction with the workshop. Further, our analysis revealed three important processes important to the development of community harmony in the region: (a) mutual recognition and collectivisation; (b) affirmation of ancestral roots and connections to Mother Earth and (c) inspiring action and momentum towards solutions. These mechanisms, and the socio-political contexts that undermine them, have important implications for how global health programmes are developed and how collective processes for well-being are understood within an inequitable, conflict-laden world.
Dickinson, Pauline; Coggan, Carolyn; Bennett, Sara
This paper outlines the conceptual background and findings from the pilot phase of TRAVELLERS--an early intervention programme designed to enhance protective factors for young people experiencing change, loss and transition events and early signs of emotional distress. The pilot study aimed to determine whether TRAVELLERS was a feasible, acceptable and promising intervention for young people within secondary schools in Aotearoa/New Zealand. The conceptual origins of the TRAVELLERS programme are described in terms of: adolescent mental health concerns; emerging mental health promotion theory and practice; and prevention and early intervention models. The key elements of the TRAVELLERS programme are described. The programme was piloted in two secondary schools, one rural and one urban with 34 participants (females n = 24, males n = 10). Evaluation methods included: review of programme materials; identification of potential selection tools appropriate to Year 9 students; analysis of selection questionnaire; and conduct of feedback from participants, facilitators and parents/caregivers. The TRAVELLERS programme provides a means of identifying and selecting young people who may benefit from participating in an early intervention programme. The programme has achieved a statistically significant reduction in participants' distress (p Young people were overwhelmingly enthusiastic about most aspects of TRAVELLERS. School personnel reported that TRAVELLERS was an appropriate and acceptable programme to the school. Targeted interventions provided within a supportive school environment can contribute to enhancing protective factors such as personal and interpersonal coping strategies, increased help-seeking behaviour, and young people feeling more positive about themselves and their lives. The pilot programme has been amended and prepared for a two year trial phase in 10 secondary schools during 2002-2003.
Fairclough, Stuart J; McGrane, Bronagh; Sanders, George; Taylor, Sarah; Owen, Michael; Curry, Whitney
PE lessons are the formal opportunity in schools for promotion of physical activity and fitness. This study aimed to evaluate the effectiveness of a pilot PE intervention on physical activity, fitness, and psychosocial outcomes. Participants were 139 children aged 10-11 years from four schools. For six weeks children in two schools received a twice-weekly pilot 'Born to Move' (BTM) physical activity (PA) and fitness intervention alongside one regular PE lesson. Children in the two comparison (COM) schools received their regular twice weekly PE lessons. Outcomes were lesson time and whole-day light (LPA), moderate (MPA), vigorous (VPA), and MVPA, and sedentary time, muscular fitness, cardiorespiratory fitness (CRF), and lesson-specific perceived exertion, enjoyment, and perceived competence. Outcomes were assessed at baseline (T0), midway through the intervention (T1), and at the end (T2) using ANOVAs and ANCOVAs. Intervention fidelity was measured using child and teacher surveys at T2 and analysed using Chi-square tests. The BTM group engaged in moderate PA for significantly more lesson time (29.4 %) than the COM group (25.8 %; p = .009, d = .53). The amount of moderate-to-vigorous PA (MVPA) during the T1 BTM lesson contributed 14.0 % to total MVPA, which was significantly more than the COM group's T1 PE lesson (11.4 %; p competence increased in both groups (p fitness, and psychosocial outcomes. Further, BTM was enjoyed by the children, and valued by the teachers. This study can inform the design of a modified larger-scale cluster RCT evaluation.
McKeague, L.; Morant, N.; Blackshaw, E.; Brown, J. S. L.
BACKGROUND: Adolescents with emotional difficulties need accessible, acceptable and evidence-based mental health interventions. Self-referral workshops (DISCOVER workshops) were offered to stressed 16- to 19-year olds in 10 Inner London schools. METHOD: Semistructured interviews were conducted with three groups of participants: students who attended a 1-day workshop (n = 15); students who initially showed interest in the DISCOVER workshop programme, but decided not to take part (n...
McKeague, Lynn; Morant, Nicola; Blackshaw, Emily; Brown, June
Background: Adolescents with emotional difficulties need accessible, acceptable and evidence-based mental health interventions. Self-referral workshops (DISCOVER workshops) were offered to stressed 16- to 19-year olds in 10 Inner London schools. Method: Semistructured interviews were conducted with three groups of par- ticipants: students who attended a 1-day workshop (n = 15); students who initially showed interest in the DIS- COVER workshop programme, but decided not to take part (n = 9); a...
Núñez, Ana; Robertson-James, Candace; Reels, Serita; Jeter, Janay; Rivera, Hilda; Yusuf, Zena; Liu
Perceptions of masculinity and femininity influence behaviors and can be identified in young children and adolescents (Brannon, 2004). Thus, adolescents' engagement in health risk or promoting behaviors is influenced by perceptions of masculinity and femininity and the differences in expectations, norms and responsibilities for girls and boys (WHO, 2007). Girls and boys have different needs, and gender-based interventions that consider similarities as well as differences are needed. A gender-based nutrition and sexual health promotion program was developed and piloted by the Philadelphia Ujima Coalition in a high school setting. To explore the gender differences in adolescents' perceptions of the influence of gender norms on weight, nutrition, physical activity, and sexual health and the implication of these differences in future gender-integrated health promotion programming for youth, a content analysis of student and facilitator debriefing forms were implemented for the participating schools. The content analysis was used to identify central themes, concepts gained, and overall impact of the intervention sessions. Overall, gender norms influence healthy eating practices and activity through influencing perceptions of body type in adolescents. Gender norms also influence sexual activity and decision making through influencing perceptions of beauty, masculinity, femininity, pressures and popular concepts related to sexual activity. Thus, interventions that address gender may more effectively promote health and wellness in adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.
Van Lippevelde, Wendy; Bere, Elling; Verloigne, Maïté; van Stralen, Maartje M; De Bourdeaudhuij, Ilse; Lien, Nanna; Vik, Frøydis Nordgård; Manios, Yannis; Grillenberger, Monika; Kovács, Eva; ChinAPaw, Mai J M; Brug, Johannes; Maes, Lea
Screen-related behaviours are highly prevalent in schoolchildren. Considering the adverse health effects and the relation of obesity and screen time in childhood, efforts to affect screen use in children are warranted. Parents have been identified as an important influence on children's screen time and therefore should be involved in prevention programmes. The aim was to examine the mediating role of family-related factors on the effects of the school-based family-focused UP4FUN intervention aimed at screen time in 10- to 12-year-old European children (n child-parent dyads = 1940). A randomised controlled trial was conducted to test the six-week UP4FUN intervention in 10- to 12-year-old children and one of their parents in five European countries in 2011 (n child-parent dyads = 1940). Self-reported data of children were used to assess their TV and computer/game console time per day, and parents reported their physical activity, screen time and family-related factors associated with screen behaviours (availability, permissiveness, monitoring, negotiation, rules, avoiding negative role modeling, and frequency of physically active family excursions). Mediation analyses were performed using multi-level regression analyses (child-school-country). Almost all TV-specific and half of the computer-specific family-related factors were associated with children's screen time. However, the measured family-related factors did not mediate intervention effects on children's TV and computer/game console use, because the intervention was not successful in changing these family-related factors. Future screen-related interventions should aim to effectively target the home environment and parents' practices related to children's use of TV and computers to decrease children's screen time. The study is registered in the International Standard Randomised Controlled Trial Number Register (registration number: ISRCTN34562078).
Stuart J. Fairclough
Full Text Available Abstract Background PE lessons are the formal opportunity in schools for promotion of physical activity and fitness. This study aimed to evaluate the effectiveness of a pilot PE intervention on physical activity, fitness, and psychosocial outcomes. Methods Participants were 139 children aged 10–11 years from four schools. For six weeks children in two schools received a twice-weekly pilot ‘Born to Move’ (BTM physical activity (PA and fitness intervention alongside one regular PE lesson. Children in the two comparison (COM schools received their regular twice weekly PE lessons. Outcomes were lesson time and whole-day light (LPA, moderate (MPA, vigorous (VPA, and MVPA, and sedentary time, muscular fitness, cardiorespiratory fitness (CRF, and lesson-specific perceived exertion, enjoyment, and perceived competence. Outcomes were assessed at baseline (T0, midway through the intervention (T1, and at the end (T2 using ANOVAs and ANCOVAs. Intervention fidelity was measured using child and teacher surveys at T2 and analysed using Chi-square tests. Results The BTM group engaged in moderate PA for significantly more lesson time (29.4 % than the COM group (25.8 %; p = .009, d = .53. The amount of moderate-to-vigorous PA (MVPA during the T1 BTM lesson contributed 14.0 % to total MVPA, which was significantly more than the COM group’s T1 PE lesson (11.4 %; p < .001, d = .47. The BTM group were significantly more active during the whole-day (p < .05 and the school-day (p < .01. In both groups push-up test performance increased (p < .001 and CRF test performance decreased (p < .01. Perceived exertion, enjoyment, and perceived competence increased in both groups (p < .05, but the BTM group rated their enjoyment of the T1 BTM lesson higher than the COM group rated their PE lesson (p = .02, d = .56. The children’s and teachers’ responses to the intervention indicated that the delivery aims of enjoyment
Study protocol for the optimisation, feasibility testing and pilot cluster randomised trial of Positive Choices: a school-based social marketing intervention to promote sexual health, prevent unintended teenage pregnancies and address health inequalities in England.
Ponsford, Ruth; Allen, Elizabeth; Campbell, Rona; Elbourne, Diana; Hadley, Alison; Lohan, Maria; Melendez-Torres, G J; Mercer, Catherine H; Morris, Steve; Young, Honor; Bonell, Chris
Since the introduction of the Teenage Pregnancy Strategy (TPS), England's under-18 conception rate has fallen by 55%, but a continued focus on prevention is needed to maintain and accelerate progress. The teenage birth rate remains higher in the UK than comparable Western European countries. Previous trials indicate that school-based social marketing interventions are a promising approach to addressing teenage pregnancy and improving sexual health. Such interventions are yet to be trialled in the UK. This study aims to optimise and establish the feasibility and acceptability of one such intervention: Positive Choices. Design: Optimisation, feasibility testing and pilot cluster randomised trial.Interventions: The Positive Choices intervention comprises a student needs survey, a student/staff led School Health Promotion Council (SHPC), a classroom curriculum for year nine students covering social and emotional skills and sex education, student-led social marketing activities, parent information and a review of school sexual health services.Systematic optimisation of Positive Choices will be carried out with the National Children's Bureau Sex Education Forum (NCB SEF), one state secondary school in England and other youth and policy stakeholders.Feasibility testing will involve the same state secondary school and will assess progression criteria to advance to the pilot cluster RCT.Pilot cluster RCT with integral process evaluation will involve six different state secondary schools (four interventions and two controls) and will assess the feasibility and utility of progressing to a full effectiveness trial.The following outcome measures will be trialled as part of the pilot:Self-reported pregnancy and unintended pregnancy (initiation of pregnancy for boys) and sexually transmitted infections,Age of sexual debut, number of sexual partners, use of contraception at first and last sex and non-volitional sexEducational attainmentThe feasibility of linking administrative
The impact of active stakeholder involvement on recruitment, retention and engagement of schools, children and their families in the cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP): a school-based intervention to prevent obesity.
Lloyd, J; McHugh, C; Minton, J; Eke, H; Wyatt, K
Recruitment and retention of participants is crucial for statistical power and internal and external validity and participant engagement is essential for behaviour change. However, many school-based interventions focus on programme content rather than the building of supportive relationships with all participants and tend to employ specific standalone strategies, such as incentives, to improve retention. We believe that actively involving stakeholders in both intervention and trial design improves recruitment and retention and increases the chances of creating an effective intervention. The Healthy Lifestyles Programme, HeLP (an obesity prevention programme for children 9-10 years old) was developed using intervention mapping and involved extensive stakeholder involvement in both the design of the trial and the intervention to ensure that: (i) delivery methods were suitably engaging, (ii) deliverers had the necessary skills and qualities to build relationships and (iii) the intervention dovetailed with the National Curriculum. HeLP was a year-long intervention consisting of 4 multi-component phases using a range of delivery methods. We recruited 1324 children from 32 schools from the South West of England to a cluster-randomised controlled trial to determine the effectiveness of HeLP in preventing obesity. The primary outcome was change in body mass index standard deviation score (BMI SDS) at 24 months post randomisation. Secondary outcomes included additional anthropometric and behavioural (physical activity and diet) measures at 18 and 24 months. Anthropometric and behavioural measures were taken in 99%, 96% and 94% of children at baseline, 18 and 24 months, respectively, with no differential follow up between the control and intervention groups at each time point. All children participated in the programme and 92% of children and 77% of parents across the socio-economic spectrum were considered to have actively engaged with HeLP. We attribute our excellent
Hetherington, Erin; Eggers, Matthijs; Wamoyi, Joyce; Hatfield, Jennifer; Manyama, Mange; Kutz, Susan; Bastien, Sheri
Abstract Background Diarrheal disease is a major cause of mortality and morbidity in low and middle income countries with children being disproportionately affected. Project SHINE (Sanitation & Hygiene INnovation in Education) is a grassroots participatory science education and social entrepreneurship model to engage youth and the wider community in the development of sustainable strategies to improve sanitation and hygiene. Methods Based in rural and remote Tanzania, this pilot study engaged...
Ono, Yutaka; Awata, Shuichi; Iida, Hideharu; Ishida, Yasushi; Ishizuka, Naoki; Iwasa, Hiroto; Kamei, Yuichi; Motohashi, Yutaka; Nakagawa, Atsuo; Nakamura, Jun; Nishi, Nobuyuki; Otsuka, Kotaro; Oyama, Hirofumi; Sakai, Akio; Sakai, Hironori
Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention re...
Full Text Available Abstract Background Given the increase in overweight and obesity prevalence in adolescents in the last decade, effective prevention strategies for these conditions in adolescents are urgently needed. The PRALIMAP (Promotion de l'ALImentation et de l'Activité Physique trial aims to evaluate the effectiveness for these conditions of 3 health promotion strategies -- educational, screening and environmental -- applied singly or in combination in high schools over a 2-year intervention period. Methods PRALIMAP is a stratified 2 × 2 × 2 factorial cluster randomised controlled trial including 24 state high schools in Lorraine, northeastern France, in 2 waves: 8 schools in 2006 (wave 1 and 16 in 2007 (wave 2. Students entering the selected high schools in the 4 academic years from 2006 to 2009 are eligible for data collection. Interventional strategies are organized over 2 academic years. The follow-up consists of 3 visits: at the entry of grade 10 (T0, grade 11 (T1 and grade 12 (T2. At T0, 5,458 (85.7% adolescents participated. The educational strategy consists of nutritional lessons, working groups and a final party. The screening strategy consists in detecting overweight/obesity and eating disorders in adolescents and proposing, if necessary, an adapted care management program of 7 group educational sessions. The environmental strategy consists in improving dietary and physical activity offerings in high schools and facilities, especially catering. The main outcomes are body size evolution over time, nutritional behaviour and knowledge, health and quality of life. An evaluation process documents how each intervention strategy is implemented in the schools and estimates the dose of the intervention, allowing for a per protocol analysis after the main intention-to-treat analysis. Discussion PRALIMAP aims at improving the prevention and management of overweight and obesity in adolescents by translating current evidence into public health practice
Tarp, Jakob; Domazet, Sidsel Louise; Froberg, Karsten
an executive functions test of inhibition (flanker task) with the primary outcomes being accuracy and reaction time on congruent and incongruent trials. Secondary outcomes included mathematics performance, physical activity levels, body-mass index, waist-circumference and cardiorespiratory fitness. RESULTS....../m2 (95% CI: -0.39-0.05). Contrary to our predictions, a significantly larger change in interference control for reaction time was found in favor of the control group (5.0 milliseconds (95% CI: 0-9). Baseline to mid-intervention changes in physical activity levels did not differ significantly between...
Krustrup, Peter; Hansen, Peter Riis; Nielsen, Claus Malta
-randomized into a control group that maintained their usual activities (CON; two classes, n = 51, 21 boys and 30 girls) and a football training group that performed an additional 3 × 40 min of small-sided football training per week (FT; two classes, n = 46, 23 boys and 23 girls). No baseline differences were observed......The present study investigated the cardiac effects of a 10-week football training intervention for school children aged 9-10 years using comprehensive transthoracic echocardiography as a part of a larger ongoing study. A total of 97 pupils from four school classes were cluster...
Full Text Available Abstract Background Although several previous projects have attempted to address the issue of child obesity through school-based interventions, the overall effectiveness of school-based programs on health-related outcomes in youth has been poor. Thus, it has been suggested that multi-level interventions that aim to influence healthy lifestyle behaviors at the community, school and family levels may prove more successful in the prevention of childhood obesity. Methods/Design This paper describes the rationale, design, and implementation of a community-, school-, and family-based intervention aimed at modifying key behaviors (physical activity, screen time (Internet, television, video games, and nutrition related to childhood obesity among third through fifth graders in two mid-western cities. The intervention involves a randomized study of 10 schools (5 intervention and 5 control schools. The intervention is being conducted during the duration of the academic year – approximately 9 months – and includes baseline and post-intervention measurements of physical activity, dietary intake, screen time and body composition. Discussion We hope this report will be useful to researchers, public health professionals, and school administrators and health professionals (nurses and physical/health educators seeking to develop similar prevention programs. It is obvious that more collaborative, inter-disciplinary, multi-level work is needed before a proven, effective intervention package to modify behaviors related to childhood obesity can be generally recommended. It is our hope that SWITCH is a step in that direction. Trial Registration ClinicalTrials.gov NCT00685555
Llauradó, Elisabet; Tarro, Lucia; Moriña, David; Queral, Rosa; Giralt, Montse; Solà, Rosa
To assess the reproducibility of an educational intervention EdAl-2 (Educació en Alimentació) programme in 'Terres de l'Ebre' (Spain), over 22 months, to improve lifestyles, including diet and physical activity (PA). Reproduction of a cluster randomised controlled trial. Two semi-rural town-group primary-school clusters were randomly assigned to the intervention or control group. Pupils (n=690) of whom 320 constituted the intervention group (1 cluster) and 370 constituted the control group (1 cluster). Ethnicity was 78% Western European. The mean age (±SD) was 8.04±0.6 years (47.7% females) at baseline. Inclusion criteria for clusters were towns from the southern part of Catalonia having a minimum of 500 children aged 7-8 year; complete data for participants, including name, gender, date and place of birth, and written informed consent from parents or guardians. The intervention focused on eight lifestyle topics covered in 12 activities (1 h/activity/session) implemented by health promoting agents in the primary school over three academic years. The primary outcome was obesity (OB) prevalence and the secondary outcomes were body mass index (BMI) collected every year and dietary habits and lifestyles collected by questionnaires filled in by parents at baseline and end-of-study. At 22 months, the OB prevalence and BMI values were similar in intervention and control groups. Relative to children in control schools, the percentage of boys in the intervention group who performed ≥4 after-school PA h/week was 15% higher (p=0.027), whereas the percentage of girls in both groups remained similar. Also, 16.6% more boys in the intervention group watched ≤2 television (TV) h/day (p=0.009), compared to controls; and no changes were observed in girls in both groups. Our school-based intervention is feasible and reproducible by increasing after-school PA (to ≥4 h/week) in boys. Despite this improvement, there was no change in BMI and prevalence of OB. Clinical Trials
Westerlund, Tommy; Almarsdóttir, Anna Birna; Melander, Arne
Objectives. (1) To document types and number of drug-related problems identified by community pharmacy personnel in Sweden; (2) to determine relationships among the types and number of problems identified and the gender, age and number of prescribed drugs in patients; and (3) to document the inte......Objectives. (1) To document types and number of drug-related problems identified by community pharmacy personnel in Sweden; (2) to determine relationships among the types and number of problems identified and the gender, age and number of prescribed drugs in patients; and (3) to document...... the interventions made by pharmacy personnel with patients and prescribers. Method. Random samples of pharmacists, prescriptionists and pharmacy technicians were drawn nationwide in Sweden; 144 (63 per cent) of the employees fulfilling the inclusion criteria agreed to take part. The participants documented drug......-related problems, interventions and patient variables on a data collection form, and tallied the number of patients they served on another form. Setting. One hundred and sixteen community pharmacies and 12 outpatient hospital pharmacies. Key findings. One problem or more was identified among 2.5 per cent...
Robbins, Lorraine B; Pfeiffer, Karin Allor; Wesolek, Stacey M; Lo, Yun-Jia
The purpose was to evaluate the reach, dose, and fidelity of Guys Only Activity for Life (G.O.A.L.), a 7-week pilot intervention conducted from February to March 2011 to increase 6th and 7th grade boys' moderate-to-vigorous physical activity (MVPA). One middle school was randomly assigned to the G.O.A.L. intervention and another from the same urban school district in the Midwestern U.S. to a comparison condition. Thirty boys, ages 10-14 years, participated in each school. The intervention, guided by the Health Promotion Model (HPM) and Self-Determination Theory (SDT), consisted of a 90-min after-school physical activity club 4 days/week and one motivational interviewing session with a registered (school) nurse. Data were gathered via attendance records, club observations, heart rate monitors, audio-taping of motivational interviewing sessions, and surveys. On average boys attended the club 2.11 days/week (SD=.86). A trained independent process evaluator reported that the physical activity club instructors provided the boys with the opportunity for a mean of 25.8 min/day of MVPA. Using a four-point Likert scale (1=disagree a lot; 4=agree a lot), the process evaluator perceived that the club was delivered with high fidelity and adherence to the underlying theories (M=3.48; SD=0.39). Sessions with the nurse lasted an average of 13 min, 29 s. All boys attended. Two trained independent coders indicated that the nurse demonstrated at least beginning proficiency for all tasks associated with motivational interviewing, with the exception of using sufficient open- as opposed to closed-ended questions and reflections compared to questions. Fidelity related to session delivery and adherence to the theories was high (M=3.83; SD=0.19). The process evaluation data indicated that strategies are needed to increase attendance and boys' MVPA during the club time. Copyright © 2013 Elsevier Ltd. All rights reserved.
Bundy, Anita C; Wyver, Shirley; Beetham, Kassia S; Ragen, Jo; Naughton, Geraldine; Tranter, Paul; Norman, Richard; Villeneuve, Michelle; Spencer, Grace; Honey, Anne; Simpson, Judith; Baur, Louise; Sterman, Julia
Providing children and adults with opportunities to engage in manageable risk taking may be a stepping stone toward closing the gap in life conditions currently experienced by young people with disabilities. We aim to demonstrate the effectiveness of a simple, innovative program for 1) changing the way parents and teachers view manageable risk-taking for children with disabilities and 2) increasing the level of responsibility that children take for their own actions, as seen on the school playground. We will employ a cluster repeated measures trial with six Sydney-area primary-school-based programs for children with disabilities. The intervention comprises two arms. 1) Risk-reframing--teachers and parents will participate together in small group intervention sessions focusing on the benefits of manageable risk-taking; 2) Introduction of play materials--materials without a defined purpose and facilitative of social cooperation will be introduced to the school playground for children to use at all break times. A control period will be undertaken first for two school terms, followed by two terms of the intervention period. Outcome measures will include playground observations, The Coping Inventory, qualitative field notes, and The Tolerance of Risk in Play Scale. New national programs, such as Australia's National Disability Insurance Scheme, will place increasing demands on young people with disabilities to assume responsibility for difficult decisions regarding procuring services. Innovative approaches, commencing early in life, are required to prepare young people and their carers for this level of responsibility. This research offers innovative intervention strategies for promoting autonomy in children with disabilities and their carers. Australian and New Zealand Clinical Trials Registration Number ACTRN12614000549628 (registered 22/5/2014).
Full Text Available This study evaluated the impact of generalization of the Social Competence Intervention-Adolescent (SCI-A curriculum in a school setting for individuals with high-functioning autism or Asperger's Syndrome (=6. This study examined to what degree the generalization of the SCI-A curriculum could be measured when delivered in a school setting. Across the six participants preliminary results suggest improvement on teacher reports of social skills and executive functioning. Some improvements were also evident in direct measures of facial-expression recognition. Data collected in the nonintervention settings indicated that some generalization of social interaction skills may have occurred for all six participants. Future research directions are discussed.
Yonas, Michael A; Burke, Jessica G; Brown, Shawn T; Borrebach, Jeffrey D; Garland, Richard; Burke, Donald S; Grefenstette, John J
To develop a conceptual computational agent-based model (ABM) to explore community-wide versus spatially focused crime reporting interventions to reduce community crime perpetrated by youth. Agents within the model represent individual residents and interact on a two-dimensional grid representing an abstract nonempirically grounded community setting. Juvenile agents are assigned initial random probabilities of perpetrating a crime and adults are assigned random probabilities of witnessing and reporting crimes. The agents' behavioral probabilities modify depending on the individual's experience with criminal behavior and punishment, and exposure to community crime interventions. Cost-effectiveness analyses assessed the impact of activating different percentages of adults to increase reporting and reduce community crime activity. Community-wide interventions were compared with spatially focused interventions, in which activated adults were focused in areas of highest crime prevalence. The ABM suggests that both community-wide and spatially focused interventions can be effective in reducing overall offenses, but their relative effectiveness may depend on the intensity and cost of the interventions. Although spatially focused intervention yielded localized reductions in crimes, such interventions were shown to move crime to nearby communities. Community-wide interventions can achieve larger reductions in overall community crime offenses than spatially focused interventions, as long as sufficient resources are available. The ABM demonstrates that community-wide and spatially focused crime strategies produce unique intervention dynamics influencing juvenile crime behaviors through the decisions and actions of community adults. It shows how such models might be used to investigate community-supported crime intervention programs by integrating community input and expertise and provides a simulated setting for assessing dimensions of cost comparison and intervention effect
Kinchin, Irina; Jacups, Susan; Tsey, Komla; Lines, Katrina
Empowerment programs have been shown to contribute to increased empowerment of individuals and build capacity within the community or workplace. To-date, the impact of empowerment programs has yet to be quantified in the published literature in this field. This study assessed the Indigenous-developed Family Wellbeing (FWB) program as an empowerment intervention for a child safety workforce in remote Indigenous communities by measuring effect sizes. The study also assessed the value of measurement tools for future impact evaluations. A three-day FWB workshop designed to promote empowerment and workplace engagement among child protection staff was held across five remote north Queensland Indigenous communities. The FWB assessment tool comprised a set of validated surveys including the Growth and Empowerment Measure (GEM), Australian Unity Wellbeing Index, Kessler psychological distress scale (K10) and Workforce engagement survey. The assessment was conducted pre-intervention and three months post-intervention. The analysis of pre-and post-surveys revealed that the GEM appeared to be the most tangible measure for detecting positive changes in communication, conflict resolution, decision making and life skill development. The GEM indicated a 17 % positive change compared to 9 % for the Australian Unity Wellbeing Index, 5 % for the workforce engagement survey and less than 1 % for K10. This study extended qualitative research and identified the best measurement tool for detecting the outcomes of empowerment programs. The GEM was found the most sensitive and the most tangible measure that captures improvements in communication, conflict resolution, decision making and life skill development. The GEM and Australian Unity Wellbeing Index could be recommended as routine measures for empowerment programs assessment among similar remote area workforce.
Turhan, Abdullah; Onrust, Simone A; Ten Klooster, Peter M; Pieterse, Marcel E
To test the effectiveness of the Healthy School and Drugs (HSD) programme on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends upon subtypes of SE schools and the level of implementation. In a quasi-experimental design with baseline and post-treatment follow-up, 363 students were allocated arbitrarily or depending on teacher motivation to either intervention condition (n = 205) or usual curriculum (n = 158). Thirteen secondary SE schools spread throughout the Netherlands. Participants were recruited during the autumn of 2013 from three school subtypes: SE for adolescents with intellectual/physical disabilities (SEI; n = 13), behavioural/emotional difficulties (SEB; n = 136) and learning disabilities/developmental disorders (SEL; n = 214). Self-reported life-time smoking prevalence and life-time drinking frequency as outcomes, and school subtype (SEL/SEB) and implementation fidelity (high/low) as moderators. No significant differences were found at follow-up in life-time smoking [odds ratio (OR) = 1.52; 95% confidence interval (CI) = 0.74-3.12] and drinking frequency (d = 0.01; 95% CI = -0.16 to 0.18). Interaction analyses revealed adverse effects in SEB students for alcohol use (d = 0.43; 95% CI = 0.16-0.69). Effect on tobacco refusal self-efficacy was moderated positively by implementation fidelity (d = 0.35; 95% CI = 0.07-0.63). The Healthy School and Drugs programme adapted for secondary special education in the Netherlands lacked clear evidence for effects on all outcomes. This pilot study suggests further that, within special education, substance use interventions may need to be targeted at school subtypes, as these may have harmful effects among students with behavioural difficulties. Finally, limited evidence was found that programme effectiveness may depend upon implementation fidelity. © 2016 Society for the Study of Addiction.
Burke, Rachel M; Meyer, Adria; Kay, Christi; Allensworth, Diane; Gazmararian, Julie A
Over the past 30 years, obesity in the United States has increased twofold in children and threefold in adolescents. In Georgia, nearly 17% of children aged 10 - 17 are obese. In response to the high prevalence of child obesity in Georgia and the potential deleterious consequences that this can have, HealthMPowers was founded in 1999 with the goal of preventing childhood obesity by improving health-enhancing behaviors in elementary schools, utilizing a holistic three-year program. This study measures the effectiveness of the HealthMPowers program in improving the school environment, student knowledge, behavior, cardiovascular fitness levels, and Body Mass Index (BMI). The present analysis utilizes data from 40 schools that worked with HealthMPowers over the course of the 2012 - 2013 school year (including schools at each of the three years of the intervention period) and provided information on demographics, student knowledge and behaviors, BMI, performance on the PACER test of aerobic capacity, and school practices and policies (measured via school self-assessment with the HealthMPowers-developed instrument "Continuous Improvement Tracking Tool" or CITT), measured at the beginning and end of each school year. Paired two-sample T tests were used to compare continuous variables (e.g., student knowledge scores, BMI-for-age Z scores), while chi-squared tests were used to assess categorical variables (e.g., trichotomized PACER performance). Students across all grades and cohorts demonstrated improvements in knowledge and self-reported behaviors, with particularly significant improvements for third-graders in schools in the second year of the HealthMPowers program (p grades and gender, with the most significant decreases for students overweight or obese at baseline (p Students also showed significant increases in performance on the PACER test across grades and cohorts (p improve their practices over time, as measured via the CITT instrument. The present report
Levy, Susan R; Anderson, Emily E; Issel, L Michele; Willis, Marilyn A; Dancy, Barbara L; Jacobson, Kristin M; Fleming, Shirley G; Copper, Elizabeth S; Berrios, Nerida M; Sciammarella, Esther; Ochoa, Mónica; Hebert-Beirne, Jennifer
African Americans and Latinos share higher rates of cardiovascular disease (CVD) and diabetes compared with Whites. These diseases have common risk factors that are amenable to primary and secondary prevention. The goal of the Chicago REACH 2010-Lawndale Health Promotion Project is to eliminate disparities related to CVD and diabetes experienced by African Americans and Latinos in two contiguous Chicago neighborhoods using a community-based prevention approach. This article shares findings from the Phase 1 participatory planning process and discusses the implications these findings and lessons learned may have for programs aiming to reduce health disparities in multiethnic communities. The triangulation of data sources from the planning phase enriched interpretation and led to more creative and feasible suggestions for programmatic interventions across the four levels of the ecological framework. Multisource data yielded useful information for program planning and a better understanding of the cultural differences and similarities between African Americans and Latinos.
Berger-Jenkins, Evelyn; Rausch, John; Okah, Ebiere; Tsao, Daisy; Nieto, Andres; Lyda, Elizabeth; Meyer, Dodi; McCord, Mary
Background: Obesity is a public health concern that disproportionately affects underserved and minority communities. Purpose: To evaluate whether a comprehensive obesity prevention program that targets children and school staff in an underserved Hispanic community affects obesity related knowledge, attitudes, and behaviors among both students and…
Koporc, Kimberly M.; Strunz, Eric; Holloway, Cassandra; Addiss, David G.; Lin, William
Background Between 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007–2012. Methodology Data from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA. Principal Findings Of the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%. Conclusions and Significance To continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled. PMID:26657842
Full Text Available The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT. Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs with basic instruction (control; RDTs with provider training (provider arm; and RDTs with provider training plus a school-based community intervention (provider-school arm. The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93% of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36: stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26 in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19 in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47. Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines.ClinicalTrials.gov NCT01350752.
Ferreira, Ronél; Ebersöhn, Liesel
The article describes the pilot phase of a participatory reflection and action (PRA) study. The longitudinal investigation explores teachers' ability to provide psychosocial support within the context of HIV/AIDS following an asset-based intervention. The study ensued from our desire to understand and contribute to knowledge about the changed roles of teachers due to adversity in the community, specifically in relation to HIV/AIDS and education. The supportive teachers, assets and resilience (STAR) intervention was facilitated from November 2003 to October 2005 and consisted of the research team undertaking nine field visits and facilitating 20 intervention sessions (2-3 hours each), and 12 post-intervention research visits have been conducted to date. Ten female teachers were selected for participation through random purposeful sampling at a primary school in an informal settlement outside Port Elizabeth, South Africa. Data-generation included PRA activities, observation, informal interactive interviews, and focus group discussions. The data were analysed by means of inductive thematic analysis. We found that the teachers did not view vulnerability as being related to children or HIV/AIDS in isolation, but rather that their psychosocial support to children and the school community was inclusive across a spectrum of vulnerabilities and services. We argue that teachers who are inclined to provide such support will fulfil this role irrespective of understanding policy or receiving training. We contend that teachers are well-positioned to manage school-based psychosocial support in order to create relevant and caring spaces for vulnerable individuals in the school community.
Benson, Jeryl DiSanti
The purpose of this study was to explore the role of occupation in school-based occupational therapy practice. The research questions were (1) How do school-based occupational therapists describe the role of occupation during intervention? (2) Which theories of occupation do school-based occupational therapists associate with their own practice?…
Doll, Beth; Nastasi, Bonnie K.; Cornell, Laura; Song, Samuel Y.
School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in…
Eke, Chidi Idi; Singh, Shakila
School-based violence is serious, and on the rise in South African schools. The violence affects learners, teachers, communities and the management of schools. Towards finding possible ways to manage school violence, this article presents social networking as a strategic tool in the management of school-based violence in high schools, based on the…
Thomas, R; Perera, R
Smoking rates in adolescents are rising in some countries. Helping young people to avoid starting smoking is a widely endorsed goal of public health, but there is uncertainty about how to do this. Schools provide a route for communicating with a large proportion of young people, and school-based programmes for smoking prevention have been widely developed and evaluated. To review all randomized controlled trials of behavioural interventions in schools to prevent children (aged 5 to12) and adolescents (aged 13 to18) starting smoking. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Tobacco Addiction Group's Specialized Register, MEDLINE, EMBASE, PsyclNFO, ERIC, CINAHL, Health Star, Dissertation Abstracts and studies identified in the bibliographies of articles. Individual MEDLINE searches were made for 133 authors who had undertaken randomized controlled trials in this area. Types of studies: those in which individual students, classes, schools, or school districts were randomized to the intervention or control groups and followed for at least six months. Children (aged 5 to12) or adolescents (aged 13 to18) in school settings. Types of interventions: Classroom programmes or curricula, including those with associated family and community interventions, intended to deter use of tobacco. We included programmes or curricula that provided information, those that used social influences approaches, those that taught generic social competence, and those that included interventions beyond the school into the community. We included programmes with a drug or alcohol focus if outcomes for tobacco use were reported. Types of outcome measures: Prevalence of non-smoking at follow up among those not smoking at baseline. We did not require biochemical validation of self-reported tobacco use for study inclusion. We assessed whether identified citations were randomized controlled trials. We assessed the quality of design and execution, and
Gumpel, T P; Meadan, H
An important first step in understanding school-based violence is understanding children's subjective perceptions of the phenomena. Understanding these perceptions is likely to be a major factor in determining the integrity of both prevalence and intervention studies. We investigated how elementary and secondary aged children perceived school-based violence. A sample of 979 children from a nested random sample of elementary (grades 3-6) and middle school (grades 7-8) classrooms in Jerusalem participated in this study. To understand children's perception of school violence, we used an instrument composed of 19 dichotomous items, each presenting a one-line description of a behaviour, which the respondent would define as either 'intentionally harmful' or not. Eighth graders were significantly less likely to label the behaviours described as violent compared to all other grades; and seventh graders were less likely as compared to third, fourth and fifth graders; also, some between-gender differences were found. The respondents often view the behaviours described as intentional and aggressive; this finding should serve as an impetus to widen the scope of school-based violence interventions to include these behaviours, especially for younger children.
One hundred and ninety-one parents attending an urban, community college were surveyed about what topics schools should teach their children about sexuality education, and how they communicate with their child about sexuality topics. The quantitative data was collected using a "School Sexuality Education Questionnaire" (SSEQ), and the "Parenting…
Kong, Alberta S.; Farnsworth, Seth; Canaca, Jose A.; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L.
Background: In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles…
Nasir, Bushra; Kisely, Steve; Hides, Leanne; Ranmuthugala, Geetha; Brennan-Olsen, Sharon; Nicholson, Geoffrey C; Gill, Neeraj S; Hayman, Noel; Kondalsamy-Chennakesavan, Srinivas; Toombs, Maree
Little is known of the appropriateness of existing gatekeeper suicide prevention programs for Indigenous communities. Despite the high rates of Indigenous suicide in Australia, especially among Indigenous youth, it is unclear how effective existing suicide prevention programs are in providing appropriate management of Indigenous people at risk of suicide. In-depth, semi-structured interviews and focus groups were conducted with Indigenous communities in rural and regional areas of Southern Queensland. Thematic analysis was performed on the gathered information. Existing programs were time-intensive and included content irrelevant to Indigenous people. There was inconsistency in the content and delivery of gatekeeper training. Programs were also not sustainable for rural and regional Indigenous communities. Appropriate programs should be practical, relevant, and sustainable across all Indigenous communities, with a focus on the social, emotional, cultural and spiritual underpinnings of community wellbeing. Programs need to be developed in thorough consultation with Indigenous communities. Indigenous-led suicide intervention training programs are needed to mitigate the increasing rates of suicide experienced by Indigenous peoples living in rural and remote locations.
Angeles, Ricardo N; Dolovich, Lisa; Kaczorowski, Janusz; Thabane, Lehana
Applying existing theories to research, in the form of a theoretical framework, is necessary to advance knowledge from what is already known toward the next steps to be taken. This article proposes a guide on how to develop a theoretical framework for complex community-based interventions using the Cardiovascular Health Awareness Program as an example. Developing a theoretical framework starts with identifying the intervention's essential elements. Subsequent steps include the following: (a) identifying and defining the different variables (independent, dependent, mediating/intervening, moderating, and control); (b) postulating mechanisms how the independent variables will lead to the dependent variables; (c) identifying existing theoretical models supporting the theoretical framework under development; (d) scripting the theoretical framework into a figure or sets of statements as a series of hypotheses, if/then logic statements, or a visual model; (e) content and face validation of the theoretical framework; and (f) revising the theoretical framework. In our example, we combined the "diffusion of innovation theory" and the "health belief model" to develop our framework. Using the Cardiovascular Health Awareness Program as the model, we demonstrated a stepwise process of developing a theoretical framework. The challenges encountered are described, and an overview of the strategies employed to overcome these challenges is presented.
Mwinzi Pauline NM
Full Text Available Abstract Background Schistosome and soil-transmitted helminth (STH infections are recognized as major global public health problems, causing severe and subtle morbidity, including significant educational and nutritional effects in children. Although effective and safe drugs are available, ensuring access to these drugs by all those at risk of schistosomiasis and STHs is still a challenge. Community-directed intervention (CDI has been used successfully for mass distribution of drugs for other diseases such as onchocerciasis and lymphatic filariasis. A national control programme is yet to be instituted in Kenya and evidence for cost-effective strategies for reaching most affected communities is needed. This study evaluated the effectiveness and feasibility of the CDI strategy in the control of schistosomiasis and STHs, in East Uyoma location, Rarieda district, a community of western Kenya that is highly endemic for both infections. Results Pre-treatment prevalence of S. mansoni averaged 17.4% (range 5-43% in the entire location. Treatment coverage in different villages ranged from 54.19 to 96.6% by community drug distributor (CDD records. Assessment from a household survey showed coverage of 52.3 -91.9% while the proportion of homesteads (home compounds covered ranged from 54.9-98.5%. Six months after one round of drug distribution, the prevalence levels of S. mansoni, hookworm and Trichuris trichura infections were reduced by 33.2%, 69.4% and 42.6% respectively. Conclusions This study shows that CDI is an accepted and effective strategy in the mass treatment of schistosomiasis and STH infections in resource constrained communities in Kenya and may be useful in similar communities elsewhere. A controlled trial comparing CDI and school based mass drug administration to demonstarte their relative advantages is ongoing.
A school-based intervention incorporating smartphone technology to improve health-related fitness among adolescents: rationale and study protocol for the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study.
Lubans, David R; Smith, Jordan J; Peralta, Louisa R; Plotnikoff, Ronald C; Okely, Anthony D; Salmon, Jo; Eather, Narelle; Dewar, Deborah L; Kennedy, Sarah; Lonsdale, Chris; Hilland, Toni A; Estabrooks, Paul; Finn, Tara L; Pollock, Emma; Morgan, Philip J
Physical inactivity has been described as a global pandemic. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be 'scaled-up' and disseminated. This study aims to: (1) assess the effectiveness of two physical activity promotion programmes (ie, NEAT and ATLAS) that have been modified for scalability; and (2) evaluate the dissemination of these programmes throughout government funded secondary schools. The study will be conducted in two phases. In the first phase (cluster randomised controlled trial), 16 schools will be randomly allocated to the intervention or a usual care control condition. In the second phase, the Reach, Effectiveness, Adoption, Implementation and Maintenance (Re-AIM) framework will be used to guide the design and evaluation of programme dissemination throughout New South Wales (NSW), Australia. In both phases, teachers will be trained to deliver the NEAT and ATLAS programmes, which will include: (1) interactive student seminars; (2) structured physical activity programmes; (3) lunch-time fitness sessions; and (4) web-based smartphone apps. In the cluster RCT, study outcomes will be assessed at baseline, 6 months (primary end point) and 12-months. Muscular fitness will be the primary outcome and secondary outcomes will include: objectively measured body composition, cardiorespiratory fitness, flexibility, resistance training skill competency, physical activity, self-reported recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem and well-being. This study has received approval from the University of Newcastle (H-2014-0312) and the NSW Department of Education (SERAP: 2012121) human research ethics committees. This study is funded by the Australian Research Council (FT
Brave Heart, Maria Yellow Horse; Chase, Josephine; Elkins, Jennifer; Martin, Jennifer; Nanez, Jennifer; Mootz, Jennifer
Although there is literature concentrating on cross-cultural approaches to academic and community partnerships with Native communities, few address the process and experiences of American Indian women leading federally funded and culturally grounded behavioral health intervention research in Native communities. This paper summarizes relevant literature on community-engaged research with Native communities, examines traditional roles and modern challenges for American Indian women, describes the culturally grounded collaborative process for the authors' behavioral health intervention development with Native communities, and considers emergent themes from our own research experiences navigating competing demands from mainstream and Native communities. It concludes with recommendations for supporting and enhancing resilience.
Kam, Chi-Ming; Greenberg, Mark T; Walls, Carla T
In order for empirically validated school-based prevention programs to "go to scale," it is important to understand the processes underlying program dissemination. Data collected in effectiveness trials, especially those measuring the quality of program implementation and administrative support, are valuable in explicating important factors influencing implementation. This study describes findings regarding quality of implementation in a recent effectiveness trial conducted in a high-risk, American urban community. This delinquency prevention trial is a locally owned intervention, which used the Promoting Alternative THinking Skills Curriculum as its major program component. The intervention involved 350 first graders in 6 inner-city public schools. Three schools implemented the intervention and the other 3 were comparison schools from the same school district. Although intervention effects were not found for all the intervention schools, the intervention was effective in improving children's emotional competence and reducing their aggression in schools which effectively supported the intervention. This study, utilizing data from the 3 intervention schools (13 classrooms and 164 students), suggested that 2 factors contributed to the success of the intervention: (a) adequate support from school principals and (b) high degree of classroom implementation by teachers. These findings are discussed in light of the theory-driven models in program evaluation that emphasized the importance of the multiple factors influencing the implementation of school-based interventions.
Full Text Available benchmarking, monitoring and intervention programme. Community road safety needs in the respective wards are articulated through the ward councillor. The rationale is that the community exactly knows where these problem areas are, because they suffer as a...
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Background: this study in the prospect of promoting adherence to the primary and secondary preven- tion programmes will research knowledge, attitudes and behaviors of the student population attending high schools regarding HPV infections and will also promote health education sessions based on peer education.
Methods: we carried out a cross-sectional kaP survey regarding HPV infection, HPV vaccination, and sexual health, of students and a peer educational intervention. To verify the effectiveness of peer educators in changing opinions and beliefs about HPV a self-com- pletion questionnaire was made and distributed pre (T1 and post (T2 peer educator intervention. The same questionnaires were assigned to the control group.
Results: the sample consisted of 900 students, mean age was 16.6±1.4, having relationship 34.4%. at T1, 64.6% of students in experimental group said that they knew HPV, 83.4% how it is transmitted and 71.1% HPV vaccination, 54.7% perceived dangerousness with significant gender-related difference. at T2 the percentages increased. at T1, 14.1% of females were vaccinated at T2 they were 17.5%. The main factors associated with the students’ propensity to vaccination were: having at least one sister; being in favour of vaccinations in general; knowing that the vaccine is aimed at preventing cervical cancer; and being aware that they could be infected by HPV.
Conclusion: both the HPV test and HPV vaccine need effective communication and monitoring of the spread of knowledge, especially among women identified as most in need of information and included in the age group at risk, in wich it is crucial to encourage informed choices. This underlines the need to plan adequate educational programmes....
Bryant, Keneshia; Moore, Todd; Willis, Nathaniel; Hadden, Kristie
Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.
Ornelas, India J; Deschenie, Desiree; Jim, Jesse; Bishop, Sonia; Lombard, Kevin; Beresford, Shirley A
Yéego Gardening! is a community garden intervention to increase gardening behavior, increase access to low-cost fruit and vegetables, and ultimately increase consumption in Navajo communities. To design a theory-based, culturally relevant intervention with three components: a community garden, monthly workshops on gardening and healthy eating, and community outreach. Gardens were constructed and maintained in collaboration with community-based organizations in two Navajo communities. Monthly workshops were held throughout the growing season and incorporated aspects of Navajo culture and opportunities to build confidence and skills in gardening and healthy eating behaviors. In addition, program staff attended community events to promote gardening and healthy eating. Community input was essential throughout the planning and implementation of the intervention. If effective, community gardens may be a way to increase fruit and vegetable availability and intake, and ultimately reduce risk of obesity and diabetes.
Ramírez Toro Graciela I
Full Text Available Abstract Background Waterborne disease is a major risk for small water supplies in rural settings. This study was done to assess the impact of an educational intervention designed to improve water quality and estimate the contribution of water to the incidence of diarrhoeal disease in poor rural communities in Puerto Rico a two-part study was undertaken. Methods An educational intervention was delivered to communities relying on community water supplies. This intervention consisted of student operators and administrators supervising and assisting community members who voluntarily "operate" these systems. These voluntary operators had no previous training and were principally concerned with seeing that some water was delivered. The quality of that water was not something they either understood or addressed. The impact of this intervention was measured through water sampling for standard bacteriological indicators and a frank pathogen. In addition, face-to-face epidemiological studies designed to determine the base-line occurrence of diarrhoeal disease in the communities were conducted. Some 15 months after the intervention a further epidemiological study was conducted in both the intervention communities and in control communities that had not received any intervention. Results Diarrhoeal illness rates over a four week period prior to the intervention were 3.5%. Salmonella was isolated from all of 5 distributed samples prior to intervention and from only 2 of 12 samples after the intervention. In the 15 months follow-up study, illness rates were lower in the intervention compared to control communities (2.5% vs 3.6%% (RR = 0.70, 95%CI 0.43, 1.15, though this was not statistically significant. However, in the final Poisson regression model living in an intervention system (RR = 0.318; 95%CI 0.137 - 0.739 and owning a dog (RR = 0.597, 95%CI 0.145 - 0.962 was negatively associated with illness. Whilst size of system (RR = 1.006, 95%CI 1.001 - 1
Full Text Available Currently, in the Bologna context, university teaching methods focus on the student and on a learning experience based on practical methods. Under the guidance of teachers, students in the second year of the first Environmental Health Course at the Polytechnic Institute of Beja have designed and developed the following nine community intervention projects relating to environmental health: dangerous products (mercury; habitability and geriatrics; health education and the environment; drinking water; information and communication in environmental health; efficient use of resources in public buildings; child development in outdoor spaces; and allergenic factors in housing. This pedagogical action takes place over three semesters, corresponding to the three distinct phases: design, implementation and evaluation / dissemination. To ensure the viability of the projects, each group of three students has established partnerships with various entities, such as city and parish councils, hospitals, schools, consumer cooperatives, companies dealing with hazardous waste, the Youth Institute and other commercial enterprises. Although it has not been possible to evaluate the whole project, preliminary results suggest that the planned activities have been very successful, with health benefits for the people involved, through environmental improvements or an increase in empowerment. It was also possible to achieve economic gains and contribute to the conservation of the environment. The students were able to gain skills and knowledge in a teaching model characterized by the absence of lectures in which students, assisted by teachers, take decisions and independent action, simulating a real context of professional practice. This experience suggests that, by utilizing the Bologna method, the polytechnic institutions may improve their real contribution to the health of communities.
Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents.
Singh, A.S.; Chin A Paw, M.J.M.; Kremers, S.P.J.; Visscher, T.L.S.; Brug, J.; van Mechelen, W.
Background: Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. Methods: Applying the
Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT) : Systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents
A. Singh (Amika); M.J.M. Chin A Paw (Marijke); S.P.J. Kremers (Stef); T.L.S. Visscher (Tommy); J. Brug (Hans); W. van Mechelen (Willem)
textabstractBackground: Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. Methods:
Full Text Available Abstract Background Given limited research evidence for community-based alcohol interventions, this study examines the intervention preferences of rural communities and alcohol professionals, and factors that influence their choices. Method Community preferences were identified by a survey of randomly selected individuals across 20 regional Australian communities. The preferences of alcohol professionals were identified by a survey of randomly selected members of the Australasian Professional Society on Alcohol and Other Drugs. To identify preferred interventions and the extent of support for them, a budget allocation exercise was embedded in both surveys, asking respondents to allocate a given budget to different interventions. Tobit regression models were estimated to identify the characteristics that explain differences in intervention preferences. Results Community respondents selected school programs most often (88.0% and allocated it the largest proportion of funds, followed by promotion of safer drinking (71.3%, community programs (61.4% and police enforcement of alcohol laws (60.4%. Professionals selected GP training most often (61.0% and allocated it the largest proportion of funds, followed by school programs (36.6%, community programs (33.8% and promotion of safer drinking (31.7%. Community views were susceptible to response bias. There were no significant predictors of professionals' preferences. Conclusions In the absence of sufficient research evidence for effective community-based alcohol interventions, rural communities and professionals both strongly support school programs, promotion of safer drinking and community programs. Rural communities also supported police enforcement of alcohol laws and professionals supported GP training. The impact of a combination of these strategies needs to be rigorously evaluated.
Schiffman, Jason; Stephan, Sharon Hoover; Hong, L Elliot; Reeves, Gloria
Students with emerging psychosis often experience delays in diagnosis and treatment that impact mental health and academic outcomes. School systems have tremendous potential to improve early identification and treatment of adolescent psychosis. As a community-based resource, schools can support outreach, education, and screening for adolescents with psychosis and engage identified students and their families for treatment. The concept of duration of untreated psychosis (DUP; the gap between symptom onset and treatment initiation) in adolescent psychosis and the potential role of schools in reducing DUP are reviewed. Future directions for clinical care and research needed to support school-based interventions are proposed. Copyright © 2015 Elsevier Inc. All rights reserved.
Lv, Jun; Liu, Qing-Min; Ren, Yan-Jun; He, Ping-Ping; Wang, Sheng-Feng; Gao, Fang; Li, Li-Ming
To assess the short-term impact of a comprehensive, community-based multilevel intervention on knowledge, beliefs and practices with respect to smoking, physical activity and diet in Hangzhou, China. A non-randomised, controlled, before-after quasi-experimental trial was conducted in two intervention areas and one comparison area. The intervention built on a socioecological framework and took place across four settings: neighbourhoods, schools, workplaces and community health centres. Two independent cross-sectional surveys of adults aged 18-64 years at baseline and a subsequent follow-up were conducted in 2008/2009 and 2011 in the intervention and comparison areas. A 2-year intervention programme was begun in mid-2009 and continued until mid-2011. A total of 2016 adults at baseline and 2016 adults at follow-up completed the survey. Over the 2-year intervention period, the intervention areas showed a statistically significant decline (25.2% vs 18.7%, psmoking compared with the comparison area (18.0% vs 16.4%, p=0.343). The proportion of individuals who had noticed anyone smoking in any of nine locations in the previous 30 days demonstrated a statistically significant decline in the intervention (78.9% vs 66.5%, psmoking and physical activity but not diet. A community-based multilevel intervention programme is feasible in urban China.
Wijlhuizen, G.J.; Bois, P. du; Dommelen, P. van; Hopman-Rock, M.
The objective of the study was to evaluate the effectiveness of a multifactor and multimethod community intervention programme to reduce falls among older persons by at least 20%. In a pre-test-post test design, self-reported falls were registered for 10 months in the intervention community and two
Trickett, Edison J.; Espino, Susan Ryerson; Hawe, Penelope
Recent discussions about the conduct of community interventions suggest the importance of developing more comprehensive theorizing about their nature and effects. The present study is an effort to infer how community interventions are theorized by the way they are represented in the peer-reviewed scholarly literature. A coding of a random sample…
Full Text Available Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals. Discussion The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. Trial registration UMIN Clinical Trials Registry (UMIN-CTR UMIN000000460.
Ono, Yutaka; Awata, Shuichi; Iida, Hideharu; Ishida, Yasushi; Ishizuka, Naoki; Iwasa, Hiroto; Kamei, Yuichi; Motohashi, Yutaka; Nakagawa, Atsuo; Nakamura, Jun; Nishi, Nobuyuki; Otsuka, Kotaro; Oyama, Hirofumi; Sakai, Akio; Sakai, Hironori; Suzuki, Yuriko; Tajima, Miyuki; Tanaka, Eriko; Uda, Hidenori; Yonemoto, Naohiro; Yotsumoto, Toshihiko; Watanabe, Naoki
To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. This study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals). The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. UMIN Clinical Trials Registry (UMIN-CTR) UMIN000000460.
Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming
To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.
Rollins, Pamela Rosenthal; Campbell, Michelle; Hoffman, Renee Thibodeau; Self, Kayli
This study examined Pathways Early Autism Intervention, a community-based, parent-mediated, intensive behavioral and developmental intervention program for children with autism spectrum disorders that could be used as a model for state-funded early intervention programs. A single-subject, multiple-baseline, across-participants design was used.…
Healthcare professionals working in the community setting have limited knowledge of the evidence-based management of malnutrition. The present study aimed to evaluate a community dietetics intervention, which included an education programme for healthcare professionals in conjunction with the introduction of a community dietetics service for patients \\'at risk\\' of malnutrition. Changes in nutritional knowledge and the reported management of malnourished patients were investigated and the acceptability of the intervention was explored.
Full Text Available The purpose of this study was to examine the effect of various community-based interventions in support of HPV vaccination implemented by cities and towns within Tochigi prefecture, Japan with a view to identifying useful indicators which might guide future interventions to improve HPV vaccination coverage in the prefecture. A postal questionnaire survey of all 27 local governments in Tochigi Prefecture was conducted in December 2010. All 27 responded, and 22 provided the exact numbers of the targeted and vaccinated populations of 13- to 15-year-old girls from April to December 2010. The local governments also answered questions on the type of interventions implemented including public subsidies, school-based programs, direct mail, free tickets and recalls. Local governments that conducted a school-based vaccination program reported 96.8% coverage for the 1(st dose, 96.2% for the 2(nd dose, and 91.2% for the 3(rd dose. Those that provided subsidies without school-based programs reported a wide range of vaccination rates: 45.7%-95.0% for the 1(st dose, 41.1%-93.7% for the 2(nd dose and 3.1%-90.1% for the 3(rd dose. Among this group, the combination of a free ticket, direct mail and recall was most effective, with 95.0% coverage for the 1(st dose, 93.7% for the 2(nd dose, and 90.1% for the 3(rd dose. The governments that did not offer a subsidy had the lowest vaccination coverage, with 0.8%-1.4% for the 1(st dose, 0.0%-0.8% for the 2(nd dose, and 0.1%-0.1% for the 3(rd dose. The results of this survey indicate that school-based vaccinations and public subsidies are the most effective method to improve HPV vaccination coverage; however, the combination of a free ticket, direct mail, and recalls with public subsidies are also important measures in increasing the vaccination rate. These data may afford important indicators for the successful implementation of future HPV vaccination programs.
To access the effects of life style interventions on impaired glucose regulation (IGR) in Shanghai urban communities, China. Two communities were randomly cluster-sampled to be carried out epidemiological intervention trial. Totally, 232 subjects with IGR were randomly allocated into 4 groups: control group,sports intervention group, diet intervention group, and sports and diet intervention group with the physical examinations in the baseline and end of this study respectively. Tests for fasting blood glucose, OGTT, HbA1c, total cholesterol,etc. were done. Data statistical analysis was occupied in SPSS 16.0. Compared to subjects of control group,fasting blood glucose, OGTT, HbAlc,total cholesterol,BMI,waist hip ratio and blood pressures were significantly decreased among subjects with three interventions (P intervention and sports and diet intervention (P intervention (P interventions groups (8.6% vs. 0, Fisher' s exact P = 0.002), and the rate of transferring into normal blood glucose levels (fasting blood glucose interventions group (3.4% vs. 8.6%, 14.0% and 16.9%, respectively) but only significant difference was observed between control group and sports and diet intervention group (OR = 5.74, 95% CI 1. 19-27. 64, P = 0.029). The life style interventions could decrease the risk of diabetes mellitus, help their transferring into normal blood glucose, and improve diabetic measures for the IGR population in Shanghai urban communities.
Getrich, Christina; Heying, Shirley; Willging, Cathleen; Waitzkin, Howard
Community-based health interventions have emerged as a growing focus for anthropological research. The application of ethnographic approaches in clinical practice settings reveals that community-based interventions must grapple with "noise," or unanticipated factors such as patients' own perceptions of illness and treatment, primary care providers' non-adherence to guidelines-based treatment, the social dynamics of the clinic site itself, and incomplete understanding and acceptance of an intervention by a clinic's staff members. Such noise can influence the implementation and quality of treatment. Thus, identifying clinic-based noise is critical in assessments of fidelity to intervention protocols as well as outcomes of community-based interventions. This paper highlights findings from an evaluation of a mental health intervention focusing on the role of promotoras (briefly trained, non-professional community health workers) as mental health practitioners in two urban New Mexico, USA, community health centers. Our research identified three areas of clinic-based noise: the clinics' physical ability to "absorb" the intervention, the challenges of co-worker instability and interpersonal relationships, and balancing extra workplace demands. The findings demonstrate the value of ethnographic approaches in community-based intervention research.
Verbestel, Vera; De Henauw, Stefaan; Maes, Lea; Haerens, Leen; Mårild, Staffan; Eiben, Gabriele; Lissner, Lauren; Moreno, Luis A; Frauca, Natalia Lascorz; Barba, Gianvincenzo; Kovács, Eva; Konstabel, Kenn; Tornaritis, Michael; Gallois, Katharina; Hassel, Holger; De Bourdeaudhuij, Ilse
The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The
Khavjou, Olga A; Honeycutt, Amanda A; Yarnoff, Benjamin; Bradley, Christina; Soler, Robin; Orenstein, Diane
Limited data are available on the costs of evidence-based community-wide prevention programs. The objective of this study was to estimate the per-person costs of strategies that support policy, systems, and environmental changes implemented under the Community Transformation Grants (CTG) program. We collected cost data from 29 CTG awardees and estimated program costs as spending on labor; consultants; materials, travel, and services; overhead activities; partners; and the value of in-kind contributions. We estimated costs per person reached for 20 strategies. We assessed how per-person costs varied with the number of people reached. Data were collected in 2012-2015, and the analysis was conducted in 2015-2016. Two of the tobacco-free living strategies cost less than $1.20 per person and reached over 6 million people each. Four of the healthy eating strategies cost less than $1.00 per person, and one of them reached over 6.5 million people. One of the active living strategies cost $2.20 per person and reached over 7 million people. Three of the clinical and community preventive services strategies cost less than $2.30 per person, and one of them reached almost 2 million people. Across all 20 strategies combined, an increase of 10,000 people in the number of people reached was associated with a $0.22 reduction in the per-person cost. Results demonstrate that interventions, such as tobacco-free indoor policies, which have been shown to improve health outcomes have relatively low per-person costs and are able to reach a large number of people. Copyright © 2018 Elsevier Inc. All rights reserved.
McCool, Barent N; Lyford, Conrad P; Hensarling, Natalie; Pence, Barbara; McCool, Audrey C; Thapa, Janani; Belasco, Eric; Carter, Tyra M
Cancer risk is high, and prevention efforts are often minimal in rural communities. Feasible means of encouraging lifestyles that will reduce cancer risk for residents of rural communities are needed. This project developed and tested a model that could be feasibly adopted by rural communities to reduce cancer risk. This model focuses on incorporating multi-faceted cancer risk education in the local supermarket. As the supermarket functions both as the primary food source and an information source in small rural communities, the supermarket focus encourages the development of a community environment supportive of lifestyles that should reduce residents' risk for cancer. The actions taken to implement the model and the challenges that communities would have in implementing the model are identified.
intervention involving women's groups in Mchinji District, Malawi. The intervention was ... live below the poverty line of less than $1.25 per day and. 90.4% live below the .... (India), Salima, Kasungu, Lilongwe and Ntcheu districts. (Malawi) and ...
Kline, Emily R; Chokran, Cole; Rodenhiser-Hill, Janine; Seidman, Larry J; Woodberry, Kristen A
Many school districts in the United States employ mental health professionals to provide assessment, counselling and crisis interventions within the school setting; however, little is known about actual clinical practices of psychosis screening in schools. The aim of the present study is to examine attitudes and practices regarding psychosis screening among school mental health providers in metropolitan Boston, Massachusetts. School-based mental health clinicians (N = 100) completed an anonymous survey assessing familiarity, screening, and involvement with psychosis and psychosis risk prior to attending trainings on psychosis. Providers reported screening for psychosis less often than other mental health problems and rated themselves as less confident treating psychosis relative to other mental health concerns. Frequency of screening for psychosis was significantly associated with familiarity with psychosis assessment and case management, confidence providing treatment for individuals experiencing psychosis, and the number of students with or at risk for psychosis with whom providers had been involved. Frequency of screening for psychosis was not associated with years of practice, suggesting that both novice and experienced school-based providers may benefit from training on this issue. Community outreach via school-based provider training on assessment and management of psychosis may help to increase providers' understanding of psychosis and increase the practice of verbal or written screening for psychosis and psychosis risk within schools. © 2018 John Wiley & Sons Australia, Ltd.
... 45 Public Welfare 4 2010-10-01 2010-10-01 false How are funds for school-based service-learning... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS Distribution of Funds § 2516.600 How are funds for school-based service-learning programs distributed? (a) Of...
Dariotis, Jacinda K.; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T.; Mendelson, Tamar
Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings. PMID:28670007
Reveruzzi, Bianca; Buckley, Lisa; Sheehan, Mary
Background: This review examines the breadth of first aid training delivered to school students and the components that are age appropriate to adolescents. Method: Eligible studies included school-based first aid interventions targeting students aged between 10 and 18 years. Online databases were searched, for peer-reviewed publications available…
Thompson, John L.; And Others
The manual outlines the processes, policies, and actual program implementation of one component of a Minnesota program for emotionally disturbed adolescents (Project SAIL): the development of school-based therapy/intervention groups. The characteristics of SAIL students are described, and some considerations involved in providing group services…
Gruber, Reut; Somerville, Gail; Bergmame, Lana; Fontil, Laura; Paquin, Soukaina
The objective of this study was to develop and evaluate the effectiveness of a school-based sleep education program aimed at improving the sleep and academic performance of school-age children. Using a community-based participatory research approach, we created a school-based sleep education program, "Sleep for Success"™ (SFS), composed of four distinct modules that addressed the children, their family and community, the school staff, and decision makers within the school setting. Implementation was carried out in three elementary schools. Seventy-one students participated in the evaluation of the program. The effectiveness of the SFS program was evaluated using non-randomized controlled before-and-after study groups (intervention and control) assessed over two time points (pre- and post-program implementation). Before (baseline) and after implementation, sleep and academic performance were measured using actigraphy and report card marks, respectively. In the intervention group, true sleep was extended by 18.2 min per night, sleep efficiency improved by 2.3%, and sleep latency was shortened by 2.3 min, and report card grades in mathematics and English improved significantly. No changes were noted in the control group. Participation in the sleep education program was associated with significant improvements in children's sleep and academic performance. Copyright © 2016 Elsevier B.V. All rights reserved.
Rhodes, Scott D; Daniel, Jason; Alonzo, Jorge; Duck, Stacy; García, Manuel; Downs, Mario; Hergenrather, Kenneth C; Alegría-Ortega, José; Miller, Cindy; Boeving Allen, Alex; Gilbert, Paul A; Marsiglia, Flavio F
Our community-based participatory research partnership engaged in a multistep process to refine a culturally congruent intervention that builds on existing community strengths to promote sexual health among immigrant Latino men who have sex with men (MSM). The steps were the following: (1) increase Latino MSM participation in the existing partnership, (2) establish an Intervention Team, (3) review the existing sexual health literature, (4) explore needs and priorities of Latino MSM, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latino MSM's lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. The developed intervention contains four modules to train Latino MSM to serve as lay health advisors known as Navegantes. These modules synthesize locally collected data with other local and national data; blend health behavior theory, the lived experiences, and cultural values of immigrant Latino MSM; and harness the informal social support Latino MSM provide one another. This community-level intervention is designed to meet the expressed sexual health priorities of Latino MSM. It frames disease prevention within sexual health promotion.
Hansen-Nord, Nete Sloth; Kjaerulf, Finn; Almendarez, Juan; Rodas, Victor Morales; Castro, Julio
To examine the impact of a 3 year community-based violence prevention intervention on risk of violence and social capital in two poor urban communities in Honduras in 2011-2014. A quasi-experimental design pre and post implementation of the intervention was conducted based on data from two randomly selected samples using the same structured questionnaire in 2011 and in 2014. Community members had a 42 % lower risk of violence in 2014 compared to 2011. There was a positive relation between participation in the intervention and structural social capital, and participants had more than twice the likelihood of engaging in citizenship activities compared to the general population. The intervention contributed to decreasing violence and increasing community resilience in two urban areas in Honduras. Citizenship activities and active community participation in the violence prevention agenda rather than social trust and cohesion characteristics was affected by the intervention. This research introduces important lessons learned to future researchers aiming to retrieve very sensitive data in a similarly violent setting, and provides strong research opportunities within areas, which to this date remain undiscovered.
Background Traditional methods of process evaluation encompass what components were delivered, but rarely uncover how practitioners position themselves and act relative to an intervention being tested. This could be crucial for expanding our understanding of implementation and its contribution to intervention effectiveness. Methods We undertook a narrative analysis of in-depth, unstructured field diaries kept by nine community development practitioners for two years. The practitioners were responsible for implementing a multi-component, preventive, community-level intervention for mothers of new babies in eight communities, as part of a cluster randomised community intervention trial. We constructed a narrative typology of approaches to practice, drawing on the phenomenology of Alfred Schutz and Max Weber's Ideal Type theory. Results Five types of practice emerged, from a highly 'technology-based' type that was faithful to intervention specifications, through to a 'romantic' type that held relationships to be central to daily operations, with intact relationships being the final arbiter of intervention success. The five types also differed in terms of how others involved in the intervention were characterized, the narrative form (e.g., tragedy, satire) and where and how transformative change in communities was best created. This meant that different types traded-off or managed the priorities of the intervention differently, according to the deeply held values of their type. Conclusions The data set constructed for this analysis is unique. It revealed that practitioners not only exercise their agency within interventions, they do so systematically, that is, according to a pattern. The typology is the first of its kind and, if verified through replication, may have value for anticipating intervention dynamics and explaining implementation variation in community interventions. PMID:20003399
management, improved health systems support, and improved family and community practices, also known as Community-. IMCI (C-IMCI). Since families have the major responsibility of caring for their children, success in reducing childhood mortality and in promoting optimal growth and development of children requires a ...
Halton, Kate; Sarna, Mohinder; Barnett, Adrian; Leonardo, Lydia; Graves, Nicholas
Executive Summary Background Southeast Asia has been at the epicentre of recent epidemics of emerging and re-emerging zoonotic diseases. Community-based surveillance and control interventions have been heavily promoted but the most effective interventions have not been identified. Objectives This review evaluated evidence for the effectiveness of community-based surveillance interventions at monitoring and identifying emerging infectious disease; the effectiveness of community-based control interventions at reducing rates of emerging infectious disease; and contextual factors that influence intervention effectiveness. Inclusion criteria Participants Communities in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. Types of intervention(s) Non-pharmaceutical, non-vaccine, and community-based surveillance or prevention and control interventions targeting rabies, Nipah virus, dengue, SARS or avian influenza. Types of outcomes Primary outcomes: measures: of infection or disease; secondary outcomes: measures of intervention function. Types of studies Original quantitative studies published in English. Search strategy Databases searched (1980 to 2011): PubMed, CINAHL, ProQuest, EBSCOhost, Web of Science, Science Direct, Cochrane database of systematic reviews, WHOLIS, British Development Library, LILACS, World Bank (East Asia), Asian Development Bank. Methodological quality Two independent reviewers critically appraised studies using standard Joanna Briggs Institute instruments. Disagreements were resolved through discussion. Data extraction A customised tool was used to extract quantitative data on intervention(s), populations, study methods, and primary and secondary outcomes; and qualitative contextual information or narrative evidence about interventions. Data synthesis Data was synthesised in a narrative summary with the aid of tables. Meta-analysis was used to statistically pool quantitative results. Results
Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.
Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes
Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was
As a result, mining sites are at great risk of HIV transmission. While a ... Both quantitative and qualitative methods were used to collect data. ... The programmes carried out intervention activities which included HIV/AIDS education campaigns, ...
population was screened for hypertension, non- ... a large effect in the subgroup above the cut-off point for hypertension .... were addressed by means of posters, billboards and mailings in ... intensity intervention (UI) that focused on the use of.
Albert, David A.; McManus, Joseph M.; Mitchell, Dennis A.
School-based health centers (SBHCs) often are located in high-need schools and communities. Dental service is frequently an addition to existing comprehensive services, functioning in a variety of models, configurations, and locations. SBHCs are indicated when parents have limited financial resources or inadequate health insurance, limiting…
de Silva, AM; Hegde, S; Akudo Nwagbara, B; Calache, H; Gussy, MG; Nasser, M; Morrice, HR; Riggs, E; Leong, PM; Meyenn, LK; Yousefi-Nooraie, R
BACKGROUND: Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES: Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and period...
Department of Community Health and Primary Care, College of Medicine, University ..... Gove S. Integrated management of childhood illness by outpatient ... management guidelines for asthma and chronic heart failure, other common chronic.
Guttmacher, Sally; Kelly, Patricia J; Ruiz-Janecko, Yumary
...: diabetes, cancer, cardiovascular disease, HIV, asthma, and obesity. Following the trend begun by CDC and other agencies, the book takes a proactive and evidence-based approach reducing risk for individuals and communities...
Rasmus, Stacy M; Charles, Billy; Mohatt, Gerald V
This paper describes the development of a Yup'ik Alaska Native approach to suicide and alcohol abuse prevention that resulted in the creation of the Qungasvik, a toolbox promoting reasons for life and sobriety among youth. The Qungasvik is made up of thirty-six modules that function as cultural scripts for creating experiences in Yup'ik communities that build strengths and protection against suicide and alcohol abuse. The Qungasvik manual represents the results of a community based participatory research intervention development process grounded in culture and local process, and nurtured through a syncretic blending of Indigenous and Western theories and practices. This paper will provide a description of the collaborative steps taken at the community-level to develop the intervention modules. This process involved university researchers and community members coming together and drawing from multiple sources of data and knowledge to inform the development of prevention activities addressing youth suicide and alcohol abuse. We will present case examples describing the development of three keystone modules; Qasgiq (The Men's House), Yup'ik Kinship Terms, and Surviving Your Feelings. These modules each are representative of the process that the community co-researcher team took to develop and implement protective experiences that: (1) create supportive community, (2) strengthen families, and (3) give individuals tools to be healthy and strong.
Jayawardene, Wasantha P.; Lohrmann, David K.; YoussefAgha, Ahmed H.; Nilwala, Dayani C.
Background: Dengue fever and dengue hemorrhagic fever (DF/DHF) are epidemic and endemic in tropical and subtropical countries including Sri Lanka. Numerous structural and community interventions have been shown to be effective in interrupting the life cycle of mosquitoes that transmit DF/DHF; however, these interventions are not always implemented…
Gubbels, J.S.; Mathisen, F.K.S.; Samdal, O.; Lobstein, T.; Kohl, L.F.M.; Leversen, I.; Lakerveld, J.; Kremers, S.P.J.; Assema, P.
Background: The assessment of real-life, community-based interventions to tackle obesity is an important step in the development of effective policies. Especially multi-level interventions have a high likely effectiveness and potential reach in counteracting the obesity epidemic. Although much can
Smith, Isabel M.; Koegel, Robert L.; Koegel, Lynn K.; Openden, Daniel A.; Fossum, Kristin L.; Bryson, Susan E.
The Nova Scotia early intensive behavior intervention model--NS EIBI (Bryson et al., 2007) for children with autistic spectrum disorders was designed to be feasible and sustainable in community settings. It combines parent training and naturalistic one-to-one behavior intervention employing Pivotal Response Treatment--PRT (R. Koegel & Koegel,…
Fox, Patrick J.; Vazquez, Laurie; Tonner, Chris; Stevens, Judy A.; Fineman, Norman; Ross, Leslie K.
Using a randomized controlled trial, we tested the efficacy of a fall prevention intervention to reduce falls among adults in a community-based health promotion program. Adults aged 65 and older within two counties were recruited (control n = 257; intervention n = 286). After 12 months, there was a significant decrease in the number of falls in…
Kubik, Martha Y.; Lee, Jiwoo
Because one in three children is already overweight or obese, school-based interventions targeting secondary obesity prevention merit consideration. This study assessed parent interest in participating in a school-based, school nurse-led weight management program for young school-aged children. A random sample of parents ("n" = 122) of…
D'Oosterlinck, Franky; Broekaert, Eric
Explores the possibility of integrating school-based and therapeutic conflict management models, comparing two management models: a school-based conflict management program, "Teaching Students To Be Peacemakers"; and a therapeutic conflict management program, "Life Space Crisis Intervention." The paper concludes that integration might be possible…
Brunton, Ginny; Thomas, James; O'Mara-Eves, Alison; Jamal, Farah; Oliver, Sandy; Kavanagh, Josephine
Government policy increasingly supports engaging communities to promote health. It is critical to consider whether such strategies are effective, for whom, and under what circumstances. However, 'community engagement' is defined in diverse ways and employed for different reasons. Considering the theory and context we developed a conceptual framework which informs understanding about what makes an effective (or ineffective) community engagement intervention. We conducted a systematic review of community engagement in public health interventions using: stakeholder involvement; searching, screening, appraisal and coding of research literature; and iterative thematic syntheses and meta-analysis. A conceptual framework of community engagement was refined, following interactions between the framework and each review stage. From 335 included reports, three products emerged: (1) two strong theoretical 'meta-narratives': one, concerning the theory and practice of empowerment/engagement as an independent objective; and a more utilitarian perspective optimally configuring health services to achieve defined outcomes. These informed (2) models that were operationalized in subsequent meta-analysis. Both refined (3) the final conceptual framework. This identified multiple dimensions by which community engagement interventions may differ. Diverse combinations of intervention purpose, theory and implementation were noted, including: ways of defining communities and health needs; initial motivations for community engagement; types of participation; conditions and actions necessary for engagement; and potential issues influencing impact. Some dimensions consistently co-occurred, leading to three overarching models of effective engagement which either: utilised peer-led delivery; employed varying degrees of collaboration between communities and health services; or built on empowerment philosophies. Our conceptual framework and models are useful tools for considering appropriate and
Verheijden, M.W.; Kok, F.J.
Community-based interventions have increasingly received attention since researchers and public health professionals have come to acknowledge the importance of an environment that makes the healthy choice the easy choice. All stakeholders including the target community are involved to achieve
Randomized controlled trials are the gold standard in research but may not fully explain or predict outcome variations in community-based interventions. Demonstrating efficacy of externally driven programs in well-controlled environments may not translate to community-based implementation where resources and priorities vary. A bottom-up evaluation…
Healthcare professionals working in the community do not always prescribe oral nutritional supplements (ONS) according to best practice guidelines for the management of malnutrition. The present study aimed to determine the impact of a community dietetics intervention on ONS prescribing practices and expenditure 1 year later.
Grajo, Lenin C.; Candler, Catherine
We employed a community of practice to expand the application of the Occupation and Participation Approach to Reading Intervention (OPARI) and build the capacity of practitioners to support children with reading difficulties. Twelve pediatric practitioners participated in a community of practice for 7 months. We used a one…
Laura E. Bruno
Conclusions: Opportunities to participate in a community based intervention program should be extended throughout all communities in an effort to improve holistic well-being. Further, type and duration as well as point of data collection of such programs should be differentiated in future research.
To determine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. A three-year experimental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Cameroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. With the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problems with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.
Richard E Sanya
Full Text Available Praziquantel-based mass treatment is the main approach to controlling schistosomiasis mansoni in endemic areas. Interventions such as provision and use of safe water, minimising contact with infested water, disposal of stool in latrines and snail control provide key avenues to break the transmission cycle and can sustain the benefits of mass treatment in the long term. Efforts are also being made to develop a schistosomiasis vaccine which, if effective, might reduce the incidence of re-infection after treatment. However, any interventions deployed need to be acceptable to, and sustainable by, the target communities.In this qualitative study, we investigated the perceptions of six Lake Victoria island communities of Koome, Uganda, about interventions to control Schistosoma mansoni infection and their willingness to participate in Schistosoma vaccine trials. Thirty-two in-depth interviews, 12 key informant interviews and 10 focus group discussions were conducted. Data were analysed using a thematic content approach.Intestinal schistosomiasis was not regarded as a serious health problem because a mass treatment programme is in place. However, the communities lack safe water sources and latrines. Mass treatment with praziquantel, safe water supplies and use of toilets were deemed the most acceptable interventions by the participants. The communities are willing to participate in Schistosoma vaccine trials.Knowledge of a community's perception about interventions to control schistosomiasis can be valuable to policy makers and programme implementers intending to set up interventions co-managed by the community members. In this study, the views of the Lake Victoria island communities of Koome are presented. This study also provides data to guide further work on alternative interventions such as Schistosoma vaccine trials in these communities.
Sanya, Richard E; Tumwesige, Edward; Elliott, Alison M; Seeley, Janet
Praziquantel-based mass treatment is the main approach to controlling schistosomiasis mansoni in endemic areas. Interventions such as provision and use of safe water, minimising contact with infested water, disposal of stool in latrines and snail control provide key avenues to break the transmission cycle and can sustain the benefits of mass treatment in the long term. Efforts are also being made to develop a schistosomiasis vaccine which, if effective, might reduce the incidence of re-infection after treatment. However, any interventions deployed need to be acceptable to, and sustainable by, the target communities. In this qualitative study, we investigated the perceptions of six Lake Victoria island communities of Koome, Uganda, about interventions to control Schistosoma mansoni infection and their willingness to participate in Schistosoma vaccine trials. Thirty-two in-depth interviews, 12 key informant interviews and 10 focus group discussions were conducted. Data were analysed using a thematic content approach. Intestinal schistosomiasis was not regarded as a serious health problem because a mass treatment programme is in place. However, the communities lack safe water sources and latrines. Mass treatment with praziquantel, safe water supplies and use of toilets were deemed the most acceptable interventions by the participants. The communities are willing to participate in Schistosoma vaccine trials. Knowledge of a community's perception about interventions to control schistosomiasis can be valuable to policy makers and programme implementers intending to set up interventions co-managed by the community members. In this study, the views of the Lake Victoria island communities of Koome are presented. This study also provides data to guide further work on alternative interventions such as Schistosoma vaccine trials in these communities.
Joshi, Shashank V; Hartley, Samantha N; Kessler, Moira; Barstead, Maura
Suicide is a leading cause of preventable death in youth, and numerous curricula and other prevention and intervention programs have been developed in the last 15 years. Comprehensive suicide prevention planning should include the 4 components of health promotion, prevention/education, intervention, and postvention. School-based suicide prevention and mental health education programs have become more common as an efficient and cost-effective way to reach youth. Process considerations that are based on the principles of therapeutic engagement with patients and families can provide mental health professionals with strategies that can assist education professionals, students, and the larger school community simultaneously. Copyright © 2015 Elsevier Inc. All rights reserved.
Morais Ximenes, Verônica; Universidade Federal do Ceará; Camurça Cidade, Elívia; Universidade Federal do Ceará.; Barbosa Nepomuceno, Bárbara; Universidade Federal do Ceará.
The purposeis to analyze, from Community Psychology’s perspective, psychosocial expressions of poverty and their contributions for intervention in public policy. Community Psychology accents the critique about the factors that maintain those material and symbolic aspects that interfere with the subjective constitution of the poor. Exploratory research, quantitative and qualitative, was conducted with 417 adult subjects of a rural and urban community in Brazil. Poverty involves moral explanati...
Denise L Buchner
Full Text Available Integrated community case management (iCCM involves delivery of simple medicines to children with pneumonia, diarrhea and/or malaria by community health workers (CHWs. Between 2010 and 2012, an iCCM intervention trial was implemented by Healthy Child Uganda. This study used qualitative tools to assess whether project stakeholders perceived that iCCM improved access to care for children under five years of age.The intervention involved training and equipping 196 CHWs in 98 study villages in one sub-county in Uganda in iCCM. During the eight-month intervention, CHWs assessed sick children, provided antimalarials (coartem for fever, antibiotics (amoxicillin for cough and fast breathing, oral rehydration salts/zinc for diarrhea, and referred very sick children to health facilities. In order to examine community perceptions and acceptability of iCCM, post-intervention focus groups and key respondent interviews involving caregivers, health workers, CHWs and local leaders were carried out by experienced facilitators using semi-structured interview guides. Data were analyzed using thematic analysis techniques.Respondents reported increased access to health care for children as a result of iCCM. Access was reportedly closer to home, available more hours in a day, and the availability of CHWs was perceived as more reliable. CHW care was reported to be trustworthy and caring. Families reported saving money especially due to reduced transportation costs, and less time away from home. Respondents also perceived better health outcomes. Linkages between health facilities and communities were reportedly improved by the iCCM intervention due to the presence of trained CHWs in the community.iCCM delivered by CHWs may improve access to health care and is acceptable to families. Policymakers should continue to seek opportunities to implement and support iCCM, particularly in remote communities where there are health worker shortages.
Martin, Molly A; Rothschild, Steven K.; Lynch, Elizabeth; Christoffel, Katherine Kaufer; Pag?n, Militza M.; Rodriguez, Jose Luis; Barnes, Anna; Karavolos, Kelly; Diaz, Antonieta; Hoffman, Lucretia M.; Plata, Diana; Villalpando, Sandra
Background The objective of this study was to design and test the feasibility and impact of a community health worker (CHW) intervention for comorbid asthma and obesity. Methods Using a proof of concept study design, we collected pre/post outcomes from a single intervention cohort of urban low-income in a single community area. A community-based participatory research approach was employed. Forty-six children and their caregivers were recruited. Children were 5?12 years old with physician-dia...
Bzowyckyj, Andrew S; Dow, Alan; Knab, Mary S
Health professions education programs can have direct effects on patients and communities as well as on learners. However, few studies have examined the patient and community outcomes of educational interventions. To better integrate education and health care delivery, educators and researchers would benefit from a unifying framework to guide the planning of educational interventions and evaluation of their impact on patients.The authors of this Perspective mirrored approaches from Miller's pyramid of educational assessment and Moore and colleagues' framework for evaluating continuing professional development to propose a conceptual framework for evaluating the impact of educational interventions on patients and communities. This proposed framework, which complements these existing frameworks for evaluating the impact of educational interventions on learners, includes four levels: (1) interaction; (2) acceptability; (3) individual outcomes (i.e., knowledge, skills, activation, behaviors, and individual health indicators); and (4) population outcomes (i.e., community health indicators, capacity, and disparities). The authors describe measures and outcomes at each level and provide an example of the application of their new conceptual framework.The authors encourage educators and researchers to use this conceptual framework to evaluate the impact of educational interventions on patients and to more clearly identify and define which educational interventions strengthen communities and enhance overall health outcomes.
Rotheram-Borus, M J; Rebchook, G M; Kelly, J A; Adams, J; Neumann, M S
Long-term collaborations among researchers, staff and volunteers in community-based agencies, staff in institutional settings, and health advocates present challenges. Each group has different missions, procedures, attributes, and rewards. This article reviews areas of potential conflict and suggests strategies for coping with these challenges. During the replication of five effective HIV prevention interventions, strategies for maintaining mutually beneficial collaborations included selecting agencies with infrastructures that could support research-based interventions; obtaining letters of understanding that clarified roles, responsibilities, and time frames; and setting training schedules with opportunities for observing, practicing, becoming invested in, and repeatedly implementing the intervention. The process of implementing interventions highlighted educating funders of research and public health services about (a) the costs of disseminating interventions, (b) the need for innovation to new modalities and theories for delivering effective interventions, and (c) adopting strategies of marketing research and quality engineering when designing interventions.
Waylen, Kerry A; Fischer, Anke; McGowan, Philip J K; Thirgood, Simon J; Milner-Gulland, E J
Conservation interventions require evaluation to understand what factors predict success or failure. To date, there has been little systematic investigation of the effect of social and cultural context on conservation success, although a large body of literature argues it is important. We investigated whether local cultural context, particularly local institutions and the efforts of interventions to engage with this culture significantly influence conservation outcomes. We also tested the effects of community participation, conservation education, benefit provision, and market integration. We systematically reviewed the literature on community-based conservation and identified 68 interventions suitable for inclusion. We used a protocol to extract and code information and evaluated a range of measures of outcome success (attitudinal, behavioral, ecological, and economic). We also examined the association of each predictor with each outcome measure and the structure of predictor covariance. Local institutional context influenced intervention outcomes, and interventions that engaged with local institutions were more likely to succeed. Nevertheless, there was limited support for the role of community participation, conservation education, benefit provision, and market integration on intervention success. We recommend that conservation interventions seek to understand the societies they work with and tailor their activities accordingly. Systematic reviews are a valuable approach for assessing conservation evidence, although sensitive to the continuing lack of high-quality reporting on conservation interventions.