Global Mapping of Evidence on Vaccination Related Education Through School Based Curriculum

Background: Vaccine hesitancy, associated with medical mistrust, confidence, complacency and knowledge of vaccines, presents an obstacle to the campaign against the coronavirus disease 2019 (COVID-19). The relationship between vaccine hesitancy and conspiracy beliefs may be a key determinant of the success of vaccination campaigns. This study provides a conceptual framework to explain the impact of pathways from conspiracy beliefs to COVID-19 vaccine hesitancy with regard to medical mistrust, confidence, complacency and knowledge of vaccines. Methods: A non-probability study was conducted with 1015 respondents between 17 April and 28 May 2021. Conspiracy beliefs were measured using the coronavirus conspiracy scale of Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS), and vaccine conspiracy beliefs scale. Medical mistrust was measured using the Oxford trust in doctors and developers questionnaire, and attitudes to doctors and medicine scale. Vaccine confidence and complacency were measured using the Oxford COVID-19 vaccine confidence and complacency scale. Knowledge of vaccines was measured using the vaccination knowledge scale. Vaccine hesitancy was measured using the Oxford COVID-19 vaccine hesitancy scale. Confirmatory factor analysis (CFA) was used to evaluate the measurement models for conspiracy beliefs, medical mistrust, confidence, complacency, and knowledge of vaccines and vaccine hesitancy. The structural equation modeling (SEM) approach was used to analyze the direct and indirect pathways from conspiracy beliefs to vaccine hesitancy. Results: Of the 894 (88.1%) respondents who were willing to take the COVID-19 vaccine without any hesitancy, the model fit with the CFA models for conspiracy beliefs, medical mistrust, confidence, complacency and knowledge of vaccines, and vaccine hesitancy was deemed acceptable. Conspiracy beliefs had significant direct (β = 0.294), indirect (β = 0.423) and total (β = 0.717) effects on vaccine hesitancy; 41.0% of the total effect was direct, and 59.0% was indirect. Conspiracy beliefs significantly predicted vaccine hesitancy by medical mistrust (β = 0.210), confidence and complacency (β = 0.095), knowledge (β = 0.079) of vaccines, explaining 29.3, 11.0, and 13.2% of the total effects, respectively. Conspiracy beliefs significantly predicted vaccine hesitancy through the sequential mediation of knowledge of vaccines and medical mistrust (β = 0.016), explaining 2.2% of the total effects. Conspiracy beliefs significantly predicted vaccine hesitancy through the sequential mediation of confidence and complacency, and knowledge of vaccines (β = 0.023), explaining 3.2% of the total effects. The SEM approach indicated an acceptable model fit (χ2/df = 2.464, RMSEA = 0.038, SRMR = 0.050, CFI = 0.930, IFI = 0.930). Conclusions: The sample in this study showed lower vaccine hesitancy, and this study identified pathways from conspiracy beliefs to COVID-19 vaccine hesitancy in China. Conspiracy beliefs had direct and indirect effects on vaccine hesitancy, and the indirect association was determined through medical mistrust, confidence, complacency, and knowledge of vaccines. In addition, both direct and indirect pathways from conspiracy beliefs to vaccine hesitancy were identified as intervention targets to reduce COVID–19 vaccine hesitancy.

The Healthy School Project in Yugoslavia was established in 1992 and was being implemented until 1996; it included 13 elementary schools in Serbia and Montenegro. On the occasion of 20 years since the completion of the implementation of the Healthy School project activities, the author in his article writes about the events and activities related to the realisation of the afore-mentioned project. In order to have successful health promotion in elementary schools, the author draws attention to the results achieved in the realization of the Yugoslav Healthy School Project, a project of NEW HEALTH EDUCATION AND PROMOTION in schools. Systematic work on health education in schools is the only way to achieve good results in the expansion of the concept of health and health education, to improve health vocabulary, hygienic conditions and health status of pupils, to improve the quality of pupils' nutrition, to contribute to the progress in the field of sexual development, better communication among teachers, pupils and parents in schools and to enhance health habits of pupils, teachers and parents in schools.

Background: Many factors in Saudi society have led to the need for health education services in schools, while concerns related to the role of health educators in schools still unclear. The aim of this study was to analyze the role of health educators in public schools exploring the obstacles which affect their role. Subjects and Methods: A cross-section design was used; data were collected using self-administered questionnaire which consisted of four parts: covered demographic data, roles of health educators, the obstacles that affect them, and the attitudes regarding their role. A sample of 234 health educators working in public schools in Riyadh city participated in the study. Descriptive statistics and a Chi-square test were used for data analysis. Results: The results showed that the mean age of the participants was 40.31 years. There was no statistically significant difference between males and females in performing the majority of roles related to implementing health education activities in their schools, while there was a statistically significant difference between elementary, middle, and secondary schools in performing most of these roles. There are many obstacles that affect the role of health educators in public schools, while they have a positive attitude regarding their role with a mean score of 2.58 ± 0.28. Conclusion: The findings revealed that health educators in public schools face many obstacles when implementing health education activities which negatively impact on the health promotion of school children. The attitude of health educators was positive, indicating that they like their role; therefore, they need more training programs to be well prepared in order to perform their role effectively.

Background Schools struggle to timetable health education. Interventions integrating academic and health education to reduce substance use and violence offer promise. No current systematic reviews examine such interventions. Objectives To review evidence to explore the following questions: (1) what types of interventions integrating health and academic education in schools serving those aged 4–18 years have been evaluated? (2) What theories of change inform these interventions? (3) What factors facilitate or limit the successful implementation and receipt of such interventions, and what are the implications for the delivery of such implementations in the UK? (4) How effective are such interventions in reducing smoking and violence and the use of alcohol and drugs, and at increasing attainment? Does this vary by students’ sociodemographic characteristics? (5) What factors appear to influence the effectiveness of such interventions? Data sources In total, 19 databases were searched from 18 November to 22 December 2015, updating searches for outcome evaluations for violence on 28 February 2018 and for substance use on 14 May 2018. References were extracted from included studies and authors contacted. Review methods Included studies reported on theories of change, and process or outcome evaluations of interventions that integrated academic and health education to reduce substance use and/or violence. References were screened on the title/abstract and then on the full report. Data extraction and appraisal used Cochrane, Evidence for Policy and Practice Information Centre and other established tools. Theories of change and process data were qualitatively synthesised. Outcome evaluations were synthesised narratively and meta-analytically. Results In total, 78,451 unique references were originally identified and 62 reports included. Search updates on 28 February and 14 May 2018 retrieved a further 2355 and 1945 references, respectively, resulting in the inclusion of six additional reports. Thirty-nine reports described theories, 16 reports (15 studies) evaluated process and 41 reports (16 studies) evaluated outcomes. Multicomponent interventions are theorised to erode ‘boundaries’ (strengthen relationships) between academic and health education, teachers and students, behaviour in classrooms and in the wider school, and schools and families. Teachers, pro-social peers and parents are theorised to act as role models and reinforcers of healthy behaviours learnt in lessons. There was clear evidence that interventions are facilitated by supportive senior management and alignment with the schools’ ethos, collaborative and supportive teaching environments, and positive pre-existing student, teacher and parent attitudes towards interventions. The barriers were overburdened teachers who had little time to both learn and implement integrated curricula. The strongest evidence for effectiveness was found for the reduction of substance use in school key stages (KSs) 2 and 3. For example, a meta-analysis for substance use at KS3 reported a mean difference of –0.09 (95% confidence interval –0.17 to –0.01). A meta-analysis for effectiveness in reducing violence victimisation in KS2 found no effect. There was mixed evidence for effects on academic outcomes, with meta-analysis precluded by methodological heterogeneity. Limitations Study quality was variable. Integration was sometimes not emphasised in theories of change. Conclusions These interventions are undertheorised but involve multiple forms of boundary erosion. There is clear evidence of characteristics affecting implementation. Interventions are likely to have the greatest impact on substance use. These programmes may be effective in reducing substance use but do not appear to reduce violence and findings on educational impacts are mixed. Future work Future evaluations should assess interventions with clearer theories of change and examine academic outcomes alongside violence and substance use outcomes. Study registration This study is registered as PROSPERO CRD42015026464. Funding The National Institute for Health Research Public Health Research programme.

School-age youth constitute a neglected but highly vulnerable group concerning sexual health risks in low-resource countries. Robust evidence concerning the research landscape of school-based interventions on human papillomavirus in Africa is currently lacking. Therefore, this systematic scoping review (SSR) aims to map evidence about school-based HPV interventions and identify emerging themes, gaps and lessons learned in Africa. This review was guided by Joanna Brigg’s Institute’s guidelines for SSRs and reported based on the Preferred Reporting Items for Systematic Reviews and Metanalysis for Scoping Reviews. Five databases—PubMed, CINAHL, PsycINFO, SCOPUS, and Allied and Complementary Medicine—were searched for relevant literature using appropriate search terms and Boolean operators. The retrieved literature was extracted, deduplicated and screened using the Rayyan software. Only those articles which met the eligibility criteria were included for data charting, collation, and summarization. Ten articles were included in this review. The articles demonstrate that a life-course approach is significant in health intervention. School-based health interventions help reach adolescents in a dynamic life stage, affecting their vulnerability to sexual health risks. The school-based interventions serve as an ideal platform to offer HPV peer education, improving their HPV knowledge and subsequent testing services and enhancing their acceptability for screening and vaccination. Cervical cancer education and screening can be effectively combined in HPV health services for women. While the studies are geographically diverse, such effective interventions, which help reduce bottlenecks in accessing HPV screening and vaccination, are very few in Africa. In conclusion, school-based intervention is a viable strategy that can be adopted for adolescent protection from HPV-induced diseases. However, the current evidence on the impact of these interventions, particularly HPV vaccination, is inadequate.

A qualitative improvement in school health education is required to improve health for school-aged children in developing countries. This study aimed to clarify the factors that enable the provision of comprehensive and consistent health education in Japan. We reviewed health education in Japanese schools and the feature of curriculum revision, and clarified the factors that enable the provision of comprehensive and consistent health education. We identified nine points as enabling factors: (i) clear description of the purpose of health education; (ii) clear provision of teaching content and adequate time allocation; (iii) comprehensive school health framework and clarification of the position of the health education; (iv) systems for surveying and screening children's health problems; (v) regular revising of the Courses of Study; (vi) well trained teachers responsible for health education; (vii) health education specialists in higher education facilities; (viii) various materials related to health education; and (ix) collaboration with related health workers. We proposed measures to enhance health education in developing countries: (i) clarifying the role of health education toward achieving goals set out in laws and policies related to education; (ii) providing appropriate learning content and time allocation; (iii) establishing a comprehensive school health framework; (iv) establishing a system that continuously monitors children's health issues; (v) identifying the person responsible for health education in a school and establishing a training system; (vi) providing a teacher's guide and teaching materials to facilitate child participatory learning, and (vii) collaborating with guardians, community members, and local health workers.

The primary objective of this paper was to determine the factors that affects health instruction in secondary schools in Edo State, Nigeria. The descriptive survey research method was used for the study and data were analyzed descriptively using frequency count and percentages. The results of the study reveals that school principals negative administrative styles and the inadequacy of duration/time allotted to health instruction in the schools were critical factors that affects health instruction in Edo State secondary schools. The study equally show that lack of health education teachers, lack of relevant health education textbooks, pamphlets and posters were factors central to the poor state of health instruction in Edo State secondary schools. Based on the findings, the authors made several recommendations including the need for school authorities in Edo State to provide relevant and modern textbooks, pamphlets, posters, computers and other related instructional materials. It was also recommended that the State's Ministry of Education should help in enhancing the tenets of health education by posting at least one experienced health education staff in the Inspectorate Division of the Ministry had been assigned the responsibility of visiting the schools regularly in order to ensure that the schools, students and teachers are adequately implementing the health education curriculum.

Evaluation of a Health and Nutrition Education Program in Primary School Children of Crete over a Three-Year Period

"Physical-Medical Integration" combines sports science and medical disease prevention, supporting the "Healthy China 2030" strategy. Health education, originating from medicine, is vital for promoting youth health knowledge and is key to integrating with school sports. This study examines the challenges and solutions of combining school sports and health education under this integration. The study uses literature review, mathematical analysis, and logical reasoning. Core journal papers from databases like CNKI, Wanfang, and VIP were analyzed using keywords like "Physical-Medical Integration," "Health Education," and "School Sports" (2000-2025). CiteSpace is used for keyword clustering to support challenge diagnosis. The study also compares policy evolution and international experiences to propose solutions for the coupling of school sports and health education. (1) Health Education Analysis: From 2000 to 2025, "mental health" and "social health" co-occurred in only 18.7% of papers, much lower than "physical health" at 61.3%. Policy comparison shows China's focus on disease prevention and sports skills, while the U.S. emphasizes mental health and social adaptability, requiring them to account for at least 40%. (2) Cross-departmental Collaboration: Only 9.5% of 42 policy documents address inter-departmental cooperation, mostly in vague terms. Data sharing between education and health sectors is just 22.4%, leading to "information silos." (3) Pre-service Teacher Training: Medical courses in China's physical education programs are under 5%, while U.S. universities include "sports medicine" and "public health" as required courses (15%-20%). (4) Health Education Evaluation: Keywords like "health literacy" and "behavioral intervention" have increased since 2016, but policy development of evaluation tools and standardized guidelines is still behind. Conclusions: (1) Coupling Challenges: 1. Health education in school sports lacks "localization" and focuses too much on physical health, conflicting with the three-dimensional health model. 2. Poor coordination between education, sports, and health departments hinders interdisciplinary integration. 3. Gaps between physical and medical health education create a shortage of interdisciplinary talent. 4. Health education outcomes are not reflected in school sports evaluations. (2) Strategies: 1. Strengthen "three-dimensional" health education by increasing focus on mental and social health in curricula. 2. Establish a joint health education office for education, sports, and health departments to develop regional standards and policies. 3. Add medical courses related to health education in physical education programs and pilot joint "health education" minors. 4. Develop a multidimensional health education evaluation framework using physical, psychological, and behavioral indicators.

This investigation investigates the critical role of improving public health education in Nigerian schools to address deficiencies in health literacy, disease prevention, and sanitation. In Nigeria, preventable maladies, such as malaria, cholera, and diarrhea, are a significant public health concern. This is exacerbated by a dearth of health information and poor hygiene habits among the populace. The research identifies the primary challenges associated with the current school health education framework, including inadequate curricular integration, inadequate teacher preparation, substandard school infrastructure, and limited community involvement. It posits that schools, as fundamental institutions in child development, offer a critical framework for the development of enduring health behaviors and practices. The document underscores the necessity of a comprehensive strategy for public health education in institutions. This strategy should encompass curriculum modifications, teacher training, school building enhancements, and collaborative efforts with parents, communities, and health professionals. The proposed reforms aim to cultivate a sustainable and effective school health education system by incorporating community-oriented techniques, digital resources, and experiential learning. This study underscores the importance of recognizing school-based health education as a fundamental factor that impacts national health security and long-term sustainable development in Nigeria, rather than solely as an ancillary component. The study adopts the Socio-Ecological Model (SEM) as its conceptual framework, providing a multilevel lens to analyze individual, interpersonal, institutional, community, and policy influences on school health education. In the end, the improvement of health education in schools will result in the development of a healthier cohort of students who are capable of contributing to the improvement of public health outcomes in their communities.

Background: Offshore oil‑and‑gas installations are high-risk, high-mobility environments where infectious‑disease outbreaks can rapidly disrupt operations. Effective COVID-19 vaccination depends not only on vaccine availability but also on workers’ knowledge of the vaccine and their perceptions of its safety and value. Objective: To assess the level of factual knowledge about, and attitudinal perceptions toward, the COVID-19 vaccine among offshore oil‑and‑gas workers in Nigeria. Methods: A facility-based cross-sectional survey was conducted among 295 offshore oil and gas workers. Data on knowledge and perception of the COVID-19 vaccine were obtained from modifying the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) tool on vaccine hesitancy. Knowledge of the COVID-19 vaccine was assessed using seven structured items. A composite knowledge score ranging from 0 to 7 was calculated for each respondent, with scores of 4 or higher indicating good knowledge. The perception of the COVID-19 vaccine was measured using eight statements, each rated on a five-point Likert scale (1 = strongly disagree to 5 = strongly agree), with higher scores indicating more favorable perceptions. Respondents with mean scores of 3.0 or higher were classified as having a positive perception. Descriptive statistics were used to summarize the data. Results: The mean knowledge score was 4.6 ± 1.6; 55.6 % of respondents met the threshold for good knowledge. The highest mean scores were recorded for items related to antibody production (0.76) and WHO approval (0.73), whereas the route of administration was the least understood (0.45). The mean perception score was 2.89 ± 0.71; 47.1 % of workers held a positive perception. Conclusion: Offshore personnel demonstrated moderate knowledge of COVID-19 vaccines, yet fewer than half expressed positive perceptions. Targeted, work‑site-specific education that clarifies vaccine administration and safety evidence is warranted to bridge this knowledge–perception gap and support sustained immunization uptake in the sector.

In pediatric clinical practice, it is found that common and frequently-occurring diseases in children have the characteristics of acute onset, rapid change, aggregation and being preventable and controllable. School health education is particularly important for the prevention and control of common and frequently-occurring diseases in preschool and school-age children. School health education refers to the combination of kindergarten, school and other places of staff advocated by the various learning experience, the development of students from now on to learn to deal with various expected health challenges with necessary cognitive skills and behavioral skills. The former State Education Commission and the Ministry of Health jointly promulgated the "Regulations on School Health Work" in 1980, making our country's school health work followed by regulations. In 1992, the "Basic Requirements for Health Education for Primary and Secondary School Students" was jointly promulgated, which clearly stipulated the objectives and basic contents of health education in primary and secondary schools in China. In 2007, the Central Committee of the Communist Party of China and the State Council in the `Opinions on Strengthening Youth Sports to Enhance the Physical Fitness of Adolescents (Central Document No.7)' required that 'local education administrative departments should include the implementation of health education in schools as one of the important indicators of school supervision and assessment', and 'schools at all levels should actively carry out adolescent health education activities such as disease prevention, scientific nutrition, health and safety, drug control and tobacco control, and ensure the necessary health education time'. Although the health problems of primary and middle school students have received continuous attention and investment from the state and society, the health literacy of primary and middle school students in China has not been significantly improved in recent years, and the overall downward trend of students' health level has not been fundamentally curbed, partly due to China's lagging school health education system. Through literature mining, this paper refines the research focus of foreign health education and the challenges faced by foreign health education. By combing the research progress of health behavior and academic performance, adolescent media cognitive ability and health education workers' health cognitive ability, it reflects the future research direction of health education in China.

A variety of legislation, initiatives and organizations exist to support, encourage and even oblige schools to collaborate more effectively with parents or guardians. However, there is minimal understanding of the experiences and opinions of parents and school staff about their roles, especially in relation to children's health education. This study examined how parents of 10-11-year-old children perceive the roles of both home and school in educating children about health. A questionnaire, based partly on the Finnish national core curriculum for basic education, was administered to 348 parents; the response rate was 53%. Factor analysis was used to define sum variables, which were then used as dependent variables in an analysis of variance examining the effects of children's gender and health; parents' education, gender, work status and year of birth; and school location (urban/rural). The results suggested that parents considered that either health education was mainly their responsibility, or it was a mutual responsibility with the school. Parents living in rural areas and the youngest group of parents were more likely to consider that health education should be shared with schools than were parents living in cities, or older parents. To expand awareness about the role of home and school in children's health education and to develop further health promotion within the whole school community, it is important to gather parents' views regarding health issues. This study was conducted as part of a broader program in the health promotion network of the Schools for Health in Europe (SHE).

BackgroundAdolescence is a period marked by critical changes in behaviours and body composition that place adolescents at an increased risk of becoming overweight and obese. Health education in schools has...

Background Increasingly constrained school timetables mean that there is often little space for specifically timetabled health education lessons. Interventions that integrate health education into academic lessons may prove more appealing to schools, and may be a promising means of addressing outcomes such as violence and substance use while also promoting academic attainment. This evidence has not yet been systematically reviewed. We synthesised evidence for these interventions’ effectiveness and analysed their components. Methods We searched 19 bibliographic databases and 32 websites. References were extracted from the reference lists of included studies and authors were contacted.We included reports with no restrictions on language or date. References were screened on title/abstract and those passing this screening were then screened on full report. Data extraction and appraisal were informed by the Cochrane risk of bias tool. Outcome evaluations were synthesised by key stage (KS) using multilevel meta-analysis where possible; otherwise, evidence was narratively synthesised. Components were analysed inductively. This study is registered as PROSPERO 2015:CRD42015026464. Results 78 451 unique references were identified, of which 35 (13 studies) evaluated outcomes. Quality of evidence was highly variable, and often related to whether meta-analysis was possible. The strongest evidence for the effectiveness of interventions integrating academic and health education was found in the reduction of substance use in KS2 and KS3, and a meta-analysis for the effectiveness of these interventions in reducing violence victimisation in KS2 did not find an effect. We described intervention components in terms of a) the number of domains (school, classroom, family) targeted, b) the planned duration of the intervention, c) how integration was specified (using literature, teaching study skills, supporting teachers to integrate in their own classrooms). Discussion There is under-theorisation and understanding of characteristics affecting implementation of integrated academic and health curricula as well as appreciation of how academic attainment and reduced risk-taking may be linked. However, available data suggest that multi-level interventions that aim to erode boundaries—or rather, strengthen pro-social relationships—between academic and health curricula, teachers and students, classrooms and schools and schools and families are likely to have the greatest impact on reducing risk-taking and improving academic outcomes. These programmes may be effective in reducing substance use but do not appear to reduce outcomes related to violence.