Health Promoting School Initiative Research Articles

Bridging the SEL CASEL Framework with European educational policies and assessment approaches

The importance of enhancing social and emotional skills in educational settings has gained prominence, with many countries and organizations embracing the Social and Emotional Learning (SEL) framework to equip individuals with the tools needed for shaping a self-identity, emotional regulation, goal achievement, empathy, nurturing relationships, and responsible decision-making and overall well-being. In this paper, we aim to connect the globally acknowledged Collaborative for Academic, Social, and Emotional Learning SEL framework with international policies that underscore the importance of social and emotional skills in the school context. To accomplish this goal, we first provide a brief overview of the key components of the SEL framework. Subsequently, we explore two significant educational policies within the European context. The first policy is the World Health Organization Health Promoting Schools initiative. We present its objectives, a WHO-affiliated program example, the promoted and assessed competencies of students, and its results, connecting its framework with the CASEL SEL approach. The second focus is the Organisation for Economic Co-operation and Development Study on Social and Emotional Skills, describing its developmental process and the assessment framework. Finally, we describe the alignment of SEL with these European educational policies and illustrate their role in advancing and improving the evaluation of SEL initiatives in educational environments.

The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future.

Background: The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children’s health and health behaviors. Methods: The study used a mixed-methods design. The school context (n = 4) was assessed by the characteristics of the school population, teacher’s health-promoting (HP) practices, implementers’ perceived barriers, school’s HP elements, and dominating organizational issues. Outcomes included objectively assessed BMI z-scores and physical activity (PA), and parent and child-reported dietary intake. Analyses included linear mixed models (four intervention schools versus four control schools), and qualitative comparisons between intervention schools with similar HP changes. Results: Effects on outcomes varied considerably across schools (e.g., range in effect size on light PA of 0.01–0.26). Potentially moderating contextual aspects were the child’s socioeconomic background and baseline health behaviors; practices and perceived barriers of employees; and organizational issues at a school level. Conclusions: Similar HP changes lead to different outcomes across schools due to differences in the school context. The adoption of a complex adaptive systems perspective contributes to a better understanding of the variation in effects and it can provide insight on which contextual aspects to focus on or intervene in to optimize the effects of HP initiatives.

ENGAGING YOUTH AS AGENTS FOR CHANGE: HEALTH PROMOTING SCHOOLS POSITIVELY IMPACT KNOWLEDGE, BEHAVIORS AND MORBIDITY FROM MALARIA

Abstract BACKGROUND: Schools in low/middle income countries (LMICs) traditionally send home children found sick in class devolving subsequent care to parents. Where malaria is endemic this infection is the principal reason a child will miss school and morbidity is high as the majority of parents in LMICs fail to access WHO-endorsed diagnosis and treatment. OBJECTIVES: Post intervention evaluation of using the WHO Health Promoting School (HPS) model to engage and inform pupils in rural Uganda about malaria, and empower teachers to provide rapid diagnostic testing (RDT) and treatment with artemesinin combination therapy (ACT). Our hypothesis was that this would reduce morbidity from malaria and also generate a sustained increase in knowledge and long term change in behavior. DESIGN/METHODS: This 2 year project was evaluated 12 months after delivery. In year 1 (pre-intervention) we had established malaria-focused WHO HPS activities in 4 primary schools; evaluated children’s knowledge and parents’ behavior re febrile illness; introduced peer to peer learning via youth ‘champions’; monitored days of absence from school (as a surrogate for morbidity); trained teachers to identify probable infectious illness and how to provide RDT and ACT. In year 2 (intervention) trained volunteer teachers added RDT evaluation of all children found sick at school and treated those positive with ACT. Now schools independently continue the RDT/ACT program and maintain an educational focus on malaria with youth champion involvement. RESULTS: Pre-intervention <1:5 of 1764 pupils had basic knowledge about malaria (caused by mosquitos; can be prevented; requires rapid diagnosis and effective medication). In year 1 953 of the 1764 pupils were sent home due to illness; parents only took 1:4 to clinics for diagnosis or anti-malarial treatment. Mean duration of absence was 6.5 (SD 3.17) school days. In year 2 1066/1774 pupils were sick, all had teacher administered RDT, 765/1066 (68%) tested positive for malaria and received ACT; their duration of absence fell to 0.59 (SD 0.64) school days (p<0.001), and overall absence decreased to 2.55 days from 6.5 in year 1 (p<0.001). By year 2 all children knew the signs and symptoms of malaria and had essential epidemiological knowledge. Twelve months post intervention the universality of this knowledge has been sustained in spite of new enrollment, the whole school focus on malaria continues. Children report better health, consistent attendance and improved academic achievement; they pass key health knowledge to new pupils and have now become proactive in prevention strategies and 6% fewer test positive for malaria. CONCLUSION: WHO HPS initiatives generate new knowledge and health practices that change behaviors. Youth ‘champions’ (school-aged leaders trained by local health care professionals) contribute by engaging pupils in health promotion through peer-to-peer activities. Morbidity from malaria was improved by providing HPS activities that included RDT/ACT use by teachers and children gained new knowledge. Post-intervention the health ethos of the schools has changed, children’s knowledge and behaviors remain enhanced and malaria awareness is greater in the broader community. Our model is a community empowerment approach applicable to other low-resource settings worldwide where malaria is endemic and morbidity high.

Evaluation of a health promoting schools program in a school board in Nova Scotia, Canada.

A Health promoting schools (HPS) approach aims to make schools a healthy place through a holistic approach that promotes a supportive ‘school ethos’ and emphasizes improvements in physical, social, and emotional well-being and educational outcomes. A HPS initiative in rural Nova Scotia (Canada) provided an opportunity for a population-level natural experiment. This study investigated student well-being and health behaviours between schools with and without HPS implementation and schools with high and low school ethos scores.Student well-being, nutrition, and physical activity were examined in a cross-sectional survey of elementary students in Nova Scotia, Canada in 2014. Multiple regression was used to assess the relationship with student well-being using the Quality of Life in School (QoLS) instrument and health behaviours. The main exposure was attending one of the 10 HPS schools; secondary exposure was the school ethos score.The overall QoLS score and its subdomain scores in the adjusted models were higher in students attending HPS schools compared to those in non-HPS schools, but the differences were not statistically significant and the effect sizes were small. Students in schools that scored high on school ethos score had higher scores for the QoLS and its subdomains, but the difference was only significant for the teacher-student relationship domain.Although this study did not find significant differences between HPS and non-HPS schools, our results highlight the complexity of evaluating HPS effects in the real world. The findings suggest a potential role of a supportive school ethos for student well-being in school.

School health promotion and teacher professional identity

Purpose– Health and education are inextricably linked. Health promotion sits somewhat uncomfortably within schools, often remaining a marginal aspect of teachers’ work. The purpose of this paper is to examine the compatibility of an HP-initiative with teacher professional identity.Design/methodology/approach– A qualitative research design was adopted consisting of semi-structured interviews. In total, 49 teachers in two school districts in the Auvergne region in central France were interviewed in depth post having completed three years’ involvement in a health promoting schools initiative called “Learning to Live Better Together” (“Apprendre a Mieux Vivre Ensemble”).Findings– Teachers in the study had a broad conceptualisation of their role in health promotion. In keeping with international trends, there was more success at classroom than at whole school level. While generally teachers can be reluctant to engage with health promotion, the teachers in this study identified having little difficulty in understanding their professional identity as health promoters and identified strong compatibility with the HP-initiative.Practical implications– Teachers generally viewed professional development in health promotion in a positive light when its underlying values were commensurate with their own and when the context was seen as compatible with the school mission. The promotion of health in schools needs to be sensitive to professional identity and be tailored specifically to blend more successfully with current teacher identity and practice.Originality/value– The promotion of health in schools needs to be sensitive to professional identity and be tailored specifically to blend more successfully with current teacher identity and practice.

Viability in delivering oral health promotion activities within the Health Promoting Schools Initiative in KwaZulu-Natal

Background. The Health Promoting Schools Initiative can provide a platform to explore integration of oral health promotion activities within the broader context of healthcare delivery. Objectives. To understand the contextualised delivery of oral health service provision within Health Promoting Schools, to conduct a situational analysis of existing services provided at these schools and to review current health and education policies. Methods. The explorative study design used a mixed methods approach. Twenty-three schools of a total sample of 154 were selected using multistage cluster sampling. Data collection comprised policy reviews, a self-administered questionnaire, a data capture sheet and an interview schedule. The study was approved by the Humanities and Social Sciences Research Ethics Committee of the University of KwaZulu-Natal (HSS/0509/013D). Results. Although policies included statements on oral health promotion, this was not translated into practice at school level. Barriers and challenges identified for successful implementation of an oral health promotion programme included lack of funds, human resources, knowledge and ownership, as well as high workloads and time constraints. Conclusion. Current delivery of oral health promotion services within the Health Promoting Schools Initiative will not reap the desired oral health outcomes owing to the inherent mismatch between policy planning and implementation. More research needs to be conducted to address opportunities and challenges facing educators and other oral healthcare providers working in the school environment.

Health Promotion Facilities In Schools :WHO ‘’Health Promoting Schools Initiative

Health Promotion Facilities In Schools :WHO ‘’Health Promoting Schools Initiative

Health Promotion facilities in Schools: WHO “Health Promoting Schools Initiative”

Health Promotion facilities in Schools: WHO “Health Promoting Schools Initiative”

Combining Realism with Rigour: An Evaluation of a National Kitchen Garden Program in Australian Primary Schools

School garden and kitchen-based activities have potential as health-promoting school initiatives but lack well-designed evaluation frameworks. This article outlines an evaluation of a national kitchen garden program conducted in Australian primary schools. The aim was to evaluate the implementation and impact of a national garden and kitchen program in Australia, including child and health-related impacts of the program, and program implementation factors. The evaluation was undertaken using a multi-component, hierarchical evaluation framework that incorporated a modified case-control design and mixed methods. A cross-section of initiative (N=28) and comparison (N=14) schools was included. The Stephanie Alexander Kitchen Garden model achieved overall improvements in students’ food choices (as reported by students; t=2.26, p=0.024) and kitchen lifestyle behaviours (as reported by parents; t=2.35, p=0.019); female students and students from provincial schools had statistically greater improvements in food choices than other students and girls showed higher scores than boys (t=6.19, p&lt;0.001). The evaluation framework generated data that addressed the evaluation questions. Program integrity was maintained. Factors related to the program's implementation, sustainability, generalisability and return on investment were reported. Factors impacting the evaluation included lack of baseline data, specific data collection methods and time issues. The main conclusion drawn from the study is that structured hierarchical, multi-component evaluation is needed to provide practical insights into effective health promotion initiatives in schools.

Combating Increasing Chronic Non Communicable Diseases: The Need, Progress and Way Forward for Health Promoting Schools in South Africa

Epidemic increase in chronic non-communicable diseases (CNCDs) is resulting in immense challenges in developing countries such as South Africa. Previously misunderstood to affect only high-income countries, 80% deaths due to CNCDs occur in developing countries. This review article traces the path of health promotion in the Eastern Cape and South Africa while considering health promotion developments globally. An example is the HealthPromoting school initiative in 180 schools in the Eastern Cape Province based on the World Health Organization’s Health-Promoting School Initiative. Alma Ata’s holistic ‘health for all’ ideals, the WHO’s ‘Right to health’ along with South Africa’s Bill of Rights have remained important paper based progress. However partial implementation of certain policies and lack of implementation of most broad based health promotion is a major challenge in South Africa which has to be addressed urgently to reverse the advancing CNCD epidemic. Keeping healthy population healthy and training them to prevent CNCDs to the maximum possible extent is feasible by strategically focusing on Health promoting schools in South Africa. Community participation, women’s organizations and youth participation are critical in implementing Health promoting schools in South Africa while being supported by the intersect oral cooperation of key stakeholders in the Department of Health, Department of Education and community engagement services of Universities.

Activities for engaging schools in health promotion

Purpose – The purpose of this paper is to describe activities used to initiate health promotion in the school setting. Design/methodology/approach – Description of successful pilot Health Promoting School (HPS) initiatives in Canada and Uganda and the validated measures central to each program. Evaluation methodologies: quantitative data from the tools used complimented by descriptive/qualitative methods. Findings – Previously validated tools/methodologies used include: The World Health Organization (WHO) growth charts for comparison of children ' s height, weight, head circumference, and BMI against multi-ethnic standards; a 24-h dietary recall instrument to assess dietary diversity as a proxy measure of nutritional adequacy; urine analysis to evaluate baseline renal function and the effect of supplemental hydration; “photo-voice” to aid discussion of personal and community issues of concern; “role play” to promote dialogue and promote social competence; and fitness training. Each activity can combine th...

The Experience of Health-Promoting Schools in Iran

Background: Iran, with the second youngest population in the Eastern Mediterranean Region, faces a high demand on health and education. The Iranian youth are at risk for common behavioral problems that may affect their present and future health. The Health Promoting School Initiative is a well-known international approach that addresses these risks. The Health-Promoting School Program was launched as a national initiative in Iran in 2003. Objectives: This article is the result of an evaluation study that evaluated the intermediate outcomes of this initiative. Materials and Methods: The study was a before-after single community intervention with cluster sampling in which 32 clusters were randomly selected from 215 health-promoting schools in 6 socioeconomically representative provinces of Iran. The calculated sample size was 1260 students from the first grade (grade 9) of secondary school. Educational approach was a mix of active education, peer education and life skills training which targeted 6 prime messages on risk behaviors. Results: We observed improvement in the students’ knowledge on sound definition of health, the cause of HIV/AIDS and the route of transmission, different risks and the places with high potential to encounter a risk, consequences of smoking and violence. Attitudes of the participants towards risk and protective behaviors, with the exception of better understanding of laws, improved with little difference between male and female participants. Conclusions: The Health Promoting School Program model in Iran can significantly improve knowledge and attitude of students regarding the prime messages that address risk behaviors. There is a need to revise the material to maximize the outcomes.

Communal child-rearing: The role of nurses in school health

Child-rearing remains a concern within our communities, especially because families of today lack primary parents due to multifaceted challenges such as working mothers, diseases and violence. Health-promoting school initiatives are necessary because they allow a multifaceted approach to child-rearing. They further provide a conducive environment for continued schoolchild-rearing moving from home to school. This study promotes an integrated approach to school care using the African concept ofUbuntu - solidarity and sense of community - as a point of departure. The socio-ecological model was used, which includes the work of the school healthcare nurse in contributing to holistic health services. An integrative review was conducted in January 2013, which included methodology studies, a theory review and a variety of studies related to school health. The studies were categorised according to school health,Ubuntu and the socio-ecological model. The role of school healthcare nurses entails acting as a liaison officer between a variety of stakeholders who work together to shape the future of children. Ubuntu, together with the socio-ecological model, can assist us to involve an entire community to raise children. This knowledge serves as a background to the planning of a school health programme. The role of the nurse in school health can also assist in collaborative efforts to formulate the programme and develop the competencies that will inform school health nurse training curricula.

Views of Irish primary school principals on implementing health-promoting school initiatives

Views of Irish primary school principals on implementing health-promoting school initiatives

P1-419 Health promoting school initiative in ashram schools of Wardha district: an evaluation

ObjectiveTo study the effect of health promoting school-based intervention for disadvantaged children in the residential Ashram Schools of rural Wardha district of central India.Material and MethodsAt baseline, 1287 children in...

Psychometric Properties of a Scale Focusing on Perceived Attributes of a Health Promoting School Approach

The purpose of this paper was to investigate the psychometric properties of a newly-designed scale intended to measure the perceived attributes of a Health Promoting School initiative and its context in terms of factor structure, reliability and predictive validity. The scale was developed to explore possible predictors of the adoption of the Healthy School approach (HS) in Québec. Data were gathered from a 2007 cross-sectional study of 107 schools and 141 participants (school principals and school health promotion delegates). The scale was based on 7 attributes borrowed from the theories on diffusion of innovation. The factor structure of the scale was tested by exploratory and confirmatory factor analyses. The final scale included 14 items capturing 4 factors: school contextual barriers, collective efficacy, anticipated benefits and relative advantages. Reliability, in terms of internal consistency of the factors, ranged from a high of 0.85 to a low of 0.60. Three of the 4 factors significantly predicted HS adoption. Overall, the scale showed good psychometric properties and may be useful to assess the attributes that could influence the adoption of this type of initiative.

Inequalities in toothbrushing among adolescents in Scotland 1998-2006

The aim of this study was to examine trends in toothbrushing and inequalities in toothbrushing among girls and boys in Scotland between 1998 and 2006. A secondary aim was to investigate the association between the health promoting school (HPS) initiative and toothbrushing. Data from the Health Behaviour in School-aged Children 1998, 2002 and 2006 surveys were analysed using multilevel logistic regression for boys and girls aged 11, 13 and 15 years. Girls' twice-a-day toothbrushing increased with age while that of boys' remained stable. Toothbrushing increased significantly between 1998 and 2006 for all but 15-year-old girls. Family structure was significantly associated with toothbrushing for 11-year-old boys and 13-year-old boys and girls. Socio-economic inequalities in toothbrushing were significant for both boys and girls at all ages. Largest inequalities were seen among 13-year-old girls and 15-year-old boys. Inequalities persisted over time for all but 15-year-old boys who saw a significant reduction between 1998 and 2006. The HPS initiative in schools in deprived areas was associated with increased odds of twice-a day toothbrushing among 11-year-old boys and 15-year-old girls.

A comparative analysis of Health Promoting school initiatives and the development of media literacy curriculum in order to facilitate health literacy in youth suffering from disordered eating

A comparative analysis of Health Promoting school initiatives and the development of media literacy curriculum in order to facilitate health literacy in youth suffering from disordered eating

Beyond deworming: the promotion of school-health-based interventions by Japan

Deworming bestows a variety of health and socioeconomic benefits and has been embraced by developing countries. To extend the beneficial impact of deworming, the Asian Centre of International Parasite Control (ACIPAC) project has carried out activities to link deworming with health-promoting school programs in the Greater Mekong Subregion (Cambodia, Laos, Myanmar, Thailand and Vietnam). ACIPAC has also conducted an integrated school-health-based program, including deworming and malaria education, under the umbrella of the health-promoting schools initiative. Implementing "beyond-deworming" efforts is now a practical challenge in the subregion.

Student participation: a democratic education perspective--experience from the health-promoting schools in Macedonia.

The paper addresses the issue of student participation from the perspective of the health-promoting schools initiative. It draws on experience from the Macedonian Network of Health-Promoting Schools and its collaboration with the Danish as well as other country networks within the European Network of Health-Promoting Schools. Student participation is viewed as one of the main focal points of the conceptual framework and model of a health-promoting school developed within the Macedonian context. This model and the model distinguishing between two different qualities of participation-genuine and token participation-are presented and discussed in the paper. Underpinning values that these models endorse as important for the processes of health promotion in schools include self-determination, participation, democracy, diversity and equity.