School Health Action , Planning And Evaluation System Research Articles

Eveningness in Energy Intake among Adolescents with Implication on Anthropometric Indicators of Nutritional Status: The CRO-PALS Longitudinal Study.

Shifting of energy intake towards a later time in the day is associated with an increased risk of obesity in adults. However, there is a lack of data for adolescents. The aim of this study was to investigate adolescents eveningness in energy intake (EV) and its association with anthropometric indicators of nutritional status. This investigation was based on results from the Croatian physical activity in adolescence longitudinal study (CRO-PALS). The cohort included 607 adolescents (50.25% females and 49.75% males) who were assessed at the age of 15/16 and 18/19. A single multi-pass 24-h recall was used as a dietary assessment method, while anthropometric indicators of nutritional status included body mass index (BMI), waist to hip ratio (WHR) and the sum of four skinfolds. The School Health Action, Planning and Evaluation System (SHAPES) questionnaire was used to assess active daily energy expenditure and sedentary behaviors. EV was significantly higher at 18/19 years compared to 15/16 years in whole population (p < 0.01), among male adolescents (p < 0.01), but not among female adolescents (p > 0.05). Although a significant correlation between EV and WHR was found in females at the age of 15/16 (p < 0.01), the results of this study suggest that EV has no or a minor effect on anthropometric indicators of nutritional status in adolescence.

One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS).

Background Little is known about the concurrent change in physical activity (PA), sedentary behavior (SB) and sport participation (SP) during adolescence. The main purpose of this prospective and partly objective study was to simultaneously investigate PA, SBs and SP changes between the 1st and 2nd grades of high school in urban adolescents. Methods In this 1-year follow-up study, the participants were 81 secondary-school students (28 boys and 53 girls) aged 15.5 years at the baseline. PA was assessed with the SenseWear Armband multi-sensor activity monitor, while SBs were assessed by using School Health Action, Planning and Evaluation System (SHAPES) PA questionnaire. The SHAPES questionnaire was supplemented with two questions inquiring about SP in organized sports in school and outside of school. Results PA decreased markedly in both genders between the 1st and 2nd grades of high school. Total energy expenditure (TEE) was reduced by 13 kcal/kg/day on average in boys and by 10 kcal/kg/day in girls (p for both <0.001), while mean daily active energy expenditure (AEE) decreased by 7 kcal/kg/day (p < 0.001) and 3 kcal/kg/day (p = 0.04) in boys and girls, respectively. Similarly, the amount of moderate PA declined by 49 min/day in boys and 21 min/day in girls (p for both <0.001). At the same time vigorous PA was cut by 14 min/day (p < 0.001) and 3 min/day (p = 0.003) in boys and girls, respectively. Conversely, time spent in SBs did not show any change. Conclusion In conclusion, a decline in PA between the 1st and 2nd grades of high school was marked but was not accompanied with an increase in SBs. Policies aimed at increasing PA should be targeting the period of entering secondary school to offset the observed drop in PA.

Effectiveness of School Based Recruitment Procedures and Modular Data Collections

Purpose: The School Health Action, Planning and Evaluation System (SHAPES) is a school-based data collection and knowledge exchange system designed to improve the health of youth. This paper outlines the design of the SHAPES study, examines the impact of different school recruitment models on participation rates, and examines the impact of using two different research modules during data collection on the prevalence of core behaviours being measured. Methods: In total, 76 schools were recruited from seven health regions and data were collected using the SHAPES Tobacco (TM) and Physical Activity Modules (PAM). Results: It was found that school recruitment rates were higher when both the researchers and the health unit, worked together to recruit schools. Significant differences were found between students who completed the TM and students who completed the PAM with respect to body mass index, smoking susceptibility, the number of friends who smoke, and the number of active friends. Conclusions: This paper provides valuable real-world insight for future researchers interested in performing population-level school-based studies of youth risk behaviours. Our experience suggests that a modular approach to data collection is feasible and that recruitment rates are improved when researchers work in collaboration with health unit staff who have existing relationships with schools.

School-based tobacco-control programming and student smoking behaviour

The study examined the association of a school-based tobacco-control program with students' smoking behaviour over time using three cross-sectional, provincial census datasets (grade 10 students in 1999, grade 11 students in 2000, grade 12 students in 2001). Data were collected from all secondary schools in Prince Edward Island (Canada) using the Tobacco module of the School Health Action, Planning and Evaluation System (SHAPES). The proportion of regular smokers increased from grade 10 (22.3%) to grade 12 (27.8%, chi(2) = 10.35, df = 1, p < 0.001). Being exposed to different school-based tobacco programs and policies in grades 10 and 11 was not associated with the smoking behaviour of grade 12 students. The strongest predictors of smoking behaviour were having friends or close family members who smoke. This preliminary evidence suggests that programs and policies associated with banning smoking and enforcing smoking restrictions at school may be insufficient unless they also address the influence of smoking peers and family members and link to comprehensive programming within the broader context of other community and policy level interventions.

Integrating Research, Policy, and Practice in School-Based Physical Activity Prevention Programming: The School Health Action, Planning, and Evaluation System (SHAPES) Physical Activity Module

The School Health Action, Planning, and Evaluation System (SHAPES) is a data collection and feedback system designed to support population-based intervention planning, evaluation, and field research related to youth. The Physical Activity Module of SHAPES consists of: (a) a machine readable questionnaire to collect physical activity data from all students (grades 6 to 12) in a school, (b) a school administrator questionnaire to assess school policies, programs, and resources related to physical activity, and (c) a school-specific feedback report documenting student behavior and school programs and policies. This SHAPES module provides schools with feedback that enables them to take stock of patterns of activity and obesity within their school, recognize what is (and what is not) in place to support physical activity, and how to plan and evaluate their own prevention efforts. SHAPES enables researchers and stakeholders to identify what interventions work, in what contexts, with what students.

The Effect of Social Support and School- and Community-based Sports on Youth Physical Activity

To examine how social support, participation in intramurals, varsity and community sports are associated with physical activity among Ontario secondary school students, and explore gender differences in the prevalence of physical activity and participation in school- and community-based sports. Data from 25,416 students (grades 9-12) attending 76 Ontario secondary schools were collected using the School Health Action, Planning, and Evaluation System (SHAPES). Logistic regression analyses examined how social support and school- and community-based sports participation were associated with physical activity. Males and females with low social support for physical activity were less likely to be active than their lower-risk peers (males: OR 0.61; females: OR 0.72). Males and females were more likely to be active if they participated in intramural activities (males: OR 1.92; females: OR 1.55), varsity sports (males: OR 1.93; females: OR 1.77), or community sports (males: OR 2.84; females: OR 2.90). Since students with low social support for physical activity were less likely to be active, interventions to increase support and engagement in physical activity should be targeted to these students. In addition, considering that participation in school- and community-based sports increases the likelihood that students were active, practitioners should seek to enhance opportunities for participation in and access to these programs in order to increase the level of activity obtained by students.

Susceptibility to smoking and its association with physical activity, BMI, and weight concerns among youth

Research has yet to examine how physical activity, body mass index (BMI) and concerns about weight among youth populations are associated with susceptibility to smoking among never smokers. The Physical Activity Module of the School Health Action, Planning and Evaluation System (SHAPES) was completed by 25,060 students in grades 9 to 12 within 76 secondary schools in Ontario (Canada) to examine how being overweight, weight concerns, and physical activity are associated with susceptibility to smoking in a large sample of youth. Among the 14,795 students who were never smokers, 3,809 (25.8%) were classified as susceptible to future smoking and 10,986 (74.2%) were classified as non-susceptible to future smoking. Smoking susceptibility was negatively associated with being highly active or at risk of overweight and positively associated with perceptions of being slightly overweight or slightly underweight. Students who report 1 or more hours of screen or phone time per day were also more likely to be susceptible. This is the first study to identify that susceptibility to future smoking among never smokers is associated with physical activity, overweight and concerns about weight. This is valuable new insight for tailoring and targeting future school-based tobacco control and/or physical activity programming to youth populations.

Modifiable characteristics associated with sedentary behaviours among youth

Childhood overweight and obesity is a major public health issue. A better understanding of factors associated with sedentary behaviours would provide valuable insight for tailoring interventions to prevent or reduce overweight among youth. Data were collected from 25,416 grade 9 to 12 students attending 76 secondary schools in Ontario, Canada, using the Physical Activity Module of the School Health Action, Planning and Evaluation System (SHAPES). Sex specific multivariate logistic regression analyses were then used to examine how physical activity, BMI, social influences, and smoking behaviour were associated with screen time, time spent reading, and time spent on homework. The average screen time per day was 2.7 (+/-1.7) hours, yet 48.1% of students reported spending less than one hour reading per week and 30.2% spent less than an hour of time on homework per week. Among males, being underweight (< or = 5% percentile BMI, adjusted for age and sex) was associated with more screen time (OR 1.23, 95%CI 1.01-1.50) and time spent reading (OR 1.19, 95%CI 1.00-1.43), whereas being at risk of overweight (> or = 85% percentile BMI, adjusted for age and sex) was associated with less time spent on homework (OR 0.75, 95%CI 0.65-0.85). Conversely, among females, being at risk of overweight was associated with more screen time (OR 1.24, 95%CI 1.10-1.41), and time spent reading (OR 1.19, 95%CI 1.05-1.35). Aside from BMI, other factors associated with sedentary behaviours included physical activity, parental encouragement and support for physical activity, close friend physical activity behaviour, and smoking status. We found that students are highly involved in screen-based sedentary behaviours, but spend a limited time on more productive sedentary behaviours, like reading and homework. Developing a better understanding of sedentary behaviours is critical for preventing and reducing obesity among youth populations.

Integrating Public Health Policy, Practice, Evaluation, Surveillance, and Research: The School Health Action Planning and Evaluation System

The Canadian Cancer Society and the National Cancer Institute of Canada have charged their Centre for Behavioral Research and Program Evaluation with contributing to the development of the country's systemic capacity to link research, policy, and practice related to population-level interventions. Local data collection and feedback systems are integral to this capacity. Canada's School Health Action Planning and Evaluation System (SHAPES) allows data to be collected from all of a school's students, and these data are used to produce computer-generated school "health profiles." SHAPES is being used for intervention planning, evaluation, surveillance, and research across Canada. Strong demand and multipartner investment suggest that SHAPES is adding value in all of these domains. Such systems can contribute substantially to evidence-informed public health practice, public engagement, participatory action research, and relevant, timely population intervention research.

The relationship between school-based smoking policies and prevention programs on smoking behavior among grade 12 students in Prince Edward Island: A multilevel analysis

Purpose To examine how school-based smoking policies and prevention programs are associated with occasional and regular smoking among a cohort of grade 12 students in Prince Edward Island, Canada, between 1999 and 2001. Methods Data from the Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) collected from 3,965 grade 12 students in 10 high schools were examined using multi-level regression analysis. Results Attending a school with smoking prevention programming was associated with a decreased risk of being an occasional smoker (OR 0.42, 95% CI: 0.18, 0.97). School-based policies banning smoking on school property were associated with a small increased risk of occasional smoking (OR 1.06, 95% CI: 0.67, 1.68) among some students. The combination of both policies and programs was not associated with either occasional or regular smoking. Conclusion This preliminary evidence suggests that tailored school-based prevention programming may be effective at reducing smoking uptake; however, school smoking policies and the combination of programs and policies were relatively ineffective. These findings suggest that a new approach to school-based tobacco use prevention may be required.

Reliability and Validity of a School-Based Physical Activity Questionnaire

To determine the reliability and validity of the School Health Action, Planning and Evaluation System (SHAPES) physical activity questionnaire, a machine-readable questionnaire designed to collect data from all students in a school from grades 6 to 12 and to provide feedback to the school for planning and evaluation. Study 1 assessed test-retest reliability by administering the questionnaire twice, 1 wk apart to 2812 students in grades 9-12. Study 2 assessed criterion validity using MTI accelerometers worn consecutively for 7 d, and measured height and weight (N = 67, grades 6-12). The overall kappa/weighted kappa coefficient for the 1-wk test-retest reliability of the questionnaire items indicated moderate agreement (mean 0.57 +/- 0.24). Self-reported and accelerometer-measured average daily time spent performing moderate to vigorous physical activity were significantly correlated (Spearman r = 0.44, P < 0.01); however, students tended to overreport physical activity. Height and weight were not consistently over- or underreported. Self-reported and measured body mass index were significantly correlated (Spearman r = 0.90, P < 0.001). Classification of weight status by body mass index was similar using self-reported values compared with measured values. The findings of these studies suggest that the SHAPES physical activity questionnaire has acceptable reliability and validity and is suitable for use in large-scale school-based data collections for child and adolescent populations.

A Multi-Level Analysis Examining how Smoking Friends, Parents, and Older Students in the School Environment are Risk Factors for Susceptibility to Smoking Among Non-Smoking Elementary School Youth

The purpose of this study was to examine how social models for smoking are related to smoking susceptibility among a sample of non-smoking elementary school students. The Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) was administered to 6,431 students (grades 6 to 8) in 57 elementary schools in the province of Ontario, Canada. Multi-level logistic regression analysis was used to examine how smoking friends, parents, and the prevalence of smoking among grade 8 students at a school were related to smoking susceptibility among the 2,478 non-smoking grade 6 and 7 students. Findings indicate that non-smoking grade 6 and 7 students are more likely to be susceptible to smoking if they have (a) smoking friends, (b) a mother who smokes, or (c) two or more close friends who smoke and attend a school with a relatively high smoking rate among the grade 8 students. Sub-populations of non-smoking youth may be at increased risk for smoking because of the elementary school they attend. Future school-based smoking prevention programs might benefit from targeting prevention programming activities to the schools that are putting students at the greatest risk for smoking.