School Health Promotion Initiatives Research Articles

Peering in: youth perspectives on Health Promoting Schools and youth engagement in Nova Scotia, Canada.

Health Promoting Schools (HPS) is a whole-school approach that shapes the conditions necessary to support student health and well-being. Youth engagement is recognized as key to HPS implementation, yet research related to the involvement of youth voice in school health promotion initiatives is limited. The purpose of this study was to understand youth perspectives on HPS and school youth engagement. Ten youth (grades 9–10, ages 14–16) were trained as peer researchers using a Youth Participatory Action Research approach. The peer researchers interviewed 23 of their peers (grades 7–10, ages 12–16) on perspectives related to HPS and school youth engagement. All interviews were audio-recorded, transcribed and data were analysed using inductive ‘codebook’ thematic analysis. Themes related to a healthy school community were mapped onto the pillars of HPS: (i) Social and Physical Environment, (ii) Teaching and Learning, (iii) Partnerships and Services and (iv) School Policies. Participants placed more importance on the social and physical environment of the school including respect, inclusivity, supportive relationships and the design of spaces. Key factors for youth engagement were: (i) safe and supportive spaces, (ii) passion and interest, (iii) using their voice, (iv) power dynamics, (v) accessibility and (vi) awareness. With recognition that youth engagement is a crucial part of HPS, this work provides relevant and applicable information on areas of the healthy school community that are important to youth, and if/how they are meaningfully engaged in school decision-making.

Collaborating With Youth in School Health Promotion Initiatives With Photovoice.

Photovoice, a community-based approach that is being embraced in school settings, can help to nurture collaborations with youth, particularly adolescents, and engage them in the development of social policy and health promotion projects. Photovoice is an approach that positions school nurses to inspire youth to take ownership of health promotion issues that directly affect them in the school and in their communities. Engaging youth in Photovoice not only allows advocates to directly work with youth but also promotes critical thinking and the exploration of topics that may not otherwise be considered. Photovoice raises awareness about issues through critical dialogue and is well suited to engage youth and provide a channel for youth to assert their voices.

Perceived school climate, academic well-being and school-aged children's self-rated health: a mediator analysis.

Schools are crucial settings for young people's development. Rare studies have examined the impact of perceived school-climate and academic well-being on young people's self-rated health in joint analyses. This study focuses on the role of perceived school-climate and academic well-being for young people's self-rated health and examines whether school climate is mediated by indicators of academic well-being. Data were obtained from the German National Educational Panel Study, including seventh grade students (n = 6838) aged 11-12, nested in 710 classes within 277 schools. Indicators of school climate (teacher control, demands, autonomy, interaction, goal setting and orientation, teaching quality) and academic well-being (satisfaction with school, helplessness in major school subjects) were reported from students. Multilevel modelling was used to analyze the relative importance of perceived school-climate and academic well-being on school-aged children's self-rated health. Results showed that academic well-being is strongly related to self-rated health. The better students perceive their academic well-being, the lower the likelihood of poor self-rated health. In contrast, indicators of perceived school climate are only indirectly related to self-rated health, mediated by academic well-being or are not at all associated with self-rated health. This study suggests that school climate is important for academic well-being but not as important for students' self-rated health as academic well-being. Health promotion initiatives in schools have to ensure that school climate serves to enhance students' academic well-being to avoid health problems in the long-run.

Children as change agents for family health

PurposeThe purpose of this paper is to explore ways in which children and young people are being positioned as change agents for families through school health promotion initiatives in New Zealand.Design/methodology/approachThe paper maps and describes the kinds of policies and initiatives that directly or indirectly regard children as conduits of healthy eating and exercise messages/practices for families. Drawing on post-structural theoretical frameworks, it explores what these resources suggest in terms of how healthy families should live.FindingsFamilies are positioned as central to school health promotion initiatives in New Zealand, especially in relation to obesity prevention policies and strategies. Children are further positioned as agents of change for families in many of the resources/policies/initiatives reviewed. They are represented as key transmitters and translators of school-based health knowledge and as capable of, and responsible for, helping their families eat well and exercise more.Social implicationsWhile recognising children’s agency and capacity to translate health messages is a powerful and welcome message at one level, the author need to consider the implications of requiring children to convey health information, to judge their family practices and, at times, to be expected to change these. This may create anxiety, family division and expect too much of children.Originality/valueThe paper takes a novel post-structural perspective on a familiar health promotion issue. Given the proliferation of family-focussed health initiatives in New Zealand and elsewhere, this perspective may help us to explore, critique and understand more fully how children are expected to be engaged in these initiatives, and the potentially harmful implications of these expectations.

Systems thinking and complexity: considerations for health promoting schools.

The health promoting schools concept reflects a comprehensive and integrated philosophy to improving student and personnel health and well-being. Conceptualized as a configuration of interacting, interdependent parts connected through a web of relationships that form a whole greater than the sum of its parts, school health promotion initiatives often target several levels (e.g. individual, professional, procedural and policy) simultaneously. Health promoting initiatives, such as those operationalized under the whole school approach, include several interconnected components that are coordinated to improve health outcomes in complex settings. These complex systems interventions are embedded in intricate arrangements of physical, biological, ecological, social, political and organizational relationships. Systems thinking and characteristics of complex adaptive systems are introduced in this article to provide a perspective that emphasizes the patterns of inter-relationships associated with the nonlinear, dynamic and adaptive nature of complex hierarchical systems. Four systems thinking areas: knowledge, networks, models and organizing are explored as a means to further manage the complex nature of the development and sustainability of health promoting schools. Applying systems thinking and insights about complex adaptive systems can illuminate how to address challenges found in settings with both complicated (i.e. multi-level and multisite) and complex aspects (i.e. synergistic processes and emergent outcomes).

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<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.

School Community Participation and School Health Promotion: Challenges and Opportunities

Issues surrounding community participation at schools are frequently debated in South African education spheres. However, communities remain not totally convinced to participate in health promoting activities at schools. In this paper I report on the importance of community participation in health promotion processes at schools and elaborate on what community participation entails, its levels and reasons for non-participation. Data was generated from two strata: principals and chairpersons of health committees by means of semi-structured one-to-one interviews. The findings revealed that participating schools had an opportunity to build strong links with community organisations to sustain their School Health Promotion initiatives but failed due to lack of trust and leadership. The challenge in these schools is lack of understanding of community participation and its benefits. DOI: 10.5901/mjss.2014.v5n27p1458

School Health Promotion to Increase Empowerment, Gender Equality and Pupil Participation: A Focus Group Study of a Swedish Elementary School Initiative

A school health promotion project was carried out in an elementary school in Sweden where active participation, gender equality, and empowerment were leading principles. The objective of the study was to understand challenges and to identify social processes of importance for such a project. Focus group interviews were conducted with 6 single-sex groups (7–12 year olds) in grade 1–2, grade 3–4, and grade 5–6 on 2 occasions. The analysis used a grounded theory approach. The analysis identified the core category “normalization processes of violence and harassment.” It is argued that school health promotion initiatives need to be aware of normalization processes of violence and, which may be counter-productive to the increase of empowerment and participation among all pupils.

Understanding the factors that characterise school‐community partnerships

PurposeThe purpose of this study is to examine the factors that characterise effective school‐community partnerships that support the sustainability of school health initiatives applied within a health‐promoting schools approach.Design/methodology/approachThe study used an explanatory case study approach of five secondary schools participating in a health‐promoting school programme, “The Logan Healthy Schools Project” in Logan, South‐East Queensland, Australia to investigate how school‐community partnerships support the sustainability of school health initiatives. Semi‐structured interviews were conducted with 16 deputy principals, school staff members, and community‐based partners, along with observations and a documentary analysis of Logan Healthy School Project activities. A thematic analysis was conducted on the data.FindingsThe factors that characterise effective school‐community partnerships that support the sustainability of school health initiatives include: a focus on building relationships between school and community partners, complementary capacities of school personnel and service providers, commonality of intent and shared goals between both parties, and competence of practice, primarily of the community service provider. These four factors were consistent at the school operational level and strategic programme co‐ordination level of the Logan Healthy Schools Project, yet varied in importance across the initiation, growth, and maturity of the school‐community partnerships.Originality/valueThe study adds to the limited body of knowledge that surrounds effective school‐community partnerships and how the features of these partnerships contribute to the sustainability of school health initiatives. The study highlights the importance of initiating, growing, and maintaining school‐community partnerships and provides insight into the factors that should be considered when planning and developing school health promotion initiatives.

Grounds for movement: green school grounds as sites for promoting physical activity

An environmental factor of particular importance to children's physical activity levels appears to be the presence of parks and open space. Thus, in promoting children's health, school grounds merit consideration as a potential setting for intervention. This paper explores how 'green' school grounds, which contain a greater diversity of landscaping and design features, affect the quantity and quality of physical activity among elementary school children. Teachers, parents and administrators associated with 59 schools across Canada completed questionnaires (n = 105). Analysis reveals that through greening, school grounds diversify the play repertoire, creating opportunities for boys and girls of all ages, interests and abilities to be more physically active. Complementing the rule-bound, competitive games supported by asphalt and turf playing fields, green school grounds invite children to jump, climb, dig, lift, rake, build, role play and generally get moving in ways that nurture all aspects of their health and development. Of particular significance is the potential to encourage moderate and light levels of physical activity by increasing the range of enjoyable, non-competitive, open-ended forms of play at school. Seen in this light, green school grounds stand to be an important intervention to be included in school health promotion initiatives.

An evaluation of the role of elementary school teachers in Kuwait in promoting health

The health promoting school concept is now a well-established framework for the development of health promotion initiatives in schools. Teachers who are part and parcel of the school environment can play an important role in evaluating or assessing the extent to which their school environment is supporting health promotion. This study was designed to assess the perception of teachers about the school environment and the role of the teacher in promoting health education in elementary schools in Kuwait. The findings from this study revealed that elementary school teachers in Kuwait expressed approval of their school environment in promoting health education.

The School, a Viable Educational Site for Interdisciplinary Health Promotion

An interdisciplinary health promotion module, using the community-based teaching approach, is offered by the University of the Western Cape (UWC). Schools in Delft, a poor socio-economic area with high unemployment, crime and a range of social problems, are used as the teaching site. To assess the status of the health promotion initiatives in schools where students were placed. A self-administered structured questionnaire for teachers and principals. Variables included were demographic data, views of health promotion, health promotion activities at the school, barriers and opportunities to implement health promotion activities. A response rate of 68.75 % (n = 55) for teachers and 100 % (n = 4) for principals was obtained. Most (87%) teachers felt that health promotion has a place within the curriculum. They reportedly focused on topics related to health within the school curriculum. Partners, such as public health nurses, university students, and a pharmaceutical company, offer additional health promotion initiatives. These include general health checks, HIV/AIDS information, adolescent health and dental health. Barriers to initiate and sustain programmes include lack of resources, insufficient staff training, lack of commitment by both teaching staff and the community, insufficient time, the heavy workload of teachers, and communication problems as a result of language barriers. Only 36% of teachers felt the school environment was conducive to learning. Health promotion initiatives in the schools concerned are uncoordinated, erratic, based on the resources that the school has access to at a given time and the demands of the curriculum.

Evaluating the health promoting school: a case study approach

The health promoting school concept is now a well‐established framework for the development of health promotion initiatives in schools. Increasingly, attention has focused on the evaluation of school‐based health promotion and debate continues over appropriate evaluation designs for the school setting. The authors argue that the case study design provides a useful approach because of its ability to explore the real‐life complexities of social contexts using a combination of quantitative and qualitative methods, with a strong emphasis on process as well as outcome measures. The current ENHPS project in Scotland uses a multiple‐case study design to evaluate healthy eating initiatives in four schools, based on the principles of the health promoting school. Provides a description of the project and highlights the advantages of case study methodology in addressing key issues around effectiveness of school‐based health promotion based on the health promoting school concept.