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Background: Schools are an attractive platform for improving the dietary knowledge, attitudes and behaviors of children and their families, yet limited nutrition knowledge amongst educators can impede nutrition education efforts. Information and communication technology (ICT) can potentially overcome this barrier, yet there is limited evidence for its effectiveness in school settings in low- and middle-income countries. Methods: We implemented a randomized field experiment in 50 schools in the North Region of Cameroon to assess the effectiveness of a school-based nutrition education program at improving the nutrition knowledge of fifth and sixth grade students and their parents. We evaluate the relative effectiveness of video-based versus typical classroom instruction. Nutrition knowledge is assessed using a pre-post questionnaire and analyzed using analysis of covariance. Results: We find that students exposed to the video treatment improved their nutrition knowledge scores by 0.45 standard deviation more (equivalent to an additional 1.3 out of 14 correct answers) than students that received traditional classroom instruction. There is no differential impact of video on the nutrition knowledge scores of parents. Conclusion: Videos can improve knowledge gains compared with typical classroom instruction, but questions remain as to the conditions under which videos and other ICT are most effective as instructional tools. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity continues to be a global epidemic and many child-based settings (e.g. school, afterschool programs) have great potential to make a positive impact on children's health behaviors. Innovative and time-sensitive methods of gathering health behavior information for the purpose of evaluation and strategically deploying support are needed in these settings.Purpose: The aim is to (1) demonstrate the feasibility of mobile health (mHealth) for monitoring implementation of healthy eating and physical activity (HEPA) standards and, (2) illustrate the utility of mHealth for identifying areas where support is needed, within the afterschool setting.Methods: Site leaders (N = 175) of afterschool programs (ASPs) were invited to complete an online observation checklist via a mobile web app (Healthy Eating and Physical Activity Mobile, HEPAm) once per week during ASP operating hours. Auto-generated weekly text reminders were sent to site leaders' mobile devices during spring and fall 2015 and 2016 and spring 2017 school semesters. Data from HEPAm was separated into HEPA variables, and expressed as a percent of checklists where an item was present. A higher percentage for a given item would indicate an afterschool has higher compliance with current HEPA standards.Results: A total of 141 site leaders of ASPs completed 13,960 HEPAm checklists. The average number of checklists completed per ASP was 43 (range 1-220) for healthy eating and 50 (range 1-230) for physical activity. For healthy eating, the most common challenge for ASPs was 'Staff educating children about healthy eating', and for physical activity checklists, 'Girls only physical activity is provided at ASP'.Conclusion: HEPAm was widely used and provided valuable information that can be used to strategically deploy HEPA support to ASPs. This study gives confidence to the adoption of mHealth strategies as a means for public health practitioners to monitor compliance of an initiative or intervention. [ABSTRACT FROM AUTHOR]

Childhood obesity is an increasing threat to the health of primary school students in Hong Kong. Obesity results from energy excess from food relative to energy expenditure through physical activity. In Hong Kong, a whole day primary schooling policy has been implemented since 1993 and today most primary school students have their lunch on campus and some also purchase snacks and drinks from school tuck shops or vending machines. The EatSmart School Accreditation Scheme (ESAS) aiming at combating childhood obesity was launched in 2009/2010. Professional (health promotion, dietary, programme, etc.) support is provided to help schools formulate policies, introduce structures and implement measures to help students develop the habit of healthy eating. The aim of this study is to investigate the change of childhood obesity (including overweight) rates over time among schools awarded with ESAS accreditation. Seven-year retrospective data on obesity status were obtained for the period 2007/2008-2013/2014 (number of students = 113,322, number of measurements = 314,746) from all 105 ESAS-accredited schools. Before schools were geared up for the accreditation scheme obesity rates were fairly stable (slope test p > 0.05) among their student population ranging from 23.2% to 21.9%, whereas the rates dropped significantly (slope test p < 0.05) from 21.9% to 19.3% after intervention. For ESAS-accredited schools, there was an average annual reduction of 0.49% point in obesity rate which was 0.18% point higher than that of 0.31% point among non-ESAS-accredited schools. These results show that schools achieving ESAS accreditation are associated with a bigger improvement in the student obesity problem. [ABSTRACT FROM AUTHOR]

Background: The aim of this pilot study was to examine the impact of a brief physical activity intervention on adolescents' subjective sleep quality. Cross-sectional studies indicate that physically active adolescents have better subjective sleep quality than those with more sedentary habits. However, less is known about the effectiveness of physical activity interventions in improving adolescents' subjective sleep quality.Methods: In a three-week physical activity intervention, four Icelandic upper secondary schools were randomized to either an intervention group with pedometers and step diaries or a control group without pedometers and diaries. Out of 84, a total of 53 students, aged 15-16 years, provided complete data or a minimum of two days step data (out of three possible) as well as sleep quality measures at baseline and follow-up. Subjective sleep quality, the primary outcome in this study, was assessed with four individual items: sleep onset latency, nightly awakenings, general sleep quality, and sleep sufficiency. Daily steps were assessed with Yamax CW-701 pedometers.Results: The intervention group ( n = 26) had significantly higher average step-count ( p = 0.03, partial η2 = 0.093) compared to the control group ( n = 27) at follow-up. Subjective sleep quality improved ( p = 0.02, partial η2 = 0.203) over time in the intervention group but not in the control group.Conclusions: Brief physical activity interventions based on pedometers and step diaries may be effective in improving adolescents' subjective sleep quality. This has important public health relevance as the intervention can easily be disseminated and incorporated into school curricula. [ABSTRACT FROM AUTHOR]

Background: Student-school connectedness is inversely associated with multiple health risk behaviors, yet research is limited on the relative contributions of a student's connectedness with school and an overall context of school social cohesion to peer victimization/bullying.Purpose: We examined associations of perceived school cohesion and student-school connectedness with physical victimization, verbal victimization, and social exclusion in the past six months in adolescents in grades 6-11 (N = 774) attending 11 public and private urban schools in Colombia.Methods: Cross-sectional data were collected via a self-administered questionnaire and analyzed using mixed-effects linear regression models.Results: Higher perceived school cohesion was inversely related with exposure to three bullying types examined (p < 0.05); student-school connectedness was negatively related to verbal victimization among girls only (p < 0.01). In full models, school cohesion maintained inverse associations with three bullying types after controlling for student-school connectedness (p ≤ 0.05).Conclusion: Enhancing school cohesion may hold benefits for bullying prevention beyond a student's individual school connectedness. [ABSTRACT FROM AUTHOR]

Unplugged is a school-based prevention programme designed and tested in the EU-Dap trial. The programme consists of 12 units delivered by class teachers to adolescents 12-14 years old. It is a strongly interactive programme including a training of personal and social skills with a specific focus on normative beliefs. The aim of this work is to define the theoretical model of the program, the contribution of the theories to the units, and the targeted mediators. The programme integrates several theories: Social Learning, Social Norms, Health Belief, theory of Reasoned Action-Attitude, and Problem Behaviour theory. Every theory contributes to the development of the units' contents, with specific weights. Knowledge, risk perception, attitudes towards drugs, normative beliefs, critical and creative thinking, relationship skills, communication skills, assertiveness, refusal skills, ability to manage emotions and to cope with stress, empathy, problem solving and decision making skills are the targeted mediators of the program. [ABSTRACT FROM AUTHOR]