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The study’s purpose was to evaluate an intervention to reduce fruit and vegetable food neophobia and influence attitudes and behaviors among children using a four-month, non-experimental, before-and-after intervention. Participants were children aged 5–11 years in an intervention school (IS) and a control school (CS). Children were offered fruit or vegetable samples weekly utilizing school-specific psychosocial and educational practices to encourage participation. The outcomes of interest included attitudes measured using a written survey-based food neophobia scale (FNS), behavioral observations, and an oral survey. The post-intervention IS FNS score was significantly lower compared to pre-intervention (p = 0.04). Repeated-measures ANOVA revealed a statistically significant overall effect of time (p = 0.006). School type-time interaction was not significant (p = 0.57). Pre-intervention observational data showed the proportions finishing and taking another fruit and vegetable sample were higher in the CS (p &lt, 0.001 for both). Post-intervention, the proportions taking the vegetable (p = 0.007) and the fruit (p &lt, 0.001) were higher in the IS. The percentage tasting the vegetable was higher in the CS (p = 0.009). Offering samples of produce in school lunchrooms may reduce food neophobia. This intervention is an inexpensive program that volunteers can quickly implement.

Ensuring the sustainability of school-based public health intervention activities remains a challenge. The Young and Active (Y&amp, A) intervention used peer-led workshops to promote movement and strengthen students’ sense of community in 16 Danish high schools. Peer mentors inspired first-year students to implement movement activities. To support sustainability, we applied a three-year stepwise implementation strategy using university students as peer mentors in year 1 and senior high school students in the following two years. This study explores the sustainability potential of Y&amp, A, focusing on school coordinators’ reflections on the intervention’s fit to their schools and the student-driven approach, and we assess the three-step implementation strategy. The study is based on telephone interviews with coordinators (n = 7) from schools that participated in all three years and participant observations of four workshops (a total of approximately 250 participating students). Results were generated through an abductive analysis. Seven schools continued the intervention throughout the three years and adapted it to fit their priorities. The student-driven approach was perceived to be valuable, but few student-driven activities were initiated. Teacher support seemed crucial to support students in starting up activities and acting as peer mentors in workshops. The three-step implementation strategy proved valuable due to the peer-approach and the possibility of gradual adaptation. In future similar initiatives, it is important to address how the adequate staff support of students can be facilitated.

This pilot study used accelerometers to investigate the effectiveness of a multiple recess school intervention on physical activity patterns in younger elementary children using a post-test only with nonequivalent groups design. First and second grade students (N = 157) participating in a larger study, the LiiNK Project&reg, (Let&rsquo, s inspire innovation &lsquo, N Kids), wore accelerometers for the duration of the school day for two weeks to measure physical activity intensity and number of steps taken daily. Students attended either an intervention school (N = 90), participating in four 15-min unstructured, outdoor recesses and one 15-min character development lesson daily, or a control school (N = 67), participating in two 15-min unstructured, outdoor recesses daily and no character development program. The intervention students, grades 1 and 2, took more steps (p &lt, 0.001) and time spent in moderate (p &lt, 0.001) and vigorous (p &lt, 0.001) physical activity (MVPA) than the control school students. Intervention students averaged approximately 900 more steps per day than the control school students. These results show young children given 60 min of recess daily continue to increase physical activity patterns over those with 30 min of recess daily. Next steps are to evaluate if children demonstrate healthier body fat levels as a result of these higher patterns of MVPA daily.

Background: Parental involvement is one of the important factors in pupils’ academic achievement. Aim: The study sought to assess whether an intervention to enhance the interaction of parents with Grade 4 learners (aged 10–15 years) in homework would improve the learners performance in Chitonga and Mathematics. Setting: This study was conducted with two rural primary schools in the Kalomo District of Southern Province, Zambia. Methods: The participants were Grade 4 learners and their parents. A total of 168 participants were enlisted (84 learners and 84 parents). Elementary tests in Mathematics and Chitonga, the quality of parent–child interaction in homework, the quality and frequency of parent–school communication in homework, and the use of home resources in the instruction of children to increase Chitonga and Mathematics skills were assessed. One school served as a control while the other was the target of intervention. Parents in the intervention group received a 10-week programme of sensitisation on how to support their children in homework using available local resources and on parent–child interactions. Questionnaires and interviews were sent to collect data from parents while tests in Mathematics and Chitonga, systematically developed by the national regulatory body, were set to assess the learners’ performance. Results: Post-test scores of learners in Mathematics and Chitonga in the intervention school were significantly higher, in addition to increased parent–child interaction and the use of home resources in instruction. Conclusion: The authors conclude that interventions which empower parents with knowledge and skills for greater involvement in their children’s homework can be effective in improving the learners’ performance.

Objective Sports activities is broadly utilized to support well-being of youth after a disaster or conflict. However, scientific validation of programs have not been conducted. The Mastery Approach to Coaching (MAC) is a coaching-education program on sports activities. The MAC reported to have a positive effect on youngsters’ self-esteem. As self-esteem is generally known to be beneficial for mental status, we tested the effect of a MAC program on students’ self-esteem in a disaster-affected area: Leyte, Philippines. We recruited 10th grade students from three schools; one school was allocated to the MAC intervention and the two schools to the control group. All schools were encouraged to involve students in volleyball from January to February 2015. In January 2015, MAC workshop was conducted in the intervention school before the sports activity. Results A total of 293 students completed the questionnaires. The intervention school (n = 51) showed a significant change in self-esteem, with the mean score increasing from 20.2 to 21.1 (p = 0.02). Neither school in the control group showed the significant change. The result showed the feasibility and a positive effect of sports activity with the MAC. However, further investigation should be conducted. Trial registration UMIN Clinical Trials Registry ID: UMIN000033197 on June 30th 2018. Retrospectively registered

The aim of this pilot study was to assess whether the installation of ultraviolet radiation (UVR) meters in secondary schools has the potential to improve adolescents&rsquo, sun protection-related knowledge, attitudes, and behaviours and reduce their exposure to UVR during school hours. Data were collected from students at two schools via online pre- and post-intervention surveys, measurement of sunscreen usage, polysulfone UVR exposure badges, and photographs of the schoolyards to assess hat and shade use. Several operational issues limited the quantity and quality of data that could be collected, and findings were mixed. While there were no significant changes in either self-reported or observed sun protection behaviours, there were significant improvements in UVR knowledge among students at the intervention school, and reactions to the meter were highly favourable. Students reported consulting the meter regularly and using it to make decisions about their sun protection behaviours. Overall, the study results offer some support for the use of UVR meters in areas frequented by adolescents and provide insights into the process issues that are likely to need to be addressed when attempting to trial sun protection interventions in schools.

Objective: A school tobacco policy (STP) commonly is used to reduce smoking among adoles-cents, but the effectiveness of such programs is unclear. We evaluated the impact of an STP on tobacco use in 4 schools. Methods: The study included 4 intervention and 4 control schools, located in the inner city of Stockholm, Sweden. Schools self-selected for assignment to either an intervention program or a comparison group. In total, the study was comprised of 2671 students in grades 9 and 11, ages 15 to 18, and 1998 students (75%) responded to the questionnaire. We used a repeated cross-sectional design with assessment of tobacco use prevalence before im-plementation of the STP in 2016 and after 2 years under the program, in 2018. Results: Two years after the STP, the intervention school in grade 9 showed a lower prevalence (13.5% vs 1.6%) in the proportion of students who reported smoking (χ2 = 4.54; p < .05) whereas the proportion reporting snus use was practically unchanged. We found no statistically significant impact of the STP for grade 11. Conclusions: The results are promising with regard to smoking, when the STP is implemented in early adolescence. (Less)

Objective Compare the effectiveness of community-based HPV-related education and onsite school-based vaccination versus community-based education only for increasing HPV vaccine uptake in a rural, medically underserved area. Methods Our cohort included 2307 Rio Grande City Consolidated Independent School District (RGCISD) middle school students from 3 schools enrolled in August 2016 and followed until April 2018. Using a quasi-experimental design, this study implemented an onsite school-based vaccination program and physician-led education on HPV and HPV vaccines for parents/guardians, school nurses/staff, and pediatric/family providers in the surrounding community (15-mile radius of RGCCISD) at 1 middle school (“intervention school”), and education-only for the remaining 2 schools (“comparison schools”). The Centers for Disease Control and Prevention's HPV-related educational materials supplemented the education. HPV vaccine status was obtained from school immunization records and the project's contracted vaccine vendor. HPV vaccine initiation and completion rates were compared pre and post intervention and between the intervention and comparison schools. Logistic regression was used to compare the odds of newly initiating/completing vaccination between the intervention and comparison schools. Results At baseline, the intervention school had lower HPV vaccine initiation and completion rates than the comparison schools (20.00% and 8.70% vs 28.97% and 14.56%). Post intervention, the intervention school had higher initiation and completion rates than the comparison schools (53.67% and 28.36% vs 41.56% and 20.53%). Students from the intervention school were over 3.6-times more likely to newly initiate/complete the HPV vaccinations than students from the comparison schools. Conclusion The school with on-site vaccination events and community-based education had a higher adolescent HPV vaccination rate compared to schools that received community-based education only., Highlights • Our study implemented the first school-based vaccination program in a rural, medically underserved area in Texas. • School-based vaccinations and community education increased the HPV vaccination rate at a greater rate than education only. • Our work demonstrates that middle schools provide feasible and effective settings for increasing HPV vaccination rates.

Background: Modern-day technology is appealing to children. Few studies, however, have conducted longitudinal analyses of a school-based exergaming program&rsquo, s effect on physical activity (PA) behaviors and fitness in children. Therefore, this study examined the longitudinal effect of an 8-month school-based exergaming intervention on children&rsquo, s objectively-measured PA and cardiorespiratory fitness (CRF). Materials and Methods: Eighty-one fourth grade students (X̅age = 9.23 &plusmn, 0.62, 39 girls, 54.3% African American, 30.9% Non-Hispanic White, 14.8% other) participated in this study from 2014&ndash, 2015. The intervention school&rsquo, s children participated in a once-weekly 50-minute exergaming intervention during recess throughout the school year, while the control school continued regular recess. Children&rsquo, s in-school PA and sedentary behavior (SB) were measured with ActiGraphGT3X+ accelerometers, with CRF assessed via the half-mile run. All measurements were taken at baseline, mid-intervention (four months) and post-intervention (eight months). Repeated-measures two-way ANCOVAs using age and race as covariates were conducted to examine between-school differences over time for SB, light PA (LPA), moderate-to-vigorous PA (MVPA), and CRF. Results: Significant time by group interactions were observed for LPA, F(1, 79) = 7.82, &eta, 2 = 0.09, p &lt, 0.01, and MVPA, F(1, 79) = 4.58, &eta, 2 = 0.06, p &lt, 0.05, as LPA increased among the control group, while MVPA increased among intervention group. Children in both groups experienced decreased SB during the intervention (intervention: &minus, 7.63 minutes, control: &minus, 17.59 minutes), but demonstrated lower CRF over time (intervention: +46.73 seconds, control: +61.60 seconds). Conclusions: Observations suggested that school-based exergaming implementation may be effective in increasing children&rsquo, s MVPA and decreasing their SB over the course an academic year (i.e., ~eight months). More research is needed, however, to discern how modifications to school-based exergaming might also promote improved CRF in children.

The present study adopted a quasi-experimental mixed method approach to investigate the influence of an improved school ground on children’s academic performance. In total, 123 children from two (intervention and control) primary schools in Bangladesh participated. In the intervention school, a barren school ground was redesigned with several behavior settings (e.g., gardens and amphitheater) for teaching and learning. Treatment group children ( n = 29) received math and science classes outdoors, while a comparison group ( n = 32) received usual indoor classes. A control school with no changes to the outdoor environment was included ( n = 62). The redesigned school ground was associated with higher levels of academic attainment. Furthermore, all intervention schoolchildren perceived more opportunities to explore in the redesigned school ground. Qualitative insights suggest the diverse settings provided more opportunities to explore, experiment, and work collaboratively. These results highlight the potential for school ground design to contribute to improvement of children’s academic attainment in developing countries.

Objectives: To evaluate the effectiveness of a one-year teaching intervention to increase moderate to vigorous physical activity (MVPA) during primary school physical education (PE). Methods: A quasi-experimental, non-equivalent group design involving four classes from two primary schools in the West Midlands, UK. In March 2014 schools were selected through purposive sampling to match schools in terms of size and demographics (baseline, n = 111: post-intervention, n = 95); data were collected from children in school years 3 and 4 (aged 7 to 9 years). The intervention involved developing teacher effectiveness through the SHARP Principles Model which was grounded in the Self Determination Theory (SDT), the Social Ecological Model (SEM) and three key ingredients from the Behaviour Change Taxonomy (BCT). MVPA was assessed at baseline and four weeks post-intervention using the System for Observing Fitness and Instruction Time (SOFIT). Four individual teacher interviews were conducted with the intervention school, to explore teachers' perceptions of the intervention. Results: A two-way ANOVA (Analysis of Variance) indicated large interaction effect sizes for time spent in MVPA (F(1, 27) = 11.07, p = 0.003, ηp2 = .316) and vigorous activity (VPA) (F = (1,27) = 8.557, p = .007, ηp2 = .263). PA in the intervention school increased significantly whereas in the control school MVPA remained relatively constant and VPA decreased. The qualitative findings revealed two main emergent themes: a paradigm shift and teacher's developing pedagogy. Conclusions: The intervention was effective in increasing MVPA in PE. Recommendations based on this evaluation would be for the SHARP Principles Model to be replicated and evaluated on a wider scale across a variety of contexts., Highlights • We designed and evaluated a primary PE teaching strategy intervention. • The intervention yielded a large effect size, and increased children's MVPA by 30%. • The SHARP Principles Model re-directed the school's approach to primary PE. • Qualitative data suggested a paradigm shift in the teacher's thinking towards PE. • Mixed methods assisted in understanding the effectiveness of the intervention.

Objective: Use a school-based food garden as an instrument to improve healthy dietary consumption, habits, and practices among children from the third to fifth grade in public schools in Chile. Design: Quasi-experimental, six-month intervention with an evaluation of dietary consumption, habits, and practices and use of the school-based food garden among the 3rd to 5th grade students. Setting: Two municipal schools in a low-middle income district in Santiago de Chile; one with a school garden intervention and a control school without a garden. Subjects: 155 third to fifth grade children, 63 in the intervention school and 92 in the control school (average age 10 years old, 58% boys). Results: In the intervened school, there was a significant improvement in the children’s dietary habits, such as peeling and slicing fruit (p Conclusions: The school-based food garden was effective in achieving change in dietary habits and practices among the third to fifth grade children. The project should be carried out for a longer period of time, so that the changes will be reflected in the students’ food consumption and nutritional status.

The purpose of this study was to explore the physical activity patterns and emotional states differences among elementary school students at two private schools with differently structured school days. Students at one school received the LiiNK Project® pilot intervention, which included an additional two 15-minute recess breaks (unstructured outdoor play) throughout the school day and a 15-minute character development lesson three to four times weekly. Students at the comparison school received only one 30-minute recess daily and no additional character development curriculum. Grades K-2 children from two schools (N=262) wore pedometers for one school week and were observed for emotional expressions during recess. A univariate ANOVA revealed that intervention school students took significantly more steps on average than comparison school students, F(1, 260)=0.784, p, {"references":["Centers for Disease Control and Prevention. School health policies and practices study: 2014 Overview. Atlanta, GA: U.S. HHS 2015.","Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act 2011; 8(98): 1-22. https://doi.org/10.1186/1479-5868-8-98","Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Broday J, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005; 352(11): 1138-45."]}

Purpose Misuse and/or lack of booster seat use are often associated with high rates of injury and death among school-aged children. This pilot study examined the efficacy and the potential effectiveness of a booster seat intervention in the classroom. Methods Two elementary schools participated (randomly assigned as one intervention school and one control school). At the intervention school, a certified car seat specialist and a police officer held an interactive booster seat session. The height and age for each child were recorded. Children received a certificate indicating whether they met the requirements for booster seat use and a postcard with car seat restraint specifications. Children in the control school received a brochure on car seat safety. Pre- and post-intervention self-reports were collected and booster seat use was observed. Results Observational findings showed a decline in booster seat use at the control school and an increase in use at the intervention school. Self-reports of booster seat use indicated a decline at both schools; however, cell sizes were too small to permit statistical analyses. Conclusion Anecdotally researchers found the sessions were easy to conduct and were well received by the children and could be easily integrated into programming in schools. Classroom sessions may have the potential to positively influence booster seat use among 6- to 8-year-olds.

We assessed whether supplying soap to primary schools on a regular basis increased pupil hand washing and decreased Escherichia coli hand contamination. Multiple rounds of structured observations of hand washing events after latrine use were conducted in 60 Kenyan schools, and hand rinse samples were collected one time in a subset of schools. The proportion of pupils observed practicing hand washing with soap (HWWS) events was significantly higher in schools that received a soap provision intervention (32%) and schools that received soap and latrine cleaning materials (38%) compared with controls (3%). Girls and boys had similar hand washing rates. There were non-significant reductions in E. coli contamination among intervention school pupils compared with controls. Removing the barrier of soap procurement can significantly increase availability of soap and hand washing among pupils; however, we discuss limitations in the enabling policy and institutional environment that may have prevented reaching desired levels of HWWS.

Background: Primary schools are increasingly used as arenas for public health initiatives. The aim of this study was to assess a primary school-based food intervention. Methods: The intervention comprised timetabled kitchen classroom sessions (90 min, fortnightly). Pupils prepared and cooked food, which they then ate together. Children's relationship with food, including food enjoyment, experience and food neophobia, were addressed at the intervention school (baseline n = 154; follow-up n = 164) and at a matched control school (baseline n = 171; follow-up n = 174). Results: Pupils at the intervention school scored significantly higher (M = 3.90, SD = 1.81) for scores on Kitchen Equipment, compared to the control school (M = 3.06, SD = 2.12); and again scored significantly higher (M = 9.34, SD = 3.79) for the overall Cooking Experience Score compared to the control school (M = 7.98, SD = 4.57). Shifts accompanying the intervention in three outcome measures for pupils (taste description, liking for cooking and helping with cooking at home) were also revealed. No main intervention effect for food neophobia and fussiness was found; a close to significant time by intervention interaction (P = 0.053) was evident. Conclusions: The study indicates limited but encouraging changes, and contributes to the growing literature regarding school-based food initiatives.

Summary Background: Schools provide a prime environment for interventions that attempt to increase physical activity and prevent obesity. Objective: This study examined the effect of a 30-min, structured recess using 22 games of known energy expenditure on moderate-to-vigorous physical activity when compared to free play implemented with third graders from two elementary schools over 9 weeks. Methods: Moderate-to-vigorous physical activity and other cardiovascular risk factors were assessed pre- and post-intervention in 27 children. Results: Moderate-to-vigorous physical activity during recess increased significantly in intervention school children from 6.9 0.8 to 14.9 0.9 min pre- and post-intervention, respectively (adjusted mean change 8.0 1.1; P < 0.0001), with no differences by gender or body mass index (BMI). In-school, moderate-tovigorous physical activity also increased significantly more for intervention compared to control children (adjusted mean change 14 4 min vs. 3 3 min; P = 0.014, respectively). Conclusion: There was no significant difference in BMI and cardiovascular risk factors. A structured recess is feasible to implement and can significantly increase moderate-to-vigorous physical activity.

Background Elementary schools represent both a source of childhood sun exposure and a setting for educational interventions. Methods Sun Protection of Florida's Children was a cluster randomized trial promoting hat use at (primary outcome) and outside of schools among fourth-grade students during August 8, 2006, through May 22, 2007. Twenty-two schools were randomly assigned to the intervention (1115 students) or control group (1376 students). Intervention schools received classroom sessions targeting sun protection attitudes and social norms. Each student attending an intervention school received two free wide-brimmed hats. Hat use at school was measured by direct observation and hat use outside of school was measured by self-report. A subgroup of 378 students (178 in the intervention group and 200 in the control group) underwent serial measurements of skin pigmentation to explore potential physiological effects of the intervention. Generalized linear mixed models were used to evaluate the intervention effect by accounting for the cluster randomized trial design. All P values were two-sided and were claimed as statistically significant at a level of .05. Results The percentage of students observed wearing hats at control schools remained essentially unchanged during the school year (baseline = 2%, fall = 0%, and spring = 1 %) but increased statistically significantly at intervention schools (baseline = 2%, fall = 30%, and spring = 41%) (P < .001 for intervention effect comparing the change in rate of hat use over time at intervention vs control schools). Self-reported use of hats outside of school did not change statistically significantly during the study (control: baseline = 14%, fall = 14%, and spring = 11%; intervention: baseline = 24%, fall = 24%, and spring = 23%) nor did measures of skin pigmentation. Conclusions The intervention increased use of hats among fourth-grade students at school but had no effect on self-reported wide-brimmed hat use outside of school or on measures of skin pigmentation.

In looking for new strategies to promote physical activity (PA), the purpose of this study was to determine whether providing equipment, playground markings, and a physical education (PE)-based intervention effectively increases PA levels during school recess. A total of 223 children (mean age = 7.10 years ± 0.6; 45.3% female) from three schools participated in this study in 2012. In the first intervention school (G1; n = 75) six previous PE classes teaching games for recess were performed and playground markings and game equipment were provided. In the second intervention school (G2; n = 68) only playground markings and game equipment were provided. The third school served as the control group (GC; n = 80). PA was assessed with pedometers. The increase in mean steps after intervention in G2 was higher than the G1 and GC ( P < 0.001). No differences between G1 and GC were observed at post-intervention ( P = 0.05). The effects did not vary by gender or BMI. Providing game equipment and playground marks may increase children PA in recess. Nevertheless, additional PE-based intervention did not imply an improvement, and was not effective in increasing PA. Normal 0 21 false false false ES X-NONE X-NONE

The process of a life skills-based nutrition education program and impact on upper grade students in elementary schools were evaluated with regard to their knowledge, attitude, behavior while eating snacks and breakfast, and self-esteem. The subjects for this study were students from two elementary schools in Osaka prefecture. The students in the intervention school participated in a nutrition education program between the second trimester of the fifth grade and the first trimester of the sixth grade that focused on eating healthier snacks and eating breakfast every day. Questionnaires were completed by the students in the intervention and control schools before and after the program. A total of 160 students (88 in the intervention school and 72 in the control school) participated in the survey. A chi-square test, t-test, McNemar test, and Wilcoxon signed-ranks test were used to examine the effects of the program. The statistical significance level was 0.05.Although the teachers could implement well the program for eating healthier snacks, they pointed out the need to reexamine the process and worksheets of the program for eating breakfast. The overall program had a positive effect on nutritional and behavioral knowledge and on the self-control of students in selecting healthy snacks. However, it did not change to the expected extent the intake of oily snacks, attitude and behavior toward eating breakfast, and self-esteem. These results suggest that the program should be revised to improve life skills including decision-making and goal-setting abilities among elementary school students, and to strengthen the relationship between schools and families.

Evidence for adverse effects of screen media exposure has led to recommendations to limit children's screen time. This paper describes a randomized controlled trial of SMART (Student Media Awareness to Reduce Television), an 18-lesson, theory-based classroom curriculum to reduce screen time among third and fourth grade children in two matched public elementary schools (n = 181). Intervention school children significantly reduced their weekday television viewing and weekday and Saturday video game playing compared to controls. Greater effects were found among boys and more adult-supervised children. Mothers, fathers, and siblings and other children in intervention school households also reduced their television viewing. The findings demonstrate the efficacy of a classroom intervention to reduce screen time among elementary school children and their family/household members.

To investigate changes in student food selection and consumption in response to the new National School Lunch Program meal patterns during fall 2011.Eight elementary and four intermediate schools in one Houston area school district were matched on free/reduced-price meal eligibility and randomized into control or intervention conditions.Both intervention and control school cafeterias served the same menu. The intervention school cafeterias posted the new meal pattern daily; students could select one fruit and two vegetable servings per reimbursable meal. Control school students could only select the previous meal pattern: a total of two fruit and vegetable servings per meal.Students were observed during lunch: student sex and foods selected/consumed were recorded. Diet analysis software was used to calculate energy/food groups selected/consumed.Cochran-Mantel-Haenszel χ² tests examined differences in the percent of students selecting each meal component by condition, controlling for sex, grade, and school free/reduced-price meal eligibility. Analysis of covariance assessed differences in amount of energy/food groups selected and consumed, and differences in percent of food groups consumed.Observations were conducted for 1,149 elementary and 427 intermediate students. Compared with students in the control schools, significantly more intervention elementary and intermediate school students selected total (P0.001, P0.05) and starchy vegetables (P0.001, P0.01); more intervention intermediate school students selected fruit (P0.001), legumes (P0.05), and protein foods (P0.01). There were significantly greater amounts of these foods selected and consumed, but no differences in the proportion of the foods consumed by condition. Fewer calories were consumed by elementary and intermediate school intervention students.More intervention students selected fruit and vegetables at lunch and consumed them compared with control condition students. Future studies with larger and more diverse student populations are warranted.

Adolescents do not consume the recommended daily amount of whole fruit. As part of the effort to improve the dietary choices of adolescents, traditional nutrition education alone has not been successful. School cafeterias are a strategic place to focus efforts to promote positive behavior change at the site of students’ food selection and consumption. Garden-based sustainability programs correlate with the state-mandated science standards taught in the middle school classroom and have been effective at increasing fruit consumption in children. This study measured the effect of a vermicomposting model on whole fruit consumption in the middle school lunch room. Students were introduced to the concept of vermicomposting in the classroom through a lesson plan. Students were invited to participate in the vermicomposting process by contributing their fruit scraps to a worm bin that was placed in the school cafeteria for the duration of the study. A significant increase in familiarity with the topic of vermicomposting was observed after implementation of the lesson plan. Compared to baseline, the control school experienced an overall increase in fully consumed and partially consumed fruit, while the intervention school experienced a simultaneous decrease in consumption. No significant changes in fruit selection were observed.

El principal objetivo de este trabajo se ha centrado en poner de relieve cómo los distintos contextos o escenarios en los que se desarrolla la vida del niño de seis a doce años (familia, escuela y comunidad próxima), pueden contribuir a su educación para la salud y en concreto, a la formación en él de estilos de vida saludables. El segundo objetivo ha sido sensibilizar a futuros educadores (maestros de educación primaria en segundo curso de formación) sobre la importancia de la educación para la salud, e incrementar su conocimiento sobre los estilos de vida de sus futuros alumnos, así como sobre formas de intervención de la escuela en este sentido, en colaboración con las familias y la comunidad. Para conseguir estos dos grandes objetivos se ha realizado una actualización conceptual en la primera parte del trabajo y una aproximación empírica en la segunda, mediante la recogida de datos sobre los estilos de vida de diez niños/as de seis a doce años y la reflexión, en el contexto de clases interactivas, sobre características de los mismos y de la intervención de diversos agentes educativos.http://dx.doi.org/10.15304/ie.24.2047

Preventing children's thermal injuries requires changes to both the home environment and the behaviour of family members. Two pilot studies were undertaken of a school-based programme that taught children aged 7-11 years about burns and scalds hazards, and encouraged changes to the home environment and family practices through a take-home exercise. Both studies took place at ethnically diverse schools from low/middle-income areas of Waitakere City, New Zealand. Study 1 involved 55 children who received the programme, and Study 2 involved 64 children who received the programme and 71 children from a control school. The children's ability to identify the burns and scalds hazards illustrated in a series of pictures was measured before and after the programme. Children who received the programme showed considerable improvement in hazard identification at the post-test, while children at the control school showed minimal improvement. The take-home exercise was completed by 85% of the children and their families in Study 1, and 61% of the participants from the intervention school in Study 2. In both studies families reported positive safety changes as a result of the programme. The programme appeared equally effective with all the ethnic groups involved. Future development of the programme is discussed.

Background An emerging public health strategy is to enhance children’s opportunities to be physically active during school break periods. The aim of this study was to evaluate the effects of the Lunchtime Enjoyment Activity and Play (LEAP) school playground intervention on primary school children’s quality of life (QOL), enjoyment and participation in physical activity (PA). Methods This study consisted of a movable/recycled materials intervention that included baseline, a 7-week post-test and an 8-month follow-up data collection phase. Children within an intervention school (n = 123) and a matched control school (n = 152) aged 5-to-12-years-old were recruited for the study. Children’s PA was measured using a combination of pedometers and direct observation (SOPLAY). Quality of life, enjoyment of PA and enjoyment of lunchtime activities were assessed in the 8-12year children. A multi-level mixed effect linear regression model was applied in STATA (version 12.0) using thextmixedcommand to fit linear mixed models to each of the variables to examine whether there was a significant difference (p  Results Significant overall interaction effects (group × time) were identified for children’s mean steps and distance (pedometers) in the intervention school compared to the control school. Intervention school children also spent significantly higher proportions within specified target areas engaged in higher PA intensities in comparison to the control school at both the 7-week post-test and 8-month follow-up. A short-term treatment effect was revealed after 7-weeks for children’s physical health scale QOL, enjoyment of PA and enjoyment of intra-personal play activities. Conclusions Examining the effects of this school playground intervention over a school year suggested that the introduction of movable/recycled materials can have a significant, positive long-term intervention effect on children’s PA. The implications from this simple, low-cost intervention provide impetus for schools to consider introducing the concept of a movable/recycled materials intervention on a wider scale within primary school settings. Trial registration Australian and New Zealand Clinical Trials Registration Number:ACTRN12613001155785.

Objective. Consumption of water may help promote health and prevent obesity in children by decreasing consumption of sugar-sweetened beverages. This study used evidence-based strategies to increase water consumption in Mexican-American and Mexican children. Materials and methods. In 2012, two schools in San Diego, USA and two other in Tlaltizapan, Mexico were recruited to Agua para Niños (Water for Kids), a program designed to promote water consumption among elementary grade students. Guided by operant psychology, the intervention focused on school and classroom activities to encourage water consumption. One control and one intervention school in each country wereincluded. Results. Agua para Niños resulted in increases in observed water consumption and bottle possession among US and Mexican students. Teacher receptivity to the program was very positive in both countries. Conclusions. Agua para Niños yielded sufficiently positive behavioral changes to be used in a future fully randomized design, and to contribute to school nutrition policy changes.

En el presente estudio se revisan algunos programas de intervención tanto a nivel internacional como nacional relacionados con la prevención del fracaso y/o abandono escolar en la Educación Secundaria Obligatoria (ESO). Para ello, se realizó una búsqueda en las bases de datos ProQuest, ISOC, Redalyc y Dialnet sobre intervenciones realizadas desde el año 2000 al 2010 con dicho objetivo. Aunque entre ellas existen variaciones respecto a los objetivos, duración, actividades y resultados, todas ellas muestran unas características comunes a la hora de elaborar cualquier programa de esta tipología, que son convenientes tener en cuenta para la elaboración de actuaciones futuras que permitan una mejora del rendimiento académico del alumnado y un incremento de la promoción a niveles postobligatorios.In this study are reviewed some intervention programs both internationally and nationally related to the prevention of failure and/or school drop-outs in middle school. For this aim, carried out a search in the databases ProQuest, ISOC, Redalyc and Dialnet on interventions since 2000 to 2010 with the goal. Although between them variations exist as to the objectives, duration, activities and results, all of them show characteristics common to the time to develop any program of this type, which are suitable take into account for the development of future actions that would allow an improvement in the academic performance of the students and an increase in the promotion to high school.

Objectives. We evaluated the effects of a Department of Education Fresh Fruit and Vegetable Program (FFVP) on food consumption habits in an inner-city, San Francisco high school. Methods. One intervention high school received a California state grant from the Department of Education to distribute fruit biweekly from fall 2008 to spring 2010 and coordinate associated nutrition education. Students completed 1793 surveys at the intervention school and 778 surveys at a comparison school that assessed fruit, vegetable, fast food and soda consumption habits. Pearson's chi-squared tests were used to compare consumption of foods. Results. At the end of the intervention period, the percentage of students consuming soft drinks once or more per day was significantly lower in the intervention versus comparison school (3.1% versus 8.9%, ). Consumption of candy once or more per week was also lower in the intervention versus the comparison school in fall 2009 (55.7% versus 64.0%, ). No significant changes in fruit and vegetable consumption were observed in the intervention or comparison schools. Conclusions. Fruit distribution programs in high schools may decrease high school students' consumption of soft drinks and candy.

Background This paper evaluates the effect of the World Starts With Me (WSWM), a comprehensive sex education programme in secondary schools in Uganda. The aim of the present study was to assess the effects of WSWM on socio-cognitive determinants of safe sex behaviour (delay; condom use and non-coercive sex). Methods A survey was conducted both before and immediately after the intervention among students in intervention (N = 853) and comparison (N = 1011) groups. A mixed model repeated measures analysis was performed to assess the effectiveness of the WSWM programme on the main socio-cognitive determinants of safe sex behaviour at post-test. A similar post-hoc comparison was made between schools based on completeness and fidelity of implementation of WSWM. Results Significant positive effects of WSMW were found on beliefs regarding what could or could not prevent pregnancy, the perceived social norm towards delaying sexual intercourse, and the intention to delay sexual intercourse. Furthermore, significant positive effects of WSWM were found on attitudes, self-efficacy and intention towards condom use and on self-efficacy in dealing with sexual violence (pressure and force for unwanted sex). A reversed effect of intervention was found on knowledge scores relating to non-causes of HIV (petting, fondling and deep kissing). A follow-up comparison between intervention schools based on completeness of the programme implementation revealed that almost all significant positive effects disappeared for those schools that only implemented up to 7 out of 14 lessons. Another follow-up analysis on the basis of implementation fidelity showed that schools with a "partial" fidelity score yielded more significant positive effects than schools with a "full" fidelity of implementation score. Conclusions The study showed an intervention effect on a number of socio-cognitive determinants. However, the effectiveness of WSWM could be improved by giving more systematic attention to the context in which such a programme is to be implemented. Implications for the systematic development and implementation of school-based safe sex interventions in Uganda will be discussed.

OBJECTIVE: To assess the effectiveness of a 20-week, broad intervention to prevent reinfection by Ascaris lumbricoides (AL) and Giardia lamblia (GL) among indigenous schoolchildren in northern Mexico. METHODS: A prospective, comparative, ecological study. Two isolated boarding schools, each hosting 100-120 children, 4-15 years of age, were selected based on physical infrastructure: intervention school (IS), modern; control school (CS), deprived. After initial diagnosis, children with positive stool samples received supervised treatment with oral nitazoxanide. Diagnoses were made with at least one positive microscopic result from two serial samples using the Faust technique, as reported by the independent observations of two trained, laboratory technicians. Post-treatment samples were taken, and only those with negative results were followed-up. The intervention included infrastructure improvements/maintenance and an educational preventive program for children, parents, and school personnel; no activities were undertaken in the CS. RESULTS: Baseline prevalence for AL was 37.5% at the IS versus 16.6% at the CS (P < 0.01); and for GL, 51.7% versus 37.8%, respectively. At the IS, 35.7% did not speak Spanish, compared to 6.7% in the CS (P < 0.01). Cure rates were similar in both schools for AL (~ 98%) and GL (~ 80%). Final prevalence and reinfection rates for GL were 10.4% versus 10.8%, and 17.2% versus 21% at the IS and CS, respectively. No children were infected/reinfected with AL in either school. Follow-up rates were 80%-83% at the CS and 90%-95% at the IS. CONCLUSIONS: Infection/reinfection rates were similar at the schools after 20 weeks. Supervised treatment alone every semester could effectively control AL/GL infections in this indigenous setting.

Background: School workstations are often inappropriate in not offering an optimal sitting posture. The aim of this study was to investigate the effects of individually adjustable saddle-type chairs with wheels and desks with comfort curve and arm support on schoolchildren’s working postures compared to conventional workstations. Methods: Ninety-seven participants aged 12-16 years were followed for 1 year, 47 at an intervention school and 50 at a control school. Anthropometrics and workstation dimensions were measured and working postures analyzed for a part of each group (n = 21, both groups) by means of video recording at baseline, before new workstations were introduced, and during follow-up. Results: There was a significant increase in upright back (p= .012) and neck (p= .019) postures in the intervention group compared to controls during follow-up. The saddle-type chairs allowed significantly greater trunk-thigh angles (p < .001) among participants than conventional chairs. Conclusions: In schoolchildren, using individually adjustable saddle-type chairs and desks with comfort curve, a better match between workstations and anthropometric dimensions and improved working postures are obtained than using conventional workstations.

This study compared the performances of students at the University of North Carolina at Chapel Hill School of Medicine who had access to sets of problem exercises and a computer database to support their learning of bacteriology with the performances of students at the University of Iowa College of Medicine who did not have such access. The study also examined the extent of a student's database use as a predictor of posttest performance. The students studied were randomly selected groups of 32-44 first-year students per year at each school; the study was conducted in three academic years (1988-1990) with some modifications in the intervention as the host environment evolved. The criterion measure was a posttest created from the same pool of problems used to generate the problem sets. The students at the intervention school scored significantly higher on the posttest in two of the three years, and overall. Also in two of the three years and overall, there was a significant relationship between the extent of a student's database use and his or her posttest score. Although the observed effects may have been due to other factors in this quasi-experimental design, the authors conclude that the use of problem sets and a computer database had a positive influence on the students' learning.

Background: This study evaluated an environmental intervention intended to increase consumption of the fruit serving among elementary school children participating in the National School Lunch Program (NSLP).

Beat the Street aims to get children more active by encouraging them to walk and cycle in their neighbourhood using tracking technology with a reward scheme. This pilot study evaluates the impact of Beat the Street on active travel to school in Norwich, UK. Eighty children 8-10 yrs were recruited via an intervention and control school. They wore an accelerometer for 7 days at baseline, mid-intervention and post-intervention (+20 weeks), and completed a travel diary. Physical activity overall was not higher at follow-up amongst intervention children compared to controls. However, there was a positive association between moderate-to-vigorous physical activity (MVPA) during school commute times and the number of days on which children touched a Beat the Street sensor. This equated to 3.46min extra daily MVPA during commute times for children who touched a sensor on 14.5 days (the mean number of days), compared to those who did not engage. We also found weekly active travel increased at the intervention school (+10.0% per child) while it decreased at the control (-7.0%), p=0.056. Further work is needed to understand how improved engagement with the intervention might impact outcomes.