Search

Purpose: Adapting the Health Promotion School (HPS) approach to context specifics is acknowledged as being essential for implementation and achieving optimal effectiveness. This study aims to explore implementation variations on seven HPS spectra (such as top-down to bottom-up involvement of stakeholders) on which implementation of the HPS approach can vary, and the factors that relate to navigation on these spectra. Design/methodology/approach: In 2020, fourteen HPS researchers and professionals from ten European countries participated in semi-structured interviews. Findings: Navigation variations on the HPS spectra occurred throughout most spectra. Further, a tendency was found towards spectrum extremes of addressing multiple core-components, implementing non-disruptive Health Promotion (HP) programmes, and evaluating the HPS approach through an action-oriented research approach. Important general factors were resources, staff capacity and time available to staff members for implementing the HPS approach. Some spectra required more specific factors like organisational skills, leadership or a certain level of democracy. Practical implications: The implementation of the HPS approach should be supported by implementation strategies addressing the spectrum-specific factors, but more generic factors such as staff capacity, resources and the level of democracy should also be considered. Originality/value: This study explores navigation variations throughout HPS spectra rather than the HPS approach in general. It also nuances implementation diversity across and within different European contexts.

Background: Although principles of the health promoting school (HPS) approach are followed worldwide, differences between countries in the implementation are reported. The aim of the current study was (1) to examine the implementation of the HPS approach in European countries in terms of different implementation indicators, that is, percentage of schools implementing the HPS approach, implementation of core components, and positioning on so‐called HPS‐related spectra, (2) to explore patterns of consistency between the implementation indicators across countries, and (3) to examine perceived barriers and facilitators to the implementation of the HPS approach across countries. Methods: This study analyzed data from a survey that was part of the Schools for Health in Europe network's Monitoring Task 2020. The survey was completed by HPS representatives of 24 network member countries. Results: Large variations exist in (the influencing factors for) the implementation of the HPS approach in European countries. Observed patterns show that countries with higher percentages of schools implementing the HPS approach also score higher on the implementation of the core components and, in terms of spectra, more toward implementing multiple HPS core components, add‐in strategies, action‐oriented research and national‐level driven dissemination. In each country a unique mix of barriers and facilitators was observed. Conclusion: Countries committed to implementing the HPS approach in as many schools as possible also seem to pay attention to the quality of implementation. For a complete and accurate measurement of implementation, the use of multiple implementation indicators is desirable. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of children are facing health problems as a result of physical inactivity. Besides the home, school is a natural place to promote children's daily physical activity (PA). Knowledge about factors promoting or preventing children's PA at school, from the perspective of children, is limited. Purpose: The purpose of this study is to learn the factors that eight- and nine-year-old schoolchildren identify from their school environment related to physical activity during their school day. This study was established as a sub-project within a larger, sixteen-country collaboration project by HEPCOM (Promoting Healthy Eating and Physical Activity in Local Communities) and reports on a piloting phase. Sample: Finnish second-graders (age 8-9 years, n = 22) from one primary school participated in the study. Method: A photo-elicitation methodology was used, including photographs taken by children and interviews in groups based on the photographs. The data were analysed qualitatively by inductive content analysis. Results: The children described factors appearing in the physical environment, such as the playground, and those in the nonmaterial, abstract environment, such as the weather. According to the findings, three categories emerged: (1) personal and economic, related to children's individual preferences and opportunities; (2) sociocultural, related to friends and belonging in a group; and (3) environmental, related to physical and political outdoor and indoor solutions at the school, as well as to policies and rules in the school community. Children emphasised the importance of friends and games, but play areas were also experienced as significant. Based on children's experiences, rules and laws direct all activities at school, which was not always perceived as a positive thing. Conclusions: Although the findings of this small-scale study cannot be generalised, the children's perceptions suggest some crucial areas for future research. Playing and exercising during the school day are important in fulfilling the recommendations for daily PA for children, as well as in promoting their mental and social health. To enable equal possibilities for an active lifestyle for all children at school, positive and encouraging adults, as well as age-appropriate and safe infrastructure, are needed. The children's day should be viewed as a whole, not as single situations, where physical activities are offered.

SuperFIT aims to improve the dietary and physical activity behaviour of children (2–4 years) in the Dutch childcare and home setting. Healthy parenting practices, policies, and availability of materials, fruits, and vegetables were promoted over the course of a year. This pilot study, with a quasi-experimental design, examined the effectiveness of children's intake of fruits, vegetables, water, and sweet beverages. Families attending intervention preschools could participate in the partial (preschool) or full (preschool + home) intervention. Parental 24-hour recalls assessed the child's diet at baseline and two follow-ups. Data from 81 control and 88 intervention children was included in a three-level hierarchical logistic regression. The full intervention showed significantly favourable effects for sweet beverages (B = −1.85, P < 0.05) and unfavourable effects for vegetables (B = −1.94, P < 0.05), compared to the control between the second follow-up and baseline. No significant effects were found for fruit or water, nor for the partial intervention. More research in a larger sample is needed to confirm current findings. Trial registration: ClinicalTrials.gov identifier: NCT03021980. [ABSTRACT FROM AUTHOR]

This paper describes the evaluation of an adoption strategy for the school-based healthy diet programme Krachtvoer. Health promotion (HP) professionals from five Regional Public Health Services (RPHSs) in The Netherlands were asked to recruit a total of 25 schools to adopt the Krachtvoer programme in accordance with this strategy. Afterwards, they were interviewed about their adherence to and subjective evaluation of the strategy. The adoption rate of the programme was calculated and 10 adopting and 9 rejecting teachers were interviewed about the reasons for their decision. The HP professionals' adherence to the strategy was good, as well as their appreciation and the perceived feasibility of the strategy. The person-to-person approach that characterized this strategy was considered important. The strategy led to an adoption rate of 53.2%. On average, adopters mentioned 4.4 reasons and rejecters mentioned 5.4 reasons for their decision. Most reasons were school related and programme related and in case of the adopters also teacher related. The diversity of reasons revealed the complexity of teachers' decision making. Although there is some room for improvement of the adoption strategy and the programme itself, especially socio-political conditions in schools and in RPHSs need change for a further increase in programme adoption. (Contains 2 tables.)

To enable improvements in school health promotion, this paper examines associations between the number of health-promotion issues addressed by primary school teachers in the Netherlands and factors thought to influence this behavior. The main factors studied are context characteristics and constructs of attitude, social influence, self-efficacy (SE) and perceived barriers. A total of 180 primary school teachers teaching 9- to 12-year olds (Grades 6, 7 and 8) participated in a cross-sectional survey. The results show that it is possible to differentiate between teachers addressing three or more health issues per year versus those who address fewer based on grade level (more health issues are addressed at higher grades), perceived disadvantages, SE and staff support. The latter seems to exert the greatest influence and may be one of the most promising focus points for improvements of school health promotion in the Netherlands. (Contains 5 tables and 1 figure.)

Online platforms can support health and educational professionals in their daily work; however, it is challenging to keep online platforms sustainable. This paper aims to indicate the most important factors of platform sustainability from the perspective of professionals involved in online platforms. Further, it aims to understand how these factors operate. A mixed methods study was carried out among professionals from Europe, Australia, the USA and Canada. In the first phase, the importance of 54 factors from the literature was assessed with a questionnaire among 17 professionals. The relative importance of the factors and the consensus regarding this importance were calculated using median scores and interquartile deviations. In total, 19 factors were selected representing general characteristics, characteristics related to the platform, communication, visitor and context. In the second phase, insight was gained regarding the experiences with those factors through 12 individual Skype interviews. The most frequently mentioned important factors of platform sustainability were (i) having sufficient time, resources and expertise, (ii) user friendliness and (iii) creating a sense of belonging. Platforms should use a planned approach to address a combination of factors directly from platform development. Gaining long-term resources is challenging and should be considered from the start of a project by building partnerships. To promote user friendliness, platforms should be simple, have a clear set-up and provide high-quality tools. Finally, establishing a sense of belonging could be supported by branding and face-to-face networking activities. For all aspects, involving visitors and stakeholders is essential. [ABSTRACT FROM AUTHOR]

Abstract Background Krachtvoer is a Dutch healthy diet programme for prevocational schools, developed in 2001 and revised for a broader target group in 2007, based on the findings of an evaluation of the first version. The goal of this study was to report on the short- and longer-term total and subgroup effects of the revised programme on students’ fruit, fruit juice, breakfast, and snack consumption. Methods Schools were randomized to the experimental condition, teaching the Krachtvoer programme, or to the control condition teaching the regular nutrition lessons. Self-reported consumption of fruit, fruit juice, breakfast and snacks was measured at baseline directly before programme implementation, one to four weeks after finishing programme implementation, and after six months. Mixed linear and logistic regression analyses were conducted. Results In total 1117 students of 13 experimental schools and 758 students of 11 control schools participated in the study. Short- and longer-term favourable intervention effects were found on fruit consumption (mean difference between experimental and control group 0.15 servings at both posttests). Regarding fruit juice consumption, only short-term favourable effects were revealed (mean difference between experimental and control group 0.05 glasses). Intervention effects on breakfast intakes were limited. No changes in snack frequency were reported, but students made healthier snack choices as a result of the programme. Some favourable as well as unfavourable effects occurred in subgroups of students. Conclusions The effects on fruit consumption and snack choices justify the current nationwide dissemination of the programme. Achieving changes in breakfast consumption may, however, require other strategies.

Abstract Background Krachtvoer is a school-based healthy diet programme, developed in 2001 and revised in 2007 to meet the needs of particular segments of the target population as well as a wider target group. The main aims of the present process evaluation of the revised programme were to examine student and teacher appreciation of the programme, completeness of and adherence to its implementation, and relations between appreciation and completeness of implementation. Methods Data were collected among 22 teachers and 1117 students of 13 schools, using student evaluation forms, teacher logbooks, telephone interviews, and classroom observations. Results Results indicate favourable levels of teacher and student appreciation for the programme in general and the revised elements. Girls, first-year students and students with more favourable dietary intakes particularly appreciated individual programme elements. Levels of completeness of implementation were high, but several teachers did not adhere to the intended implementation period. Some moderately strong relations were found between teacher appreciation and completeness of implementation scores. Conclusion We conclude that the revisions have resulted in a programme that was appreciated well, also by the extended target group, and was implemented with a high degree of completeness. Teacher appreciation proved potentially important for completeness of implementation. We identified several aspects requiring improvement, indicating the importance of continued programme updates and repeated evaluation.