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Objective: To describe an innovative school-based intervention to promote healthy lifestyles. To evaluate its effects on children's food habits and to highlight the key components which contribute most to the beneficial effects obtained from children's, teachers' and parents' perspectives. Design: An educational tool to improve personal awareness, promote healthy food choices and increase children's levels of physical activity was developed and evaluated. The tool used a community-based approach and included family members, schools, university, families, sports societies, farms, mass media and municipalities. Setting: A total of 11 primary school classes in five schools in Spoleto, Umbria. Methods: The tool dealt with healthy food choices, lifestyle and physical activities and is structured in four phases (4 months). The Kidmed test (a validated index based on principles sustaining Mediterranean dietary patterns as well as those that undermine them) and open-ended questionnaires (to highlight the key components which contributed most to the beneficial effects) were used to assess the effectiveness of the intervention. Kidmed scores were evaluated both before and after intervention (T0-T1) and the written answers collected (from teachers, parents and children) were subjected to content analysis using a form of grounded theory. Results: Data point to a significant before/after increase on Kidmed scores (t=-3.88; p=.000), revealing an increase in children's adherence to the Mediterranean Diet, healthy habit changes, greater parental awareness of their educational responsibilities regarding food choices as well as physical activity, and a new school-family alliance as a result of the educational intervention. Conclusion: Project findings reveal positive effects on children's food habits and highlight key components necessary to enhance the effectiveness of a school-based educational intervention.

Very often people with diabetes, particularly in certain age groups, do not adopt healthy behaviours, despite education (Norris et al, 2001). Telling one's story and sharing it with others who [...]

The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients toward their health management. This study describes the design, development, and optimization of PHEinAction, a theoretically-driven intervention program to increase patient engagement in older chronic populations and consequently to foster healthy changes that can help reduce risks of health problems. The development process followed the UK Medical Research Council's (MRC) guidelines and involved selecting the theoretical base for the intervention, identifying the relevant evidence-based literature, and conducting exploratory research to qualitatively evaluate program's feasibility, acceptability, and comprehension. The result was a user-endorsed intervention designed to improve older patients' engagement in health management based on the theoretical framework of the Patient Health Engagement (PHE) model. The intervention program, which emerged from this process, consisted of 2 monthly face-to-face 1-h sessions delivered by a trained facilitator and one brief telephonic consultation, and aimed to facilitate a range of changes for patient engagement (e.g., motivation to change, health information seeking and use, emotional adjustment, health behaviors planning). PHEinAction is the first example of a theoretically-based patient engagement intervention designed for older chronic targets. The intervention program is based on psychological theory and evidence; it facilitates emotional, psychological, and behavioral processes to support patient engagement and lifestyle change and maintenance. It provides estimates of the extent to which it could help high-risk groups engage in effective health management and informs future trials. [ABSTRACT FROM AUTHOR]