Comprehensive school health, the social determinants of health, and the health status of children

As children are becoming increasingly inactive and obese, there is an urgent need for effective early prevention and intervention programs. One solution is a comprehensive school health (CSH) program, a health promotion initiative aimed at educating students about healthy behaviours and lifestyles, which also provides a link between the school, students, families, and the surrounding community. The purpose of this study was to explore the relationship between different components of CSH programs, as well as three determinants of health (gender, social support, socio-economic status), and physical activity, on the aerobic fitness and body mass index (BMI) of children. A newly developed and pilot-tested survey derived from Health Canada's fourpart CSH model (instruction, social support, support services, and a healthy physical environment) was sent to elementary school principals. Data on the gender, physical activity, parental education, and social support levels of students from these schools were gathered from a previous study. Multiple regression procedures were conducted to estimate the relationships between CSH components, the social determinants of health, physical activity, and BMI and aerobic fitness. Results showed that three CSH components were significantly associated with both BMI and aerobic fitness values in children, but accounted for less than 5% of the variance in both variables. Physical activity partially mediated the relationship between the significant CSH components, BMI, and particularly aerobic fitness. Furthermore, the social determinant and physical activity variables played independent roles in aerobic fitness values. No moderating effects of the social determinants were discovered.

Comprehensive school health : an ethnographic case study

The purpose of this ethnographic case study was to describe the characteristics of one school's Comprehensive School Health (CSH) initiative and to explore the experiences of school community members in order to gain an understanding of how one school embraced a Comprehensive School Health approach. An elementary school (grades Junior Kindergarten to six) in Burlington, Ontario was the research site for this study. Multiple methods of data collection (observations, document analysis, interviews) were used in keeping with the ethnographic and case study approach. The data were coded using both a deductive and then inductive process (Merriam, 1998). From a deductive perspective, the coding system and the subsequent identification of categories were based on a priori categories identified by using the elements of CSH based on the Comprehensive School Health Consensus Statement prepared by the Canadian Association of School Health and the research questions. Findings included the role that various school community members as well as the implementation of different programs and policies played in applying a CSH approach. The impact ofthe physical environment was described as well as successes and challenges related to the school's experience in implementing CSH. Three main themes emerged that characterized this school's experience. The first theme relates to the fundamental question about CSH which is the school community's understanding o/the concept. The second theme focused on positive school culture and the third and most diverse theme was that of capacity. Engaging in CSH is a complex and long-term undertaking involving both the school and greater community. Based on the experiences of this school's community members, recommendations address the different levels of influence on the health of children.

Participation factors in optional high school health and physical education

Student enrolment rates in optional health and physical education (HPE) classes have been steadily declining, to the point where most Ontario students stop taking HPE after completion of their one required credit, typically taken in grade nine. This study looked at factors that could contribute to HPE enrolment, sampling 227 grade ten students from five schools. These factors included selfefficacy (SE), perceived autonomy support (PAS), task value (TV), motivational regulation (autonomous, AR; controlled, CR), HPE grade average and body size discrepancy (BSD). Qualitative information was also gathered from students regarding likes and dislikes ofHPE, as well as reasons for their HPE enrolment choice. Cronbach Alpha values of each scale fell within acceptable values. ANOVA analysis revealed differences between enrolment groups in SE, TV, AR, HPE grade average, and BSD (p < .05). Reasons students reported for not taking HPE included a dislike of health classes, scheduling challenges, not needing HPE for future endeavors, concerns about social self-presentation, and a dislike of sports and/or competition. This research shows important differences between students and their HPE class choices and calls for a re-evaluation of how HPE classes are structured, advertised and scheduled by high school practitioners. Future works should look toward what other factors could be at play in students' decisions for or against optional HPE and how those factors interact with the constructs that were found to be of significance in this study. Keywords: Health and physical education, high school students, participation.

The journey towards comprehensive school health within an aboriginal community

The purpose of this research is to describe the journey towards Comprehensive School Health at two Aboriginal elementary schools. An advocate and a healthy schools committee were identified at both schools and were responsible for developing initiatives to create a healthy school community. A case study was used to gather an in-depth understanding of Comprehensive School Health for the two schools involved. As a researcher, I functioned within the role of a participantobserver, as I was actively involved in the programs and initiatives completed in both schools. The research process included: the pilot study, ethics clearance and distribution of letters of invitation and consent forms. Data collection included 16 semi-structured, guided interviews with principals, teachers, and stupents. Participant observations included sites of the gymnasium, classroom, playgrounds, school environments, bulletin boards as well as artifact analysis of decuments such as school newsletters, physical education schedules and school handbooks. The interviews were transcribed and coded using an inductive approach which involves finding patterns, themes and categories from the data (patton, 2002). Research questions guided the findings as physical activity, physical education, nutrition and transportation were discussed. Themes developed t~rough coding were teacherstudent interactions, cultural traditions, time constraints and professional development and were discussed using a Comprehensive School Health framework.

A needs assessment of public health professionals: supporting the implementation of Ontario 2010 revised elementary health and physical education curriculum

Based on the Comprehensive School Health framework, Ontario's Foundations for a Healthy School (2009) outlines an integrated approach to school health promotion. In this approach the school, community and partners (including public health) are fully engaged With a common goal of youth health. With the recent introductions of the Ontario Public Health Standards (2009) and the revised elementary health and physical education curriculum (2010), the timing for a greater integration of public health with schools is ideal. A needs assessment was conducted to identify the perceived support required by public health professionals to implement the mandates of both policy documents in Ontario. Data was collected for the needs assessment through facilitated discussions at a provincial roundtable event, regional focus groups and individual interviews with public health professionals representing Ontario's 36 public health units. Findings suggest that public health professionals perceive that they require increased resources, greater communication, a clear vision of public health and a suitable understanding of the professional cultures in which they are surrounded in order to effectively support schools. This study expands upon these four categories and the corresponding seventeen themes that were uncovered during the research process.

Ontario high school sport : an investigation of organizational design and its context

In 2002, The Ontario Federation of School Athletic Associations (OFSAA) identified that in providing extracurricular sport programs schools are faced with the 'new realities' of the education system. Although research has been conducted exploring the pressures impacting the provision of extracurricular school sport (Donnelly, Mcloy, Petherick, & Safai, 2000), few studies within the field have focused on understanding extracurricular school sport from an organizational level. The focus of this study was to examine the organizational design (structure, systems, and values) of the extracurricular sport department within three Ontario high schools, as well as to understand the context within which the departments exist. A qualitative multiple case study design was adopted and three public high schools were selected from one district school board in Ontario to represent the cases under investigation. Interviews, observations and documents were used to analyze the extracurricular sport department design of each case and to better understand the context within which the departments exist. As the result of the analysis of the structure, systems and values of each case, two designs emerged- Design KT1 and Design KT2. Differences in the characteristics of design archetype KT1 and KT2 centered on the design dimension of values, and therefore this study identified that contrasting organizational values reflect differences in design types. The characteristics of the Kitchen Table archetype were found to be transferable to the sub-sector of extracurricular school sport, and therefore this research provides a springboard for further research in organizational design within the education sector of extracurricular high school sport. Interconnections were found between the data associated with the external and internal contexts within which the extracurricular sport departments exist. The analysis of the internal context indicated the important role played by organizational members in shaping the context within which the departments exist. The analysis of the external context highlighted the institutional pressures that were present within the education environment. Both political and cultural expectations related to the role of extracurricular sport within schools were visible and were subsequently used by the high schools to create legitimacy and prestige, and to access resources.

The role of self-presentation in adolescent health risk behaviours

Self-presentation has been identified as playing a key role in the perfonnance of various potentially hazardous health behaviours such as substance abuse, eating disorders and reckless behaviours (Leary, Tchividjian, & Kraxberger, 1994; Martin & Leary, 2001; Martin, Leary, & O'Brien, 2001). The present study investigated the role of selfpresentation on adolescent health-risk behaviours. Specifically, this study examined the prevalence of adolescent identified health-risk behaviours rooted in self-presentational motives in youths aged 13-18 years. The current study also identified the specific images associated with these behaviours desired by youth, and the targets of these behaviours. Also, the relationship between these behaviours, and several trait measures (social physique anxiety, public-self consciousness, fear of negative evaluations, selfpresentational efficacy) of self-presentation were examined. Finally, the gender differences in health risk behaviours and self-presentational concerns were examined. Participants in the present study were 96 adolescent students, 34 male and 62 female, recruited from various private schools across Southern Ontario. Students ranged in age from 13 to 18 years for both males (M age = 15.81 years, SD = 1.49) and females (M age = 14.89 years, SD = 1.17) and ranged from grades 8 through 13. Results of the current study suggested that Canadian adolescents between the ages of 13 and 18 years participated in health risk behaviours for self-presentational purposes. Drinking alcohol, skipping school, and performing stunts and dares were identified as the most common health risk behaviours performed for self-presentational purposes by both males and females. Appearing fun and cool were the most commonly reported desired images while appearing brave and mature were the least reported. The most desired target group cited was same sex friends, followed by other sex friends. Trait measures of self-presentational concerns identified females as being higher in public self-consciousness, and social physique anxiety than males. Males were found to be higher in self-presentational efficacy than females. The total number of health risk behaviours was predicted by selfpresentational efficacy and social physique anxiety for males, and social physique anxiety for females. Findings of the current study suggest that Canadian adolescents' health risk behaviours are rooted, in part, in self-presentational motives. Thus far, an educational approach to health interventions has been favoured and/or adopted by teachers, health promoters, and educators (Jessor, 1992). Implications of the current study suggest that although educational interventions are beneficial in presenting the associated risks with certain activities and/or behaviours, one reason this type of approach may be ineffective in changing adolescent behaviour over the long run is that it does not address the strong and prominent influences of interpersonal motives on health damaging behaviour. It is evident that social acceptance and public image are of importance to adolescents, and the desire to make the "right" impression and to achieve peer approval and acceptance often override health and safety concerns (Jessor, 1992). Thus, a self-presentational approach focusing on changing the images associated with the behaviours may be more successful at deterring adolescent health risk behaviours.

Implementing the OPTIMAL model : the impact on students' motivation in an elementary school games environment

Optimal challenge occurs when an individual perceives the challenge of the task to be equaled or matched by his or her own skill level (Csikszentmihalyi, 1990). The purpose of this study was to test the impact of the OPTIMAL model on physical education students' motivation and perceptions of optimal challenge across four games categories (i. e. target, batting/fielding, net/wall, invasion). Enjoyment, competence, student goal orientation and activity level were examined in relation to the OPTIMAL model. A total of 22 (17 M; 5 F) students and their parents provided informed consent to take part in the study and were taught four OPTIMAL lessons and four non-OPTIMAL lessons ranging across the four different games categories by their own teacher. All students completed the Task and Ego in Sport Questionnaire (TEOSQ; Duda & Whitehead, 1998), the Intrinsic Motivation Inventory (IMI; McAuley, Duncan, & Tanmien, 1987) and the Children's Perception of Optimal Challenge Instrument (CPOCI; Mandigo, 2001). Sixteen students (two each lesson) were observed by using the System for Observing Fitness Instruction Time tool (SOFTT; McKenzie, 2002). As well, they participated in a structured interview which took place after each lesson was completed. Quantitative results concluded that no overall significant difference was found in motivational outcomes when comparing OPTIMAL and non-OPTIMAL lessons. However, when the lessons were broken down into games categories, significant differences emerged. Levels of perceived competence were found to be higher in non-OPTIMAL batting/fielding lessons compared to OPTIMAL lessons, whereas levels of enjoyment and perceived competence were found to be higher in OPTIMAL invasion lessons in comparison to non-OPTIMAL invasion lessons. Qualitative results revealed significance in feehngs of skill/challenge balance, enjoyment and competence in the OPTIMAL lessons. Moreover, a significance of practically twice the active movement time percentage was found in OPTIMAL lessons in comparison to non-OPTIMAL lessons.

Youth's experiences of motivation in school physical education and sport

This study's objective was to examine how thirteen year-old females perceive and describe their lived experiences of being physically active in school PE (physical education) and organized youth sport settings through a self-determination theory (Deci & Ryan, 1985) lens. Motivational factors and links between both settings were discussed with five participants using in-depth interviews. Participants discussed factors that facilitated and disrupted their motivation to be active in PE and sport settings. The selfdetermination theory was used as a framework in this qualitative study and results are based on participants' own words and perspectives. Results indicate that participants' positive experiences in school PE and organized sport have the potential to meet their needs of autonomy, competence and relatedness. The autonomy supportive behaviours of social agents, feeling challenged and successful at activities and the strong relationships formed in both settings are all things that motivated young people in this study to continue being physically active throughout high-school and into adulthood.

The nature of the highly artistic student in visual arts at secondary school /

This qualitative investigation examined the nature of 7 highly artistic visual arts students at 2 secondary schools in southcentral Ontario. Through interviews, questionnaires, observations, and artwork documents, this study attempted to understand these highly artistic students in terms of creativity, motivation, social and emotional perspectives, and cognitive processes. Data collection occuned over a 3-monlh period. and the data analysis program NVivo 7 was used for coding to develop themes and categories for organizing data. The findings of this study illustrate the significant place that \ isual arts can lake in the growth and development for the youth of today. Participants idcniificd dcxclopnig critical thinking and problem-solving skills, taking risks, and meeting challenges ilirouuh their engagement in the creative process. The transferability of these skills \\ as referenced to numerous aspects of their lives. By enhancing individual perspectives through the study of visual arts, their local and world connections were extended, and environmental and societal concerns evolved. In addition, the communicative opportunities that visual arts provided for these students in terms of personal expression provided emotional health and paths of personal discovery. Through the participants' production of artwork with the many stages this involves, combined with insight into their needs, the participants relayed miportant suggestions for programming enhancements and educational settmgs lor \ isiial arts classrooms. These suggestions are meaningful for educators and curriculum developers of the future.

An impact evaluation of the Ontario ban on smoking in schools and on school property : does the ban on smoking influence high school students' intentions to smoke cigarettes?

The Ontario Tobacco Control Act of 1994 imposed a total ban on smoking in schools, and on school property for every school in the province. The imposition of this policy created problems for school administrators. For instance, students who were smoking on walkways and properties adjacent to school boundaries, clashed with neighbouring property owners who were angry about the resulting damage and disruption. The enforcement of this policy consumes valuable resources at each school; therefore, knowledge about the impact of the policy is important. If effective, this policy has the potential to improve the health of students over their lifetime, by preventing or delaying smoking behaviour. Alternatively, an ineffective policy will continue to create administrative problems for the school and serve no legitimate purpose. Therefore, knowledge about the impact of the smoking ban policy on students' smoking intentions assists policy makers and school administrators in their understanding of the policy's impact within the schools. This research provided an impact evaluation of the ban on smoking in schools and on school property in Ontario. A total of 2069 students, from five high schools, in the Niagara Region, provided complete responses to a survey, designed to test whether smoking intentions were affected by the imposition of the policy. The study used Ajzen's theory of planned behaviour (Ajzen, 1991), specifically, the perceived behavioural control measure, to gain some understanding of students' perceptions of control over smoking imposed by the ban. The findings indicate the policy has the potential to influence students' overall smoking intentions. The ban on smoking policy was found to be a significant predictor of the smoking intentions of high school students. As well, attitude, social norms, and perceptions of control were significant predictors of smoking intentions. Exploratory findings also indicated differences between the control beliefs of students from different high schools, indicating potential differences in the enforcement of the smoking ban between schools. The findings also support the utility of the theory of planned behaviour as a methodology for evaluating the influence of punitive policies. This research study should be continued by utilizing the full theory of planned behaviour, including two phases of data collection and the measurement of actual smoking behaviour.

Athletic injury care training in high school coaches

The purpose of this qualitative study was to understand the client and occupational therapist experiences of a mental health group. A secondary aim was to explore the extent to which this group seemed to have reflected a client-centred approach. The topic emerged from personal and professional issues related to the therapist as teacher and to inconsistencies in practice with the profession's client-centred philosophy. This philosophy, the study's frame of reference, was established in terms of themes related to the client-therapist relationship and to client values. Typical practice was illustrated through an extensive literature review. Structured didacticexperiential methods aiming toward skill development were predominant. The interpretive sciences and, to a lesser extent, the critical sciences directed the methodology. An ongoing support group at a community mental health clinic was selected as the focus of the study; the occupational therapist leader and three members became the key participants. A series of conversational interviews, the . core method of data collection, was supplemented by observation, document review, further interviews, and fieldnotes. Transcriptions of conversations were returned to participants for verification and for further reflection Analysis primarily consisted of coding and organizing data according to emerging themes. The participants' experiences of group, presented as narrative stories within a group session vignette, were also returned to participants. There was a common understanding of the group's structure and the importance of having "air time" within the group; however, differences in perceptions of such things as the importance of the group in members' lives were noted. All members valued the therapeutic aspects of group, the role of group as weekly activity and, to a lesser extent, the learning that came from group. The researcher's perspective provided a critique of the group experience from a client-centred perspective. Some areas of consistency with client-centred practice were noted (e.g., therapist attitudes); however the group seemed to function far from a client-centred ideal. Members held little authority in a -relationship dominated by the leaders, and leader agendas rather than member values controlled the session. Possible reasons for this discrepancy ranging from past health care encounters through to co-leader discord emerged. The actual and potential significance of this study was discussed according to many areas of implications: to OT practice, especially client-centred group practice, to theory development, to further areas of research and methodology considerations, to people involved in the group and to my personal growth and development.

Bullying in physical education : its prevalence & impact on the intention to continue secondary school physical education

The purpose of this study was to determine the prevalence of bullying in physical education and its influence on students' intention to participate in the class in the future. Additionally, the study researched the relationship between bullying and body image as well as bullying and physical competency in physical education. A survey was utilized that collected both quantitative and qualitative data about students' experiences in physical education. Two-hundred and thirty-four grade 10 students (144 female and 90 male) from 8 different secondary schools participated in the study. Data analyses were completed using the Statistical Package for the Social Sciences (SPSS) version 16.0. Results showed thaLapproximately 18.3% of respondents had .experienced physical bullying in physical education; 23.7% had experienced verbal bullying; and 20.4% experienced social bullying. Furthermore, those who experienced frequent bullying in physical education did not intend on taking the class in the future. The relationship between body image and bullying was not found to be significant. However, physical competence was found to significantly predict bullying in physical education. These results show how prevalent bullying is in physical education classes and how it negatively impacts future participation in the class.

Escape and connection : a phenomenological investigation into the meaning of an after-school program for adolescent boys

The purpos e of this phenomenological research is to explore the meaning of a YMCA-sponsored after-school recreation program in the lives of four adolescent boys. Listening to youth voice is impor t ant to the ability of othe r s to design, implement and evaluate high-quality programs tha t facilitate learning opportunities tha t a r e meaningful to participants. Within the context of interviews, task-based activities we r e used to ga the r data. Guided by Creswell's analytic spiral (1998), data wa s analyzed according to van Manen's (1990) thematic analysis and Caeilli's (2000) creative narrative analysis. It wa s found tha t this after-school progr am provided the s e adolescents with the opportunity to escape from the i r monotonous after-school activities and the instability of the i r home and school environments. Also, they we r e connected wi th positive peers, caring adults and the wide r community, opportunities tha t we r e limited in othe r aspects of the i r lives. Methodological issues a r e also discussed.

A Study of One Living School Partnership

Abstract The purpose of this paper was to explore the ways one partnership evaluated its partners and relationships using Gray‟s model of collaboration (2000). The model consists of five approaches that are made up of: problem-focused, relational, cognitive, structural, and political. These approaches were tested at one „Living School‟ partnership that was constituted by a school, a public health department, the City‟s Park and Recreation Department, commercial enterprises, and organizations from the non-profit sector. Eight pre-arranged interviews were conducted using conversational interview technique, with three additional interviews on-site. The results of the research revealed that based on Gray‟s five approaches, this one Living School partnership was found to be successful. Consistent with partnership research, trust, social capital and structure were found to be key ingredients, as well as new themes of leadership, role clarity, and a shared vision were also found to be vital.