Lay people's views of school food policy options: associations with confidence, personal values and demographics

A random population survey administered by mail to examine lay people's views of children's food policies and their associations with demographics, personal values and confidence in authorities was conducted among adults in Victoria, Australia. Three hundred and seventy-seven people responded (response rate 57.6%). The questionnaire contained 35 items about children's healthy eating policy options plus details like personal values, confidence and demographic items. There was widespread support for healthy school food policies. The strongest support was for life skills education and school-based nutrition and physical education programmes. Many age-related associations indicated that people >48 years were more in favour of healthy eating policies than younger people. There were fewer statistically significant associations with parent status and sex. In contrast, many associations showed that respondents with strong equity–harmony values and those with least confidence in the authorities were most in favour of healthy eating policies for schoolchildren. It is concluded that there is widespread support for school-based health and nutrition education and for active school food policies. However, differences between demographic and values groups suggest the need for caution in the promotion of public health nutrition initiatives among schoolchildren.

Can health promoting schools contribute to the better health and wellbeing of young people? The Hong Kong experience.

Background: The Health Promoting School (HPS) is a WHO sponsored framework, compiled to enable education and health sectors to be more effective in school based initiatives.

Aims: This study attempted to test the hypothesis that students from schools that had comprehensively embraced the HPS concept as indicated by the Healthy School Award, were better, in terms of health risk behaviour, self reported health status, and academic results, than students from schools that did not reach the standard of the award.

Methods and Results: The results presented came from nine schools (four primary and five secondary) applying for accreditation of the Healthy Schools Award after adopting the HPS framework for two years. Regular consultancy support and training were available to all schools. Students had completed before and after surveys to assess their health behaviours, self reported health status, and academic standing before the two year intervention, and at its end. Data from the before and after surveys of the students attending schools that reached certain level of HPS standard as indicated by the award, were compared with students whose schools did not receive the award, and the results showed differences. Some differences were found to be more significant among the primary school students than secondary schools students. This illustrated early intervention for lifestyle changes to be more effective. Students’ satisfaction with life also improved if their schools adopted the concept of HPS comprehensively.

Conclusions: The results suggest that comprehensive implementation of HPS would contribute to differences in certain behaviours and self reported health and academic status.

A new approach to assessing the health benefit from obesity interventions in children and adolescents: the assessing cost-effectiveness in obesity project

OBJECTIVE: To report on a new modelling approach developed for the assessing cost-effectiveness in obesity (ACE-Obesity) project and the likely population health benefit and strength of evidence for 13 potential obesity prevention interventions in children and adolescents in Australia. METHODS: We used the best available evidence, including evidence from non-traditional epidemiological study designs, to determine the health benefits as body mass index (BMI) units saved and disability-adjusted life years (DALYs) saved. We developed new methods to model the impact of behaviours on BMI post-intervention where this was not measured and the impacts on DALYs over the child's lifetime (on the assumption that changes in BMI were maintained into adulthood). A working group of stakeholders provided input into decisions on the selection of interventions, the assumptions for modelling and the strength of the evidence. RESULTS: The likely health benefit varied considerably, as did the strength of the evidence from which that health benefit was calculated. The greatest health benefit is likely to be achieved by the 'Reduction of TV advertising of high fat and/or high sugar foods and drinks to children', 'Laparoscopic adjustable gastric banding' and the 'multi-faceted school-based programme with an active physical education component' interventions. CONCLUSIONS: The use of consistent methods and common health outcome measures enables valid comparison of the potential impact of interventions, but comparisons must take into account the strength of the evidence used. Other considerations, including cost-effectiveness and acceptability to stakeholders, will be presented in future ACE-Obesity papers. Information gaps identified include the need for new and more effective initiatives for the prevention of overweight and obesity and for better evaluations of public health interventions.

Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature

Preventing the development of obesity in children is an international health priority. To assess the effectiveness of interventions designed to prevent obesity, promote healthy eating and/or physical activity and/or to reduce sedentary behaviours in 0–5-year-old children, a systematic review of the literature was performed. Literature searches were limited to articles published between January 1995 and June 2006, printed in English and sampling children aged 0–5-years. Searches excluded literature concerned with breastfeeding, eating disorders, and interventions which were school-based or concerned with obesity treatment. Two reviewers independently extracted data and assessed study strengths and weaknesses. Nine included studies were grouped based on the settings in which they were delivered. Most studies involved multi-approach interventions, were conducted in the USA and varied in study designs and quality. All showed some level of effectiveness on at least one obesity-behaviour in young children. These studies support, at a range of levels, the premise that parents are receptive to and capable of some behavioural changes that may promote healthy weight in their young children. The small quantity of research heralds the need, particularly given the potential for early intervention to have long-lasting impacts on individual and population health, to build in a substantial way upon this evidence base.

Associations among individual, social, and environmental barriers and children's walking or cycling to school

Purpose. To examine associations among individual, social, and environmental barriers and children's walking or cycling to school.

Design. Exploratory cross-sectional study.

Setting. All eight capital cities in Australia.

Subjects. Parents (N = 720) of school-aged children (4-13 years; 27% response rate 49% parents of boys,).

Measures. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) for parental reporting of barriers to their children's walking or cycling to school, based on a computer-assisted telephone interview.

Results. Forty-one percent of children walked or cycled to school at least once per week. Multivariable analyses found inverse associations with individual ("child prefers to be driven" [OR = 0.4, 95% CI = 0.3-0.6], "no time in the mornings" [OR 0.5, 95% CI = 0.3-0.8]); social ("worry child will take risk" [OR = 0.6, 95% CI = 0.3-0.9], "no other children to walk with" [OR = 0.7, 95% CI = 0.4-0.99], "no adults to walk with" [OR = 0.6, 95% CI = 0.4-0.9]); and environmental barriers ("too far to walk" [OR = 0.1, 95% CI = 0.0- 0.1], "no direct route" [OR = 0.4, 95% CI = 0.2-0. 7]) and positive associations with "concern child may he injured in a road accident" (OR = 1.9, 95% CI = 1.1-3.1) and active commuting.

Conclusion. Working with parents, schools, and local authorities to improve pedestrian, skills and environments may help to overcome barriers.

Evaluating a community lifestyle intervention: adherence and the role of perceived support

Background Interventions that increase participation in physical activity and positive dietary changes may improve the health of the community through modifying the lifestyle contribution to preventable disease. However, previous evaluations have identified concerns about inequitable and unsustainable uptake, adherence and retention within healthy lifestyle schemes.

Intervention study The intervention evaluated here was designed to be a 12-week intervention for participants, offering free testing of physiological indicators of health, one-to-one health advice and a range of exercise, activity and cookery classes, at no or reduced cost, at local venues throughout the community. This paper reports the findings from a small qualitative study undertaken to explore the experiences and reflections of those who took part in the intervention to different extents, including those who fully and partially participated as well as those who dropped out or declined to take part.

Method Sixteen respondents took part in semi-structured interviews (5 male, 11 female; 8 black, 8 white; age range 25–85).

Findings The findings suggest that participants assessed the healthy lifestyle intervention in terms of how well it met their pre-existing needs and opportunities for change, and that they selected the aspects of the scheme that suited them, interested them and were perceived as delivering salient results. There is also evidence for a stronger role of perceived support in influencing uptake and maintenance of lifestyle changes, and that support was conceptualised by participants as one of the services offered by the scheme. Perceived support and related perceptions of reliance on the scheme to sustain lifestyle changes also suggested that in some cases full adherence to a scheme is not as likely to produce long-term adherence to lifestyle changes as compared to partial, but more realistic adherence and smaller lifestyle changes. Implications for delivering and evaluating healthy lifestyle interventions are also discussed.

New media pathways: navigating the links between home, school, and the workplace

This chapter uses the case of students enrolled in the Multimedia Pathway offered by Harbourside High School to discuss the tensions and contradictions inherent in the views that: (a) school curriculum and pedagogy have much to learn from young people's informal and leisure-based learning; and (b) school-based courses in new media are important because they increase student retention and the chance of success in post-school employment. We draw on literature about the "new work order" (Gee, Hull, & Lankshear, 1996) to explore the nature of these students' learning about and with lCTs and show that the students' knowledge exists "in a network of relationships" (Gee, 2000) that bridge the formal and informal learning divide. Finally, we discuss the parts played by their in- and out-oi-school engagements with lCT in their becoming the kinds of portfolio people supposedly required by the new capitalism.

Interventions for preventing obesity in children (Review)

Background
Obesity prevention is an international public health priority. The prevalence of obesity and overweight is increasing in child populations throughout the world, impacting on short and long-term health. Obesity prevention strategies for children can change behaviour but efficacy in terms of preventing obesity remains poorly understood.

Objectives
To assess the effectiveness of interventions designed to prevent obesity in childhood through diet, physical activity and/or lifestyle and social support.

Search strategy
MEDLINE, PsycINFO, EMBASE, CINAHL and CENTRAL were searched from 1990 to February 2005. Non-English language papers were included and experts contacted.

Selection criteria
Randomised controlled trials and controlled clinical trials with minimum duration twelve weeks.

Data collection and analysis
Two reviewers independently extracted data and assessed study quality.

Main results
Twenty-two studies were included; ten long-term (at least 12 months) and twelve short-term (12 weeks to 12 months). Nineteen were school/preschool-based interventions, one was a community-based intervention targeting low-income families, and two were family-based interventions targeting non-obese children of obese or overweight parents.

Six of the ten long-term studies combined dietary education and physical activity interventions; five resulted in no difference in overweight status between groups and one resulted in improvements for girls receiving the intervention, but not boys. Two studies focused on physical activity alone. Of these, a multi-media approach appeared to be effective in preventing obesity. Two studies focused on nutrition education alone, but neither were effective in preventing obesity.

Four of the twelve short-term studies focused on interventions to increase physical activity levels, and two of these studies resulted in minor reductions in overweight status in favour of the intervention. The other eight studies combined advice on diet and physical activity, but none had a significant impact.

The studies were heterogeneous in terms of study design, quality, target population, theoretical underpinning, and outcome measures, making it impossible to combine study findings using statistical methods. There was an absence of cost-effectiveness data.

Authors' conclusions
The majority of studies were short-term. Studies that focused on combining dietary and physical activity approaches did not significantly improve BMI, but some studies that focused on dietary or physical activity approaches showed a small but positive impact on BMI status. Nearly all studies included resulted in some improvement in diet or physical activity. Appropriateness of development, design, duration and intensity of interventions to prevent obesity in childhood needs to be reconsidered alongside comprehensive reporting of the intervention scope and process.

The Resilient Families program: promoting health and wellbeing in adolescents and their parents during the transition to secondary school.

Resilient Families is a school-based prevention program designed to help students and parents develop knowledge, skills and support networks to promote health and wellbeing during the early years of secondary school. the program is designed to build within-family connectedness (parent--adolescent communication, conflict resolution) as well as improve social support between different families, and between families and schools. It is expected to promote social, emotional and academic competence and to prevent health and social problems in youth.

A primary numeracy : a mapping review and analysis of Australian research in numeracy learning at the primary school level : report

The outcome from this project produces a database of over 185 projects and 726 publications relating to numeracy research to systematically ‘mapped’ Australian research on primary school numeracy over the last decade. The database incorporates research summaries and findings that are easily accessible to teachers and teacher educators, and act as a valuable tool for determining further research directions. The project report examines the available research and organises the discussion of the research findings under a set of themes and sub-themes.

Some summarised examples from the report reveals that:

* Effective teachers of numeracy:
- have high expectations of their students;
- focus on children’s mathematical learning, rather than on providing pleasant classroom experiences;
- provide a challenging curriculum;
- use higher-order questioning;
- make connections both within mathematics and between mathematics in different contexts; and
- use highly interactive teaching involvement with students in class discussion.

* Effective professional development programmes:
- provide teachers with the time and appropriate resources to enable them to reflect on their teaching;
- provide continuing support and encouragement while teachers explore possibilities and trial new strategies in their classrooms;
- involve teachers in school-based and wider networks;
- are of sufficient duration to allow significant changes to habitual beliefs and practices; and
- create opportunities for the exploration of theory-practice relationships.

Investigation of the factors responsible for the superior performance of male students in standardised testing at one primary school

The project set out to investigate one primary school where, for four years or more, boys have outperformed girls in standardized Year 3 and 5 Basic Skills Tests in literacy and numeracy, which contradicts general findings on male and female performance in standardized literacy and numeracy testing. The school placed a heavy emphasis on literacy programs, which appear to be making a difference to the boys. Over time, there has been a slight improvement in boys’ literacy performance but the greatest area of growth is generally boys’ numeracy, rather than boys’ literacy.

Further aims of the study were to isolate school-based factors, which are potentially responsible for this phenomenon, from community-based factors and to explore the possibility that, rather than boys being advantaged, girls were actually being disadvantaged by practices at the school. The approach adopted by the research team employed intensive case-study methods and ethnographic approaches, including interviews, document analysis, and structured and unstructured observation of a range of school activities.

This paper describes how the school has transformed itself, the effects that this has had upon the teaching and learning environment and the results that have been achieved in the key areas of numeracy and literacy.

Perceived sports competence mediates the relationship between childhood motor skill proficiency and adolescent physical activity and fitness : a longitudinal assessment

Background: The purpose of this paper was to investigate whether perceived sports competence mediates the relationship between childhood motor skill proficiency and subsequent adolescent physical activity and fitness.

Methods: In 2000, children's motor skill proficiency was assessed as part of a school-based physical activity intervention. In 2006/07, participants were followed up as part of the Physical Activity and Skills Study and completed assessments for perceived sports competence (Physical Self-Perception Profile), physical activity (Adolescent Physical Activity Recall Questionnaire) and cardiorespiratory fitness (Multistage Fitness Test). Structural equation modelling techniques were used to determine whether perceived sports competence mediated between childhood object control skill proficiency (composite score of kick, catch and overhand throw), and subsequent adolescent self-reported time in moderate-to-vigorous physical activity and cardiorespiratory fitness.

Results: Of 928 original intervention participants, 481 were located in 28 schools and 276 (57%) were assessed with at least one follow-up measure. Slightly more than half were female (52.4%) with a mean age of 16.4 years (range 14.2 to 18.3 yrs). Relevant assessments were completed by 250 (90.6%) students for the Physical Activity Model and 227 (82.3%) for the Fitness Model. Both hypothesised mediation models had a good fit to the observed data, with the Physical Activity Model accounting for 18% (R2 = 0.18) of physical activity variance and the Fitness Model accounting for 30% (R2 = 0.30) of fitness variance. Sex did not act as a moderator in either model.

Conclusion: Developing a high perceived sports competence through object control skill development in childhood is important for both boys and girls in determining adolescent physical activity participation and fitness. Our findings highlight the need for interventions to target and improve the perceived sports competence of youth.

The impact of childhood conditions and concurrent morbidities on child health and well-being

Background. Understanding the impact of illnesses and morbidities experienced by children and adolescents is essential to clinical and population health programme decision making and intervention research. This study sought to: (1) examine the population prevalence of physical and mental health conditions for children and quantify their impact on multiple dimensions of children's health and well-being; and (2) examine the cumulative effect of concurrent conditions.

Methods. We conducted a cross-sectional school-based epidemiological study of 5414 children and adolescents aged 5–18 years, and examined parental reports of child health and well-being using the parent-report Child Health Questionnaire (CHQ) PF50 13 scales are scored on a 0–100 pt scale with clinically meaningful differences of five points and the presence of childhood conditions (illnesses and health problems).

Results. Asthma, dental, vision and allergies are the most commonly identified health problems for children and adolescents, followed by attention- and behaviour-related problems (asthma 17.9–23.2%, dental 11.9–22.7%, vision 7.2–14.7%, chronic allergies 8.8–13.9%, attention problems 5.1–13.8% and behaviour problems 5.7–12.0%). As the number of concurrent health problems increase, overall health and well-being decreases substantively with mean differences in CHQ scale scores of 14 points (−7.69 to −21.51) for physical health conditions, and 28 points (−5.15 to −33.81) for mental health conditions.

Conclusions. Children's health and well-being decreases linearly with increasing presence and frequency of health problems. Having three or more conditions concurrently significantly burdens children's health and well-being, particularly for family-related CHQ domains, with a greater burden experienced for mental health conditions than physical health conditions.

Enacting problem based classroom scenarios through forum theatre

While the school based practicum experience is a vital aspect of teacher education, a 'simulated' classroom can provide a less confrontational space for teacher education students to implement new teaching strategies and techniques. The project used actors to generate a series of short scenarios that dramatise classroom problems. The project employed the methodology of applied theatre in an educational setting.