BackgroundAPPLE Schools is a Comprehensive School Health (CSH) project, started in schools in socioeconomically disadvantaged areas where dietary habits are poor, physical activity (PA) levels are low, and obesity rates are high. Earlier research showed program effects whereby energy intake, PA and weight status of students in APPLE Schools had reached similar levels as that of students in other schools. However, it is unknown whether the effects of CSH are sustained when children grow into adolescents. Effects of APPLE Schools on health-related knowledge, attitudes, self-efficacy, diet, PA, and weight status, seven years after the start of the project, when students were in junior high and high school were assessed. We hypothesised that APPLE School graduates and comparison school graduates will remain at similar levels for these indicators.MethodsIn the 2015/16 school year, junior high and high school graduates (grades 7–12) in Northern Alberta, Canada participated in a Youth Health Survey. Participants included graduates from APPLE elementary schools (n = 202) and comparison elementary schools (n = 338). Health-related knowledge, attitudes, self-efficacy, diet (24-h dietary recall), PA (pedometer step count) and weight status were assessed. Mixed effects regression was employed to assess differences in these outcomes between APPLE School graduates and comparison school graduates. Comparisons between elementary school (2008/09) and junior high/high school (2015/16) of self-efficacy, PA and weight status were also conducted.ResultsAPPLE School graduates did not significantly differ from comparison school graduates on any outcomes (i.e. knowledge, attitudes, self-efficacy, diet, PA, and weight status). Additionally, no significant differences existed in the comparisons between 2008/09 and 2015/16.ConclusionOur findings of no difference between the APPLE School graduates and comparison school graduates suggest that the effects of APPLE Schools may continue into adolescence or the new school environment may have an equalizing effect on the students. Since lifestyle practices are adopted throughout childhood and adolescence, and the school environment has an important influence on development, an extension of CSH initiatives into junior high/high schools should be considered. This will help to consolidate and support the continuance of healthy lifestyle messages and practices throughout childhood and adolescence.
ObjectiveTo determine whether a school-based health promotion program affects children’s weekend physical activity and whether this effect varies according to socioeconomic-status.MethodsThis was a quasi-experimental trial of school-based programs on physical activity levels implemented in disadvantaged neighborhoods in Alberta, Canada. In 2009 and 2011, 7 full days of pedometer data were collected from cross-sectional samples of grade 5 students (age 10–11 years) from 10 intervention schools in low-socioeconomic neighbourhoods and 20 comparison schools in middle-socioeconomic neighbourhoods. Multilevel models assessed differences in step-counts between intervention and comparison groups over-time by weight (objectively measured) and socioeconomic status subgroups.ResultsIn 2009, children from intervention schools were less active on weekends relative to comparison schools (9212 vs. 11186 steps/day p<0.01). Two years later, daily step-counts on weekend days among children in low socioeconomic intervention schools increased such that they approximated those of children from middle socioeconomic comparison schools (12148 vs. 12121 steps/day p = 0.96). The relative difference in steps between intervention and comparison schools on weekends reduced from -21.4% to 0.2% following the intervention. The normalization of weekend step counts was similar for normal weight (–21.4% to +2.0%) and overweight (-19.1 to +3.9%) children, and was balanced across socioeconomic subgroups.ConclusionsThese data suggest that school-based health promotion is effective for reducing inequities in physical activity levels outside school hours. Investments in school-based health promotion lead to behavior modification beyond the school environment.Trial RegistrationClinicalTrials.gov NCT01914185
Friendships play a significant role in child development and may influence children’s physical activity (PA). Using a whole-network approach, this study examined whether school-based friends are more similar in their pedometer-measured PA compared to children who are not friends, and whether these patterns vary by gender, strength of friendship (best vs. close friends), and during vs. outside of school. The analytical sample included 706 grade 5 students (10- to 11-years-old) in 27 schools who were participating in the APPLE Schools project (Alberta Project Promoting healthy Living for Everyone in schools) in Edmonton and Fort McMurray, Alberta, Canada in the spring of 2013. Data collected included student and parent survey responses, time-stamped pedometer data for nine consecutive days, and close and best within-school and within-grade friendship nominations. We used Multiple Regression - Quadratic Assignment Procedure (MR-QAP) to examine the effect of friendship ties on PA similarity overall, and for during and outside of school periods, controlling for covariates and clustering within schools. When all friendships (i.e., close and best) were considered, female friends exhibited more similar levels of overall PA than non-friends, and these findings held for school days, the during-school period, and non-school days. When close and best friends were examined separately in the same model (non-friends as the referent), both close and best friends were more similar than non-friends. The close friendship findings held for non-school days, and the best friendship findings held for school days, including the during-school and before- and after-school periods. For males, only reciprocated best friends had more similar levels of overall PA compared to unreiprocated friendships and non-friends. Programs and policies that focus on increasing PA in children may benefit from incorporating friendship-based strategies and programming, especially for females.
Nursing with the nursing faculties of the Prince of Songkla University in Southern Thailand and Burapha University located near Bangkok. Both were interested in an exchange program with Curtin University School of Nursing and it was decided to offer this as an option to students in semesters six and seven.The duration of the tour was 4 weeks; the time being equally divided between the two universities. The purpose of the tour was to facilitate the study of primary health care in a culturally different setting, to provide the students with the opportunity to learn about life and culture in the host country, and to exchange ideas with staff and students from the Thai Universities. Students in semester six of the Curtin University nursing programme are required to do a 4 week placement with a community agency, and this tour provided them with the option of obtaining this experience overseas. Students were accepted to participate in the study tour with the understanding that they would be required to work and submit the necessary assignments to pass the units of study in which they were enrolled; with scope for relaxation and enjoyment to balance the program. The group was made up of 22 students: 18 from semester six and four from semester seven. The ages of people within the group varied but it was generally a young enthusiastic group. There was only one male in the party. The presence of the four semester seven students added maturity. The group was escorted by two academic staff, both members of the Primary Health Care Interest Group and the Transcultural Nursing Interest Group at Curtin University.The students gave a variety of reasons for wanting to undertake thls tour, for which they funded themselves.The reasons ranged from a desire to experience nursing in a culturally different environment to wanting the experience of flying out of Perth, to brighten up a dull curriculum vitae. Whatever the reason given for being part of this group it was emphasized to each student that the objective of the trip was the study of primary health care in a different cultural setting within a developing country. PREPARATIONPrior to the tour, students and stafl attended a 4 day workshop. Various guest speakers, some from the host country, were invited to attend the workshop. Simulations and group exercises were conducted; audio visual material showing various aspects of life and culture in Thailand were shown, and the Thai classes were attended. The preparation was very important as it was during this time that students began to establish rapport with each other and with staff.A considerable amount of time, effort and dedication was at the same time put into action by the Thai hosts in organizing suitable programmes, staff and transportation to enable us to achieve all of our aims.On arrival we were met by two staff from the Faculty of Nursing, Prince of Songkla University. The Faculty of Nursing arranged a welcome and orientation programme, during which there were many speeches made.During the 2 weeks spent at the Prince of Song...
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