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Implementation of the HealthKick intervention in primary schools in low-income settings in the Western Cape Province, South Africa: a process evaluation.
de Villiers, A, Steyn, NP, Draper, CE, Hill, J, Dalais, L, Fourie, J, Lombard, C, Barkhuizen, G, Lambert, EV
BMC public health. 2015;:818
Abstract
BACKGROUND The HealthKick intervention, introduced at eight primary schools in low-income settings in the Western Cape Province, South Africa, aimed to promote healthy lifestyles among learners, their families and school staff. Eight schools from similar settings without any active intervention served as controls. METHODS The Action Planning Process (APP) guided school staff through a process that enabled them to assess areas for action; identify specific priorities; and set their own goals regarding nutrition and physical activity at their schools. Educators were introduced to the APP and trained to undertake this at their schools by holding workshops. Four action areas were covered, which included the school nutrition environment; physical activity and sport environment; staff health; and chronic disease and diabetes awareness. Intervention schools also received a toolkit comprising an educator's manual containing planning guides, printed resource materials and a container with physical activity equipment. To facilitate the APP, a champion was identified at each school to drive the APP and liaise with the project team. Over the three-years a record was kept of activities planned and those accomplished. At the end of the intervention, focus group discussions were held with school staff at each school to capture perceptions about the APP and intervention activities. RESULTS Overall uptake of events offered by the research team was 65.6% in 2009, 75% in 2010 and 62.5% in 2011. Over the three-year intervention, the school food and nutrition environment action area scored the highest, with 55.5% of planned actions being undertaken. In the chronic disease and diabetes awareness area 54.2% actions were completed, while in the school physical activity and sport environment and staff health activity areas 25.9 and 20% were completed respectively. According to educators, the low level of implementation of APP activities was because of a lack of parental involvement, time and available resources, poor physical environment at schools and socio-economic considerations. CONCLUSIONS The implementation of the HealthKick intervention was not as successful as anticipated. Actions required for future interventions include increased parental involvement, greater support from the Department of Basic Education and assurance of sufficient motivation and 'buy-in' from schools.
2.
Active Living: development and quasi-experimental evaluation of a school-centered physical activity intervention for primary school children.
Van Kann, DH, Jansen, MW, de Vries, SI, de Vries, NK, Kremers, SP
BMC public health. 2015;:1315
Abstract
BACKGROUND The worldwide increase in the rates of childhood overweight and physical inactivity requires successful prevention and intervention programs for children. The aim of the Active Living project is to increase physical activity and decrease sedentary behavior of Dutch primary school children by developing and implementing tailored, multicomponent interventions at and around schools. METHODS/DESIGN In this project, school-centered interventions have been developed at 10 schools in the south of the Netherlands, using a combined top-down and bottom-up approach in which a research unit and a practice unit continuously interact. The interventions consist of a combination of physical and social interventions tailored to local needs of intervention schools. The process and short- and long-term effectiveness of the interventions will be evaluated using a quasi-experimental study design in which 10 intervention schools are matched with 10 control schools. Baseline and follow-up measurements (after 12 and 24 months) have been conducted in grades 6 and 7 and included accelerometry, GPS, and questionnaires. Primary outcome of the Active Living study is the change in physical activity levels, i.e. sedentary behavior (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and counts-per-minute (CPM). Multilevel regression analyses will be used to assess the effectiveness of isolated and combined physical and social interventions on children's PA levels. DISCUSSION The current intervention study is unique in its combined approach of physical and social environmental PA interventions both at school(yard)s as well as in the local neighborhood around the schools. The strength of the study lies in the quasi-experimental design including objective measurement techniques, i.e. accelerometry and GPS, combined with more subjective techniques, i.e. questionnaires, implementation logbooks, and neighborhood observations. TRIAL REGISTRATION Current Controlled Trials ISRCTN25497687 (registration date 21/10/2015), METC 12-4-077, Project number 200130003.
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Improvements in heart health behaviors and reduction in coronary artery disease risk factors in urban teenaged girls through a school-based intervention: the PATH program.
Bayne-Smith, M, Fardy, PS, Azzollini, A, Magel, J, Schmitz, KH, Agin, D
American journal of public health. 2004;(9):1538-43
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Abstract
OBJECTIVES We sought to assess the effects of a school-based intervention program on cardiovascular disease risk factors in urban girls. METHODS We compared heart health knowledge, health behaviors, cardiovascular risk factors, and physical fitness among a group of 442 multiethnic teenaged girls (310 experimental participants vs 132 control participants). Testing was conducted before and after a 12-week program of vigorous exercises integrated with lectures and discussions on diet, exercise, stress, and smoking. RESULTS Significant differences in body fat, systolic and diastolic blood pressure, heart health knowledge, and whether breakfast was eaten were observed between experimental participants and control participants. CONCLUSIONS An integrated program of exercise and heart health-related lectures and discussions had a beneficial effect on health knowledge, health behaviors, and onset of risk factors for coronary artery disease among urban girls.