Health Education Journal

Young children living in socioeconomically deprived areas of Scotland have an increased risk of becoming overweight or obese. To enhance understanding of the wider contexts within which family food practices are developed, this study examined the experiences of low-income mothers with young children.

Qualitative longitudinal design.

The Lothians, Scotland.

Two waves of individual interviews were conducted with 13 mothers at two time points within an 18-month period. All the mothers lived in socioeconomically disadvantaged areas in Eastern Scotland, and had at least one child aged 6 years and under. An inductive thematic analysis was conducted, through which the data were analysed both cross-sectionally and longitudinally.

Women experienced socioeconomic challenges which limited the financial and emotional resources, and the time they were able to commit to healthy eating practices. For some, change and instability were part of their lives, over which they had little control. Despite insecure socioeconomic contexts, women positioned themselves as expert mothers, evidenced through their strategies in dealing with the problem of ‘fussy eaters’ and their challenges of ‘expert’ advice.

This research demonstrates the significance of the broader difficulties that living in poverty presents to mothers, beyond the issue of cost, and which preventive health interventions should address.

To assess whether there was an improvement in the knowledge, attitudes and practices of students after the Healthy Eyes in Schools Project intervention and to complete a process evaluation to inform future implementation of health promotion interventions.

A descriptive, mixed-methods design was used, including questionnaires and interviews.

Four primary schools in Aileu District, Timor-Leste. Local teachers received training and resources to implement nine lessons about eye health. The intervention was supported in two schools by the concurrent creation of school gardens and improvements to the water and sanitation, where required.

Students from classes 5 and 6 participated: 384 students aged 10–17 years (median = 12 years, inter-quartile range = 12–13 years) completed the baseline knowledge, attitudes and practices survey and 237 students participated in a follow-up survey. Interviews with teachers, students and parents informed the process evaluation.

The intervention was associated with an improvement in eye health knowledge and some attitudes and practices of students. Attitudes about the capabilities of blind children and adults did not change. The teachers’ attitude and support from principals and an international non-governmental organisation appeared to be key factors in the successful implementation of the Healthy Eyes in Schools Project. The limited eye health in the existing curriculum, limited parent participation and access to healthy food may have influenced the effectiveness of the Healthy Eyes in Schools Project intervention.

A number of benefits appeared to be associated with the inclusion of eye health topics in school health and hygiene education in Timor-Leste. Concurrent development of a supportive environment appeared to enable this initiative. The results of this evaluation can be used to advocate to the Ministries of Education and Health and other education stakeholders for the inclusion of eye health in the health and hygiene curriculum.

The study aim was to explore associations between daily physical activity level, cardiorespiratory fitness and metabolic syndrome among Chinese children.

We conducted a school-based, cross-sectional study.

Participants including 112 boys and 121 girls were recruited from three schools in the urban suburbs of Tianjin city, China.

A total of 233 children (12–15 years old) were recruited from the urban suburbs of Tianjin, China. Their daily physical activity level was monitored using accelerometry. Cardiorespiratory fitness was evaluated through a predicted maximal oxygen uptake. The prevalence of metabolic syndrome and its basic components were determined. Correlations between specific components of metabolic syndrome and daily physical activity and maximal oxygen uptake were assessed.

In all, 5.4% of the boys and 2.5% of the girls had metabolic syndrome, identified by the modified International Diabetes Federation definition. Moderate physical activity level had a negative correlation with blood pressure, but did not correlate with other components. Predicted maximal oxygen uptake displayed significant correlations with more components of childhood metabolic syndrome than those of physical activity level.

Daily physical activity level did not show a significant correlation with the components of metabolic syndrome in 12- to 15-year-old Tianjin city children. However, planned exercise with a goal of improving maximal oxygen uptake should be stressed in school physical education in order to prevent the development of childhood metabolic syndrome.

The STI/HIV prevention programme in Amsterdam aims to improve the sexual health of Amsterdam residents of African, Antillean, Aruban and Surinamese origins. The programme strategy is to achieve and enhance the participation of migrant community-based organisations (CBOs) in sexual health promotion through a grant scheme and by providing support to CBOs in developing, implementing and monitoring STI/HIV projects within their own communities. This evaluation focussed on identifying obstacles and successes of the CBO projects, assessing the organisation of the programme and examining the level of CBO participation.

Multi-method qualitative approach based on a community-based research framework, including document analysis, 37 semi-structured interviews with CBO representatives and Public Health Service (PHS) professionals and participant observation.

Amsterdam, The Netherlands.

In total, 76 CBOs participated in the programme, and 110 diverse and culturally specific projects were developed. The CBOs appreciated participation in the programme, but did not necessarily perceive their participation to be at a high level. The multiple roles fulfilled by the PHS coordinator and the capacity of both the PHS and the CBOs were crucial for success.

This study shows that the strategy to achieve and enhance participation by CBOs in combination with grant schemes is efficient for developing and implementing STI/HIV projects, provided that there is on-going support to develop, implement and monitor projects. In assessing the effectiveness of the programme, a number of challenges lie ahead, especially regarding the continuous monitoring of projects and assessing programme impact on sexual health.

To assess whether a telephone-based breastfeeding intervention delivered by lactation educators influenced exclusive breastfeeding rates among low-income Hispanic women in the USA.

Randomised two-group design.

Pregnant low-income Hispanic women (298) were recruited from community health clinics in Los Angeles County (USA) and randomly assigned to either a control or an intervention group.

Data relating to the factors associated with breastfeeding were collected during the third trimester. Breastfeeding outcome data were collected at 72 hours, 1 month, 3 months and 6 months postpartum.

There were no differences between the groups in rates of breastfeeding initiation. There was a significant difference in the duration of exclusive breastfeeding among participants during the infant’s first week of life. While not significant, after controlling for covariates and intent to breastfeed at third trimester, the duration of exclusive breastfeeding among all participants was, on average, longer for intervention group mothers than control group mothers. Additionally, the intervention group mothers were more likely to report exclusive and only breastfeeding at all data points compared to the control group and less likely to discontinue breastfeeding.

Findings from this study suggest that telephone-based breastfeeding interventions delivered by a lactation educator show promise as a cost-effective strategy for improving both the quantity and the duration of breastfeeding among low-income Hispanic women in the USA. Intervention group mothers not only sustained breastfeeding for a longer durations but also provided their infants with greater amounts of breast milk over these longer durations.

To address a critical gap in health education scholarship by exploring the contexts in which self-help reading takes place, the motivations of self-help readers and the processes through which such readers engage with books on mental health.

Structured, in-depth interviews conducted with participants recruited through online classified advertisements.

Self-help readers were recruited from the four largest cities in western Canada. The setting of self-help reading as an ‘intervention’ was as natural as possible, with readers being asked to reflect upon their recent experience of reading a self-help book.

Qualitative interviews conducted with 45 readers. Interview transcripts were analysed thematically.

Illustrative narratives are provided for two categories of readers: those who read in conjunction with direct therapeutic intervention and those who read without input from a therapist. Findings within both categories indicate a high level of diversity in terms of contexts, motivations and experiences.

Understanding the diversity of readers and their experiences is an important prerequisite for health educators wishing to develop a critical and responsible approach to positioning self-help literature within the broader range of approaches to promoting mental health.

It is a legal requirement for employees in noisy workplaces such as nightclubs to be provided with suitable information regarding their noise exposure risks, used a focus group approach to examine employees’ attitudes to workplace noise and to hearing protection use. The subsequent analysis was based on an adapted Health Belief Model.

A total of five focus group interviews were conducted in three nightclubs between July and October 2011. The 32 participants were employees in nightclubs that were shown to have daily noise exposures in excess of 80 dBA.

A tailor-made noise-training programme was designed using the combined Health Belief Model and Health Promotion Model as a framework.

The focus groups provided a deeper level of understanding of the barriers faced by the employees to hearing protection use and issues with management engagement. Participants were fatalistic, and although they acknowledged that exposure to noise in nightclubs could lead to hearing loss in the distant future, they felt there was very little that they could do to prevent it from happening.

The focus groups offered insight into the barriers faced by the employees, especially relating to hearing protection use and management engagement. Findings from this study may be used to design sector-specific noise awareness training content designed to address the adapted Health Belief Model constructs identified here.

The aim of this study was to identify the complexities and pressures faced by parents when trying to embed knowledge of healthy eating in their children’s lifestyles.

Qualitative design using focus groups with parents and children aged 10 to 11 years.

The research was conducted in two phases. The first phase involved five focus groups with 47 children. The results of these focus groups then informed the development of a second phase consisting of three focus groups with 15 parents of these children. The findings from the children’s focus groups were then discussed with parents to explore their understandings and perceptions of how children perceived health, diet and lifestyle.

Parents are one of the main influences when it comes to shaping their children’s decisions in relation to healthy eating. Children, but also parents, appeared to only have a partial knowledge about food and diet, and parents did not know how to translate this knowledge into decisions about healthy eating. Parents in this study felt under pressure when trying to incorporate healthy messages within the context of their own lives and they also wanted to feel more confident about the role they can play in the nutritional choices of their children.

Healthy eating strategies may need to move away from focusing solely on parents as conduits of knowledge but instead see both them and their children as playing an active part in designing interactive strategies about making healthy food choices.

Diagnostic self-tests have become available worldwide. The most frequently performed self-tests in the Netherlands are tests to detect high cholesterol and diabetes. Since these tests can be performed without professional guidance, potential consumers need to receive independent information on the pros and cons of self-testing. The aim of this study was to develop a decision aid (DA) on cholesterol and glucose self-testing to encourage informed choice and to meet consumers’ needs and expectations.

A DA was developed based on previous research and medical practice guidelines. The first prototype was assessed for content by means of semi-structured interviews with experts (n = 13), followed by usability tests with users (n = 10), leading to improvements to the DA in an iterative process.

Comments of the experts were grouped into four categories: general comments, textual remarks, technical errors and lay-out. User comments were mainly consistent with the experts’ opinions. Important considerations that were identified concerned the safety of providing this information without direct professional counselling, whether a ranking of available tests should be provided and how strong a warning about self-testing should be.

Important considerations on how to inform consumers about self-testing were discussed, and led to important changes in the DA. Future research will have to assess the actual use of the DA once it is accessible to the general public, as well as its effects on knowledge and attitude towards self-testing.

This study sought to assess the body mass index (BMI)–alcohol relationship among a US national sample of college students.

Secondary data analysis using the Fall 2011 National College Health Assessment (NCHA).

A total of 44 US higher education institutions.

Participants included a national sample of college students (N = 27,774). BMI, frequency of alcohol consumption and binge drinking were measured based on responses to items in the NCHA. T-tests and two-way analysis of variance (ANOVA) identified differences in BMI based on drinking status and sex.

Drinkers exhibited significantly lower BMIs than non-drinkers, t(26,968) = 5.55, p < .001. Binge drinkers exhibited significantly lower BMIs than non-binge-drinkers, t(27,094) = 2.64, p < .001. A significant interaction for drinking frequency and sex existed, F(5, 20,434) = 4.121, p = .001, but no interaction effect was present for sex and binge drinking frequency. Respondents drinking 1–20 days/month had lower BMIs compared to non-drinkers. Furthermore, frequency of past month drinking (β = −.08, p < .001) made a unique contribution to explaining BMI, such that BMI decreased as the days one consumed alcohol increased.

Non-drinkers exhibited significantly higher BMIs than drinkers, regardless of whether consumption was measured as drinking status, frequency of past 30 day use, or binge drinking frequency. Findings build on previous literature which has produced mixed results depending on the operationalisation of alcohol use. Future research into why differences exist in BMI among drinkers versus non-drinkers is warranted.