Health Education Journal

The Hong Kong Healthy Schools Award Scheme (HKHSA) developed an assessment and monitoring system to examine the status of Health Promoting Schools (HPS). This study made use of the HKHSA programme to investigate the school health ‘profile’ and student health status of four gold award schools following 3–4 years’ participation in the scheme.

Repeated cross-sectional student health surveys of the same year level (Secondary 3) were conducted over different time periods, and achievement of HKHSA was assessed by repeated assessments of the school health profile using HPS indicators.

This study included four schools with the Healthy School gold award in Hong Kong, together with students from three of the four schools.

School performance in the six HPS key areas were analysed using radial plot graphs, and students’ health behaviours were measured by means of repeated cross-sectional student health surveys.

The four gold award schools demonstrated various degrees of achievement in different HPS key areas with student health behaviours markedly improving in these schools. Further analyses revealed how certain HPS key area components were associated with sustained positive health behaviours among students.

The ongoing implementation of HPS impacts on schools’ environment and students’ health behaviours. The HKHSA is designed for formative and summative assessment of school health promotion. Findings provide insight into an HPS assessment process, signalling future directions for the development of school health promotion.

To evaluate the effects of a universal prevention programme for disordered eating behaviours (DEB) and sedentary lifestyle among Mexican young people.

Non-experimental single group field study with repeated measures (pre-test, post-test and at 6-month follow-up).

Public high school in Hidalgo, Mexico.

In all, 214 young women and 154 young men aged 15–18 years with a mean age of 16.4 participated in the study. For both young women and men, data were collected using the Brief Questionnaire for Disordered Eating Behaviours (DEB) and the short form of the International Physical Activity Questionnaire. Among young men, additional data were collected using the Drive for Muscularity Scale (DMS).

Five activity-based sessions. In the first four sessions, the following topics were addressed: thinness culture, myths and realities of dieting and supplements, healthy eating behaviours and healthy menus. At the end of each session, students engaged in an enjoyable physical activity hour. In the fifth session, participants were divided into three parallel workshop groups focusing on: thinness culture, healthy menus, and physical activity. The programme incorporated a variety of dissonance-based interventions using interactive psychoeducational strategies.

After 6 months, repeated-measures analyses of variance (ANOVAs) revealed a significant reduction in the mean DEB scores in young women. In young men, DEB and DMS mean scores decreased but not significantly. Physical activity frequency and duration showed a significant increase in the total sample over time.

Overall, implementation of the programme had positive effects on young people and important differences were found between the sexes.

To examine the effectiveness of an interdisciplinary, discovery-oriented teaching unit designed to provide science and health information about HIV from the perspective of viral biology, population statistics and epidemiology.

Single group pre- and post-curriculum pilot study.

Fifteen middle and high school classrooms recruited from districts in and around a large, diverse, urban area in the mid-southern USA.

Science educators, clinicians, virologists and biologists collaborated to develop a set of five activities intended to increase content knowledge related to HIV, while developing students’ science-related skills in the context of an authentic, relevant example. The activities were piloted with six hundred and twenty-four 12- to 18-year-old students. Multiple-choice pre- and post-tests were used to assess changes in students’ knowledge, and teacher evaluations were used to gauge appropriateness of content, ease of activity implementation and teacher perceptions of student skill development, learning and engagement.

Student pre- and post-tests and teacher post-evaluations indicated that the curriculum was effective in increasing content knowledge for students across all age ranges, with 13- to 14-year-old, grade 8 students achieving the greatest knowledge gains. Teacher-reported information also suggested that students were able to apply relevant skills to their interpretation of authentic data related to the incidence and transmission of HIV infection around the world.

The developed activities have the potential to provide timely, relevant information to students while strengthening science-related content knowledge and skills as well as health literacy.

To examine how student midwives in higher education learn to become competent and confident woman-centred practitioners.

Participant observation study using a ‘buddy’ approach.

Bachelor of Midwifery students in one higher education institution in the Netherlands

First-year student midwives followed one woman throughout the continuum of childbirth. The students attended a minimum of five of the woman’s antenatal care encounters and a minimum of one postnatal care encounter. In addition, students explored the woman’s professional care network. Student midwives used participant observation, structured interview techniques and reflective practice to focus on (1) the woman and to gain insight into her wishes and experiences of care throughout the continuum of pregnancy, birth and postpartum period; (2) the impact of the caregiver on the woman; and (3) the woman’s experience of the partnership. Lectures, peer-debriefing, competency assessments, research activities and a logbook supported students’ learning.

Learning was achieved through the student’s relational continuity and active engagement with the individual woman. Students gained insight into the experiences of individual pregnant and postpartum women, the individual practice of healthcare practitioners and the interaction between the woman and the healthcare practitioner. Students’ development of critical thinking and reflective practice was enhanced to begin to form a vision of woman-centred care.

The project was successful in equipping Bachelor of Midwifery students with competencies to support them in their learning of providing woman-centred care and offered them unique and in-depth experiences supporting and augmenting their personal, professional and academic development.

In South Africa, Black African women between the ages of 15 and 24 years are especially vulnerable to HIV. The heterosexual transmission of the disease is exacerbated by social and cultural conditions that perpetuate gender relations of inequality. Problematic conceptualisations of femininity increase sexual risk. The objective of this article is to examine the ways in which undergraduate university Black African female students make meaning of gender and sexuality on campus and the social processes through which femininities are produced.

Qualitative research study.

University of KwaZulu-Natal, South Africa.

In total, 10 in-depth interviews and focus group discussions with 25 Black African undergraduate female students aged between 18 and 24 years old.

Campus life was conceived as a place of heterosexual freedom, sexual enjoyment and engagement with dating relationships. Relationships were forged based on romantic notions of love and versions of femininity based on trust lead to sexual risk and unwanted pregnancy. In the context of material inequalities, ‘sugar daddy’ relationships further limited female students’ ability to negotiate safe sex. The overall climate on campus was structured along gender power inequalities. Female students feared and were victims of verbal, physical assault and sexual coercion. The lack of campus security exacerbated female students’ vulnerability to violence on campus.

Addressing the specific meanings expressed by Black African female students on campus can help to improve the effectiveness of campus-based health education interventions promoting safe sex, gender equality and student safety.

Health-related fitness knowledge holds the potential for physical activity and behavioural changes. The purpose of this retrospective longitudinal study with retrospective data was (a) to examine high-school students’ health-related fitness knowledge growth through the 9th, 10th and 11th grades under one curriculum condition and (b) to examine gender- and school-level correlates of students’ health-related fitness knowledge and its rate of growth.

This study used existing data collected by school districts as they implemented the curriculum. Participants were students (n = 9,883, 49.4% girls) from 40 high schools following the same curriculum. Health-related fitness knowledge performance was assessed annually for 3 years using an online platform. Potential student- and school-level correlates were collected. A three-level hierarchical linear model was used to examine student health-related fitness knowledge growth and its relation to gender- and school-level correlates.

The results showed that high-school student health-related fitness knowledge growth was linear during the 3-year period, with an estimated growth rate of 9.14 ± 1.40% per year under the curriculum condition. Girl students had a higher growth rate than boys, holding other factors constant. Other school-level variables were not significant predictors of health-related fitness knowledge.

Overall, the curriculum context was conducive to student health-related knowledge growth. The different knowledge growth rate between boys and girls was a possible reason for gender discrepancy at the 11th grade.

The purpose of this study was to evaluate the healthy weight services in one local authority in England, where obesity levels have been above the national average since 2006.

We conducted process and outcome evaluation using a qualitative methodology. Data were generated in focus group discussions and semi-structured interviews with clients, practitioners, healthcare professionals and volunteers.

A total of 91 individuals from six services participated in the evaluation. Staff competencies and empowerment outcomes were identified as areas of strength. However, despite examples of excellent practice and enthusiastic recommendations from clients, access and referral processes were areas of weakness.

In England, local authorities have an important role to play in tackling obesity. It is crucial that they are provided with the tools to be able to implement healthy weight interventions effectively. A whole-systems approach presents a real opportunity for staff in local authorities and public health to work collaboratively and innovatively towards the same goal of continuous improvement in obesity management.

This study sought to determine the feasibility of (a) engaging college students in experiential learning through a 10-day whole foods plant-based diet intervention, (b) bringing pertinence to the course topics that had an emphasis on chronic conditions and (c) understanding how the intervention influenced students’ perceptions and behaviours.

Quasi-experimental design. Biomarkers, dietary perceptions and behaviours were collected at baseline and 11-day post-intervention.

The study was implemented in the context of an undergraduate/graduate public health course.

We assessed the feasibility of the intervention using an acceptability focus, including participant retention in the intervention, and participant self-reported experience with the plant-based diet. We also utilised an implementation research focus, concerning the extent, likelihood and manner in which an intervention can be fully implemented as planned and proposed.

The intervention was determined to be feasible. Participants learned that their diet can affect multiple health conditions and all changed their diet in some way or another as a result. Of the 10 participants, mean change in total cholesterol was −26 mg/dL, high-density lipoprotein (HDL) cholesterol was −6.1 mg/dL and low-density lipoprotein (LDL) cholesterol was −21.6 mg/dL, all with p values <.05.

Findings suggest that through experiential learning, students will consider a whole food plant-based diet and/or make some personal lifestyle changes as a result.

The aim of this study was to assess the effectiveness of Question, Persuade, Refer (QPR) gatekeeper suicide prevention training on individuals’ ability to recognise the warning signs of suicide, intention to question someone they think is suicidal, persuade the suicidal person to stay alive, and know how and where to get help for the person. We also examined whether QPR training increased an individual’s intention to intervene with a suicidal individual.

A pretest–posttest online survey, based on the theory of planned behaviour, was employed before and after the face-to-face QPR training.

The study was conducted on a small regional college campus in the Midwest USA.

Faculty, staff, and students at a regional campus completed two online questionnaires (pretest, n = 108, and posttest, n = 79) answering questions about attitudes, subjective norms, and perceived behavioural control regarding suicide intervention, as well as their intention to intervene with someone who was suicidal. They also completed a 1-hour QPR gatekeeper training event.

QPR training significantly improved attitudes, subjective norms, and perceived behavioural control regarding suicide intervention, and intention to intervene. It was also effective at increasing intention to question, persuade and refer (the three core goals of QPR).

QPR training has been shown to be effective in the short-term at increasing intention to intervene within a US college community.

This article describes a university course that aimed to create public health champions and its evaluation. The course attracted 92 participants, over three cohorts. Participants included healthcare professionals, fitness instructors, a belly dancer, housing officers, community workers and those who worked in public health policy.

The course evaluation aimed to provide a longitudinal understanding of the participants’ learning and the impact of the course in terms of developing the attributes of public health champions.

A university setting in England.

Evaluation methods included questionnaires, self-assessment against UK Public Health Skills and Knowledge Framework statements, ‘check out’ sentences post action learning set meetings, impact statements and unstructured interviews.

The evaluation illuminated the participants’ experience of their learning journey, which comprised cognitive, affective and conative learning, the development of public health competences and evidence of putting the learning into public health practice.

In total, 76 participants achieved a university award. There was evidence of participants identifying the underlying causes of ill health and using an evidence-based approach to planning, partnership and influencing others. Some participants reported actions that indicated they had become transformative leaders and public health champions. The article discusses limitations to the evaluation and current challenges to public health workforce development in England.

The objective of this study was to describe the suitability of adult drug court handbooks for participants with low literacy.

A convenience sample of seven drug court participant handbooks from urban drug courts in three regions of the USA were assessed for reading and literacy suitability for low-literacy learners using the Fry Index Readability Formula and the Suitability Assessment of Materials (SAM). The Fry Index Readability Formula follows an objective approach using a three-step process of counting three random samples of 100-word passages to calculate grade reading level. The SAM uses a 0–2 range scale to assess six distinct factors of written materials to yield a numerical score as superior, adequate or not suitable.

All handbooks were written above the reading level for low-literacy learners with scores at the eighth grade reading level or higher. A few handbooks scored adequate ratings in some SAM categories, and only two handbooks scored superior ratings in any one category. Overall SAM scores showed all handbooks were not suitable for low-literacy learners.

Findings indicate that drug court participant handbooks from this sample are not written for low-literacy learners. Key recommendations are to develop a drug court handbook appropriate for participants with low literacy, assess drug court participants’ literacy for reading grade level and comprehension and provide multi-modal teaching formats to promote effective learning.

First aid programmes should include not only the transfer of knowledge and skills but also improve participants’ helping attitudes. The aim of this study was to evalute the immediate and long-term effects of a 3-day first aid programme for kindergarten children.

One hundred and eighteen kindergarten children (5–7 years old) from an inner-city kindergarten located in Pécs, Hungary, were involved in this study between January 2016 and June 2017. Training consisted of three 45-minute sessions involving the transfer of theoretical knowledge and practical skills about first aid. Knowledge, skills and attitudes were assessed by means of a questionnaire developed for the study and through observation. Participants were tested before and immediately after the programme and at 4 and 15 months.

The majority of children had no prior knowledge in first aid. Knowledge and skills significantly improved immediately after training and remained significantly higher at 4 and 15 months when compared to baseline – calling the ambulance (p < 0.01), performing cardiopulmonary resuscitation (CPR; p < .01), using an automated external defibrillator (AED; p < .01), handling an unconscious patient (p < .01) and managing bleeding (p < .01). Attitudes towards first aid improved significantly after the programme (p < .01) and remained improved after 4 and 15 months when compared to baseline (p < .01).

Beginning first aid education in kindergarten can be useful. Children cannot become professional bystanders immediately following training, but the programme can offer an introduction of first aid. However, the results decreased substantially after 15 months so regular refreshing training should be recommended.

Policymakers, health services researchers, community leaders and health care delivery organisations are key stakeholders in addressing economic, environmental, social and systemic barriers to health equity in vulnerable communities. However, they often operate in silos, leaving gaps in efforts to effectively address health disparities. It is important to develop a new approach to influencing responsive health equity–focused policies.

An innovative, collaborative model is outlined that leverages strengths across these four stakeholders to reduce inequity in target populations. The model brings together undergraduate and graduate student researchers in a front-end policy partnership with elected officials based on mutually agreed-upon commitment to address local health disparities impacting the policymaker’s constituency.

Students and faculty at Arizona State University partnered with the office of a Phoenix City Council member representing a constituency largely comprised of low-income and Hispanic community members.

Relationships were developed with the policymaker specifically targeting food insecurity and paediatric asthma. Graduate student researchers conducted academic placements within the elected official’s office, attended relevant municipal meetings, engaged with local community-based organisations and partnered with a major academic medical centre to collect data and understand current efforts related to the two focus areas.

Elected officials were provided with a policymaker-tailored toolkit including a current state analysis, stakeholder assessment and recommendations for action. Collective discussion took place concerning the strengths and limitations of stakeholders’ ability to improve population health and present findings from the model’s first application to local government.

By ensuring ‘buy-in’ from policymakers at the onset of collaboration, stakeholders worked as a transdisciplinary team to translate academic research into actionable policy to benefit high-need communities. This model adopted can potentially accelerate and improve the development and implementation of actionable policies, thereby increasing social capital and building relationships with policymakers to address the root causes of health inequities.