Evaluating school-community health in Cyprus

Pike, Jo; Ioannou, Soula

doi:10.1093/heapro/dat044

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…Implementation fidelity to the school component was low regarding management support, except in one school, and very little change occurred in all schools. This is in contrast to findings from a health-promoting school project in Cyprus with the IVAC methodology in which action and environmental change was achieved in 6 of 7 participating schools [27].…”

Section: Discussioncontrasting

confidence: 92%

Process evaluation of implementation fidelity in a Danish health-promoting school intervention

et al. 2018

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Background“We Act” is a health-promoting school intervention comprising an educational, a parental and a school component. The intervention was implemented in 4 Danish public schools with 4 control schools. The objectives were to improve pupils’ dietary habits, physical activity, well-being and social capital using the Investigation, Vision, Action & Change (IVAC) health educational methodology. The target group was pupils in grades 5–6. The purpose of this study was to evaluate implementation fidelity and interacting context factors in the intervention schools.MethodsThe Medical Research Council’s new guidance for process evaluation was used as a framework. Data were collected concurrently and evenly at the 4 intervention schools through field visits (n = 43 days), questionnaires (n = 17 teachers, 52 parents), and interviews (n = 9 teachers, 4 principals, 52 pupils). The data were analysed separately and via triangulation.ResultsA total of 289 pupils participated, and 22 teachers delivered the educational component in 12 classes. In all schools, the implementation fidelity to the educational methodology was high for the Investigation and Vision phases as the teachers delivered the proposed lessons and activities. However, the implementation fidelity to the Action & Change phase was low, and little change occurred in the schools. The pupils’ presentation of their visions did not work as intended as an impact mechanism to prompt actions. The implementation of the parental and the school components was weak. The main context factors influencing implementation fidelity were a poor fit into the school-year plan and weak management support.ConclusionsAlthough ‘We Act’ was designed to comply with evidence- and theory-based requirements, IVAC and the health-promoting school approach did not result in change. The time dedicated to schools’ preparation and competence development may have been too low. This must be considered in future process evaluation research on health-promoting schools and by school health promotion administrators when planning future school interventions.Trial registration ISRCTN85203017 Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6289-5) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 92%

Process evaluation of implementation fidelity in a Danish health-promoting school intervention

et al. 2018

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“…Due to this intervention, students' HKU increased. An insight, which confirms existing findings from participatory approaches, which addresses active lifestyles in PE (64) or health promotion in the whole school context (65). The present study purposefully dispensed with any structured intervention programs for teachers to follow.…”

Section: Ca Rl (Partly)supporting

confidence: 83%

Effects of a Participatory School-Based Intervention on Students' Health-Related Knowledge and Understanding

Strobl

Ptack

Töpfer

et al. 2020

Front. Public Health

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Introduction: The development of knowledge and understanding in relation to movement and health is a basic requirement to facilitate lifelong engagement in physical activity with its accompanying possible health benefits. To train teachers in applying adequate strategies, implementation studies have often shown little acceptance of traditional top-down approaches. Thus, the purpose of the Health.edu project was to develop, implement and evaluate effective and feasible measures addressing students' health-related knowledge and understanding (HKU) in physical education (PE) via a participatory approach. Materials and Methods: For evaluation, a controlled pre-post-test study with 233 students from eight different secondary schools in Germany was carried out. Four schools (with two PE teachers at each school) comprised the intervention group and they participated in a 1-year participatory planning process to conceptualize and implement evidence-based PE lessons addressing students' HKU. Control schools carried out their regular PE lessons. Evaluation followed a mixed-methods research design, assessing program implementation via written documentary technique as well as program effectiveness using a standardized questionnaire. Results: Results show a significant intervention effect on students' HKU with a medium effect size. However, due to the participatory process, there were considerable differences between the intervention schools that were involved. Student's HKU improved most in schools where program implementation corresponded to relevant principles of fostering HKU. Discussion: The present study purposefully dispensed with any structured intervention programs for PE teachers to follow. The results show the potential effects of this participatory approach to strengthen student's HKU. However, the participatory planning does not always work in the intended manner, emphasizing that numerous contextual factors influence the implementation process.

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“…Thus students are not supposed to be targeted individually, as "healthy eaters" or "unhealthy eaters" but as active citizens who can contribute to the promotion of healthy eating in their community. For instance students in Cyprus, who were encouraged to promote collective actions regarding healthy eating, increased their access to healthy eating by changing their school's canteen menu, as well as menus of local restaurants (Pike and Ioannou, 2013).…”

Section: Learning Objectives Of the Checmentioning

confidence: 99%

“…Many schools find it difficult to move on from an approach which puts sole responsibility on the individual for behavioural change to an approach which adds an emphasis on the effect of the living conditions (Colquhoun et al, 2008;Pike and Colquhoun, 2010;Pike and Ioannou, 2013). As Burkhart (2011) argues, regarding drug prevention across Europe, despite weak evidence for the effectiveness of the information-only prevention approaches, they continue to be the most commonly used, compared with environmental drug prevention approaches which are theoretically based on an empowerment philosophy.…”

Section: Introductionmentioning

confidence: 99%

Cyprus Health Education Curriculum from “victim blaming to empowerment”

2015

Self Cite

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Purpose – Health promotion can fall into a victim blaming approach and put social pressure on particular students who could be marginalized due to their personal, economical, cultural, social or ethnic characteristics, for example, students who are obese, drug users or HIV carriers. The purpose of this paper is to present and discuss ways in which the design of the newly reformed Cyprus Health Education Curriculum (CHEC) attempted to protect learners from victim blaming. Design/methodology/approach – The paper describes and reflects on the learning objectives, teaching methods and teaching activities of the CHEC. Findings – The paper gives specific examples of how the design of the CHEC attempts to ensure that the curriculum does not promote victim blaming. It describes learning objectives, content, suggested teaching methods and activities from three thematic areas of the curriculum which are particularly susceptible to victim blaming: “food and health”, “emotional health” and “family planning, sexual and reproductive health”. It discusses how the design of the CHEC attempts to encourage educators to address the underlying social and environmental determinants of health and thus avoid stigmatization. Practical implications – The paper can be useful for curriculum designers and school educators. It describes how the design of a health education curriculum and health education lessons can refrain from burdening the individual with total personal responsibility for health behaviour and lifestyle. Social implications – Understanding and implementing the basic learning themes and objectives of the CHEC has social and community implications. It promotes collective responsibility, emphasizing a non-blaming and community approach. The design of the CHEC challenges the idea of free choice, acknowledges the social determinants of health and promotes students’ empowerment as active members of society. Originality/value – The originality of this paper lies in the description and reflection of the design of the first health education curriculum in Cyprus, which attempts to secure learners from victim blaming in its implementation. The aspects of the design of the CHEC described in this paper may be applicable to other European countries.

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Evaluating school-community health in Cyprus

Cited by 9 publications

References 17 publications

Process evaluation of implementation fidelity in a Danish health-promoting school intervention

Process evaluation of implementation fidelity in a Danish health-promoting school intervention

Effects of a Participatory School-Based Intervention on Students' Health-Related Knowledge and Understanding

Cyprus Health Education Curriculum from “victim blaming to empowerment”

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