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After successful pilot projects, Zhejiang Province, China, decided to systematically scale-up health promoting schools (HPS) over the entire province of 47 million. This study describes the interventions and self-reported changes in attitudes, knowledge and behavior during the first phase of scaling-up. Group interviews were conducted with a sample...
Citations
... Thirty-eight articles discussed or examined school counseling roles and activities, counseling interventions and related outcomes in China, demonstrating perspectives of parents, teachers, students, and school counselors. School counselors were noted to perform a wide spectrum of roles ranging from school-wide moral/character education (e.g., Caldarella et al., 2013;Shi et al., 2014), classroom guidance curriculum (e.g., Aldinger et al., 2008;Hue, 2011;Ho & Leung, 2016;Wu Deli & Awang-Hashhim, 2021), individual and group counseling (Dwyer & Mcnaughton, 2004;, crisis intervention (Harrison et al., 2021), to conflict resolution (Dwyer & Mcnaughton, 2004;Ma, 2021). Scholars reached a consensus on the lack of clarity and inconsistency concerning school counselor roles in China (Lam & Hui, 2010;, which led to them not only being responsive to students' development but also teachers' and parents' emotional well-being (e.g., van Schalkwyk, 2013). ...
... In a comprehensive review of the school counseling literature across 25 countries including China, Martin et al. (2015) found 11 overarching factors that have influenced the development and practice of school counseling such as education laws and policies, social movements, local stakeholder perceptions, characteristics of the public education system, and related cultural factors. These overarching factors may explain the greater use of preventative strategies (e.g., moral and mental health education, university admission planning) in China (e.g., Aldinger et al., 2008;; whereas, school counselors in the U.S. may place a higher emphasis on leadership, advocacy, and systemic change (Carey, 2020). ...
... At the implementational level, variations exist among Chinese schools when it comes to delineating and fulfillment of school counseling roles and activities. Notably, school counselors in China perform a wide spectrum of roles and activities spanning from moral and mental health education, individual and group counseling, crisis intervention, to providing psychoeducation to parents and constituent partners (e.g., Aldinger et al., 2008;Dwyer & Mcnaughton, 2004;Shi et al., 2014). However, the scope of school counseling practice may subject to adjustment according to schools' characteristics. ...
Scholars have documented historical contexts and contemporary practice of school counseling in China, highlighting the increase of school-based mental health services in schools and government support. We identified some sporadic empirical evidence concerning school counseling interventions in Chinese schools within various geographic regions. There is a lack of comprehensive and critical review of school counseling development and practice in China. In response to the gap, we performed a systematic review of articles on school counseling in China published between 2004 and 2023. Our review generated five categories: (1) Development of the Profession; (2) Social–Cultural Contexts; (3) School Counselor Roles and Activities, Counseling Interventions, and Outcomes; (4) Theoretical Models; and (5) China–West Comparison. Our findings further illuminated sociopolitical and sociocultural contexts intertwined with the development and practice of school counseling in China. We also noted stark contrasts within school counseling practice across school settings and geographic regions of China. We advocate for legitimacy and unification of school counselors’ professional identity and allocation of resources for school counseling practice in rural China.
... 4) Students can be trained through the SHP to become effective health ambassadors, especially in areas of challenge like vaccine uptake and coverage in hard-toreach places and behavioural change communication. 18 It has been shown that where SHP is effectively implemented, the impact is extensive, including school enrolment, retention, and the health and nutritional benefits of staff, families, and communities. 19 ...
This position paper summarises the current understanding of the School Health Services (SHS) component of the School Health Programme (SHP) in Nigeria in light of the results of the Nationwide Situation Analysis (SITAN) Survey conducted, existing literature exploration, and findings from the interactive sessions with relevant stakeholders on SHP. This article on SHS complements and is intended to integrate with parallel position papers on other components of the School Health Programme: Healthful school environment, School feeding services, School-based health education, and School home and community relationships in Nigeria. Challenges and solutions related to pre-entry medical screening, routine health screening/examinations, immunisation, school health records, sick bay, first aid and referral services were all reviewed. Gaps in our understanding of SHS in Nigeria and avenues for further research were also examined. Recommendations include a mandatory review of the National School Health Policy of 2006, training and retraining of staff and students on attitudinal change to become advocates for health in both the schools and communities, linkage of schools with healthcare providers, especially paediatricians and nurses, in a hub and spoke model; and development of precise performance -monitoring indicators for SHS. Gaps in our understanding of SHS in Nigeria and avenues for further research work were also highlighted.
... Participants reported various changes in attitudes, knowledge, and behaviour. These changes included paying more attention to health, attaining better psychological well-being and confidence, forming friendships between teachers and students, feeling more relaxed, increasing knowledge about various health issues, developing a broader understanding of health, gaining a better understanding of the HPS concept, actively participating, increasing physical activity, improving sanitary habits, reducing or quitting smoking, eating more nutritious food, increasing safety behaviour, experiencing fewer injuries, and improving parent-child communication (Aldinger et al., 2008). There is a shortage of scientific information regarding the architecture of effective school-based health promotion interventions (HPIs), despite their ubiquitous usage in schools. ...
Objective: This study aims to review knowledge, attitude, and practice (behaviour) among students in the health promotion school Methods: This qualitative systematic article was based on scholarly papers in the Google Scholar, Scopus, and Web of Science databases. Content analysis was adopted in this study. Results: The findings show that schools have implemented all health promotion school (HPS) components, including health policy, physical school environment, psychosocial school environment, health education, health services, nutrition services, counselling/mental health, physical exercise, staff health promotion, and family and community outreach. These components have been tailored to local conditions. Conclusions: Changes in attitudes, knowledge, and behaviour were documented and essential. Examples of changes included paying more attention to health, improving psychological well-being and confidence, forming teacher-student friendships, feeling more relaxed, increasing knowledge about various health issues, broadening health knowledge, and understanding the HPS concept and impact on increasing knowledge, attitude, and practice (behaviour) among students in the health promotion school. Recommendation: The recommendation for further studies is to continue questionnaires and interviews to gain more insights into respondents' perceptions.
... Meanwhile, some studies also present different results [31]. In China, the long-term impacts of traditional concepts lead parents to focus almost exclusively on their children's academic performance rather than on psychological well-being [32]. Adolescents living with parents might suffering physical and verbal punishment when they didn't study hard, which increased the risk of high depressive symptomatology. ...
Background
Exploring etiological clues to adolescent depression, especially in female adolescents, might be helpful to improve the social environment of female adolescents. The aim at this study is to explore psycho-social factors of female adolescents with high depressive symptomatology and gender differences in depressive symptoms among Chinese adolescents.
Method
We examined 4100 adolescents from Wuhan city and Jianli county via a cross-sectional study. Depressive symptomatology was screened through the Chinese version of Center for Epidemiology Studies Depression Scale. Multivariate logistic regression was performed to explore the factors related to high depressive symptomatology in female and male adolescents, respectively.
Results
The prevalence of high depressive symptomatology in female and male were 38.9 and 30.2% respectively. The psycho-social factors of high depressive symptomatology in female adolescents were age (Adjusted odds ratio [aOR] = 1.201, 95% confidence interval [CI], 1.076 ~ 1.341), single parent family (aOR = 2.004, 95%CI, 1.448 ~ 2.772) and fathers’ education level (compared to primary school and below, [Junior middle school, aOR = 0.641, 95%CI, 0.439 ~ 0.934; Senior middle school, aOR = 0.603, 95%CI, 0.410 ~ 0.888; College degree and above, aOR = 0.639, 95%CI, 0.437 ~ 0.936]).
Conclusion
Fathers’ education level was associated with high depressive symptomatology in female adolescents. Female adolescents whose father with primary school education or below deserves more attention. Further epidemiologic researches need to be conducted to explore the different risk factors between female and male adolescents in China.
... They also recognised the parents' need for connecting with their child (and children had a unique position in the Chinese one-child families). Deliverers then educated the children on smoking and cessation, which eventually helped to motivate their parents to quit [66]. Level of evidence was also high for "Cosmopolitanism" (networks of the organisation with external organisations; "Outer setting") and "Networks and Communications" ("Inner setting"). ...
The vast majority of patients with chronic respiratory disease live in low- and middle-income countries (LMICs). Paradoxically, relevant interventions often fail to be effective particularly in these settings, as LMICs lack solid evidence on how to implement interventions successfully. Therefore, we aimed to identify factors critical to the implementation of lung health interventions in LMICs, and weight their level of evidence.
This systematic review followed Cochrane methodology and PRISMA reporting standards. We searched eight databases without date- or language restrictions in July 2019, and included all relevant original, peer-reviewed articles. Two researchers independently selected articles, critically appraised them (using CASP/MetaQAT), extracted data, coded factors (following CFIR), and assigned levels of confidence in the factors ( via GRADE-CERQual). We meta-synthesised levels of evidence of the factors based on their frequency and the assigned level of confidence. (PROSPERO:CRD42018088687)
We included 37 articles out of 9111 screened. Studies were performed across the globe in a broad range of settings. Factors identified with a high level of evidence were 1) Understanding needs of local users , 2) ensuring Compatibility of interventions with local contexts (cultures, infrastructures), 3) identifying influential stakeholders and applying Engagement strategies, 4) ensuring adequate Access to knowledge and information , and 5) addressing Resource Availability . All implementation factors and their level of evidence were synthesised in an implementation tool.
To conclude, this study identified implementation factors for lung health interventions in LMICs, weighted their level of evidence, and integrated the results into an implementation tool for practice. Policymakers, non-governmental organisations, practitioners, and researchers may use this FRESH AIR Implementation tool to develop evidence-based implementation strategies for related interventions. This could increase interventions’ implementation success, thereby optimising the use of already-scarce resources and improving health outcomes.
... In an effort to reverse and stop the increased trend of overweight and obesity, children should be brought up in a health promoting environment where instead of traditionally following the choices of others they can make informed choices about their health [3]. The school is viewed as an ideal health-promoting environment that can develop children and adolescents physically, emotionally and socially [8]. Literature on school obesity interventions exists, and while some literature that specifically focuses on diet and physical activity exists, such tend to focus on anthropometric measures such as body mass index (BMI) only, self-efficacy and some positive evaluations and outcomes [9][10][11]. ...
Background:
South Africa is currently undergoing a nutrition transition, and overweight and obesity is on the increase in South African children. Urbanization and other health determinants have led to reduced physical activity and unhealthy eating that have increased the risk of adverse chronic health conditions. This study aims to provide evidence of the effectiveness of a school-based intervention study that targets diet and physical activity for the prevention of child and adolescent overweight and/or obesity.
Methods:
We will employ a mixed method study design which is divided into two phases. Phase 1, namely the qualitative elicitation research phase will inform the development of the quantitative intervention phase (phase 2), consisting of a cluster-randomized trial, based on input from key stakeholders. The study will be undertaken in 16 government-funded primary schools in the iLembe district of KwaZulu-Natal, South Africa. The study will target learners in Grades 4 and 7, their parents, Life Orientation educators, school principals and members of school governing bodies. Assessment for the primary objective (BMI Z scores), and the secondary objectives (change in knowledge, attitudes and behaviours regarding diet and physical activity) in both study arms will be conducted at baseline in March 2020 and at the end of the study in October 2020.
Discussion:
The study will be a novel combined mixed methods/RCT design that focuses on diet, physical activity school and family-based interventions in the context of rapidly increasing overweight and obesity prevalence in KwaZulu-Natal. To encourage behaviour change and management of malnutrition, education including diet and physical activity, is an important strategy that must be considered. Nutrition education extends beyond the dissemination of food information; it includes addressing the needs of participants, empowers and encourages decision-making and choice of foods, change in nutrition attitudes, beliefs and influences based on resources available and within cultural boundaries.
Trial registration:
Pan African Clinical Trial Registry PACTR201711002699153. Protocol registered on 16 November 2017.
... These results are particularly compelling because previous research has recognized the difficulty, yet importance, of involving families in school-based health interventions (Langford et al. 2015). Previous studies have examined the reach of various schoollearned behaviours into the home and community (Aldinger et al. 2008;Gadhoke et al. 2015;Flurry 2007); however, no existing studies rely solely upon the student perspective exclusively through student voice. ...
... Last, students drove changes in their homes through their awareness and modification of unhealthy behaviours. Others have emphasized the role that children play in advising family members about behaviours, including smoking (Aldinger et al. 2008), fast food purchasing (Gadhoke et al. 2015), environmental behaviours (Ballantyne et al. 2001), and unhealthy food consumption (Rausch et al. 2015). Our results align with these findings, and support existing research regarding students' ability to educate their families about unhealthy behaviours. ...
Objective
Sedentary behaviours, physical inactivity, and poor diets in Canadian children are a major public health problem. Comprehensive school health (CSH) recognizes the importance of school and home collaboration; however, it is unknown how health behaviours promoted in school are adopted at home. The purpose of this research was to explore student perceptions of the translation of an intervention taking a CSH approach in Alberta, Canada, into the home environment.
Methods
The guiding method was focused ethnography, using photovoice as the data generation strategy. Grades 5 and 6 students were purposively sampled (n = 25), and asked to take photos of what CSH looks like in their home environment. Subsequent one-on-one interviews were conducted as part of the photovoice process to gain a deeper understanding of student perceptions.
Results
Two main themes emerged: students embraced the CSH philosophy, and students are driving change to create a healthy home culture. The underlying concept of leadership and independence was necessary for students to impact their health and the health of family members. Results demonstrated that students are catalyzing positive changes in the home environment by supporting changes in the home food environment, trying new things, facilitating improvements to healthy eating and active living, and monitoring unhealthy behaviours.
Conclusion
This study illustrates students’ abilities to positively impact the home environment as a result of their involvement in CSH. Student leadership and independence should be promoted and emphasized in CSH to facilitate transition of health behaviours into the home environment.
... Several studies have reported associations between a child's ability to perform FMS and their habitual PA or physical fitness levels (Fisher et al. 2005;Haga 2008) as well as associations between knowledge and motor skill performance (Wall 2004), and physical activity participation (Aldinger et al. 2008). Although these separate associations have been reported, the lack of a valid measurement tool has prevented researchers from accurately measuring the success of multi-dimensional PL programs, which incorporate all the aforementioned components in one (Giblin et al. 2014;Tremblay and Lloyd 2010). ...
The purpose of this study was to determine whether the introduction of a fundamental movement skills (FMS) program to grade 4–6 physical education (PE) classes could improve students’ physical literacy (PL) and influence the amount of effort exerted in PE class. Athletics Canada’s grassroots Run Jump Throw Wheel (RJTW) Program was delivered for 10 weeks during PE classes (2 schools: four grade 4, four grade 5, two grade 6, one split grade 5–6 class, and one split grade 6–7 class, totalling 310 students). Participants completed the Canadian Assessment of Physical Literacy (CAPL) and wore heart rate monitors and pre- and postintervention. The CAPL score increased 3.3 (±8.8) points from the pretest to the post-test (t = 6.47, p < 0.001). Improvements were not significantly different by grade or gender, but those in the suburban-area school improved more so than those attending the rural-area school (F[1,294] = 4.82, p < 0.004). Among those participants that increased their PL (n = 186), the CAPL scores increased by 8.6 (±5.9) points versus those that decreased (n = 110; –5.6 ± 4.8 points), F[1,294] = 452.11, p < 0.001. No significant differences in time spent in physical activity were observed between the pre- and post-test (i.e., 17.0 ± 7.0 min and 19.3 ± 7.0 min, respectively, t = 1.70, p = 0.091). The RJTW program increased participants’ overall FMS, as well as their knowledge and understanding regarding these FMS, both key components of PL.
... Já as ações que dizem respeito à educação física (ampliação das horas dedicadas à atividade física, recreação e esportes, melhoramento dos espaços físicos) foram mencionados apenas por dois estudos: Aldinger et al. 14 15 , que foi baseado no projeto Young Minds, que avaliou 216 voluntários composto por professores, facilitadores e alunos. Tal projeto foi desenvolvido em diferentes países europeus que colaboraram com questões relacionadas à saúde. ...
... A partir da análise dos três eixos para acreditação das EPSs (Processo de Planejamento, Atividades Desenvolvidas e Participantes no Programa), três dos cinco estudos não mencionaram informações consistentes 4,12,14 . Embora as escolas citadas nestes estudos apresentassem atividades de educação em saúde, prevenção de doenças e acidentes e/ou promoção da saúde, não contemplaram todos os critérios para serem certificadas como EPS. ...
... A discussão sobre um ambiente escolar seguro e o aspecto da violência, está relacionado a outro critério para a acreditação de uma EPS que são as ações desenvolvidas dentro da dimensão Fatores Psicossociais Protetores, mencionados no presente estudo por Lee et al. 12 , Simovska 13 e Aldinger et al. 14 . ...
Resumo O objetivo deste artigo é analisar os critérios de acreditação dos estudos que avaliaram as ações de promoção da saúde e prevenção de fatores de risco das Escolas Promotoras de Saúde (EPSs). Realizou-se uma revisão sistemática conduzida a partir das recomendações propostas no guia Preferred Reporting Items for Systematic Reviewsand Meta-Analyses (PRISMA) dos artigos que avaliaram as EPSs nas bases de dados: SciELO, Lilacs, Medline, PubMed e Portal Capes. A partir da análise dos três eixos para acreditação das EPS, três dos estudos analisados não contemplaram todos os critérios para serem certificadas como EPS nos eixos “Processo de Planejamento” e “Atividades de Promoção de Saúde desenvolvidas”. As escolas citadas nestes estudos apresentam atividades de educação em saúde, prevenção e/ou promoção da saúde, no entanto, é equivocado se autodenominarem EPS. Identificou-se como principais desafios enfrentados para a implantação, o desenvolvimento e a continuidade das EPS, a intersetorialidade e a insuficiência de recursos financeiros e humanos capacitados. As EPSs precisam ser certificadas e submetidas a um processo avaliativo contínuo. Sugere-se ainda a inclusão do tema promoção de saúde nos currículos dos cursos de formação dos professores e outros profissionais da educação e da saúde.
... Programs to improve teachers 'mental health have been implemented in some countries such as China in implementing a comprehensive school health program and teachers' perceived results include: paying more attention to health, attaining better 'psychological quality' and confidence, forming friendships between teachers and students and feeling more relaxed (Aldinger, Zhang, Liu, Pan, Yu, Jones, Kass, 2008). Gratitude training as a form of intervention on mental health of teachers from NES is effective in reducing symptoms of mental health problems of teachers. ...
