The Heart Smart cardiovascular school health promotion: Behavior correlates of risk factor change

ArticleinPreventive Medicine 21(1):18-32 · February 1992with29 Reads
DOI: 10.1016/0091-7435(92)90003-Z
Background: A growing awareness of health promotion and positive lifestyle change, coupled with the knowledge that cardiovascular risk has its origins in childhood, has led to the development of health promotion programs in the elementary school. While most school-based programs target specific behaviors or enlist singular intervention modalities, the Heart Smart cardiovascular school health promotion targeted the total school environment with a multidisciplinary approach to prompt the school's varied institutions to implement changes in curriculum, school lunch, and physical education. Methods: Components of the Heart Smart environmental intervention included: (a) a school lunch program providing cardiovascular healthful food choices, reduced in fat by 30% and in sodium and sugar by 50%; (b) a physical education program promoting personal fitness and aerobic conditioning; and (c) cardiovascular risk factor screening, measuring fasting lipids and lipoproteins, anthropometrics, and blood pressure. Changes in cardiovascular risk factor status, school lunch selections, and exercise performance were compared. Results: Screening participants showed greater improvement in health knowledge than nonparticipants. School lunch choices were successfully altered, and children whose lunch choices were cardiovascular healthful evidenced the greatest cholesterol reduction. Improvements in run/walk performance were related in predicted directions to the overall cardiovascular risk profile. Increases in high-density lipoprotein cholesterol were observed at intervention schools. Conclusion: Observations indicate a relationship between behavior change and physiologic changes achieved in a total school health promotion to reduce cardiovascular risk.
    • "Table 4Intervention characteristics of included studies aimed at increasing students' health-related fitness knowledge (studies with low methodological quality). Study Design; country Participants Intervention description Results Health-related fitness knowledge Physical activity/fitness (Arbeit et al., 1992) Controlled trial; USA n ¼ 319, 4th and 5th grade Intervention group: The 2.5-year Heart Smart school-based intervention consisted of several components: (a) Superkids- Superfit exercise programme: 12 didactic lessons and aerobic activities to promote knowledge, behavioural skills and patterns of physical activity; (b) School lunch programme to provide healthful food choices; (c) risk factor screening to measure fasting lipids and lipoproteins, anthropometrics and blood pressures. Control group: no special intervention. "
    [Show abstract] [Hide abstract] ABSTRACT: This systematic review includes 34 studies examining the effects of school-based physical activity interventions on students' health-related fitness knowledge. The study design, methodological quality, and effectiveness of interventions on students' health-related fitness knowledge were analysed. The majority of the studies (79.4%) revealed significant positive intervention effects on students' health-related fitness knowledge. Studies examining adolescents were more frequently in a position to influence students' health-related fitness knowledge (87.5%) than studies examining children (75%), and studies with low methodological quality (88.8%) had more frequent positive effects than studies with moderate quality (75%). The effects on students' health-related fitness knowledge were independent of moderator variables such as the intervention content, duration and frequency. Only few studies were able to simultaneously positively influence students' health-related fitness knowledge and students' physical activity and/or fitness levels. These programmes can positively influence students' health-related fitness knowledge, but it remains unclear what the practical significance of these changes is. Further research is needed to clarify the influence of students' health-related fitness knowledge on reflection, understanding, physical activity behaviour, and overall physical literacy levels.
    Article · Aug 2015
    • "Following the intervention, the necessary assessment should be completed in order to determine (i) knowledge and skills obtained by children, and (ii) any changes in terms of knowledge, attitudes, perceptions and behavior, by both children and parents. Research in this area could add to the existing knowledge base on healthy lifestyles, food security, healthy farming practices, consumer behavior and the outcome of health promoting interventions (Arbeit et al. 1992, Harrell et al. 1996, Reading 2002). In addition, a study of this nature can directly impact on the manner in which individuals function in their daily lives and how they perceive their own physical, mental and social well-being. "
    [Show abstract] [Hide abstract] ABSTRACT: Abstract: In order to truly be innovative in education, it is sometimes necessary to break away from conventional practices while, at the same time, keeping the students’ best interests in mind. We support the notion that innovation in teaching and learning plays a vital role in the success of an institution and as such have launched innovative initiatives amongst various institutions. These initiatives present various benefits, such as empowering children and supporting well-being through innovative educational wellness indicators and health promoting intervention. Based on the results obtained in this study, and the needs and knowledge based on the teachers and learners, an intervention plan was developed to support positive change within the schools and the community. This intervention plan includes the development of learning content that can be included in the curriculum without adding any additional burden to the teachers as well as the training of teachers to better implement this curriculum. The intervention further aims to assist with social change by guiding the schools in improving their learner feeding scheme and physical activity programme. The TEARS principle is an innovative 5-step enterprise that has been developed and implemented in order to pioneer the necessary changes in education.
    Full-text · Article · Jun 2015 · BMC Public Health
    • "Searches yielded 48 551 records, from which we identified 67 eligible studies (Figure 1). Summary details of the types of interventions are presented inTable 3. Twenty-nine studies were conducted in North America (27 USA [22,23,25262729,35,37,39,40,45,48,5051525758596061626365, 66,70,75,83], 2 in Canada [71,82]), 19 in Europe19202124,30, 32,33,36,41,42,44,47,53,74,76777885], 11 in Australasia [28,31,34,46,54,64,68,69,72,73,81] and eight in middleor low-income countries (China [56,79,84], India [55], Mexico [38,49], Egypt [80] and Tanzania [67] ). Thirtyfour studies focused on physical activity and/or nutrition . "
    [Show abstract] [Hide abstract] ABSTRACT: Healthy children achieve better educational outcomes which, in turn, are associated with improved health later in life. The World Health Organization's Health Promoting Schools (HPS) framework is a holistic approach to promoting health and educational attainment in school. The effectiveness of this approach has not yet been rigorously reviewed. METHODS: We searched 20 health, education and social science databases, and trials registries and relevant websites in 2011 and 2013. We included cluster randomised controlled trials. Participants were children and young people aged four to 18 years attending schools/colleges. HPS interventions had to include the following three elements: input into the curriculum; changes to the school's ethos or environment; and engagement with families and/or local communities. Two reviewers identified relevant trials, extracted data and assessed risk of bias. We grouped studies according to the health topic(s) targeted. Where data permitted, we performed random-effects meta-analyses. RESULTS: We identified 67 eligible trials tackling a range of health issues. Few studies included any academic/attendance outcomes. We found positive average intervention effects for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small. On average across studies, we found little evidence of effectiveness for zBMI (BMI, standardized for age and gender), and no evidence for fat intake, alcohol use, drug use, mental health, violence and bullying others. It was not possible to meta-analyse data on other health outcomes due to lack of data. Methodological limitations were identified including reliance on self-reported data, lack of long-term follow-up, and high attrition rates. CONCLUSION: This Cochrane review has found the WHO HPS framework is effective at improving some aspects of student health. The effects are small but potentially important at a population level.
    Article · Feb 2015
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