Introduction: The health-promoting school (HPS) approach was developed by the World Health Organization to create health promotion changes in the whole school system. Implementing the approach can be challenging for schools because schools are dynamic organizations with each a unique context. Many countries worldwide have a health promotion system in place in which healthy school (HS) advisors support schools in the process of implementing the HPS approach. Even though these HS advisors can take on various roles to provide support in an adaptive and context-oriented manner, these roles have not yet been described. The current study aims to identify and describe the key roles of the HS advisor when supporting schools during the dynamic process of implementing the HPS approach. Methods: The study was part of a project in which a capacity-building module was developed for and with HS advisors in the Netherlands. In the current study, a co-creation process enabled by participatory research was used in which researchers, HS advisors, national representatives, and coordinators of the Dutch HS program participated. Co-creation processes took place between October 2020 and November 2021 and consisted of four phases: (1) a narrative review of the literature, (2) interviews, (3) focus groups, and (4) a final check. Results: Five roles were identified. The role of “navigator” as a more central one and four other roles: “linking pin,” “expert in the field,” “critical friend,” and “ambassador of the HPS approach.” The (final) description of the five roles was recognizable for the HS advisors that participated in the study, and they indicated that it provided a comprehensive overview of the work of an HS advisor in the Netherlands. Discussion: The roles can provide guidance to all Dutch HS advisors and the regional public health organizations that employ them on what is needed to provide sufficient and context-oriented support to schools. These roles can inspire and guide people from other countries to adapt the roles to their own national context.
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BACKGROUND: Knowledge about the beneficial role of physical activity (PA) for health and school performance is growing. Studies investigating the link between PA and school absenteeism due to illness are lacking. Therefore, we investigated associations between habitual PA and school absenteeism due to illness in adolescents and explored whether mental health and cardiovascular fitness mediated this association. METHODS: We studied 328 students in grades 7 and 9 (mean age 13.8 years; 49% boys). The PA was measured objectively by an ActivPAL3™ accelerometer attached on the thigh during 1 full week (24 hours/day). Depressive symptoms and self-esteem were self-reported by the Center for Epidemiologic Studies Depression Scale (CES-D) and Rosenberg Self-Esteem Scale, respectively, and included as a proxy for mental health in the analyses. Cardiovascular fitness was measured by the 20-m shuttle-run test. School absenteeism due to illness data was provided by the school administration. RESULTS: The PA was not significantly associated with school absenteeism, though there was an indirect association between PA and school absenteeism by cardiovascular fitness. CONCLUSIONS: Cardiovascular fitness mediates the association between PA and school absenteeism due to illness. Thus, cardiovascular fitness of students should be improved to reduce school absenteeism due to illness.
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Background: Although principles of the health promoting school (HPS) approach are followed worldwide, differences between countries in the implementation are reported. The aim of the current study was (1) to examine the implementation of the HPS approach in European countries in terms of different implementation indicators, that is, percentage of schools implementing the HPS approach, implementation of core components, and positioning on so‐called HPS‐related spectra, (2) to explore patterns of consistency between the implementation indicators across countries, and (3) to examine perceived barriers and facilitators to the implementation of the HPS approach across countries. Methods: This study analyzed data from a survey that was part of the Schools for Health in Europe network's Monitoring Task 2020. The survey was completed by HPS representatives of 24 network member countries. Results: Large variations exist in (the influencing factors for) the implementation of the HPS approach in European countries. Observed patterns show that countries with higher percentages of schools implementing the HPS approach also score higher on the implementation of the core components and, in terms of spectra, more toward implementing multiple HPS core components, add‐in strategies, action‐oriented research and national‐level driven dissemination. In each country a unique mix of barriers and facilitators was observed. Conclusion: Countries committed to implementing the HPS approach in as many schools as possible also seem to pay attention to the quality of implementation. For a complete and accurate measurement of implementation, the use of multiple implementation indicators is desirable.
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BackgroundWhile the indoor environmental quality of classrooms is a potential issue because it may affect the wellbeing of school children, the relations are still poorly studied. This study aimed to investigate the relations between classroom characteristics and health and comfort of school children.Material and methodsA questionnaire was distributed among 1311 school children (8–12 years old, average 10) of 54 classrooms at 21 schools in The Netherlands. Additionally, the survey included an inspection of the school and its installations and an inspection of the classrooms surveyed using checklists, and monitoring of some environmental parameters (temperature, relative humidity and CO2 concentration) in the classrooms.ResultsAmong the children studied, 87% was bothered by noise, 63% by smells, 42% by sunlight when shining, 35% didn't like the temperature in the classroom (too cold or too warm) and 34% experienced temperature changes. Main diseases reported comprised of allergies (26%), rhinitis (17%), hay fever (16%) and eczema (16%). Health and comfort in non-traditional schools was better than in the traditional schools studied (A non-traditional school is a school in which the way of educating children is different from the traditional way of education, according to a different educational theory). Physical building characteristics of the classrooms studied in the traditional schools were associated with the Classroom Symptom Index (location of school building, heating system, solar devices hampering opening windows or ventilation) and the Classroom Comfort Index (ventilation type, window frame colour, floor material and vacuum cleaning frequency).ConclusionsMeasures to improve acoustical, air, and thermal conditions of children in classrooms are needed. More research is required on the use of different lighting systems and use of different colours in classrooms.
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Background: Increasing health literacy (HL) in children could be an opportunity for a more health literate future generation. The aim of this scoping review is to provide an overview of how HL is conceptualized and described in the context of health promotion in 9–12-year-old children. Methods: A systematic and comprehensive search for ‘health literacy’ and ‘children’ and ‘measure’ was performed in accordance with PRISMA ScR in PubMed, Embase.com and via Ebsco in CINAHL, APA PsycInfo and ERIC. Two reviewers independently screened titles and abstracts and evaluated full-text publications regarding eligibility. Data was extracted systematically, and the extracted descriptions of HL were analyzed qualitatively using deductive analysis based on previously published HL definitions. Results: The search provided 5,401 original titles, of which 26 eligible publications were included. We found a wide variation of descriptions of learning outcomes as well as competencies for HL. Most HL descriptions could be linked to commonly used definitions of HL in the literature, and some combined several HL dimensions. The descriptions varied between HL dimensions and were not always relevant to health promotion. The educational setting plays a prominent role in HL regarding health promotion. Conclusion: The description of HL is truly diverse and complex encompassing a wide range of topics. We recommend adopting a comprehensive and integrated approach to describe HL dimensions, particularly in the context of health promotion for children. By considering the diverse dimensions of HL and its integration within educational programs, children can learn HL skills and competencies from an early age.
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The ‘Sport Physical Education and Coaching for Health (SPEACH) project, co-financed by the Erasmus+ Programme of the European Union (2015-2017) aims to increase awareness and behavioral change in sport professionals and European citizens towards an active and healthy lifestyle. The target is to develop and test Health Enhancing Physical Activities or HEPA modules that can be integrated in Physical Education Training Education structures and Sport Coaching courses. The different steps in this EU project are: (1) needs analyses among students (survey, interviews, focus groups), (2) development of most relevant HEPA modules based on the needs analysis results, (3) teach-the-teacher course (4) testing of 3 selected HEPA modules in a real-life setting with physical education and sport coaching students (n=60, from 8 countries) and teachers (n=12, from 7 countries), (5) sustainability of the project results, coordinated by the European Network of Sport Education (ENSE). The project is in its last phase (step 6). The titles of the three field-tested modules are (a) Development of a family-based HEPA project in the school & sport club context, (b) Promoting health enhancing physical activity among children and youth, and (c) Designing educational sport environments for children with special needs. The presentation will illustrate how the module on family-based HEPA was build up in content and didactical approach. The students were given the task to work out a health promotion project together with local sport clubs, school(s) and other local organizations. The goal of the intervention was to enhance (and maintain) health with children and make sure that parents are aware of possibilities to integrate PA in daily life for their children and themselves. A stepwise approach in small students groups was worked out concentrating on the themes: insight in stakeholders and their role in health promotion, behavior change theories, motivational interviewing and intervention mapping protocol. Advices for implementation on different educational levels (vocational, bachelor and master) and usefulness at national and international educational contexts will be given for the family-based module and for the project in general. Acknowledgements: this project is co-finance by the Erasmus+ programme of the European Union, 557083-EPP-1-2014-1-NL-SPO-SCP) Keywords: health policy, family-based intervention, school and sport club context, teacher training, sport coaching courses,
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This paper investigates whether encouraging children to become more physically active in their everyday life affects their primary school performance. We use data from a field quasi‐experiment called the Active Living Program, which aimed to increase active modes of transportation to school and active play among 8‐ to 12‐year‐olds living in low socioeconomic status (SES) areas in the Netherlands. Difference‐in‐differences estimations reveal that while the interventions increase time spent on physical activity during school hours, they negatively affect school performance, especially among the worst‐performing students. Further analyses reveal that increased restlessness during instruction time is a potential mechanism for this negative effect. Our results suggest that the commonly found positive effects of exercising or participating in sports on educational outcomes may not be generalizable to physical activity in everyday life. Policymakers and educators who seek to increase physical activity in everyday life need to weigh the health and well‐being benefits against the probability of increasing inequality in school performance.
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In November 2021, the Lecturer Position at Institutes (L.INT) professorship was established by Saxion and Medical Spectrum Twente and as partners physiotherapy practice Pro-F and the Thoracic Centre Twente, with Sandra van Hogen-Koster as a professor. With this, the first Dutch professorship that focuses on the ideas of Positive Health has been launched.
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Limited evidence is available about (non)-representativeness of participants in health-promoting interventions. The Dutch Healthy Primary School of the Future (HPSF)-study is a school-based study aiming to improve health through altering physical activity and dietary behaviour, that started in 2015 (registered in ClinicalTrials.gov on14-06-2016, NCT02800616). The study has a response rate of 60%. A comprehensive non-responder analysis was carried out, and responders were compared with schoolchildren from the region and the Netherlands using a cross-sectional design. External sources were consulted to collect non-responder, regional, and national data regarding relevant characteristics including sex, demographics, health, and lifestyle. The Chi-square test, Mann-Whitney U test, or Student's t-test were used to analyse differences.
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Purpose: Adolescents are the least likely to seek help for their mental health problems. School may be an important route to improve early recognition of adolescents with mental health problems in need for support, but little is known about the barriers to school support.Materials and methods: Data were collected in a longitudinal cohort study of Dutch adolescents (age 12–16) in secondary school (n = 956). We assessed the relation between level of psychosocial problems at the beginning of the school year (T1) and the support used in school at the end of that school year (T2), whether the willingness to talk to others (measured at T1) mediates this relation, and whether stigma towards help-seeking (T1) moderates this mediation.Results: Adolescents with more psychosocial problems were more likely to use support in school and were less willing to talk to others about their problems, but the willingness to talk to others was not a mediator. Stigma moderated the relationship between psychosocial problems and willingness to talk to others.Conclusions: Most adolescents with psychosocial problems get support in Dutch secondary school regardless of their willingness to talk to others about their problems. However, perceiving stigma towards help-seeking makes it less likely for someone to talk about their problems.
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