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- Carmen Aldinger
- International Symposium on School Health Education and Promotion
- November 25-26, 2005, Beijing
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- Project Director at Education Development Center (EDC), an international
NGO with about 800 employees, and more than 335 projects in 50 countries
- EDC’s division of Health and Human Development Programs fosters healthy
lifestyles and healthy environments
- We are a WHO Collaborating Center to Promote Health through Schools and
Communities
- Ph.D. student at Lesley University
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- The link between health and education
- Research on school-based health education
- Multi-component interventions
- Health education interventions
- Success factors
- Limitations/Challenges
- Systems for identifying effective health education interventions
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- Research over many years has shown:
- Improvements in health are linked to improvements in learning
- Improvements in general education are associated with improvements in
health
- School-based health education is associated with improvements in health
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- Several studies have shown that school-based health education programs
can have long-term effects
- School-based programs that address specific health issues have shown
changes in knowledge, attitudes, intentions, behaviors and/or biomedical
risk factors, though sometimes not in all of these aspects or only in
the short term
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- Target population: 442 multi-ethnic urban teenage girls in the United
States
- Intervention: School-based intervention on cardiovascular disease:
12-week program of vigorous exercises integrated with heart
health-related lectures and discussions on diet, exercise, stress, and
smoking
- Evaluation: Controlled design: Experimental and control group, pre- and
post-test
- Results: Significant differences in body fat, blood pressure, heart
health knowledge, and eating breakfast
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- Some school-based programs have not shown long-term effects on health
outcomes
- Some school-based programs have shown positive changes in knowledge or
attitudes, but not in behavior or health status
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- Target population: 16 middle schools in the United States
- Intervention: Teens Eating for Energy and Nutrition at School (TEENS), a
multi-level behavioral intervention involving classroom curricula,
school environment, policy, and family components to increase fruit,
vegetable and low fat food consumption
- Evaluation: Randomized design
- Results: Despite positive interim results, the positive effects for the
intervention were not seen for primary outcomes at end of second year.
Positive effects were seen for food choice scores (suggesting students
choosing lower versus higher fat foods), but not for measures of food
intake
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- Multi-component interventions
- Concepts such as the “health-promoting school” and “coordinated school
health” call for multiple coordinated interventions
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- Health education interventions
- Evaluations of school-based curricular health interventions
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- Gaining commitment
- Theoretical underpinnings
- Relevant content
- Participatory teaching methods
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- Timing and Sequence
- Multiple strategies for maximum outcomes
- Teacher training and professional development
- Relevance
- Participation
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- Fidelity of implementation
- Length and quality of the intervention
- Validity of the questionnaire
- Limitations of self-reported behavior
- Attrition of students most at risk
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- National Registry of Evidence-Based Programs and Practices (NREPP) of
the
- U.S. Department of Health and Human Services
- Substance Abuse and Mental Health Services Administration (SAMHSA)
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- http://modelprograms.samhsa.gov/
- Content Focus
- Academic Achievement, Alcohol Use/Abuse, Antisocial/Aggressive
Behavior, HIV/AIDS, Illegal Drugs, Psychological Trauma, Social and
Emotional Competency, Tobacco, Violence, others (not specifically
addressing substances)
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- Program: Lions-Quest Skills for Adolescence
- Description: A comprehensive positive youth development and prevention
program designed for schoolwide and classroom implementation.
- Target Population/Setting: 10 to 14 years olds, in rural, suburban, and
urban middle schools
- Key Outcomes: Deter initiation of regular cigarette smoking,
experimental marijuana use, monthly use of alcohol and binge drinking;
delay progression of regular cigarette smoking and marijuana use among
students who had initiated alcohol use
- Key Program Strategies: Classroom curriculum, Parent and family
involvement, positive school climate, community involvement
- Cost Estimates: contract workshop (2 days) $4,500-4,500 for 12
participants; regional workshop $425-500 per person; Materials $5.95 per
student
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- Cochrane Review
- The Cochrane Collaboration is an international non-profit and
independent organization, dedicated to making up-to-date, accurate
information about the effects of healthcare readily available worldwide.
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- http://www.cochrane.org/index1.htm
- Content includes:
- Many clinical interventions, but also some prevention and behavioral
interventions for:
- Drugs and Alcohol Abuse
- HIV/AIDS
- Injuries
- Tobacco Addiction
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- School-based programs for preventing smoking (Thomas, 2005)
- Objectives: To review all randomized controlled trials (RCTs) of
behavioral interventions in schools to prevent children (5-12 yrs) and
adolescents (13-18 yrs) starting smoking
- Search Strategy: 13 databases, bibliographies, MEDLINE searches of 133
authors
- Selection Criteria: By types of studies, types of participants, types of
interventions, types of outcome measures
- Data collection and analysis: Assessed quality of design and execution,
narrative systematic review, no meta-analysis
- Main results: Of 76 RCTs, 16 were “most valid.” 15 of them were social
influences interventions. Of these, 8 showed some positive effect on
smoking prevalence, 7 failed to do so
- Author’s conclusions: There is little evidence that information alone is
effective. There are well-conducted RCTs of social influences
interventions: half of them showed less smoking in intervention group.
There is a lack of high-quality evidence of combinations of interventions
and multi-modal programs that include communities.
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- Leeds Health Education Effectiveness Database: Evaluations of health
education programs in developing countries
- By Dr. John Hubley, independent consultant, principal lecturer at Leeds
Metropolitan University, UK
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- http://www.hubley.co.uk/listing.htm
- http://www.hubley.co.uk/1schools.htm
- Content includes:
- AIDS and STDs; Family Planning; Breastfeeding Promotion; Immunization;
Oral rehydration; Nutrition; Infectious diseases; Water, sanitation and
hygiene education; Oral Health; Eye Health; Chronic diseases, substance
abuse and mental health; Miscellaneous health topics, safety education
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- Evaluation of a comprehensive school-based AIDS education program in
rural Uganda (Kinsman et al., 2001)
- Target group: Schoolchildren in primary and secondary school in
southwest Uganda
- Intervention methodology: Curriculum adapted from WHO/UNESCO School
Health Education Resource Package; training workshop for teachers;
12-month intervention, based on a model closely related to Theory of
Reasoned Action
- Evaluation method: More than 2,000 students from 20 intervention schools
and 11 control schools completed baseline and follow-up questionnaires;
93 students in 12 focus group discussions
- Impact achieved: Data from questionnaires suggest overall program effect
was minimal and not statistically significant. Data from focus groups
suggest that the program was incompletely implemented and key activities
such as condoms and role play exercises were covered only superficially.
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- Carmen Aldinger
- Education Development Center, Inc.
- 55 Chapel Street
- Newton, MA 02458 USA
- Tel. +1-617-618-2362
- Fax +1-617-527-4096
- Email caldinger@edc.org
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Notes