Comprehensive Nutrition Interventions in First Nation-Operated Schools in Canada

Comprehensive school-based nutrition interventions offer a promising strategy to support healthy eating for First Nations children. A targeted strategic review was performed to identify nutrition interventions in 514 First Nation-operated schools across Canada through their websites. Directed content analysis was used to describe if interventions used 1 or more of the 4 components of the Comprehensive School Health (CSH) framework. Sixty schools had interventions. Nearly all (n = 56, 93%) schools offered breakfast, snack, and (or) lunch programs (social and physical environment). About one-third provided opportunities for students to learn about traditional healthy Indigenous foods and food procurement methods (n = 18, 30%) (teaching and learning) or facilitated connections between the school and students’ families or the community (n = 16, 27%) (partnerships and services). Few schools (n = 10, 17%) had a nutrition policy outlining permitted foods (school policy). Less than 1% (n = 3) of interventions included all 4 CSH components. Results suggest that most First Nation-operated schools provide children with food, but few have nutrition interventions that include multiple CSH components. First Nation-operated schools may require additional financial and (or) logistical support to implement comprehensive school-based nutrition interventions, which have greater potential to support long-term health outcomes for children than single approaches.

School-Level Factors within Comprehensive School Health Associated with the Trajectory of Moderate-to-Vigorous Physical Activity over Time: A Longitudinal, Multilevel Analysis in a Large Sample of Grade 9 and 10 Students in Canada

(1) The majority of Canadian youth are insufficiently active, and moderate-to-vigorous physical activity (MVPA) decreases substantially during secondary school. School factors within the comprehensive school health (CSH) framework may help attenuate this decline. This study aimed to examine how youth MVPA changes over a three-year period and evaluate the school characteristics associated with preventing the decline in MVPA over time, guided by the CSH framework. (2) This study uses COMPASS survey data from 78 secondary schools in Ontario and Alberta that participated in Year 2 (2013/14), Year 3 (2014/15), and Year 4 (2015/16), and 17,661 students attending these schools. Multilevel (linear mixed effects) models were used to determine the association between school-level factors and student MVPA (weekly minutes) over time, stratified by gender. (3) Both male and female students had a significant decline in MVPA across the 3 years, with a greater decrease observed among female students. Within the CSH framework, the school’s social environment, partnerships, and policies were associated with student MVPA over time, however the specific school factors and directions of associations varied by gender. (4) School-based interventions (e.g., public health partnerships) may help avoid the decline in MVPA observed in this critical period and support student health.

School Health Services (SHS): A need in the context of Pakistan

School Health Services (SHS) are school health programs that promote health in school children. The value of SHS is recognized globally and practices around SHS vary with different regions. Its positive outcomes are already acknowledged by high-income countries, where education ministries are typically involved in cultivating comprehensive School Health Services. Low-income countries remain hesitant to implement SHS, due to various constraints. In Pakistan, SHS have been introduced and restructured several times, but never comprehensively executed. Private schools in Pakistan offer better health programs than public schools but none of the schools follow standardized school health guidelines. This paper aims to analyze the role of SHS in Pakistan and provide several recommendations regarding the establishment of SHS in local schools. The proposed suggestions revolve around establishing model clinics in schools, which would be central to subsequent school-based health programs in Pakistan. If properly designed and equipped, school clinics can support a wide range of health outcomes, from emergency first aid care, to immunizations, to health education. The involvement of ministries and national authorities is encouraged for smooth delivery of SHS and compliance with public health guidelines.

A Canadian-wide Perspective on the Essential Conditions for Taking a Comprehensive School Health Approach

Background: The primary purpose of this research was to explore Comprehensive School Health (CSH) stakeholders’ perceptions of the essential conditions for taking a CSH approach in other contexts across Canada. The secondary purpose was to examine the need for and development of an evaluative tool or resource to assess the implementation of the essential conditions.Methods: Data were generated through individual semi-structured interviews (n = 38) and small group interviews (n = 3) with 45 participants across Canada involved in implementing policies or programs which take a CSH approach. Interviews were subjected to content analysis. Results: There was positive support for the essential conditions and results indicated the essential conditions are relevant across Canada. Findings revealed the necessity for a new essential condition that reflected support and leadership from the school district and/or provincial/territorial governing bodies. Modifications to the description of each of the essential conditions were also suggested to provide clarity. Results also indicated that an evaluative tool that was concise, meaningful, and provided immediate feedback would be useful to school communities to establish readiness, assess, and improve ongoing implementation of CSH approaches. Conclusions: This research contributes to the evidence-base of CSH by providing school communities across Canada with a set of refined and understandable essential conditions that support successful implementation. Further, the development of an evaluation tool will support school health champions, researchers, and policymakers in the optimization and implementation of policies or programs which take a CSH approach, ultimately supporting healthier school communities across the country.

A Canadian-wide perspective on the essential conditions for taking a comprehensive school health approach

Background The primary purpose of this research was to explore Comprehensive School Health (CSH) stakeholders’ perceptions of the essential conditions for taking a CSH approach in other contexts across Canada. The secondary purpose was to examine the need for and development of an evaluative tool or resource to assess the implementation of the essential conditions. Methods Data were generated through individual semi-structured interviews (n = 38) and small group interviews (n = 3) with 45 participants across Canada involved in implementing policies or programs which take a CSH approach. Interviews were subjected to content analysis. Results There was positive support for the essential conditions and results indicated the essential conditions are relevant across Canada. Findings revealed the necessity for a new essential condition that reflected support and leadership from the school district and/or provincial/territorial governing bodies. Modifications to the description of each of the essential conditions were also suggested to provide clarity. Results also indicated that an evaluative tool that was concise, meaningful, and provided immediate feedback would be useful to school communities to establish readiness, assess, and improve ongoing implementation of CSH approaches. Conclusions This research contributes to the evidence-base of CSH by providing school communities across Canada with a set of refined and understandable essential conditions that support successful implementation. Further, the development of an evaluation tool will support school health champions, researchers, and policymakers in the optimization and implementation of policies or programs which take a CSH approach, ultimately supporting healthier school communities across the country.

The Efficacy of Comprehensive School Health Course in Changing Pre-Service Teachers’ Attitudes and Reactions Toward Weight-Related Teasing

Teachers view overt expressions of weight stigma, such as weight-related teasing, as troublesome but are often ill-prepared to address instances of weight-related teasing when they arise in the classroom. Comprehensive school health is an emerging framework that aims to better prepare teachers to address issues of health and wellness in the classroom, including weight-related teasing. We examined the efficacy of a university course in comprehensive school health in changing pre-service teachers’ attitudes and perceptions of weight-related teasing. Pre-service teachers read a vignette and responded to 10 items about the vignette at both the beginning and end of the semester-long course. Items relating to pre-service teachers’ perception of, responsibility and obligation to address the weight-related teasing event showed significant, positive change from the beginning to end of the semester. These results suggest that exposure to developmentally sound methods of delivering health-related content can support adaptive educator reactions to weight-related teasing.