Global Health Promotion最新文献

Background: Many studies have investigated the adoption and implementation of school-based physical activity interventions, but only a few have reported on their sustainability. Understanding the factors contributing to school-based physical activity interventions being maintained or abandoned is necessary to ensure that resource investments are effective.

Objective: This study aims to contribute to this understanding. We investigated the actions and strategies developed by the school teams participating in the Quebec Active at school! initiative in ensuring that the tailored interventions they had developed over the three-year degressive funding were maintained.

Methods: Target population was the 415 schools that reached the end of the three-year funding period in 2020. An online survey consisting of 27 multiple choice questions, each followed by open-ended questions in which respondents explained or justified their choice, was sent to all participating schools.

Results: A total of 397 of the 415 schools responded to the survey. The analysis showed that the school teams have integrated actions to foster sustainability during initial project planning and adoption. Eight main strategies were deployed to sustain the interventions: maintenance of the most popular physical activities, inclusion of the 60-min daily physical activity (DPA) initiative in the school Educational Project, student involvement in implementing DPA, maintaining a person in charge of DPA implementation, maintaining the committee in charge of DPA implementation, training new staff, researching new sources of funding, maintaining developed collaborations.

Conclusion: The initiative's bottom-up approach has favored school teams developing various sustainability strategies, whether at the institutional, organizational or community level. Given the acceleration of contemporary changes, it is inevitable that DPA interventions will need to be adapted and transformed. Therefore, what should be sustained is the schools' capacity building and innovativeness that has been generated by the new program implementation.

The early years in life are critical in many ways as they significantly impact future health outcomes. In line with the 2018-2022 National French Health Strategy, Alliance for Health is a complex intervention that deploys a health-promotion program based on a health determinants approach and oriented toward 8- to 11-year-olds. It aims to increase their psychosocial competencies and health literacy levels. The objective of the study was to understand and assess the outcomes and implementation process of an evidence-based health-promotion program targeting both primary schools and the children's local environment. To reach this goal, pupils were exposed to health-promoting actions carried out by their teachers and a health-promoting environment, both inside and outside the school. A multisite cluster trial involving a complex intervention in the population was performed with one experimental group and one control group during three academic years. The project took place in four districts of the Auvergne-Rhône-Alpes region and involved 101 schools (10,000 pupils: intervention group 5000 + control group 5000). This research intervention program gathered local policy makers, regional education authorities, the regional public health agency, and researchers (education and public health). The intervention's focus was on its sustainability, its integration in the everyday practices of the professionals, and its impact on the children's psychosocial competencies and health literacy. This paper describes the project's protocol, the research design, and the interventions deployed to improve health-promotion services provided in primary schools and the children's local environment.

Objectives: In order to prevent people from taking up smoking on a daily basis, the P2P program has been developed based on the Theory of Planned Behavior (TPB) and relying on the peer-to-peer method. A cluster randomized controlled trial involving 1573 high school students in the Occitanie region of France showed a reduction in the increase in daily smoking. Given the effectiveness observed, the aim was to assess the transferability of P2P to two other French regions (Ile-de-France and Auvergne).

Method: The RE-AIM (Recruitment, Effectiveness, Adoption, Implementation, Maintenance) methodology was used. A total of 190 interviews were conducted with school referents, peer educators, peer receivers and regional coordinators. A self-questionnaire (before and after the intervention) assessed changes in daily smoking habits.

Results: P2P has been implemented faithfully in 29 vocational high schools, with adaptations to suit different contexts and actors. The main obstacles were organizational (timetable and school career). The levers are the support provided by prevention structures. Recruiting pairs of nurse referents and improving the pedagogical guide, which is recognized as a support tool, will be necessary. In terms of effectiveness, more than 3229 students in 10th Grade in vocational high schools were followed for 1 year. The prevalence rates of daily smoking changed by -1.6%, +2.9% and +0.7%, respectively, showing no significant difference between these regions, with no difference in effect depending on the place of implementation.

Discussion: The P2P program is transferable to other regions despite differences in how the organizations and high schools involved operate, and differences in the characteristics of the high school students targeted. It is also reproducible, maintaining a beneficial effect in preventing increased daily smoking among vocational high school students.