An intervention to reduce playground equipment hazards.
(9/1031)
OBJECTIVES: A community intervention trial was carried out to evaluate the relative effectiveness of two methods of reducing playground hazards in schools. The study hypotheses were: (1) a health promotion programme addressing barriers to implementing the New Zealand Playground Safety Standard will reduce playground hazards and (2) the intervention programme will be more successful than providing information alone. METHODS: Twenty four schools in Wellington, New Zealand were randomly allocated into two groups of 12 and their playgrounds audited for hazards. After the audit, the intervention group received a health promotion programme consisting of information about the hazards, an engineer's report, regular contact and encouragement to act on the report, and assistance in obtaining funding. The control group only received information about hazards in their playground. RESULTS: After 19 months, there was a significant fall in hazards in the intervention schools compared with the control schools (Mann-Whitney U test, p = 0.027). No intervention schools had increased hazards and eight out of 12 had reduced them by at least three. In contrast, only two of the control schools had reduced their hazards by this amount, with three others increasing their hazards in that time. CONCLUSIONS: It is concluded that working intensively with schools to overcome barriers to upgrading playground equipment can lead to a reduction in hazards, and that this form of intensive intervention is more effective than providing information alone. (+info)
Self-diagnosis as a possible basis for treating urinary schistosomiasis: a study of schoolchildren in a rural area of the United Republic of Tanzania. Partnership for Child Development.
(10/1031)
A questionnaire for schoolchildren about symptoms of urinary schistosomiasis is becoming widely used to identify schools where the prevalence of infection with Schistosoma haematobium is greater than 50%, the threshold for applying mass treatment. This strategy typically leaves many schools without treatment even though some of the children have urinary schistosomiasis and blood in urine. We examined data collected during an evaluation of a school health programme in Tanga Region, the United Republic of Tanzania, to determine whether self-diagnosis could be used as a basis for giving treatment. Over 2300 children in 15 schools were asked by a nurse whether they had kichocho (urinary schistosomiasis) and their answers were compared with the results of tests for visible and occult blood in urine, and microscopy for S. haematobium eggs. An average of 75% of children were correct in their self-diagnosis (95% confidence interval (CI) = 72-78%), while 3% gave a false-positive diagnosis (95% CI = 2-4%). The remaining 22% gave a false-negative diagnosis (95% CI = 20-25%) and would not have been treated, although most of these children were lightly infected. These proportions were independent of a wide range of prevalence levels (7-77%) and intensity of infection (23-827 eggs per 10 ml of urine). Self-reported schistosomiasis might thus be used to treat children in schools where mass treatment is not applied. (+info)
Health promoting schools in England--a way forward in development.
(11/1031)
Schools are identified as a key setting for health promotion in the UK Government's consultation report on the public health strategy for England. The concept of the 'healthy' or 'health promoting school' provides the basis for a broad settings approach to health promotion in schools. The approach extends beyond the formal health education curriculum to include a consideration of the physical and social environment of schools and their links and partnerships with parents and the wider community, in pursuit of better health. There is growing evidence that the health promoting school approach is effective in influencing outcomes related to health and education. Initiatives in the form of projects and schemes are commonly used by Health Promotion Specialist services and health partnerships, to stimulate and support the adoption of the approach by schools. A national healthy school scheme is to be launched alongside these local initiatives in 1999. The paper reviews research and practice in this area and makes recommendations to inform the future development of schools as health promoting organizations. (+info)
Effects of a replication of a multicomponent model for preventing adolescent pregnancy in three Kansas communities.
(12/1031)
CONTEXT: A significant amount of attention has been devoted to the complex issue of teenage pregnancy and to programs for reducing pregnancy among adolescents. Careful evaluations of such programs are needed to ascertain what strategies will be most effective at reducing teenage pregnancy. METHODS: A pretest-posttest comparison group design was used to analyze the effects of a comprehensive multicomponent school and community intervention on estimated pregnancy rates and birthrates among young people in three Kansas communities: Geary County, Franklin County and selected neighborhoods of Wichita. RESULTS: There were high levels of program activity in all three communities during the intervention period, including teacher training and sexuality education for students. Survey respondents rated highly such project interventions as the extension of school-linked clinic hours to accommodate student schedules and support groups established in middle schools. Between 1994 and 1997, the proportions of adolescents reporting that they had ever had sex decreased significantly among all ninth and 10th graders in Geary County, from 51% to 38% among females and from 63% to 43% among males. In Franklin County, more males in grades 11 and 12 reported using condoms in 1996 (55%) than had done so in 1994 (39%). Age at first intercourse remained relatively stable in Franklin and Geary counties during the intervention period. The estimated pregnancy rate among adolescents aged 14-17 decreased between 1994 and 1997 in Geary Country, while it increased in comparison areas. The estimated pregnancy rates among 14-17-year-olds decreased in both Franklin County and its comparison communities. The birthrate declined both in one target area of Wichita and in its comparison area from 1991-1993 to 1994-1996. Over the same time period, the birthrate increased in a second target area of Wichita, while it decreased in the comparison community. CONCLUSIONS: This evaluation of a comprehensive multicomponent program for adolescent pregnancy prevention contributes to our understanding of this model and its replicability in diverse communities. Ongoing program evaluation is important for developing initiatives and for refining strategies so they respond to local conditions. (+info)
The extent of drug therapy for attention deficit-hyperactivity disorder among children in public schools.
(13/1031)
OBJECTIVES: The purpose of this study was to determine the extent of medication use for attention deficit-hyperactivity disorder (ADHD) in southeastern Virginia. METHODS: Students enrolled in grades 2 through 5 in school districts in city A (n = 5767 students) and city B (n = 23,967 students) were included. Nurses recorded students who received ADHD medication in school. RESULTS: The proportion of students receiving ADHD medication was similar in both cities (8% and 10%) and was 2 to 3 times as high as the expected rate of ADHD. Receipt of drug therapy was associated with social and educational characteristics. Medication was used by 3 times as many boys as girls and by twice as many Whites as Blacks. Medication use increased with years in school, and by fifth grade 18% to 20% of White boys were receiving ADHD medication. Being young for one's grade was positively associated with medication use (P < .01). The prevalence of ADHD was 12% in district A, 63% in district B. CONCLUSIONS: These findings suggest that criteria for diagnosis of ADHD vary substantially across US populations, with potential overdiagnosis and overtreatment of ADHD in some groups of children. (+info)
A public health vs a risk-based intervention to improve cardiovascular health in elementary school children: the Cardiovascular Health in Children Study.
(14/1031)
OBJECTIVES: This study sought to determine the population effects of both classroom-based and risk-based interventions designed to reduce cardiovascular disease risk factors in children. METHODS: Elementary school children (n = 2109; age range: 7-12 years) were randomized by school to a classroom-based intervention for all third and fourth graders, a risk-based intervention only for those with 1 or more cardiovascular disease risk factors, or a control group. The 8-week interventions involved both knowledge--attitude and physical activity components. RESULTS: School-level analyses showed that physical activity in the risk-based group and posttest knowledge in the classroom-based group were significantly higher than in the control group. With regard to trends shown by individual-level analyses, cholesterol dropped more in the classroom-based than in the control group, and skinfold thickness decreased 2.9% in the classroom-based group and 3.2% in the risk-based group (as compared with a 1.1% increase in the control group). CONCLUSIONS: Both classroom-based and risk-based interventions had positive effects on physical activity and knowledge, with trends toward reduced body fat and cholesterol. However, the classroom-based approach was easier to implement and evidenced stronger results than the risk-based intervention. (+info)
Cluster randomised controlled trial of expert system based on the transtheoretical ("stages of change") model for smoking prevention and cessation in schools.
(15/1031)
OBJECTIVES: To examine whether a year long programme based on the transtheoretical model of behaviour change, incorporating three sessions using an expert system computer program and three class lessons, could reduce the prevalence of teenage smoking. DESIGN: Cluster randomised trial comparing the intervention to a control group exposed only to health education as part of the English national curriculum. SETTING: 52 schools in the West Midlands region. PARTICIPANTS: 8352 students in year 9 (age 13-14 years) at those schools. MAIN OUTCOME MEASURES: Prevalence of teenage smoking 12 months after the start of the intervention. RESULTS: Of the 8352 students recruited, 7444 (89.1%) were followed up at 12 months. The intention to treat odds ratio for smoking in the intervention group relative to control was 1.08 (95% confidence interval 0.89 to 1.33). Sensitivity analysis for loss to follow up and adjustment for potential confounders did not alter these findings. CONCLUSIONS: The smoking prevention and cessation intervention based on the transtheoretical model, as delivered in this trial, is ineffective in schoolchildren aged 13-14. (+info)
The opportunities and effectiveness of the health promoting primary school in improving child health--a review of the claims and evidence.
(16/1031)
School health programs have been part of schooling for most of this century. The health promoting school is a recently developed concept which seeks to provide a multifaceted approach to school health. Will it provide a better frame-work to assist schools address the health issues of their students? This paper examines the development of the health promoting school and identifies its structural components. It reviews the claims and evidence which have emerged from the school health research literature which focus on primary schools. Findings indicate health gains for primary school students are difficult to assess, and will most likely occur if a well-designed program is implemented which links the curriculum with other health promoting school actions, contains substantial professional development for teachers and is underpinned by a theoretical model. The paper concludes by discussing how improvements can be made in more accurately assessing the effectiveness of the health promoting primary school in improving school health. (+info)