Abstract
Objectives
To assess what health promotion policies and practices were adopted by schools in Nova Scotia and the extent that these policies and practices affected the diet quality, physical activity (PA) and weight status of students.
Methods
We developed and administered a ‘school practice assessment tool’ to assess the presence of 72 different school-based health promotion policies and practices. Surveys were conducted in 2003 and 2011 to assess diet, PA and weight status in approximately 10,000 grade 5 students. We used multilevel regression methods to examine changes in these outcomes across schools with varying levels of health promotion policies and practices between the two time-points.
Results
Between 2003 and 2011 the diet quality of students improved, PA decreased and the prevalence of childhood obesity increased. Although we did not find consistent or significant favourable benefits resulting from higher implementation levels, we did observe fewer negative trends among schools at higher levels of implementation.
Conclusion
Our results build on the current gap in knowledge on the impact of Health Promoting Schools (HPS) implementation through population health interventions, but there is a continued need for further evaluation and monitoring of school policies to understand how HPS practices are supporting healthier eating and PA for students.
Key Words: Public health, schools, health promotion, health behaviour, prevention
Résumé
Objectifs
Évaluer les politiques et les pratiques de promotion de la santé adoptées dans les écoles de la Nouvelle-Écosse et leur effet sur la qualité du régime, l’activité physique (AP) et le statut pondéral des élèves.
Méthodes
Nous avons élaboré et administré un « outil d’évaluation des pratiques scolaires » pour évaluer la présence de 72 politiques et pratiques distinctes de promotion de la santé à l’école. Des sondages ont été menés en 2003 et en 2011 pour évaluer le régime, l’AP et le statut pondéral d’environ 10 000 élèves de 5e année. Nous avons utilisé des méthodes de régression multiniveaux pour examiner les changements dans les résultats obtenus par les écoles ayant adopté divers niveaux de politiques et de pratiques de promotion de la santé entre les deux dates.
Résultats
Entre 2003 et 2011, la qualité du régime des élèves s’est améliorée, l’AP a diminué, et la prévalence de l’obésité juvénile a augmenté. Nous n’avons pas trouvé d’avantages systématiques ou significatifs résultant de niveaux de mise en oeuvre supérieurs, mais nous avons observé moins de tendances négatives dans les écoles aux niveaux de mise en oeuvre supérieurs.
Conclusion
Nos résultats comblent une partie des lacunes actuelles dans les connaissances sur l’effet de la mise en oeuvre d’interventions en santé des populations dans les « écoles faisant la promotion de la santé » (EPS), mais il existe encore un besoin d’évaluer et de surveiller les politiques scolaires afin de comprendre comment les pratiques des EPS appuient l’alimentation saine et l’AP chez les élèves.
Mots Clés: santé publique, écoles, promotion de la santé, comportement sanitaire, prévention
Footnotes
Funding source: This research was funded by an operating grant from the Canadian Institutes of Health Research (FRN: 93680).
Conflict of Interest: None to declare.
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