Background: School-based mental health promotion aims to strengthen mental health and reduce stress. Results on the effectiveness of such programs are heterogeneous. This study realized a school-based mental health promotion program (StresSOS) for all students and aimed to identify moderators (mental health status, gender, grade level) of pre- to post-changes in stress symptoms and knowledge. Methods: Participants were N = 510 adolescents (from 29 classes; 46.7% female) aged 12–18 years (M = 13.88, SD = 1.00; grade levels 7–10). They were without mental health problems (65.9%), at risk for mental health problems (21.6%), or with mental health problems (12.5%) and participated in a 90 min per week face-to-face training with 8 sessions in class at school. Demographic variables, mental health status, stress symptoms, and knowledge about stress and mental health were collected at baseline. Program acceptance, stress symptoms, and knowledge were collected post-intervention. Multilevel mixed effects models were conducted with the fixed effects time (within factor), mental health status, gender, and grade level (between factors). Random effects for students within classes were included. Results: In the pre-post comparison, mental health status moderated the changes on psychological stress symptoms (p < 0.05). In adolescents with mental health problems the largest reduction in stress symptoms was observed between pre- and post-assessment. Gender and grade level were less relevant. For all adolescents knowledge gains were revealed (p < 0.001). Program acceptance was moderated by mental health status and grade level (p < 0.01). Mentally healthy adolescents and within the group of adolescents at-risk or with mental health problems, especially younger students (7th/8th grade), rated program acceptance higher. Conclusion: Psychological stress symptoms decreased among adolescents with mental health problems and not among adolescents at risk for or without mental health problems. Mental health-related knowledge increased for all adolescents. The results add to knowledge on school-based mental health intervention research and practice. Its implications for different prevention strategies (universal, selective or a combination of both) are discussed.

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-01-28T14:55:02Z No. of bitstreams: 1 arquivototal.pdf: 1500764 bytes, checksum: f68db277b1f574de6c241629ac53514d (MD5) / Made available in DSpace on 2016-01-28T14:55:03Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1500764 bytes, checksum: f68db277b1f574de6c241629ac53514d (MD5) Previous issue date: 2015-04-14 / Health Promotion is considered an important strategy for overcoming the development of purely curative and individual actions aimed at health, which are characteristic of the biomedical model. The same proposes the development of care, preventive and promotional health. However, this proposal reflects numerous obstacles, among them stands out the conceptual aspect, which was being shaped over the years from the development of understanding of the concept of health. Based on the scope of health promotion, the School Health Program was created in 2007, the same propose to the articulation of the Family Health Strategy with the school and it is proposed to integrate and link the two sectors with actions that aim to improve the quality of life of students in basic education schools. Thus, the present study was to identify the program inconsistencies from the design of health promotion that it incorporates in confront the understanding that the World Health Organization has about the same which is based on seven principles, which are: holism, intersectionality, empowerment, social participation, equity, multi-strategy actions and sustainability. This is a bibliographic and documentary research. Data collection occurred in the period from January to June 2014. Initially a literature review was conducted through a prior reading of titles and abstracts of articles, dissertations and theses contained in the scientific material to be defined. The collection was conducted with the Scielo databases ; Bireme ; Lilacs ; Medline and Cochrane Library , and the descriptors were used: health promotion; school health ; School Health Program ; Health strategy and school health . 35 articles and eight dissertations were obtained . This step was followed by desk research. As a result was obtained that: can not identify specifically that health promotion is adopted as nuclear center of the program; there is the definition of a concept of health promotion, before there is a mix of concepts that can be seen from the recommended actions; the structural difficulties faced by the FHS compromise its operation; predominates the trend of personal guilt is individual as your reality, is the professional regarding the commitment to the success of the proposed actions; do not see the incorporation of the seven principles defined by the WHO; the preponderance given to the health sector to conduct the proposed actions indicates serious weakness; the actions that stand out are the healing and promotion actions are confused with prevention. Therefore, identifies the importance of commitment to the critical evaluation of the program and the involvement of many other sectors of the political sphere and the active participation of individuals to the development of actions that are consistent with the broader concept of health and can focus the social determinants. / A Promoção da Saúde é considerada uma importante estratégia para a superação do desenvolvimento de ações meramente curativas e individuais direcionadas à saúde, pois propõe o desenvolvimento de ações assistenciais, preventivas e promocionais à saúde. Entretanto, essa proposta reflete inúmeros empecilhos, dentre eles destaca-se o aspecto conceitual, que foi sendo moldado ao longo dos anos a partir da evolução da compreensão acerca do conceito de saúde. Tomando por base o escopo da promoção da saúde, o Programa Saúde na Escola (PSE) foi criado no ano de 2007. O programa operacioanaliza-se a partir da articulação da Estratégia Saúde da Família com a escola. O presente estudo foi realizado com o objetivo de identificar as inconsistências do PSE a partir da concepção de promoção à saúde que incorpora, tendo como contraponto o entendimento que a Organização Mundial da Saúde tem sobre a temática, que se alicerça em sete princípios, quais sejam: concepção holística, intersetorialidade, empoderamento, participação social, eqüidade, ações multi-estratégicas e sustentabilidade. Trata-se de uma pesquisa bibliográfica e documental. A coleta dos dados ocorreu no período compreendido entre janeiro a junho de 2014. Inicialmente foi realizado um levantamento bibliográfico através de uma leitura prévia dos títulos e resumos dos artigos, dissertações e teses constantes no material científico a ser delimitado. A coleta foi realizada junto às bases de dados do Scielo; Bireme; Lilacs; Medline e Biblioteca Cochrane, e foram utilizados os descritores: promoção da saúde; saúde na escola; Programa Saúde na Escola; Estratégia Saúde da Família e saúde escolar. Foram obtidos 35 artigos e 8 dissertações. Esta etapa foi seguida pela pesquisa documental. Nessa etapa foram utilizados os Documentos referentes ao PSE e à Estratégia Saúde da família. Por fim, o tratamento dos conteúdos selecionados se deu a partir da análise dos resultados obtidos, no qual foi realizada a apresentação dos achados da pesquisa tendo em vista os objetivos estabelecidos. Como resultados obteve-se que: não foi possível identificar concretamente que a promoção da saúde seja adotada como centro nuclear do Programa; não há a delimitação de uma concepção de promoção da saúde, antes há uma mescla de concepções que podem ser observadas a partir das ações preconizadas; as dificuldades estruturais enfrentadas pela ESF comprometem seu funcionamento; predomina-se a tendência da culpabilização pessoal seja do indivíduo quanto a sua realidade, seja do profissional referente ao compromisso com o sucesso das ações propostas; não visualiza-se a incorporação dos sete princípios delimitados pela OMS; a preponderância dada ao setor saúde para a condução das ações propostas indica séria fragilidade; as ações que se destacam são as curativas e as ações de promoção são confundidas com as de prevenção. Diante disso, identifica-se a importância do compromisso com a avaliação crítica do programa e do envolvimento de diversos setores, da esfera política e da participação ativa dos indivíduos para o desenvolvimento de ações que sejam condizentes com o conceito ampliado de saúde e que possam incidir sobre determinantes sociais.

The topic of the following thesis is the health promotion included in curriculum of Special Medical High School and Medical High School in Prague 1. The aim of a qualitative research is to find out how the school adopted the possibility of health promotion in its curriculum and other educational documents, what is the life style of the teachers and their particular experience in health promotion during their classes. Three different data collecting techniques were used when doing the research: semi- structured interviews with selected teachers; class observation; analysis of relevant pedagogical documents. The thesis is divided into the theoretical and practical part. The theoretical part deals with the history and presence of the schools selected, pedagogical documents and also with chosen pedagogical staff. Further it informs about specific school health support projects. The practical part contains final results of qualitative research which shows that the topic of health support is included in many areas of chosen documents. Its following realization depends not only on financial possibilities and capacity of the school but mainly on particular teachers and their responsible approach to this issue within their lessons and lifestyle. In conclusion this school can be considered as a good example...