Ten years after the introduction of the new democratic political dispensation in 1994, violence in schools are as rife as before. There has been no significant decrease in school violence during this period. Violence has only increased and become part of people's everyday lives. School violence remains a serious problem for both learners and educators. Various factors contribute to school violence and it has become necessary to determine to what extent school violence influences the learners of South Africa. Education is available for everyone to utilize. For learners to achieve optimally, safe environments need to be created. In order to eradicate the problem of school violence, it is important to know what the concept school violence entails, which factors contribute to school violence and to what extent school violence has influenced the schools up to date. It is also important to keep track of international trends which promote health in schools globally. Health is undoubtedly linked to educational achievement. The World Health Organization has initiated a project to promote health and healthy lifestyles universally. To counteract the persisting violence in schools, the possibility of creating health promoting schools in South Africa deserves attention. In order to unravel the phenomenon of violence in schools, a qualitative method of research was used, with data being collected by means of focus-group interviews, through intentional sampling. The transcriptions were subjected to descriptive analysis. The findings of the research are presented with an overview of school violence in the West Rand region. Factors contributing to school violence in this region have been identified as: drug and alcohol abuse, gangsterism, gambling, intolerance and the influence of educators. Physical and Psychological violence are the two main categories of violence identified in this region with various sub-categories which include fighting, harassment, sexual abuse, intimidation and victimization which enhance the violence and violent behaviour in this region. A nation's wealth lies within the youth of a country. They assure the future and our children are the most important natural resources we possess, therefore we need to respond to the challenges -violent behaviour and crime in our schools. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2005.

Ten years after the introduction of the new democratic political dispensation in 1994, violence in schools are as rife as before. There has been no significant decrease in school violence during this period. Violence has only increased and become part of people's everyday lives. School violence remains a serious problem for both learners and educators. Various factors contribute to school violence and it has become necessary to determine to what extent school violence influences the learners of South Africa. Education is available for everyone to utilize. For learners to achieve optimally, safe environments need to be created. In order to eradicate the problem of school violence, it is important to know what the concept school violence entails, which factors contribute to school violence and to what extent school violence has influenced the schools up to date. It is also important to keep track of international trends which promote health in schools globally. Health is undoubtedly linked to educational achievement. The World Health Organization has initiated a project to promote health and healthy lifestyles universally. To counteract the persisting violence in schools, the possibility of creating health promoting schools in South Africa deserves attention. In order to unravel the phenomenon of violence in schools, a qualitative method of research was used, with data being collected by means of focus-group interviews, through intentional sampling. The transcriptions were subjected to descriptive analysis. The findings of the research are presented with an overview of school violence in the West Rand region. Factors contributing to school violence in this region have been identified as: drug and alcohol abuse, gangsterism, gambling, intolerance and the influence of educators. Physical and Psychological violence are the two main categories of violence identified in this region with various sub-categories which include fighting, harassment, sexual abuse, intimidation and victimization which enhance the violence and violent behaviour in this region. A nation's wealth lies within the youth of a country. They assure the future and our children are the most important natural resources we possess, therefore we need to respond to the challenges -violent behaviour and crime in our schools. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2005.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Transition from school to work entails the preparation, education and training of learners, leading to their placement in desired work situations. The right of children with disabilities to be included in ordinary schools and employment thereafter is being advocated internationally. However, despite this, preparation for transition from school to work still poses a major challenge for many learners with intellectual disabilities. The aim of this study was to explore how schools in the Cape Metropole, South Africa, are preparing adolescent learners with Down syndrome for the transition to work. The objectives of the study were to explore: school policies related to the transition process; schools’ physical and psychosocial environments; the link between schools and the community; learners’ acquisition of skills and education support services. Collaborative qualitative research design was used with a partnership between the researcher and the Western Cape Down Syndrome Association. The participants included two teachers with experience of teaching learners with intellectual disabilities, two parents of adolescent learners with Down syndrome, ten participants with Down syndrome, amongst them, two adolescent youths in post school training who were identified in this study as role models and eight learners at school. As learners with Down syndrome might not be fluent in verbal communication, an alternative research strategy, photovoice was used. Photovoice (photography) was used a means of accessing learners’ views of the transition planning and making these views accessible to others. The eight schoolgoing learners were given cameras and requested to take photographs of things and experiences that helped to prepare them for work. The learners were then interviewed. Subsequently adults with Down syndrome (role models), who were in post school training, were also interviewed. Finally, parents and teachers were interviewed. Data analysis included translating, transcribing of raw data from the recorded tapes and content analysis by using codes and identifying themes. The synthesis of the findings from all the participants yielded multiple themes including: education support services: acquisition of skills: supportive relationships; home, community, classroom and school environments; and dreams of the participants. Ethical considerations included getting permission from the University of the Western Cape, the Western Cape Education Department, the principals of the schools, the participants and their parents/guardians. The study has illustrated that, given opportunities and proper preparation in school, adolescent learners with Down syndrome have the potential to become active members of society. For better outcomes of the transition planning process, there is need for: teachers to work closely with the parents; increased government support; job coaches and class assistants in the schools and a greater collaboration between government departments.

Philosophiae Doctor - PhD / This thesis investigated the education support services provided by occupational therapists, physiotherapists and speech and language therapists in the Western Cape Province of South Africa. Changes in the education policy in South Africa to an inclusive education system have major implications for the way therapists provide support. Therapists have been challenged to move from a medical model of support with a focus on highly specialised treatment for a small number of individual learners with disabilities, to a systemic and health promoting model which focuses on support for the education system, including all learners, teachers and parents. The aim of this research was to develop an appropriate and integrated approach for therapists to support schools within an inclusive and health promoting schools framework in South Africa. Participatory action research using quantitative and qualitative methodology was used. Two surveys were conducted in the Western Cape Province. The first was a survey of all therapists to determine who was working with pre-school and school-aged learners and where. The second survey was of all therapists working in special schools and a small number of private practitioners to identify the roles of the therapists in providing direct and indirect support. In two of the seven education districts in the province, focus group discussions were held with 45 teachers from special and ordinary schools, and 21 parents of school-aged learners - to identify the support they needed. Workshops, incorporating focus groups, were also held with the therapists to, firstly, identify the support they needed to give to learners, teachers, parents and the education system and, secondly, to identify the competencies they needed to give this support. The data from the surveys were subjected to simple descriptive statistical analysis. These analyses reveal that therapists have a very wide range of roles relating to direct support, including: assessment, intervention with individual learners and learners in groups, and evaluation. Interventions include the development of hearing, speech and communication skills; skills for activities of daily living; life skills; home management skills; work related skills; motor function skills; and play and leisure skills. Therapists from different disciplines frequently provide the same type of support. Indirect support provided includes support for the schools system, teachers and parents. Thirty six percent of the therapists in this study want to increase the proportion of time they spent on indirect support. The study also revealed that multidisciplinary collaboration and teamwork were Teachers involved in the study identified that they need an enormous amount of support in fulfilling their crucial roles in identifying barriers to learning; identifying the support learners need; and addressing the barriers. This includes the need for support to teach a diverse group of learners; adapting content, presentation and evaluation of the curriculum; adapting the physical environment; accepting new roles of teachers and therapists; making changes to the school system; developing relationships with the parents; addressing challenges related to socio-economic problems; networking with the community; facilitating positive attitudes to diversity; developing supportive relationships with therapists; and further training poorly developed. Teachers involved in the study identified that they need an enormous amount of support in fulfilling their crucial roles in identifying barriers to learning; identifying the support learners need; and addressing the barriers. This includes the need for support to teach a diverse group of learners; adapting content, presentation and evaluation of the curriculum; adapting the physical environment; accepting new roles of teachers and therapists; making changes to the school system; developing relationships with the parents; addressing challenges related to socio-economic problems; networking with the community; facilitating positive attitudes to diversity; developing supportive relationships with therapists; and further training. Parents in this study indicated that they need access to education and support for their children, including direct support for their children; effective means of communicating with their children; specific competencies to facilitate caring for their children; emotional support; advocates to work with them in support of their children addressing environmental physical and attitudinal barriers, and developing a supportive community; and supportive relationships with therapists.

Philosophiae Doctor - PhD / Health professionals worldwide are currently inadequately trained to address the health issues of communities, particularly in developing countries where there are major health disparities. This study argues for an alternative and more appropriate education, one which would better prepare future health professionals to address these needs. The study draws attention to how the University of the Western Cape (UWC) responded to preparing its health professional graduates to better meet the needs of South African society. The thesis explores the rationale for a shift in health professions education to one which supports service-learning, locating the study within the broader developments in higher education within South Africa. The specific aim of this thesis was to evaluate a community-based interdisciplinary health promotion course offered to the undergraduate health sciences students from the faculties of Community and Health Sciences and Dentistry at the University of the Western Cape (UWC). It focused on evaluating the perceived effectiveness and the impact on the stakeholders of the Interdisciplinary Health Promotion course, with the aim of developing an appropriate framework to guide the teaching of health promotion at higher education institutions in South Africa. Ten primary schools in three disadvantaged communities in the Western Cape were used as the health promotion settings for the Interdisciplinary Health Promotion course. The study design was a programme evaluation that used the explanatory sequential mixed-methods design. An evaluation matrix was developed, consisting of three core concepts (curriculum, community-based learning, and university-school collaboration) against which the course was evaluated. Indicators and criteria were developed for each core concept. Questionnaires were distributed to all the stakeholders, that is, the university students, the lecturers, the supervisors and the school educators, involved in the Interdisciplinary Health Promotion Course during 2006. Focus group discussions with the stakeholders were also conducted at the UWC campus and in the Delft community. There was a good response from all the stakeholders who participated in the study (students (72.4%), lecturers (85%), supervisors (100%) and school educators (71.5%)). A main finding of the study was that the Interdisciplinary Health Promotion course was relevant and up-to-date with developments in the field of health promotion. Course topics were dealt with in sufficient depth and the assignments were clear, specific and related to the course outcomes. The interdisciplinary teaching and learning approach allowed the university students to learn and develop a better understanding of the roles and contributions that the various professions played in health promotion in a community. The course was perceived as having been of value to all the stakeholders and having a positive impact on the schools. The findings revealed that the health promotion projects implemented in the schools helped the university students to learn how to plan, implement and evaluate a project in a community setting. Furthermore, the findings suggest that the schools offered an ideal placement for university students to learn about health promotion and its application. In addressing a concern about the course not making any meaningful long-term impact on the schools and the surrounding communities, the study showed that it is important to revisit the current teaching and learning approach of the Interdisciplinary Health Promotion course. It revealed that service-learning as an alternative to the field education approach would facilitate a closer relationship between theoretical and practical knowledge, where the practical application was translated into a service that met the needs of a community. The study further revealed that the collaboration model between the university and the school also needed to be reconceptualized, to include all the stakeholders as well as their needs in relation to health promotion in the schools. It was recommended that the Health Promoting School framework should be seen as the overarching framework for the sustainability of school-based health promotion. In conclusion, this study showed that the recognition and establishment of university community partnerships and reliance upon them in the educational process, would provide many new opportunities for relevant and meaningful health professional education and training. These efforts would contribute to improving the quality of higher education delivered to students, thereby ensuring their competency to better meet the needs of the communities they will serve.

Contexte : Les interventions de promotion de la santé (IPS) en milieu scolaire visent à soutenir le développement des jeunes et promouvoir l'adoption de modes de vie sains. Une culture scolaire promotrice de santé a été identifiée comme un facteur facilitant l’adoption, la mise en œuvre et l’efficacité des interventions. Toutefois, la culture scolaire peut varier d'une école à l'autre, particulièrement dans celles accueillant des élèves issus de milieux défavorisés, et des inégalités dans l’offre d’IPS risqueraient d’exacerber les inégalités de santé existantes. Un écart de connaissances persiste sur les inégalités sociales dans la culture scolaire et l’offre d’IPS dans les écoles desservant des élèves de statut socio-économique différent. Objectifs : L'objectif était d'étudier les associations entre le niveau de défavorisation de l’école, la culture scolaire et la disponibilité d’IPS. Nous avons cherché à: (1) quantifier l'association entre la défavorisation de l’école, l'importance de problématiques de santé et la disponibilité d’IPS; (2) quantifier l'association entre la défavorisation de l’école et la culture scolaire promotrice de santé. Les résultats de l'objectif 1 ayant montré un gradient social dans la disponibilité d’IPS en matière de santé mentale, nous avons approfondi pour: (3) quantifier l'association entre des variables du contexte scolaire et la présence d’IPS de santé mentale; (4) les caractériser par rapport aux meilleures pratiques (ex. approche globale, optimisation de la culture scolaire). Méthodes : Les données sont tirées de PromeSS, une étude transversale comprenant 171 écoles primaires du Québec, Canada (2017-2019). Quatre mesures d'une culture scolaire promotrice de santé ont été développées à partir du modèle théorique «Health Promoting Schools». Des modèles de régression logistique, ANOVA unidirectionnelle et tests de Tukey ont servi à estimer les associations entre les variables d’intérêt. Des données approfondies sur un échantillon de 25 IPS de santé mentale ont été analysées dans le cadre d'une analyse de cas croisés. Résultats : Les écoles défavorisées ont signalé plus de problématiques de santé que les écoles favorisées. Les proportions d’IPS disponibles étaient similaires, sauf pour les IPS de santé mentale offertes en plus grande proportion dans les écoles favorisées. Les écoles favorisées avaient une culture scolaire plus promotrice de la santé que les écoles défavorisées, principalement en termes d'engagement avec les familles et la communauté. Les écoles plus susceptibles de mettre en œuvre des IPS de santé mentale étaient les écoles favorisées, ayant une culture scolaire plus promotrice de santé et où les problématiques de santé mentale étaient considérées comme importantes. Bien que généralement bien adaptées à leur contexte, peu d’IPS de santé mentale étaient alignées avec les meilleures pratiques. Conclusions : Cette thèse illustre l’importance du contexte dans lequel les IPS sont mis en œuvre, incluant la culture scolaire comme caractéristique essentielle pour des IPS efficaces et les conditions socioéconomiques des élèves. La capacité des écoles à établir une culture scolaire promotrice de santé et à mettre en œuvre des interventions fondées sur les données probantes devrait être renforcée, en particulier pour les écoles défavorisées, afin d'améliorer la santé des élèves et de réduire les inégalités. / Background: School-based health-promoting interventions (HPIs) are key components of public health strategies that aim to support youth development and promote the adoption of healthy lifestyles. A health-promoting school culture, which represents the school’s context for HPI implementation, has been identified as a facilitator of HPI adoption, implementation, and effectiveness. However, school culture may vary across schools and in particular, schools serving students from disadvantaged backgrounds which face known challenges for HPI implementation. Inequalities in school culture and HPI programming may exacerbate existing health inequalities across disadvantaged versus advantaged settings. Yet little is known about social inequalities in school culture or HPI availability across schools serving student populations of varying socio- economic status. Objectives: The aim of this dissertation was to investigate the associations among school deprivation, school culture and HPI availability. Specifically we aimed: (1) to quantify the association between school deprivation and each of perceived importance of health issues and HPI availability; (2) to quantify the association between school deprivation and health-promoting school culture. Because results from objective 1 showed a social gradient in the availability of mental health HPIs, we delved deeper: (3) to quantify the association between school context variables and the availability of mental health HPIs; and (4) to characterize them according to their alignment with best practices for effective school-based mental health promotion. Methods: Data were drawn from the PromeSS study, a cross-sectional survey of school principals including 171 elementary schools across Québec, Canada (2017-2019). Four measures of a health- promoting school culture were developed drawing from the Health Promoting Schools theoretical model. Logistic regression models, one-way ANOVA and post-hoc Tukey tests were used to estimate associations between school deprivation, health-promoting school culture, importance of health issues, and HPI availability. In-depth data on a sample of 25 mental health HPIs implemented in study schools were analyzed in cross-case analysis. Results: The three articles that comprise this thesis show that: (1) disadvantaged schools reported more health issues as important than advantaged schools, but similar proportions of HPIs, except for mental health HPIs (a higher proportion of advantaged schools reported offering one in the past year); (2) advantaged schools had a more health-promoting school culture than disadvantaged schools, primarily in terms of engagement with families and the wider school community; (3) in the case of mental health promotion, advantaged schools, schools with a more health-promoting school culture, and schools where mental health issues were seen as important were more likely to implement mental health HPIs; and (4) although schools generally implemented interventions that were highly tailored to their context, few mental health HPIs were aligned with best practices for effective mental health promotion (e.g., whole-school approach, optimization of school culture). Conclusion: This thesis suggests that the context in which school-based HPIs are implemented matters, including student socioeconomic conditions. It strengthens empirical support for health- promoting school culture as a crucial feature for effective HPIs. School capacity for establishing a health-promoting school culture and implementing evidence-based interventions should be reinforced, especially for disadvantaged schools to improve student health and reduce inequalities.estimate associations between school deprivation, health-promoting school culture, importance of health issues, and HPI availability. In-depth data on a sample of 25 mental health HPIs implemented in study schools were analyzed in cross-case analysis. Results: The three articles that comprise this thesis show that: (1) disadvantaged schools reported more health issues as important than advantaged schools, but similar proportions of HPIs, except for mental health HPIs (a higher proportion of advantaged schools reported offering one in the past year); (2) advantaged schools had a more health-promoting school culture than disadvantaged schools, primarily in terms of engagement with families and the wider school community; (3) in the case of mental health promotion, advantaged schools, schools with a more health-promoting school culture, and schools where mental health issues were seen as important were more likely to implement mental health HPIs; and (4) although schools generally implemented interventions that were highly tailored to their context, few mental health HPIs were aligned with best practices for effective mental health promotion (e.g., whole-school approach, optimization of school culture). Conclusion: This thesis suggests that the context in which school-based HPIs are implemented matters, including student socioeconomic conditions. It strengthens empirical support for health- promoting school culture as a crucial feature for effective HPIs. School capacity for establishing a health-promoting school culture and implementing evidence-based interventions should be reinforced, especially for disadvantaged schools to improve student health and reduce inequalities.