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published_or_final_version / Community Medicine / Master / Master of Public Health

The purpose of this research is to mainly determine and describe what the current role of physical education and extra‐curricular activities and how other factors and elements influence childhood obesity so that I can make recommendations on what can be done to combat childhood obesity. The desire to under‐go this research was motivated by the prevalence of childhood obesity that is increasing at an exponential rate which has gained popularity as a universal problem.

The aim of the study was to determine the Body Mass Index with regards to overweight and obesity of Black African children between the ages of six and nine years who were enrolled in three rural public schools within Mpumalanga Province, South Africa. The researcher used a quantitative descriptive research design. Each child’s weight and height was measured and their BMI and BMI percentile for gender and age calculated. According to the BMI percentile calculations for gender and age for the sample which consisted of 902 children, three percent were defined as being underweight, 79 percent as being normal weight, 11 percent as being overweight, and seven percent as being obese. In the sample there were also 21.3 percent children who were at risk of becoming overweight (3.5 percent) and obese (17.8 percent). Without intervention these at risk learners may in their adolescent and adult years be adversely affected by the physiological and psychosocial consequences related to their condition. Suggestion is made to utilise a Forum through which various stakeholders can pool their expertise and resources to develop a programme of intervention with the aim to prevent escalation of overweight and obesity, as well as reversing the current prevalence as identified within the research population.

The purpose of this project was to explore parent perceptions about their children's weight and the perceived barriers to implementing healthy eating habits and patterns of physical activity for their children.

The purpose of this project was to explore parent perceptions about their children's weight and the perceived barriers to implementing healthy eating habits and patterns of physical activity for their children.

Thesis (M. Tech. Dept. of Hospitality, Tourism and PR Management)--Vaal University of Technology, 2009. / Background: Approximately 45% of South Africans are overweight, including 20% of children under six years of age. Snack foods are now targeted in the food industry, globally, as an obesity prevention initiative, focusing on children to ensure the adoption of a healthy lifestyle from an early age. Objectives: The purpose of this study was to determine the nutritional status and snack consumption patterns of children (n=290) 9 to 13 years old in the Vaal Region at two purposively selected primary schools in order to develop a healthy snack food item that will address obesity in children from a very young age. Methods: A baseline survey included a pre-tested questionnaire, administered by trained fieldworkers to determine snack food consumption patterns. Anthropometric measurements included weight and height. A snack food item was developed to meet certain criteria identified from the literature and baseline survey. The methods included: snack food development and preparation, chemical analyses to determine actual content, microbiological tests to determine shelf life and sensory analyses to determine acceptability. Study design: Cross-sectional analytical study. Data analyses: Data of the questionnnaires were captured and analysed for descriptive statistics (frequencies, means and standard deviations). The anthropometric data were captured and analysed using the World Health Organisation (WHO) standards for 2007. Results: The results showed that the children in the sample knew the meaning of healthy snacks, although the majority (66.8%) consumed unhealthy snacks, especially from school tuck shops. The top ten snack foods most commonly consumed daily were: coffee (48.3%), tea (46.1%), crispy chips (39.1%), fruit juice (38.0%), chicken (35.1%), fried potato chips (33.6%), carbonated drinks (26.9%), biscuits (26.2%), toffees (26.2%) and yoghurt (25.8%). The majority (56.8%) of the respondents indicated that they receive between R2 and R5 per week for tuck shop money, besides their monthly pocket money (64.6%). Most of the respondents (45.4%) spend their pocket money on snack food items and these are mainly consumed while watching television (36.9%) and when bored (29.5%). The anthropometric results indicated that 11.7% of the group were underweight, 12.1% of the group were stunted; in addition 20% were at risk of underweight, and 23.4% at risk of being stunted. A significantly higher percentage of girls (16.81) were stunted compared with the boys (5.0%). Also 7.6% of the group were overweight. More girls were overweight compared with boys. A snack food item was developed to address obesity in this region. The criteria met were that it was affordable, at cost of R0.55 per 30g portion, was low in fat and had high-density nutritional value, with at least 20% of the DRI for protein and iron, had a shelf life of 28 days and was generally acceptable to the majority of the respondents. Conclusion and recommendations: This study showed that obesity is becoming a problem amongst children in the Vaal Region. Although primary school children knew healthy snack foods, their behaviour indicated a large consumption of unhealthy snack foods. A low-fat, low-energy, low-cost and acceptable snack food item was successfully developed to address the obesity problem in the region. Further research is recommended where this snack food item is implemented in an intervention study to measure its impact on the nutritional status of obese primary school children. / National Research Foundation

The school environment is often the focus of healthy eating and physical activity policies intended to address childhood obesity. However, students are usually excluded from the development and implementation of such policies. The purpose of this study was to explore grade nine student perspectives regarding: supports and barriers to healthy eating and physical activity at school; strategies for improving the school nutrition and physical activity environments; and potential student contribution to the development, implementation, and evaluation of school-based policies. A qualitative approach utilizing focus groups and photovoice with 30 students from two schools in southern Alberta was used to collect data. Major themes included: access to healthy food choices; teacher influences; peer influences; access to physical activity opportunities; impact of marketing; and conflicting messages. Students can provide valuable insights to policy development, implementation and evaluation. Implications for future research and policy development are reviewed. / xi, 179 leaves : ill. ; 29 cm

Kwok Man Ki. / Accompanying CD-ROM entitled: DRAGON program 2005. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 193-203). / Abstracts in English and Chinese; appendices also in Chinese. / Abstract --- p.i / Abstract (Chinese version) --- p.iii / Acknowledgement --- p.v / Table of contents --- p.vi / List of tables --- p.xi / List of figures --- p.xviii / Presentations --- p.xix / Chapter Chapter one: --- Introduction --- p.1 / Hong Kong preschoolers' nutritional health situation --- p.1 / Chapter (I) --- Breastfeeding & complementary feeding practices --- p.1 / Chapter (II) --- "Diet, mealtime and physical activity patterns" --- p.3 / Chapter (III) --- Weight status --- p.6 / Health risk factors accumulated up to preschool age --- p.8 / Childhood Obesity Prevention: School-based intervention --- p.12 / Chapter (I) --- Primary obesity prevention and health promoting schools --- p.12 / Chapter (II) --- Feasibility of health promotion initiatives in Hong Kong kindergartens --- p.14 / Chapter (III) --- Nutrition and physical activity intervention studies --- p.18 / Chapter (IV) --- Hong Kong kindergarten health initiative: DRAGON Program --- p.23 / Aim and scope of the DRAGON Program --- p.28 / Chapter Chapter two: --- Methodology --- p.30 / Kindergarten recruitment --- p.30 / Formative preparatory stage --- p.32 / Chapter (I) --- Teaching kit development --- p.32 / Chapter (II) --- Teaching kit pretesting --- p.33 / Chapter (III) --- Parents' focus group --- p.35 / Chapter (IV) --- Questionnaires development --- p.35 / Chapter (V) --- Ethics approval --- p.37 / Subject recruitment --- p.37 / Pre-intervention stage --- p.37 / Chapter (I) --- Anthropometric measurements --- p.37 / Chapter (II) --- Parental questionnaires --- p.38 / DRAGON Program implementation --- p.38 / Chapter (I) --- Preschoolers' health curriculum --- p.38 / Chapter (II) --- Pre-intervention data management and analysis --- p.39 / Chapter (III) --- Booster activities planning and implementation --- p.40 / Chapter (IV) --- Parents' newsletters --- p.42 / Post-intervention stage --- p.42 / Chapter Chapter three: --- Results --- p.46 / Enrollment and response rate --- p.46 / Between schools baseline comparison --- p.50 / Education vs. Control Schools baseline comparison --- p.53 / Chapter (I) --- Demographic and socioeconomic characteristics --- p.53 / Chapter (II) --- Children's dietary patterns --- p.60 / Chapter (III) --- "Regular meals, snack patterns and other mealtime behaviors" --- p.65 / Chapter (IV) --- Usual activity patterns --- p.67 / Chapter (V) --- Parents' health knowledge and preferred communication channels --- p.72 / Chapter (VI) --- Child's height and weight measurements --- p.77 / Chapter (VII) --- Factors associated with children's weight status --- p.79 / Chapter (VIII) --- "Associations between socioeconomic status (SES) and children's dietary, mealtime and activity patterns" --- p.81 / Process and outcome evaluations of the Dragon Program --- p.90 / Part a) 1st follow up after finishing all health curriculum --- p.90 / Chapter (I) --- Children's dietary patterns --- p.90 / Chapter (II) --- Mealtime behaviors --- p.95 / Chapter (III) --- Usual activity patterns --- p.99 / Chapter (IV) --- Health curriculum effectiveness evaluation by AM/PM sessions --- p.103 / Part b) 2nd follow up after finishing promotional activities --- p.107 / Chapter (I) --- Children's dietary patterns --- p.108 / Chapter (II) --- Mealtime behaviors --- p.116 / Chapter (III) --- Usual activity patterns --- p.122 / Between subgroups comparisons --- p.131 / Chapter (I) --- First follow up --- p.131 / Chapter (II) --- Second follow up --- p.132 / Parent Focus groups (baseline) --- p.136 / Chapter (I) --- Awareness of local adults' and preschoolers' health status --- p.136 / Chapter (II) --- Children's dietary habits and lifestyle --- p.137 / Chapter (III) --- Factors affecting their children's health behaviors --- p.139 / Parent Focus groups (booster activities) --- p.140 / Teachers´ةquestionnaires --- p.142 / Teachers after class assessment --- p.149 / Teachers´ة focus groups --- p.155 / Principals´ة Interviews --- p.157 / Chapter (I) --- Importance of creating healthy school environment --- p.157 / Chapter (II) --- Students' & teachers´ة performance in first half-year DRAGON Program --- p.158 / Chapter (III) --- Comments on implementing second half-year DRAGON Program --- p.160 / Chapter (IV) --- Recommendations for the development of the Program --- p.161 / Chapter Chapter four: --- Discussion --- p.163 / Implications of the findings --- p.164 / Chapter (I) --- Socioeconomic and demographic factors associated with preschoolers' diet and lifestyle at baseline --- p.164 / Chapter a) --- Association between SES and children´ةs dietary habits --- p.164 / Chapter b) --- Association between SES and children's weight status and their mealtime interactions with parents --- p.166 / Chapter c) --- "Association between children's weight status and their dietary mealtime, and activity patterns" --- p.167 / Chapter (II) --- Local preschool age children´ةs health situation --- p.170 / Chapter (III) --- Program Effectiveness assessment --- p.173 / Chapter a) --- After the implementation of the one-term health curriculum --- p.173 / Chapter b) --- After the implementation of health curriculum and promotional activities --- p.179 / Chapter (IV) --- Program acceptability and feasibility --- p.186 / Limitations --- p.189 / Recommendation for future preschool health program --- p.190 / Chapter Chapter five: --- Conclusion --- p.192 / References --- p.193 / Appendices --- p.204 / Chapter A1 --- School invitation letter with program briefing details (English version) --- p.204 / Chapter A2 --- School invitation letter with program briefing details (Chinese version) --- p.209 / Chapter B1 --- School background information (English version) --- p.213 / Chapter B2 --- School background information (Chinese version) --- p.217 / Chapter C1 --- DRAGON Program Teacher's Guide for nursery grade (Chinese version) --- p.221 / Chapter C2 --- DRAGON Program Teacher's Guide for lower level (Chinese version) --- p.244 / Chapter C3 --- DRAGON Program Teacher's Guide for upper level (Chinese version) --- p.269 / Chapter D1 --- Parents´ة focus group (Jan) (English version) --- p.297 / Chapter D2 --- Parents´ة focus group (Jan) (Chinese version) --- p.301 / Chapter E1 --- Teachers´ة self-administered questionnaires (English version) --- p.305 / Chapter E2 --- Teachers´ة self-administered questionnaires (Chinese version) --- p.324 / Chapter F1a --- Parents´ة self-administered questionnaires [baseline] (English version) --- p.344 / Chapter F1b --- Parents´ة self-administered questionnaires [1st follow up] (English version) --- p.349 / Chapter F1c --- Parents' self-administered questionnaires [2nd follow up] (English version) --- p.354 / Chapter F2a --- Parents´ة self-administered questionnaires [baseline] (Chinese version) --- p.359 / Chapter F2b --- Parents´ة'self-administered questionnaires [1st follow up] (Chinese version) --- p.364 / Chapter F2c --- Parents´ة self-administered questionnaires [2nd follow up] (Chinese version) --- p.369 / Chapter G1 --- Parents´ة consent form (English version) --- p.374 / Chapter G2 --- Parents´ة consent form (Chinese version) --- p.376 / Chapter H1a --- Sample health lesson worksheet for nursery grade (Chinese version) --- p.378 / Chapter H1b --- Sample health lesson worksheet for lower level (Chinese version) --- p.379 / Chapter H1c --- Sample health lesson worksheet for upper level (Chinese version) --- p.380 / Chapter 11 --- Sample parents´ة newsletter (English version) --- p.382 / Chapter 12 --- Sample parents´ة newsletter (Chinese version) --- p.387 / Chapter J1 --- Questions for pretest parents´ة newsletter (Chinese and English version) --- p.392 / Chapter K1 --- Principals´ة interview (English version) --- p.395 / Chapter K2 --- Principals´ة interview (Chinese version) --- p.397 / Table A_1 to A_17 --- p.399 / DiscAl DRAGON Program: teaching materials for health lessons --- p.414 / DiscA2 DRAGON Program: materials for three booster activities --- p.414 / DiscA3 DRAGON Program: health lesson worksheets --- p.414 / DiscA4 DRAGON Program: parents´ة newsletters --- p.414

Cheung Yuk Lin Porky. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 236-248). / Abstracts in English and Chinese; appendices also in Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / 論文摘要 --- p.iv / Table of Contents --- p.vi / List of Figures --- p.xii / List of Tables --- p.xiii / List of Abbreviations --- p.xix / Presentations --- p.xx / Chapter CHAPTER 1: --- INTRODUCTION --- p.1 / Chapter 1.1 --- Overview on Childhood Obesity --- p.1 / Chapter 1.1.1 --- Worldwide Situation --- p.1 / Chapter 1.1.2 --- Hong Kong Situation --- p.3 / Chapter 1.2 --- Consequences of Childhood Obesity --- p.4 / Chapter 1.2.1 --- Physiological Problems --- p.4 / Chapter 1.2.2 --- Psychosocial Problems --- p.6 / Chapter 1.2.3 --- Economic Problems --- p.6 / Chapter 1.3 --- Possible Causes and Associated Factors of Childhood Obesity --- p.7 / Chapter 1.3.1 --- Genetics --- p.7 / Chapter 1.3.2 --- Lifestyle Patterns --- p.8 / Chapter 1.3.2.1 --- Physical Activity --- p.8 / Chapter 1.3.2.2 --- Dietary Factors --- p.8 / Chapter 1.3.3 --- Environmental Influence --- p.10 / Chapter 1.3.3.1 --- Parental Influence and Home Environment --- p.10 / Chapter 1.3.3.2 --- Other External Environmental Factors --- p.10 / Chapter 1.4 --- Prevention and Treatment of Childhood Obesity --- p.12 / Chapter 1.4.1 --- Clinical Trials --- p.12 / Chapter 1.4.2 --- Family Based Interventions --- p.13 / Chapter 1.4.3. --- School Based Interventions --- p.14 / Chapter 1.4.4 --- Other Possible Measures --- p.17 / Chapter 1.5 --- Local Intervention Implementation --- p.17 / Chapter 1.6 --- "Study Rationale, Design，Aims and Objectives" --- p.18 / Chapter 1.6.1 --- Study Rationale --- p.18 / Chapter 1.6.2 --- Study Design --- p.19 / Chapter 1.6.3 --- Study Aims and Objectives --- p.21 / Chapter 1.7 --- Conceptual Framework and Hypothesis --- p.21 / Chapter 1.7.1 --- Conceptual Framework --- p.22 / Chapter 1.7.2 --- Hypothesis --- p.23 / Chapter CHAPTER 2: --- METHODOLOGY --- p.23 / Chapter 2.1 --- Sample --- p.23 / Chapter 2.1.1 --- School Recruitment --- p.23 / Chapter 2.1.2 --- Subject Recruitment --- p.23 / Chapter 2.2 --- Parental Consent --- p.24 / Chapter 2.3 --- Focus Groups --- p.24 / Chapter 2.4 --- Assessment Tools --- p.25 / Chapter 2.4.1 --- Weight and Height measures --- p.25 / Chapter 2.4.2 --- Physical Fitness Tests --- p.25 / Chapter 2.4.3 --- Student Questionnaire --- p.26 / Chapter 2.4.4 --- Parental Questionnaire --- p.27 / Chapter 2.4.5 --- Questionnaires Pre-testing --- p.27 / Chapter 2.5 --- Intervention --- p.28 / Chapter 2.5.1 --- Intervention A: Mighty Heart Health Promotion Program --- p.28 / Chapter 2.5.1.1 --- Materials --- p.28 / Chapter 2.5.1.2 --- Procedures --- p.30 / Chapter 2.5.2 --- Intervention B: Health Club --- p.31 / Chapter 2.5.2.1 --- Materials --- p.31 / Chapter 2.5.2.2 --- Procedures --- p.32 / Chapter 2.6 --- Evaluation --- p.35 / Chapter 2.6.1 --- Qualitative Evaluation --- p.35 / Chapter 2.6.2 --- Quantitative Evaluation --- p.35 / Chapter 2.7 --- Data Manasement --- p.36 / Chapter 2.8 --- Statistics --- p.37 / Chapter 2.8.1 --- Health Knowledge and Food Preferences Scores of Students --- p.37 / Chapter 2.8.2 --- "Health Knowledge, Dietary Habits and Home Food Availability Scores of Parents" --- p.40 / Chapter 2.9 --- Ethical Approval --- p.42 / Chapter CHAPTER 3: --- RESULTS --- p.43 / Chapter PART A: --- Baseline Focus Groups Results / Chapter 3.1 --- Baseline Focus Groups Results --- p.43 / Chapter 3.1.1 --- General Description of Participants --- p.44 / Chapter 3.1.2 --- "Views of ""Health"" held by students" --- p.44 / Chapter 3.1.3 --- "Views of ""Health"" of parents" --- p.45 / Chapter 3.1.4 --- "Views of ""Healthy Eating"" of students" --- p.46 / Chapter 3.1.5 --- "Views of ""Healthy Eating"" held by parents" --- p.47 / Chapter 3.1.6 --- "Perceived views on ""Physical Activity"" by students" --- p.48 / Chapter 3.1.7 --- "Views on ""Physical Activity"" of parents" --- p.49 / Chapter 3.1.8 --- Preferred delivery mode of activities communication channels --- p.50 / Chapter PART B: --- Baseline Profile of Participants / Chapter 3.2 --- Response Rate --- p.52 / Chapter 3.3 --- Baseline Characteristics and Socio-dem ograph ic Profile of Participants --- p.54 / Chapter 3.3.1 --- Students --- p.54 / Chapter 3.3.2 --- Parents --- p.56 / Chapter 3.4 --- "Self-perceived Important Values, Health and Weight Status at baseline" --- p.60 / Chapter 3.4.1 --- Students --- p.60 / Chapter 3.4.2 --- Parents --- p.62 / Chapter 3.5 --- Baseline Physical Activity --- p.63 / Chapter 3.5.1 --- Students --- p.63 / Chapter 3.5.2 --- Parents --- p.69 / Chapter 3.6 --- Baseline Dietary Aspects --- p.71 / Chapter 3.6.1 --- Students --- p.71 / Chapter 3.6.2 --- Parents --- p.81 / Chapter 3.7 --- Summary of Baseline associations between students，and parents 'parameters --- p.94 / Chapter 3.7.1 --- Factors associated with Students' weight status --- p.94 / Chapter 3.7.2. --- Factors associated with Studente´ة Dietary Habits --- p.97 / Chapter 3.7.3 --- Factors associated with students´ة physical Activity Habits --- p.104 / Chapter 3.8 --- Summary of Baseline Profile of Participants --- p.108 / Chapter PART C: --- Outcome Evaluation / Chapter 3.9 --- The Final MH activities Conducted --- p.111 / Chapter 3.10 --- Comparisons of Weight Status --- p.112 / Chapter 3.11 --- Comparisons of Self-perceived Health Status and Important Values --- p.114 / Chapter 3.12 --- Comparisons of Physical Activity Parameters --- p.118 / Chapter 3.12.1 --- Students --- p.118 / Chapter 3.12.2 --- Parents --- p.126 / Chapter 3.13 --- Comparisons of Dietary and Health Related Aspects --- p.129 / Chapter 3.13.1 --- Students --- p.129 / Chapter 3.13.2 --- Parents --- p.148 / Chapter 3.13.3 --- Home Food and Meal Environments --- p.167 / Chapter PART D: --- Results of Health Club / Chapter 3.14 --- Baseline Profile of the Participants --- p.180 / Chapter 3.14.1 --- Characteristics and Health Status --- p.180 / Chapter 3.14.2 --- Baseline Physical Activity --- p.181 / Chapter 3.14.3 --- Baseline Dietary Related Parameters --- p.183 / Chapter 3.15 --- The Final HC Lessons Conducted --- p.187 / Chapter 3.16 --- Outcome Evaluation of HC program --- p.188 / Chapter 3.16.1 --- Physical Fitness and Anthropometric Parameters --- p.188 / Chapter 3.16.2 --- Self-perceived Health Status and Important Values --- p.192 / Chapter 3.16.3 --- Physical Activity Related Aspects --- p.193 / Chapter 3.16.4 --- Dietary Aspects --- p.196 / Chapter 3.17 --- Summary of results of the HC Program --- p.201 / Chapter PART E: --- Process Evaluation / Chapter 3.18 --- Process Evaluations of Mighty Heart --- p.203 / Chapter 3.18.1 --- Students --- p.203 / Chapter 3.18.1.1 --- Comments on Program Activities and Materials --- p.203 / Chapter 3.18.1.2 --- Comments on Program Effectiveness and Acceptability --- p.204 / Chapter 3.18.1.3 --- Overall Comments and Suggestions --- p.204 / Chapter 3.18.2 --- Teachers --- p.205 / Chapter 3.18.2.1 --- Comments on Program Activities and Materials --- p.205 / Chapter 3.18.2.2 --- Comments on Program Effectiveness and Acceptability --- p.205 / Chapter 3.18.2.3 --- Overall Comments and suggestions --- p.206 / Chapter 3.19 --- Process Evaluations of the Health Club --- p.207 / Chapter 3.19.1 --- Students --- p.207 / Chapter 3.19.1.1 --- Comments on Program Activities and Materials --- p.207 / Chapter 3.19.1.2 --- Comments on Program Effectiveness and Acceptability --- p.208 / Chapter 3.19.1.3 --- Overall Comments and Suggestions --- p.208 / Chapter 3.19.2 --- Teacher --- p.209 / Chapter 3.19.2.1 --- "Comments on Program Activities, Educational Materials/Resources" --- p.209 / Chapter 3.19.2.2 --- Comments on Program Effectiveness and Acceptability --- p.210 / Chapter 3.19.2.3 --- Overall Comments and Suggestions --- p.211 / Chapter Chapter 4: --- Discussion --- p.212 / Chapter 4.1 --- Overall Effects of the MH Program --- p.213 / Chapter 4.1.1 --- Changes in PA-related Aspects --- p.213 / Chapter 4.1.2 --- Changes in Dietary-related Aspects --- p.216 / Chapter 4.1.3 --- Changes in Health Status related Aspects --- p.225 / Chapter 4.1.4 --- Acceptability and Appropriateness of the MH --- p.225 / Chapter 4.2 --- Overall Effects of the HC Program --- p.226 / Chapter 4.2.1 --- Changes in PA Related Aspects --- p.226 / Chapter 4.2.2 --- Changes in Dietary-related Aspects --- p.227 / Chapter 4.2.3 --- Changes in Health Status related Aspects --- p.228 / Chapter 4.2.4 --- Acceptability and Appropriateness of the HC --- p.229 / Chapter 4.3 --- Strengths and Limitations of the Study --- p.231 / Chapter 4.4 --- Implications and Recommendations for Future Research --- p.233 / Chapter Chapter 5: --- Conclusions --- p.234 / References --- p.236 / Appendix A Principal/ teacher Questionnaire --- p.249 / Appendix B Consent form for parents --- p.252 / Appendix C Focus group questionnaire - Students --- p.258 / Appendix D Focus group questionnaire - Parents --- p.262 / Appendix E Survey questionnaire -Students --- p.266 / Appendix F Survey Questionnaire - Parents --- p.274 / Appendix G Powerpoint material for teachers´ة monthly sharing --- p.282 / Appendix H Working sheets --- p.283 / Appendix I Newsletters for parents --- p.287 / Appendix J Teachers´ة guide for the “Mighty Heart´حprogram --- p.302 / Appendix K Teachers' guide for Health Club --- p.307 / Appendix L The student workbook --- p.311 / "Appendix M Discussion guide for students participating in the ""Mighty Heart ""program" --- p.312 / Appendix N Discussion guide for students participating in the Health Club --- p.313 / Appendix O Discussion guide for teachers conducting the Mighty Heart program --- p.314 / Appendix P Discussion guide for the teachers conducting the Health Club --- p.316