The purpose of the study was to examine a particular division-level implementation of the Health-Promoting Schools (HPS) Approach, the Battle River Project (BRP). Schools have become an important setting to positively affect health behaviors of children and youth. Although evidence exists for the efficacy of the HPS approach, there are recognized gaps in the areas of implementation and policy development. The BRP was initiated by Ever Active Schools (Alberta) and focused on social and organizational levels, with the end goal of positively affecting student health outcomes and policy. The participating schools and the division were supported by all partners involved in the research and worked to facilitate the development of healthy, active school communities. The study is presented as a series of four papers bracketed by introduction and conclusion chapters. The introduction chapter details the theoretical framework, literature review, context, and methodology of the study. The first paper introduces the BRP, provides provincial background, and details the structure and framework of the project. The second paper examines the use of evidence to effect change in schools and the division. The takeaway points from the project included the value of stakeholder involvement throughout the process, the need to share gathered evidence with those in a position to implement effective practice and capable of effecting change, and the importance of encouraging an embedding of health in school and division culture. The third paper shares the findings from the case study of the BRP under three dominant themes: participation, coordination, and integration. Evidence gathered in the study strongly support the efficacy of school divisionbased HPS implementation. The fourth paper examines the development and early implementation of healthy school policy in the Battle River School Division. Several themes were gleaned from the case study data, including perceptions and misconceptions, the importance of a bottom-up/top-down process, flexible rigidity with regard to implementation, and the need to make healthy schools the way we do business. The concluding chapter provides a summary of the work, highlights results, provides recommendations, and next steps.

Philosophiae Doctor - PhD / After suffering almost total collapse. Rwanda has made impressive post-genocide progress. Many children of school going age are now attending school, but regrettably, only half complete primary school. High numbers of orphans, disabled children and a growing number of children from child-headed households still suffer the consequences of the poverty inherited from the past. Health problems include HIV/Aids, STIs, malaria, tuberculosis, enteric diseases, mental health problems, hunger and malnutrition. Use of drugs and substance abuse, unwanted pregnancies, lack of support services, unavailability of teaching and learning materials, inflexible curricula and poor teaching methodologies also contribute to learning breakdown. It is against this background that this thesis was conducted to investigate the development of a health-promoting schools model to provide an appropriate strategy to address barriers to learning and to promote healthy development of school children in Rwanda. Two research questions were the focus of this research, first, how does a health-promoting schools model provide an appropriate strategy to address barriers to learning and to promote healthy development of school-aged children in Rwanda and second, what are the participants’ views on and understanding of the model and its potential use in their schools? A mixed methods research design that employed both qualitative and quantitative approaches was used. The study followed sequential implementation: Phase 1 was concerned with the identification of the components for the model. It was a case study of four schools, two rural schools and two urban schools in Kigali City. The sample included 60 teachers, pupils, principals and parents from schools and nine key informants who were policymakers from the Ministries of Education and Health and Social Welfare, line institutions and the UNICEF. Data collection strategies included focus group discussions, semi-structured, in-depth individual interviews, a transect walk and observations. Data analysis was through content analysis. Eight themes emerged out of the data: school leadership and management; school health policies; pupil wellbeing; school partnership with parents, families and local communities; school health services; factors affecting teaching and learning for all children; teacher wellbeing; and a healthy physical school environment. These themes became the components that informed the development of a health-promoting schools model. In Phase 2, the degree of understanding of this proposed model and its components were investigated in each school community.

Philosophiae Doctor - PhD / Introduction: This study was conducted because of a gap in information on the factors influencing the health promoting schools (HPS) implementation process in South Africa (SA) specifically and in secondary schools globally. The aim of this context- sensitive, practice-based study was to explore and understand the complexity of the factors that influenced the implementation process of HPS in three secondary schools in a resource-limited setting in Cape Town, SA. This research drew on a five year project that initiated the implementation of HPS in these schools. Methodology: An exploratory qualitative study was used, adopting a multiple case study design. The sample included two principals, ten teachers and 30 students involved in HPS implementation at their schools, and the three school facilitators, who served as mentors to the schools. The data collection methods included: individual interviews, focus group discussions, documentary review, secondary data and observations. A conceptual framework was developed drawing on the settings approach and various implementation frameworks and was used to analyse the findings. Thematic analysis was employed and the data for each case were analysed separately first before undertaking cross case analysis. Findings: A combination of several internal and external factors influenced the ability of the schools to implement and integrate HPS as a whole school approach. A key factor was the degree of understanding of the HPS concept by all key actors and where there was lucid understanding, there was better integration. Significant school factors included the schools’ readiness for change; a culture of collaboration and cooperation; existing school structures, practices and workload; the leadership style and management role of the principals; the role and influence of HPS champion teachers; and the role that students played. The major external factors included the role of the education district; the role of project team as external catalysts for change; and the community context. The main achievements in all schools were discrete activities, including co-curricular activities rather than changes to routine school functions. This highlighted the difficulty in implementing HPS as a whole school approach, a challenge typical of all health promoting settings. Conclusion: The findings illustrate the challenge of achieving full integration of HPS, although the influencing factors, and hence level of integration varied mainly according to context. This highlights the complexity of the different factors and their impact. The study demonstrates the paradox of HPS implementation. In that, despite the recognition of the value of HPS, the challenges to address the complexity of factors that would have brought about change through a whole school approach were too great. It was too difficult to change the status quo from what was routinely done to a more radical way of working due to the conservatism of traditional ways of working and extent of adjustment that it would have resulted. It was therefore only possible to put simple, discrete, strategies in place and that was not too resource intensive. The study concluded that this does not imply that HPS should not be attempted, particularly where there are adverse conditions that would benefit from HPS. Starting with marginal changes, it can be effective in increasing the schools’ readiness for change, building on the achievements both in activities and structures, and the resultant commitment by those involved. Once they experience these changes it will more likely enable schools to incrementally attempt more complex changes. The key recommendations for within the school include: building the understanding and capacity of relevant actors to actively support the implementation of HPS; building the capacity of the principal to create an environment which is conducive to change; and providing support for the HPS champions and students. Recommendations for those external to the school include: support from external catalysts who can provide expertise and mentorship; support from the education district, especially in terms of policies on integration, resources, and raising the profile of HPS; and better collaboration between the education and health sectors. Although most of the literature on HPS implementation identifies similar issues to those found in this study, the complexity has not, to date, been sufficiently described. The contribution of this study, therefore, is to take the debate on the complexity of the factors influencing HPS implementation forward.

No description available.

No / This article provides an academic and professional context for the articles written for this special issue. It discusses 4 broad questions often asked about the public health approach to palliative care: what is the evidence for the effectiveness of the approach?; will this approach embedded inside palliative care services deliver the kinds of social changes needed to address the social epidemiology of living with life limiting illness, long term caregiving and grief and bereavement?; Is recent interest in this approach simply all about cost-savings for governments?; and will an emphasis on health promotion and community development subtract from efforts to increase or maintain clinical supports at the end of life?

Aim of the study - to evaluate the opportunities for implementation of Health Promoting initiatives and International Health Promoting Standards in hospitals of Lithuanian HPH Network. Objectives: 1. To evaluate managers’ knowledge and attitudes towards implementation of Health Promoting initiatives in hospital. 2. To ascertain structures and personnel which could implement Health Promotion activities at hospital. 3. To compare attitudes towards possibilities of establishment and implementation of Health Promoting initiatives and Health Promoting standards among managers from Kaunas Medical University hospital (KMUH) and hospitals involved in Lithuanian HPH Network. Methods. The study was carried out in KMUH and hospitals of Lithuanian HPH Network. A standard questionnaire was distributed via internet both to managers (n=33) of all departments in KMUH and those from Lithuanian HPH Network (n=11). The questionnaire included two parts: general (created by author of survey) and special (based on WHO experts’ questionnaire, translated into lithuanian). The response rate was 88%. Results. The majority of respondents define HP initiatives as a very wide spectrum of activities including health education programs both for staff and patients, support in creating healthy and safe workplace, continuous quality improvement plans and efficient management of financial and human resources. According to the survey, level of awareness of HPH’s aims and goals appeared to be rather low among... [to full text]

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.

Sammanfattning Ett hälsofrämjande ledarskap bidrar till att främja hälsan hos sina medarbetare. Året 2020 blev ett speciellt år på många sätt, men speciellt inom vård och omsorg. Syftet med denna studie var att öka kunskapen om olika synsätt som finns på ett hälsofrämjande ledarskap hos vård och omsorgspersonal. En kvalitativ metod valdes och datainsamlingsmetod var semistrukturerade intervjuer. Fem informanter deltog i studien varav alla jobbar inom kommunal vård och omsorg i Göteborgs Stad. Informanterna intervjuades med hjälp av en intervjuguide och materialet analyserades enligt en innehållsanalys. De framkom tre teman ur materialet ledarskap, hälsofrämjande insatser och arbetsplatsen. Resultatet visar centrala delar inom ledarskap var närvarande, information, kommunikation och återhämtning. Hälsofrämjande insatserbeskrevs som friskvård och planeringsdagar. Under arbetsplats framkom sjukfrånvaro och vikarier samt skyddsutrustning. Slutsatsen är att ledarskapet varit positivt om än literörigt under pandemin. Under året 2020 har störst skillnader varit skyddsutrustningen och frånvaro eller anpassningar kring planeringsdagar.

There is a breadth of literature on educating international students. The typical foci are on international students as economic contributors to foreign countries, or on challenges they face. Canadian educational institutions have the most rapidly growing population of international students, yet literature on how to create successful and health-promoting experiences and campus environments is lacking. The purpose of this study was to break new ground by using a mixed-method, secondary analysis approach guided by settings-based health promotion and Health Promoting University theories to explore and understand the health-related experience of international students. The secondary analysis drew on international student data generated from a CB-PAR guided study, The VOICE Study 2012: Revisiting healthy campus development at UBC’s Okanagan campus (UBCO). The two research objectives were: (a) to identify and understand health-related experiences of international students on post-secondary campuses; and (b) recommend strategies for enhancing health-promoting change in campus communities, particularly UBCO, that take into account the international student health-related experience. Responses to 378 community dialogue questionnaires, transcripts from two focus groups (4 participants) and one interview were analyzed. Quantitative analysis was done using descriptive and frequency statistics, and Pearson’s Chi-square test was performed to further understand the statistical findings. Qualitative analysis was done to identify over-arching categories related to participants’ health-related experiences. A synthesis of the qualitative and quantitative findings identified fourteen categories that encompassed the health-related experience of international students at UBCO, and are consistent with the principles of health promotion. The fourteen categories are policy/rules, cleanliness, campus environment, sense of community, orientation, discrimination, food, water, activity, transportation, services, substance use, expenses, and cheating. Of the fourteen categories, international students most frequently selected food, study spaces, and physical activity. Each category was discussed in detail and linked to relevant literature when possible. In the end, this Master’s thesis reflects the health-related interests and experiences of international students, and suggests ways to create a university that promotes health and well-being. / Graduate / 0680 / 0569 / 0745 / robyndwiebe@gmail.com

A series of acts which were passed during the apartheid era have undoubtedly deprived the marginalized groups, namely, the so called Coloureds, Indians and the black majority their political rights. Apartheid policies enshrined in the then constitution, ill-considered the wellbeing and wellness of these groups, while at the same time, a white minority was solely privileged. Being the victims of segregation, the deprived groups continuously suffered from the political, and socio-economic setbacks, which disabled them to lead healthy lifestyles. Racial division which was prevalent in many workplaces, particularly in the mining sector, disadvantaged many of them, blacks in particular, to perform skilled labour. They were therefore destined to perform unskilled labour which classified them as cheap labourers, hence meagre wages. The results of segregation bore the fruits of abject poverty which impacted negatively on many. Problems of housing and infrastructure are still confronting many households to date since scores of them are 'shack dwellers' nationwide, living in squalid conditions which are a threat to their health. Overcrowding and poor teaching and learning were prime causes of learners to discontinue their education prematurely. High dropout rates became prevalent mostly in rural areas, where schooling accommodation was limited. Schools can only be safe places of teaching and learning when all horrifying acts of violence such as sexual abuse, rape, intimidation, assaults, bullying and murder are urgently eliminated. All the stakeholders in education should collectively work together to ensure that health promotion in schools is maintained. Against the abovementioned background the primary aim of this research was to determine what health promotion entails within the context of a selected group of 10 primary schools in the Southern Region of the North West Province. A qualitative research methodology was selected to achieve this outcome. Data was gathered by means of focus group interviews. The transcriptions were analysed generating items that were labeled as main categories and subcategories. Pertaining the main categories it was evident that are several aspects that can determine the health and well-being in a school. These include: the leadership of the school, the role of the parents, the duties of the educators, the existence of plans and the policy concerning HIV/Aids. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007.