Globally there is a serious need to equip children and young people with knowledge, attitudes, skills and values to assist them in making healthy lifestyle choices. Life skills education is possibly among the most important answers to the problems and challenges many young people are faced with. Life skills programs are being developed to address the alarming increase in high risk health behaviours among adolescents. According to international research, Health promotion is a critical life skill to acquire, since health impacts on almost every facet of a person and their society. The South African Department of Education introduced Life Orientation as a Learning Area as part of Outcomes Based Education. The paramount role of Life Orientation within the context of the Health Promoting School is increasingly being recognised by educational planners, policy makers, school managers, teachers, parents and even learners themselves. Health promotion as part of Life Orientation aspires to promote a healthy lifestyle and equip learners with the knowledge and skills to attain and maintain a healthy lifestyle. It further aims to reduce risk behaviours and equip learners with social skills. Empirical research was done in the Gauteng Province of South Africa. In order to give voice to teachers and health co-ordinators in terms of their views and comments on Life Orientation, questionnaires and focus group interviews were utilised. Based on the evidence gathered in questionnaires, discussions and observations in the selected Health Promoting Schools, it emerged that Life Orientation has a major role to play in instilling knowledge and skills to promote health and well-being. However, even though Health promotion is included in the Life Orientation curriculum, there seems to be a lack of energy and motivation to progress to Health Promoting Schools. It emerged that Life Orientation teachers viewed a healthy lifestyle as the link between Life Orientation and Health promotion, which is a positive indication that schools are making progress towards becoming Health Promoting Schools. Furthermore, the quantitative research revealed key issues that need be dealt with, especially proper water and sanitation, policies on tobacco and substance use, the enhancement of physical well-being of the learners and an integrated nutrition program. Schools need an effective safety and security plan to ensure a safe school environment conducive to teaching-and-learning. Learners should receive basic health screening with appropriate referrals from school nurses. Also, trained health promoters should oversee and manage the health promoting program in the Health Promoting School. The qualitative research indicated that healthy lifestyles are promoted, with particular focus on balanced diets, clean and hygienic environments and adequate physical activity. It emerged that stakeholders play an important role, including the community, school nurses, private companies and governmental departments. Community involvement is particularly important, since community members assist the school by cleaning, cooking, gardening and participating in health promoting awareness. It can be concluded that Life Orientation has a prominent role to play in the Health Promoting School. A successful initiative requires the involvement of the entire school, changes to the schools’ psychosocial environment and participation from the parents and wider community. / Thesis (PhD (Educational Psychology))--North-West University, Potchefstroom Campus, 2013.

Globally there is a serious need to equip children and young people with knowledge, attitudes, skills and values to assist them in making healthy lifestyle choices. Life skills education is possibly among the most important answers to the problems and challenges many young people are faced with. Life skills programs are being developed to address the alarming increase in high risk health behaviours among adolescents. According to international research, Health promotion is a critical life skill to acquire, since health impacts on almost every facet of a person and their society. The South African Department of Education introduced Life Orientation as a Learning Area as part of Outcomes Based Education. The paramount role of Life Orientation within the context of the Health Promoting School is increasingly being recognised by educational planners, policy makers, school managers, teachers, parents and even learners themselves. Health promotion as part of Life Orientation aspires to promote a healthy lifestyle and equip learners with the knowledge and skills to attain and maintain a healthy lifestyle. It further aims to reduce risk behaviours and equip learners with social skills. Empirical research was done in the Gauteng Province of South Africa. In order to give voice to teachers and health co-ordinators in terms of their views and comments on Life Orientation, questionnaires and focus group interviews were utilised. Based on the evidence gathered in questionnaires, discussions and observations in the selected Health Promoting Schools, it emerged that Life Orientation has a major role to play in instilling knowledge and skills to promote health and well-being. However, even though Health promotion is included in the Life Orientation curriculum, there seems to be a lack of energy and motivation to progress to Health Promoting Schools. It emerged that Life Orientation teachers viewed a healthy lifestyle as the link between Life Orientation and Health promotion, which is a positive indication that schools are making progress towards becoming Health Promoting Schools. Furthermore, the quantitative research revealed key issues that need be dealt with, especially proper water and sanitation, policies on tobacco and substance use, the enhancement of physical well-being of the learners and an integrated nutrition program. Schools need an effective safety and security plan to ensure a safe school environment conducive to teaching-and-learning. Learners should receive basic health screening with appropriate referrals from school nurses. Also, trained health promoters should oversee and manage the health promoting program in the Health Promoting School. The qualitative research indicated that healthy lifestyles are promoted, with particular focus on balanced diets, clean and hygienic environments and adequate physical activity. It emerged that stakeholders play an important role, including the community, school nurses, private companies and governmental departments. Community involvement is particularly important, since community members assist the school by cleaning, cooking, gardening and participating in health promoting awareness. It can be concluded that Life Orientation has a prominent role to play in the Health Promoting School. A successful initiative requires the involvement of the entire school, changes to the schools’ psychosocial environment and participation from the parents and wider community. / Thesis (PhD (Educational Psychology))--North-West University, Potchefstroom Campus, 2013.

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.

A shool-based support programme for the intermedediate learner wuth depression This study is aimed at determining whether a school-based support programme can aid the intermediate learner with depression in decreasing his depression levels. It focuses on: the world of experience of the intermediate learner with depression; the role of the school as an overall health-promoting environment; and the creation of a school-based support programme for the intermediate learner with depression. The learner (the intermediate learner included) spends most of the day at school, so the educator can play an important role in identifying and following up problems and getting the school to function as a health-promoting environment. South African schools are focused mainly on primary and tertiary intervention, while secondary intervention reveals a serious deficiency. In the empirical investigation, 16 intermediate learners who were identified with depression were, involved in a purposeful convenience test sample by means of the CDI questionnaire. There was an experimental and a control group of eight members respectively. According to the results of the pretestposttest, the school-based support programme in which the experimental group participated caused their depression levels to decrease significantly. The need for a school support programme for the intermediate learner with depression was validated from this point of view. / Thesis (Ph.D. (Education))--North-West University, Vaal Triangle Campus, 2005.

The purpose of this study was to determine, by means of a review of literature and empirical research, the impact of dietary interventions on the classroom health promotion of Foundation Phase learners with ADD. In order to reach this goal, it was imperative to illustrate the meaning of the concepts health, wellness, health promoting schools, nutrition and Attention Deficit Disorder (ADD). The objective of the empirical research was to determine whether dietary interventions would promote the health of Foundation Phase learners with ADD in the classroom by focusing on decreasing their levels of hyperactivity, increasing their concentration and improving their social behaviour. In conclusion, the following are some of the findings of this study. Dietary interventions impacted positively on: the hyperactivity level of participating foundation phase learners with ADD in the classroom; the ability of participating foundation phase learners with ADD to concentrate in the classroom; and the social behaviour of participating foundation phase learners with ADD in the classroom. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2005.

A call for parents to be involved in the education of their children is not a modern phenomenon at all. It is increasingly a call which invites parents to be involved in every sphere of their children‟s lives, including their health. Children of South Africa, like many other children in Africa, are engulfed with health issues. These problems range from drug abuse, teenage pregnancy, obesity, violence, suicide, alcohol, etc. Therefore, it is crucial to engage parents in an effort to promote the health of their children in school and together with schools. Various parental roles were established during the early part of the century when parents were obliged to raise their children according to the set standard. As time went by, schools clearly drew a line to distinguish their role from parents‟ roles. Later on a need for parental involvement in schools arose again and a call for parents to attend to their obligations was a necessity, although parents were seen as problems by teachers. This allowed a space for barriers to grow between parents and teachers to such an extent that there was no collaboration in addressing problems affecting children in schools. To investigate the issue of parental roles and health promotion in schools thoroughly, qualitative measures were applied. The analysis indicated that there is indeed a great need for parents to be involved in promoting the health of their children in schools. However, a lack of knowledge amongst parents and a lack of skills to work with parents amongst teachers hamper the possibility of preventing most of the health issues affecting many children of South Africa. Indeed parental participation in schools and health promoting schools can yield positive results not only for the children, but for the schools and parents as well. Therefore, the government must employ practical strategies to involve parents in promoting the health of children in schools. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2011

The purpose of this research was to implement and evaluate a whole-school health model (Health Promoting Secondary Schools [HPSS]), grounded in self-determination theory (SDT). The approach used a "For Youth with Youth" planning strategy designed to change school environments (culture, policy and practices) in order to help high school students become more physically active and eat more healthful diets. Three interrelated research projects were conducted to address the purpose of this study. A concurrent mixed-methods design was used to: (a) gain an understanding of the experiences of teachers and the Action Team as they planned and implemented school-based healthy living strategies (Project 1); (b) evaluate the impact on and relationship between SDT constructs and students’ motivation to engage in health-related behaviours (Project 2); and (c) evaluate the motivation of students in physical education classes grounded in SDT and its impact on their enrolment in grade 11 elective physical education (Project 3). In Project 1, 23 teachers and 37 Action Team members participated in focus group interviews. School observation field notes and Action Team meeting minutes were collected throughout the intervention process. Analysis of the data revealed that several factors were associated with participants’ experiences and motivational processes. These factors included: (a) Competing Responsibilities, Technical Difficulties, and Lack of Computer Access (b) Resources, Reminders, Workshops, and Collaboration (c) Choice-Based Design Impacts Participants’ Experiences; (d) Teacher Control Impacts Student Engagement (e) Teacher Job Action Inhibited Implementation of HPSS Action Plans. The findings from this study can facilitate future school-based projects by providing insights into student and teacher perspectives on the planning and implementation of a whole-school health model. In Project 2, 379 grade 10 students in ten participant schools (5 intervention schools; 5 control schools) completed self-report questionnaires pre and post intervention to evaluate the impact on students’ motivation to engage in health-related behaviours. Results showed students attending HPSS intervention schools reported significantly lower amotivation scores for healthy eating compared to students in usual practice schools. No significant differences were found between conditions on motivation towards physical activity. The findings indicate that a choice-based whole-school health approach may be an effective approach for decreasing amotivation towards healthy eating behaviours. In Project 3, a sample of 373 grade 10 students completed self-report questionnaires to assess their perceptions of autonomy, relatedness, and competence towards grade 10 Physical Education. Enrolment rates were collected from participant schools to determine the impact of the HPSS intervention on student enrolment in grade elective physical education. Multilevel analysis showed no significant differences between conditions post intervention on overall psychological need satisfaction or individual SDT constructs. For enrolment in elective physical education, chi-square analyses showed a significant difference in proportion of female students in HPSS intervention schools enrolled in grade 11 elective physical education. Findings show support for a whole-school health model to improve female student enrolment in elective physical education programs. / Graduate

Despite having been endorsed by the World Health Organisation (WHO) almost a decade ago, and its widespread adoption as a model of "best practice" for school health promotion throughout the world, the Health Promoting Schools framework has not been subjected to widespread evaluation in a way that fully recognises its core tenets. Most evaluations have focused on individual targeted interventions addressing students' health behaviours, or implementation issues such as school health policies or access to services. No evaluations of this approach could be found which investigated the impact of the HPS model on teachers, as a critical factor influencing the school climate, or on organisational processes associated with employee wellbeing within the school setting. There is a vast literature pertaining to conditions of the work environment that affect employee health, including work-related stress. Teaching is considered a highly stressful occupation, and as social pressure continues to place teachers and schools in the role of "in loco parentis" for the socialisation of children, it seems timely to identify those characteristics of the school environment that promote positive health and wellbeing for all. In theory, the HPS model provides a set of principles and procedures that aim to promote health and wellbeing for all members of the school community, yet the impact on school staff has yet to be demonstrated. This thesis reports on research investigating the extent to which adoption of the HPS approach creates a positive work environment for teachers, through enhanced organisational and social capital, and whether selected work environment variables impact on teachers' physical and mental wellbeing, health risk behaviours, job stress, and job commitment. After conducting a statewide audit of health promotion activities in Queensland primary schools, two samples of schools that differed significantly in the extent to which they were implementing organisational strategies consistent with the HPS approach were selected, one sample of 20 schools actively implementing HPS strategies, and a comparison sample of 19 schools not implementing the approach. Schools were matched on geographic location (rural/urban), school size (number of student enrolments), and socio-economic rank (IRSED). A cross-sectional design using a mail-out survey to 1,280 teachers was conducted, and statistical comparisons of the two groups were conducted. Apart from providing the samples of schools for the main research, the statewide audit provided a profile of health promotion activity in Queensland primary schools. Urban, rather than rural schools, and those with higher student enrolments, were most frequently implementing HPS strategies. Socio-economic ranking did not have any statistical bearing on adoption of these strategies. Implementation of school health policies was the most common strategy, although the social and physical environments were also addressed to some extent. The instrument designed for the study, the HPS Audit Checklist, proved effective in distinguishing a continuum of HPS "total scores" and demonstrated good psychometric properties. With respect to differences in measures of the school environment, mean scores for all 11 dimensions of school organisational health, and all 4 dimensions of school social capital, were statistically higher in High HPS, although differences between the two groups were not outstanding. Trends in the results did, however, confirm that schools actively adopting a HPS approach provide a more positive work environment than non-health promoting schools. Effect size was most significant for School Morale, Decision Authority, and Co-worker Support. Both organisational and occupational commitment was higher for teachers in High HPS, and Turnover Intention (plans to leave the workforce/workplace) was lower for teachers in High HPS. Teachers in High HPS reported less job strain and higher skill discretion, despite slightly greater job demands (work pressure) in these schools. They also reported significantly less general psychological distress on 5 measures, and significantly better self-rated mental and physical health. Job strain was most strongly associated with co-worker support, appreciation, and school morale in High HPS, but in Low HPS strain was most strongly associated with leadership style, school morale, and role clarity, suggesting more subtle differences between the two sets of schools. No statistically significant differences were found between teachers in High and Low HPS on self-reported weight, daily dietary habits, dental check-ups, preventive health screenings, alcohol consumption, smoking, cholesterol, BP and exercise. Although this research was limited by its dependence on self-report measures, the high response rate suggests that the results provide a valid profile of the health and psychological wellbeing of teachers in Health Promoting Schools in Queensland. These results also suggest that the HPS approach creates a more positive school environment through building social and organisational capital, and this is reflected in better mental health and stronger job commitment of the teaching workforce. Implications of these results for human resource management within the education sector are discussed. In addition, the implications of a healthier "learning environment", including less stressed and more connected teaching staff, for children's psychosocial and educational outcomes are considered in light of potential future directions for this research.

School connectedness, defined as the cohesiveness between diverse groups in the school community, including students, families, school staff and the wider community, is a well-documented protective factor for child and adolescent health. However, strategies for promoting school connectedness are less well known. The Western Gateway Health Promoting Schools Grant Scheme is a program that aims to increase school connectedness by using the health promoting school approach in disadvantaged communities in South-East Queensland, Australia. The scheme provides an opportunity for schools to apply for funding to implement strategies that increase students' sense of school connectedness, using a Health Promoting School approach. Evaluation of the Western Gateway Health Promoting School Grant Scheme provided an opportunity to investigate the influence of the health promoting school approach on school connectedness. The influence of the health promoting school approach on school connectedness was evaluated using a qualitative case study methodology. Three school communities were investigated as single, related case studies to examine the impact of the health promoting school approach on school connectedness. A conceptual framework, based on the theoretical understanding of how the health promoting school approach influences school connectedness, was developed and used as a guide to investigate the relationships within the case study schools. The health promoting school model, which is a 'settings' approach to health promotion, has the potential to promote school connectedness as it is based on the inclusive, participatory, and democratic principles shown to be necessary for the development of social connectedness at the broader community level. The model illustrates this potential through two mechanisms 1) processes that are characterised by the inclusion of a diverse range of members that make up a community; the active participation of community members and equal 'power' relationships, or equal partnerships among community members; and 2) structures such as school policies, school organisation and the school physical environment, that reflect the values of participation, democracy and inclusion andor that promote processes based on these values. These processes and structures, which are located both in the classroom and within the broader school environment, collectively hold the potential to promote connectedness in the school setting. Data on these relationships were collected using in-depth interviews with representatives of groups within the school community such as school staff, parents, students, health service and community agency workers. Additionally, student focus groups and documentary evidence, such as school program reports and observations of health promoting school activities were used in the collection of data. Data sources were triangulated to gain a complete understanding of the impact of the health promoting school approach on school connectedness. Data analysis was conducted by categorising the data into themes and categories based on, but not limited to, the conceptual framework that guided data collection. Data display matrices enabled theoretical relationships between the health promoting school approach and school connectedness to be drawn. The results of the in-depth qualitative evaluation of the program show that the health promoting school approach influences school connectedness through the mechanisms of a 'whole-school approach' that encourage interaction between members of the whole school community. Specific activities that promoted school connectedness were 'whole school' activities that celebrated the school community, for example, the launch of a school cafd and 'whole-class' activities where students and school staff work together towards a shared goal, such as the planning of a school breakfast tuckshop. Activities that encouraged links between classes and school staff in a school community, for example, shared curriculum planning in the co-ordination of a school breakfast tuckshop program also contributed to school connectedness by promoting interaction among school community members. Health promoting school structures and processes help to develop mutual reciprocal relationships characterised by school community members getting to know others better and developing care and support for each other, which in turn develops into other indicators of school connectedness, such as tolerance of diversity, perceptions of being valued, trust, perceptions of safety, and decreased absenteeism. A key element of health promoting school structures and processes that enables the formation of these relationships is the inclusive nature of the approach, which encourages school community members to participate in the school community. This encourages the formation of mutual reciprocal relationships. A number of elements of the health promoting school approach encourage participation in the community. For example, the formation of mutual, reciprocal relationships requires activities that are economically inclusive, and characterised by a social, positive, fun or celebratory element; that are informal and well-managed. Specifically, events characterised by eating food together; real-life activities; activities the school community 'owns' by having a say in them; and activities that involve school community members working together are important for the development of mutual reciprocal relationships. These elements occur at the level of the school and the broader school community interactions, as well as at the level of the class and interactions between classes within the school. In summary, this research provides evidence that the health promoting school approach is an effective model to influence school connectedness, which in effect promotes the health and well-being of children and adolescents.

Asthma affects over 2.2 million people in Australia. Asthma morbidity is increasing while mortality is decreasing. People with asthma experience shortness of breath as their airways narrow and become inflamed. After an episode of acute asthma many patients experience a relapse requiring further emergency department care. Numerous studies have been undertaken to identify the determinants of asthma morbidity and these studies have primarily used asthma oriented and co-morbidity scales such as anxiety and depression indices. Other studies in this area have indicated psychosocial factors such as coping, asthma attitudes and beliefs that may be linked to people with asthma who are non-compliant or adherent to treatment. Currently, there is no research available that has examined the link between general health promoting behaviours, an individual’s risk behaviour assessment and a brief asthma education encounter that is patient-centred. This study provides a description of the health promoting and risk taking behaviours of people who attend the emergency department with acute asthma. Secondly, it examines the effectiveness of patient-centred education compared with standard education. One hundred and forty-six people with acute asthma who attended the emergency departments of the Princess Alexandra and Mater Adult Public Hospitals were enrolled in this study. Participants self-reported health promoting and risk taking behaviours by completing the questionnaire that contained the Health Promoting Lifestyle Profile (HPLPII) and the Health Risk Appraisal (HRA) instruments. The Hospital Anxiety and Depression Scale (HADS) was also incorporated into the questionnaire to ascertain levels of anxiety and depression in this acute asthma group of people. The asthma education curriculum had the same topics for both the standard education and the patient-centred groups. However, the patient-centred group were able to prioritise the order of the topics according to their identified need. Secondly, the patient-centred group were asked two questions to ascertain the most important issue and asthma issue for them at that point in time. Both groups of participants were educated using the Asthma Foundation Leaflet “Asthma - Basic Facts” during the individual education session. There were 56% females and 44% males with a mean age (+SD) of 34 (13.8) years with 70.3% reported year 12 or above education and 49% of participants earned less that $20,000. Nearly half of the participants were admitted to a hospital ward following emergency department assessment and care. A large proportion of the participants had either moderate or severe asthma. The health behaviour findings from this study suggest people with acute asthma follow preventive health recommendations and safety guidelines more so than the wider community. However, they did not self-initiate home based health actions such as breast self-examination. At the time of attendance to the emergency department with acute asthma there were no statistical difference between the patient-centred education and standard format education groups for age, gender, education, income, asthma control and previous emergency department attendances. The patient-centred education group had fewer re-attendances in the four months after the education intervention when compared with prior emergency department attendances than the control group (p=0.057; p=0.486). In conclusion, people with acute asthma report undertaking a number of preventive health behaviours and actions according to national guidelines and safety recommendations. They report a lack of self-initiated home based health behaviours. Further research is required to investigate the impact on the National Asthma Council’s recommendations of the importance of asthma action plans on people who follow preventive health guidelines and who lack self-initiative abilities. In terms of asthma education, patient-centred education when compared to standard format education may be useful in reducing further emergency department attendances for acute asthma. More research is required to identify other key education issues for people with acute asthma.