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This paper evaluates the implementation of a school-based physical activity intervention and discusses how the intervention outcomes can be influenced by the implementation.

In four of the nine lower secondary schools in which the intervention was conducted, the authors examined implementation fidelity, adaptation, quality, responsiveness and dose received. The authors conducted focus group interviews with teachers (n = 8) and students (n = 46) and made observations. Dose delivered was examined quantitatively, with weekly registrations.

Results showed that two out of four schools made few and positive adaptations, implemented the intervention with high fidelity and quality and responded positively. Four main factors were found to influence implementation: frame factors, intervention characteristics, participant characteristics and provider characteristics.

A cross-sectional design was used and may not represent implementation throughout the whole school year.

In terms of large-scale implementation, the intervention may be generalizable. However, intervention criteria such as adequate facilities and a flexible timetable may be unattainable for some schools. The intervention can be adapted without compromising its purpose, but adaptations should be a result of cooperation between students and teachers.

Process evaluations on this topic are rare. This study adds to a limited knowledge base concerning what factors may influence implementation of school-based physical activity interventions for adolescents.

Involvement of parents/carers may increase effectiveness of primary school-based alcohol-misuse prevention projects through strengthening family-based protective factors, but rates of parental engagement are typically low. This paper reports findings from an exploratory trial of a school-based prevention intervention – Kids, Adults Together (KAT), based on the Social Development Model, which aimed to promote pro-social family communication in order to prevent alcohol misuse, and incorporated strategies to engage parents/carers. The purpose of this paper is to assess the feasibility and value of conducting an effectiveness trial of KAT.

The study was a parallel-group cluster randomised exploratory trial with an embedded process evaluation. The study took place in south Wales, UK, and involved nine primary schools, 367 pupils in Years 5/6 (aged 9-11 years) and their parents/carers and teachers. Questionnaires were completed by pupils at baseline and four month follow-up, and by parents at six month follow-up.

Overall KAT was delivered with good fidelity, but two of five intervention schools withdrew from the study without completing implementation. In total, 50 per cent of eligible parents participated in the intervention, and KAT had good acceptability among pupils, parents and teachers. However, a number of “progression to effectiveness trial” criteria were not met. Intermediate outcomes on family communication (hypothesised to prevent alcohol misuse) showed insufficient evidence of an intervention effect. Difficulties were encountered in identifying age appropriate outcome measures for primary school-age children, particularly in relation to family communication processes. The study was unable to find comprehensive methodological guidance on exploratory trials.

It would not be appropriate to conduct an effectiveness trial as key progression criteria relating to intervention and trial feasibility were not met. There is a need for new measures of family communication which are suitable for primary school-age children, and more guidance on the design and conduct of exploratory/feasibility trials.

KAT achieved high rates of parental involvement, and its theoretical framework and processes could be adapted by other interventions which experience difficulties with recruitment of parents/carers.

Adolescent mental health is a global concern. There is an urgent need for creative, multimedia interventions reflecting adolescent culture to promote mental health literacy and well-being. This study aims to assess the impact of a film-based intervention on adolescent mental health literacy, well-being and resilience.

A pretest-posttest intervention with a multi-methods evaluation was used. A convenience sample of ten schools facilitated students aged 15–17 years to engage in an online intervention (film, post-film discussion, well-being Webinar). Participants completed surveys on well-being, resilience, stigma, mental health knowledge and help-seeking. Five teachers who facilitated the intervention participated in post-implementation interviews or provided a written submission. Analysis included paired-t-test and effect size calculation and thematic analysis.

Matched pretest-posttest data were available on 101 participants. There were significant increases in well-being, personal resilience and help-seeking attitudes for personal/emotional problems, and suicidal ideation. Participants’ free-text comments suggested the intervention was well-received, encouraging them to speak more openly about mental health. Teachers similarly endorsed the intervention, especially the focus on resilience.

Intinn shows promise in improving adolescents’ mental health literacy and well-being. Film-based interventions may encourage adolescents to seek professional help for their mental health, thus facilitating early intervention.

The teaching of cooking is an important aspect of school-based efforts to promote healthy diets among children, and is frequently done by external agencies. Within a limited evidence base relating to cooking interventions in schools, there are important questions about how interventions are integrated within school settings. The purpose of this paper is to examine how a mobile classroom (Cooking Bus) sought to strengthen connections between schools and cooking, and drawing on the concept of the sociotechnical network, theorise the interactions between the Bus and school contexts.

Methods comprised a postal questionnaire to 76 schools which had received a Bus visit, and case studies of the Bus’ work in five schools, including a range of school sizes and urban/rural locations. Case studies comprised observation of Cooking Bus sessions, and interviews with school staff.

The Cooking Bus forged connections with schools through aligning intervention and schools’ goals, focussing on pupils’ cooking skills, training teachers and contributing to schools’ existing cooking-related activities. The Bus expanded its sociotechnical network through post-visit integration of cooking activities within schools, particularly teachers’ use of intervention cooking kits.

The paper highlights the need for research on the long-term impacts of school cooking interventions, and better understanding of the interaction between interventions and school contexts.

This paper adds to the limited evidence base on school-based cooking interventions by theorising how cooking interventions relate to school settings, and how they may achieve integration.

The purpose of this paper is to explore the process of involving students and staff on school action groups, and staff and student experiences of reviewing local data and initiating school-level changes, to address bullying and other aggression.

The authors draw on qualitative, process data collected at four purposively sampled pilot intervention schools in England via semi-structured interviews with school managers, action group members and facilitators (n=33), focus groups with students (n=16) and staff (n=4), and observations.

School staff used multiple methods to recruit a diverse range of students onto school action groups. Locally tailored data reports were an important catalyst for action groups to identify priorities and plan whole school change – both through the process of “validation” (whereby existing concerns were confirmed) and “discovery” (whereby new problems were identified). An unexpected benefit of providing schools with these data was that it triggered analyses of other data sources, including routine monitoring data. External facilitators were important in promoting student voice and ensuring the intervention retained integrity as a whole-school restorative approach.

It was feasible to involve young people using action groups, and there was evidence of school-level actions led by students, including in disadvantaged school contexts. Future Health Promoting Schools interventions could incorporate this approach to support locally appropriate, school-level change.

The micro-level processes that were observed, whereby action groups interrogated feedback reports and collected additional data, suggest the responsiveness of such youth-involvement interventions to local needs. Contrary to many public health interventions, implementation appeared to be facilitated rather than hindered by features of the secondary-school “market” whereby parents have some choice between schools.

This paper aims to explore four disruptions that practice theory makes to traditional social marketing approaches to school physical activity (PA) intervention.

The paper draws on existing literature from sustainable consumption, sociology of health and illness and the authors’ experiences working with primary schools in the UK to plan and execute social marketing approaches to PA, targeting interconnected social practices from which PA emerges or fails to emerge. The paper explores a practice-oriented theoretical framing, engaging with calls from interdisciplinary areas for PA interventions to shape the PA emerging from a school’s everyday routines, rather than promote PA participation at an individual level.

The paper argues first that a practice perspective would focus on situation research rather than audience research, with practices rather than people as the focus. Second, the purpose of practice-oriented social marketing would be to achieve transitions in practices rather than behaviour change. Third, the planning and management approach of practice-oriented social marketing would account for unintended consequences and complex interconnections between practices. Finally, an evolved evaluation approach to practice-oriented social marketing would take a longer term approach to understand how cultural transitions are emerging.

This paper contributes to an important stream of critical social marketing scholarship that seeks to advance social marketing away from its individualist routes. It sets an agenda for further research that considers the ontological and practical possibilities for practice informed approach to social marketing.

The smoking rate of male high school students continues to increase. Therefore, the purpose of this paper is to examine the effectiveness of a smoking cessation program on self-esteem, attitude, perception and practice regarding smoking behavioral control among male high school students in Ubon Ratchathani Province, Thailand.

The effectiveness of the smoking cessation program was tested by a quasi-experimental pre-posttest and follow-up with a 24-week design. Multistage sampling was used to recruit 70 male high school students, including 35 male students in the intervention group and 35 male students in the control group. The intervention group received a 12-week smoking cessation program based on information-motivation-behavioral skills and stages of change models and follow-up at 12 weeks, whereas the control group did not. A self-administered questionnaire was used to assess the improvement of subjects’ self-esteem, attitude toward smoking, perceived control over smoking, number of cigarettes per day and urine cotinine test. The descriptive statistics, generalized estimating equation and proportion test were used for data analysis.

After the program, there were statistically significant differences in mean scores between the group and control groups; the difference of self-esteem was 4.15 (95% CI: 1.95, 6.36), attitude toward smoking was 3.30 (95% CI: 1.89, 5.52) and perceived control over smoking was 6.99 (95% CI: 4.04, 9.94). Thus, all differences in the intervention group were significantly higher than in the control group. The proportion of non-smokers, measured by the urine cotinine test at follow-up, was 25 percent (95% CI: 0.03, 0.48) significantly higher (p-value = 0.015), in the intervention group. Therefore, the smoking cessation program in this study was effective at changing the behavior of male high school student smokers.

This smoking cessation program increased self-esteem, attitude toward smoking, perceived control over smoking and decreased smoking per day among male high school students. Therefore, schools and parents should focus on developing these factors to encourage students to quit smoking.

High school students are a common target group in initiatives addressing discriminatory attitudes towards people with mental illness. However, these initiatives are rarely evaluated and documented. The aim of our paper is to evaluate the effectiveness of a school-based educational intervention for improving adolescents' attitudes and reducing the desire for social distance from people with mental illness living in their community. A total of 161 students aged 16-18 years old were questioned at baseline assessment and 86 of them received a three-workshop educational intervention while 75 students comprised the control group. A follow-up assessment 1 month post intervention evaluated its impact. Attitudes and the social distance were assessed through the Community Attitudes towards the Mentally Ill scale and a 10-statement questionnaire based on the Self-report Inventory of Fear and Behavioural Intentions, respectively. Data from 140 subjects were analyzed. All attitude dimensions and half of the measured social distance statements were significantly improved in the intervention group at follow up assessment compared to controls. However, the statements measuring more intimate types of social relationships did not change significantly post intervention. In conclusion, short educational interventions can be effective to some extent in reducing discriminatory attitudes towards people with mental illness. However, effective interventions to address deeply held negative stereotypes will require further research.

This paper aims to present a description of the development and implementation of a combined school- and community-based intervention for the prevention of overweight among children, using the combined methods of social marketing (SMk) and intervention mapping (IM).

The SMk total process planning (TPP) framework was used, a simple but robust framework that consists of five stages: scoping, development, implementation, evaluation and follow-up. In addition, IM tools were embedded in the development stage to strengthen the development element of the campaign.

The use of the SMk TPP framework led to the selection of one specific target segment and behaviour. IM tools helped to select the most important and modifiable determinants and behaviours in the target segment, as well as to select and appropriately apply theoretical methods for influencing determinant and behaviour change. The resulting “Water Campaign” was aimed at Turkish and Moroccan mothers and their 6-12-year-old-children (target segment). This intervention addresses the consumption of sugar-sweetened beverages through the promotion of tap water drinking (target behaviour). The systematic involvement of key stakeholders resulted in capacity-building and co-creation.

A key finding of the present work is that the SMk TPP framework and IM tools can be successfully combined in intervention development, helping to develop enhanced interventions. Combining these methods led to a theory-based and client-oriented intervention, which was directed at multiple ecological levels and which systematically involved key stakeholders. With this detailed description of the intervention development, this paper aims to assist other researchers and practitioners in their quest to develop better interventions.

In many countries, schools move toward healthier canteen assortments by limiting the supply of unhealthy foods. The question arises whether this gives any undesirable side effects with students (e.g. compensation in purchases from school to outside retailers, reactance) and how to handle these so that operating school canteens remains financially viable. The purpose of this paper is to identify perspectives toward healthy school food assortments held by vocational education students and professionals within secondary and vocational schools with responsibility for school food policy (e.g. school canteen workers, teachers, school directors) in the Netherlands.

Four focus groups were conducted with students at a vocational school (n=25 in total). A semi-structured interview guide was used to conduct discussions. The interview guide also included three school canteen scenario’s (A: 100 percent healthy food, B: 50 percent healthy/50 percent unhealthy foods and C: 100 percent unhealthy food) and a set of nine intervention strategies. A brief survey included questions on the same three scenario’s and nine intervention strategies. A web-based survey was conducted among 68 professionals responsible for school food policy and included their evaluation of the same canteen scenarios and interventions. Survey data were analyzed using descriptive statistics and content analysis. Content analysis was done on the qualitative data.

School food professionals were highly supportive of Scenario A (100 percent healthy food), as this formed a better fit with their policies and was believed to stronger encourage healthy eating. They did worry about financial feasibility given lower affordability and student reluctance to accept the assortment. Students were less in favor of Scenario A. Students discussed getting value for money and remaining freedom to make unhealthy choices. The authors discuss implications for policy makers who aim to implement measures to improve young people’s eating habits.

This study contributes to the literature on creating healthier school food environments. This study uniquely examines a healthier school canteen from a viability perspective, including the views of students as primary customers. Given the need to progressively increase the number of foods complying to dietary guidelines in canteen assortments, this study provides insights into how and why assortment changes best can be implemented.