HealthKick: a nutrition and physical activity intervention for primary schools in low-income settings (original) (raw)
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BMC Public Health, 2015
Background: The HealthKick intervention, introduced at eight primary schools in low-income settings in the Western Cape Province, South Africa, aimed to promote healthy lifestyles among learners, their families and school staff. Eight schools from similar settings without any active intervention served as controls. Methods: The Action Planning Process (APP) guided school staff through a process that enabled them to assess areas for action; identify specific priorities; and set their own goals regarding nutrition and physical activity at their schools. Educators were introduced to the APP and trained to undertake this at their schools by holding workshops. Four action areas were covered, which included the school nutrition environment; physical activity and sport environment; staff health; and chronic disease and diabetes awareness. Intervention schools also received a toolkit comprising an educator's manual containing planning guides, printed resource materials and a container with physical activity equipment. To facilitate the APP, a champion was identified at each school to drive the APP and liaise with the project team. Over the three-years a record was kept of activities planned and those accomplished. At the end of the intervention, focus group discussions were held with school staff at each school to capture perceptions about the APP and intervention activities. Results: Overall uptake of events offered by the research team was 65.6 % in 2009, 75 % in 2010 and 62.5 % in 2011. Over the three-year intervention, the school food and nutrition environment action area scored the highest, with 55.5 % of planned actions being undertaken. In the chronic disease and diabetes awareness area 54.2 % actions were completed, while in the school physical activity and sport environment and staff health activity areas 25.9 and 20 % were completed respectively. According to educators, the low level of implementation of APP activities was because of a lack of parental involvement, time and available resources, poor physical environment at schools and socioeconomic considerations. Conclusions: The implementation of the HealthKick intervention was not as successful as anticipated. Actions required for future interventions include increased parental involvement, greater support from the Department of Basic Education and assurance of sufficient motivation and 'buy-in' from schools.
BMC Public Health, 2012
Background: This study evaluated the primary school environment in terms of being conducive to good nutrition practices, sufficient physical activity and prevention of nicotine use, with the view of planning a school-based health intervention. Methods: A sample of 100 urban and rural disadvantaged schools was randomly selected from two education districts of the Western Cape Education Department, South Africa. A situation analysis, which comprised an interview with the school principal and completion of an observation schedule of the school environment, was done at all schools.
JMIR Research Protocols
Background: The burden of poverty-related infectious diseases remains high in low-and middle-income countries, while noncommunicable diseases (NCDs) are rapidly gaining importance. To address this dual disease burden, the KaziBantu project aims at improving and promoting health literacy as a means for a healthy and active lifestyle. The project implements a school-based health intervention package consisting of physical education, moving-to-music, and specific health and nutrition education lessons from the KaziKidz toolkit. It is complemented by the KaziHealth workplace health intervention program for teachers. Objectives: The aim of the KaziBantu project is to assess the effect of a school-based health intervention package on risk factors for NCDs, health behaviors, and psychosocial health in primary school children in disadvantaged communities in Port Elizabeth, South Africa. In addition, we aim to test a workplace health intervention for teachers. Methods: A randomized controlled trial (RCT) will be conducted in 8 schools. Approximately 1000 grade 4 to grade 6 school children, aged 9 to 13 years, and approximately 60 teachers will be recruited during a baseline survey in early 2019. For school children, the study is designed as a 36-week, cluster RCT (KaziKidz intervention), whereas for teachers, a 24-week intervention phase (KaziHealth intervention) is planned. The intervention program consists of 3 main components; namely, (1) KaziKidz and KaziHealth teaching material, (2) workshops, and (3) teacher coaches. After randomization, 4 of the 8 schools will receive the education program, whereas the other schools will serve as the control group. Intervention schools will be further randomized to the different combinations of 2 additional intervention components: teacher workshops and teacher coaching. Results: This study builds on previous experience and will generate new evidence on health intervention responses to NCD risk factors in school settings as a decision tool for future controlled studies that will enable comparisons among marginalized communities between South African and other African settings. Conclusions: The KaziKidz teaching material is a holistic educational and instructional tool designed for primary school teachers in low-resource settings, which is in line with South Africa's Curriculum and Assessment Policy Statement. The ready-to-use lessons and assessments within KaziKidz should facilitate the use and implementation of the teaching material. Furthermore, the
2019
BACKGROUND The burden of poverty-related infectious diseases remains high in low- and middle-income countries, while non-communicable diseases are rapidly gaining importance. To countermeasure this dual disease burden, the KaziBantu project aims at improving and promoting health literacy as a means for a healthy and active lifestyle. The project implements a school-based health intervention package, consisting of physical education, moving-to-music and health- and nutrition education lessons from the KaziKidz toolkit. It is complemented by the KaziHealth workplace health intervention program for teachers. OBJECTIVE The goal of the KaziBantu project is to assess the impact of a school-based health intervention package on risk factors for non-communicable diseases (NCDs), health behaviors and psychosocial health in primary schoolchildren in disadvantaged communities in Port Elizabeth, South Africa. Additionally, we aim to test a workplace health intervention for teachers. METHODS A ra...
Background: Recent evaluation of the Interdisciplinary Health Promotion (IHP) course offered by the University of the Western Cape (UWC) at schools revealed that the needs expressed by the schools had not changed in the last five years. Objectives: This paper describes the process that was undertaken to identify specific interventions that would have an impact on the schools and, in turn, the broader community, and provides an overview of the interventions conducted in 2011 - 2012. Methods: A stakeholder dialogue explored notions of partnership between the university and the schools, sustainability of health promotion programmes in the schools, and social responsiveness of the university. An action research design was followed using the nominal group technique to gain consensus among the stakeholders as to which interventions are needed, most appropriate and sustainable. Results: A comprehensive plan of action for promoting health in schools was formulated and implemented based on the outcome of the stakeholder dialogue. Conclusion: The study’s findings reiterate that an ongoing dialogue between schools and higher education institutions is imperative in building sustainable partnerships to respond to health promotion needs of the school community.
South Africa Whadi-ah Parker Population Health, Health Systems and Innovation
2015
This study explores the feasibility of implementing the curriculum and action-planning components of the HealthKick (HK) intervention in eight low-resourced schools in the Western Cape, South Africa. Process evaluation comprising workshops and personal interactions with teachers and principals were followed up with semi-structured interviews and focus group discussions, along with a questionnaire and evaluation sheet, during three implementation phases. Since promoting healthy habits during the early formative years is of key importance, the research team actively intervened to ensure successful implementation of the curriculum component. Time constraints, teachers' heavy workload, and their reluctance to become involved in non-compulsory activities, were the main reasons for non-compliance in using the curriculum document. Furthermore, the priorities of the teachers were not necessarily those of the researchers. However, findings indicate that with an appropriate introduction a...
Gender and Behaviour , 2023
The World Health Organisation's Health Promoting Schools programme aims at creating school environments conducive to health promotion in low income or disadvantaged communities. The aim of this study was to evaluate the implementation fidelity of the Heath Promoting School programme in primary schools. Purposive sampling was used to recruit 11 of the 13 health-promoting primary schools in the City of Tshwane, Gauteng, South Africa, between 2020 and 2021.The Gauteng Department of Education auditing method and tool was used. After auditing schools, both item and composite scores were calculated for each of the nine Likert scales on the audit tool. Barriers to successful implementation included a lack of policy knowledge; leadership; competence; and resources. All schools showed weak multiple stakeholder collaboration. The study findings could inform the development and review of school health policies.
Ethnicity & Disease
South Africa is an upper-middle income country that has a quadruple burden of disease. These include: 1) maternal, child health and nutritional deficiencies; 2) non-communicable diseases (NCDs); 3) injuries; and 4) chronic communicable diseases, such as HIV/AIDs and tuberculosis. 1 Malnutrition presents as both under-nutrition and over-nutrition, with stunting in South African children under five years at 27.4% and overweight and obesity being highly prevalent in adults, at 31% in men and 67.6% in women. 1 In South Africa, 29% of all deaths are from NCDs, with 18% of these from cancers and cardiovascular disease. 2 Substantial evidence has indicated that up to 80% of NCDs, such as type 2 diabetes, heart disease and stroke and more than one third of cancers can be prevented through minimising exposure to risk factors: unhealthy diet and obesity, tobacco use, physical inactivity, and harmful use of alcohol. 3,4 In 2009 the South African Medical Research Council initiated a randomised controlled intervention trial HealthKick (HK) aimed at primary school children, educators and caregivers in disadvantaged areas around Cape Town. Intervention results have been published on the educators and learners 5-7 but to date no data have been published on caregivers of children in the HK study. The results of a health risk assessment conducted on educators participating in the formative assessment phase of the HK study
BMC Public Health, 2015
Background: Numerous studies in schools in the Western Cape Province, South Africa have shown that children have an unhealthy diet with poor diversity and which is high in sugar and fat. HealthKick (HK) was a three-year randomised controlled trial aimed at promoting healthy eating habits. Methods: Sixteen schools were selected from two low-income school districts and randomly allocated to intervention (n = 8) or control school (n = 8) status. The HK intervention comprised numerous activities to improve the school nutrition environment such as making healthier food choices available and providing nutrition education support. Dietary intake was measured by using a 24-h recall in 2009 in 500 grade 4 learners at intervention schools and 498 at control schools, and repeated in 2010 and 2011. A dietary diversity score (DDS) was calculated from nine food groups and frequency of snack food consumption was determined. A school level analysis was performed. Results: The mean baseline (2009) DDS was low in both arms 4.55 (SD = 1.29) and 4.54 (1.22) in the intervention and control arms respectively, and 49 % of learners in HK intervention schools had a DDS ≤4 (=low diversity). A small increase in DDS was observed in both arms by 2011: mean score 4.91 (1.17) and 4.83 (1.29) in the intervention and control arms respectively. The estimated DSS intervention effect over the two years was not significant [0 .04 (95 % CI: −0.37 to 0.46)]. Food groups least consumed were eggs, fruit and vegetables. The most commonly eaten snacking items in 2009 were table sugar in beverages and/or cereals (80.5 %); followed by potato crisps (53.1 %); non-carbonated beverages (42.9 %); sweets (26.7 %) and sugar-sweetened carbonated beverages (16 %). Unhealthy snack consumption in terms of frequency of snack items consumed did not improve significantly in intervention or control schools. Discussion: The results of the HK intervention were disappointing in terms of improvement in DDS and a decrease in unhealthy snacking. We attribute this to the finding that the intervention model used by the researchers may not have been the ideal one to use in a setting where many children came from low-income homes and educators have to deal with daily problems associated with poverty. Conclusions: The HK intervention did not significantly improve quality of diet of children.