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The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future

Background: The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children’s health and health behaviors. Methods: The study used a mixed-methods design. The school context (n = 4) was assessed by the characteristics...

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Autores principales: Bartelink, Nina, van Assema, Patricia, Jansen, Maria, Savelberg, Hans, Kremers, Stef
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651395/
https://www.ncbi.nlm.nih.gov/pubmed/31323922
http://dx.doi.org/10.3390/ijerph16132432
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author Bartelink, Nina
van Assema, Patricia
Jansen, Maria
Savelberg, Hans
Kremers, Stef
author_facet Bartelink, Nina
van Assema, Patricia
Jansen, Maria
Savelberg, Hans
Kremers, Stef
author_sort Bartelink, Nina
collection PubMed
description Background: The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children’s health and health behaviors. Methods: The study used a mixed-methods design. The school context (n = 4) was assessed by the characteristics of the school population, teacher’s health-promoting (HP) practices, implementers’ perceived barriers, school’s HP elements, and dominating organizational issues. Outcomes included objectively assessed BMI z-scores and physical activity (PA), and parent and child-reported dietary intake. Analyses included linear mixed models (four intervention schools versus four control schools), and qualitative comparisons between intervention schools with similar HP changes. Results: Effects on outcomes varied considerably across schools (e.g., range in effect size on light PA of 0.01–0.26). Potentially moderating contextual aspects were the child’s socioeconomic background and baseline health behaviors; practices and perceived barriers of employees; and organizational issues at a school level. Conclusions: Similar HP changes lead to different outcomes across schools due to differences in the school context. The adoption of a complex adaptive systems perspective contributes to a better understanding of the variation in effects and it can provide insight on which contextual aspects to focus on or intervene in to optimize the effects of HP initiatives.
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spelling pubmed-66513952019-08-08 The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future Bartelink, Nina van Assema, Patricia Jansen, Maria Savelberg, Hans Kremers, Stef Int J Environ Res Public Health Article Background: The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children’s health and health behaviors. Methods: The study used a mixed-methods design. The school context (n = 4) was assessed by the characteristics of the school population, teacher’s health-promoting (HP) practices, implementers’ perceived barriers, school’s HP elements, and dominating organizational issues. Outcomes included objectively assessed BMI z-scores and physical activity (PA), and parent and child-reported dietary intake. Analyses included linear mixed models (four intervention schools versus four control schools), and qualitative comparisons between intervention schools with similar HP changes. Results: Effects on outcomes varied considerably across schools (e.g., range in effect size on light PA of 0.01–0.26). Potentially moderating contextual aspects were the child’s socioeconomic background and baseline health behaviors; practices and perceived barriers of employees; and organizational issues at a school level. Conclusions: Similar HP changes lead to different outcomes across schools due to differences in the school context. The adoption of a complex adaptive systems perspective contributes to a better understanding of the variation in effects and it can provide insight on which contextual aspects to focus on or intervene in to optimize the effects of HP initiatives. MDPI 2019-07-09 2019-07 /pmc/articles/PMC6651395/ /pubmed/31323922 http://dx.doi.org/10.3390/ijerph16132432 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bartelink, Nina
van Assema, Patricia
Jansen, Maria
Savelberg, Hans
Kremers, Stef
The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future
title The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future
title_full The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future
title_fullStr The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future
title_full_unstemmed The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future
title_short The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future
title_sort moderating role of the school context on the effects of the healthy primary school of the future
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651395/
https://www.ncbi.nlm.nih.gov/pubmed/31323922
http://dx.doi.org/10.3390/ijerph16132432
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