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Diet and Physical Activity in Schools: Perspectives from the Implementation of the WHO Global Strategy on Diet, Physical Activity and Health.

ABSTRACT: Non-communicable diseases (NCD), such as heart disease, stroke, cancer and diabetes, are by far the leading cause of mortality in the world, representing 60% of all deaths. Unhealthy diets and physical inactivity are well-established risk factors for overweight and the major NCD.In response to the rapid global growth of the NCD burden, the 2008 Action Plan on Prevention and Control of NCD and the 2004 Global Strategy on Diet, Physical Activity and Health (DPAS) have been developed and endorsed as key international policy instruments.As part of the work of the World Health Organization (WHO) to implement these resolutions, a framework describing the core elements for the development and implementation of a national school policy focused on diet and physical activity has been developed. This framework is included in the “DPAS implementation tool box”, and it aims to guide policy-makers in the development and implementation of policies that promote healthy eating and physical activity in the school setting through changes in environment, behaviour and education.The article describes the key elements of the framework and details how this tool is integrated into other WHO activities to provide leadership, guidance, capacity building, evidence-based recommendations and advocacy for action to improve dietary practices and increase physical activity globally.Electronic Supplementary MaterialSupplementary material is available for this article at 10.1007/BF03405623 and is accessible for authorized users.

SUBMITTER: Candeias V

PROVIDER: S-EPMC6973604 | biostudies-literature | 2010 Jul

REPOSITORIES: biostudies-literature

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Project description:BackgroundRural Latino children have higher rates of obesity compared to non-Latino Whites. Schools are in a unique position to address rural childhood obesity through policies. While evidence exists on factors that promote or impede school-based physical activity (PA) and nutrition policies, only a fraction has been in rural communities. This study seeks to understand 1) the knowledge and perceptions of school nutrition and PA policies and 2) barriers and facilitators to their implementation among rural school stakeholders from Washington State.MethodsWe conducted 20 semi-structured, in-depth interviews with school stakeholders (e.g., principals and school nutrition directors) from four K-12 school districts in the Lower Yakima Valley of Eastern Washington State. Thematic analysis was conducted using inductive, constant comparison approach to identify themes around knowledge and perceptions of policies and barriers and facilitators of policy implementation.ResultsThree main themes were identified: perceptions and knowledge of school PA and nutrition policies, barriers to policy implementation, and facilitators of policy implementation. The majority of stakeholders were supportive of school-based policies promoting PA and a healthy diet, even when lacking a specific understanding of these policies. Four subthemes were identified as barriers to policy implementation: viewing PA as a low priority, misuse of recess time, funding constraints, and lack of strong leadership. Facilitators of implementation included strong leadership at the district level, creating healthy norms through school-community linkages and pooling community resources to improve nutrition and PA among children.ConclusionsSchools provide a unique setting to promote healthy diet and PA behaviors among children and their families. Study findings show that while knowledge of specific nutrition and PA policies may vary, support for such policies were high among rural stakeholders. Study findings can inform policy development and support strategies for policy implementation in rural settings. Future studies may want to examine whether implementation of strategies addressing the barriers and enhancing facilitators lead to success in rural school settings.

Project description:Background"Decolonizing global health" (DGH) may help global health trainees understand and remediate the effects of historical colonialism on global health, but little is known regarding how trainees perceive DGH. Understanding their perspectives is critical for designing educational interventions tailored to their needs.ObjectivesTo understand how trainees perceive DGH research and to determine if perspectives differ between trainees from high- (HICs) versus low- and middle-income countries (LMICs).MethodsAn online survey of all 2017-2022 pre-doctoral and post-doctoral trainees (n = 111) and mentors (n = 91) within a multi-university program that supports US and international investigators in one-year mentored global health research. The survey evaluated individuals' self-reported knowledge and attitudes toward DGH and their perceptions of historical colonialism's impact on eight aspects of global health.FindingsThe response rate to trainee surveys was 56%. Trainees from LMICs were less aware of the concept of DGH; 5/25 (20%) had never heard of DGH and 16/25 (64%) reported that they "know a little," whereas all HIC trainees had heard of DGH and 29/36 (81%) reported that they "know a little" (p = 0.019). For three aspects of global health (i.e., which research questions get asked; development of collaborative relationships; and data/statistical analyses), trainees from LMICs were more likely to report positive effects of colonialism. However, in open-ended responses, no thematic differences existed between how LMIC and HIC trainees defined DGH (i.e., actively eliminating power imbalances; prioritizing local needs; promoting local leadership; providing equitable opportunities; and ensuring programs are culturally appropriate).ConclusionsDifferent perspectives surrounding what DGH means suggest a shared understanding may be needed and is arguably prerequisite to designing educational interventions to help global health trainees recognize, understand, and act in global health. Future research is needed to understand perspectives on decolonization across diverse contexts with attention to constructs such as race, ethnicity, and gender.

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Diet and Physical Activity in Schools: Perspectives from the Implementation of the WHO Global Strategy on Diet, Physical Activity and Health.

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