(An item from the ISHN Member information service)   Most of the discussion and debates about curriculum design in health-personal-social development education has revolved around teaching knowledge (facts) and/or skills. In fact, the design and delivery of HPSD education is far more sophisticated than these two elements. They include attitudes, health beliefs/self-efficacy, normative beliefs, functional knowledge, behavioural intentions, perceptions of risk and more. An article in Issue #3, 2015 of Global Health Promotion reminds us yet another element, multiple intelligences (MI). The concept of MI recognizes that students learn in a variety of ways, through verbal, logical, spatial, bodily, interpersonal, naturalistic and existentialist intelligences. The article reports on a Nigeria study where a programme of drug education based on the Multiple Intelligences Teaching Approach (MITA) was developed. "An experimental group was taught using this programme while a control group was taught using the same programme but developed based on the Traditional Teaching Approach. Pupils taught with the MITA acquired more drug refusal skills than those taught with the Traditional Teaching Approach." Note: The ISHN description of HPSD education can be found here.  Read more>>

(An item from the ISHN Member information service)  This blog advocates use of ecological analysis and action (comprising an ecological approach) so that the complex, inter-related factors in the real world can be considered when identifying and implementing interventions to influence both individual behaviours as well as conditions that influence those behaviours. An article in Issue #3, 2015 of Health Promotion International got our attention when it called for more attention to " time, a dimension beyond the socio-ecological model, is a critical factor of families' busy lives". We have no quarrel with the argument presented in the article. "Physical activity and healthy eating have long been promoted as key strategies in tackling the ‘wicked problem’ of obesity. Both practices are assumed to go hand-in-hand, but whether one dominates the other has largely remained unexamined. ". The study conducted 47 family interviews as part of a mixed methods study examining environmental influences on youth obesity. "Time pressure to meet the demands associated with scheduled physical activity for youth was the dominant theme across interviews from all neighborhoods. Physical activity and healthy eating were valued differently, with greater value placed on physical activity than healthy eating. The pressure to engage youth in organized physical activity appeared to outweigh the importance of healthy eating, which led to neglecting family meals at home and consuming fast food and take out options. Our findings further reinforce the need to move beyond the socio-ecological model to integrate critical dimensions such as ‘time’, to allow for a more nuanced understanding of contemporary healthy living." Our quarrel rests with the interpretation of the ecological model. Surely that is the purpose of examining the ecology of the situation, including all relevant factors such as time, transportation, economics and much more. Note: The ISHN definition of an ecological approach can be found here.  Read more>>

(An item from the ISHN Member information service)  Many of the national and provincial mental health strategies announced in recent years have included schools as a primary component, with teachers being critical, especially their "mental health literacy". An article in Issue #3, 2015 of School Mental Health reports on a small scale study that describes teacher perceptions of their role(s). It is noteworthy that teacher competence in MH is only one of the six factors identified as barriers by teachers. "This paper explores the teacher role in inter-professional collaboration in mental health promotion and identifies teachers’ perceived challenges to collaborative work in this field. Data are derived from a mixed method design, with three focus group interviews (n = 15) and survey research (n = 771) conducted with Norwegian K-12 teachers. The findings show that teachers perceive their gatekeeping role to be prominent, in that they are front line professionals to identify students’ mental health problems and, if necessary, make referrals to mental health services. However, teachers realize that mental health promotion encompasses more than the assessment of difficulties, and they call for more support and information through inter-professional collaboration in order to extend their engagement in student mental health beyond the gatekeeping role. Based on this, six main challenges to inter-professional collaboration are identified. These are the challenges of: (1) communication and confidentiality, (2) time constraints, (3) contextual presence and understanding, (4) cross-systems contact, (5) school leadership and (6) teacher competence in mental health."  Read more>>

(An item from the ISHN Member information service)  With the global community now debating the purposes and aspects of quality education as part of the 2015-30 Social Development Goals development, an article in Issue #3, 2015 of Comparative Education Review makes a timely point about the lack of a connection between increased student testing and subsequent economic growth. "This article considers the growth of the international testing regime. It discusses sources of growth and empirically examines two related sets of issues: (1) the stability of countries’ achievement scores, and (2) the influence of those national scores on subsequent economic development over different time lags. The article suggests that stability over time and across tests has historically been weak but is increasing in the post-1990 era. In addition, the analysis finds little evidence of macro-level effects of test score performance on subsequent economic growth. Read more>>

(An item from the ISHN Member information service)  An article in the August 2015 Issue of Social Indicators reports on the well-being of children in south-east Asia. We agree with the author's assertion that such reports are too often biased towards western Europe and North America. "Much progress has been made recently in expanding the literature on international comparison of children’s wellbeing. Nevertheless, most studies are skewed toward western or European countries, with the Asian nations rarely included. The purpose of this study is to fill the gap by conducting an exploratory comparison of children’s wellbeing in East and Southeast Asian countries. A multidimensional approach is adopted by analyzing material wellbeing, health, educational wellbeing, behavior, environment, and psychosocial wellbeing, together with their associated components and indicators. All countries are ranked according to their overall child wellbeing indices, including and excluding the dimension of psychosocial wellbeing. The results show that Japan, Korea, and Singapore perform best while Malaysia, Vietnam, Thailand, and Indonesia do less well in terms of children’s wellbeing. Various issues, including the paucity of data, are discussed as items to be considered in the agenda for future research." ISHN also agrees with the suggestion in the article that an agenda for research and knowledge development on child and adolescent health should be developed within the region. Read more>>

(An item from the ISHN Member information service)  An article in Issue #4, 2015 of Public Administration Review helps us to understand one aspect of the decision-making processes that occur in professional bureaucracies such as health, education or other ministries/systems. The article examines advice networks and the role that structures, internal competition and Individual attributes play in shaping those networks and the advice. The authors summarize their work: "Interpersonal networks are increasingly important for organizational learning and performance. However, little is known about how these networks emerge. In this article, exponential random graph models are employed to explore the underlying processes of advice network formation in 15 organizations. The author examines the influence of (1) structural effects (reciprocity, transitivity, multiplexity), (2) actor attribute effects (job function, tenure, education, self-efficacy), and (3) peer competition. Results suggest that employees rely more on reciprocity, closure, and similarity in job function than on peer expertise or status when seeking advice. In addition, employees who perceive greater levels of competition with peers are significantly less likely to both seek and provide advice. As public organizations look to private sector strategies that promote internal competition to improve efficiency and accountability, public managers need to be aware of the negative implications those strategies can have on interpersonal networks and organizational learning." In school health promotion and social development we have traditionally ignored the systems above schools, even though we know that eventually and inevitably, educators and nurses in schools will need to report back and ask for resources from these agencies, ministries and systems. Read more>>

(An item from the ISHN Member information service)  ISHN has been discussing the limits systematic review in this blog. An article in Issue #3, 2015 of Evidence & Policy extends our skepticism by examining how various "evidence tools (health impact assessments, systematic reviews and cost-benefit studies) are used, misused and misinterpreted in the real world of public decision-making. The authors conclude that "Each has been promoted as a means of synthesising evidence for policy makers but little is known about policy actors' experiences of them. Employing a literature review and 69 interviews, we offer a critical analysis of their role in policy debates, arguing that their utility lies primarily in their symbolic value as markers of good decision making." Not having access to the full text of that article, we did find a very similar version online that includes this statement "‘evidence tools’ can be important means of supporting policy decisions because they appear to be objective and credible (or at least more objective and credible than single studies may be). In addition, the interviewee suggests that ‘evidence tools’ employing quantitative data and providing clear and simple ‘answers’ to policy questions represent ‘gold dust’ to policymakers, who are often desperate for some sense of certainty within complex (and often contested) debates. " They go on to say that " All this leads us to conclude that ‘evidence tools’ represent means of drawing policymakers’ attention to particular kinds of evidence (and, implicitly, away from other kinds). As such, they might best be understood as ‘research-informed advocacy tools’ constructed and employed by actors (researchers using their black magic) working to inform the policy process. Read more>>

(An item from the ISHN Member information service)  A Cochrane Review published in the August 2015 issue of the newsletter reports that there is little evidence that multiple lifestyle interventions can reduce cardiovascular risks in low and middle income countries. The authors report that "Due to the limited evidence currently available, we can draw no conclusions as to the effectiveness of multiple risk factor interventions on combined CVD events and mortality. There is some evidence that multiple risk factor interventions may lower blood pressure levels, body mass index and waist circumference in populations in LMIC settings at high risk of hypertension and diabetes. There was considerable heterogeneity between the trials, the trials were small, and at some risk of bias." Even more startling was the statement in the introduction of the article that suggests there is limited evidence supporting such multiple lifestyle interventions in high income countries as well. Read more>>