(An item from the ISHN Member information service) An article in the February 2014 issue of Public Health Nutrition reports on the use of the RE-AIM implementation model was used to monitorreach, effect, implementation and maintenance of two different streams of an elementary school nutrition education program. Most noteworthy is that "Thirty-seven per cent of third-grade teachers in the dissemination sample reordered SMC materials during the subsequent school year thereby reporting on the likely maintenance of the program after the trial. The authors also noted that "Results In the evaluation sample, differences between the control and intervention groups were observed for nutrition knowledge, self-efficacy, outcome expectancies, and intakes of vegetables, fruit (girls only), soda, and low-nutrient high-energy foods from pre- to post-survey. Group differences in change in knowledge, outcome expectancies and vegetable intake were sustained through the 3-month follow-up (efficacy). One hundred per cent of intervention teachers in the evaluation sample implemented all of the lessons (implementation). The dissemination sample represented 42 % of third-grade students (reach) and 39 % of third-grade classrooms in public elementary schools in California during 2010–2011 (adoption)." The value of this RE-AIM framework is that it provides an indication of likely ongoing uptake of this program without any specific funding or technical support. Consequently, the authors conclude that the program demonstrates a moderate to high potential impact. Read more>>
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(An item from the ISHN Member information service) The protocol for a cross-border study of health ministry use of evidence-based practices in chronic disease prevention is presented in the December 2013 issue of Implementation Science. The authors state "Evidence-based public health approaches to prevent chronic diseases have been identified in recent decades and have the potential for high impact. Yet, barriers to implement prevention approaches persist as a result of multiple factors including lack of organizational support, limited resources, competing emerging priorities and crises, and limited skill among the public health workforce. The purpose of this study is to learn how best to promote the adoption of evidence based public health practice related to chronic disease prevention. This study has the potential to be innovative in several ways. This study will be among the first to provide the public health field with information about the facilitators and strategies that state level practitioners use in evidence based chronic disease prevention. Measures of dissemination among practitioners working in prevention of cancer and other chronic diseases are lacking [79-82]. This study will be among the first to develop, test, and utilize such measures. This study is among the first to apply Institutional Theory with frameworks used in public health, specifically Diffusion of Innovations and a knowledge transfer and utilization framework. The study has the potential for future large scale impact as it may identify effective ways to disseminate public health knowledge needed for EBDM processes in different contexts and help shorten the time between research evidence discovery and program application delivery." To this list of innovative aspects, we add one more. This is one of the first times that the subjects of the study are officials in health ministries, identifying their concerns, rather than focusing on front-line practitioners. At the same time, it should be noted that the specific focus of the study appears to be focused on whether the ministry officials are aware of and are using knowledge about better practices. Since knowledge exchange and transfer is only one of several system capacities required to implement and maintain quality improvements (others include coordinated policy, assignment of coordinators, formal and informal mechanisms for cooperation, ongoing work force development, regular monitoring/reporting, joint strategic issue management across systems and explicit sustainability planning), the study may or may not determine or describe the real world roles of ministry officials in promoting better practices and system change. Read more>>
(An item from the ISHN Member information service) "Going beyond training and hoping" is a colourful way to describe the paradigm shift now underway in research, practice and policy-making in school health promotion and social development. The words in the titles of the articles the October 2013 Issue of implementation Science are indicative of the new concepts that must be among the new, fundamentally different way that we approach our work and careers in the future. Although these concepts are applied to non-school settings and practices, their resonance should be self-evident. They include: transfer and implementation, scale-up, spread, and sustainability, making change last, leadership in complex networks, multifaceted, multilevel continuous quality improvement programs, dynamic sustainability frameworks and Social network diagnostics. Read more>>
(An item from the ISHN Member information service) An article in Issue #6, 2013 of Prevention Science presents a portrait of substance abuse prevention programs in US schools from 2001-07. "Based on school administrators’ reports, schools and school districts offer students an average of 1.62 prevention programs during their school years from elementary through high school. Bivariate and multivariate regression analyses were conducted with school demographic characteristics public versus private, size, population density, region of the country, school race/ethnic composition, and socioeconomic status of the student body (SES) as predictors of total number of programs that students received and of the relative use of local, state, and commercial programs. Schools in the West had significantly fewer prevention programs than those in other regions of the country. Students in predominantly White and in higher SES schools received significantly more prevention programs than students in majority African American, majority Hispanic, or in lower SES affluent schools. The most frequently reported programs that students received were locally developed. D.A.R.E. was the most widely adopted prevention program. Findings from this study suggest that schools often develop their own curriculum to suit their students’ needs, and students are exposed to multiple prevention programs through their school years, making it difficult to examine the effectiveness of any single program." Read more>>
(An item from the ISHN Member information service) Three articles in Issue #5, 2013 of Environmental Education Research provide a parallel discussion currently underway in the healthy schools sector about integrating health, social and environmental programs within education systems in order that they become sustainable and seen as a core part of schooling. The first article examines the constraints that exist within a school district and how a long-term plan/model (Eco-schools) can be combined with the literature on school improvement to make progress despite the constraints. The second article discusses how "environmental education" and "education for sustainable development" are different, with one (EE) seeking specific innovations and the other (ESD) seeking transformative change or system reform. The third article suggests the use of a systems-based approach to secure a long-term commitment to ESD from universities or other educational institutions. All three of these concepts are echied in the parakllel discussions withiun the school health movement. Read more>>
(An item from the ISHN Member information service) An article in Issue #6, 2013 of the American Journal of Public Health reports on the growing use of the RE-AIM Framework, a planning/assessment tool that measures changes in the system implementing innovations.Almost all of the 45 studies reviewed used all five elements of the assessment tool, namely Reach, Effectiveness, Adoption, Implementation, and Maintenance. It is the latter two elements that offer greater insights into capacity and sustainability issues. Read more>>
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