Schools in the Community: Action Research on Safety (SCARS) Project. Deliverable Number 2, Report on Before Surveys

This document represents the second deliverable of the Schools in the Community: Action Research on Safety (SCARS) project. The project is a joint one between Leeds City Council's Road Safety Promotion Unit (RSPU), the Faculty of Health and Social Care at Leeds Metropolitan University (LMU) and the Institute for Transport Studies at the University of Leeds (ITS). The objectives of the project are: To develop a whole school approach to road safety To raise awareness among adults about their responsibilities for road safety To evaluate the benefits of the approach This document outlines the way the project team has approached the last of these, the evaluation of the benefits. In particular it gives details on the selection of study sites, the various studies that were undertaken and some preliminary results from these studies. This document does not give information on the interventions that have and are taking place. It is inevitable that, as part of these interventions additional information about the success or otherwise of the initiative may be obtained, such as how much information has been successfully imparted to children, how many meetings of community groups have occurred etc. The studies outlined in this document, therefore, only form part of the evaluation process. As the project is only part way through, this document does not include any evaluation of the success or otherwise of the initiative as a whole for the very simple reason that no 'after' studies have yet taken place. The initiative as a whole will be evaluated in the Final Report of the project

Prison staff and the health promoting prison.

Purpose – This paper aims to discuss some of the obstacles to implementing policy and strategy related to health promoting prisons. It focuses on the role of prison officers and raises issues concerning their conditions of service, training and organisational culture in a situation where the prison system faces security issues, overcrowding and high levels of ill health among prisoners. Design/methodology/approach – This paper emerged as a result of significant overlapping themes between two separate studies conducted by the authors. The paper draws on the authors' qualitative data from these studies. Findings – The findings demonstrate the ambiguities and tensions in changing organisational cultures and among prison staff. Alongside the qualitative data, the paper draws on theory regarding policy implementation at the micro-level to show how staff can block or speed up that implementation. Practical implications – Prison officers are an essential part of health promoting prisons, but have been relatively ignored in the discussion of how to create healthier prisons. Originality/value – The contribution that prison staff make to creating health promoting prisons has been under-explored, yet pertinent theory can show how they can be more effectively involved in making changes in organisational culture

Schools in the Community: Action Research on Safety (SCARS) Project. Deliverable Number 2, Report on Before Surveys

This document represents the second deliverable of the Schools in the Community: Action Research on Safety (SCARS) project. The project is a joint one between Leeds City Council's Road Safety Promotion Unit (RSPU), the Faculty of Health and Social Care at Leeds Metropolitan University (LMU) and the Institute for Transport Studies at the University of Leeds (ITS). The objectives of the project are: To develop a whole school approach to road safety To raise awareness among adults about their responsibilities for road safety To evaluate the benefits of the approach This document outlines the way the project team has approached the last of these, the evaluation of the benefits. In particular it gives details on the selection of study sites, the various studies that were undertaken and some preliminary results from these studies. This document does not give information on the interventions that have and are taking place. It is inevitable that, as part of these interventions additional information about the success or otherwise of the initiative may be obtained, such as how much information has been successfully imparted to children, how many meetings of community groups have occurred etc. The studies outlined in this document, therefore, only form part of the evaluation process. As the project is only part way through, this document does not include any evaluation of the success or otherwise of the initiative as a whole for the very simple reason that no 'after' studies have yet taken place. The initiative as a whole will be evaluated in the Final Report of the project

Control and choice in English prisons: developing health-promoting prisons.

The 'health-promoting prison' has been informed by a broader settings-based philosophy to health promotion which conceptualizes health as the responsibility for all social settings. Though in its relative infancy, the notion of a health-promoting prison has gained political backing from international organizations like the World Health Organization, but the implementation of the policy rhetoric has not translated across all prison environments. The aim of this paper is to consider how key elements of health promotion discourse-choice, control and implicitly, empowerment-can apply in the context of imprisonment. These concepts were examined in three category-C (secure) prisons in England, through interviews with 36 male prisoners and 19 prison staff conducted by the first author. Analysis showed that prisoners negotiated the norms, structures and strictures of prison life by both relinquishing control and also by taking control, showing resistance and exercising some element of choice. The paradox is that, as most prisoners are expected to be released at some point they need to exercise some agency, control and choice, but these learning experiences may be constrained whilst 'inside'. The paper argues that if a settings approach in prison is truly to move forward, both conceptually and practically, then health promoters should seek to embed the key values of health promotion within the prison setting

Socio-cultural factors surrounding mental distress during the perinatal period in Zambia: a qualitative investigation.

BACKGROUND: The presence of mental distress during pregnancy and after childbirth imposes detrimental developmental and health consequences for families in all nations. In Zambia, the Ministry of Health (MoH) has proposed a more comprehensive approach towards mental health care, recognizing the importance of the mental health of women during the perinatal period. AIM: The study explores factors contributing to mental distress during the perinatal period of motherhood in Zambia. METHODS: A qualitative study was conducted in Lusaka, Zambia with nineteen focus groups comprising 149 women and men from primary health facilities and schools respectively. FINDINGS: There are high levels of mental distress in four domains: worry about HIV status and testing; uncertainty about survival from childbirth; lack of social support; and vulnerability/oppression. CONCLUSION: Identifying mental distress and prompt referral for interventions is critical to improving the mental health of the mother and prevent the effects of mental distress on the baby. RECOMMENDATION: Strategies should be put in place to ensure pregnant women are screened for possible perinatal mental health problems during their visit to antenatal clinic and referral made to qualified mental health professionals. In addition further research is recommended in order to facilitate evidence based mental health policy formulation and implementation in Zambia

A study investigating infant and young child feeding practices in Foni Kansala district, western region, Gambia

It has been documented and a well-established fact that good nutrition including appropriate infant and young child feeding practices is central to the growth and development of all infants and young children. A study to investigate infant and young child feeding practices was conducted in Foni Kansala District, The Republic of The Gambia. The overall aim of the study was to explore the situation of infant and young child feeding practices that are prevalent and perceived effective in promoting the health and nutritional status of young children in the study area. A total of three focus group discussion (FGDs) and five in-depth interviews were conducted, and interviews were conducted in natural settings. Purposive sampling technique was used to recruit the participants. Thematic analysis approach was used to analyse the responses from the interviews. The results of the study found that exclusive breastfeeding up to six months was rarely practiced in the area due to strong cultural and traditional beliefs and inadequate information on the importance of exclusive breastfeeding. Colostrum was perceived as impure and unsafe to be given to the infant. Breastfeeding is the most common method of infant feeding, while bottle was practiced by only two mothers who participated in the FGD. Initiating breastfeeding after delivery is usually delayed due to cultural and traditional practices and the involvement of partners. The role of health workers, opinion leaders, traditional communicators, NGOs and grand mothers in supporting mothers to adequately feed their infants have been highly valued in the area. In addition, increased workload of women, maternal illness or death after delivery, breast milk insufficiency and the involvement of grand mothers, husbands, friends and other family members play an influential role in the early introduction of complementary foods to infants. Also, mothers’ socio-economic status, culture and tradition have been found to have an influence on early introduction of complementary foods. This article presents an analysis and summary of the data collected during the course of the explorative research conducted in the study area

Evaluation of implementation and effect of primary school based intervention to reduce risk factors for obesity

OBJECTIVES: To implement a school based health promotion programme aimed at reducing risk factors for obesity and to evaluate the implementation process and its effect on the school. DESIGN: Data from 10 schools participating in a group randomised controlled crossover trial were pooled and analysed. SETTING: 10 primary schools in Leeds. Participants 634 children (350 boys and 284 girls) aged 7­11 years. MAIN OUTCOME MEASURES: Response rates to questionnaires, teachers' evaluation of training and input, success of school action plans, content of school meals, and children's knowledge of healthy living and self reported behaviour. RESULTS: All 10 schools participated throughout the study. 76 (89%) of the action points determined by schools in their school action plans were achieved, along with positive changes in school meals. A high level of support for nutrition education and promotion of physical activity was expressed by both teachers and parents. 410 (64%) parents responded to the questionnaire concerning changes they would like to see implemented in school. 19 out of 20 teachers attended the training, and all reported satisfaction with the training, resources, and support. Intervention children showed a higher score for knowledge, attitudes, and self reported behaviour for healthy eating and physical activity. CONCLUSION: This programme was successfully implemented and produced changes at school level that tackled risk factors for obesity

Randomised controlled trial of primary school based intervention to reduce risk factors for obesity

OBJECTIVE: To assess if a school based intervention was effective in reducing risk factors for obesity. DESIGN: Group randomised controlled trial. SETTING: 10 primary schools in Leeds. PARTICIPANTS: 634 children aged 7­-11 years. INTERVENTION: Teacher training, modification of school meals, and the development of school action plans targeting the curriculum, physical education, tuck shops, and playground activities. MAIN OUTCOME MEASURES: Body mass index, diet, physical activity, and psychological state. RESULTS: Vegetable consumption by 24 hour recall was higher in children in the intervention group than the control group (weighted mean difference 0.3 portions/day, 95% confidence interval 0.2 to 0.4), representing a difference equivalent to 50% of baseline consumption. Fruit consumption was lower in obese children in the intervention group ( - 1.0, - 1.8 to - 0.2) than those in the control group. The three day diary showed higher consumption of high sugar foods (0.8, 0.1 to 1.6)) among overweight children in the intervention group than the control group. Sedentary behaviour was higher in overweight children in the intervention group (0.3, 0.0 to 0.7). Global self worth was higher in obese children in the intervention group (0.3, 0.3 to 0.6). There was no difference in body mass index, other psychological measures, or dieting behaviour between the groups. Focus groups indicated higher levels of self reported behaviour change, understanding, and knowledge among children who had received the intervention. CONCLUSION: Although it was successful in producing changes at school level, the programme had little effect on children's behaviour other than a modest increase in consumption of vegetables