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

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

The influence of social constructs of hegemonic masculinity and sexual behaviour on acceptability of vaginal microbicides in Zambia

Vaginal microbicides are heralded as a woman’s HIV prevention method. This ethnographic study, conducted in a trial setting in Zambia, explored how the social construction of masculinity and sexual behaviour influenced the acceptability of vaginal microbicides from the man’s perspective. The data was generated from 18 In-depth Interviews (IDIs), and 8 Focus Group Discussions (FGDs). The data was analysed thematically. The study found that hegemonic masculinity influenced the use of gel use among women in multiple ways: decision to initiate gel use, autonomous use of the gel and consistent use of the gel. Men were seen as heads of households and decision makers who approved their partners’ intentions to initiate gel use. Autonomous gel use by women was not supported because it challenged men’s position in sexual matters and at family level. The socially accepted notion that men engaged in multiple sexual relationships also influenced women’s decision to use the gel. Sustained gel use depended on the perceived effect of the gel on men’s sexual desires, sexual performance, fertility, and sexual behaviour. This study suggests that acceptability of microbicides partially lies within the realm of men, with use constrained and dictated by cultural constructs and practice of masculinity and gender