Controles en el desarrollo de plataformas carbonatadas

External stakeholders comprise individuals and organisations working externally to the school; they include government departments, city and district councils, district health boards, non- government organisations, health professionals, food suppliers and sports trusts. External stakeholders have in common the fact that when they initiate contact with schools, they typically do so in order to promote particular health programmes and to encourage involvement in health promotion activities. External stakeholders also offer schools resources for professional development as well as for health and physical education (PE) teaching programmes. Schools typically initiate contact with external stakeholders when seeking training, support or resources to address specific health promotion concerns. External stakeholders, such as food vendors, who sell

children products which are discouraged or prohibited at school are seen by school staff as problematic42_.

5.2.2.

Communication between Schools and Children

The central path of communication in school-based health promotion is between the school (source) and children (receiver). Fundamental health promotion objectives for schools are determined by the New Zealand Curriculum Framework, a set of policy statements defining learning principles and achievement aims for all students in all New Zealand schools (Ministry of Education, 2004). The national curriculum statements are flexible thus allowing schools and teachers to tailor promotions to the perceived learning needs of their students and communities. Communication regarding nutrition and physical activity is centred on creating awareness of healthy lifestyles, establishing a positive image of healthy lifestyles through positive associations, and influencing health behaviour. Health promotions are based on the requirements of the curriculum (government policy) and whatever health issues schools perceive as priorities for their community. Based on key insights outlined in this section, the juxtaposition of government policy and community priorities was identified as one of the underlying themes of communication processes within school-based health promotions. This Theme A is discussed in Chapter Seven (section 7.2, p.129).

The New Zealand Curriculum Framework operates as a message channel, created by policy makers, through which health and PE is delivered to children in schools. The curriculum is the official policy for teaching, learning, and assessment. Schools operate within a set of National Education Guidelines (NEGs) which include National Education Goals, foundation curriculum policy statements, national curriculum statements and National Administration Guidelines (NAGs). Under the Education Act 1989, every school Board must prepare and maintain a school charter which establishes the mission and objectives of the school. The charter must be prepared and updated in accordance with the NAGs (Ministry of Education, 2008a).

The focus of this research is nutrition and physical activity health promotions. Over the study duration (2004-2008), the New Zealand government enacted several legislative changes in education regarding these topics43_{. Effective from Term 1, 2006, was an addition to the NAGs}

requiring schools to implement programmes which "give priority to regular quality physical activity". Then, in September 2006, the government launched Mission-On, a $67 million interagency campaign designed to improve nutrition and increase physical activity among children and young

42 _{It is noted that the sale of confectionery (and/or other unhealthy food products) as a school fundraising}

method also sends messages to children that conflict with healthy eating concepts taught and practiced at school.

43 _{The enactment of changes to curriculum requirements regarding nutrition and physical activity did not affect}

the research focus of this study, but did contribute to the findings as an important influence on school-based health promotions.

New Zealanders (New Zealand Government, 2006). The Mission-On package includes ten initiatives. Two are relevant to this study and are the joint responsibility of the Ministries of Health and Education: improving nutrition in schools and early childhood education (ECE) services, and school-based health promotion. In March 2007, new Ministry of Health food and nutrition guidelines were distributed to schools. The guidelines, which form part of the Mission-On package, are designed to assist schools in creating healthy eating environments for students. As of June 2008, boards of trustees are required to promote healthy food and nutrition for all students; and where food and beverages are sold on school premises they must have only healthy options available.

In summary, schools are required to operate in accordance with the national curriculum framework which is administered by the New Zealand government. Recent changes to the curriculum have strengthened the framework for promotion of nutrition and physical activity, requiring schools to focus on these topics and ensure the school environment supports healthy practices. The curriculum framework sets out the prescribed objectives for health promotions and is the channel through which they are delivered to children. Schools tailor the curriculum to their students, determine messages and select communication tools accordingly.

The key point here is that communication processes within school-based health promotions are unique and this is due to the influence of government policy in the guise of curriculum. As such, the a priori conceptual framework of this study does not fit the case data. In the a priori model, it was proposed that communication involved schools (source) having a communications objective, which was then transformed into a message, delivered via a message channel. The findings, however, show that schools (source) have prescribed (by government) communications objectives, which they then transform into messages which can be delivered via a prescribed message channel (curriculum). This important perception contributed to the impetus for revising the conceptual framework. My revised a posteriori framework, presented in section 5.8, accordingly incorporates new knowledge which more accurately illustrates communication processes within school-based health promotions.

5.2.3.

Communication between Schools and Parents

In the a priori conceptual framework, the source of communication within school-based health promotions was thought to be schools, primarily communicating health messages to children (receiver). In applying the framework, though, it was found that as well as communicating health promotion messages to children, schools also attempt to communicate with parents regarding health and PE. The objective of such communication is typically to inform parents about current promotions. Teachers may, however, initiate communication with parents in order to not only increase parents‟ awareness of healthy lifestyles but also to influence parents‟ health behaviours.

Additionally, schools may contact parents if they have a particular health concern regarding a child. From the schools‘ perspectives, parents rarely initiate contact unless they are concerned about something. Teachers feel parents are largely initiating communication to complain; there are few instances when parents contact the school simply for the purpose of conveying positive feedback. These findings indicate that communication within school-based health promotions is not limited to the transfer of messages between schools and children. Rather, findings from this investigation highlight that schools and parents also communicate directly with each other for health promotion purposes. This new appreciation was gleaned through applying my a priori framework. Ultimately, the new awareness contributed to the impetus for revising the framework to more accurately represent communication processes within school-based health promotions as they occurred in the six school cases.

5.2.4.

Communication between Parents and Children

Based on the discussion in section 5.2.3 above, we now know that communication within school-based health promotions occurs between schools and children and between schools and parents. Additionally, children are exposed to health communications at home, so communication also occurs between parents and children. The important point to note is that school and home are the two main environments from within which children receive health messages and the extent to which these messages are consistent with each other is unclear. Schools primarily make assumptions about health communication at home based on their interactions with, and observations of, children when they are at school. School staff perceive that health messages children receive from their parents, and from within the home environment, are varied; they range from being either consistent with, or contradictory to those messages which are promoted at school. The extent to which the home or school is the foremost source of health promotion for children is thus also unclear. These findings indicate that the roles teachers and parents perceive they play in health promotion is an important element of communication. The concept of stakeholder roles, based on these insights (among others discussed in this chapter), therefore, forms part of communication Theme B. Theme B focuses on stakeholder roles and relationships in health promotions and is discussed in Chapter Seven (section 7.3, p.140).

As stated, the second component of Theme B is stakeholder relationships, which was also found to be an important aspect of communication. This is because despite the rhetoric of partnerships between schools and families in promoting healthy behaviours to children, schools perceive they often carry the majority of the burden. Schools have little knowledge of what health concepts are discussed and practiced at home. They feel many parents have relinquished their responsibilities to reinforce, or be involved in teaching children positive health behaviours. In this

study, though, the parent survey44 _{showed that as far as some parents are concerned, the school}

reinforces or supports positive practices already in place at home. This indicates that some parents perceive they are actively promoting healthy nutrition and physical activity behaviours, while school staff perceive some parents, for whatever reasons, are achieving this to a lesser degree, or perhaps not at all. Thus, there is a tension of perception with some parents believing they are leading nutrition and physical activity health promotion, while staff often perceive that the school is leading. Ultimately, schools focus their health promotion efforts on children and continue to work towards positive outcomes, regardless of what they perceive home environments might be like. From this discussion we can, therefore, see the significance of relationships (or lack thereof) between teachers and parents in facilitating school-based health promotions. Hence these insights contributed to communication Theme B, Stakeholder Roles and Relationships, which is discussed in Chapter Seven (section 7.3, p.140).

5.3.

Message and Communication Tools

In my a priori conceptual framework of communication processes within school-based health promotions, the intent of the message construct was to represent health messages delivered by schools to children. Based on the discussion in section 5.2.2, we know that the New Zealand Curriculum Framework outlines the requirements of schools for the delivery of health and PE. In the case of health promotion, the curriculum framework serves as both a foundation from which schools can develop messages and also a channel through which those messages can be delivered. Across the schools in this study, a variety of key food, nutrition and physical activity messages are promoted.

Schools aim to teach children about topics such as food groups (e.g. fruit and vegetables, dairy products, breads, cereals and grains etc.), the importance of drinking water, healthful foods and the benefits of consuming different types of foods (e.g. their vitamins or mineral components). Broader healthy eating messages include consumption in moderation, so children learn, for instance, that treat foods can be enjoyed, but not necessarily every day. The impacts of diet and exercise on the body and the body‘s functions are also key messages. Particular emphasis is placed on highlighting the importance of healthy eating and exercise for brain function and learning. PE involves both participating in, and learning about, the benefits of physical activity. Activities enable students to improve their health and fitness, develop motor skills, and learn about the social dimensions of sport, such as sportsmanship, competition and team work.

In addition to identifying what messages are promoted to children by schools, the a priori

framework was also used to explore how messages are delivered. This was achieved by investigating the communication methods used by schools to deliver health promotions, based on the tools used

by marketers outlined in the conceptual framework. Primary types of marketing communications tools include mass media advertising, online advertising, sales promotions, point-of-purchase displays, direct mail, publicity, event sponsorships and personal selling. These types of communication constitute what is traditionally known as the ‗promotion‘ component of the marketing mix (Chitty et al., 2005). The following discussion examines tools used in school-based health promotions, how they are applied, and the degree to which schools perceive these methods to be effective45_.