Warsaw University, Poland University of Bergen, Norway
Leuphana University Lüneburg, Germany National University of Ireland, Galway, Ireland Ludwig Boltzmann Gesellschaft, Austria
State Environmental Health Centre, Ministry of Health, Lithuania
Trigger: In Europe close to one in four school children are overweight, with
numbers rapidly increasing. An integrated approach is required to stop this trend. Across member states there are many initiatives on reducing the prevalence of overweight among school-aged children with a practical focus towards developing activities, programmes and teaching methods. However, currently no EU member state has effective national school policy in operation. HEPS aims to bridge this gap by being a policy development project on a national level across Europe. HEPS introduces the health promoting school approach as a new way of developing school health policy.
Moreover, the HEPS Project is connected with the Schools for Health in Europe (SHE) network. SHE-coordinators will be able to give their input during the HEPS Project and profit from the outcomes. At the same time they are the key figures who will implement the HEPS Schoolkit in their own country.
Targeted Communities: In Europe it is generally accepted that every child has a
right to education, health and security. Schools can contribute to improve children’s health by promoting healthy eating and physical activity and by encouraging their participation and training their skills. A strategy built on the health promoting school approach helps school communities to:
manage health and social issues; enhance student learning; improve school effectiveness
One of the core values for health promoting schools is equity: that all children and young people have equal access to health and to develop health literacy. This is one of the founding principles - that is built into the HEPS Schoolkit. Furthermore, in the health promoting school approach the school plays a central role. The health programmes and activities are carefully chosen to meet the specific needs of the school, which is important to reach the target group in an effective way.
Evaluation: In the 3rd year the impact of the HEPS Schoolkit on national and
regional policy development on promoting healthy eating and physical activity in schools will be assessed.
Contact Details: For more information, please contact:
Goof Buijs
NIGZ, Manager SHE network +31 348 437 615
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2.1.3 Research Studies
The Pro Children Project was designed to provide information on actual consumption levels of vegetables and fruits in European schoolchildren and their parents, to understand the determinants of consumption patterns among the children, and to develop and test effective strategies to promote adequate consumption levels of fruits and vegetables among schoolchildren. The project consists of two phases. In the first phase, relevant information for the planned development and implementation of fruit- and vegetable-promoting interventions is gathered. In the second phase, the planned interventions are developed, implemented and evaluated in group-randomized field studies. The first phase is conducted in 9 participating countries, i.e. in Austria, Belgium, Denmark, Iceland, the Netherlands, Norway, Portugal, Spain and Sweden, while the second phase is restricted to 3 countries, i.e. Spain, the Netherlands and Norway, as efficacy will have to be established prior to broader dissemination.
Aim: The specific research objectives are:
Assessing fruit and vegetable consumption and correlates of consumption levels
To develop valid and reliable instruments for assessing fruit and vegetable consumption among schoolchildren and parents
To develop valid and reliable instruments for identifying factors influencing consumption patterns among schoolchildren
To determine the consumption levels of fruits and vegetables among schoolchildren and their parents in participating countries and in various subgroups (such as gender, socio-economic groups and cultural background)
To determine factors influencing the consumption of fruits and vegetables among schoolchildren in participating countries and in various subgroups (such as gender, socio-economic groups and cultural background)
To determine cross-national differences in fruit and vegetable consumption among children and their parents, as well as determinants of fruit and vegetable consumption among children
To determine the local, regional and national policies and organizational structures (including school meals) related to fruit and vegetable consumption
Design, implementation and evaluation (process, impact and efficacy) of the intervention programme
To design culturally relevant, but theoretically similar intervention programmes to be implemented in 3 participating countries
To determine facilitating and inhibiting factors for implementing the planned interventions
To determine how the various intervention components are perceived by the target groups (i.e. children and parents), as well as by other relevant actors (including teachers, school health personnel, local fruit and vegetable producers and distributors)
To determine to what extent the various intervention components are being implemented as planned
To determine whether the intervention produce the expected increase in fruit and vegetable consumption
To determine whether the intervention is equally effective in producing change across countries and within countries (in different demographic groups such as gender and socio-economic groups)
To determine whether changes in the identified theoretical factors account for the observed changes in fruit and vegetable consumption
To determine the cost-effectiveness of such an intervention programme.
Pro Children Project
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Support: The Pro Children project started April 1, 2002 for duration of 48
months, financed by the European Commission Research Directorate General (Contract no. QLK1-CT-2001-00547)
Ten research organisations from nine European countries were involved: 1. University of Oslo, Norway
2. Unidad de Nutricion Comunitaria, Spain 3. Landspitali University Hospital, Iceland 4. University of Copenhagen, Denmark 5. Universidade do Porto, Portugal 6. University of Vienna, Austria
7. Royal Veterinary and Agricultural University, Denmark 8. Erasmus Medical Centre Rotterdam, Netherlands 9. Karolinska Institutet, Sweden
10. Ghent University, Belgium
Trigger: The project was initiated by Knut-Inge Klepp in collaboration with
Johannes Brug, both based at Universities. There was a scientific basis to start the project. Similar project were available in the USA but not yet in Europe. Moreover, up to date data on consumption levels of fruit and vegetables among schoolchildren was not available. In order to develop an evidence based intervention, there was the need to investigate consumption levels and its determinants.
Targeted Communities: The intervention developed within the whole project
was implemented at primary schools, and was not specifically developed to target children from low SES families. In the Netherlands, however, the intervention was implemented at schools in Rotterdam, one of the major cities and with a high proportion of non-Western immigrant children (about 50%). The school was choosen as the location of intervention because all children can be reached, also those who are normally hard to reach, such as children from low SES families.
Evaluation: The project has already been evaluated and has been published [21]. The programme has proven to be effective, at least at the shorter term, after one year into the intervention (see publication). After two years the intervention was only effective in Norway, where the intervention seems to be best implemented. The intervention was most intensive during the first year, when children were not only provided with free fruit and vegetables but also were involved in class activities such as taste testing and homework assignments. During the first year parents were also involved by means of parent meetings, newsletters and homework assignments.
Additional analyses showed children’s appreciation and parental involvement were important mediators of the intervention [22].
No subgroup analyses have been conducted to see whether children from low SES families improved more or less compared to children from high SES families. Furthermore, no health conditions were measures and it could therefore not be examined whether the intervention improved the health condition of the children.
Contact Details: For more information, please contact:
Knut-Inge Klepp or Mona Bjelland
Department of Nutrition, University of Oslo +47 22 85 13 78
[email protected] [email protected]
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