Dissertations / Theses on the topic 'Sanitation and Hygiene Education (Program)'

In India poor sanitation accounts for 1,600 daily deaths of children under the age of five (Dasra, 2012). The societal and environmental conditions in India and many other developing countries have continuously stood as barriers to facilitating changes in sanitation behavior. Efforts made to improve hygiene have continuously faced opposing forces including major gaps between the supply and demand of sanitation. This paper will focus on one pilot program conducted in Chennai, India over the summer of 2014. This program was designed to teach school children safe sanitation and hygienic habits by providing a guiding tool to teachers. The study analyzed qualitative observational data collected over the seven-week pilot program period to identify the barriers to implementation experienced in this case study. The results indicate that the school administration was the greatest barrier to implementation in this case study. The results also highlight the contextual sensitivity of each of the barriers and their relationships to one another. The findings suggest that depending on the context of implementation of a health, hygiene, and sanitation program these barriers may be re-ordered in hierarchy to work towards achieving sustainable programs.

Background: Estimations from the Joint Monitoring program for Water Supply and Sanitation (JMP, 2012) reveal that “less than five percent of water and sanitation interventions are revisited once they have been completed and less than one percent are monitored over the long term”. Since 2000, the Centers for Disease Control and Prevention(CDC) has been working with the American Red Cross (ARC) to evaluate the long-term sustainability of post-disaster water, sanitation and hygiene interventions (WASH) provided in Guatemala, Honduras, Nicaragua and El Salvador. Sustainability assessments were conducted in 2006, 2009 and most recently in 2012. In the 2012 evaluation, a qualitative approached was included to extent the results obtained from quantitative surveys through an exploration of individual perceptions and current practices. Methodology: Key-informant interviews were conducted with the heads of household in 15 communities purposively selected. All interviews were recorded, transcribed, coded and analyzed using the computer assisted qualitative data analysis software MAXQDA10 Results: Interviewees discussed issues related to the quality, safety and adequacy of the water and sanitation infrastructure and hygiene education sessions received. Issues of corruption in the water committees and delayed repair of damaged infrastructure resulting in erratic service were frequently reported. In addition, lack of financial support, community engagement, and equity were identified by heads of household as major limitations to sustain and improve WASH interventions. Conclusions: This exploration provides valuable information to further examine the factors driving people’s adoption of hygienic practices and maintenance of water and sanitation facilities in the Central American region.

BACKGROUND: Trachoma is a leading cause of avoidable blindness. Currently, trachoma is endemic in 57 countries, infects approximately 84 million people globally, and continues to threaten over 10 % of the world’s population with the risk of blindness. Caused by the bacteria Chlamydia trachomatis, blindness due to trachoma is caused by repeated eye infection resulting in the inflammation of the upper eyelid eventually leading the upper lid to pull inward scratching and tearing the cornea causing it to become opaque resulting in loss of vision. The World Health Organization recommends eliminating trachoma as a public health problem using the SAFE strategy: Surgery, Antibiotic, Face washing and Environmental control. OBJECTIVES: This review examined the benefits of the added value of water, sanitation, and hygiene education interventions on preventive mass drug administration for trachoma. METHODS: Trials were identified from MEDLINE, PubMed, and LISTA EBSCO databases using a series of search terms. No restrictions were put on study date, location, design, or language of publication. The abstracts were examined from each of the searches, and any abstract describing risk factors, survey results of mass drug administration (MDA), or providing a general overview of trachoma were automatically discarded. Full text of papers including the combined use of key words including SAFE, WASH, intervention, impact, added value, MDA, azithromycin/ Zithromax® were obtained for review. Twelve full texts articles were retrieved all relevant information were placed in a standardized data extraction form. MAIN RESULTS: Three studies met the complete criteria for inclusion. All studies found a significant change in reduction of active trachoma prevalence. One study focused on the added benefit of antibiotic and environmental components on hygiene education delivered by radio. Another trial compared two villages; the control community performed MDA and the surgery while the intervention village added the F and E components. The final study as well focused the added benefit of ‘F’ and ‘E’ on ‘A’. Two of the three studies found this reduction was from the added benefit of face washing ‘F’ and environmental control ‘E’ to antibiotic use. CONCLUSIONS: In order to eliminate blinding trachoma as a public health problem, recurrence of the active form of the disease must be interrupted before repeated scarring leads to trichiasis. The antibiotic component of the SAFE strategy is a quick fix to the immediate problem. The ‘F’ and ‘E’ components are the more sustainable interventions, yet little research has been done on the actual amount of added value the individual ‘A’‘F’&’E’ components have to one another. After thorough review of the articles, articles were found which documented the ‘F’ and ‘E’ components provide significant value to the overall decrease of prevalence of active. However, the limited results of the search suggest more research can better elucidate the ability of the ‘F’ and ‘E’ components to reduce trachoma prevalence and ultimately impact blinding.

Background: In 2010, a massive earthquake left the capitol Port-au-Prince in ruins and destroyed infrastructure providing electricity, piped clean water, and waste removal to the region. Water, sanitation, and hygiene intervention programs attempt to reduce the burden of water-related disease in earthquake-affected regions. However, there are few evaluations of these programs, especially following natural disasters. Methods: Data provided by Samaritan’s Purse Canada’s WASH program were examined. The data set included a household (N=1198) and a latrine (N=167) survey that recorded household use of laundry pads, bath houses, hand-pumped drilled wells, health and hygiene education sessions, and latrines as well as demographic data. Data analysis was conducted in IBM SPSS Version 20.0. Descriptive statistics were computed, and statistical relationships were analyzed for 1.) Health and hygiene education session attendance and program outcomes and 2.) Household diarrheal disease and program interventions Results:This study found that households attending any of four health and hygiene sessions were significantly more likely to use program-provided bath houses and hand-pumped wells (p Discussion: This study concluded that health and hygiene session attendance is positively associated with the utilization of program interventions. However, further improvements in data collection methodology are needed to fully understand the effects of this multi-intervention WASH program on target communities.

Background: In 2010, a massive earthquake left the capitol Port-au-Prince in ruins and destroyed infrastructure providing electricity, piped clean water, and waste removal to the region. Water, sanitation, and hygiene intervention programs attempt to reduce the burden of water-related disease in earthquake-affected regions. However, there are few evaluations of these programs, especially following natural disasters. Methods: Data provided by Samaritan’s Purse Canada’s WASH program were examined. The data set included a household (N=1198) and a latrine (N=167) survey that recorded household use of laundry pads, bath houses, hand-pumped drilled wells, health and hygiene education sessions, and latrines as well as demographic data. Data analysis was conducted in IBM SPSS Version 20.0. Descriptive statistics were computed, and statistical relationships were analyzed for 1.) Health and hygiene education session attendance and program outcomes and 2.) Household diarrheal disease and program interventions Results: This study found that households attending any of four health and hygiene sessions were significantly more likely to use program-provided bath houses and hand-pumped wells (p<0.05). Attendance was also significantly associated with increased knowledge of diarrheal disease prevention and hand washing technique. Households using the program-provided hand pump reported lower rates of diarrhea in children under five years old. Discussion: This study concluded that health and hygiene session attendance is positively associated with the utilization of program interventions. However, further improvements in data collection methodology are needed to fully understand the effects of this multi-intervention WASH program on target communities.

This thesis describes research designed to quantify and describe the impact of improved access to school water, sanitation, and hygiene (WASH) access on pupils' helminth infection and diarrhoeal disease and absence from school. The research was undertaken as part of a five-year cluster-randomized trial in 185 public primary schools in Nyanza Province, Kenya that addressed school WASH impacts, knowledge diffusion, sustainability, and advocacy. One hundred eighty-five schools were randomly selected and assigned to five study arms to receive various water treatment, hygiene promotion, sanitation, and water supply improvements. All pupils at enrolled schools were dewormed at baseline and at two follow-up time pOints. A total of 11,458 pupils were interviewed over two years to compare rates of school absence, rates and intensity of reinfection with soil transmitted helminths, and risk of diarrhoeal disease. We found no overall impact of our school-based WASH intervention on pupil absence. However, a domain analysis revealed a substantial and significant reduction in absence for girls attending schools that received WASH improvements. Schools that received a hygiene promotion and water treatment (HP&WT) intervention showed statistically similar reductions to those that received HP&WT in addition to sanitation improvements. Gender-specific effects were also found for reduced reinfection of soiltransmitted helminth infection. Girls showed a significant decline in prevalence and intensity of infection with Ascaris lumbricoides, while boys showed reduced reinfection for Hookworm. Household WASH characteristics significantly modified the effect of the school-based intervention, revealing potential questions about exposure to fecal pathogens at home and at school. Schools that received HP&WT and those that received HP&WT plus sanitation improvements showed no reduction in diarrhoeal disease prevalence. However, schools allocated to the water "scarce" research group, which received water supply improvements in addition to HP&WT and sanitation, did show significant and substantial reductions in both prevalence and duration of diarrhoeal illness. While household-level WASH has been investigated extensively, this is the first comprehensive study to investigate the impact of improved WASH at schools. Overall, our results reveal the important role that school WASH can play in mitigating disease burden and lowering pupil absence. Additional research is necessary to fully explore these issues.

Educating girls is advantageous for future livelihood security and socio economic development. Menstruating schoolgirls especially need to experience improved menstrual hygiene management (MHM) within schools in order to obtain quality education towards securing future as well as present wellbeing. This paper explores how menstruating schoolgirls’ opportunities are affected by insufficient water, sanitation and hygiene (WASH) facilities in schools within Sub-Saharan Africa. The required information has been gathered through a qualitative research method using scientifically based material on the situation of MHM in Sub-Saharan African schools as well as semi-structured questionnaires alongside my personal recollection of MHM. Focus has been given to the capabilities of menstruating schoolgirls under existing WASH facilities in schools analysed through the Capability Approach. Effects of poor MHM in schools are known to cause discomfort and poor constructive participation during lessons as well as decreased school attendance. A gender-based approach has also been examined which presents most schools as non-conducive towards girl’s education promotion.
Utbildning är gynnsam för deras framtida försörjningsmöjligheter samt för socioekonomisk utveckling. Menstruerande skolflickor är mest utsatta under de otillräckliga sanitetsförhållanden som råder i flera skolor söder om Sahara. Den här rapporten utforskar skolflickors förmåga att sköta deras menshygien under skolvistelsen samt hur bristande sanitetsresurser påverkar flickornas framtida utsikter och akademiska kapacitet. Undersökningen är baserad på en kombination av kvalitativa metoder och material som vetenskapliga studier, en semistrukturerade enkätundersökning samt min egen erfarenhet av menshygien i skolor söder om Sahara. Fokus har tillägnats menstruerande skolflickors möjligheter att hantera deras mens i ohygieniska förhållanden genom att koppla detta till ”The Capability Approach”. Avsaknaden av fungerande sanitetsstrukturer försämrar skolflickors välmående vilket leder till nedsatt deltagande under lektioner samt minskad skolgång vid mens. En könsbaserad utgångspunkt har det också påvisat att skolorna är mindre anpassande för flickor.

The following is a study to determine if sufficient demand exists to start a Bachelor of Science and Master of Science degree program in dental hygiene through a joint agreement for completion degrees between Valencia Community College and the University of Central Florida. To accomplish this objective two survey instruments were administered to randomly selected licensed dentists and dental hygienists in the state of Florida. Dental hygienists represented the potential student base for the proposed programs, and dentists represented the potential and prospective employers of graduated students of the proposed programs. To determine demand and demand characteristics, one survey instrument was mailed to 1,000 dental hygienists who were randomly selected using SAS software from a population of N=12,066 dental hygienists actively licensed to practice in the state of Florida. This sample of hygienists was approximately 8.3% of the total population. Of the 1,000 samples, 134 (or 13.4%) were returned. Of the 134 surveys returned, 123 (n=123) were included in this study. Eleven surveys were not included because of a majority of missing data or because the respondent indicated he or she already possessed a Bachelor or Master degree. A Likert-scale questionnaire was sent to each group of actively licensed dentists and actively licensed dental hygienists from the state of Florida. Responses from dental hygienists were overwhelmingly positive towards the addition of the Bachelor of Science degree program with an online distance-learning component. Those in favor of the Bachelor of Science degree program also provided a favorable response towards adding a Master of Science degree program in dental hygiene. The dentists, as potential future employers, also showed strong support in their responses for the additional degree programs with an additional management track component and believed it would elevate the professional standards of the dental hygiene field.
Ph.D.
Department of Health Professions
Health and Public Affairs
Public Affairs PhD

Maintenance of appropriate posture is essential for the prevention of various musculoskeletal disorders. Postural stress is a common issue in elementary school children. The literature review indicated that schoolteachers have inadequate and improper postural knowledge. Based on such concepts, elementary schoolteachers in this present study implemented a postural awareness education program designed by the American Posture Institute. The present study indicated that postural awareness amongst schoolteachers was significantly low before the start of the program and was significantly increased after implementing the program (p < 0.01). Moreover, the program results seemed to match the expectations of the posture awareness program. However, the analysis also indicated that teachers failed to achieve requisite postural knowledge on all postural concepts (p < 0.01). Hence, the study necessitated the need for improving the postural awareness program (which was designed and developed by API). The study participants failed to develop a holistic knowledge on postural concepts and could not correlate different postural concepts with one another (p > 0.05). The study necessitated the need for sensitizing schoolteachers on different aspects of physiology and anatomy before implementing a postural education program.

In order for a student to be successful in dental hygiene education, the student must gain the required knowledge and skills necessary to perform as a hygienist and possess the ability to utilize critical thinking to apply these attributes while in the program and on the National Board of Dental Hygiene Examination (NBDHE) (Alzahrani, Thompson, & Bauman, 2007; Fried, Maxey, Battani, Gurenlian, Byrd, & Brunick, 2017). Dental hygiene students who attend a medical university have the option to take required pre-requisite courses at a community college or a four-year university. All dental hygiene students transfer from another institution and all have the potential to exhibit transfer shock, which may contribute to a drop in GPA following the transfer to another institution. Transfer shock typically occurs for students who transfer from a community college to a university (Hills 1965; Ivins, Copenhaver, & Koclanes, 2016). This study investigates the impact of transfer shock on students who transfer into a dental hygiene program from a two-year community college as opposed to a four-year university. This study examined whether the type of institution, two-year community college versus a four-year university, attended prior to dental hygiene school is a predictor of success in a dental hygiene program in terms of ending program GPA and NBDHE first-attempt pass rates. After data analysis, results suggested that transfer shock did occur with both community college and four-year university students,. However, the four-year university group experienced less transfer shock than those who attended a community college during the first semester. Neither group increased their GPAs from the first to second semesters in the program. When comparing the entering GPAs with the end of program GPAs, both groups showed a significant drop. However, the community college group’s decrease in GPA was greater. Only five students in the total population (two from the four-year university group and three from the community college group) failed the NBDHE on the first attempt. Students who were unsuccessful in passing the NBDHE had final program GPAs that ranged from 2.2 to 2.45.

Quality assurance in healthcare is fundamental in ensuring the achievement of desired outcomes for patients. In 2011 a quality assurance plan was created at the East Tennessee State University (ETSU) dental hygiene program in order to meet accreditation standards. The purpose of this study was to evaluate this plan in order to determine its effectiveness in improving the quality of patient care indicators. One hundred fifty patient charts were selected and audited. Deficiencies were counted in the categories of assessment, treatment, documentation, referral, caries management, perio management, patient education, and follow-up. Research findings were varied; however, external variables with the potential to affect the study’s results were identified. Furthermore, statistical process control procedures indicated that the quality assurance program was effective or had the potential to be effective. Although further research is warranted, this study could be used to improve quality assurance practices at the ETSU dental hygiene program.

Maintaining appropriate glucose levels is important to patients with diabetes because it helps to improve patients' quality of life and prevents medical complications. This study was designed to determine if there was a statistically significant difference in blood glucose levels between a treatment group that completed a certified diabetes education program with telephonic follow-up by a diabetes educator and a comparison group that also received the certified diabetes education program but without telephonic follow-up. A pretest/posttest control group design was used which randomly assigned subjects to groups by clusters. From the analysis of data it was determined that there was no statistical difference in blood glucose levels between the treatment and the comparison groups. Therefore, weekly telephonic follow-up did not statistically impact blood glucose levels in the treatment group. However, the results did indicate that the telephonic follow-up may have impacted the proportion of patients who returned for post blood glucose testing and sought treatment for other related health concerns.
Department of Physiology and Health Science

This study was concerned with the impact of telephone and letter follow-up on the glycosylated hemoglobin (HbAlc) levels and quality of life of adult patients who completed the recognized diabetes education program at Ball Memorial Hospital's Diabetes Care Center between March 2002 and October 2002. The study was a quasi-experimental design, randomly assigning subjects by clusters to one of three treatment groups: telephone follow-up only, letter follow-up only, or telephone and letter follow-up. All follow-up attempts were made by certified diabetes educators employed by Ball Memorial Hospital for twelve weeks following the completion of the program. Reviewing patient records prior to and twelve weeks following the completion of the recognized diabetes education program determined HbAlc levels. Quality of life was measured, using a pre-existing instrument, prior to and twelve weeks after the completion of the program. A two-way design analysis of variance for repeated measures was used to determine if pretest/posttest differences in HbA 1 c and quality of life were different among treatment groups. There was a lack of statistical significance in mean HbAlc levels and quality of life values from pretest to posttest among subjects of the three treatment groups. However, a test of within-groups effects showed a statistically significant difference in the pretest and posttest quality of life values and HbAlc levels for all subjects included in the study.
Department of Physiology and Health Science

Thesis (M.S.)--West Virginia University, 2002.
Title from document title page. Document formatted into pages; contains ix, 92 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 45-46).

The initial development of a social services program in a college health setting is presented, with discussion regarding causes, methods, and outcomes. Both empirical and anecdotal data which were influential in the initial formation of the program are reviewed, in the context of an examination of the research literature relating to this area. The actual development and implementation of the program is followed through its first year of existence. Outcomes are presented in the form of qualitative data analysis and case studies. Discussion of the results and recommendations for both future research and improvements to the program are presented.

This thesis is about a behavioural medicine approach in periodontal treatment and oral hygiene self-care. The aim of this thesis was to develop, describe, and evaluate an individually tailored oral health educational program on oral hygiene behaviour and non-surgical periodontal treatment success, and to determine factors of importance for predicting oral hygiene behaviour. Two separate studies, both conducted at a specialist clinic for periodontics in a Swedish county council are described. In the first study, the program was developed and described in two experimental single-case studies with multiple baseline designs (Paper I). The second study was a randomised controlled single-blinded trial [n = 113, mean age 51.2, 53% female] in which, the effectiveness of the program was compared with standard treatment on oral hygiene habits, plaque control, and gingivitis (Paper II), periodontal status (Paper III), and attitudes, subjective norms, and self-efficacy (Paper IV). The tailored oral health educational program included a motivational interviewing method and cognitive behavioural techniques, and the individual tailoring for each participant was based on participants’ thoughts and cognitions, intermediate and long-term goals, and oral health status. Participants in the individually tailored program reported higher frequency of daily interdental cleaning and were more confident about maintaining the attained level of behaviour change, had better oral hygiene, and healthier gingival tissue, particularly interproximally. There was a great reduction in periodontal pocket depth and bleeding on probing scores (BoP) for participants in both programs with a greater reduction in BoP scores in the tailored-treatment group. A lower dental plaque score at treatment start increased the predicted probability of attaining treatment success, and self-efficacy towards interdental cleaning predicted oral hygiene behaviour. These studies demonstrate an individually tailored oral health education program is preferable to standard program as an oral hygiene behaviour change interventions in non-surgical periodontal treatment.
Behavioural medicine perspectives for change and prediction of oral hygiene behaviour

The purpose of this study was to evaluate the effect of a school-based fluoride mouthrinse program in a fluoridated community. Such an evaluation is important because the effect of such programs may decrease over time due to the widespread use of fluoride. Two elementary schools were chosen. One had a fluoride mouthrinse program: the other did not. The subjects were children in grades one and six. Their caries experience was examined using dft. dfs. DFT, and DFS scores. There were no statistically significant differences between the two schools. The program had no significant effect in the community studied.

It is often difficult to optimize strength qualities in-season due to the conflicting influences of extensive skill practices combined with frequent game play of the competition schedule. The purpose of this study was to investigate the effects of two interventions on strength qualities and CMJ performance. Thirteen women volleyball players competing in NCAA Division I were tested before and after four weeks of an inseason strength training program with emphasis on heavy squatting (6-IORM), and then before and after three weeks of unloaded jump training. Dynamic squat strength, isometric squat strength, optimal power, CMJ, SJ and approach jump and reach were all tested before and after both cycles. There was a significant increase in both average 1RM squat strength (5%) and vertical jump (1%) following the strength cycle. Following the unloaded training, there was a significant increase in both peak power output (18%) and peak velocity (14%) in the CMJ. SJ performance significantly increased in both peak force (6%) and maximum height (10%). Throughout training, there were no decreases in maximal strength levels or post-test Vertec jump and reach. This study indicates that heavy squatting can improve vertical jump as well as 1RM squat despite a high volume in-season practice and competition schedule. Furthermore, unloaded training can improve the explosive qualities of athletes when used as a peaking cycle late in-season. Athletes maintained dynamic strength and jumping ability from pre-testing scores, while significantly increasing both peak velocity and power in the CMJ.
School of Physical Education

The purpose of this project was to design a series of self-directed learning modules for enrollees in the Women, Infants, and Children (WIC) program in Riverside County, California. The WIC Program is a supplemental nutrition program that, among other things, provides participants with nutrition education to help them understand the health benefits of choosing more nutritious food. This project features information concerning the problem of food insecurity, the nutrition education of low-income women and children in the WIC program, and the characteristics of adult learners. The objective was to examine the WIC participants' comprehension and willingness to use self-directed learning modules as a nutrition education supplement.

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data to evaluate the racial differences in the mean change in CVD biomarkers between 163 AAs and 228 Caucasians civilian workers participating in a U.S. Marine Corp self-directed WWP. The 4 CVD biomarkers evaluated were systolic blood pressure (SBP), diastolic blood pressure (DBP), and waist-to-hip ratio. Repeated measures MANCOVA analysis was used to establish the contribution of the independent variable (race) to SBP, DBP, LDL cholesterol, and waist-to-hip ratio. Results showed an overall significant main effect of time for changes in SBP and DBP even after controlling for race, sex, age, and days from baseline. However, there was no overall main effect of time for changes in LDL cholesterol or waist-to-hip ratio. Further research using randomization, a comprehensive health risk appraisal, and a larger sample size may yield additional benefits to AAs. Implications for positive social change include reduction of the extraordinarily high CVD disease burden and disparity among AAs.

This study was done with the objective of designing and applying a nutrition education program based on a test of improved practices for pregnant women and women of childbearing age in the rural communities of Ibarra canton: La Riconada and Cuambo. For this, information was collected on knowledge, attitudes, and practices (KAP) regarding the eating habits of pregnant women. These results were used to identify content and recommendations to reinforce and/or instruct about eating during pregnancy. Nutrition education was based on the methodology of the improved practices test, which consisted of testing the recommendations in families' homes before recommending them and recording information on their acceptability. The results indicate that pregnant women in the two communities don't eat all the food groups every day. They need to increase the consumption of foods rich in calcium and iron, as well as foods that supply energy, protein, and fats. The pregnant women don't eat additional foods to cover these recommendations during the pregnancy. Despite the knowledge they have and the lessons they received, there are women who don't eat greens, vegetables, and fruits because they don't like them, and those who do eat them don't meet the established nutritional recommendations. The women prefer to eat artificial drinks with unboiled water, and they do not look after personal hygiene. The test of improved practices has been useful for observing if they really put in practice the knowledge about eating during pregnancy, and at the same time it helped design the educational proposal that served as a guide to help improve eating practices of pregnant women in the two rural communities, considering their motivations and recommendations.

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Este trabalho buscou avaliar a contribuição do Projeto de Educação Ambiental (PEA) do Programa Bahia Azul na construção de conhecimentos e no desenvolvimento de valores e atitudes relativos ao meio ambiente e saneamento junto aos agentes multiplicadores, bem como caracterizar o processo de monitoramento e avaliação do projeto junto aos gestores e especialistas envolvidos na sua execução, fornecendo subsídios para a definição de indicadores de acompanhamento e avaliação de projetos desta natureza. A coleta de dados foi realizada por método qualitativo, envolvendo a aplicação de formulário junto aos agentes multiplicadores da comunidade da Bacia do Alto Pituaçu e questionários junto aos gestores e especialistas. A análise dos dados obtidos possibilitou constatar que as ações educativas do PEA proporcionaram a construção de conhecimento sobre meio ambiente, saúde e saneamento, os quais por sua vez, resultaram no desenvolvimento de atitudes e valores, que se expressam através do envolvimento da comunidade na melhoria e manutenção da qualidade ambiental. A mudança de comportamento da comunidade resgata a importância da ação educativa dos agentes multiplicadores, contudo, a falta de acompanhamento por parte do órgão executor, tem restringido a sua atuação na comunidade, o que poderá se refletir negativamente na manutenção do sistema de esgotamento sanitário. A metodologia de avaliação do PEA privilegiou uma abordagem predominantemente quantitativa, baseada na verificação do cumprimento das metas do projeto, inconsistente com os objetivos das ações educativas implementadas. Os gestores e especialistas reconhecem a importância da avaliação e da necessidade de definir e mensurar indicadores que possibilitem a obtenção de dados relativos ao grau de informação das comunidades sobre meio ambiente e saneamento e de participação na conservação dos equipamentos implantados. A carência de monitoramento e avaliação do PEA impossibilita a contínua alimentação de dados e a respectiva análise, inviabilizando a utilização dos resultados obtidos como parâmetros para planejamento e implementação de um próximo programa.
Salvador

Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or chlorination' were provided to all 14,400 families and 42 schools in Lower Nyakach, Kenya. From February to May, 2015, adjacent districts had serious cholera outbreaks, but in Lower Nyakach, where education and the use of chlorine were nearly universal, there were no cases of cholera and steadily decreasing rates of diarrhea. A cross-sectional study was conducted to verify self-reported water treatment practices with evidence-based microbiological testing. A random sample of 377 households revealed that 95% treat their water each and every time they collect. Microbiological verification found 96% of household safe water storage vessels were low risk compared to their very high risk source water. A strong association (p < 0.001) existed between the observed decrease in diarrhea trends from health facilities in Lower Nyakach and exposure to the novel training. The strategy used by FOTO could be replicated to empower communities worldwide to identify contaminated drinking water sources and to reduce the incidence of waterborne disease.

Parents provide a social learning environment where family nutrition, eating habits and physical activity are largely influenced by and correlated with parental modeling of these behaviors. Increasing self-efficacy is an important component in parents being role models because theoretically, it promotes cognitive change that supports their confidence and ability to modify behaviors that contributes to healthier family practices and biometric outcomes. Phase one of this sequential two-phase study used biometric data (body mass index [BMI], cholesterol, glucose, and blood pressure) from parents (N = 37) participating in their employer’s family wellness initiative as dependent variables. Parental perceptions of nutrition, eating habits, and physical activity related to self-efficacy and role modeling collected via a survey questionnaire served as the independent variables. Correlation analysis indicated significant associations between BMI and nutrition self-efficacy, eating habits self-efficacy and eating habits role modeling. Linear regression analysis showed that nutrition self-efficacy and eating habits role modeling were significant predictors of BMI. A repeated measures t test revealed statistically, attending the family health and weight management program may help participants reduce their BMI, cholesterol, and diastolic blood pressure readings. Phase two used multiple cases (parents, n = 12) that were selected for interviews using purposeful sampling based on their scores reflecting high and low ranges on the self-efficacy and role modeling subscales from the surveys. Each interview was transcribed, coded using the constant comparative method, and individually analyzed for themes. Cross-case synthesis was used to analyze all the cases for commonality and variations. As a result of the findings, participants may be inclined to continue participating in wellness programs because the employer provides opportunities to assist families in their efforts to build confidence and demonstrate role modeling behaviors. The correlations and predictive results in phase one may help substantiate the benefits of participating in the program. Findings from phase two indicated parents acknowledged their role as leaders in creating environments that assist their families in establishing healthy behaviors and voluntarily engaged in this program because it provided assistance and projected them in the right direction for their family to be successful with health and weight management concerns.

[Truncated abstract] Indigenous Australians suffer cardiovascular disease (CVD) at a rate six times greater than the general population in Australia and while the incidence of CVD has been reduced dramatically amongst the majority of non-indigenous Australians and amongst Indigenous populations in other countries in the last 30 years, there has been little change in the figures for Aboriginal Australians, showing that heart health campaigns have little impact, for this group of people. Aims : The principal aims of this study were firstly, to determine and record the barriers to the development and delivery of CVD prevention programs amongst Indigenous Australians and secondly, to develop an alternative, effective and culturally sensitive method of delivering heart health messages. Methods and results : The study was qualitative research undertaken in three South-West towns of Western Australia where the incidence of CVD was high amongst the Aboriginal community members. The use of semi-formal interviews, informal individual consultation, observation, and focus groups were methods implemented to obtain information. The first phase of the research was to identify the barriers which affected the Aboriginal Health Workers’ ability to deliver specialist educational programs. Questionnaires and interviews with the Aboriginal Health Workers and other health professionals in the towns, and community focus groups were undertaken in this phase of the study. The second phase of the research was aimed at developing an alternative strategy for delivering heart health messages. The focus changed to adopt more traditional ways of passing on information in Indigenous communities. The idea of small gatherings of friends or family with a trusted community member presenting the health message was developed. The third phase of the research was to implement this new approach. Lay educators who had been identified within focus groups and by Aboriginal Health Workers were trained in each of the towns and a protocol involving discussions of health issues, viewing a video on CVD, produced by the National Heart Foundation, sharing in a ‘heart healthy’ lunch and partaking in a ‘heart health’ knowledge game which was developed specifically for the gatherings. Several of these gatherings were held in each of the towns and they became known as ‘HeartAware parties’.

Access to safe water and improved sanitation remains threatened by the ever increasing demand in urbanised cities of the world. Adequate management of this problem could not be achieved through technical and regulatory methods alone. A human values-based education approach, namely the Human Values Water, Sanitation and Hygiene Education (HVWSHE) programme, was considered a suitable intervention strategy to bring about the desired changes in attitude and behaviour by the water users. This research involves an empirical case study approach that explores the experiences of Laotian teachers as adult learners of the HVWSHE intervention as well as a literature study on adult education, adult learning facilitation, human values-based education and teacher beliefs. Focus group meetings, lesson observations, participant observation, field notes and a researcher journal was used to collect data. This study revealed that the HVWSHE training programme had a positive effect on the adult learners’ attitude and behaviour towards a better water-use and sanitation-friendly ethic.
Educational Studies
M. Ed. (Adult Education)

The purpose of this study was to develop and evaluate a nutrition education program for men on healthy eating when dining out. The Health Belief Model provided the basic framework to identify factors that would potentially motivate men over 40 to change their dietary behavior to reduce heart disease risk. Roundtable discussions were held to identify nutrition needs. A 10 minute "Dine Right with MENu Insight" slide program on low-fat eating away from home was developed. Three educational messages were the key concepts of the program: 1) relationship between diet and health, 2) proportionality, variety and moderation as themes of the Food Guide Pyramid and 3) low-fat food choices at home and away. A four page handout was developed to supplement the slide show presentation. Four programs were presented to a total of 148 people (136 males, 12 females) at Rotary and Kiwanis groups in Corvallis and Albany, Oregon in January and February, 1994. Each program included a pretest, the "Dine Right with MENu Insight" slide presentation and a group discussion. Of the 136 males, forty-eight volunteered (aged 40-60 years) and completed the 10-15 minute follow-up phone post-test 3-4 weeks after attending the program. Pre-test responses showed limited knowledge of the Food Guide Pyramid, with 65% of the men incorrectly selecting the vegetable group as the base of the Pyramid. Knowledge of low-fat menu choices was high with an average score of 4.7+1.1 (out of a possible 5 points) and a range of 0-5 prior to the education program. An attitude score measuring awareness of healthy dietary practices underlying the Pyramid (eg, variety, proportionality and moderation) had a mean of 5.3+1.7 (out of a possible 15) with a range of 3-8. These pre-test data suggested that participants were aware of the relationship between diet and health. In the post-test, 98% of the men correctly selected the bread group as the Food Guide Pyramid food group that should be eaten in the largest amount. This was a significant increase (p<.001) from pre-test scores. Half of the men had heard of the Pyramid prior to the program. A reassessment of healthy dietary practices awareness showed a significant increase in positive attitudes (p [less than or equal to] .001) with a mean of 3.6+.93 (out of a possible 15 points) and a range of 5-7. Seventy-three percent of the men reported that their diet could be "somewhat healthier". In the past year, 69% reported increasing their consumption of foods (eg, vegetables, grains) to reduce heart disease; 79% reported decreased consumption (eg, red meat). Seventy-five percent reported that they "sometimes" try to select lower fat foods when eating out. Personal preference (65%), menu selection (80%) and the restaurant (27%) influenced lower fat food selection decisions. Many participants indicated awareness of the relationship between proper food selection and optimal health before the program. However, awareness did increase as a result of the program. There was a significant positive (p [less than or equal to] .005) change in attitudes toward the importance of watching fat in the diet in order to stay healthy between pre and posttests. In addition, a positive (r=.36, p [less than or equal to] .05) correlation was reported between knowing that the amount of dietary fat affects the chance of heart disease and watching fat in the diet in order to stay healthy. These data suggest that the Dine Right program conveyed a tie between diet and optimum health. Significant changes in participants' knowledge about the Food Guide Pyramid and underlying concepts also suggest that the program had an impact on participants. These data suggest that knowledge of nutritious food choices at home and away from home increased or was reinforced by the program. The majority (79%) of men learned "some new things" from the program. As a result of the program, 65% planned on making changes in their diets when eating out (eg, by increasing grains, fruits, vegetables). Thirty-five percent planned to make changes at home. Eighty-three percent reported showing the Dine Right handout to someone else and 85% talked about the program with their spouse, family member, coworker or friend. The results of this research indicate that men respond to nutrition education programs. Therefore nutrition and health campaigns to reach the American male are merited. Men's health and nutrition programs such as "Dine Right with MENu Insight" could be followed by additional education programs utilizing a theoretical framework. Future research should test each of the components of the Health Belief Model on men's dietary behavior. Also extensions to other samples of men (such as those with lower educational levels) is warranted in order to better understand how to target nutrition education programs to this important audience.
Graduation date: 1995

This study compared the effect of two sources of instruction and verbal encouragement on the participation of individuals with mental retardation (MR) in a 10-week physical activity program. Participants were 17 adult employees of a sheltered workshop (5 females, 12 males) ranging in age from 30 to 65 years. The program was offered at work 3 days per week and involved aerobic dance activities. Group engagement in moderate to vigorous intensity physical activity (MVPA) was systematically observed and was compared using a reversal design. Condition A involved an exercise leader plus an exercise video to deliver instructional cues and verbal promotion of participation. Condition B used an exercise video as the only source of instruction and verbal promotion. The exercise videos were designed specifically for the participant group to address the low fitness levels and limited ability to make activity transitions. Data indicated that, on average, a higher percentage of the group was engaged in MVPA when the leader-plus-video condition (A) was applied. However, the difference was not practically meaningful when the administrative ease and cost-effectiveness of videos are considered. Further, a considerable overlap of data points in the graphical analyses indicated that withdrawing the leader did not control exercise behavior. Program attendance was variable but remained high over the course of the study. Group engagement levels were higher during the sessions with fewer participants, which suggested that a small group of highly compliant participants were more consistently on-task. Work performance was not negatively impacted when employees took time out of their workday to participate in physical activity. It is of importance that several participants continued to participate in the exercise program over the 4-week maintenance phase. This study provided a convenient, inexpensive method for adults with MR to independently participate in physical activity.
Graduation date: 1999

Thesis (Ph. D.)--University of Delaware, 1997.
Principal faculty adviser: James A. Whitson, Dept. of Educational Development. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Cheung Yuk Lin Porky.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (leaves 236-248).
Abstracts in English and Chinese; appendices also in Chinese.
Acknowledgements --- p.i
Abstract --- p.ii
論文摘要 --- p.iv
Table of Contents --- p.vi
List of Figures --- p.xii
List of Tables --- p.xiii
List of Abbreviations --- p.xix
Presentations --- p.xx
Chapter CHAPTER 1: --- INTRODUCTION --- p.1
Chapter 1.1 --- Overview on Childhood Obesity --- p.1
Chapter 1.1.1 --- Worldwide Situation --- p.1
Chapter 1.1.2 --- Hong Kong Situation --- p.3
Chapter 1.2 --- Consequences of Childhood Obesity --- p.4
Chapter 1.2.1 --- Physiological Problems --- p.4
Chapter 1.2.2 --- Psychosocial Problems --- p.6
Chapter 1.2.3 --- Economic Problems --- p.6
Chapter 1.3 --- Possible Causes and Associated Factors of Childhood Obesity --- p.7
Chapter 1.3.1 --- Genetics --- p.7
Chapter 1.3.2 --- Lifestyle Patterns --- p.8
Chapter 1.3.2.1 --- Physical Activity --- p.8
Chapter 1.3.2.2 --- Dietary Factors --- p.8
Chapter 1.3.3 --- Environmental Influence --- p.10
Chapter 1.3.3.1 --- Parental Influence and Home Environment --- p.10
Chapter 1.3.3.2 --- Other External Environmental Factors --- p.10
Chapter 1.4 --- Prevention and Treatment of Childhood Obesity --- p.12
Chapter 1.4.1 --- Clinical Trials --- p.12
Chapter 1.4.2 --- Family Based Interventions --- p.13
Chapter 1.4.3. --- School Based Interventions --- p.14
Chapter 1.4.4 --- Other Possible Measures --- p.17
Chapter 1.5 --- Local Intervention Implementation --- p.17
Chapter 1.6 --- "Study Rationale, Design，Aims and Objectives" --- p.18
Chapter 1.6.1 --- Study Rationale --- p.18
Chapter 1.6.2 --- Study Design --- p.19
Chapter 1.6.3 --- Study Aims and Objectives --- p.21
Chapter 1.7 --- Conceptual Framework and Hypothesis --- p.21
Chapter 1.7.1 --- Conceptual Framework --- p.22
Chapter 1.7.2 --- Hypothesis --- p.23
Chapter CHAPTER 2: --- METHODOLOGY --- p.23
Chapter 2.1 --- Sample --- p.23
Chapter 2.1.1 --- School Recruitment --- p.23
Chapter 2.1.2 --- Subject Recruitment --- p.23
Chapter 2.2 --- Parental Consent --- p.24
Chapter 2.3 --- Focus Groups --- p.24
Chapter 2.4 --- Assessment Tools --- p.25
Chapter 2.4.1 --- Weight and Height measures --- p.25
Chapter 2.4.2 --- Physical Fitness Tests --- p.25
Chapter 2.4.3 --- Student Questionnaire --- p.26
Chapter 2.4.4 --- Parental Questionnaire --- p.27
Chapter 2.4.5 --- Questionnaires Pre-testing --- p.27
Chapter 2.5 --- Intervention --- p.28
Chapter 2.5.1 --- Intervention A: Mighty Heart Health Promotion Program --- p.28
Chapter 2.5.1.1 --- Materials --- p.28
Chapter 2.5.1.2 --- Procedures --- p.30
Chapter 2.5.2 --- Intervention B: Health Club --- p.31
Chapter 2.5.2.1 --- Materials --- p.31
Chapter 2.5.2.2 --- Procedures --- p.32
Chapter 2.6 --- Evaluation --- p.35
Chapter 2.6.1 --- Qualitative Evaluation --- p.35
Chapter 2.6.2 --- Quantitative Evaluation --- p.35
Chapter 2.7 --- Data Manasement --- p.36
Chapter 2.8 --- Statistics --- p.37
Chapter 2.8.1 --- Health Knowledge and Food Preferences Scores of Students --- p.37
Chapter 2.8.2 --- "Health Knowledge, Dietary Habits and Home Food Availability Scores of Parents" --- p.40
Chapter 2.9 --- Ethical Approval --- p.42
Chapter CHAPTER 3: --- RESULTS --- p.43
Chapter PART A: --- Baseline Focus Groups Results
Chapter 3.1 --- Baseline Focus Groups Results --- p.43
Chapter 3.1.1 --- General Description of Participants --- p.44
Chapter 3.1.2 --- "Views of ""Health"" held by students" --- p.44
Chapter 3.1.3 --- "Views of ""Health"" of parents" --- p.45
Chapter 3.1.4 --- "Views of ""Healthy Eating"" of students" --- p.46
Chapter 3.1.5 --- "Views of ""Healthy Eating"" held by parents" --- p.47
Chapter 3.1.6 --- "Perceived views on ""Physical Activity"" by students" --- p.48
Chapter 3.1.7 --- "Views on ""Physical Activity"" of parents" --- p.49
Chapter 3.1.8 --- Preferred delivery mode of activities communication channels --- p.50
Chapter PART B: --- Baseline Profile of Participants
Chapter 3.2 --- Response Rate --- p.52
Chapter 3.3 --- Baseline Characteristics and Socio-dem ograph ic Profile of Participants --- p.54
Chapter 3.3.1 --- Students --- p.54
Chapter 3.3.2 --- Parents --- p.56
Chapter 3.4 --- "Self-perceived Important Values, Health and Weight Status at baseline" --- p.60
Chapter 3.4.1 --- Students --- p.60
Chapter 3.4.2 --- Parents --- p.62
Chapter 3.5 --- Baseline Physical Activity --- p.63
Chapter 3.5.1 --- Students --- p.63
Chapter 3.5.2 --- Parents --- p.69
Chapter 3.6 --- Baseline Dietary Aspects --- p.71
Chapter 3.6.1 --- Students --- p.71
Chapter 3.6.2 --- Parents --- p.81
Chapter 3.7 --- Summary of Baseline associations between students，and parents 'parameters --- p.94
Chapter 3.7.1 --- Factors associated with Students' weight status --- p.94
Chapter 3.7.2. --- Factors associated with Studente´ة Dietary Habits --- p.97
Chapter 3.7.3 --- Factors associated with students´ة physical Activity Habits --- p.104
Chapter 3.8 --- Summary of Baseline Profile of Participants --- p.108
Chapter PART C: --- Outcome Evaluation
Chapter 3.9 --- The Final MH activities Conducted --- p.111
Chapter 3.10 --- Comparisons of Weight Status --- p.112
Chapter 3.11 --- Comparisons of Self-perceived Health Status and Important Values --- p.114
Chapter 3.12 --- Comparisons of Physical Activity Parameters --- p.118
Chapter 3.12.1 --- Students --- p.118
Chapter 3.12.2 --- Parents --- p.126
Chapter 3.13 --- Comparisons of Dietary and Health Related Aspects --- p.129
Chapter 3.13.1 --- Students --- p.129
Chapter 3.13.2 --- Parents --- p.148
Chapter 3.13.3 --- Home Food and Meal Environments --- p.167
Chapter PART D: --- Results of Health Club
Chapter 3.14 --- Baseline Profile of the Participants --- p.180
Chapter 3.14.1 --- Characteristics and Health Status --- p.180
Chapter 3.14.2 --- Baseline Physical Activity --- p.181
Chapter 3.14.3 --- Baseline Dietary Related Parameters --- p.183
Chapter 3.15 --- The Final HC Lessons Conducted --- p.187
Chapter 3.16 --- Outcome Evaluation of HC program --- p.188
Chapter 3.16.1 --- Physical Fitness and Anthropometric Parameters --- p.188
Chapter 3.16.2 --- Self-perceived Health Status and Important Values --- p.192
Chapter 3.16.3 --- Physical Activity Related Aspects --- p.193
Chapter 3.16.4 --- Dietary Aspects --- p.196
Chapter 3.17 --- Summary of results of the HC Program --- p.201
Chapter PART E: --- Process Evaluation
Chapter 3.18 --- Process Evaluations of Mighty Heart --- p.203
Chapter 3.18.1 --- Students --- p.203
Chapter 3.18.1.1 --- Comments on Program Activities and Materials --- p.203
Chapter 3.18.1.2 --- Comments on Program Effectiveness and Acceptability --- p.204
Chapter 3.18.1.3 --- Overall Comments and Suggestions --- p.204
Chapter 3.18.2 --- Teachers --- p.205
Chapter 3.18.2.1 --- Comments on Program Activities and Materials --- p.205
Chapter 3.18.2.2 --- Comments on Program Effectiveness and Acceptability --- p.205
Chapter 3.18.2.3 --- Overall Comments and suggestions --- p.206
Chapter 3.19 --- Process Evaluations of the Health Club --- p.207
Chapter 3.19.1 --- Students --- p.207
Chapter 3.19.1.1 --- Comments on Program Activities and Materials --- p.207
Chapter 3.19.1.2 --- Comments on Program Effectiveness and Acceptability --- p.208
Chapter 3.19.1.3 --- Overall Comments and Suggestions --- p.208
Chapter 3.19.2 --- Teacher --- p.209
Chapter 3.19.2.1 --- "Comments on Program Activities, Educational Materials/Resources" --- p.209
Chapter 3.19.2.2 --- Comments on Program Effectiveness and Acceptability --- p.210
Chapter 3.19.2.3 --- Overall Comments and Suggestions --- p.211
Chapter Chapter 4: --- Discussion --- p.212
Chapter 4.1 --- Overall Effects of the MH Program --- p.213
Chapter 4.1.1 --- Changes in PA-related Aspects --- p.213
Chapter 4.1.2 --- Changes in Dietary-related Aspects --- p.216
Chapter 4.1.3 --- Changes in Health Status related Aspects --- p.225
Chapter 4.1.4 --- Acceptability and Appropriateness of the MH --- p.225
Chapter 4.2 --- Overall Effects of the HC Program --- p.226
Chapter 4.2.1 --- Changes in PA Related Aspects --- p.226
Chapter 4.2.2 --- Changes in Dietary-related Aspects --- p.227
Chapter 4.2.3 --- Changes in Health Status related Aspects --- p.228
Chapter 4.2.4 --- Acceptability and Appropriateness of the HC --- p.229
Chapter 4.3 --- Strengths and Limitations of the Study --- p.231
Chapter 4.4 --- Implications and Recommendations for Future Research --- p.233
Chapter Chapter 5: --- Conclusions --- p.234
References --- p.236
Appendix A Principal/ teacher Questionnaire --- p.249
Appendix B Consent form for parents --- p.252
Appendix C Focus group questionnaire - Students --- p.258
Appendix D Focus group questionnaire - Parents --- p.262
Appendix E Survey questionnaire -Students --- p.266
Appendix F Survey Questionnaire - Parents --- p.274
Appendix G Powerpoint material for teachers´ة monthly sharing --- p.282
Appendix H Working sheets --- p.283
Appendix I Newsletters for parents --- p.287
Appendix J Teachers´ة guide for the “Mighty Heart´حprogram --- p.302
Appendix K Teachers' guide for Health Club --- p.307
Appendix L The student workbook --- p.311
"Appendix M Discussion guide for students participating in the ""Mighty Heart ""program" --- p.312
Appendix N Discussion guide for students participating in the Health Club --- p.313
Appendix O Discussion guide for teachers conducting the Mighty Heart program --- p.314
Appendix P Discussion guide for the teachers conducting the Health Club --- p.316

Kwok Man Ki.
Accompanying CD-ROM entitled: DRAGON program 2005.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (leaves 193-203).
Abstracts in English and Chinese; appendices also in Chinese.
Abstract --- p.i
Abstract (Chinese version) --- p.iii
Acknowledgement --- p.v
Table of contents --- p.vi
List of tables --- p.xi
List of figures --- p.xviii
Presentations --- p.xix
Chapter Chapter one: --- Introduction --- p.1
Hong Kong preschoolers' nutritional health situation --- p.1
Chapter (I) --- Breastfeeding & complementary feeding practices --- p.1
Chapter (II) --- "Diet, mealtime and physical activity patterns" --- p.3
Chapter (III) --- Weight status --- p.6
Health risk factors accumulated up to preschool age --- p.8
Childhood Obesity Prevention: School-based intervention --- p.12
Chapter (I) --- Primary obesity prevention and health promoting schools --- p.12
Chapter (II) --- Feasibility of health promotion initiatives in Hong Kong kindergartens --- p.14
Chapter (III) --- Nutrition and physical activity intervention studies --- p.18
Chapter (IV) --- Hong Kong kindergarten health initiative: DRAGON Program --- p.23
Aim and scope of the DRAGON Program --- p.28
Chapter Chapter two: --- Methodology --- p.30
Kindergarten recruitment --- p.30
Formative preparatory stage --- p.32
Chapter (I) --- Teaching kit development --- p.32
Chapter (II) --- Teaching kit pretesting --- p.33
Chapter (III) --- Parents' focus group --- p.35
Chapter (IV) --- Questionnaires development --- p.35
Chapter (V) --- Ethics approval --- p.37
Subject recruitment --- p.37
Pre-intervention stage --- p.37
Chapter (I) --- Anthropometric measurements --- p.37
Chapter (II) --- Parental questionnaires --- p.38
DRAGON Program implementation --- p.38
Chapter (I) --- Preschoolers' health curriculum --- p.38
Chapter (II) --- Pre-intervention data management and analysis --- p.39
Chapter (III) --- Booster activities planning and implementation --- p.40
Chapter (IV) --- Parents' newsletters --- p.42
Post-intervention stage --- p.42
Chapter Chapter three: --- Results --- p.46
Enrollment and response rate --- p.46
Between schools baseline comparison --- p.50
Education vs. Control Schools baseline comparison --- p.53
Chapter (I) --- Demographic and socioeconomic characteristics --- p.53
Chapter (II) --- Children's dietary patterns --- p.60
Chapter (III) --- "Regular meals, snack patterns and other mealtime behaviors" --- p.65
Chapter (IV) --- Usual activity patterns --- p.67
Chapter (V) --- Parents' health knowledge and preferred communication channels --- p.72
Chapter (VI) --- Child's height and weight measurements --- p.77
Chapter (VII) --- Factors associated with children's weight status --- p.79
Chapter (VIII) --- "Associations between socioeconomic status (SES) and children's dietary, mealtime and activity patterns" --- p.81
Process and outcome evaluations of the Dragon Program --- p.90
Part a) 1st follow up after finishing all health curriculum --- p.90
Chapter (I) --- Children's dietary patterns --- p.90
Chapter (II) --- Mealtime behaviors --- p.95
Chapter (III) --- Usual activity patterns --- p.99
Chapter (IV) --- Health curriculum effectiveness evaluation by AM/PM sessions --- p.103
Part b) 2nd follow up after finishing promotional activities --- p.107
Chapter (I) --- Children's dietary patterns --- p.108
Chapter (II) --- Mealtime behaviors --- p.116
Chapter (III) --- Usual activity patterns --- p.122
Between subgroups comparisons --- p.131
Chapter (I) --- First follow up --- p.131
Chapter (II) --- Second follow up --- p.132
Parent Focus groups (baseline) --- p.136
Chapter (I) --- Awareness of local adults' and preschoolers' health status --- p.136
Chapter (II) --- Children's dietary habits and lifestyle --- p.137
Chapter (III) --- Factors affecting their children's health behaviors --- p.139
Parent Focus groups (booster activities) --- p.140
Teachers´ةquestionnaires --- p.142
Teachers after class assessment --- p.149
Teachers´ة focus groups --- p.155
Principals´ة Interviews --- p.157
Chapter (I) --- Importance of creating healthy school environment --- p.157
Chapter (II) --- Students' & teachers´ة performance in first half-year DRAGON Program --- p.158
Chapter (III) --- Comments on implementing second half-year DRAGON Program --- p.160
Chapter (IV) --- Recommendations for the development of the Program --- p.161
Chapter Chapter four: --- Discussion --- p.163
Implications of the findings --- p.164
Chapter (I) --- Socioeconomic and demographic factors associated with preschoolers' diet and lifestyle at baseline --- p.164
Chapter a) --- Association between SES and children´ةs dietary habits --- p.164
Chapter b) --- Association between SES and children's weight status and their mealtime interactions with parents --- p.166
Chapter c) --- "Association between children's weight status and their dietary mealtime, and activity patterns" --- p.167
Chapter (II) --- Local preschool age children´ةs health situation --- p.170
Chapter (III) --- Program Effectiveness assessment --- p.173
Chapter a) --- After the implementation of the one-term health curriculum --- p.173
Chapter b) --- After the implementation of health curriculum and promotional activities --- p.179
Chapter (IV) --- Program acceptability and feasibility --- p.186
Limitations --- p.189
Recommendation for future preschool health program --- p.190
Chapter Chapter five: --- Conclusion --- p.192
References --- p.193
Appendices --- p.204
Chapter A1 --- School invitation letter with program briefing details (English version) --- p.204
Chapter A2 --- School invitation letter with program briefing details (Chinese version) --- p.209
Chapter B1 --- School background information (English version) --- p.213
Chapter B2 --- School background information (Chinese version) --- p.217
Chapter C1 --- DRAGON Program Teacher's Guide for nursery grade (Chinese version) --- p.221
Chapter C2 --- DRAGON Program Teacher's Guide for lower level (Chinese version) --- p.244
Chapter C3 --- DRAGON Program Teacher's Guide for upper level (Chinese version) --- p.269
Chapter D1 --- Parents´ة focus group (Jan) (English version) --- p.297
Chapter D2 --- Parents´ة focus group (Jan) (Chinese version) --- p.301
Chapter E1 --- Teachers´ة self-administered questionnaires (English version) --- p.305
Chapter E2 --- Teachers´ة self-administered questionnaires (Chinese version) --- p.324
Chapter F1a --- Parents´ة self-administered questionnaires [baseline] (English version) --- p.344
Chapter F1b --- Parents´ة self-administered questionnaires [1st follow up] (English version) --- p.349
Chapter F1c --- Parents' self-administered questionnaires [2nd follow up] (English version) --- p.354
Chapter F2a --- Parents´ة self-administered questionnaires [baseline] (Chinese version) --- p.359
Chapter F2b --- Parents´ة'self-administered questionnaires [1st follow up] (Chinese version) --- p.364
Chapter F2c --- Parents´ة self-administered questionnaires [2nd follow up] (Chinese version) --- p.369
Chapter G1 --- Parents´ة consent form (English version) --- p.374
Chapter G2 --- Parents´ة consent form (Chinese version) --- p.376
Chapter H1a --- Sample health lesson worksheet for nursery grade (Chinese version) --- p.378
Chapter H1b --- Sample health lesson worksheet for lower level (Chinese version) --- p.379
Chapter H1c --- Sample health lesson worksheet for upper level (Chinese version) --- p.380
Chapter 11 --- Sample parents´ة newsletter (English version) --- p.382
Chapter 12 --- Sample parents´ة newsletter (Chinese version) --- p.387
Chapter J1 --- Questions for pretest parents´ة newsletter (Chinese and English version) --- p.392
Chapter K1 --- Principals´ة interview (English version) --- p.395
Chapter K2 --- Principals´ة interview (Chinese version) --- p.397
Table A_1 to A_17 --- p.399
DiscAl DRAGON Program: teaching materials for health lessons --- p.414
DiscA2 DRAGON Program: materials for three booster activities --- p.414
DiscA3 DRAGON Program: health lesson worksheets --- p.414
DiscA4 DRAGON Program: parents´ة newsletters --- p.414

Η πραγματοποίηση αυτής της μελέτης έγινε με σκοπό να διερευνήσει τις θεσμικές ρυθμίσεις, τις διαδικασίες και τους τρόπους με τους οποίους σχεδιάσθηκε, συγκροτήθηκε, οργανώθηκε και ασκήθηκε η εκπαιδευτική πολιτική για την Σχολική Υγιεινή στη χώρα μας κατά την περίοδο 1911 - 1949. Η εργασία εστιάζεται στη συγκέντρωση, αξιολόγηση και θεματολογική ταξινόμηση του πρωτογενούς υλικού με την μέθοδο της ιστορικής έρευνας (ιστορικοσυγκριτική ανάλυση: Καζαμίας, 2002) με στόχο την κατανόηση με φαντασία (Carr, 1983) και την ερμηνεία των ιστορικών τεκμηρίων (ιστορική ερμηνευτική προσέγγιση: Πυργιωτάκης, Ι. & Παπαδάκης, Ν., 1998). Με την ενδελεχή διερεύνηση των ιστορικών μας τεκμηρίων επιχειρούμε την ανασύνθεση της ιστορικής πραγματικότητας, αλλά και την ανάλυση και ερμηνεία των γεγονότων σε μια χρονική περίοδο (1911-1949) που καλύπτει την περίοδο, όπου παρατηρούνται οι σημαντικότερες πολιτικές κοινωνικής πρόνοιας και αντίληψης στο χώρο της σχολικής υγιεινής. Η δική μας, επομένως προσέγγιση δεν είναι γεγονοτογραφική (Δημαράς, 1988), δε μένει στο τι έγινε αλλά επιχειρεί και απαντήσεις στα γιατί; Ερμηνεύει (ερμηνεύουσα ιστορία: Δερτιλής, 1995) στηριγμένη σε θεωρητικές προσεγγίσεις περί Κράτους Πρόνοιας και Νέας Αγωγής. Χρησιμοποιώντας την ποιοτική ανάλυση περιεχομένου (Berelson, 1952), εξετάσαμε τις διαφοροποιήσεις που υπήρξαν για τη θεσμική εξέλιξή της στις χρονικές περιόδους – τομές και για τις εξής παραμέτρους – κατηγορίες ανάλυσης: την υγιεινή των διδακτηρίων, του μαθητή, των διδασκόντων, την σχολιατρική υπηρεσία και τον σχολιατρικό έλεγχο, τα μέτρα σχολικής μέριμνας που ελήφθησαν από το κράτος με ιδιαίτερες αναφορές στα μαθητικά – σχολικά συσσίτια καθώς και στην δημιουργία θεσμών ευρύτερης κοινωνικής αντίληψης όπως: οι παιδικές εξοχές – μαθητικές κατασκηνώσεις, τα υπαίθρια σχολεία, τα σχολικά λουτρά, τα μαθητικά ιατρεία – σχολικές κλινικές και τα κέντρα μαθητικής αντίληψης. Επίσης, τη διδασκαλία του μαθήματος της υγιεινής και τέλος, την εκλαΐκευση και τα περιοδικά σχολικής υγιεινής, ξεκινώντας από τις δύο βενιζελικές περιόδους, προχωρώντας στη μεταξική περίοδο και συνεχίζοντας στη μεταπολεμική περίοδο μέχρι και το 1949. Ιστορικοί, πολιτικοί, οικονομικοί, επιστημονικοί και γεωγραφικοί παράγοντες επηρέαζαν την υγεία των παιδιών, η οποία ήταν συνυφασμένη με τις πολιτισμικές και κοινωνικές συνθήκες και τους όρους διαβίωσης κάθε κοινωνικής ομάδας ή ατόμου σε κάθε εποχή στην χώρας μας. Εν κατακλείδι, η πρόβλεψη υπηρεσιών υγιεινής για τα παιδιά της σχολικής ηλικίας, σύμφωνα και με τις επιστημονικές επιταγές, κατείχε υψηλή προτεραιότητα στα προγράμματα υγειονομικής και κοινωνικής πολιτικής του κράτους, χαρακτηριζόμενη όμως, συχνά, από μια αναντιστοιχία των νομοθετημάτων με την πορεία υλοποίησης και εφαρμογής τους. Ως αιτίες αυτών των αναντιστοιχιών, πέραν των εσωτερικών πολιτικών αντιφάσεων, μπορούν να εντοπισθούν η πολιτική ρευστότητα της εποχής και η οικονομική δυσπραγία όσον αφορά στα δημοσιονομικά μεγέθη του Ελληνικού δημοσίου
The purpose of this study is to investigate the institutional regulations, processes and modes of planning, formation, organization and making education policy for the school sanitation and hygiene in Greece during the period 1911-1949. The study focuses on the collection, evaluation and thematic classification of the primary sources with the method of historical research (comparative-historical analysis: Kazamias, 2002) in order to comprehend with imagination (Carr, 1983) and to interpret the historical presumptions (an interpretive-historical approach: Pyrgiotakis, I. & Papadakis, N. 1998). Through the detailed research of our historical documents, we are attempting not only to recompose the historical reality but also to analyse and to interpret the facts during the period 1911-1949, a period characterized by the most important welfare state policies in the area of the school sanitation and hygiene. Thus, our approach is not a fact-based approach (Dimaras, 1988), it does not confine itself to what happened but it also attempts to provide answers to “why”. It interprets (interpreting history: Dertilis, 1995), based on welfare state and new education theoretical approaches. Using the qualitative content analysis (Berelson, 1952), we examined the differentiations of the institutional progress in the periods-sections and for the following parameters-analysis categories: school sanitation, students’ hygiene, teachers’ hygiene, medical and health service/control in school, medicare and perception measures in schools on behalf of the state (with special references to school lunch mess and to the creation of wider social perception institutions like: childhood countries-student camps, outdoor schools, student baths, student health centers-student clinics and the centers of student perception), hygiene education, popularization and the school hygiene magazines, from the two “venizelians” periods, the metaxian and the post war period to 1949. Historical, political, financial, scientific and geographical factors were affecting the children’s health, connected to the cultural and social conditions and the living conditions of every social group or individual during all epochs of our country. In conclusion, the health services for school age children were having a big priority in sanitation and social policy programs, characterised although quite often by discrepancy between laws and their implementation. This is due not only to the internal political contradictions but also to the political fluidity of that era and to the economic recession related to the greek state financial sizes.