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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Building school-based cardiovascular health promotion capacity in youth: a mixed methods study

Authors: Roberta L Woodgate, Corey M Sigurdson

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Essential to building cardiovascular health promotion capacity in youth, which extends into adulthood, are approaches that seek to empower, educate, and support. The Five Cs model of positive youth development (PYD) guided this study. This model represents the ability of youth to develop competence, confidence, connection, character, and caring when given the appropriate resources. The purpose of this two-year school-based feasibility study was to determine if providing a research intervention in the form of education, empowerment, and support build youth’s capacity for cardiovascular health promotion.

Methods

A mixed methods case study design was used to evaluate the process, and outcome of a youth-led cardiovascular health promotion program. Twenty-six youth aged 12–13 years from a Canadian middle school took part in the study. Youth participating in this study planned, implemented, and monitored cardiovascular health promotion activities in four areas: smoking, physical inactivity, nutrition and obesity. Qualitative data was collected from the youth participants using three focus groups and individual reflective journals. Quantitative data was collected with the PYD.2, a self-report questionnaire that assesses positive youth development and consists of 5 subscales: character, competence, caring, connection, and confidence. The participants completed the PYD before and after the program to determine if there were any changes in PYD scores after the intervention. The quantitative data was analyzed using paired samples t-tests, and the qualitative data was analyzed using constant comparative analysis.

Results

While the PYD scores showed no significant changes, the qualitative findings confirmed that the youth acquired increased awareness and understanding of cardiovascular health promotion initiatives. Four themes emerged from the qualitative data, (1) doing the right thing, (2) wanting to make a change, but feeling constrained, (3) I get it, and (4) The project has changed me! The intervention was found to be acceptable and feasible for the youth participants and their school.

Conclusions

The contributions of this study were twofold. It generated evidence to support integrating positive youth development strategies into cardiovascular health promotion programs. Secondly, this study determined that the research intervention improved the participants’ knowledge and attitudes about cardiovascular health and were suitable for further implementation and testing.
Literature
1.
2.
3.
4.
Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa heart study. Pediatrics. 2001;108(3):712–8.CrossRefPubMed
5.
6.
Partners in Planning for Healthy Living. Manitoba youth health survey. Winnipeg, Canada: Author; 2009.
7.
Kavey RW, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K. American heart association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation. 2003;107(11):1562–6.CrossRefPubMed
8.
Veugelers PJ, Fitzgerald AL. Effectiveness of school programs in preventing childhood obesity: a multilevel comparison. Am J Public Health. 2005;95(3):432.CrossRefPubMedPubMedCentral
9.
Foster GD, Sherman S, Borradaile KE, Grundy KM, Vander Veur SS, Nachmani J, et al. A policy-based school intervention to prevent overweight and obesity. Pediatrics. 2008;121(4):e794–802.CrossRefPubMed
10.
Mauriello LM, Ciavatta MMH, Paiva AL, Sherman KJ, Castle PH, Johnson JL, et al. Results of a multi-media multiple behavior obesity prevention program for adolescents. Prev Med. 2010;51(6):451–6.CrossRefPubMedPubMedCentral
11.
12.
Werch CE, Bian H, Carlson JM, Moore MJ, DiClemente CC, Huang I-C, et al. Brief integrative multiple behavior intervention effects and mediators for adolescents. J Behav Med. 2011;34(1):3–12.CrossRefPubMed
13.
Fuster V, Kelly BB. Cardiovascular health promotion early in life. In: Fuster V, Kelly BB, editors. Promoting cardiovascular health in the developing world: a critical challenge to achieve global health. Washington, DC: National Academies Press; 2010.
14.
Flay BR. Positive youth development requires comprehensive health promotion programs. Am J Health Behav. 2002;26(6):407–24.CrossRefPubMed
15.
Laaksonen M, Luoto R, Helakorpi S, Uutela A. Associations between health-related behaviors: a 7-year follow-up of adults. Prev Med. 2002;34(2):162–70.CrossRefPubMed
16.
Peters LW, Kok G, Ten Dam GT, Buijs GJ, Paulussen TG. Effective elements of school health promotion across behavioral domains: A systematic review of reviews. BMC Public Health. 2009;9(182):14.
17.
Werch CC, Moore MJ, DiClemente CC, Bledsoe R, Jobli E. A multihealth behavior intervention integrating physical activity and substance use prevention for adolescents. Prev Sci. 2005;6(3):213–26.CrossRefPubMed
18.
Flay BR, Snyder FJ, Petraitis J. The theory of triadic influence. In: DiClemente RJ, Crosby RA, Kegler M, editors. Emerging theories in health promotion practice and research. 2nd ed. San Francisco, CA: John Wiley & Sons; 2009. p. 451–510.
19.
Cargo M, Grams GD, Ottoson JM, Ward P, Green LW. Empowerment as fostering positive youth development and citizenship. Am J Health Behav. 2003;27(Supplement 1):S66–79.CrossRefPubMed
20.
Wallerstein N. Empowerment to reduce health disparities. Scand J Public Health. 2002;59(suppl):72–7.CrossRef
21.
Wong NT, Zimmerman MA, Parker EA. A typology of youth participation and empowerment for child and adolescent health promotion. Am J Community Psychol. 2010;46(1–2):100–14.CrossRefPubMed
22.
Lerner RM, Lerner JV, Almerigi JB, Theokas C, Phelps E, Gestsdottir S, et al. Positive youth development, participation in community youth development programs, and community contributions of fifth-grade adolescents: findings from the first wave of the 4-h study of positive youth development. J Early Adolesc. 2005;25(1):17–71.CrossRef
23.
Lerner RM, Thompson LS. Promoting healthy adolescent behavior and development: issues in the design and evaluation of effective youth programs. J Pediatr Nurs. 2002;17(5):338–44.CrossRefPubMed
24.
Catalano RF, Fagan AA, Gavin LE, Greenberg MT, Irwin CE, Ross DA, et al. Worldwide application of prevention science in adolescent health. Lancet. 2012;379(9826):1653–64.CrossRefPubMedPubMedCentral
25.
Dzewaltowski DA, Rosenkranz RR. Youth development: an approach for physical activity behavioral science. Kinesiology Review. 2014;3(1):92–100.CrossRef
26.
Gavin LE, Catalano RF, David-Ferdon C, Gloppen KM, Markham CM. A review of positive youth development programs that promote adolescent sexual and reproductive health. J Adolesc Health. 2010;46(3):S75–91.CrossRefPubMed
27.
Shek DT, Yu L. Prevention of adolescent problem behavior: longitudinal impact of the project paths in Hong Kong. Sci World J. 2011;11:546–67.CrossRef
28.
Shek DT, Ma C. Impact of the project paths in the junior secondary school years: individual growth curve analyses. Sci World J. 2011;11:253–66.CrossRef
29.
Dzewaltowski DA, Estabrooks PA, Welk G, Hill J, Milliken G, Karteroliotis K, et al. Healthy youth places: a randomized controlled trial to determine the effectiveness of facilitating adult and youth leaders to promote physical activity and fruit and vegetable consumption in middle schools. Health Educ Behav. 2009;36(3):583–600.CrossRefPubMed
30.
Bandura A. Adolescent development from an agentic perspective. In: Pajares F, Urdan TC, editors. Self-efficacy beliefs of adolescents. 1st ed. Greenwich, CT: Information Age; 2006. p. 1–43.
31.
Delgado M, Zhou H. Youth-led health promotion in urban communities: a community capacity-enhancement perspective. Lanham, MD: Rowman & Littlefield; 2008.
32.
Forneris T, Fries E, Meyer A, Buzzard M, Uguy S, Ramakrishnan R, et al. Results of a rural school-based peer-led intervention for youth: goals for health. J Sch Health. 2010;80(2):57–65.CrossRefPubMed
33.
Stock S, Miranda C, Evans S, Plessis S, Ridley J, Yeh S, et al. Healthy buddies: a novel, peer-led health promotion program for the prevention of obesity and eating disorders in children in elementary school. Pediatrics. 2007;120(4):e1059–68.CrossRefPubMed
34.
Starkey F, Audrey S, Holliday J, Moore L, Campbell R. Identifying influential young people to undertake effective peer-led health promotion: the example of a stop smoking in schools trial (assist). Health Educ Res. 2009;24(6):977–88.CrossRefPubMed
35.
Heck KE, Subramaniam A. Youth development frameworks. In: Monograph. University of California, Davis; 2009.
36.
Phelps E, Zimmerman S, Warren A, Jeličić H, von Eye A, Lerner RM. The structure and developmental course of positive youth development (pyd) in early adolescence: implications for theory and practice. J Appl Dev Psychol. 2009;30(5):571–84.CrossRef
37.
Bowers EP, Li Y, Kiely MK, Brittian A, Lerner JV, Lerner RM. The five cs model of positive youth development: A longitudinal analysis of confirmatory factor structure and measurement invariance. J Youth Adolesc. 2010;39(7):720–35.CrossRefPubMed
38.
Stake RE. Qualitative case studies. In: Denzin NK, Lincoln YS, editors. The sage handbook of qualitative research. 3rd ed. Thousand Oaks, CA: Sage; 2005. p. 443–66.
39.
Merriam SB. Qualitative research and case study applications in education: revised and expanded from “case study research in education”. San Francisco: Jossey-Bass; 1998.
40.
Yin RK. Case study research: design and methods, vol. 5. Thousand Oaks, CA: Sage; 2003.
41.
Patton MQ. How to use qualitative methods in evaluation, vol. 4. Thousand Oaks, CA: Sage; 1987.
42.
Patton MQ. Qualitative research & evaluation methods. 3rd ed. Thousand Oaks, CA: Sage; 2003.
43.
Carey M. The group effect in focus groups: planning, implementing, and interpreting focus group research. In: Morse JM, editor. Critical issues in qualitative research methods. Thousand Oaks, CA: Sage; 1994. p. 225–41.
44.
Hoppe MJ, Wells EA, Morrison DM, Gillmore MR, Wilsdon A. Using focus groups to discuss sensitive topics with children. Evaluation Rev. 1995;19(1):102–14.CrossRef
45.
Berg BL. Qualitative research methods for the social sciences. 3rd ed. Boston: Pearson; 1994.
46.
Halkier B. Focus groups as social enactments: integrating interaction and content in the analysis of focus group data. Qual Res. 2010;10(1):71–89.CrossRef
47.
Lehoux P, Poland B, Daudelin G. Focus group research and “the patient’s view”. Soc Sci Med. 2006;63(8):2091–104.CrossRefPubMed
48.
Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 9th ed. Philadelphia: Lippincott; 2012.
49.
Benson PL, Scales PC, Hamilton SF, Sesma A. Positive youth development: theory, research, and applications. In: Lerner RM, Damon W, editors. Handbook of child psychology: theoretical models of human development. Volume 1. 6th ed. New York: John Wiley & Sons; 2006. p. 884–941.
50.
QSR International (Americas) Inc. Nvivo 10 qualitative data analysis software. Burlington, MA; 2012.
51.
Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. Thousand, Oaks, CA: Sage; 2006.
52.
Charmaz K. The grounded theory method: an explication and interpretation. In: Emerson RM, editor. Contemporary field research: a collection of readings. 1st ed. Boston, MA: Little, Brown & Company; 1983. p. 109–26.
53.
Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park, CA: Sage Publications; 1990.
54.
Strauss A, Corbin J. Grounded theory: an overview. In: Denzin NK, Lincoln YS, editors. The handbook of qualitative research. Thousand Oaks, CA: Sage Publications; 1994. p. 273–85.
55.
IBM Corp. Ibm spss statistics for windows, version 22.0. Armonk, NY; 2013.
56.
Lincoln YS, Guba EG. Naturalistic inquiry, vol. 75. Newbury Park, CA: Sage; 1985.
57.
Woodgate RL, Leach J. Youth’s perspectives on the determinants of health. Qual Health Res. 2010;20(9):1173–82.CrossRefPubMed
58.
Campbell AC, Barnum D, Ryden V, Ishkanian S, Stock S, Chanoine JP. The effectiveness of the implementation of healthy buddies™, a school-based, peer-led health promotion program in elementary schools. Can J Diabetes. 2012;36(4):181–6. e182.CrossRef
59.
Lynagh M, Knight J, Schofield MJ, Paras L. Lessons learned from the hunter region health promoting schools project in new south wales, australia. J Sch Health. 1999;69(6):227–32.CrossRefPubMed
60.
Haerens L, Deforche B, Maes L, Cardon G, Stevens V, De Bourdeaudhuij I. Evaluation of a 2-year physical activity and healthy eating intervention in middle school children. Health Educ Res. 2006;21(6):911–21.CrossRefPubMed
61.
Patton G, Bond L, Butler H, Glover S. Changing schools, changing health? Design and implementation of the gatehouse project. J Adolesc Health. 2003;33(4):231–9.CrossRefPubMed
62.
Atkins LA, Oman RF, Vesely SK, Aspy CB, McLeroy K. Adolescent tobacco use: the protective effects of developmental assets. Am J Health Promot. 2002;16(4):198–205.CrossRefPubMed
63.
Leffert N, Benson PL, Scales PC, Sharma AR, Drake DR, Blyth DA. Developmental assets: measurement and prediction of risk behaviors among adolescents. Appl Dev Sci. 1998;2(4):209–30.CrossRef
64.
Mytton J, DiGuiseppi C, Gough D, Taylor R, Logan S. School-based secondary prevention programmes for preventing violence. Cochrane Database Syst Rev. 2006;3(2).
65.
Camino L. Pitfalls and promising practices of youth–adult partnerships: an evaluator’s reflections. J Community Psychol. 2005;33(1):75–85.CrossRef
66.
Larson R, Walker K, Pearce N. A comparison of youth‐driven and adult‐driven youth programs: balancing inputs from youth and adults. J Community Psychol. 2005;33(1):57–74.CrossRef
67.
Ozer EJ, Cantor JP, Cruz GW, Fox B, Hubbard E, Moret L. The diffusion of youth-led participatory research in urban schools: the role of the prevention support system in implementation and sustainability. Am J Community Psychol. 2008;41(3–4):278–89.CrossRefPubMed
68.
69.
Story M, Lytle LA, Birnbaum AS, Perry CL. Peer‐led, school‐based nutrition education for young adolescents: feasibility and process evaluation of the teens study. J Sch Health. 2002;72(3):121–7.CrossRefPubMed
70.
71.
Woodgate RL, Safipour J, Tailor K. Canadian adolescents’ perspectives of cancer risk: A qualitative study. Health Promot Int, Advance Access published March 17, 2014, doi:10.1093/heapro/dau011
72.
Woodgate RL, Kreklewetz CM. Youth’s narratives about family members smoking: parenting the parent- it's not fair! BMC Public Health. 2012;12(965):13.
73.
Busch V, de Leeuw JRJ, de Harder A, Schrijvers AJP. Changing multiple adolescent health behaviors through school‐based interventions: a review of the literature. J Sch Health. 2013;83(7):514–23.CrossRefPubMed
74.
Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. 2nd ed. Thousand Oaks, CA: Sage; 2003.
75.
Linnan L, Steckler A. Process evaluation for public health interventions and research: an overview. In: Steckler A, Linnan L, editors. Process evaluation for public health interventions and research. San Francisco, CA: Jossey-Bass; 2002. p. 7–25.
76.
Catalano RF, Gavin LE, Markham CM. Future directions for positive youth development as a strategy to promote adolescent sexual and reproductive health. J Adolesc Health. 2010;46(3 Suppl):S92–6.CrossRefPubMed
Metadata
Title
Building school-based cardiovascular health promotion capacity in youth: a mixed methods study
Authors
Roberta L Woodgate
Corey M Sigurdson
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1759-5

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