Chronic Diseases of Lifestyle Unit, Medical Research Council (MRC), Tygerberg, South Africa.
BMC Public Health. 2012 Sep 17;12:794. doi: 10.1186/1471-2458-12-794.
This study evaluated the primary school environment in terms of being conducive to good nutrition practices, sufficient physical activity and prevention of nicotine use, with the view of planning a school-based health intervention.
A sample of 100 urban and rural disadvantaged schools was randomly selected from two education districts of the Western Cape Education Department, South Africa. A situation analysis, which comprised an interview with the school principal and completion of an observation schedule of the school environment, was done at all schools.
Schools, on average, had 560 learners and 16 educators. Principals perceived the top health priorities for learners to be an unhealthy diet (50%) and to far lesser degree, lack of physical activity (24%) and underweight (16%). They cited lack of physical activity (33%) and non-communicable diseases (NCDs; 24%) as the main health priorities for educators, while substance abuse (66%) and tobacco use (31%) were prioritised for parents. Main barriers to health promotion programmes included lack of financial resources and too little time in the time table. The most common items sold at the school tuck shops were crisps (100%), and then sweets (96%), while vendors mainly sold sweets (92%), crisps (89%), and ice lollies (38%). Very few schools (8%) had policies governing the type of food items sold at school. Twenty-six of the 100 schools that were visited had vegetable gardens. All schools reported having physical activity and physical education in their time tables, however, not all of them offered this activity outside the class room. Extramural sport offered at schools mainly included athletics, netball, and rugby, with cricket and soccer being offered less frequently.
The formative findings of this study contribute to the knowledge of key environmental and policy determinants that may play a role in the health behaviour of learners, their parents and their educators. Evidently, these show that school environments are not always conducive to healthy lifestyles. To address the identified determinants relating to learners it is necessary to intervene on the various levels of influence, i.e. parents, educators, and the support systems for the school environment including the curriculum, food available at school, resources for physical activity as well as appropriate policies in this regard.
本研究从有利于良好营养实践、充足身体活动和预防尼古丁使用的角度评估了小学环境，以期规划基于学校的健康干预措施。
从南非西开普教育部门的两个教育区随机抽取了 100 所城乡贫困学校作为样本。对所有学校进行了情况分析，包括与校长面谈和填写学校环境观察表。
平均而言，每所学校有 560 名学生和 16 名教育工作者。校长认为学生的首要健康问题是饮食不健康（50%），其次是缺乏身体活动（24%）和体重过轻（16%）。他们认为教育工作者的主要健康问题是缺乏身体活动（33%）和非传染性疾病（NCD；24%），而家长则将药物滥用（66%）和吸烟（31%）列为首要问题。促进健康计划的主要障碍包括缺乏财政资源和课程时间太少。学校小卖部最常出售的商品是薯片（100%），其次是糖果（96%），而小贩主要销售糖果（92%）、薯片（89%）和冰棒（38%）。只有很少的学校（8%）有政策规定在学校出售的食品类型。在 100 所被访问的学校中，有 26 所拥有菜园。所有学校都报告在课程表中安排了体育活动和体育课，但并非所有学校都在课堂外提供此类活动。学校提供的课外体育活动主要包括田径、无挡板篮球和橄榄球，板球和足球的参与度较低。
本研究的形成性发现有助于了解可能对学生、学生家长和教育工作者健康行为产生影响的关键环境和政策决定因素。显然，这些发现表明学校环境并不总是有利于健康的生活方式。为了解决与学生相关的确定因素，有必要在各个层面进行干预，即家长、教育工作者以及包括课程、学校可用食物、身体活动资源以及这方面的适当政策在内的学校环境支持系统。
