McIsaac Jessie-Lee D, Penney Tarra L, Ata Nicole, Munro-Sigfridson Lori, Cunningham Jane, Veugelers Paul J, Storey Kate, Ohinmaa Arto, Kirk Sara F L, Kuhle Stefan
Faculty of Health Professions and Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada.
Tri-County Regional School Board, Yarmouth, NS, Canada.
Prev Med Rep. 2017 Jan 25;5:279-284. doi: 10.1016/j.pmedr.2017.01.008. eCollection 2017 Mar.
A Health promoting schools (HPS) approach aims to make schools a healthy place through a holistic approach that promotes a supportive 'school ethos' and emphasizes improvements in physical, social, and emotional well-being and educational outcomes. A HPS initiative in rural Nova Scotia (Canada) provided an opportunity for a population-level natural experiment. This study investigated student well-being and health behaviours between schools with and without HPS implementation and schools with high and low school ethos scores. Student well-being, nutrition, and physical activity were examined in a cross-sectional survey of elementary students in Nova Scotia, Canada in 2014. Multiple regression was used to assess the relationship with student well-being using the Quality of Life in School (QoLS) instrument and health behaviours. The main exposure was attending one of the 10 HPS schools; secondary exposure was the school ethos score. The overall QoLS score and its subdomain scores in the adjusted models were higher in students attending HPS schools compared to those in non-HPS schools, but the differences were not statistically significant and the effect sizes were small. Students in schools that scored high on school ethos score had higher scores for the QoLS and its subdomains, but the difference was only significant for the teacher-student relationship domain. Although this study did not find significant differences between HPS and non-HPS schools, our results highlight the complexity of evaluating HPS effects in the real world. The findings suggest a potential role of a supportive school ethos for student well-being in school.
健康促进学校（HPS）方法旨在通过一种整体方法使学校成为一个健康的场所，这种方法促进一种支持性的“学校风气”，并强调改善身体、社会和情感健康以及教育成果。加拿大新斯科舍省农村地区的一项HPS倡议提供了一个进行人群水平自然实验的机会。本研究调查了实施HPS和未实施HPS的学校以及学校风气得分高和低的学校之间学生的健康状况和健康行为。2014年，在加拿大新斯科舍省对小学生进行的一项横断面调查中，对学生的健康状况、营养和体育活动进行了检查。使用多元回归，通过学校生活质量（QoLS）工具和健康行为来评估与学生健康状况的关系。主要暴露因素是就读于10所HPS学校之一；次要暴露因素是学校风气得分。在调整后的模型中，就读于HPS学校的学生的总体QoLS得分及其子领域得分高于未就读于HPS学校的学生，但差异无统计学意义，效应大小较小。学校风气得分高的学校的学生在QoLS及其子领域的得分更高，但差异仅在师生关系领域显著。尽管本研究未发现HPS学校和非HPS学校之间存在显著差异，但我们的结果突出了在现实世界中评估HPS效果的复杂性。研究结果表明支持性的学校风气对学生在校健康状况具有潜在作用。
