School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2022 Aug;42(8):344-352. doi: 10.24095/hpcdp.42.8.04.
Northern communities in Canada experience a disproportionate burden of chronic diseases including mental illness. To mitigate the growing health inequalities, an ongoing Comprehensive School Health program promoting healthy lifestyle behaviours and mental health and well-being was expanded to rural and remote northern communities. We report on the program's impact on knowledge, attitudes, lifestyle behaviours (healthy eating, physical activity, screen time), weight status and the mental health and well-being of elementary school students during the first four years of implementation.
Following a repeated cross-sectional design, we surveyed 440, 352 and 384 Grade 4 to 6 students (9-12 years old) from eight schools in 2016, 2018 and 2020/21, respectively. Students were approximately equally represented by girls and boys.
Between 2016 and 2018, students reported modest increases in vegetable and fruit consumption and dietary variety; declines in screen time; no changes in physical activity; and declines in attitudes toward healthy lifestyle and in mental health and well-being. Between 2018 and 2020/21, lifestyle behaviours deteriorated substantially, while attitudes and mental health and well-being continued to decline.
A program that was successful in socioeconomically disadvantaged urban neighbourhoods had a favourable, though modest, impact on selected lifestyle behaviours, but not on attitudes and mental health and well-being, in rural and remote northern communities. In light of cultural differences and logistical challenges in Canada's North, systematic and proactive adaptations to local contexts, increased intensity, and longer program delivery are essential to facilitate sustainable improvements in lifestyle behaviours and mental health and well-being.
加拿大北部社区经历着不成比例的慢性病负担,包括精神疾病。为了减轻日益严重的健康不平等,正在持续开展一项综合学校卫生计划,以促进健康的生活方式行为以及心理健康和幸福感,该计划已扩展到农村和偏远的北部社区。我们报告了该计划在实施的头四年中对小学生的知识、态度、生活方式行为(健康饮食、身体活动、屏幕时间)、体重状况以及心理健康和幸福感的影响。
采用重复横断面设计,我们分别于 2016 年、2018 年和 2020/21 年调查了来自 8 所学校的 440、352 和 384 名 4 至 6 年级学生(9-12 岁)。学生的男女比例大致相等。
在 2016 年至 2018 年间,学生报告蔬菜和水果摄入量和饮食多样性略有增加;屏幕时间减少;身体活动没有变化;对健康生活方式的态度以及心理健康和幸福感下降。在 2018 年至 2020/21 年期间,生活方式行为大幅恶化,而态度和心理健康和幸福感继续下降。
在社会经济处于不利地位的城市社区中成功的计划对选定的生活方式行为产生了有利的影响,尽管影响较小,但对农村和偏远的北部社区的态度和心理健康和幸福感没有影响。鉴于加拿大北部在文化差异和后勤挑战方面的情况,需要对当地情况进行系统和积极的调整、增加计划强度和延长计划实施时间,以促进生活方式行为和心理健康和幸福感的可持续改善。