OBJECTIVE: Universal school lunches hold the potential to improve student nutritional intake and access to food, but to do so menus must be nutritionally adequate. There is growing interest in school lunch programs (SLPs) in Australia, and one is currently being trialled in Tasmania. No nutrition guidelines currently exist for menu development in Australian schools.
METHODS: A desktop review of international SLPs was completed, and findings analysed in the context of Australian Nutrient Reference Values and Australian Dietary Guidelines to inform the development of Tasmanian SLP guidelines.
CONCLUSIONS: Globally, SLPs are guided by portion sizes and/or nutrient criteria. SLPs (many of which address food insecurity) must provide children the opportunity to meet energy and nutrient needs, while minimising food waste. We propose energy-based nutrient criteria and qualitative recommendations for menu development. SO WHAT?: We have developed guidelines to inform the development of Tasmanian SLP menus. These guidelines may be applicable to other states and territories piloting similar programs.

UNASSIGNED: Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines in a representative sample of children living in Texas.
UNASSIGNED: We analyzed cross-sectional data from a statewide sample of fourth-grade children in Texas who completed the 2019-2020 Texas School Physical Activity and Nutrition (Texas SPAN) survey. The Texas SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban-rural status, and economic disadvantage.
UNASSIGNED: A total of 16.7% of fourth-grade children met physical activity guidelines every day during the week (mean age = 9.4 ± 0.6 years; female = 48.7, 51.8% Hispanic, mean days meeting PA guideline = 3.6 ± 2.3 days). One in ten (11.2%) children did not meet daily PA guidelines on any day of the week, and 72.1% met them between 1 and 6 days. Participating in sports (b = 0.22, 95%CI:0.14, 0.30), any other organized physical activities (b=0.13, 95%CI:0.017, 0.19), and playing outdoors 1-3 days (b = 0.25, 95%CI:0.04, 0.46) and 4-7 days in the past week (b = 0.77, 95%CI:0.57, 0.97) was significantly and positively associated with the number of days children met PA guidelines.
UNASSIGNED: Participating in sports, participating in other organized physical activities, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.

暂无摘要。

BACKGROUND: This study aimed to investigate associations of meeting 24-h movement behavior (24-HMB: physical activity [PA], screen time [ST] in the school-aged youth, and sleep) guidelines with indicators of academic engagement, psychological functioning, and cognitive function in a national representative sample of U.S. youth.
METHODS: In this cross-sectional study, 1794 participants aged 6 to 17 years old were included for multivariable logistic regression to determine the above-mentioned associations, while adjusting for sociodemographic and health covariates.
RESULTS: The proportion of participants who met 24-HMB guideline(s) varied greatly (PA+ ST+ sleep = 34 [weighted 1.17 %], PA + ST = 23 [weighted 1.72 %], PA + sleep = 52 [weighted 2.15 %], PA = 34 [weighted 2.88 %], ST = 142 [weighted 7.5 %], ST+ sleep = 209 [weighted 11.86 %], sleep = 725 [weighted 35.5 %], none = 575 [weighted 37.22 %]). Participants who met ST guideline alone and integrated (ST + Sleep and ST + sleep + PA) guidelines demonstrated the consistently beneficial associations with learning interest/curiosity, caring for school performance, completing required homework, resilience, cognitive difficulties, self-regulation (ps < 0.05).
CONCLUSIONS: Meeting 24-HMB guidelines in an isolated or integrative manner was associated with improved academic engagement, psychological functioning, and reduced cognitive difficulties. These findings highlight the importance of the promotion of 24-HMB guidelines in youth with internalizing problems. Future longitudinal studies are needed to investigate whether changes or modifications of meeting specific 24-HMB guidelines (especially ST) is beneficial for youth with internalizing problems.

OBJECTIVE: Implementation of school meal guidelines is often inadequate, and evidence for effective implementation strategies for school-based nutrition interventions is limited. The aim of the present study was to examine the implementation and effectiveness of a multi-strategy implementation intervention to increase adherence to the Norwegian national school meal guideline.
METHODS: The study was a school-based hybrid implementation effectiveness trial with a pre-post non-equivalent control group design, testing three implementation strategies: internal facilitation, training and an educational meeting.
METHODS: Primary schools and after-school services in two counties in south-east Norway.
METHODS: School principals, after-school leaders and class teachers from thirty-three schools in the intervention county and principals and after-school leaders from thirty-four schools in a comparison county.
RESULTS: There was a significant difference of 4 percentage points in change scores between the intervention and the comparison groups at follow-up, after adjusting for baseline adherence (B = 0·04, seB = 0·01, t = 3·10, P = 0·003). The intervention effect was not associated with the school\'s socio-economic profile. School-level fidelity was the implementation dimension that was most strongly correlated (r s = 0·48) with the change scores in the intervention group, indicating that principals\' support is important for gaining the largest intervention effects.
CONCLUSIONS: A school-based intervention with low intensity, based on trained teachers as internal facilitators, can increase adherence to the national school meal guideline among Norwegian primary schools, irrespective of local socio-economic conditions. Implementation fidelity, at an organisational level, may be a useful predictor for intervention outcomes in schools.

BACKGROUND: During the COVID-19 pandemic, decision-making on measures to reduce or prevent transmission of SARS-CoV-2 in schools was rendered difficult by a rapidly evolving and uncertain evidence base regarding their effectiveness and unintended consequences. To support decision-makers, an interdisciplinary panel of scientific experts, public health and school authorities as well as those directly affected by school measures, was convened in an unprecedented effort to develop an evidence- and consensus-based public health guideline for German schools. This study sought to assess whether and how this guideline impacted decision-making processes.
METHODS: This study comprised three components: (1) we sent inquiries according to the Freedom of Information Acts of each Federal State to ministries of education, family, and health. (2) We conducted semi-structured interviews with individuals involved in decision-making regarding school measures in two Federal States, and (3) we undertook semi-structured interviews with members of the guideline panel. The content of response letters in component 1 was analysed descriptively; data for components 2 and 3 were analysed using deductive-inductive thematic qualitative content analysis according to Kuckartz.
RESULTS: Responses to the Freedom of Information Act inquiries showed that the guideline was recognised as a relevant source of information by ministries of education in nine out of 16 Federal States and used as a reference to check existing directives for school measures in five Federal States. All participants (20 interviews) emphasised the value of the guideline given its evidence- and consensus-based development process but also noted limitations in its usability and usefulness, e.g., lack of context-specificity. It was consulted by participants who advised policy-makers (5 interviews) alongside other sources of evidence. Overall, perceptions regarding the guideline\'s impact were mixed.
CONCLUSIONS: Our findings suggest that the guideline was relatively well-known in Federal States\' decision-making bodies and that it was considered alongside other forms of evidence in some of these. We suggest that further research to evaluate the impact of public health guidelines on (political) decision-making is warranted. Guideline development processes may need to be adapted to account for the realities of decision-making during public health emergencies and beyond.

BACKGROUND: Norwegian school health services received a national best-practice guideline in 2017. To promote healthy life skills and identify adolescents needing support, the guideline includes strong recommendations for individual consultations with all 8th graders and increased collaboration with schools. To help implement the recommendations, a blended implementation strategy (SchoolHealth) was co-created with school nurses, students, and stakeholders. SchoolHealth consists of three implementation elements: Digital dialog and administration tool (audit and feedback +), Dialog support (external consultation), and Collaboration materials (targeted dissemination). This hybrid study will test the main and combined effects of the elements on guideline fidelity and effectiveness.
METHODS: The GuideMe study is a factorial cluster randomized controlled trial examining SchoolHealth\'s effectiveness on guideline fidelity and guideline effectiveness goals. Forty Norwegian secondary schools will be randomized to eight different combinations of the elements in SchoolHealth. Participants will include school nurses and school personnel from these schools, and 8th grade students (n = 1200). Primary outcomes are school nurses\' fidelity to the guidelines and student\'s ability to cope with their life (i.e., health literacy, positive health behaviors and self-efficacy). Quantitative methods will be used to test effects and mechanisms, while mixed- and qualitative methods will be used to explore mechanisms, experiences, and other phenomena in depth. Participants will complete digital questionnaires at the start and end of the schoolyear, and after the consultation during the schoolyear. The study will run in two waves, each lasting for one school year. The multifactorial design allows testing of interactions and main effects due to equal distribution of all factors within each main effect. Sustainment and scale-up of optimized SchoolHealth elements using national infrastructure are simultaneously prepared.
CONCLUSIONS: The study will investigate possible effects of the implementation elements in isolation and in combination, and hypothesized implementation mechanisms. In-depth study of user experiences will inform improvements to elements in SchoolHealth. The results will yield causal knowledge about implementation strategies and the mechanisms through which they assert effects. Mixed-methods will provide insights into how and when the elements work. Optimizing guideline implementation elements can support adolescents in a crucial life phase.
BACKGROUND: ISRCTN24173836. Registration date 8 August 2022.

OBJECTIVE: We examined whether introduction of national guidelines limiting sports club activities at school was associated with adolescents\' exercise and cardiorespiratory fitness.
METHODS: We conducted interrupted time-series analysis to quantify the changes in prefecture-level aggregated data on exercise or sports activities and 20-m shuttle run (indicator of cardiorespiratory fitness) among adolescents in Japan before (2013-2017) and after (2018-2022) the introduction of the guidelines using data from the National Survey of Physical Fitness, Athletic Performance and Exercise Habits.
RESULTS: The introduction of the guidelines was associated with reductions in exercise and sports activities duration (boys, -4.8 [95% CI -5.9, -3.8] min/day; girls, -5.5 [95% CI -6.2, -4.8] min/day) and performance of 20-m shuttle run (boys, -1.2 [95% CI -1.4, -1.0] laps; girls, -2.3 [95% CI -2.5, -2.2] laps).
CONCLUSIONS: After introducing guidelines limiting sports club activities at school, levels of exercise or sports and cardiorespiratory fitness declined among adolescents.

The effective implementation of myopia prevention and control interventions is the foundation of achieving the goal of myopia prevention and control in China. However, relevant guidance documents for the implementation and evaluation of myopia prevention and control interventions are still lacking. Therefore, after in-depth research and summarizing relevant practical experiences, the Vision Health Branch of Chinese Association for Student Nutrition and Health Promotion and the Public Health Ophthalmology Branch of Chinese Preventive Medicine Association discussed and proposed the Chinese expert consensus on comprehensive public health intervention for myopia prevention and control in children and adolescents. The consensus develops a theoretical framework of comprehensive intervention actions for myopia prevention and control from the perspective of public health, creates six comprehensive intervention actions, including the establishment of vision health records and myopia risk assessment, evaluation of vision care related behaviors and the development of proper eye-use behaviors, health education for teachers, students and parents, improvement of reading and writing environment at home and school, 2 hours of daytime outdoor activities, hierarchical management and medical orthosis of myopia, and proposes a system of indicators for the implementation and effectiveness evaluation of myopia intervention actions, so as to provide a cost-effective and universally appropriate public health prescription for myopia prevention and control in children and adolescents.
近视防控干预行动有效实施是实现我国近视防控目标的基础。然而，近视防控干预的实施与评价仍然缺乏指导性文件。因此，中国学生营养与健康促进会视力健康分会、中华预防医学会公共卫生眼科分会经深入研究并总结相关实践经验，讨论形成《中国儿童青少年近视防控公共卫生综合干预行动专家共识》。本共识从公共卫生视域构建近视防控综合干预行动理论框架，形成视力健康档案建立与近视风险评估、视力保健行为评价与合理用眼行为养成、师生家长全员健康教育、家校读写环境改善、日间户外活动2 h、近视分级管理与医学矫正等6项综合干预行动，提出实施与效果评价指标体系，为儿童青少年近视防控工作提供经济有效、普遍适宜的公共卫生“处方”。.

This study aimed to compare the effectiveness of the multifaceted implementation strategy (multifaceted group) versus a discrete implementation strategy (discrete group) for implementing the Swedish Guideline for the Prevention of Mental Ill-health Problems at the Workplace on the primary intervention outcome - exhaustion - and secondary outcomes of stress, health, recovery, psychosocial safety climate, and social and organizational risk factors. Another aim was to examine whether the primary and secondary outcomes differed on the basis of guideline adherence levels, irrespective of the group.
A cluster-randomized waiting-list controlled trial with 6- and 12-months follow-up was conducted among 19 Swedish public schools. Primary and secondary outcomes as well as guideline adherence were assessed by self-reported questionnaire. Linear mixed modeling was used to compare differences in outcomes between the groups from baseline to 6 and 12 months, and in relation to different adherence levels.
The trial comprised 698 employees (83.1%) participated. There were no differences between groups in the primary and secondary outcomes at 6 months, while at 12 months differences were observed for some outcomes to the advantage of the discrete group. Better guideline adherence was associated with improvements in exhaustion at 12 months and the secondary outcomes of psychosocial safety climate, work organization and job content, interpersonal relations and leadership, and recovery over 6 and 12 months.
The multifaceted implementation strategy was no more effective than the discrete strategy in improving health outcomes or organizational and social work environment. However, higher adherence to the guideline was associated with larger improvements in health outcomes and organizational and social work environment, irrespective of the implementation strategy used.