BACKGROUND: Gender-based violence is a worldwide problem. School-based socio-educational interventions could be effective in preventing gender-based violence. We assessed the effectiveness of the Let\'s focus! program, aimed at health and equitable interpersonal relationships among high school students.
METHODS: We conducted a quasi-experimental study in an intervention group (IG, n = 560) and a comparison group (CG, n = 366) of secondary school students in Terrassa, Spain between 2019 and 2021. Specifically, we performed an online questionnaire on sexism, acceptance of violence and machismo at baseline and after the intervention. We calculated multivariate linear regression models including satisfaction with the intervention, to evaluate the change in the variables\' mean between CG and IG.
RESULTS: In comparison to the CG, in the IG hostile and benevolent sexism, and acceptance of violence decreased from baseline to after-intervention, in the group of participants highly satisfied with the intervention (42.4%); machismo did not vary. The multivariate regression analyses showed that the intervention was effective in reducing hostile sexism (β = -6.40; CI95% (-11.92; -0.88)), benevolent sexism (β = -5.57; CI95% (-10.52;-0.61)), and acceptance of violence (β = -4.79; CI95% (-9.50; -0.09)) in highly satisfied students from the IG, in comparison to the ones from the CG, regardless of their age or gender.
CONCLUSIONS: Let\'s Focus! was effective in reducing sexism and decreasing acceptance of violence among students that were highly satisfied with the intervention.

OBJECTIVE: E-cigarettes are a significant concern in schools due to their rising use by adolescents. This research aimed to identify current and preferred intervention strategies to respond to vaping in the Western Australian school setting.
METHODS: Interviews and focus groups were held with 15 school professionals (leaders, teachers and nurses), parents (n = 12) and students aged 13-17 years (n = 32). Discussions were transcribed verbatim, anonymised and thematically analysed using a deductive approach aligned to the Health Promoting Schools Framework.
RESULTS: Participants suggested that limited and varied attention has been directed towards policy in response to vaping in the school setting. Teaching and learning opportunities existed for students, parents and school professionals, albeit somewhat ad hoc in their approach. Additional training would benefit the whole-school community (students, parents and staff) to raise awareness of e-cigarette harms, increase knowledge and build skills in responding to student vaping.
CONCLUSIONS: Clearly articulated policies are needed to guide school strategies and actions towards vaping. There needs to be a dedicated, developmentally appropriate, cross-subject vaping curriculum for students that incorporates mental health outcomes and social skills reinforcement; professional development for school staff; awareness of and access to school-based health services for help and information; visual cues to de-normalise vaping and parent and community involvement to support vape-free school environments. SO WHAT?: Comprehensive prevention activities are required to reduce the uptake of vaping among adolescents. Building students\', school professionals\' and parents\' awareness of vaping and strategies to prevent use will contribute to de-normalising and reducing this practice among adolescents.

BACKGROUND: Although principles of the health promoting school (HPS) approach are followed worldwide, differences between countries in the implementation are reported. The aim of the current study was (1) to examine the implementation of the HPS approach in European countries in terms of different implementation indicators, that is, percentage of schools implementing the HPS approach, implementation of core components, and positioning on so-called HPS-related spectra, (2) to explore patterns of consistency between the implementation indicators across countries, and (3) to examine perceived barriers and facilitators to the implementation of the HPS approach across countries.
METHODS: This study analyzed data from a survey that was part of the Schools for Health in Europe network\'s Monitoring Task 2020. The survey was completed by HPS representatives of 24 network member countries.
RESULTS: Large variations exist in (the influencing factors for) the implementation of the HPS approach in European countries. Observed patterns show that countries with higher percentages of schools implementing the HPS approach also score higher on the implementation of the core components and, in terms of spectra, more toward implementing multiple HPS core components, add-in strategies, action-oriented research and national-level driven dissemination. In each country a unique mix of barriers and facilitators was observed.
CONCLUSIONS: Countries committed to implementing the HPS approach in as many schools as possible also seem to pay attention to the quality of implementation. For a complete and accurate measurement of implementation, the use of multiple implementation indicators is desirable.

UNASSIGNED: Health promoting schools (HPS) prioritize the health of students and community. One important target of HPS is noncommunicable diseases (NCDs), including prevention of heart attacks, due to their burden on healthcare.
UNASSIGNED: This study assesses the effectiveness of an educational intervention to promote knowledge of signs and symptoms, beliefs and attitudes towards heart attack, and promote knowledge of Cardiopulmonary resuscitation (CPR).
UNASSIGNED: The intervention consisted of a 6-minute educational video between a pre-and post-survey. Among other questions, the survey included the Calgary Charter on Health literacy scale, the acute coronary syndrome response index questionnaire, and items assessing knowledge of CPR.
UNASSIGNED: A total of 401 high school students participated (58.9% females). Few students had adequate baseline knowledge of heart attack symptoms (22%) and CPR (7%). The sample showed moderate level of health literacy (12 ± 2.7). Chest pain was the most identified symptom (95%) while abdominal pain was the least identified (14.25%). The intervention significantly increased knowledge, beliefs and attitudes towards heart attack, and knowledge of CPR (p < 0.001). Following the intervention, 83.2% of students demonstrated sufficient knowledge of heart attack symptoms, and 45% exhibited adequate knowledge of CPR. Variables predictive of better attitude, in other words higher confidence in recognizing and reacting to symptoms of heart attack, included having higher health literacy and prior knowledge of risk factors (p < 0.05). Needing help reading medical instructions sometimes predicted worse belief in their capacity to act if they experienced or witnessed a heart attack [score (p < 0.05)]. It was also predictive of worse attitude towards heart attack (OR = 0.18).
UNASSIGNED: High school students in Lebanon lack appropriate knowledge, attitudes, and beliefs toward heart attack, and lack CPR qualifications. Scale up of this educational initiative, along with training of teachers and school personnel, can be used as part of a holistic HPS program aimed at raising awareness of heart attack and first responder preparedness.

The incidence of skin cancer is increasing worldwide even though its main risk factor is preventable. This study evaluated the impact of the Distintivo Soludable pilot intervention on implementation of photoprotection policies and practices in preschool and primary schools in Andalusia, Spain. We completed two rounds of a Sun Protection Policies and Practices Survey (SPPPS) nine months apart. At baseline, 67 Andalusian schools earned a median score of 3/12 points (range 0-8; IQR: 2). Ten schools involved in Distintivo Soludable intervention group significantly increased their scores from 4 to 7.5/12 points (p = 0.014). We also detected a modest positive effect in 57 control group schools, an increase from 2 to 3 points (p = 0.002). This pilot study demonstrated that the main achievement of the Distintivo Soludable intervention was implementation of organizational policies regarding sun protection, an essential starting point for establishing positive attitudes toward sun protection in school communities.

This paper explores the evolution and challenges of health promotion in educational settings, focusing on the Health Promoting Schools framework. Central to this approach is the empowerment of students through participatory strategies and community engagement to address health determinants and reduce inequities. Well-being, a subjective and multifaceted concept, is crucial for student success, with positive school climates playing a key role. Additionally, life skills (LS) are identified as potential tools for promoting student well-being, though their definition and assessment remain ambiguous. The paper concludes by highlighting the need for further research and clarity in order to maximize the impact of health promotion efforts in schools.

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: Kalgal Burnbona is a framework developed for applying school-based integrated care (SBIC) across Sydney Local Health District (SLHD).
UNASSIGNED: Kalgal Burnbona is an innovative and integrative framework developed to provide holistic, integrated, multidisciplinary child and family centred care to school-aged children from priority populations within SLHD, such as those belonging to the Aboriginal community. The expected outcomes include improved health, behavioural, education and social outcomes. This article contextualises the development of the Kalgal Burnbona framework from its beginnings as a pilot site called Ngaramadhi Space (NS) within the Healthy Homes and Neighbourhoods (HHAN) initiative, through to its evolution to an integrated partnership between the New South Wales (NSW) health and education sector. An example of how the framework can be implemented in other settings within SLHD is described.
UNASSIGNED: A tiered approach to integrated care across SLHD is postulated based on evidence from a mixed methods evaluation of NS and in line with the Rainbow Model of Integrated Care (RMIC). Kalgal Burnbona is an example of a community-driven response through collaborative partnerships to improve health, education and social outcomes. The framework described provides structure for multisector teams to work within, recognising that each community and school has its own history and needs.
UNASSIGNED: The Kalgal Burnbona model can be scaled up to serve a wider network of students across SLHD. The initial successes of the model, which include improving access and engagement for children with unmet physical health, mental health and social needs while being accepted by communities provide evidence for policy changes and advocacy that centre on collaborative cross-sector partnerships.

Australian national, state and territory school-based drug education policies advise that volatile substance use (VSU) should be excluded from general drug education curriculum for fear of alerting young people to the intoxicating properties of substances such as petrol, sprays and glues. We review evidence from the United States and United Kingdom on the effects of including volatile substances in school-based drug education, to argue that these policies are due for reconsideration. Nitrous oxide and nitrites are classified as volatile substances along with solvents such as those listed above, although their patterns of use, effects and harms are different. In an era of widespread social media access, more young people than in the past are likely to have heard about VSU. But because VSU is often short-term, parents and teachers may be unaware when young people in their care consume volatile substances. The general silence about VSU in schools, difficulty in detecting use and the varying sets of risks associated with inhaling different substances mean that young people may be unaware of toxicity or harm reduction strategies when they consume volatiles as drugs. We consider some implementation challenges to be negotiated if VSU education were introduced in Australian schools.

UNASSIGNED: Behavioural and emotional disorders are a significant cause of morbidity for young people aged 10-19 years. School-based health care (SBHC) provides an innovative approach to addressing these issues within Australia.
UNASSIGNED: We describe an innovative and integrative SBHC model called Ngaramadhi Space (NS) based at a specialised behavioural school called Yudi Gunyi school (YGS) in metropolitan Sydney, Australia. NS was developed in partnership with the Aboriginal community to provide holistic, integrated, multidisciplinary child and family centred care to students experiencing problematic externalising behaviour. We contextualise the historical factors leading to the development of NS, highlighting the importance of effective partnerships between sectors, and providing the theoretical framework and key components underpinning the model of care.
UNASSIGNED: In Australia, schools are an under-utilised resource for the delivery of health and support alongside education. Collaboration between sectors can be challenging but allows a more coordinated approach to the management of complex social and health issues. By forming effective partnerships with schools and communities, the health sector has an opportunity to improve access to health and social care in a culturally safe and acceptable way. This is in line with national and international frameworks for improving health service delivery and addressing inequity.
UNASSIGNED: The health sector can play a pivotal role in improving the wellbeing of children by forming effective partnerships with schools and communities. The NS model is a practice-based example of this.