NWT RESEARCH DATABASE

Regions: Sahtu Settlement Area, North Slave Region

Tags: social sciences, wellness, health promotion, physical activity

Objective(s): To conduct a baseline evaluation that will provide information about students attending these expansion schools, parents and school principals.

Project Description: In September 2018, APPLE Schools is expanding to two schools in the NWT. The research team will conduct a baseline evaluation in May 2018 that will provide information about students attending these expansion schools, parents and school principals. Data obtained will be used by the schools and assigned School Health Facilitator (SHF) to help inform the development of school specific action plans. The research team will perform similar follow up research in 2020 to understand the effectiveness of APPLE Schools’ programming and revise school action plans. The team will also perform interviews /focus groups with teachers, SHF and the school community to understand implementation of the program and improve future implementation strategies. The proposed research has both a quantitative and qualitative components. Quantitative methods: This study comprises of three surveys: 1) parent, 2) student, 3) principal survey, measured student height and weight, and pedometer measured step counts of students. Approximately 7 days prior to the researchers' school visits, the study information letter, parental consent form, and parent survey will be sent home with students in grades 4, 5 and 6 (distributed by teachers). This survey includes questions about the home environment, the child's dietary, physical activity and sleep habits and demographic information. Parent consent forms and surveys will be returned to researchers when they visit the school to conduct the student survey, and only students who have returned parent consent forms will be allowed to participate in the study. The principal surveys will be dropped off to the school at the same time as the parental study documents. The completed survey will be picked by the researchers on the same day as they conduct the student survey. The Principal Survey will ask about the following: 1. the school's physical environment, 2. current health promotion strategies regarding students' dietary habits, physical activity, and positive mental well-being, 3. food's offered at school, 4. physical activity opportunities for students at school, and 5. what roles principals feel schools should have in promoting healthy eating, active living and position mental well-being. Researchers in teams of two to four will visit the schools to administer the student survey. The student survey will be administered in a web-based format, where students will be asked to complete an online assent form and student survey on a computer. This survey will include validated questions about physical and sedentary activities, a 24-hour dietary recall, and questions about other health-related behaviours. Researchers will ask student to wear pedometers for 9 days. During this visit, researchers will also measure student height and weight. Researchers will be in touch with an identified school staff member to ensure students are wearing their pedometers and answer any questions that may arise. Nine days after the initial visit, teachers will collect the pedometers from their students and will mail pedometers back to the researchers. No personal identifiers will be on the pedometers. The researchers will then download the students' step count data. All students in grades 4, 5, and 6 and their parents will be asked to participant. Principals in the two schools will be asked to participate Qualitative methods: The purpose is to conduct process evaluation related to the APPLE Schools expansion. 1. Pre and post training surveys with SHFs to measure competency and confidence. SHF’s will be asked to complete a short survey examining self-efficacy beliefs related comprehensive school health (CSH). This survey is based on a scale used previously with teachers involved in school health promotion and adapted based on challenges identified in previous research with SHFs. SHFs will be asked to complete the survey at up to 2 time points annually during the school year (beginning, mid-point, and/or end of year implementation). The survey asks participants to rate their level of confidence to implement healthy eating, active living and mental wellbeing activities in their school under varying conditions (e.g., “when colleagues disagree with its importance”) on a scale of 0 to 100. As well the self-efficacy survey includes questions regarding knowledge, confidence and perceptions of implementing CSH using a 5-point scale based upon the previously validated Healthy Opportunities for Preschoolers self-efficacy survey. The research team will be putting this survey into RedCap to collect the data electronically. 2. Pre-implementation surveys with administrators to determine baseline of school culture Questions will be incorporated in the quantitative Principal surveys previously discussed. 3. Collection of action plans and the healthy School Planner to assess school environments. SHFs currently complete an action plan and reflective checklist to help guide the implementation of CSH. In completing the checklist, SHFs are asked to reflect on the degree to which they are implementing CSH, in accordance with the 4 pillars, 3 primary settings, (home, school, community), and 3 content areas (physical activity, nutrition and positive social environments) of CSH using a ranking of 1 to 4 (1= no impact, 4=high impact). Reflective checklists can provide valuable information, specifically how pillars, settings and content areas are being impacted by yearly CSH goals. The information provided in these documents will be used as complementary secondary data. 4. SHF focus groups/interviews to determine key facilitating factors of CSH. The research team will be conducting interviews with the new school health facilitators to understand their experiences with implementing comprehensive school health in their more remote and rural schools. The goal of this research is to understand what barriers and facilitators they have experienced in their first year of implementation. We will asking them to complete a pre-survey to help inform the interview. 5. Community focus groups to determine impact on the broader community. Social network analysis (SNA) examines the pattern of relationships that exist between individuals or groups within a network. As such relationships are essential in CSH, the goal is to gain an understanding of the overall network structure in a sample of the APPLE schools (those near their last year of implementation and those with reduced dose, projected at n=6) and the coordinating role of health champions in building relationships and strengthening capacity for sustainable CSH. A network questionnaire will collect data on the strength and patterns of relationships among relevant individuals in each APPLE school community. Participants will be identified through reputational sampling and will be emailed a link to the password protected web-based survey (or paper-based survey, depending on the school's preference). Following collection, individual names will be replaced with anonymous identification numbers. Using network analyses and mapping software (UCINET and NETDRAW), the team will visually depict the relationships between individuals in each school community. All participants will receive a network map which will be presented during a workshop in each participating school. 6. Teacher focus groups to determine reach to target audience. This study will use an open-ended exploratory approach to identify teacher's experience of the implementation of the APPLE project, including their perception of change. Information collected from student and parents (quantitative research) will be summarized into school-specific reports and one-page infographics for each school. It will be up to the Principal to decide how these reports are shared with the school community; however, they are strongly encourage to use the reports to inform their school action plans. Researchers will use the information collected, along with information collected from other expansion schools outside the NWT (Alberta (n=12) and Manitoba (n=2)) for scientific presentations and publications. Publications will be shared with APPLE Schools and made available to be posted on their website and shared with the school community. Qualitative results will be summarized into a report. This report will be shared with the broader school community including school boards and government stakeholders. The report will help to improve implementation strategies of school-based interventions. The fieldwork for this study will be conducted from May 30, 2018 to December 17, 2018.