Schools as Hubs of Health: A Comprehensive Supplemental Nutrition Assistance Program-Education Model for Promoting Wellness in Low-Income Communities.

Research indicates that health interventions are most effective when they address multiple social determinants of health to support positive behavior. Schools as Hubs of Health, a comprehensive model of nutrition and physical activity education, was developed to support wellness within school communities defined as low-income by the national Supplemental Nutrition Assistance Program Education (SNAP-Ed). Components of the model include the following: classroom education; garden education; youth engagement; staff training; parent and community engagement; and policies, systems, and environments. Findings over the last decade indicate positive outcomes in nutrition and physical activity behaviors, youth leadership and engagement, and systems and environmental changes that support health and wellness.

Assessing the Effectiveness of an Extender Model Partnership in Implementing a Multicomponent, School-Based Nutrition Intervention.

Childhood obesity continues to be a problem of national concern; school-based obesity prevention programs that incorporate nutrition education are among the efforts to address this issue. Implementation of these programs is often conducted through partner agencies like the Supplemental Nutrition Assistance Program Education (SNAP-Ed). As educators within these agencies have limited time and many schools qualify for programming, developing programs that extend reach by partnering with classroom teachers to deliver nutrition education is critical. The purpose of this article is to evaluate the effectiveness of a teacher extender model compared with direct nutrition education from trained staff using the research-tested, evidence-based Shaping Healthy Choices Program. Data collected as part of this evaluation in intervention and control groups included nutrition knowledge, body mass index percentile, and vegetable identification in youth; lesson fidelity observations and feasibility from teachers; and demographics from parents. Overall, unequal within variances did not allow for the statistical power to detect change. Generally, teachers enjoyed the program but found it too time-consuming to implement. While results were unclear, important lessons were learned regarding the implementation of extender programs warranting further research. Overall, this study aligns with others in the literature that indicate time is a major barrier to implementing nutrition education in the classroom. This study underscores the need for policy mandating nutrition education in schools.

Patient-led partner notification for syphilis: Strategies used by women accessing antenatal care in urban Bolivia.

Maternal syphilis adversely affects close to one million pregnancies worldwide every year with consequences that may include spontaneous abortion, stillbirth, neonatal death, premature birth, neurological impairment and bone deformities of the neonate. In Bolivia, the maternal syphilis rate has been estimated at 4.3% among women with live births and 26% among women with stillbirths. Partner notification is critical to the prevention of maternal re-infection and vertical transmission of syphilis. Patient-led partner notification, also known as patient referral, is the recommended starting point for partner notification programs in resource poor settings because it requires less infrastructure and provider involvement. Though patient referral requires a higher level of engagement on the part of individuals, few studies have examined, in depth, the process of patient-led notification. Further, we found no studies of this type conducted in Bolivia, a country where culturally acceptable and appropriate interventions are needed to control maternal syphilis. This study examined partner notification, for the first time, from the perspective of women accessing treatment for maternal syphilis in Bolivia. Semi-structured interviews were conducted with 18 women who had attempted or planned to attempt notifying their partner. The interview guide was designed to investigate the experience of patient-led partner notification for syphilis with particular emphasis on the strengths and capacities of the participants. Accordingly, we applied an existing theoretical model for individual empowerment in the analysis of the interviews with the participants. This emphasis on the positive, solution-finding capacities of the participants allowed us to investigate the ways in which participants took control over an aspect of concern to their health. More studies are needed which examine successful patient-led strategies for partner notification and their connections with long-term health outcomes.