Costs of implementing and maintaining comprehensive school health: the case of the Annapolis Valley Health Promoting Schools program.

OBJECTIVE: Comprehensive school health (CSH) is increasingly receiving renewed interest as a strategy to improve health and learning. The present study estimates the costs associated with implementing and maintaining CSH. METHODS: We reviewed the accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS) program in 2008/2009. We considered support for nutrition and physical activity programs by the public system, grants, donations, fundraising and volunteers. RESULTS: The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student. Of the public funding, $140,500 was for CSH, $86,250 for breakfast programs, $28,750 for school food policy programs, and the remainder for other subsidized programs. Grants, donations and fundraising were mostly locally acquired. They totaled $127,235, which translates, on average, to $2,892 per school or $8.37 per student. The value of volunteer support was estimated to be equivalent to the value of grants, donations and fundraising combined. Of all grants, donations, fundraising and volunteers, 20% was directed to physical activity programs and 80% to nutrition programs. DISCUSSION: The public costs to implement and maintain CSH are modest. They leveraged substantial local funding and in-kind contributions, underlining community support for healthy eating and active living. Where CSH is effective in preventing childhood overweight, it is most likely cost-effective too, as costs for future chronic diseases are mounting. CSH programs that are proven effective and cost-effective have enormous potential for broad implementation and for reducing the public health burden associated with obesity.

Strength of messaging in changing attitudes in a workplace wellness program.

The potential benefits of workplace wellness programs are limited by low participation rates of employees, which could be due in part to ineffective persuasion by program providers. This study uses the Elaboration Likelihood Model, as a guiding theory in mixed methods research, to investigate feedback messages about physical activity delivered in a workplace wellness program. This study uses questionnaire and interview data from 32 employees to determine if personally relevant health messages are associated with either positive or negative responses to the messages and subsequent attitude change. General feedback is more appreciated by those who are less fit but are not effective in changing attitudes toward physical activity. Individually targeted messages result in a significant positive attitude change for participants responding positively to the messages. This suggests that individualized health promotion messages provide a stronger argument for individuals, thus increasing the likelihood of attitude change.

Exploring the influence of a social ecological model on school-based physical activity.

Among rising rates of overweight and obesity, schools have become essential settings to promote health behaviors, such as physical activity (PA). As schools exist within a broader environment, the social ecological model (SEM) provided a framework to consider how different levels interact and influence PA. The purpose of this study was to provide insight on school-based PA promotion by investigating the integration between different levels of Emmons's SEM within one public school board in a large Canadian city. Interviews were conducted with participants from the government (n = 4), the public school board (n = 3), principals (n = 3), and teachers (n = 4) and analyzed to explore perspectives on the various levels of the model. The results suggested that higher level policies "trickled down" into the organizational level of the SEM but there was pivotal responsibility for schools to determine how to implement PA strategies. Furthermore, schools have difficulty implementing PA because of the continued priority of academic achievement.