Association between the environment for physical activity in public schools and childhood obesity: a view in the light of complex systems / Associação entre ambiente para atividade física em escolas públicas e obesidade infantil: um olhar à luz de sistemas complexos

Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda.

Assessing Lifestyle Patterns and Their Influence on Weight Status in Students from a High School in Sibiu, Romania: An Adaptation of ISCOLE Questionnaires and the Child Feeding Questionnaire.

The escalation of global obesity is driving research to understand environmental influences on this process, particularly during vulnerable developmental stages such as childhood and adolescence. Efforts include the development of various structured data collection tools. We aimed to adapt a series of previously validated questionnaires from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the Child Feeding Questionnaire, and elements from the World Health Organization Childhood Obesity Surveillance Initiative (COSI) in order to assess local lifestyle patterns among Romanian high school students and their families that may predispose them to obesity. To this goal, an expert committee was formed as part of a research partnership to oversee the questionnaire's translation and adaptation. It consisted of education and school management specialists, clinical research professionals, language experts, and public health experts. The adapted questionnaires were then applied to 114 students enrolled in the 9th and 10th grades attending a high school situated in Sibiu, and their parents. The variables measured were investigated for correlations with overweight and obesity and, as a secondary objective, academic performance. The study revealed several critical findings, including suboptimal sleep durations and physical activity levels among students, a significant amount of screen time, and correlations between weight status and physical activity, sedentary time, and maternal weight status and education levels. The adapted questionnaires proved to be effective tools in capturing the multifaceted factors implicated in adolescent obesity, providing a foundation for targeted interventions and broader public health strategies to address this issue.

Perspectivas de Profissionais de Educação sobre ações do Programa Saúde na Escola em Pelotas em 2022 / Perspectives of Education Professionals on actions of the School Health Program in Pelotas in 2022

Esta pesquisa teve como objetivo descrever as ações do Programa Saúde na Escola em 2022 no município de Pelotas, Rio Grande do Sul, segundo a perspectiva de profissionais da educação. Trata-se de um estudo transversal, contemplando 51 das 60 escolas de Ensino Fundamental de nível municipal. Foram utilizados dois questionários estruturados administrados aos responsáveis pelo Programa ou membros da equipe gestora das instituições por meio telefônico, ou presencial. Os temas abordados com diretores, vice-diretores, orientadores educacionais e coordenadores pedagógicos incluíram a existência do Programa, as temáticas desenvolvidas, sua frequência, capacitação, envolvimento de profissionais de saúde e educação, articulação entre setores, apoio, autonomia de estudantes e barreiras para implementação do programa. Entre as 51 escolas analisadas, 41 (80,5%) delas possuíam o programa, com frequência das ações prevalentes a cada 3 meses (39,0%) e sendo a ação de Promoção da saúde bucal (90,2%) a mais apontada. Em 70,7% das escolas foram realizadas ações de promoção de atividade física. Além disso, observou-se o setor saúde como principal responsável pelas ações (87,8%), limitada participação dos alunos na escolha das temáticas (34,0%) e escassez de capacitações aos educadores (36,6%). Embora uma instituição universitária tenha se apresentado como fonte de apoio (53,7%) e todas as escolas com o programa registraram ao menos uma ação realizada, a sobrecarga (36,6%) e a necessidade de articulação (34,1%) foram as barreiras mais relatadas. Apesar dos desafios e dificuldades em diversos indicadores, foram identificadas iniciativas que configuram o Programa como importante ferramenta para promoção da saúde de escolares no município.

This research aimed to describe the actions of the School Health Program in 2022 in the municipality of Pe-lotas, Rio Grande do Sul, Brazil, from the perspective of education professionals. This is a cross-sectional, as-sessing 51 of the 60 municipal elementary schools. Two structured questionnaires were administered to those responsible for the Program or members of the management team of the institutions by telephone or face-to-face. Topics addressed with principals, vice-principals, educational advisors and pedagogical coordinators included the description of the existence of the Program, the themes developed, as well as its frequency, train-ing, involvement of health and education professionals, articulation between sectors, support, autonomy of students and barriers to the implementation of the program. Among the 51 schools analyzed, 41 (80.5%) of them had the program, with the frequency of prevalent actions every 3 months (39.0%) and the Oral Health Promotion action (90.2%) being the most pointed out. In 70.7% of the schools, actions to promote physical activity were carried out. In addition, the health sector was the main responsible for the actions (87.8%), limited participation in the choice of themes (34.0%) and scarcity in the provision of training for educa-tors (36.6%). Although a local university was a strong support (53.7%) and all schools with the program recorded at least one action taken, overload (36.6%) and the need for articulation (34.1%) were the most reported barriers. Despite the challenges and difficulties in several indicators, initiatives were identified that configure the Program as an important tool for promoting the health of schoolchildren in the municipality.

Where Are Czech Adolescents Active? The Patterns of Movement and Transport Behavior in Different Active Living Domains.

To understand the environmental determinants of physical activity (PA), precise spatial localization is crucial. This cross-sectional study focuses on the spatiotemporal distribution of PA among Czech adolescents (n = 171) using Global Positioning System loggers and accelerometers. The results showed that adolescents spent most of their time in sedentary behavior, with 57.2% and 58.5% of monitored time at home and school, respectively. The park and playground had the lowest proportion of sedentary behavior but also the lowest amount of moderate to vigorous PA (MVPA). However, when considering the time spent in each domain, the highest proportion of MVPA was seen in publicly accessible playgrounds (13.3% of the time). Chi-square analysis showed that the relative distribution of different PA intensities did not differ across spatial domains. Based on these results, the authors propose 2 key strategies for increasing MVPA in adolescents: Increase the time spent in activity-supportive environments, such as parks and playgrounds, and design techniques to increase MVPA at home and school settings.

Promoting physical activity and youth development in schools: the case for near-peer coaches.

Background: Sports-based youth development (SBYD) programs provide an inclusive, supportive environment for promoting physical activity as well as nurturing the development of life skills which, in combination, promote physical, mental, and emotional health in youth. The Up2Us Sports SBYD program was implemented in six schools in New Orleans, Louisiana in 2020-2022, where near-peer coaches from the community were placed in schools and present throughout the school day. The intervention period straddled the COVID-19 pandemic as well as extreme weather events, modifying program delivery. Process/methods: An exploratory case study was conducted to understand participant experience amid program disruptions and modifications, as well as their perceptions of program impact on physical activity and health. Interviews with coaches (n = 7), focus groups with youth (n = 14) and program observation data were triangulated to provide a description of the case. Results: The major theme that emerged from the case study was the centrality of the near-peer mentorship relationships between coaches and youth. Participants believed near-peer relationships facilitated life skill development and increased opportunity for physical activity in schools, but pressures on coaches' time and external challenges in the community were limiting factors to the extent of program impact. Conclusion: This community case study demonstrates the potential role for near-peer mentors in influencing the health and wellbeing of youth from under-resourced communities and highlights the opportunity for school-based SBYD programming to provide youth with a consistent source of both relational and physical activity support.

The factors associated with contraceptive use among young female students in rural Guinea / Facteurs associés à l'utilisation des méthodes contraceptives chez les jeunes filles élèves en milieu rural guinéen

Introduction: The low use of modern contraceptive methods by young girls is a real public health problem in sub-Saharan Africa, especially among young female students living in rural areas. The purpose of this study was to analyze the factors associated with contraceptive use among young female students in rural Guinea. Method: This was an analytical cross-sectional study including 607 students from 10 secondary schools in the rural district of Kankan, Guinea. Results: A total of 607 female students were interviewed and included in this study. They had an average age of 17.3 ± 1.7 years, 50.9% were in junior high school, and 49.1% were in high school. During our survey period, 67.7% of the girls reported being sexually active, while only 24.4% were on modern contraception. In the bivariate analysis, factors such as age, religion, school level, having heard of contraception, and having had sexual intercourse were statistically associated with contraceptive use. In the multivariate analysis, factors such as age (OR = 2.1; CI = 1.1­3.8), religion (OR = 5.1; CI = 2.8­9.5), and having had sexual intercourse (OR = 2.2; CI = 1.4­3.5) remained statistically associated with the use of contraceptive methods among young female students. Conclusion: Our study highlights the need to increase awareness of, and access to, contraceptive methods in schools in order to improve contraceptive practice and, in turn, to reduce the frequency of unwanted and early pregnancies among young female students in rural areas of Guinea.

Introduction: La faible utilisation des méthodes contraceptives modernes par les jeunes filles constitue un véritable problème de santé publique en Afrique subsaharienne, en particulier chez les jeunes filles élèves et résidant en milieu rural. Cette étude visait à analyser les facteurs associés à l'utilisation des méthodes contraceptives chez les jeunes filles élèves en milieu rural guinéen. Méthodes: Il s'agissait d'une étude transversale analytique incluant 607 élèves de 10 écoles secondaires du district rural de Kankan en Guinée. Résultats: Au total, 607 jeunes filles élèves ont été interrogées et incluses dans cette étude. Leur moyenne d'âge était de 17,3 ± 1,7 ans, 50,9 % d'entre elles fréquentaient le collège et 49,1 % le lycée. Pendant notre période d'enquête, 67,7 % des jeunes filles ont déclaré être sexuellement actives alors que seules 24,4 % étaient sous contraception moderne. En analyse bivariée, les facteurs comme l'âge, la religion, le niveau scolaire, avoir déjà entendu parler de contraception et avoir déjà eu un rapport sexuel étaient statistiquement associés à l'utilisation de méthodes contraceptives. En analyse multivariée, les facteurs comme l'âge (RCa = 2,1 ; IC = 1,1-3,8), la religion (RCa = 5,1 ; IC = 2,8-9,5) et avoir déjà eu un rapport sexuel (RCa = 2,2 ; IC = 1,4-3,5) restaient statistiquement associés à l'utilisation de méthodes contraceptives chez les jeunes filles en milieu scolaire. Conclusion: Notre étude souligne le besoin de renforcer la sensibilisation et l'accès aux méthodes contraceptives en milieu scolaire en vue d'améliorer la pratique contraceptive, et par ricochet réduire la fréquence des grossesses non désirées et précoces chez les jeunes filles élèves en milieu rural guinéen.

To Show or Not to Show: Factors within the School Environment That Influence the Expression of LGBTQ Identities.

Prejudice against LGBTQ people during their schooling years can be detrimental due to its long-term consequences. This includes the development of beliefs that the world is unsafe, which can perpetuate mental health struggles later in life. Fostering a school environment where LGBTQ people can express their identity can contribute to greater well-being. This qualitative study drew on interviews with 13 school graduates to examine the environmental factors within Australian schools that influenced LGBTQ students' expression of their identity. Drawing on Altman's conceptualization of oppression and liberation, this study found students typically experienced liberation in the form of acceptance and validation within their micro-environment at school. This micro-environment was composed of those close to the student, such as friends, allies, teachers, and other LGBTQ students who provided acceptance and validation, which enabled the student to express their identity regardless of oppression within the broader school environment. Oppression on the other hand originated from the invisibility of LGBTQ identities; the limited representation in curriculum and access to LGBTQ-specific resources and supports; concerns around gendered, gender-neutral, and safe spaces; and limited support from teachers. Based on the findings, implications are drawn to enhance both the micro and macro environment for LGBTQ school students.

Is Early-Life Enrichment Associated With Better Cognitive Function Among Older Adults? Examining Home and School Environments.

Objectives: We examine whether early-life enrichment, involving varied and stimulating activities to enhance cognitive function during childhood and adolescence, is associated with cognitive function in later life and whether the benefits persist over time. Methods: Growth curve models were used to examine up to five waves of data from the Health and Retirement Study-a nationally representative survey of adults 50 years and older (N = 10,070). We constructed separate measures of early-life enrichment to distinguish sources of influence (i.e., enriched home environment and enriched school environment). Global cognitive function was assessed with a modified version of the Telephone Interview for Cognitive Status. Results: Greater enrichment in each environment was incrementally associated with better cognitive function at baseline, but enrichment was not associated with change in cognitive function over time. Discussion: Receiving enrichment from multiple environments during sensitive periods of cognitive development may be advantageous for cognitive functioning in later life.

Associations of school physical activity environment with comorbid obesity and myopia in children and adolescents: Findings from a Chinese national follow-up study.

BACKGROUND: Overweight and obesity (OWOB) and myopia have become two of the most important issues affecting the health of children and adolescents worldwide. Despite the recognition that the school physical activity (PA) environment is a critical factor for preventing and controlling overweight, obesity (OWOB), and myopia in children and adolescents, research on OWOB and myopia as a comorbidity remains unexplored, with evidence for effective strategies still being inconclusive. Hence, this study aimed to assess the prevalence and progression of comorbid OWOB/myopia and each condition alone, and to explore the association with school PA environment. METHODS: A total of 9814 children and adolescents aged 6-18 years were included from the Chinese National Survey on Students' Constitution and Health follow-up survey conducted from November 2019 to November 2020 in China. Anthropometric measurements, unaided distance vision acuity and non-cycloplegic refraction data were collected to assess OWOB and myopia, while eight indicators from questionnaires for children and adolescents aged 9-18 years were investigated to assess school PA environment. We calculated the one-year incidence and progression rates of comorbid OWOB/myopia, OWOB alone, and myopia alone. Mixed effect logistic regression was evaluated the association between school PA environment and incidence and progression of comorbid OWOB/myopia, OWOB, and myopia. RESULTS: The prevalence of comorbid OWOB/myopia increased from 11.1% in 2019 to 17.9% in 2020, and the incidence of comorbid OWOB/myopia was 10.9%. Children and adolescents experiencing an unfavorable school PA environment had a higher risk of the incidence of comorbid OWOB/myopia compared to a favorable school environment (OR = 1.85, 95% CI: 1.42-2.42). Similar findings were seen in the incidence of obesity (OR = 1.86, 95% CI: 1.26-2.75). Children and adolescents in an unfavorable school PA environment had a higher risk of myopia progression (OR = 1.29, 95% CI: 1.01-1.65). CONCLUSIONS: Obesity and myopia and their comorbidity have been serious among children and adolescents in China. A favorable school PA environment might mitigate the risk of comorbid OWOB/myopia, OWOB, and myopia progression.

Associations between a technical assistance model to build school organizational capacity and improvements in student perceptions of school climate.

Organizational capacity building-the process of developing leadership, collecting and analyzing data, building buy-in, and implementing programming-is foundational to effectively changing schools, and frequently relies on technical assistance. This study employed a quasi-experimental, repeated measured design to evaluate the role of technical assistance provided through Safe School Certification model in improving school climate. Schools worked through an eight-element framework, using data from a sample of six middle and high schools in Washington, D.C. that completed data collection in all years of the evaluation. Students in schools receiving technical assistance for implementing the SSC Framework had more positive changes in perceptions of school climate than students in schools that did not receive support, but those differences were small. The results from this study offer limited evidence that providing schools with technical assistance to improve organizational capacity is associated with more positive student perceptions of school climate.

Contents, Methods, and Outcomes of Adolescent Sexual Health Promotion in School Environments: A Scoping Review.

BACKGROUND: Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. METHODS: Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. RESULTS: After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. CONCLUSIONS: The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.

Association of children's oral health and school environment on academic performance in 12-year-old schoolchildren of Quito, Ecuador.

OBJECTIVES: The primary aim of this study was to evaluate if children's oral health and oral health-related quality of life (OHRQoL) were associated with school performance. Moreover, the study aimed to examine whether school environment factors influenced this association. METHODS: This cross-sectional study was based on a population-based sample of 998 12-year-old schoolchildren from 31 public schools in Quito, Ecuador. Trained and calibrated examiners conducted clinical exams for dental caries, dental trauma and malocclusion. Furthermore, children completed the Spanish version of the Child Perception Questionnaire (CPQ11-14 ), and their parents answered questions about socio-economic status. School coordinators provided information on the physical environment, promotion of health practices and the occurrence of negative episodes in the school. There were three outcomes: grades obtained in Spanish language and mathematics and the number of missed school days. Multilevel linear and Poisson regression models were conducted using a hierarchical approach to include the variables guided by a previously created direct acyclic graph. RESULTS: Children with dental trauma and higher CPQ11-14 scores showed lower grades and school attendance. Schoolchildren from schools with episodes of vandalism had more school days missed. CONCLUSION: The school performance of 12-year-old children is affected by dental trauma and by a worse OHRQoL, as well as a negative school environment. Therefore, supportive environments and promoting health measures in schools could overcome this worse academic performance in children with oral health problems.

Development and validation of Child-Friendly School Environment Questionnaire from Chinese culture.

In the context of building Child-Friendly Cities in China, child-friendly school environments are considered as having a profound impact on children's development and growth. This study presents the development and validation of the Child-Friendly School Environment Questionnaire for assessing a child-friendly school environment. Utilizing open-ended questions and interviews, an initial questionnaire on the child-friendly school environment was compiled. An exploratory factor analysis of the preliminary test results with 696 primary school children in grades three to six was conducted to refine the questionnaire into a formal 19-item questionnaire. Subsequently, a confirmatory factor analysis was performed to analyze the evaluation results of 807 primary school children in grades three to six. The results indicated that a child-friendly school environment is a multi-dimensional construct encompassing Environment Friendly, Teaching Friendly, Peer Friendly, and Children Participation, with good reliability and validity. The promising outcomes of this study suggest that the Child-Friendly School Environment Questionnaire can be widely used as a powerful evaluation tool for the child-friendly school education practice in the future.

Assessing Obesogenic School Environments in Sibiu County, Romania: Adapting the ISCOLE School Environment Questionnaire.

The impact of the school environment on childhood weight status has garnered significant attention in recent years. This study aimed to adapt and validate the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) School and Environment questionnaire in order to assess the potential obesogenic impact of school environments in Sibiu County, Romania. The ISCOLE questionnaire was chosen for its rigorous methodology. It was derived from a comprehensive study conducted across 12 countries which aimed to capture multifaceted influences on childhood weight while emphasizing educational settings in the collection of data. To guide the translation and adaptation of the questionnaire, a multidisciplinary committee was assembled which comprised experts in teaching and school administration to ensure target responder relevance, experts in clinical research to ensure methodological robustness, experts in language adaptation to preserve the original intent of the survey, and experts in public health to steer the interpretation of the results, with potential policy implications. The data were analyzed by distinguishing between urban and rural settings, and a two-step cluster analysis was implemented to identify potential intervention targets. To assess the validity of the adapted tool, the questionnaire's construct validity and internal consistency were explored. A response rate of 71.2% of the approached schools in Sibiu County was achieved. Of the 84 responding school representatives, 37 (44%) were from a rural setting. The rural schools had significantly more limited access to gymnasiums, secured lockers, showers, and bicycle racks, and exhibited more serious problems regarding the inadequate disposal of garbage in the school vicinity. A two-step cluster analysis revealed distinct school categories, providing opportunities for public policy interventions. One of these primarily concerned rural schools with limited infrastructure but with proactive practices and policies which were termed "unable but willing"; on the opposing spectrum, the category "able but unwilling" mainly comprised urban schools which had available facilities but lacked local proactive initiatives. The findings emphasize the urgent need for targeted measures to bridge these discrepancies by investing in infrastructure in rural schools and promoting active school practices and policies in urban settings. The assessment of obesogenic school environments in Sibiu County provides a pilot model for broader applications due to the diverse school landscape and supportive local authorities. The results, which were achieved using low-cost methods, can guide future educational policies, health promotion initiatives, and preventive interventions.

Safety preparedness in arab public schools.

Background: A proper and adequate school environment is important for an effective learning process and for the maintenance of students' health, given that they spend a considerable amount of time at school. Safety preparedness in schools includes, for example, protection from biological, physical, and chemical risks and physical hazards associated with poor construction and maintenance practices. Objectives: This study aims to evaluate safety preparedness in girls' public schools in the Kingdom of Saudi Arabia (KSA). Methods: Seventeen girls' schools were randomly selected in the Eastern Province of KSA. A designed checklist was used for this study, composed of two main parts. The first part included general information about the school, while the second part was composed of 6 items with a total of 58 questions, evaluating the school's safety preparedness. Results: The safety preparedness in the studied schools ranged between 70 and 90%. Some safety practices were found to be adequately applied, others were poorly applied, and certain items were completely absent. Generally, some examined schools were not compliant several safety and emergency preparedness recommendations. Conclusion: Collaboration between the School Safety Committee and schools is essential to reach a satisfactory standard in terms of school safety. Therefore, it is recommended that the School Safety Committee engages with schools more actively, especially in terms of the preparation of a school safety management plan.

The School Environment and Physical and Social-Emotional Well-Being: Implications for Students and School Employees.

BACKGROUND: The school environment, consisting of the physical environment and social-emotional climate (SEC), plays a crucial role in both student and employee health; however, there is a lack of recent literature synthesizing school environment interventions in K-12 settings. We describe updated evidence about school environment interventions to support K-12 student and employee health in the United States. METHODS: A 2-phase search included a review of reviews (2010-2018), followed by a search for individual articles (2010-2020) that targeted school physical environment and/or SEC to address physical activity (PA) and/or nutrition. We also investigated how nutrition and PA interventions with an SEC component improves social-emotional and/or mental health outcomes. Because research on dietary and PA behaviors for school employees is limited; we included studies on other worksites (eg, hospitals and offices) to provide insight for school employees. FINDINGS: We identified 40 articles describing 40 unique studies and 45 interventions and grouped them by intervention type. Physical environment interventions demonstrated significant and positive nutrition and PA behavioral outcomes for students; outcomes among employees were mixed. Interventions with SEC components reported improvements in some mental health outcomes. IMPLICATIONS: The school environment can affect dietary and PA behaviors as well as mental health for students and employees. CONCLUSIONS: Establishing healthy school environments can support student and employee PA, dietary behaviors, and mental health.

School Greenness and Student-Level Academic Performance: Evidence From the Global South.

Greenspace in schools might enhance students' academic performance. However, the literature-dominated by ecological studies at the school level in countries from the Northern Hemisphere-presents mixed evidence of a beneficial association. We evaluated the association between school greenness and student-level academic performance in Santiago, Chile, a capital city of the Global South. This cross-sectional study included 281,695 fourth-grade students attending 1,498 public, charter, and private schools in Santiago city between 2014 and 2018. Student-level academic performance was assessed using standardized test scores and indicators of attainment of learning standards in mathematics and reading. School greenness was estimated using Normalized Difference Vegetation Index (NDVI). Linear and generalized linear mixed-effects models were fit to evaluate associations, adjusting for individual- and school-level sociodemographic factors. Analyses were stratified by school type. In fully adjusted models, a 0.1 increase in school greenness was associated with higher test scores in mathematics (36.9 points, 95% CI: 2.49; 4.88) and in reading (1.84 points, 95% CI: 0.73; 2.95); as well as with higher odds of attaining learning standards in mathematics (OR: 1.20, 95% CI: 1.12; 1.28) and reading (OR: 1.07, 95% CI: 1.02; 1.13). Stratified analysis showed differences by school type, with associations of greater magnitude and strength for students attending public schools. No significant associations were detected for students in private schools. Higher school greenness was associated with improved individual-level academic outcomes among elementary-aged students in a capital city in South America. Our results highlight the potential of greenness in the school environment to moderate educational and environmental inequalities in urban areas.

Ultra-processed food consumption is associated with variations in daily routines in elementary schoolchildren during the COVID-19 pandemic in Chile.

OBJECTIVE: To assess the association between child ultra-processed food (UPF) consumption and home-school learning environment characteristics during school closures due to the COVID-19 pandemic in schoolchildren with low- and middle income in Chile. DESIGN: Cross-sectional. UPF consumption was collected using the Nova screener. We apply the structured days hypothesis (SDH) to assess home-school learning environment characteristics with three constructs that summarised school preparedness for online teaching and learning, school closure difficulties for caregivers and child routine. We explored associations between child UPF consumption and home-school environment characteristics using multivariate linear regression analyses after controlling for child demographic and school characteristics. SETTING: Low- and middle-income neighbourhoods in southeastern Santiago, Chile. PARTICIPANTS: Children from the Food Environment Chilean Cohort (n 428, 8-10 years old). RESULTS: Based on the Nova score, child mean consumption of UPF was 4·3 (sd 1·9) groups. We found a statistically significant negative association between child routine for eating, play and study and child UPF consumption when we adjusted for child sociodemographic (model 1: ß = -0·19, (95 % CI -0·40, 0·02)) and school characteristics (model 2: ß = -0·20, (95 % CI -0·41, 0·00)). Associations between school preparedness for online teaching or school closure difficulties and UPF were not statistically significant. CONCLUSIONS: Variations in child routines during the COVID-19 pandemic were negatively associated with UPF intake in schoolchildren with low- and middle income. Our findings are consistent with the SDH, suggesting the school environment helps regulate eating behaviours. Future research should evaluate what happens when children return to in-person classes at school.

Influences of High School Physical Learning Environments on Students' Anxiety in China.

BACKGROUND: High school students are at an increased risk of developing generalized anxiety disorder (GAD) due to significant pressure to achieve academic success. AIM: Although it is known that a school's physical learning environment can influence students' GAD, there is limited research examining this relationship. To fill this knowledge gap, a cross-sectional study was conducted among 230 students from two high schools in China. METHODS: A survey questionnaire captured students' GAD self-evaluations (dependent variables), perceptions/preferences of their school physical environment (independent variables), and social and personal conditions (confounding variables). Bivariate analysis showed that students' GAD scores were associated with multiple factors related to the learning environment, physical activities, and personal characteristics. The multivariate analysis examined the relationship between GAD scores and physical learning environment variables while controlling for confounding variables. RESULTS: The results indicated that adequate lighting (B = -0.154, p = .029) and perceived effectiveness of using self-service cafeterias in reducing anxiety (B = -0.138, p = .044) were significantly associated with GAD scores. CONCLUSIONS: These findings provide evidence for the importance of designing high schools with students' mental health in mind. Specifically, school administrators and designers should consider how to improve the physical learning environment by incorporating natural light, a self-service cafeteria, and spaces for physical activities to promote students' mental well-being.

Adolescents' Internet addiction: Does it all begin with their environment?

BACKGROUND: This is one of the few studies that examines adolescent Internet addiction (IA) among Middle Eastern population. The purpose of this study is to determine whether adolescents' family and school environments play a role in their Internet Addiction. METHODS: We conduced a survey that included 479 adolescents in Qatar. The survey collected demographic data, the Internet Addiction Diagnostic Questionnaire (IADQ), the Brief Family Relationship Scale (BFRS) and questions from the WHO Health Behavior in School-aged Children (HBSC) survey that assess school environment, academic performance, teacher support, and peer support of the adolescents. Factorial analysis, multiple regression, and logistic regression were used for statistical analysis. RESULTS: Family environment and school environment were negative and significant predictors of adolescent Internet addiction. The prevalence rate was 29.64%. CONCLUSION: Results imply that interventions and digital parenting programs should not only target adolescents, but also include entities in the developmental environment of adolescents, i.e. their family and school.