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Health promotion policies and practices in Nova Scotia schools Open Access


Other title
school health
health promotion
population health
Type of item
Degree grantor
University of Alberta
Author or creator
McIsaac, Jessie-Lee D
Supervisor and department
Kirk, Sara FL (Health and Human Performance)
Veugelers, Paul J (Public Health Sciences)
Examining committee member and department
McNeill, Geraldine (Applied Health Sciences)
Mumtaz, Zubia (Public Health Sciences)
Jardine, Cindy (Centre for Health Promotion Studies)
Department of Public Health Sciences
Public Health
Date accepted
Graduation date
Doctor of Philosophy
Degree level
Canadian school jurisdictions have adopted health promotion policies and guidelines as part of a broader comprehensive strategy to address childhood obesity, but there is limited research that has investigated how these “naturally occurring” population level interventions have influenced changes in school environments and student behaviours. Following the dissemination of various policies and initiatives related to health promotion in schools, the Province of Nova Scotia (NS) offered a case for research inquiry to describe how recent provincial policies were implemented. The purpose of this research was to provide contextual understanding of the adoption, implementation and impact of health promotion policies and practices in NS. Quantitative research was employed to describe provincial trends in children’s nutrition behaviour and weight status and to assess school practices across NS schools. Qualitative methods provided context on the processes that influenced implementation using a case study approach. From the quantitative analysis, although there were some improvements in diet quality, energy intake and healthy beverage consumption of children over time, there was no significant effect observed on body weight. Furthermore, schools reported greater adoption of curriculum-related practices, rather than practices that could foster comprehensive (i.e. holistic) approaches to school health. Contextual information from the qualitative case studies provided critical insight to understanding policy, organizational and individual outcomes. Schools that were stimulated by jurisdictional vision and provided with relevant resources and support exhibited processes that facilitated adoption of health promotion policies. Commitment, leadership and a supportive school culture was also found to be important to help schools overcome barriers to implementation. Overall, the contextual focus of this research provided a comprehensive account of health promotion policy implementation to advance the effectiveness and dissemination of population-level interventions in schools. Considering the multifaceted behavioural and social structural influences of obesity, illuminating this context in population-level interventions is critical to improve implementation and the overall impact on population-level weight status. Fostering collaboration between health and education sectors and establishing a broad system for support is essential to develop an understanding of the mutual benefit between health and learning and to progress the adoption, implementation and sustainability of school health initiatives.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
McIsaac, J.-L., Sim, S. M., Penney, T. L., Kirk, S. F., & Veugelers, P. J. School Health Promotion Policy in Nova Scotia: A Case Study. 2012. PHEnex Journal, 4(2).Fung, C., McIsaac, J.D., Kuhle, S., Kirk, S.F.L., Veugelers, P.J. The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children. July 2013. Preventive Medicine. In press.McIsaac, J.-L., Raine, K., Carmichael, S., Whitby, C., & Veugelers, P. J. Developing an educational tool to support planning and tracking of Health Promoting Schools. 2010. PHEnex Journal, 2(3).McIsaac, J.D., Read, K., Veugelers, P.J., Kirk, S.F.L. Culture matters: A case of school health promotion in Canada. July 2013. Health Promotion International. In press.

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