Health promotion policies and practices in Nova Scotia schools

  • Author / Creator
    McIsaac, Jessie-Lee D
  • 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.

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  • Degree
    Doctor of Philosophy
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    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.