Reyhaneh Sadeghian, Mahsa Asadollahi Hamedani, Sajad Salehipour, Anahita Sarabandi, Fatemeh Kiani, Hassan Babamohamadi
The health literacy level and its related factors in Iranian women with breast cancer undergoing chemotherapy
Frontiers in public health
obesity important public health issue finding ways increase physical activity improve nutrition particularly children clear priority cochrane review world health organizations health promoting schools hps framework found approach improved students physical activity fitness increased fruit vegetable intake however considerable heterogeneity reported impacts paper synthesises process evaluation data studies identify factors might explain variabilitywe searched 20 health education socialscience databases trials registries relevant websites 2011 2013 language date restrictions applied included cluster randomised controlled trials participants school students aged 418 years studies included took hps approach targeting curriculum environment familycommunity focused physical activity andor nutrition presented process evaluation data framework approach used facilitate thematic analysis synthesis process datatwentysix studies met inclusion criteria conducted america europe children aged 12 years younger although interventions acceptable students teachers fidelity varied considerably across trials involving families intrinsic element hps approach viewed highly challenging several themes emerged regarding elements interventions critical success tailoring programmes individual schools needs aligning interventions schools core aims working teachers develop programmes providing ongoing training support emphasis academic subjects lack institutional support barriers implementationstronger alliances health education appear essential intervention success researchers must work schools develop implement interventions evaluate impact health educational outcomes may key determinant scalability family engagement attempted better ways achieve must developed evaluated evaluations interventions promote physical activity nutrition adolescence needed finally process evaluations must move beyond simple measures acceptabilityfidelity include detailed contextual information illuminate exactly works contexts