Paper
Health Promotion in Primary School: an experimental project in Veneto Region
- issue: Issue 3 / 2008
- authors: Elizabeth Mary Tamang Alessandro Mantovani, Martina Di Pieri, Rosanna Canova
- keywords: Italy
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abstract
Background. A recent document of World Health Organisation (WHO) "Gaining health" states the need of investing in prevention and control of non communicable diseases (NCD) to improve quality of life and well-being of people and societies. According to the WHO there are seven risk factors responsible for more than 60% of the disease burden in Europe, tobacco is the second in importance accounting for 12,3% expressed in DALY's (Disability Adjusted Life Years). In 31 of the 52 WHO Member States, tobacco is the leading risk factor for disease burden: its effects on health advances in adult age even if the smoking behavior is initiated and strengthened in adolescence.
The tobacco use in adolescence and pre-adolescence is today a severe public health problem and international publications suggest the need of health promoting interventions for children and their families. These interventions have to be focused in strengthening and improving life skills in children as protective factors as an attempt to reduce their vulnerability to social pressures towards risk behaviors while involving at the same time all the privileged settings of their lives: their family, school and peers.
Purpose. Most tobacco prevention interventions at regional and national level in Italy are addressed to students of secondary school from the age of 12-13, pre-adolescents, at an age when attitudes and knowledge about tobacco are already structured and established. The experimental project of tobacco prevention that Veneto Region has drawn up, is a health promoting intervention for children of primary school from the age of 8 to 10, ages in which attitudes and knowledge towards tobacco are not well structured, but under construction. The project aims at:
- Preventing the smoking habit and promoting a tobacco free culture in children of primary school and their families;
- Promoting behavioral competence and ability specially towards problems related to tobacco smoke in children and their families;
- Creating smoke free environments (schools, homes etc.);
- Strengthening of community action.
An important feature of the project is the attempt made to involve and work with all prevalent settings in which children live: school, family, peer, community.
During the three years of the project a lot of emphasis were put to improve life skills of the children with specific activities carried out in the classrooms. Life skills have been defined by WHO as "abilities for adaptive and positive behaviour that enable individuals to deal effectively with the demands and challenges of everyday life".
They represent the psycho-social skills that determine behaviour and include skills such as problem-solving and critical thinking, to personal skills such as self-awareness and to interpersonal relating skills. Practicing life skills helps to develop qualities such as self-esteem, sociability and tolerance, to develop competencies to take action and generate change and abilities in exercising the freedom to decide what to do and who to be. Social competencies education to promote health and well-being represents an opportunity to offer a tool right from childhood and in the primary school, to be used in all traditional subjects which can answer to health needs even in the future.
Project target:
- Children (from the age of 8 to 10)
- Parents
- Teachers
Methodology. The methodology used is to create an active group involvement of children and parents, taking into consideration individual and cultural differences, group dynamics and to the particular ages we are relating.
Group involvement, attention to socialization and to interpersonal relationships, sharing of cognitive and emotional competencies needed the interactive work to be carried out in the class, between children and between parents too.
Activities. The activities carried out are based on the use of verbal and non-verbal communication. The activities were differentiated for every project year taking in consideration the mental and emotional developmental phases in the children. The activities are listed below:
- Creative writing (use of fables and fairy tales)
- Dramatization
- Drawing
- Information Games
- Circle time
Evaluation. The project assessment has been done through the creation of an experimental group (the children who have participated to the project) and a control group. A qualitative and quantitative evaluation has been carried out. The quantitative evaluation has been done using a pre- and post- questionnaire about knowledge, competencies, life skills etc. For the qualitative evaluation focus groups were done with parents. Teachers and health education workers had to keep diaries for all the activities carried out. The outcome of quantitative evaluation will be available only at the end of project experimentation, while qualitative evaluation represents a sort of process evaluation available at the end of each year. First data available from process evaluation will be presented, however we can highlight the level of participation to the regional project as follows: 1025 children, 55 classes, 32 Schools, 12 Local Health Authorities (Aziende Ulss).
Key references
Carlson, C. I., Tharinger, D. J., Bricklin, P. M., DeMers, S. T., & Paavola, J. C. (1996). Health care reform and psychological practice in schools. Professional Psychology: Research and Practice, 27, 14-23.
Marmocchi, P., Dall'Aglio, C., & Tannini, M. (2004). Educare alle life skills. Come promuovere le abilità psico‐sociali e affettive secondo l'organizzazione Mondiale della Sanità. Trento: Erickson.
NYkkjMRSEw/181480034/9.
O.M.S. (2006). Guadagnare salute. La strategia europea per la prevenzione ed il controllo delle malattie croniche. http://dosei.who.int/uhtbin/cgisirsi/
Contacts: Elizabeth Mary Tamang, Public Health and Screening Service - Veneto Region, Dorsoduro 3493, 30123 Venezia, E-mail: Elizabeth.tamang@regione.veneto.it or etamang@gmail.com, Phone 041-2791505/1661.