Attitudes towards exercise and physical activity behaviours in Greek schoolchildren after a year long health education intervention

Within the limitations of the cogitation, the data show that school health education programmes have the potential to slow the age related decline in physical action and serve pupils establish lifelong, healthy forcible activity patterns. Promoting healthy habits and physical natural process demeanor during childhood may prevent some of the go causes of morbidity and mortality in the greek population, and besides decrease mastermind healthcare costs and improve quality of life. After alteration for initial differences in the assess variables, pupils who took part in the intervention had more incontrovertible attitudes towards physical action than the control group and scored significantly more highly on their intention to participate in physical action. furthermore, pupils in the intervention group reported more hours/week spend in organize physical activities than pupils in the control condition group ( mean ( SD ) 3.54 ( 0.32 ) volt 2.54 ( 0.26 ), phosphorus < 0.020 ). ultimately, a higher proportion of pupils in the treatment classes matched the recommendations of 60 minutes of mince to vigorous physical bodily process casual ( 77.4 % five 55.1 %, phosphorus < 0.043 ). The school based treatment plan was applied to 29 children in the 6th grade of the 2nd primary School of Agios Stefanos ( ∼12 000 inhabitants ) ; 49 pupils from the 1st primary School constituted the control group. To assess the potency of the intervention, attitude and behavioral variables were measured before and after the treatment. To achieve substantial health benefits, children should participate in at least 60 minutes of control to vigorous physical bodily process on most days of the workweek. 13 frankincense physical education ( PE ) and health education programmes should promote adulterous physical activeness, as these recommendations can not be met through PE entirely. 14, 15 accordingly, specific programmes to promote extracurricular activeness must be developed and continuously evaluated. This wallpaper reports the effects of a health education program on the attitudes and intentions of chief schoolchildren towards physical action. According to planned demeanor theory, 16 purpose is the flower cognitive element predicting behavior. Hence an improvement in attitudes and intentions towards physical activity was expected to lead to increments in physical activity levels.

inquiry attest besides indicates decrease physical activeness levels in Greece and an alarmingly high prevalence of fleshiness among greek children. 7, 8 furthermore, it has been found that a meaning percentage of 12 year olds display more than three modifiable cardiovascular risk factors. 9 In this context, school health education is considered to be one of the most promise solutions for health forwarding. Comprehensive school based health programmes can achieve both short term and long term behavioral changes. 10 Despite the above, and the incontrovertible results from some initiatives, 11, 12 health education is not introduced as a compulsory subject in Greek schools, but preferably as an educational procedure, depending on teachers ‘ enthusiasm to implement such interventions at classroom, educate, or district levels. regular participation in physical activity during childhood can lay the initiation for numerous health benefits. 1, 2 however, studies have revealed that physical action declines precipitously with long time, and bodily process levels of children are not sufficient to promote optimum health. 3 In the long run, physical inaction increases the risk of many chronic diseases in adulthood, including coronary heart disease, colon cancer, and diabetes. 4, 5 In the brusque tend, physical inactiveness has contributed to an unprecedented epidemic of childhood fleshiness, which is presently plaguing most western countries. 6 The inner consistency of the instruments measuring attitudes and captive towards exercise was calculated using Cronbach ‘s α statistic. Correlations between attitudes, captive, and physical natural process variables were determined and expressed as Pearson ‘s correlation coefficients. Mean ( SD ) was calculated for the characteristics of participants, captive and attitudes towards physical activity, and time spent in forcible activity ( hours/week ). interposition effects were examined through covariance analysis, in order to control for possible initial differences in the first measurement. In each analysis, the score of the first measurement was used as the covariate, and the score of the second measurement was used as the dependant variable. The χ 2 test and the McNemar test were used to examine between, a well as within, group changes in the percentages of pupils matching the physical activeness recommendation of > 60 minutes a day. The physical activity recall questionnaire of Aaron et al 21 was used. Children were asked to recall all centrist to vigorous physical activity, such as unionize sports and other leisure fourth dimension activities, in which they participated at least 10 times during the precede class. For all activities, pupils had to give detailed information about frequency and duration of participation and total time spent on them. The school PE teacher and the parents confirmed participation. The time ( hours/week ) devoted to activities such as walk, cycle, rhythmical gymnastics, dancing, basketball, soccer, athletics, float, running, hop, and general participation in active outdoor games was considered total tone down to vigorous physical action ( TMVPA ). Organised chasten to vigorous physical activity ( OMVPA ) is depart of TMVPA and comprises only leisure activities out of school, performed under the supervision of a trainer on a regular hebdomadally basis, probably in a sports club. The questionnaire ‘s reproducibility coefficient in Greek pupils of the like historic period has been reported as 0.92. 22 purpose was assessed by responses to the following statements : “ I intend to participate in physical bodily process three times a week outside of gymnasium class during the next 12 months ” and “ I plan to … during the adjacent 12 months ”. visualize 1B shows the reaction format. alike measures of purpose have been used in former studies in the greek physical natural process context showing sound psychometric properties. 20 The planned behavior theory questionnaire, 16 translated into greek by Theodorakis, 20 was used. Pupils indicated their attitudes towards physical action and sports participation over the approaching 12 months on four scales ( good‐bad, healthy‐unhealthy, pleasant‐unpleasant, useful‐not utilitarian ). The reply format for each adjective couple included seven choices. For example, the reply choices for the adjective pair good‐bad ranged from very good = 7 to very bad = 1 ( fig 1A ). Age ( accurate to 1 month ) was recorded. Standing altitude was measured without shoes to the nearest 0.5 curium with a commercial stadiometer ; the shoulders were kept in a loosen position and the arms were allowed to hang freely. Weight was measured with digital scales ( Seca ) to the nearest 0.5 kilogram with subjects lightly dressed and barefooted. The control group did not have any health education intervention. The PE teacher was asked to continue with the dinner dress PE program during the study. Both groups were measured at the get down ( October ) and end ( June ) of the academic year. As the important function of the family in shaping children ‘s attitudes and behavior is generally recognised, parental interest was encouraged through homework assignments with family activities, by sending educational substantial home, providing physical activity and nutritional guidelines, and by asking parents to send healthy snacks to school. last, to promote extracurricular physical natural process, information about community based sports programmes was disseminated, and parents were advised to encourage their offspring to incorporate physical action into their daily lives ( active fare to and from school, amorphous physical bodily process, etc ). part of each PE lesson was a three moment speak describing the relation back between physical bodily process and health. PE lessons were complemented with classroom lectures once a workweek. Through these lessons, the PE teacher had the chance to further addition pupils ‘ cognition on physical bodily process concepts. Computer aided lessons were besides provided to promote pupils ‘ interaction and entertainment. To maximise classroom fourth dimension, the classroom teachers were encouraged to integrate health education into several school subjects—for example, analysing exercise energy consumption in mathematics lessons, using text on nutrition in reading lessons, constructing exercise and food pyramids in handicraft lessons. During the PE classes, cooperative activities were preferred over competitive activities. The games and activities chosen were enjoyable and seaworthiness oriented. The design of the lessons allowed every scholar to choose a charge of difficulty in skill learn and drill. Goal orient activities were used, establishing a certain learn or improvement target. An individualize goal setting plan was besides introduced to the pupils. At the beginning of the intervention, pupils were measured in four health indices : the multistage 20 megabyte shuttle run trial ( cardiopulmonary seaworthiness ), the seat and reach test ( flexibility ), the sit down up test ( trunk strength/endurance ), and the body mass index ( body constitution ). 19 Pupils kept these records in their personal PE notebooks and set personal goals for improvement. It was made net to them that these records were considered personal data and would not be used for grading. The treatment program lasted one academic year ( 2004–2005 ) and was teacher delivered. Thus, before the intervention, the PE teacher and the classroom teachers involved in the project participated in teacher orientation seminars conducted by the local Office for School Health Education. The draw a bead on of the seminars was to familiarise the teachers with the objectives of the program. The meaning and benefits of incorporating health education into the course of study were emphasised. In addition, preparatory teaching substantial was developed on the footing of successful, classroom tested health promotion programmes. 17, 18 The PE teacher conducted both the physical activeness and health components of the program. The study was conducted in the town of Agios Stefanos ( ∼12 000 citizens ), Greece, with the blessing of the Greek Ministry of Education and the consent of pupils and teachers. The two primary schools of the township were randomly assigned to an interposition or a control condition. The intervention group comprised 29 pupils ( 18 boys, 11 girls ) in the 6th grade ( ages 10–12.5 years ) of the 2nd primary School of the town. similarly, 49 pupils ( 24 boys, 25 girls ) of the lapp age in the 1st primary School of the town received no health intervention and formed the master group. There was no remainder in arouse distribution by condition ( χ 2 ( 1 ) = 1.25, p < 0.26 ). All PE classes were co-ed. In accordance with the national course of study guidelines, pupils participated in PE lessons twice a workweek for 45 minutes each moral. calculate 2 illustrates the percentages of pupils in the intervention and control groups who fulfilled the forcible action recommendation for health before and after the health department of education broadcast. The χ 2 quiz revealed that 32.3 % of the intervention group and 26.5 % of the control group ( phosphorus < 0.581 ) matched the set standard in the beginning measurement, with the represent values for the second measurement being 77.4 % and 55.1 % ( χ 2 ( 1 ) = 4.09, phosphorus < 0.043 ) respectively. The McNemar test revealed significant within group differences in both groups between the first and second measurement ( phosphorus < 0.0001 and p < 0.004 for the intervention and control group respectively ).

a far as physical activity is concerned, meaning differences were observed in OMVPA between the two groups ( F 1,77 = 5.66, p < 0.020, η 2 = 0.07 ), after adaptation for differences before the intervention ( F 1,77 = 42.6, p < 0.001 ). Pupils in the intervention group reported more times per workweek spent in organize forcible activities than pupils in the operate group. Differences between pupils in the interposition and operate groups with regard to full time spent in centrist to vigorous forcible activity did not reach significance ( F 1,74 = 3.52, p < 0.064 ). As for the intent towards participating in physical action, the results revealed that, after adjustment for differences in the beginning measurement ( F 1,72 = 19.35, phosphorus < 0.001 ), there were meaning differences between the two groups ( F 1,72 = 5.1, phosphorus < 0.027, η 2 = 0.07 ). The adjusted means of the second measurement entail that pupils in the interposition group scored significantly more highly on captive towards participating in physical natural process. table 3 depicts between group differences ( results of psychoanalysis of covariance ) in the study variables, after adjustment for differences in the first measure. For attitudes toward participation in physical activeness, the results revealed that, after adaptation for differences in the inaugural measurement ( F 1,74 = 6.0, p < 0.017 ), there were significant differences between the two groups ( F 1,74 = 3.9, p < 0.05, η 2 = 0.05 ). The adjusted means of the second gear measurement revealed that pupils participating in the intervention group, compared with the pupils involved in control classes, had more plus attitudes toward participating in forcible activeness. For the first and second measurement, α = 0.92 and 0.62 for the scale assessing attitudes towards physical activity, and 0.88 and 0.79 for the scale assessing purpose towards physical activeness respectively. Adopting an α of 0.60 as an acceptable standard for the internal consistency of a scale, the two scales can be considered authentic. There was a positive association among examine variables both before and after the intervention ( postpone 2 ). These findings support the concept robustness of the measures used in this study .


In scene of the sedentary lifestyles and insalubrious habits of contemporary Greeks, 12, 23 the school environment could offer a set for effective countermeasures, through comprehensive examination health education programmes. In this survey we report the short term effects of a health education intervention on attitudinal and behavioral measures of Greek elementary schoolchildren. Our results indicate that the major goals of this intervention were achieved. The positive effects of the interposition on attitudes and intents, adenine well as the better physical activity values in the intervention group found at the second appraisal incriminate that the intervention program did influence children ‘s behavior in relation to health issues. In accord with previous studies, teaching pupils about the health benefits of physical activity had positive effects on their attitudes towards forcible activity. 24, 25, 26 The higher scores of the intervention classes on attitudinal measures, compared with the distinctive classes, can be attributed to the health related lectures and frequent health refer reminders included in the teaching material. For example, when students were doing sit ups, the teacher could remark “ our abdominals help in good pose ” ; when they were running, the teacher could remark that “ now we are improving aerobic endurance ”. There were reminders for the PE teacher to give as many such messages as possible. This has been suggested to be beneficial in attitude exchange. 27 A moment factor that possibly contributed to the observed changes in attitudinal measures may be the limited number of competitive activities in the intervention program. competitive activities do not allow equal determine opportunities for every student 28 and may not contribute to the learning process. On the other bridge player, allowing children to participate in physical activities in which they feel competent makes it more likely that they will engage in them. 29 frankincense the focus of the stage study was on children ‘s enjoyment and willingness to participate in the PE classes. For this argue, emphasis was placed on sum class participation in enjoyable, non‐competitive exercise forms. physical activities matched to the child ‘s ability are more likely to produce a feel of success than those that are at excessively high a skill degree. This should be taken into report in the design of future interventions aimed at increasing physical activity in children .

What is already known on this topic

  • greek children parade low forcible bodily process levels, which are associated with an alarmingly senior high school prevalence of fleshiness and an adverse cardiovascular risk visibility
  • The school environment may be able to contribute to effective countermeasures to improve physical fitness and promote health education

What this study adds

  • comprehensive school health education programmes can help pupils to establish goodly physical bodily process patterns
  • The promotion of physical activeness behavior during childhood may prevent some of the main causes of morbidity and deathrate in the greek population, and thereby decrease healthcare costs and improve quality of life

One of the goals of the program was to promote physical bodily process outside of school. The significantly greater increase in clock devoted to OMVPA and the higher proportion of pupils in the treatment classes who reached the recommendations of 60 minutes of chasten to vigorous physical activeness daily indicate that this goal was achieved. A like inclination was observed in the TMVPA, but without reaching meaning, probably because of the boastfully variation in the meter spent in non‐organised and irregular activities ( data not shown ). This find can credibly be attributed to out of school encouragement and the information offered to the intervention classes on the allow time/intensity of forcible natural process for health benefits, combined with parental boost to support their children in increasing their extracurricular physical natural process. Hence the significant increase in OMVPA in the intervention classes may reflect changes in parental attitudes towards increased physical activeness. There is ample evidence that parental interest in health education interventions is associated with significant gains in behavioral indices, 30, 31 whereas school based programmes with limited or no parental engagement have failed to reach such significant gains. 32, 33 Regarding changes in physical activeness, the present results are broadly consistent with earlier studies on school aged children in Greece 34 and elsewhere. 35, 36 On the other hand, other intervention programmes reported difficulties in achieving positive changes in physical action measures. 37, 38 This could be attributed to the poor blueprint or the inadequate execution of the interposition, the inability of the children to use the self management skills they were taught, or the high forcible activeness levels reported at service line. 37 The difficulty of obtaining valid and authentic measures of physical natural process in children in general may besides partially account for this discrepancy.

The award findings should not be judged independently of the overall life style alteration during the past two decades in Greece. Diminished physical activity patterns are much observed among contemporaneous Greek children, 7, 9 and the prevalence of fleshy children and adolescents in Greece seems to be among the highest in the universe. 6 Given that low physical activity levels coupled with surfeit body adipose tissue are significant predictors of developing coronary heart disease, 39 the show data indicate that public health interventions such as ours, targeting the promotion of children ‘s physical bodily process, are of major importance for future public health. It is reasonable to assume that these results may have been influenced by methodological limitations such as the limitation of the study to a unmarried school district and/or seasonality in physical bodily process. The effect of seasonality in physical activity was accounted for by using the past‐year physical activeness recall questionnaire, which provides information for the entire previous year. ultimately, our results should be interpreted with some caution, as they are based on a discipline of a relatively small number of participants. Despite the cogitation ‘s limitations, the data show that comprehensive school health department of education programmes have the potential to slow the age relate decline in physical activeness and avail pupils establish healthy forcible activeness patterns. Combining a health education course of study with PE classes optimises both physical activity and health promotion components of the program, allowing more hours of treatment. Given that attitudes towards physical activity acquired at an early long time persevere through adolescence into adulthood, 40 these data suggest that promoting healthy habits and behaviours during childhood may prevent some of the run causes of morbidity and deathrate in the greek population, decrease calculate healthcare costs, and improve timbre of life .

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