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      Validation of an instrument to evaluate health promotion at schools

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          ABSTRACT

          OBJECTIVE

          To validate an instrument designed to assess health promotion in the school environment.

          METHODS

          A questionnaire, based on guidelines from the World Health Organization and in line with the Brazilian school health context, was developed to validate the research instrument. There were 60 items in the instrument that included 40 questions for the school manager and 20 items with direct observations made by the interviewer. The items’ content validation was performed using the Delphi technique, with the instrument being applied in 53 schools from two medium-sized cities in the South region of Brazil. Reliability (Cronbach’s alpha and split-half) and validity (principal component analysis) analyses were performed.

          RESULTS

          The final instrument remained composed of 28 items, distributed into three dimensions: pedagogical, structural and relational. The resulting components showed good factorial loads (> 0.4) and acceptable reliability (> 0.6) for most items. The pedagogical dimension identifies educational activities regarding drugs and sexuality, violence and prejudice, auto care and peace and quality of life. The structural dimension is comprised of access, sanitary structure, and conservation and equipment. The relational dimension includes relationships within the school and with the community.

          CONCLUSIONS

          The proposed instrument presents satisfactory validity and reliability values, which include aspects relevant to promote health in schools. Its use allows the description of the health promotion conditions to which students from each educational institution are exposed. Because this instrument includes items directly observed by the investigator, it should only be used during periods when there are full and regular activities at the school in question.

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          Most cited references35

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          Consulting the oracle: ten lessons from using the Delphi technique in nursing research.

          The aim of this paper was to provide insight into the Delphi technique by outlining our personal experiences during its use over a 10-year period in a variety of applications. As a means of achieving consensus on an issue, the Delphi research method has become widely used in healthcare research generally and nursing research in particular. The literature on this technique is expanding, mainly addressing what it is and how it should be used. However, there is still much confusion and uncertainty surrounding it, particularly about issues such as modifications, consensus, anonymity, definition of experts, how 'experts' are selected and how non-respondents are pursued. This issues that arise when planning and carrying out a Delphi study include the definition of consensus; the issue of anonymity vs. quasi-anonymity for participants; how to estimate the time needed to collect the data, analyse each 'round', feed back results to participants, and gain their responses to this feedback; how to define and select the 'experts' who will be asked to participate; how to enhance response rates; and how many 'rounds' to conduct. Many challenges and questions are raised when using the Delphi technique, but there is no doubt that it is an important method for achieving consensus on issues where none previously existed. Researchers need to adapt the method to suit their particular study.
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            Visão além do alcance: uma introdução à análise fatorial

            Resumo: Como mensurar fenômenos que não podem ser diretamente observados? O principal objetivo desse artigo é demonstrar por que a análise fatorial é a resposta mais adequada para responder a essa pergunta. Metodologicamente, utilizamos um banco de dados com diferentes medidas de democracia para ilustrar como a técnica de análise fatorial de componentes principais pode ser utilizada para medir as duas dimensões da poliarquia propostas por Robert Dahl (1971): contestação e inclusividade. Em termos substantivos, esperamos facilitar a compreensão dessa técnica nas Ciências Sociais em geral e na Ciência Política em particular.
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              Adolescent multiple risk behaviour: an asset approach to the role of family, school and community.

              Engagement in risk behaviours may pose a significant threat to health if involvement spans multiple behaviours. The asset model suggests that contextual aspects of young people's lives, such as factors related to family, school and community, serve as a protective function against health risk behaviours. A risk-taking index was created from the English health behaviour in school-aged children study on 15 years olds, substance use and sexual activity. Using a multinomial regression, potential asset variables relating to school, family, peers, community and family affluence were tested for their association with levels of risk behaviours. Sense of neighbourhood belonging, strong school belonging and parental involvement in decision-making about leisure time were related to lower engagement in health risk behaviours. A weaker sense of family belonging was associated with increased risk behaviours if connectedness with teachers was also low. Factors related to school and community played a greater role in adolescent participation in health-related risk behaviours than family-related factors, including family affluence. Feelings of safety and belonging in the out-of-home settings of adolescents were positively associated with reduced risk behaviours, and indicate the importance of the wider community alongside parents and school as protective assets for health.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                19 February 2016
                2016
                : 50
                : 2
                Affiliations
                [I ] Programa de Pós-Graduação em Saúde Coletiva. Universidade do Vale do Rio dos Sinos. São Leopoldo, RS, Brasil
                [II ] Programa de Pós-Graduação em Saúde Coletiva. Unidade de Pesquisa e Pós-Graduação. Universidade do Vale do Rio dos Sinos. São Leopoldo, RS, Brasil
                [I ] Programa de Pós-Graduação em Saúde Coletiva. Universidade do Vale do Rio dos Sinos. São Leopoldo, RS, Brasil
                [II ] Programa de Pós-Graduação em Saúde Coletiva. Unidade de Pesquisa e Pós-Graduação. Universidade do Vale do Rio dos Sinos. São Leopoldo, RS, Brasil
                Author notes
                [Correspondence ]: Rogério Lessa Horta. Rua Jari, 671 apto 703 Passo D’Areia. 91350-170 Porto Alegre, RS, Brasil. E-mail: rogeriohortamed@ 123456gmail.com

                Authors’ Contribution: Design and planning of the study: ROP and RLH. Statistical analysis and interpretation of the data: MPP. Data collection, literature review and organization and analysis of the databases: SP, VLG, VAT, LPF, and ADB. All authors participated in the drafting and approval of the final version of the manuscript.

                Conflict of Interest: The authors declare no conflict of interest.

                [Correspondência ]: Rogério Lessa Horta. Rua Jari, 671 apto 703 Passo D’Areia 91350-170 Porto Alegre, RS, Brasil. E-mail: rogeriohortamed@gmail.com

                Contribuição dos Autores: Concepção e planejamento do estudo: ROP e RLH. Análises estatísticas e interpretação dos dados: MPP. Coleta de dados, revisão da literatura e organização e análise do banco de dados: SP, VLG, VAT, LPF e ADB. Todos os autores participaram da redação e aprovação da versão final do manuscrito.

                Conflito de Interesses: Os autores declaram não haver conflito de interesses.

                Article
                S01518-8787.2016050005855
                10.1590/S01518-8787.2016050005855
                4772694
                26982958
                1e9aa8ac-90dc-4b1b-b3f6-61538a64b3e5

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 September 2014
                : 22 August 2015
                Page count
                Figures: 0, Tables: 10, Equations: 0, References: 29, Pages: 11
                Categories
                Original Article

                school health,health promotion,program evaluation,evaluation of research programs and tools,reproducibility of results,validation studies,saúde escolar,promoção da saúde,avaliação de programas e projetos de saúde,avaliação de programas e instrumentos de pesquisa,reprodutibilidade dos testes,estudos de validação

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