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Canadian public health association’s annual conference

Canadian public health association’s annual conference. Public Health 2014 - Toronto May 29, 2014. School Health Policies in Lebanon:. How can we get there? Dr. Sima Hamadeh Assistant Professor of Public Health Nutrition Haigazian University Saint Joseph University. Overview.

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Canadian public health association’s annual conference

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  1. Canadian public health association’s annual conference Public Health 2014 - Toronto May 29, 2014.

  2. School Health Policies in Lebanon: How can we get there? Dr. SimaHamadeh Assistant Professor of Public Health Nutrition Haigazian University Saint Joseph University Dr. Sima Hamadeh - Public Health 2014

  3. Overview Lebanon • Health problems • Call for policies • Research study • Methodology, results & conclusion • Moving to action • Challenges & opportunities Dr. SimaHamadeh - Public Health 2014

  4. Globalization, Health & Food • Food globalization is having a catastrophic effect on the health of the nations in both the developing & developed countries Delisle, H. & Strychar I. Obesity at adolescence: prevention is timely even in low income countries. SCN news, 2006; 32:51-57. • Nutrition transition is taking place at a fast rate with changes related to • Food • Lifestyle factors • Healthcare systems Hamadeh S. & ElZein H. Epidemiology of obesity in children and adolescents: Prevalence and Etiology – (Ch 8)Middle East and North Africa (MENA) Countries. New York: Springer 2011. Dr. SimaHamadeh - Public Health 2014

  5. Nutrition transition • Lebanon has been experiencing a nutritional transition in food choices during the past years from typical Mediterranean diet into the fast food pattern http//www.who.int/countryfocus http//www.fao.org/ag/agn/nutrition/lbn_en.stm Dr. SimaHamadeh - Public Health 2014

  6. Obesity & Overweight • Recent Lebanese studies found obesity in Lebanon is mainly due to poor dietary practices & sedentary lifestyle (Naja et al., Eur J Nut,2011 ; Nasreddine et al., Publ Health Nut, 2011 ; Hwala et al., World Rev Nut Diet,2005) Dr. SimaHamadeh - Public Health 2014

  7. Obesity & Overweight Prevalence of Overweight & Obesity: 1) ≠ between Lebanese regions 2) higher : ♂ , less educated, lower income families

  8. Obesity & Overweight

  9. … ?! This highlights a clear need to draw on the latest scientific evidence to take action & to further recommend mobilization efforts (Government, Intl agencies, local communities…) Dr. SimaHamadeh - Public Health 2014

  10. Call for policies Previous studies Strategies & policies • Findings alert to the importance of formulating policies & nutritional strategies to curb the obesity rise in the country • School Health Strategy (SHS), 2009 Dr. SimaHamadeh - Public Health 2014

  11. School Health Strategy in Lebanon (2009) Objectives: To improve the health status of youth & the school personnel To provide a safe learning environment for students & a safe workplace for staff To reinforce the relationship between education & health professionals & the community

  12. Research study Perceptions of different stakeholders to the eventual School Nutrition Policy in Lebanese schools • Hamadeh S. & Marquis M. 2013 (3 articles) • Research summary published in the SCN news No39, 2011 of the United Nations System Standard Committee on Nutrition (UNSCN) Dr. Sima Hamadeh - Public Health 2014

  13. Objective • To explore the facilitators & the barriers to the SHS implementation by studying stakeholders’ perceptions of an eventual School Nutrition Policy in Lebanon • SHS objectives • Role distribution • SHS pertinence Dr. SimaHamadeh - Public Health 2014

  14. Methodology • Exploratory Qualitative Research : • Social marketing approach • Socio-behavioral, organizational changes and communication theories & models • Health Belief Model • Rossister-Percy Motivational Model • Theory of trying • Protection Motivation Theory • Diffusion theory • Communication theory • Theories of Organizational Change • Integrated conceptual framework • To guide the planning & the evaluation of the policy Dr. SimaHamadeh - Public Health 2014

  15. Social structure Motivation Mobilization Social conflict School Nutrition Policy Knowledge Integrated conceptual framework to study perceptions associated with an eventual development of School Nutrition Policy Hamadeh S, Marquis M, 2013.

  16. Methodology • Sample : N = 115 participants • 32 multidisciplinary key stakeholders • 8 schools (35 adults & 48 youth ) Dr. Sima Hamadeh - Public Health 2014 * Recruited in only 4 schools

  17. Methodology • Data collection (2 open-ended questionnaires) • Directed & semi-structured individual interviews • Key stakeholders, students, directors & food services managers • Focus groups (6 to 8 participants) • Teachers & parents • Analysis • Thematic qualitative analysis Dr. Sima Hamadeh - Public Health 2014

  18. Results Facilitators • Leadership • Multidisciplinary team action • Active participation • Collaboration • Coordination • Advocacy • Timing • Evaluation • Dissemination of results Dr. Sima Hamadeh - Public Health 2014

  19. Results Barriers • Lack of data • Lack of resources • Lack of cooperation (public-private sectors) • Miscommunication • Inappropriate school environments • Social structures • Socioeconomic & political status • Parental & social role modeling Dr. Sima Hamadeh - Public Health 2014

  20. Physical environment - Public schools Urban Semi rural

  21. Physical environment - Private schools Urban Semi rural

  22. Food services – Schools Public Private

  23. Results- Conceptual framework • The innovative holistic conceptual framework: • Useful in understanding the dynamic of health behaviors & the external influences on human behaviors • Offers perspectives on how School Nutrition Policy is intended to work & to produce desired changes • Can guide other national & Intl. research to develop and evaluate the components of school health policies by adapting the conceptual framework for their needs Dr. SimaHamadeh - Public Health 2014

  24. Moving to action Dr. Sima Hamadeh - Public Health 2014

  25. Moving to action Steps of SNP development Dr. Sima Hamadeh - Public Health 2014

  26. School Nutrition Policies Challenges & Opportunities Dr. Sima Hamadeh - Public Health 2014

  27. Challenges … • Government & Other sectors • Lack of data • Lack of collaboration & cooperation • Lack of motivation & mobilization • Lack of resources (financial &/or human) • Absence of multidisciplinary approach • Absence of ongoing consultation • Social conflict (role & power distribution) • Political, religious & region considerations Dr. Sima Hamadeh - Public Health 2014

  28. Opportunities… How ? When ? Multichannel communication • The “communications map” is complex, variable & unfamiliar What ? To whom ? Dr. Sima Hamadeh - Public Health 2014

  29. Opportunities… Universités Parties politiques Groupes de pression Ecosocial model adapted from Renaud et al., 2007. Dr. SimaHamadeh - Public Health 2014

  30. School Nutrition PoliciesHow We Get There ?? Multifactoral approach Regional focus National strategies + sub-strategies Community based Intersectoral collaboration Socially oriented Dr. Sima Hamadeh - Public Health 2014

  31. Thank You !! Dr. Sima Hamadeh - Public Health 2014

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