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There have been few assessments of sexual and reproductive health (SRH) education programmes in sub-Saharan Africa from the students' and educators' perspective. This study examined students' opinions on an SRH programme in northern Ghana and explored the facilitators and barriers for educators regarding the implementation of the programme. The sample comprised 147 students and 3 educators. Questionnaires were used to collect data from students, and semi-structured interviews were conducted with educators. According to the students, the SRH programme was both important and interesting. Their expectations were moderately well met. They agreed that the main objectives of the programme and most of the objectives regarding the "family planning" sessions had been achieved. Significant differences were found for school type, age and religion, but not for gender. For the educators, important facilitators were a clear manual, the presence of foreign volunteers working as educators, the increased influence of new media, students' eagerness to learn, and the feeling that the SRH programme really benefited students' lives. Important barriers were traditional and cultural influences, lack of funding and poor scheduling of the programme within the schools. The paper concludes by offering recommendations regarding the implementation of future SRH programmes in Ghana.

In this article, we examined the factorial validity of the Dutch translation of the Children's Behavior Questionnaire (CBQ) and the Very Short Form scores. In addition, we conducted cross-cultural comparisons of temperament structure. In total, 353 parents of 6- to 8-year-olds completed the instrument. The original higher order factor structure of the different CBQ forms was generally replicated and represented the three broad dimensions of temperament: Surgency/Extraversion, Negative Affectivity, and Effortful Control. For the Standard Form, results demonstrated a relatively high degree of factor similarity of the Dutch sample with other cultures (e.g., China and Japan). The findings provide evidence for applicability of the CBQ in Western Europe as a promising instrument to comprehensively assess reactive and self-regulative temperamental dimensions in young children. (Contains 4 tables.)

This paper describes the evaluation of an adoption strategy for the school-based healthy diet programme Krachtvoer. Health promotion (HP) professionals from five Regional Public Health Services (RPHSs) in The Netherlands were asked to recruit a total of 25 schools to adopt the Krachtvoer programme in accordance with this strategy. Afterwards, they were interviewed about their adherence to and subjective evaluation of the strategy. The adoption rate of the programme was calculated and 10 adopting and 9 rejecting teachers were interviewed about the reasons for their decision. The HP professionals' adherence to the strategy was good, as well as their appreciation and the perceived feasibility of the strategy. The person-to-person approach that characterized this strategy was considered important. The strategy led to an adoption rate of 53.2%. On average, adopters mentioned 4.4 reasons and rejecters mentioned 5.4 reasons for their decision. Most reasons were school related and programme related and in case of the adopters also teacher related. The diversity of reasons revealed the complexity of teachers' decision making. Although there is some room for improvement of the adoption strategy and the programme itself, especially socio-political conditions in schools and in RPHSs need change for a further increase in programme adoption. (Contains 2 tables.)

Purpose: The purpose of this study was to evaluate the role of a school health promotion (SHP) advisor in the implementation of the six steps of the Dutch "Schoolbeat" approach, aimed at establishing health promotion policies and activities in secondary schools. Design/methodology/approach: In total, 80 school board members, and 18 prevention coordinators of 18 schools in the Southern Limburg region in The Netherlands completed a written questionnaire on the implementation of the six steps of the Schoolbeat approach, and on their satisfaction with the practical assistance offered by the SHP advisor in implementing the steps, as well as the advisor's organizational competencies. Findings: Only one school implemented the Schoolbeat approach completely, and as intended. Schools were generally satisfied with the practical assistance in the process of implementing the Schoolbeat steps and with the organizational competencies of the SHP advisor. Schools which had partly implemented the Schoolbeat steps were more satisfied with the SHP advisor's practical assistance than schools who had not done so at all. Practical implications: This study showed that the SHP advisor could make a positive contribution to health promotion in schools. Since this role demands new skills, the competencies of health promotion professionals must be further developed. Originality/value: Structural school health promotion programs and policies are becoming increasingly important in many countries, and not enough is known about the role of health promotion agencies in structuring school health promotion. This paper describes the positive impact of the SHP advisor. (Contains 3 tables.)

Purpose: The purpose of this paper is to gain first insight into factors which might be associated with exposure to internet-delivered interventions. Design/methodology/approach: Semi-structured focus group interviews were conducted with five groups of Dutch adolescents (n = 54), aged 12-17 years. Several aspects of exposure: a first visit; staying long enough actually to use and process the information; and revisiting the intervention, were explored. Findings: Several factors that are likely to improve exposure to internet-delivered interventions were identified, such as the use of "word of mouth" marketing, comparison of own behaviour with friends and the use of reminders. Research limitations/implications: Focus group interviews are only a first step in the generation of ideas and opinions. A next step would be to conduct observational, experimental and longitudinal studies to test "if" and "how" these factors improve exposure to internet-delivered interventions. Practical implications: This paper is a useful source for those developing internet-delivered interventions who want to improve exposure rates to their interventions. Originality/value: The results of this exploration serve as an important first step to gain more insight into factors that improve exposure to internet-delivered interventions. (Contains 1 table.)

Background: Two primary school-based interventions were implemented, aimed at increasing fruit and vegetable (F&V) consumption by children, both with proven effectiveness: (1) a free daily F&V distribution scheme for all primary school children and (2) a multicomponent, age-specific program consisting of a classroom curriculum, parental involvement, and an environmental component. This article describes and compares the implementation, evaluation, and potential for adoption of the 2 interventions. Methods: A total of 48 teachers who worked with either of these programs filled out a questionnaire at the end of the intervention period. Additionally, 24 of the teachers who worked with the multicomponent program filled out periodic monitoring reports during the intervention. Results: Compared to the F&V distribution, the multicomponent program was less fully implemented and that implementation of activities decreased over time. Both programs were evaluated favorably, and about half of the teachers indicated that they were willing to use the program again in the following school year. Teachers who used the multicomponent program experienced more social pressure to implement the program. They rated the program they had used as more complex and risky than the other group rated the distribution program. Conclusions: The free distribution program has the greatest potential for being adopted by schoolteachers, but that efforts must be made to acquire funding for it. Until these resources are available, the multicomponent program seems to be a good alternative if improved as suggested. (Contains 4 tables.)

Purpose: The purpose of this research is to explore individual and social factors that are associated with children's F&V (fruit and vegetable) intake in order to develop a school-based intervention to increase their F&V consumption. Design/methodology/approach: Group interviews were conducted with ten groups of Dutch children (n=104), aged 4-12 years, and two groups of parents (n=28). Additionally, a total of ten parents participated in an interview by telephone. Opinions about the actual F&V consumption, awareness of consumption patterns, attitudes towards F&V, promotion of F&V consumption by parents and F&V intake at school were explored. Transcripts were analysed using Nvivo 2.0. Findings: Several factors that are likely to increase F&V consumption of the participants were identified, such as preferences, modeling of F&V consumption by teachers and parents and availability of F&V in ready-to-eat form at home and school. Although both children and parents favoured activities to promote F&V at school, most parents were not willing to participate in these activities. Research limitations/implications: The present study obtains information from a broad perspective, and not from a representative sample. Practical implications: This article is a useful source for health promotion planners that are developing food-related interventions for children. Originality/value: Information on factors that influence children's F&V consumption is usually acquired through parents. It is questionable whether parents are aware of the factors that influence their children's food choice. Therefore this study combined information gathered among parents with information gathered directly among children. (Contains 3 tables.)

Author(s): Lieke G. M. Raaijmakers[sup.1] , Marloes K. Martens[sup.2] , Charlotte Bagchus[sup.3] , Inge de Weerdt[sup.4] , Nanne K. de Vries[sup.5] , Stef P. J. Kremers[sup.1] Author Affiliations: (1) Department [...], This study examined how Dutch type 1 and type 2 diabetes patients' perceived autonomy support, as well as their perceived competence and treatment self-regulation, are associated with their diabetes self-care activities (healthy diet, physical activity, monitoring blood glucose, medication use) and general diabetes control. A cross-sectional questionnaire study was conducted among 143 type 1 diabetics and 384 type 2 diabetics. Overall, participants felt competent, supported in their autonomy, and perceived to autonomously self-regulate their diabetes. Our results underline the importance of perceived competence in type 1 and 2 diabetics, as this was strongly associated with adhering to a healthy diet and general diabetes control. Our findings also emphasize the need for autonomy supportive health care professionals in diabetes care. Interestingly, perceived competence partially mediated the influence of autonomy support on general diabetes control.