Dominique Berger

Addictive Substances: Textbook Approaches from 16 Countries.

Schools have been identified as one of the appropriate settings for addiction prevention since this is the place where pupils may come into contact with drugs for the first time and experiment with them, with the possibility of becoming addicted. To be effective, school-based drug education must be firmly based on knowledge of oneself and knowledge of the effects of various addictive substances. Biology education is then an essential part of schoolbased drug education. The aim of this work was to compare the approach taken towards addictive substances in textbooks within 16 countries involved in the European project BIOHEAD-CITIZEN. We used a specific part of the project grid for substance abuse (alcohol, tobacco and other drugs) and focussed on three major indicators: physical effects, psychological effects and social effects. Generally, in all 16 countries, the educative approaches taken in their textbooks include the three dimensions. Textbooks mainly employ text rather than visual images, and some countries textbooks have only text. Moroccan and Mozambican textbooks do not mention tobacco and other drugs, respectively. The comparative analyses highlighted that the Finnish textbook is the most comprehensive; the only one, in the study, to have a specific Health Education teaching module.

Factors influencing teachers' views of health and health education: A study in 15 countries

Objective: To analyse teachers’ health views in order to obtain general trends in factors influencing health and health education and to fit them into the negative–positive model of health proposed by Downie and collaborators. Method: This large international study involved 15 countries from Western and Eastern Europe, North and Sub-Saharan Africa, the Middle East and South America, with high socioeconomic and cultural diversity. The questionnaire constructed and validated by the European FP6 project BIOHEAD-CITIZEN was applied in each country to a balanced sample of pre-service teachers (Pre) and in-service teachers (In) of primary schools (P) and secondary schools, teaching biology (B) or national language (L). Results: Women, older persons, those having longer higher university education, primary school teachers (compared to secondary teachers) and language teachers (compared to biology teachers) have a more positive view of health. The major difference was found between countries, rather than religion, where five groups emerged from cluster analysis. Conclusion: The study does not lead to a comprehensive view of factors influencing teachers’ perceptions of health but results showed that there is a variety of variables associated with health and health education views. These findings can contribute to facilitate developing appropriate specific health education teachers’ training courses.

In search of a health education model: teachers' conceptions in four Mediterranean countries.

School programs are defined to promote the health of the pupils and to develop their competencies so that they can adopt behaviors favorable to their health. With the European project FP6 Biohead-Citizen (2004–2007), we analyzed the conceptions of teachers as regards health education, in France, Lebanon, Morocco and Tunisia, in reference to the biomedical model and the social health model. These four countries were selected because their school curricula represented different models of health education. Lebanon and Tunisia addressed health education with the biomedical model. In Morocco, the curriculum was also primarily based on the biomedical model and enclosed a few instructions issued from the social health model. In France, the health education curriculum declared an approach based on the health promotion model. Our study was based on multivariate statistical analyses of questionnaires filled out by 2537 in-service and pre-service teachers. Our analysis showed that the conceptions of the teachers concerning health education were not structured and related to a specific model. We also found that the dominating factors of influence on the choices expressed with regards to health education were, among different sociocultural variables, the religion, the home country, and, to a lesser extent, the level of training. Thus, the conceptions of the teachers were not integrated into comprehensive approaches but related to individual characteristics. Consequently health education implementation would require thorough training for pre-service and in-service teachers and should also explicitly take into account their conceptions and values.

Education à la santé dans les écoles élémentaires : Représentations et pratiques enseignantes

Leducation a la sante en ecole primaire se traduit, dans la classe, par des productions ecrites ou non, revelatrices des pratiques reelles des maitres. La recherche vise a examiner la correlation existant entre les declarations des maitres et la presence de traces manifestes (ecrits professionnels et deleves, affichages, etc.) dans la classe. Le recolement des differentes traces dES (ecrits et dispositifs) permet den dresser une typologie conduisant a lanalyse des pratiques les ayant generes, a la mise en evidence du curriculum reel et a la mesure de limpact sur la prise en charge des problematiques de sante au sein de lecole. Il sagit de mettre en relief les points dappuis et les obstacles a la mise en place de projets dES dans la classe. Les resultats montrent que lon peut approcher les pratiques des enseignants en education a la sante a partir des productions diverses presentes en classe. Ce qui est significatif dans la pratique de la classe est en correlation avec les representations des maitres et se retrouve sous forme de traces au sein de la classe. Les analyses des ecrits professionnels usuels : projets, cahier journal, preparations, dossiers documentaires... et des productions des eleves : cahiers, realisations diverses... confrontees a lintention initialement declaree par les enseignants permettent de valider lhypothese selon laquelle lecart constate est revelateur de linteraction des dispositifs pedagogiques, de lapproche didactique, de la tutelle developpee, des obstacles et des difficultes de mise en œuvre de lES au sein de la classe. Lanalyse souligne une heterogeneite importante des pratiques tant sur le plan des contenus enseignes que des approches pedagogiques et didactiques et une difficulte a definir l education a la sante comme objet denseignement. Leducation a la sante oscille entre deux poles : dun cote le developpement des savoir-faire et des savoir etre, et de lautre lapport de contenus scientifiques dans une perspective hygieniste comportementaliste. Il apparait necessaire daccompagner les maitres dans leur dynamique de promotion de la sante a lecole.

Santé de la reproduction des adolescents: les déterminants de l'implication des professionnels dans la prévention des maladies non transmissibles

Dans le domaine de la santé de la reproduction, l’essentiel des actions de prévention visant les adolescents est centré sur les maladies transmissibles. En fait, les problèmes qui affectent la santé de la reproduction ne sont pas limités aux maladies transmissibles. Prévenir les maladies non transmissives nécessite de se placer dans une dynamique de changement à long terme dans une perspective de la promotion de la santé de la reproduction. Tous les acteurs sociaux sont concernés. Ce commentaire est centré sur la question de la mobilisation des professionnels du système éducatif au Sénégal. Les données montrent le caractère surdéterminant des représentations personnelles ellesmêmes fortement conditionnées par le contexte social. Les acteurs insistent sur le besoin de formation. Des pistes quant à la création des conditions de possibilité de l’engagement des acteurs dans des dynamiques de prévention et de promotion sont proposées.

Description et déterminants des conceptions des enseignants de 4 pays méditerranéens sur l'éducation à la sexualité

Nowadays, sex education contributes to public health not only with regard to the prevention of HIV/AIDS, other sexually transmitted infections and sex abuse, but it is also concerned with addressing aspects such as interpersonal relationships and psychosocial implications. The school setting has emerged as a unique environment for access to information and scientific knowledge that contribute to better understanding of the various dimensions of sexuality. Teachers and future teachers conceptions about sex education are analysed in this paper. Data were obtained from a questionnaire designed by the European Biohead-Citizen research project. Responses were received from 2 537 teachers from four Mediterranean countries (Tunisia, Lebanon, Morocco and France) who completed the questionnaire. The methodology is based upon analyses of core components that support the discovery of teachers conceptions. Following that exercise, standardised factorial scores were calculated. Results for in-service and pre-service teachers show high correlations between their conceptions and national culture, religious beliefs, and level of academic training. Detailed results are presented and discussed.

The impact of social inequalities on children’s knowledge and representation of health and cancer

Reducing inequalities in the field of cancer involves studying the knowledge and mental representations of cancer among children. A qualitative study was conducted on 191 children aged 9 to 12 using the “write and draw” technique to get spontaneous mental representations of “healthy things”, “unhealthy things” and “cancer”. We grouped the voluntary schools according to two deprivation levels. In response to the request to “write or draw anything you think keeps you healthy”, the main responses categories were physical activity, healthy food and basic needs. Smoking, drinking alcohol, sedentary lifestyles/lack of sport were identified as “unhealthy”. The first theme associated with “cancer” is the “cancer site” implying children have a segmented perception of cancer. Deprived children have radically different views about the key items representing cancer: they are more likely to believe the illness is systematically deadly. They are less likely to believe it is a treatable illness. They are less likely to associate cancer with risky behaviors, particularly alcohol consumption.Conclusion: Social inequalities affect representations of cancer and health literacy from early childhood. Prevention programs taking into account these representations need to be introduced at school.What is Known:• Social inequalities for cancer mortality are observed in all European countries and are particularly pronounced in France.• Reducing these inequalities in prevention programs implies studying the knowledge and mental representations of cancer among children.What is New:• This study identified representations of cancer in young children according to social level.• At age 9, children living in deprived areas are less able to produce content in discussions about cancer and have narrower mental representations and a more fatalistic view.

Occupational status as a determinant of mental health inequities in French young people: is fairness needed? Results of a cross-sectional multicentre observational survey

BackgroundEmployment conditions are associated with health inequities. In 2013, French young people had the highest unemployment rate and among those who worked as salaried workers most of them had temporary job. The purpose of the study was to assess mental health state of French young people through the prism of their occupational status and to measure whether occupational status is a determinant of health inequities.MethodsA cross-sectional multicentre observational survey was performed in June and July 2010 in 115 French Local Social Centres and 74 Health Examination Centres, who were available to participate. The survey was based on an anonymous self-administrated questionnaire delivered by social workers or healthcare professionals to young people age from 16 to 25xa0years old. The questionnaire was composed of 54 items. Several health outcomes were measured: self-perceived health, mental health, addictions and to be victim of violence. The association of occupational status and mental health was assessed by adjusting results on age and gender and by introducing other explanatory variables such as social deprivation.ResultsA total of 4282 young people completed the questionnaire, a response rate of 83%, 1866 men and 2378 women, sex-ratio 0.79. French young people having a non-working occupational status or a non-permanent working status were more exposed to poor self-perceived health, poor mental health, addictions and violence. To be at school particularly secondary school was a protective factor for addiction.ConclusionsOccupational status of French young people was a determinant of mental health inequities. Young people not at work and not studying reported greater vulnerability and should be targeted therefore by appropriate and specific social and medical services.

Éducation à la sexualité : conceptions des élèves de 4e et 3e en collège et SEGPA

En France, l’Education Nationale a donne une place significative a l’education a la sante et a la sexualite dans les missions assignees a ses personnels en privilegiant une vision globale et positive de la sexualite. L’education des enfants et des adolescents a la sexualite est l’affaire de tous. Les parents, les enseignants, les services publics et les ressources specialisees ont chacun leur place dans ce domaine afin que chaque jeune puisse beneficier d’une education lui permettant de vivre sainement sa sexualite. L’etude presentee porte sur les conceptions individuelles de la sexualite, les pratiques declarees et les connaissances des eleves de college et de Section d’Enseignement General et Professionnel Adapte (Segpa), structure accueillant des eleves en grandes difficultes scolaires. La methodologie de recherche est basee sur l’administration de questionnaires (n = 524) aux deux cohortes concernees. L’objectif secondaire est de les comparer et de mettre en exergue les specificites du public des eleves de SEGPA. Les conclusions de cette recherche devraient permettre aux adultes en charge de l’education a la sexualite en college et en Segpa d’adapter les dispositifs pedagogiques en education a la sexualite.

School Health Education Nowadays

School health education has been viewed in a large variety of perspectives. In this chapter we present, in a historic approach, the biomedical model, the holistic view as well as the health promotion, autonomy and citizenship perspectives of health education. The aims of the health promoting school and the relevance of partnerships with the health sector, the pupils, their families and the community in health education are emphasised. Social representations, ethics and values in health education are referred. Special attention is given to models of school health education, the nature of knowledge in health education, prevention of health risks, effectiveness of health education practices and also to teachers practices and their role and training in health education.