title: Building school-based cardiovascular health promotion capacity in youth: a mixed methods study.
abstract: BACKGROUND
  Essential to building cardiovascular health promotion capacity in youth, which extends into adulthood, are approaches that seek to empower, educate, and support. The Five Cs model of positive youth development (PYD) guided this study. This model represents the ability of youth to develop competence, confidence, connection, character, and caring when given the appropriate resources. The purpose of this two-year school-based feasibility study was to determine if providing a research intervention in the form of education, empowerment, and support build youth's capacity for cardiovascular health promotion.
  
  
  METHODS
  A mixed methods case study design was used to evaluate the process, and outcome of a youth-led cardiovascular health promotion program. Twenty-six youth aged 12-13 years from a Canadian middle school took part in the study. Youth participating in this study planned, implemented, and monitored cardiovascular health promotion activities in four areas: smoking, physical inactivity, nutrition and obesity. Qualitative data was collected from the youth participants using three focus groups and individual reflective journals. Quantitative data was collected with the PYD.2, a self-report questionnaire that assesses positive youth development and consists of 5 subscales: character, competence, caring, connection, and confidence. The participants completed the PYD before and after the program to determine if there were any changes in PYD scores after the intervention. The quantitative data was analyzed using paired samples t-tests, and the qualitative data was analyzed using constant comparative analysis.
  
  
  RESULTS
  While the PYD scores showed no significant changes, the qualitative findings confirmed that the youth acquired increased awareness and understanding of cardiovascular health promotion initiatives. Four themes emerged from the qualitative data, (1) doing the right thing, (2) wanting to make a change, but feeling constrained, (3) I get it, and (4) The project has changed me! The intervention was found to be acceptable and feasible for the youth participants and their school.
  
  
  CONCLUSIONS
  The contributions of this study were twofold. It generated evidence to support integrating positive youth development strategies into cardiovascular health promotion programs. Secondly, this study determined that the research intervention improved the participants' knowledge and attitudes about cardiovascular health and were suitable for further implementation and testing.
authors.affiliation: Professor & Canadian Institutes of Health Research Applied Chair in Reproductive, Child and Youth Health Services and Policy Research, Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada. Roberta.Woodgate@umanitoba.ca.
authors.forename: Roberta L
authors.initials: RL
authors.lastname: Woodgate
authors.affiliation: Ph.D. Candidate, Faculty of Graduate Studies, Applied Health Sciences, University of Manitoba, Winnipeg, MB, Canada. sigurds9@myumanitoba.ca.
authors.forename: Corey M
authors.initials: CM
authors.lastname: Sigurdson
mesh_terms: D000293:Adolescent; D001290:Attitude; D002170:Canada; D057191:Capacity Building / Q000458:organization & administration*; D004032:Diet; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000517:prevention & control; D012572:School Health Services / Q000458:organization & administration*; D012649:Self Concept; D000074606:Smoking Prevention