School policies, built environment and practices for non-communicable disease (NCD) prevention and control in schools of Delhi, India

ObjectiveTo assess school policies, built environment and practices for prevention and control of non-communicable diseases in schools of Delhi, India.MethodsSchool built environments and policies were assessed using a structured observation checklist in 10 private and 9 government schools which were randomly selected from all 184 co-educational schools with primary to senior secondary level education in Delhi, India. A self-administered questionnaire was also completed by teachers from each school (n = 19) to capture information specific to school policies. Surveys were also conducted with parent of students in class II (aged 6–7 years; n = 574) and student in class XI (aged 15–16 years, n = 755) to understand school practices.ResultsThe majority of government (88.9%; n = 8) and private (80%; n = 8) schools reported having comprehensive school health policy. In terms of specific health behaviours, policies related to diet and nutrition in government schools were mostly restricted to primary levels with provision of the mid-day meal programme. All schools had two physical education periods per week of about 45–50 minutes. Most schools were compliant with tobacco-free school guidelines (n = 15 out of 19) and had alcohol control policies (n = 13 out of 19). Parent and student reports of practices indicated that school policies were not consistently implemented.ConclusionMost schools in Delhi have policies that address health behaviours in students, but there was considerable variation in the types and number of policies and school environments. Government schools are more likely to have policies in place than private schools. Further work is needed to evaluate how these policies are implemented and to assess their impact on health outcomes.

研究目的：评估印度德里地区中小学的非传染性疾病（non-communicable diseases）防控相关学校政策、建成环境与实践举措。
研究方法：从印度德里全市184所涵盖小学至高中阶段教育的男女同校学校中，随机抽取10所民办学校与9所公办学校，采用结构化观察量表对学校建成环境（built environment）与相关政策进行评估。同时，每所学校的教师（共19名）填写自填式问卷（self-administered questionnaire），以收集学校政策相关的专项信息。此外，还对二年级（学生年龄6-7岁，共574名学生）的家长以及十一年级（学生年龄15-16岁，共755名学生）开展调查，以了解学校的相关实践情况。
研究结果：多数公办学校（88.9%，n=8）与民办学校（80%，n=8）表示已制定全面的学校健康政策。在特定健康行为相关政策方面，公办学校的饮食与营养政策大多仅覆盖小学阶段，且配套实施午间供餐计划（mid-day meal programme）。所有学校每周均开设2节体育课，每节课时长约45-50分钟。绝大多数学校符合无烟校园指南要求（19所中的15所），且制定了酒精管控政策（19所中的13所）。家长与学生的实践反馈显示，学校政策并未得到一贯落实。
研究结论：德里地区多数学校已制定针对学生健康行为的相关政策，但各类政策的类型、数量以及学校环境均存在显著差异。公办学校制定相关政策的比例高于民办学校。未来仍需开展相关研究，评估这些政策的落实情况，并分析其对学生健康结局的影响。