Journal of the American College of Cardiology, 2022
Implementing a health promotion program for children is a complex endeavor. In this review, we ou... more Implementing a health promotion program for children is a complex endeavor. In this review, we outline the key lessons learned over 10 years of experience in implementing the SI! Program (Salud Integral-Comprehensive Health) for cardiovascular health promotion in preschool settings in 3 countries: Colombia (Bogotá), Spain (Madrid), and the United States (Harlem, New York). By matching rigorous efficacy studies with implementation science, we can help bridge the divide between science and educational practice. Achieving sustained lifestyle changes in preschool children through health promotion programs is likely to require the integration of several factors: 1) multidisciplinary teams; 2) multidimensional educational programs; 3) multilevel interventions; 4) local program coordination and community engagement; and 5) scientific evaluation through randomized controlled trials. Implementation of effective health promotion interventions early in life may induce long-lasting healthy behaviors that could help to curb the cardiovascular disease epidemic.
Academic conferences have several limitations. One of those is precisely their emphasis on ration... more Academic conferences have several limitations. One of those is precisely their emphasis on rational modes of interaction. Education (and, by extension, comparative education) is an experience that in real-world settings extends far beyond the intellectual. By approaching it in this primarily academic way, the true nature of education is reduced and simplified. Films provide a multidimensional aesthetic experience that allows us to go beyond just “thinking” about education. Since 2015, Open Society Foundations has sponsored a film festival within the framework of the annual Comparative Education Society (CIES)meeting. The festival has evolved in its scope and format and has become an important space for reflection on education within the conference. As its organizers and curators, we see the film festival at CIES as more than just an extracurricular activity. We see the festival as an aesthetic experience that promotes critical dialogue and questions that enrich and deepen our understanding of education more broadly and has important implications for research in comparative education. In this essay, we go behind the scenes of the festival to reveal our rationale for an aesthetics of film in comparative education. We emphasize three aspects related to an aesthetics of film: social, interactive, and integrative. These orient our approach to curating and organizing thefilm festival. In the second part of this essay, we show how this approach translated into the organization of this year’s festival held during the vCIES 2020 conference, “Education beyond the Human.”
This chapter examines Plaza Sesamo from a historical perspective identifying key milestones in th... more This chapter examines Plaza Sesamo from a historical perspective identifying key milestones in the brand’s development and exploring issues related to sustainability including funding, impact, relevance and brand management. The analysis incorporates views from stakeholder interviews conducted both within and outside of the organization as well as market and research studies conducted over the last decade. It offers a model of engagement that has valuable implications for building business strategies for lasting impact in other contexts.
Journal of the American College of Cardiology, 2020
BACKGROUND Long-term evaluations of child health promotion programs are required to assess their ... more BACKGROUND Long-term evaluations of child health promotion programs are required to assess their sustainability and the need for reintervention. OBJECTIVES This study sought to explore the long-term impact of a preschool health promotion intervention delivered in an urban low-income area of Colombia (phase 1) and to assess the effect of a new community-based intervention (phase 2). METHODS In phase 1, a cross-sectional analysis of knowledge, attitudes, and habits (KAH) toward a healthy lifestyle and ideal cardiovascular health (ICH) scores of 1,216 children 9 to 13 years old was performed. Of the total, 596 had previously received a preschool health promotion intervention at 3 to 5 years old, whereas the remaining 620 were not previously intervened (intervention-naive group). In phase 2, all children were cluster randomized 1:1 to receive either a 4-month educational intervention (the SI! Program) to instill healthy behaviors in community centers (24 clusters, 616 children) or to control (24 clusters, 600 children). Previously intervened and intervention-naive children were not mixed in the same cluster. The primary outcomes were the change from baseline in KAH and ICH scores. Intervention effects were tested for with linear mixed-effects models. RESULTS In phase 1, w85% of children had nonideal cardiovascular health, and those who previously received a preschool intervention showed a negligible residual effect compared with intervention-naive children. In phase 2, the between-group (control vs. intervention) differences in the change of the overall KAH and ICH scores were 0.92 points (95% confidence interval [CI]: À0.28 to 2.13; p ¼ 0.133) and À0.20 points (95% CI: À0.43 to 0.03; p ¼ 0.089), respectively. No booster effect was detected. However, a dose-response effect was observed, with maximal benefit in children attending >75% of the scheduled intervention; the difference in the change of KAH between the high-and lowadherence groups was 3.72 points (95% CI: 1.71 to 5.73; p < 0.001). CONCLUSIONS Although overall significant differences between the intervention and control groups were not observed, high adherence rates to health promotion interventions may improve effectiveness and outcomes in children. Reintervention strategies may be required at multiple stages to induce sustained health promotion effects (Salud Integral Colombia [SI! Colombia II]; NCT03119792) (
Inter American Journal of Education For Democracy, 2010
International organizations and donor agencies have played an important role in shaping and prodd... more International organizations and donor agencies have played an important role in shaping and prodding national educational reforms in Latin America through cooperation in the form of aid and technical assistance. This paper will draw from deliberative democratic theory to critically analyze the promise and reality of democratic participation in international cooperation in education in Latin America. It argues that there is a fundamental contradiction between the development discourse around the democratization of development relationships and the actual practices within the international organizations that wield this discourse. Moreover, international influence ranging from direct financial aid to more subtle actions, such as technical assistance, policy dialogues, and knowledge sharing, continue to limit the potential for a more democratic and deliberative form of cooperation in education. Towards a Deliberative and Democratic Model of International Cooperation in Education in Latin America 226 of promoting knowledge-sharing and capacity building (Samoff and Stromquist, 2001; Samoff, 2004). Scholars have shifted their attention to studying not only the material manifestations of power (e.g. resource allocation, aid and grantmaking) in international organizations (IOs) but also the ways in which these institutions exert influence through control over technical expertise and information, norm-setting, determination of goals to be pursued, and legitimization of certain forms of knowledge over others (Mundy, 2006;
BACKGROUND: School programs can be effective in modifying knowledge, attitudes, and habits releva... more BACKGROUND: School programs can be effective in modifying knowledge, attitudes, and habits relevant to long-term risk of chronic diseases associated with sedentary lifestyles. As part of a long-term research strategy, we conducted an educational intervention in preschool facilities to assess changes in preschoolers' knowledge, attitudes, and habits toward healthy eating and living an active lifestyle. METHODS: Using a cluster design, we randomly assigned 14 preschool facilities in Bogotá, Colombia to a 5-month educational and playful intervention (7 preschool facilities) or to usual curriculum (7 preschool facilities). A total of 1216 children aged 3-5 years, 928 parents, and 120 teachers participated. A structured survey was used at baseline, at the end of the study, and 12 months later to evaluate changes in knowledge, attitudes, and habits. RESULTS: Children in the intervention group showed a 10.9% increase in weighted score, compared with 5.3% in controls. The absolute adjusted difference was 3.90 units (95% confidence interval [CI], 1.64-6.16; P Ͻ.001). Among parents, the equivalent statistics were 8.9% and 3.1%, respectively (absolute difference 4.08 units; 95% CI, 2.03 to 6.12; P Ͻ.001), and among teachers, 9.4% and 2.5%, respectively (absolute difference 5.36 units; 95% CI, Ϫ0.29-11.01; P ϭ .06). In the intervened cohort 1 year after the intervention, children still showed a significant increase in weighted score (absolute difference of 6.38 units; P Ͻ.001). CONCLUSIONS: A preschool-based intervention aimed at improving knowledge, attitudes, and habits related to healthy diet and active lifestyle is feasible, efficacious, and sustainable in very young children.
BACKGROUND-Educational interventions in preschool children could improve dietary behavior and phy... more BACKGROUND-Educational interventions in preschool children could improve dietary behavior and physical activity, and prevent unhealthy body weights in low-and middle-income countries. Previously, we have reported the beneficial impact of an educational intervention in preschoolers in a 6-month trial. We now report extended results after 36 months. METHODS-Evaluating the cohort of previously intervened children, baseline measurements were made in May 2009 in 14 preschool facilities in Usaquén (Bogotá, Colombia). Follow-up measurements were performed at 18 and 36 months. The primary outcome was the mean change in children's knowledge and attitudes scores regarding healthy eating and living an active lifestyle, including habits scores related to physical activity. Secondary outcomes were the change over time of children's nutritional status and the mean change in parent's knowledge, attitudes, and habits. RESULTS-We included 1216 children, 3-5 years of age, and 928 parents. After adjusting by sex and age of children, socioeconomic status, age of parents, and age and education level of teachers, we found a significant increase in mean knowledge, attitudes, and habits scores at 36 months, compared with baseline: 87.94 vs 76.15 (P <.001); 86.39 vs 57.03 (P <.001); and 66.29 vs 48.72 (P <.001), respectively. We observed a similar increase in knowledge and attitude scores in parents: 73.45 vs 70.01 (P <.001); and 78.08 vs 74.65 (P <.001). The proportion of eutrophic children increased from 62.1% at baseline to 75.0% at 36 months (P <.0001).
This study identifies and compares competing policy stories of key actors involved in the Ecuador... more This study identifies and compares competing policy stories of key actors involved in the Ecuadorian education reform under President Rafael Correa from 2007-2015. By revealing these competing policy stories the study generates insights into the political and technical aspects of education reform in a context where state capacity has been eroded by decades of neoliberal policies.
Journal of the American College of Cardiology, 2022
Implementing a health promotion program for children is a complex endeavor. In this review, we ou... more Implementing a health promotion program for children is a complex endeavor. In this review, we outline the key lessons learned over 10 years of experience in implementing the SI! Program (Salud Integral-Comprehensive Health) for cardiovascular health promotion in preschool settings in 3 countries: Colombia (Bogotá), Spain (Madrid), and the United States (Harlem, New York). By matching rigorous efficacy studies with implementation science, we can help bridge the divide between science and educational practice. Achieving sustained lifestyle changes in preschool children through health promotion programs is likely to require the integration of several factors: 1) multidisciplinary teams; 2) multidimensional educational programs; 3) multilevel interventions; 4) local program coordination and community engagement; and 5) scientific evaluation through randomized controlled trials. Implementation of effective health promotion interventions early in life may induce long-lasting healthy behaviors that could help to curb the cardiovascular disease epidemic.
Academic conferences have several limitations. One of those is precisely their emphasis on ration... more Academic conferences have several limitations. One of those is precisely their emphasis on rational modes of interaction. Education (and, by extension, comparative education) is an experience that in real-world settings extends far beyond the intellectual. By approaching it in this primarily academic way, the true nature of education is reduced and simplified. Films provide a multidimensional aesthetic experience that allows us to go beyond just “thinking” about education. Since 2015, Open Society Foundations has sponsored a film festival within the framework of the annual Comparative Education Society (CIES)meeting. The festival has evolved in its scope and format and has become an important space for reflection on education within the conference. As its organizers and curators, we see the film festival at CIES as more than just an extracurricular activity. We see the festival as an aesthetic experience that promotes critical dialogue and questions that enrich and deepen our understanding of education more broadly and has important implications for research in comparative education. In this essay, we go behind the scenes of the festival to reveal our rationale for an aesthetics of film in comparative education. We emphasize three aspects related to an aesthetics of film: social, interactive, and integrative. These orient our approach to curating and organizing thefilm festival. In the second part of this essay, we show how this approach translated into the organization of this year’s festival held during the vCIES 2020 conference, “Education beyond the Human.”
This chapter examines Plaza Sesamo from a historical perspective identifying key milestones in th... more This chapter examines Plaza Sesamo from a historical perspective identifying key milestones in the brand’s development and exploring issues related to sustainability including funding, impact, relevance and brand management. The analysis incorporates views from stakeholder interviews conducted both within and outside of the organization as well as market and research studies conducted over the last decade. It offers a model of engagement that has valuable implications for building business strategies for lasting impact in other contexts.
Journal of the American College of Cardiology, 2020
BACKGROUND Long-term evaluations of child health promotion programs are required to assess their ... more BACKGROUND Long-term evaluations of child health promotion programs are required to assess their sustainability and the need for reintervention. OBJECTIVES This study sought to explore the long-term impact of a preschool health promotion intervention delivered in an urban low-income area of Colombia (phase 1) and to assess the effect of a new community-based intervention (phase 2). METHODS In phase 1, a cross-sectional analysis of knowledge, attitudes, and habits (KAH) toward a healthy lifestyle and ideal cardiovascular health (ICH) scores of 1,216 children 9 to 13 years old was performed. Of the total, 596 had previously received a preschool health promotion intervention at 3 to 5 years old, whereas the remaining 620 were not previously intervened (intervention-naive group). In phase 2, all children were cluster randomized 1:1 to receive either a 4-month educational intervention (the SI! Program) to instill healthy behaviors in community centers (24 clusters, 616 children) or to control (24 clusters, 600 children). Previously intervened and intervention-naive children were not mixed in the same cluster. The primary outcomes were the change from baseline in KAH and ICH scores. Intervention effects were tested for with linear mixed-effects models. RESULTS In phase 1, w85% of children had nonideal cardiovascular health, and those who previously received a preschool intervention showed a negligible residual effect compared with intervention-naive children. In phase 2, the between-group (control vs. intervention) differences in the change of the overall KAH and ICH scores were 0.92 points (95% confidence interval [CI]: À0.28 to 2.13; p ¼ 0.133) and À0.20 points (95% CI: À0.43 to 0.03; p ¼ 0.089), respectively. No booster effect was detected. However, a dose-response effect was observed, with maximal benefit in children attending >75% of the scheduled intervention; the difference in the change of KAH between the high-and lowadherence groups was 3.72 points (95% CI: 1.71 to 5.73; p < 0.001). CONCLUSIONS Although overall significant differences between the intervention and control groups were not observed, high adherence rates to health promotion interventions may improve effectiveness and outcomes in children. Reintervention strategies may be required at multiple stages to induce sustained health promotion effects (Salud Integral Colombia [SI! Colombia II]; NCT03119792) (
Inter American Journal of Education For Democracy, 2010
International organizations and donor agencies have played an important role in shaping and prodd... more International organizations and donor agencies have played an important role in shaping and prodding national educational reforms in Latin America through cooperation in the form of aid and technical assistance. This paper will draw from deliberative democratic theory to critically analyze the promise and reality of democratic participation in international cooperation in education in Latin America. It argues that there is a fundamental contradiction between the development discourse around the democratization of development relationships and the actual practices within the international organizations that wield this discourse. Moreover, international influence ranging from direct financial aid to more subtle actions, such as technical assistance, policy dialogues, and knowledge sharing, continue to limit the potential for a more democratic and deliberative form of cooperation in education. Towards a Deliberative and Democratic Model of International Cooperation in Education in Latin America 226 of promoting knowledge-sharing and capacity building (Samoff and Stromquist, 2001; Samoff, 2004). Scholars have shifted their attention to studying not only the material manifestations of power (e.g. resource allocation, aid and grantmaking) in international organizations (IOs) but also the ways in which these institutions exert influence through control over technical expertise and information, norm-setting, determination of goals to be pursued, and legitimization of certain forms of knowledge over others (Mundy, 2006;
BACKGROUND: School programs can be effective in modifying knowledge, attitudes, and habits releva... more BACKGROUND: School programs can be effective in modifying knowledge, attitudes, and habits relevant to long-term risk of chronic diseases associated with sedentary lifestyles. As part of a long-term research strategy, we conducted an educational intervention in preschool facilities to assess changes in preschoolers' knowledge, attitudes, and habits toward healthy eating and living an active lifestyle. METHODS: Using a cluster design, we randomly assigned 14 preschool facilities in Bogotá, Colombia to a 5-month educational and playful intervention (7 preschool facilities) or to usual curriculum (7 preschool facilities). A total of 1216 children aged 3-5 years, 928 parents, and 120 teachers participated. A structured survey was used at baseline, at the end of the study, and 12 months later to evaluate changes in knowledge, attitudes, and habits. RESULTS: Children in the intervention group showed a 10.9% increase in weighted score, compared with 5.3% in controls. The absolute adjusted difference was 3.90 units (95% confidence interval [CI], 1.64-6.16; P Ͻ.001). Among parents, the equivalent statistics were 8.9% and 3.1%, respectively (absolute difference 4.08 units; 95% CI, 2.03 to 6.12; P Ͻ.001), and among teachers, 9.4% and 2.5%, respectively (absolute difference 5.36 units; 95% CI, Ϫ0.29-11.01; P ϭ .06). In the intervened cohort 1 year after the intervention, children still showed a significant increase in weighted score (absolute difference of 6.38 units; P Ͻ.001). CONCLUSIONS: A preschool-based intervention aimed at improving knowledge, attitudes, and habits related to healthy diet and active lifestyle is feasible, efficacious, and sustainable in very young children.
BACKGROUND-Educational interventions in preschool children could improve dietary behavior and phy... more BACKGROUND-Educational interventions in preschool children could improve dietary behavior and physical activity, and prevent unhealthy body weights in low-and middle-income countries. Previously, we have reported the beneficial impact of an educational intervention in preschoolers in a 6-month trial. We now report extended results after 36 months. METHODS-Evaluating the cohort of previously intervened children, baseline measurements were made in May 2009 in 14 preschool facilities in Usaquén (Bogotá, Colombia). Follow-up measurements were performed at 18 and 36 months. The primary outcome was the mean change in children's knowledge and attitudes scores regarding healthy eating and living an active lifestyle, including habits scores related to physical activity. Secondary outcomes were the change over time of children's nutritional status and the mean change in parent's knowledge, attitudes, and habits. RESULTS-We included 1216 children, 3-5 years of age, and 928 parents. After adjusting by sex and age of children, socioeconomic status, age of parents, and age and education level of teachers, we found a significant increase in mean knowledge, attitudes, and habits scores at 36 months, compared with baseline: 87.94 vs 76.15 (P <.001); 86.39 vs 57.03 (P <.001); and 66.29 vs 48.72 (P <.001), respectively. We observed a similar increase in knowledge and attitude scores in parents: 73.45 vs 70.01 (P <.001); and 78.08 vs 74.65 (P <.001). The proportion of eutrophic children increased from 62.1% at baseline to 75.0% at 36 months (P <.0001).
This study identifies and compares competing policy stories of key actors involved in the Ecuador... more This study identifies and compares competing policy stories of key actors involved in the Ecuadorian education reform under President Rafael Correa from 2007-2015. By revealing these competing policy stories the study generates insights into the political and technical aspects of education reform in a context where state capacity has been eroded by decades of neoliberal policies.
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