Abstract
Objective: This report aims to examine health education in schools using a bone stiffness survey in Koshu City, Yamanashi Prefecture, based on the plan, adaptation, implementation, reach, effectiveness, and maintenance (PAIREM) framework.
Methods: The six factors of the PAIREM framework were used to evaluate the 2011-2020 health education practices of elementary and junior high schools in the city.
Results: Plan: The bone stiffness survey was an additional survey and targeted schools of interest. No specific achievement goals were set. Adoption: Although junior high schools no longer participate, adoption by primary schools has increased from 61.5% to 84.6% over the 10 years. Implementation: Health education was developed using the bone stiffness survey’s results and information was provided at the health committee (5 schools, 7 times/10 years) and bone research committee meetings (5 times/10 years). Reach: Bone stiffness measurements were obtained from 7,200 (97.8%) of the 7,362 eligible participants, indicating high achievement. All of the targeted children were provided with information on bone strength (100%). Effectiveness: As achievement goals were not set, the effectiveness of bone stiffness survey practice could not be evaluated. Maintenance: The average number of years of maintenance among the participating schools over 10 years was 8.36 years (standard deviation of 2.2), but the program’s long-term effect on individuals could not be examined.
Conclusion: The results showed that a school-based bone stiffness survey could be conducted with a high degree of achievement among children. Future practices need to understand the details of health education, perform evaluations at the individual level, and implement efforts to achieve specific targets.
