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Evolution

HRIDAY functions with two components – HRIDAY (Health Related Information Dissemination Amongst Youth) and SHAN (Student Health Action Network). The organization evolved in three phases, expanding from school based health education to community based health activism.

Phase I – School Component

During the first phase of HRIDAY (1992-94), the health education intervention in schools concentrated on 5 key areas:

Students of Grades 6-11 from 16 private schools (representing high socio-economic status) and 17 government schools (representing low socio-economic status) schools of Delhi were engaged. They were randomly allocated into ‘active intervention’ and ‘passive observation’groups. The activities conducted were school-based and included workshops for students and teachers, assembly talks & interactive sessions, quizzes, poster and elocution contests, and project work. Apart from these activities, HRIDAY educational tools in both Hindi and English – including posters, illustrated booklets and a film on healthy lifestyles – were provided to schools. Additional resources, such as tobacco information folders, audio-cassettes containing talks by experts on the health hazards of tobacco, alcohol and drugs use, were also used for generating awareness. An interactive computer software programme was also developed.

Analysis and evaluation (1994-96), revealed that schools in the active intervention group demonstrated greater positive change in knowledge levels, in comparison with schools in the control group. This was especially evident in the government schools, which began with lower knowledge levels, in comparison to private schools. The knowledge gap between government and private schools in the active interventiongroup narrowed down in the post-intervention evaluation, indicating greater benefits received by the government schools. Since the intervention and the evaluation instrument were composite, it was difficult to distinguish between the specific effects on tobacco-related knowledge and behaviours.

Phase II – School and Home Components

The success and lessons of Phase I of the project along with shared experiences of similar projects like CATCH (Child and Adolescent Trial for Cardiovascular Health) of USA, spurred the initiation of Phase 2 at HRIDAY. During this phase (1996-1998), students aged 11-14 years (Grade 6) of 15 government and 15 private schools were engaged. Teachers were a key component and the study included school and home settings. This time, the focus was on three areas:

Separate interventions were designed for schools and homes. School-level activities included teacher and peer leader training workshops, intra and inter-school debate competitions and other activities as in Phase I. HRIDAY educational tools including a Teachers’ Training Manual, 10 Posters and 1 Illustrated Booklet were provided to all intervention schools. Activities conducted at home level included distribution of a series of six booklets – “Trek to the Health Track”. Students were provided these booklets to be read at home and asked to perform the activities listed in it with their parents or elder siblings.

 A significant impact of the intervention was observed on initiation of tobacco use, in this young age group, with the intervention group demonstrating a lower than anticipated rise in the proportion of students experimenting with smoking, in comparison with similar schools which did not have any intervention.

Phase III – School, Home and Community Components

During phase II, environmental barriers were identified which prevented the adoption of healthy lifestyle practices in spite of enhanced awareness. Several of these barriers needed to be addressed by health promoting policies, through enabling regulatory or legislative measures. It was realised that it is important for school students – whose future health is determined by present policies – to speak up and voice their views. The recognition of this need and the potential impact of such a youth led movement gave birth to SHAN (Student Health Action Network) in 1998.

The presentation of an appeal signed by 25,000 school students of Delhi, to the Prime Minister of India on September 12, 1998 marked the formal launch of SHAN. Debates were organized (at first in 20 schools followed by a contest at the inter-school level) on the need for a governmental ban on all forms of tobacco advertising and sponsorship. SHAN subsequently conducted a signature campaign among school students, which culminated in the appeal to the Prime Minister.

SHAN (Student Health Action Network) is a network of high school students (14-17 years) in Delhi . It provides a forum for the students to periodically discuss policies and programmes relevant to their present and future health. The objectives of SHAN include promotion of informed debates on health related issues intended to draw consensus among students on actions (at the individual, family, school and community levels), which will help protect and promote their present and future health and to encourage school students to actively articulate demands for appropriate governmental policy reforms.

Introduction of SHAN in schools strengthened commitment to health promotion, among both the younger as well as older groups of students. The motto of SHAN is ‘debate the present to define the future’. The students are not passively informed but actively involved. The older students also become role models for the younger students, in a child-to-child learning process. HRIDAY extended its network to include 63 schools of Delhi, where both the programmes were provided at two levels of age. HRIDAY programme caters to the students in Grades 6-8(learning the fact) and SHAN programme involves the students in Grades 9-12 (learning to act).