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Varna Medical Forum

Health Promotion In The Secondary Bulgarian Schools

Petya Boncheva, Klara Dokova


Introduction: The school is a key place to promote the health of adolescents. The combined efforts of the entire school community, aimed at developing policies, practices, and building a health-supportive environment, form a sustainable health behavior in the pupils.
Aim: The aim of this article is to study the conditions and activities for health promotion in the Bulgarian secondary school.
Materials and Methods: A study was conducted among first-year students from the Medical University of Varna in December 2017 on the conditions and activities for health promotion in the secondary schools, which they had graduated from. Information was gathered through a direct individual survey, including 18 closed-ended questions. A descriptive analysis was conducted and the verification of hypotheses on the link between the qualitative variables was tested by the chi-square criterion. The data were statistically processed through SPSS v. 23.0, and a Microsoft Office Excel 2007 software package was used to draw the graphics.
Results and Discussion: The survey covered 75 freshmen presenting over 20 secondary schools, 44% from large cities, and 56% from small towns. Men were 28% of the respondents, 72% were women. The mean age was 21 years (SD = 5.6). Student health education activities were conducted at 62.7% of the secondary schools according to the respondents, but there was a lack of consistence in attendance - 38.4% of the students did not attend discussions and lectures during the last school year. Conditions for healthy work and rest and for physical activity have been created. There were no good conditions for observing personal hygiene. According to the students, 52.6% of the schools lacked possibilities for healthy eating, and access to unhealthy food and drink for the pupils was provided in 77.3% of the schools. Over 67% of the students determined the health awareness they received in the secondary school as incomplete and missing.


health promotion, school, health behavior

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Holden, B. et al. Myopia, an underrated global challenge to vision: Where the current data takes us on myopia control. Eye (2014). doi:10.1038/eye.2013.256

O’Donoghue, L. et al. Risk factors for childhood myopia: Findings from the NICER study. Investig. Ophthalmol. Vis. Sci. (2015). doi:10.1167/iovs.14-15549

Janowski, M., Bulte, J. W. M., Handa, J. T., Rini, D. & Walczak, P. Concise Review: Using Stem Cells to Prevent the Progression of Myopia-A Concept. Stem Cells (2015). doi:10.1002/stem.1984

Anstice, N. S. & Phillips, J. R. Effect of dual-focus soft contact lens wear on axial myopia progression in children. Ophthalmology (2011). doi:10.1016/j.ophtha.2010.10.035

Gwiazda, J. Treatment options for myopia. Optometry and Vision Science (2009). doi:10.1097/OPX.0b013e3181a6a225

Walline, J. & Smith, M. Controlling myopia progression in children and adolescents. Adolesc. Health. Med. Ther. (2015). doi:10.2147/AHMT.S55834

Vitale, S., Sperduto, R. D. & Ferris, F. L. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch. Ophthalmol. (2009). doi:10.1001/archophthalmol.2009.303

Holden, B. A. et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology (2016). doi:10.1016/j.ophtha.2016.01.006

Day, M. & Duffy, L. A. Myopia and defocus : the current understanding. Scand. J. Optom. Vis. Sci. (2011). doi:10.5384/SJOVS.vol4i1p1

Smith, E. L. et al. Effects of optical defocus on refractive development in monkeys: Evidence for local, regionally selective mechanisms. Investig. Ophthalmol. Vis. Sci. (2010). doi:10.1167/iovs.09-4969

Verma, A. & Verma, A. A novel review of the evidence linking myopia and high intelligence. Journal of Ophthalmology (2015). doi:10.1155/2015/271746

Wu, P. C., Tsai, C. L., Wu, H. L., Yang, Y. H. & Kuo, H. K. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology (2013). doi:10.1016/j.ophtha.2012.11.009

Brennan, N. A. Predicted reduction in high myopia for various degrees of myopia control. Contact Lens Anterior Eye (2012). doi:10.1016/j.clae.2012.08.046

Rosén, R., Lundström, L. & Unsbo, P. Influence of optical defocus on peripheral vision. Investig. Ophthalmol. Vis. Sci. (2011). doi:10.1167/iovs.10-5623

Lam, C. S. Y., Tang, W. C., Tse, D. Y. Y., Tang, Y. Y. & To, C. H. Defocus Incorporated Soft Contact (DISC) lens slows myopia progression in Hong Kong Chinese schoolchildren: A 2-year randomised clinical trial. Br. J. Ophthalmol. (2014). doi:10.1136/bjophthalmol-2013-303914

Smith, E. L. et al. Effects of foveal ablation on emmetropization and form-deprivation myopia. Investig. Ophthalmol. Vis. Sci. (2007). doi:10.1167/iovs.06-1264

Tan, D., Tay, S. A., Loh, K. L. & Chia, A. Topical atropine in the control of myopia. Asia-Pacific Journal of Ophthalmology (2016). doi:10.1097/APO.0000000000000232

Chua, W. H. et al. Atropine for the Treatment of Childhood Myopia. Ophthalmology (2006). doi:10.1016/j.ophtha.2006.05.062

Chia, A., Lu, Q. S. & Tan, D. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2 Myopia Control with Atropine 0.01% Eyedrops. Ophthalmology (2016). doi:10.1016/j.ophtha.2015.07.004

Adler, D. & Millodot, M. The possible effect of undercorrection on myopic progression in children. Clin. Exp. Optom. (2006). doi:10.1111/j.1444-0938.2006.00055.x

Gifford, P. & Gifford, K. L. The future of myopia control contact lenses. Optometry and Vision Science (2016). doi:10.1097/OPX.0000000000000762

Nichols, J. J., Marsich, M. M., Nguyen, M., Barr, J. T. & Bullimore, M. A. Overnight orthokeratology. Optom. Vis. Sci. (2000). doi:10.1097/00006324-200005000-00012

Kakita, T., Hiraoka, T. & Oshika, T. Influence of overnight orthokeratology on axial elongation in childhood myopia. Investig. Ophthalmol. Vis. Sci. (2011). doi:10.1167/iovs.10-5485

Lin, H. J. et al. Overnight orthokeratology is comparable with atropine in controlling myopia. BMC Ophthalmol. (2014). doi:10.1186/1471-2415-14-40

Swarbrick, H. A. Orthokeratology review and update. Clinical and Experimental Optometry (2006). doi:10.1111/j.1444-0938.2006.00044.x

Walline, J. J. Myopia control: A review. Eye and Contact Lens (2016). doi:10.1097/ICL.0000000000000207

Walline, J. J., Greiner, K. L., McVey, M. E. & Jones-Jordan, L. A. Multifocal contact lens myopia control. Optom. Vis. Sci. (2013). doi:10.1097/OPX.0000000000000036

Aller, T. A., Liu, M. & Wildsoet, C. F. Myopia control with bifocal contact lenses: A randomized clinical trial. Optom. Vis. Sci. (2016). doi:10.1097/OPX.0000000000000808



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