GenNext – exit NCDs intervention tool for prevention of NCD risk factors among schoolchildren

This Facilitator’s manual for schoolteachers is to be used along with the GenNext Intervention tool ii Facilitator’s manual for schoolteachers GenNext – Exit NCDs Intervention Tool for prevention of NCD risk factors among schoolchildren ISBN: 978-92-9022-751-9 © World Health Organization 2020 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. 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Printed in India iiiFacilitator’s manual for schoolteachers Table of Contents About this manual ............................................................................................................................. iv Acronyms ...........................................................................................................................................v Message from Regional Director ..................................................................................................... vii Acknowledgements ........................................................................................................................ viii 1. What are noncommunicable diseases? ....................................................................................... 1 Figure 1: Major NCDs and their risk factors ........................................................................... 1 2. Why is school the best setting for promoting a healthy lifestyle? ............................................. 2 3. What is a WHO health-promoting school (HPS) initiative? ......................................................... 3 Figure 2: Key features of a health promoting school ............................................................. 3 Table 1: Actions to be taken for prevention of NCDs by schools ......................................... 4 4. Intervention tool for prevention of NCD risk factors in schoolchildren ..................................... 5 5. Section I: Promotion of healthy behaviours ................................................................................ 7 1.1 Module: Physical activity ................................................................................................. 7 1.2 Module: Healthy diet..................................................................................................... 14 1.3 Module: Environmental pollution and protection ......................................................... 21 1.4 Module: Injury prevention ............................................................................................. 28 1.5 Module: Mental well-being and suicide prevention ...................................................... 36 1.6 Module: Substance abuse (tobacco and alcohol) ......................................................... 41 1.7 Module: Internet addiction and bullying ....................................................................... 53 6. Section 2: Life skills education .................................................................................................. 62 7. Bibliography ............................................................................................................................. 74 iv Facilitator’s manual for schoolteachers About this manual This manual aims to act as a guide for schoolteachers. It guides them in implementing an intervention tool for the prevention of risk factors of noncommunicable diseases (NCDs) and teaches selected relevant life skills to schoolchildren. The intervention tool imparts knowledge and describes activities to be conducted for promoting healthy lifestyles to prevent NCDs and equips them with adaptive and positive behaviour to deal with the challenges of everyday life. The manual details classroom-/school-level activities for students of classes I–X (aged 5–15 years) through teachers as facilitators. This intervention tool is to be implemented within the ambit of the health-promoting school initiative of the World Health Organization. These activities are designed to motivate students to take the corrective measures needed to lead a healthy life. Teachers are a vital component in implementing the intervention tool with the help of the Facilitator’s manual. The manual contains six modules under two major sections, i.e. promotion of a healthy lifestyle and prevention of unhealthy behaviour. The modules included in the manual are: physical activity; healthy diet; environmental pollution and protection; mental well- being and suicide prevention; Internet addiction and bullying; and life skills. These themes have been selected on a scientific basis, emphasizing the increasing burden of NCD risk factors among the youth and their capability to deal with day-to-day challenges. This manual considers various theories of behaviour change and initiatives taken in the WHO South-East Asia Region under the health-promoting school programme. The intervention tool intends to update and further augment the knowledge of teachers regarding health promotion in school- based settings. Implementation of the module on life skills is to be done as part of ongoing school health programmes at the country level. vFacilitator’s manual for schoolteachers Acronyms BMI body mass index HFSS high fat sugar salt HPN healthier populations and noncommunicable diseases E Cigarettes electronic cigarettes E waste electronic waste NCDs noncommunicable diseases NGO non-government organization PM particulate matter RTA road traffic accidents RTI road traffic injury WHO world health organization vi Facilitator’s manual for schoolteachers viiFacilitator’s manual for schoolteachers Message from Regional Director Noncommunicable diseases (NCDs) kill almost 41 million people globally every year and account for 71% of all deaths. In the WHO South-East Asia Region, NCDs kill an estimated 8.5 million people annually, with 48% of all NCD deaths in the Region premature. Tobacco use, harmful use of alcohol, insufficient physical activity, unhealthy diet, and overweight and obesity are important NCD risk factors. Since 2014, preventing and controlling NCDs through cost-effective “best buys” has been one of the Region’s eight Flagship Priority Programmes. Promoting healthy behaviour in children is a proven way to reduce the NCD burden. Many NCD-related behaviours and habits develop in childhood and adolescence. Preventive interventions in the development phase often have greater impact than interventions to reduce risk and restore health in adults. WHO has for many years promoted school health programmes as a strategic way to prevent health risks and engage the education sector. Since 1995, WHO’s Global School Health Initiative has strengthened health promotion and education activities at the local, national, regional and global levels. The aim of the initiative is to increase the number of schools that can truly be called “Health Promoting Schools”. This Intervention Tool and Facilitator’s Manual builds on WHO’s work to promote health in schools. Together the tool and manual provide guidance to school teachers on implementing evidence-based interventions that prevent NCD risk factors and imparting relevant life skills – including adaptive and positive behaviour – to schoolchildren aged 5–15 years. This will increase health promotion in schools and advance health and well-being for all. I urge all countries to adopt, adapt and implement the Intervention Tool and Facilitator’s Manual according to their needs. The evidence-based interventions contained herein will help all children in the Region get the healthiest start to life possible and reduce their risk of NCDs throughout the life-course. In doing so, the tool and manual will help the Region achieve its Flagship Priority on preventing and controlling NCDs while accelerating progress towards Sustainable Development Goal 3. WHO will continue to support Member States as they work to reduce the NCD burden and create a healthier, more productive South-East Asia Region. Dr Poonam Khetrapal Singh World Health Organization Regional Director WHO South-East Asia Region viii Facilitator’s manual for schoolteachers Acknowledgments GenNext - Exit NCDs: the school-level Intervention Tool and Facilitator’s Manual for the prevention of NCD risk factors has been produced by the technical unit Tobacco Free Initiative (TFI) of the Department of Healthier Populations and Noncommunicable Diseases (HPN) at the WHO Regional Office for South-East Asia. Dr Jagdish Kaur (Regional Adviser, Tobacco Free Initiative), provided the vision and concept for the publication, and collaborated in its execution, under the overall guidance of Dr Thaksaphon Thamarangsi (Director, HPN). Dr Harshal R. Salve, Assistant Professor at the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, provided the contents to develop the Intervention Tool and Facilitator’s Manual. The publishers would like to thank Dr Pem Namgyal, Director of Programme Management, and Dr Tjandra Yoga Aditama, Senior Adviser, at the WHO Regional Office for South-East Asia, for reviewing this publication. Valuable inputs were received from the following experts: • Ms Karma Dechen, Deputy Chief Programme Officer, Ministry of Education, Royal Government of Bhutan. • Dr Areekul Puangsuwan, ASEAN University Network, Bangkok, Thailand. • Dr Rekha Harish, Professor, Childhood Obesity & NCD Prevention, Jammu Medical College, Jammu & Kashmir, India. • Dr Harish K. Pemde, Director Professor of Paediatrics, Centre for Adolescent Health, Lady Hardinge Medical College, Kalawati Saran Children’s Hospital, New Delhi, India. • Ms Monika Arora, Executive Director, HRIDAY, New Delhi, India. • Professor Suneela Garg, Department of Preventive and Social Medicine, Maulana Azad Medical College, New Delhi, India. • Professor Shridhar Dwivedi, Senior Consultant Cardiologist, National Heart Institute, New Delhi, India. • Dr Ajay Khera, Deputy Commissioner, Child Health Programme, Ministry of Health & Family Welfare, Government of India. • Professor Saroj Yadav, Dean, Academics, National Institute of Research, National Council of Educational Research & Training, New Delhi, India. • Mr Al Hilal Ahmed, Joint Secretary (Academics & Training), Central Board of Secondary Education, New Delhi, India. ixFacilitator’s manual for schoolteachers • Dr Sachin Shinde, Director, Sangath/SEHER, New Delhi, India. • Professor Amarjeet Singh, School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India. WHO staff from the Regional Office and the Country Office for India also collaborated in the project and provided useful technical inputs. They include: • Dr Palitha Mahipala, former Coordinator, NCE, • Dr Rajesh Mehta, Regional Adviser, Child & Adolescent Health, • Dr Nazneen Anwar, Regional Adviser, Mental Health, • Dr Padmini Angela de Silva, Regional Adviser, Nutrition for Health & Development, • Dr Patanjali Nayar, Regional Adviser, Disability, Injury Prevention & Rehabilitation, • Dr Gampo Dorji, Technical Officer (NCD), • Dr Fikru Tesfaye Tullu, Team Leader (NCD), • Dr Pradeep Joshi, National Professional Officer, Health Promotion & Social Determinants of Health. This publication was edited by the Documentation Unit at the Regional Office. Mr Ramachandra B. Pokale, Chief Artist, Centre for Community Medicine, provided the graphics and designed the modules. x Facilitator’s manual for schoolteachers E xp er t g ro up m ee ti ng f or d ev el op m en t of t he in te rv en ti on t oo l a t W H O S E A R O , N ew D el hi , I nd ia 1Facilitator’s manual for schoolteachers What are noncommunicable diseases? Noncommunicable diseases (NCDs) are the leading causes of death globally and contribute in a major way to disease burden in the 21st century. NCDs are health conditions that are not caused by any infection and therefore are not transmitted from person to person. NCDs are chronic in nature and stay with the patients for a long time, requiring lifelong treatment in most cases. If left untreated, they can lead to further health complications and even early death. Common NCDs include cardiovascular (heart) diseases, stroke, diabetes, chronic respiratory (lung) diseases, and cancers. Mental health conditions are also non-infectious and common. Fig. 1 Describes the major NCDs and their risk factors. Interventions to prevent NCD risk factors and promote healthy lifestyles are essential for a healthy life. Fig. 1. Major NCDs and their risk factors Most of the risk factors for NCDs are preventable and are modifiable with the right approach. Attempts to modify the behaviour-related risks for a healthy lifestyle must be targeted towards the young population to get the maximum and desirable impact, as bad habits can be formed when young. Key NCD risk factors are tobacco and alcohol use, physical inactivity, unhealthy diet and mental stress. The current intervention tool focuses on promotion of a healthy lifestyle through physical activity, healthy diet, mental well-being, environmental protection and prevention of substance use, suicide, Internet addiction and bullying. 2 Facilitator’s manual for schoolteachers Why is school the best setting for promoting a healthy lifestyle? Schools play an important role in the physical, mental and emotional development of children. The important role of schools and teachers in the development of children and society at large is undisputed. School assembly in India Schools provide opportunities for children to acquire new knowledge and skills to grow into healthy, productive and capable future adults. Several behavioural risk factors, such as an unhealthy diet, lack of physical activity, substance abuse and tobacco and alcohol consumption, mental and emotional stress are prominent among young children and adolescents. Many of these risk factors are known to make young children susceptible to the development of NCDs in adulthood, finally leading to premature mortality and early death. Children spend most of their active time in the school. Messages delivered by teachers in schools get effectively registered in the minds and psyche of children as compared to other channels and means. Schools contribute to promoting the health of students, staff, families and community members. Teacher-driven interventions in school-based settings provide a good opportunity for making an impact on the health of children and adolescents. 3Facilitator’s manual for schoolteachers What is a WHO health-promoting school (HPS) initiative? During the year 1998, WHO provided the concept of health-promoting schools under the Global Health Initiative. A health-promoting school strives to build health into all aspects of life at school and in the community. It uses its full organizational and educational potential to promote healthy development of students, staff, families and the community. The key features of an HPS are mentioned in Fig. 2 below. A health-promoting school is a setting where education and health programmes create a “health-promoting” environment, which in turn promotes living, learning and working conditions. Health- promoting School Engage healthy education and community leaders Provide access to health services Provide a safe, healthy environment Improve health-promoting policy and practive Provide skill-based health education Improve the health of the community Fig. 2. Key features of a health-promoting school 4 Facilitator’s manual for schoolteachers The framework of an HPS provides guidance for implementation of the intervention to prevent NCD risk factors in schools. We identified the actions to be taken to implement the intervention tool in a holistic manner in schools. Domain-wise actions are described at teacher and school levels. Actions are categorized as per domains such as environment, healthy diet, mental well-being and substance use (Table 1). Table 1. Actions to be taken for prevention of NCDs by schools Domain Actions at teacher level Actions at school level Enabling environment • Multi-stakeholder engagement • Organizing student fests, sports events • Special focus on games, sports • Ensuring hobby classes • Use of media/information technology (IT) • Ensuring infrastructure – toilet facility, girl-friendly spaces • Referral linkages with hospitals • Award/reward system for teachers/ classroom for performance of health-promotion activities Healthy diet • Cultivating kitchen garden skills • Celebrating healthy snack day in a week • Banning junk food in the canteen Mental well-being and substance use prevention • Acquiring skills related to anxiety/ stress management, relationship- building • Talking about mental health • Developing a teacher network • Including mental well-being in parent–teacher meetings/orientation meetings for students • Distress manager/focal person for distress situations • Tobacco-free school • Zero tolerance policy for bullying At the government level, the following actions can be taken to implement interventions for prevention of NCD risk factors. Government-/policy-level actions • Putting health and well-being at the core of the education policy • Integrating the NCD risk factor intervention into the existing school health programme • Including health and wellness in the teachers’ training programme • Including implementation of the NCD risk factor intervention in the school accreditation system • Implementing a star/grading system for schools based on their performance in the NCD risk factor intervention. 5Facilitator’s manual for schoolteachers Intervention tool for prevention of NCD risk factors in schoolchildren The objective of the facilitator’s manual is to assist teachers in implementing the intervention tool in classroom settings. The teacher should go through this manual carefully before implementing the intervention tool. The GenNext – Exit NCDs intervention tool kit contains the following: • Intervention tool booklet – either in the form of printed flipcharts or power-point presentation, which should be shared with the students; • Facilitator’s manual – to be used by the teacher for implementation of the intervention tool; • Videos – to be shown in the classroom using audiovisual aids. The intervention tool is applicable for students from Class I (approximate age 5 years) to Class X (approximate age 15 years). The proposed duration of each session is 60 minutes, which can be modified as per availability of time and convenience. Sessions should be scheduled so that at least one session is completed per month. The proposed structure of the session will be as follows (can be adapted as per country need): Teacher’s intervention of the topic using tool booklet Exercise Video (optional) Feedback by students 10 min 20 min 5–10 min 5–10 min The intervention tool is divided into two sections – promotion of healthy lifestyles and life skills. Section I consists of seven modules on Promotion of healthy lifestyles. If the school administration finds it useful, this section of the tool can be repeated for students aged 10–15 years. This section is to be used for students from age 5 years to 10 years. The facilitator’s manual enlists exercises to be carried out at the end of each module. Exercises are customized as per the different age groups. Each exercise section describes the steps for carrying out the exercise, mode and assessment of the exercise. Feedback on the exercise should also be sought from the students during the subsequent session. A list of appropriate videos to be shown at the end of each module is mentioned in the facilitator’s manual. The school can also use available videos and other locally available and relevant material on health promotion. 6 Facilitator’s manual for schoolteachers Section II consists of ten modules on life skills education. This section is to be used for students aged 10–15 years. The proposed modules under this section are indicative only. The country can adapt this module or continue to implement an already existing life-skills education programme in the schools. Life-skills training is also included as part of an exercise in section I. Exercises for life-skills education are based on group discussions, case studies and brainstorming. These exercises can be customized as per need. The details of the modules in each section and the number of sessions required for implementation of each module are given below: Section I. Promotion of a healthy lifestyle (for students aged 5–10 years) S. no. Module Number of sessions 1.1 Physical activity 2 1.2 Healthy diet 2 1.3 Environmental pollution and protection 1 1.4 Injury prevention 1 1.5 Mental well-being and suicide prevention 1 1.6 Substance abuse (tobacco & alcohol) 1 1.7 Internet addiction and bullying 1 Section II: Life-skills education (for students aged 5–15 years) 2.1 Self-awareness 1 2.2 Empathy 1 2.3 Effective communication 1 2.4 Interpersonal relationships 1 2.5 Critical thinking 1 2.6 Creative thinking 1 2.7 Problem-solving 1 2.8 Decision-making 1 2.9 Managing emotions 1 2.10 Coping with stress 1 The steps for implementing each module in the intervention tool are described below: Step Actions Step 1 Give the intervention tool booklet to students. Step 2 The teacher explains the respective modules using the facilitator’s manual. It should preferably be an interactive discussion to engage students in the session. Step 3 Carry out the activities at the end of each module as mentioned in the facilitator’s manual. Step 4 Show the videos. Material available in the school may also be used. However, showing the videos is more appealing and effective. Step 5 Conduct assessment and feedback on the activities. 7Facilitator’s manual for schoolteachers 1.1 Module: Physical activity Learning objectives • Explain the importance of physical activity for a healthy life. • Improve physical strength and build stamina. • Make students realize the importance of physical activity and develop habits to incorporate the same in their daily routines. • Help students develop a fitness goal. Background Physical activity involves any bodily movement that requires energy expenditure (burning calories). When we walk, play, climb, dance, or even do routine household work like cleaning, we are physically active. Depending on the energy required for these activities, physical activity can be of different levels of intensity: • Light • Moderate • Vigorous/severe. Children should engage in regular moderate-to-vigorous physical activity for 60 minutes every day. This reduces the risk of developing NCDs. It also helps them to develop active and healthy habits and lifestyles. Higher levels of physical activity (vigorous or strenuous activity) serve to increase fitness by increasing the efficiency and endurance levels of the heart, lungs and muscles. Why is physical activity important? • It improves health and fitness. • It enhances cognitive performance. • It helps in psychological and social well-being. • It decreases the risk of developing NCDs. Physical activity can have immediate and long-term benefits. It improves overall health, reduces the risk of developing several diseases and makes one feel alive, vibrant and energetic. It helps to be fit and active to lead a healthy life. Section I: Promotion of healthy behaviours 8 Facilitator’s manual for schoolteachers Exercises for the Physical activity module PA: 1 Participation in physical training class Participants 5 years/Class I Materials required Appropriate shoes, sneakers (can be performed in school uniform) Mode Individual work Life skill Empathy Time required 40 minutes How to perform the exercises • The activity starts with a discussion on the importance of physical activity and being physically fit. • The teacher will brief students about the exercise. • Check to see if all your students are wearing appropriate shoes and are comfortable. • Start with a brief warm-up (like jumping jacks or jogging in place) before performing these exercises. • Light exercises – children doing light physical exercises breathe normally as they do basic gross motor activities at a controlled pace. • Sky reaches: do this three times. • Stand up. • Swing arms up to the sky. • Rise up on your tippy toes. • Reach for the sky while keeping your body tight. • Hold for 15 seconds. • Lower your heels and arms. • Squat: do this 10 times slowly. • Stand with your legs a little wider than shoulder-width apart. • Hold your arms out in front of your body. • Slowly bend your knees and squat down until your thighs are parallel to the floor. • Rise up slowly. • Hand walks: do this five times. • Bend forward at your waist. • Reach down and touch hands to the floor. • Walk your hands out for a count of 8. • Walk your hands to left for a count of 4. • Walk your hands back to the centre for a count of 4. • Walk your hands right for a count of 4. • Walk your hands back to the centre for a count of 4. • Walk your hands back for a count of 8. The teacher can help improve test scores and student behaviour by incorporating physical activity breaks into their daily classroom routine in between the teaching sessions. Assessment of the exercise Taking attendance, participation, question–answers 9Facilitator’s manual for schoolteachers PA: 2 Daily physical exercises Participants 6 years/Class II Materials required A-3 size paper, pen Mode Individual work Life skill Self-awareness Time required 40 minutes How to perform the exercises 1. The teacher will brief students about the exercises. Involve the games and physical training teachers also. 2. The teacher needs to explain the importance of physical activity and ask the students to practise repeatedly. 3. Physical activities involve performance of exercises that require physical strength, flexibility and coordination. 4. Practical exercises include: • running • swimming • jumping • gymnastics • using stairs • brisk walking • short races with friends • skipping rope alone or using a jump rope in a group. 5. The teacher will engage students in physical activities and tell them about the correct postures while sitting, walking, running and playing locally popular field games. Assessment of the exercise Participation in the session, teacher observation, 10 Facilitator’s manual for schoolteachers PA: 3 Holistic development Participants 7 years/Class III Materials required Mats Mode Individual work Time required 40 minutes Life skill Self-awareness How to perform the exercise 1. The teacher will brief students about the exercise. 2. Yoga will form an integral part of the physical training (PT) class (one period in a month). Breathing exercises will help students to become more relaxed, calm and stress free. Students will be introduced to deep breathing relaxing techniques. Step1: Sit down with legs folded. Free your hands and lay your palms on your thighs. Step 2: Close your eyes and try to calm yourself. Step 3: Take a deep breath in and then breathe out. Repeat this process slowly at least 10 times. Step 4: Now breathe through one nostril and release through the other (by blocking one nostril with the thumb of one hand). Repeat this process at least 10 times. Repeat this with the other nostril. Show videos on yoga and deep breathing as indicated in the kit. Assessment of the exercise Participation in the session and feedback PA: 4 Well-being Participants 8 years/Class IV Materials required Outside camp arrangements Mode Group work Life skills Self-awareness, interpersonal relationships Time required 3 hours How to perform the exercise 1. The teacher will brief students about the exercise. 2. The school will organize an outing for the students. The teacher will encourage students to participate in adventure activities like running, trekking, rock climbing and other activities. Alternatively, rope climbing, and different types of races and games can be organized in the school playground. Assessment of the exercise Participation in the session 11Facilitator’s manual for schoolteachers PA: 5 BMI calculation Participants 9 years/Class V Materials required BMI worksheet Mode Individual work Life skill Empathy Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. BMI (body mass index) is a calculation that uses the height and weight of a person to estimate how much body fat someone has. Doctors use it to determine how appropriate a child’s weight is for a certain height and age. 3. Have the students discuss in small groups ways by which they can help their body grow tall and write these down. Topics would focus on nutrition, balanced meals, food items, healthy foods that are packed with vitamins and minerals, and exercises (for younger students), which can be discussed in the class. 4. Ask the students to share their ideas with the class. 5. Discuss the importance of daily and regular exercise. 6. Measure the height and weight of the students and calculate the BMI. 7. Conduct a health check-up on a monthly basis by the school nurse or doctor. Assessment of the exercise Submission of the form 12 Facilitator’s manual for schoolteachers PA: 6 Self-assessment Participants 10 years/Class VI Materials required Self-assessment form Mode Individual Life skills Self-awareness, decision-making Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. The easiest and most efficient way to do a regular formal assessment is to provide criteria each day for students to do a daily self- assessment and encourage them to do it regularly. The teacher will grade the students as suggested below: • WOW – You achieved the bonus challenge of the day (different for each lesson). • GOOD JOB – You followed all the physical exercise (PE) expectations, used good sportsmanship and did your 100% best in all the activities. • KEEP ON TRYING – You got a warning from the teacher, you did not do your best or didn’t use good sportsmanship during the game. • NEED MORE EFFORT – You had to go for time out and missed some of the class time. Assessment of the exercise Submission of the form PA: 7 Physical activity and self-assessment Participants 11–15 years/Classes VII–X Materials required Self-assessment form and material required for outdoor activities Mode Group Life skill Self-awareness Time required 40 minutes How to perform the exercises 1. The teacher will brief students about the exercises. 2. Participate in daily physical activity sessions in the school. 3. Assess your own physical activity (refer to exercise no. 6). 4. Monitor your BMI on a monthly basis (refer to exercise no. 2). Assessment of the exercise Participation in the sessions and submission of the form 13Facilitator’s manual for schoolteachers A list of suggested videos to be shown to support various activities: S. no. Name Description Duration Links 1 Physical activity and kids: Let’s move it! This video explains about health and fitness. 5.20 min https://www.youtube.com/ watch?v=U4T8kXRVwTM 2 Early years – physical activity tips for children aged 5 years and under This video guides children on physical activity. 1.02 min https://www.youtube.com/ watch?v=pQyTuTioZUQ 3 How to get kids moving: expand, extend and enhance physical activity opportunities This video motivates children to do exercise or physical activity. 2.09 min https://www.youtube.com/ watch?v=SQYNFFiDUXs 4 Exercise for children – factual reasons and tips to get moving This video describes that parents should limit the time for television and encourage their children to exercise. 1.32 min https://www.youtube.com/ watch?v=Ejbdzt2586A 5 Physical activity in schools It discusses the benefits of physical activity and introduces physical literacy as an outcome of physical activity. 2.35 min https://www.youtube.com/ watch?v=JJoyWK58CvY 6. Educating the students This video highlights how physical activity and fitness affect health outcomes, and what can be done to help schools get kids to become more active. 2.40 min http://www.nationalacademies. org/hmd/reports/2013/ Educating-the-Student-Body- Taking-Physical-Activity-and- Physical-Education-to-School/ video.aspx 7 Let’s be active for health for all (WHO) This video shows how being physically active promotes health and protects people from cancers, diabetes, heart disease and obesity. 1.34 min https://www.youtube.com/ watch?v=uZX14W4rVCU 8 Introduction to physical and health literacy This video teaches children and youth about the importance of physical and health literacy in a fun and engaging way. 3.13 min https://www.youtube.com/ watch?v=_okRtLv-7Sk 14 Facilitator’s manual for schoolteachers 1.2 Module: Healthy diet Learning objectives • Help students recognize importance of healthy food items and diet. • Identify healthy and unhealthy food items. • Introduce students to the concept of the food pyramid and various food groups. • Know the importance of a balanced diet and how deficiency of nutrients can lead to certain diseases. • Understand the connection between diet and disease and how certain diseases can be prevented by a healthy diet and healthy practices. Background Eating an unhealthy diet is among the four risk factors responsible for the development of NCDs. A healthy diet is important for children as it is the building block of growth and development into a healthy adult. This module focuses on the right intake of food and nutrition, why it is essential to make the right choices, and how to ensure healthy food items in a child’s diet through conducting various activities in the classroom. A healthy diet generates positive energy in children and influences their learning capacity. Appropriate nutrition is essential for all body functions. At any age, a healthy and well-balanced diet is important to stay healthy and active, and it is especially important during childhood and adolescence. Why is a healthy diet important? • Improves health and fitness • Improves mental well-being • Results in better scholastic performance • Decreases the risk of NCDs. Tips for ensuring healthy food choices: • Start the day with a home-cooked wholesome breakfast regularly. • Prefer fresh locally available fruits and vegetables. • Eat foods rich in fibre like whole grains, cereals and their products, green vegetables. • Consume fresh foods rather than packaged foods. • Include milk and milk products in the diet. • Avoid the intake of junk foods, e.g. chips, noodles, canned food, deep fried items, etc. • Don’t skip meals. • Avoid aerated drinks. • Drink ample water. 15Facilitator’s manual for schoolteachers How do I know if my weight is healthy? Calculate your body mass index (BMI). BMI is a simple index of weight for height that is commonly used to classify overweight and obesity • Underweight <18.5 • Normal 18.5–24.9 • Overweight 25 • Obese ≥30 Exercises for the Healthy diet module HD: 1 Know healthy and unhealthy food items Participants 5 years/Class I Materials required Bring from home (newspapers, empty packets) Mode Individual work Time required 40 minutes Life skills Self-awareness, decision-making How to perform the exercise 1. The teacher will brief students about the exercise. 2. This activity starts with a discussion on food items, and the difference between healthy and unhealthy food items. The exercise should focus on what items to limit and what to include in the daily diet. 3. Ask students to bring three to five samples of unhealthy food items and three to five samples of healthy food items to school, which they have consumed in the past week. 4. Ask students to paste the packets on a board in the classroom. 5. The teacher will explain the harmful effects of unhealthy food items that they eat regularly by showing pictures. Assessment of the exercise Participation and compilation of food item packets 16 Facilitator’s manual for schoolteachers HD: 2 My menu of the day Participants 6 years/Class II Materials required Magazines/newspapers, glue, scissors, chart papers, colours Mode Group work Life skills Critical thinking, decision-making Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask students to make a chart of their “daily menu” by pasting pictures of different food items consumed in a day, e.g. breakfast, lunch, snacks, dinner. 3. After the chart is complete, tell them what the preferred menu should be and put it up in the classroom or, if possible, distribute it to the children in the form of handouts. 4. Assess the students’ understanding of healthy foods from time to time simply by asking them to tell the class about what they ate the previous day. Assessment of the exercise Participation, rewards for best work HD: 3 How much I eat daily Participants 7 years/Class III Materials required Paper sheets (A4 size) and pen/pencil Mode Individual work Life skills Decision-making, self-awareness Time required 40 minutes 1. The teacher will brief students about the exercise. 2. The teacher will explain the importance of food items and what food items to add and what items to remove from the diet. 3. Encourage students to eat a “balanced” diet. 4. Fruits and vegetables are high in vitamins, minerals and fibre, and should form part of the daily diet. 5. Students are asked to think about what makes them healthy and brainstorm these ideas as a class. 6. Physical, social and emotional health issues should form part of the discussion. 7. It is important to highlight the fact that food is only one aspect of being healthy, but it will be the focus for this activity. 17Facilitator’s manual for schoolteachers HD: 3 How much I eat daily How to perform the exercise 8. Ask students to act out how they feel when they have eaten, and then how they feel when they have not eaten anything and are very hungry. 9. Discuss the differences in how they feel. Students consider why we need to eat food. They develop a class list working with a partner and decide on the two or three most important reasons for why we eat, e.g. to grow, to have energy, to be healthy, etc. 10. Important nutrients that every child should be getting daily: Protein – meat, poultry, fish, eggs, nuts, beans, dairy products Carbohydrates – breads, cereals, rice, crackers, pasta, potatoes Fats – whole-milk dairy products, cooking oils, meat, fish, nuts Calcium – milk, cheese, yoghurt, egg yolks, broccoli, spinach, tofu Iron – meats, liver, poultry, shellfish, whole grains, beans, nuts, dates, green leafy vegetables Vitamin C – citrus fruits (such as oranges), strawberry, tomato, potato, melon, cabbage, broccoli, cauliflower, spinach, papaya, mango Vitamin A – carrot, sweet potatoes, apricot, spinach, broccoli, cabbage, fish oils, egg yolk Fibre – whole-grain cereals, chickpeas, lentils, kidney beans, seeds, nuts Assessment of the exercise Submission of the paper, evaluation of papers for correct responses and awarding the best submission HD: 4 Nutritional value Participants 8 years /Class IV Materials required Ask students in advance to collect food labels from home and the canteen and note down the information written on these Mode Individual work Life skill Critical thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Let students bring the gathered information to class. 3. Ask students to highlight important information displayed on the food packets one by one and identify key information that is missing. 4. Students can be further encouraged to conduct a survey and compare the nutritional value of a few fast food items with healthy food items. Assessment of the exercise Assessment of the response and rewarding the best submission 18 Facilitator’s manual for schoolteachers HD: 5 Consumed HFSS food items Participants 9 years/Class V Materials required Paper sheets (A4 size) and pen Mode Individual work Life skills Self-awareness, decision-making Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. The teacher will explain what high in fat, salt and sugar (HFSS) food items are, and why they are harmful. 3. Teacher should use these headings (a) when,( b) where, and (c) who (buys sugary and fatty foods) and why (they are bought) over the period of a week. 4. Fatty and sugary foods and drinks – this is the food group that is unhealthy for you. Can you list any of these foods? How often do you eat these foods? Read and discuss the text together. 5. Do a class survey of foods and drinks from this group. 6. Organize it as follows: • Each child is given a sheet to fill in for the week. Example: Name of food (suggest a list); quantity consumed per week (state unit) e.g. chocolate bars – 3 bars, packs of crisps – 2 packs, cola (aerated) drinks – 3 cans/bottles, total – 8 units. • Repeat this survey every month and note the change in attitudes towards eating unhealthy food items. Assessment of the exercise Participation in the exercise and reward for best performance 19Facilitator’s manual for schoolteachers HD: 6 Prepare school canteen menu Participants 10 years/Class VI Materials required Paper sheets (A4 size) and pen Mode Individual work Life skills Decision-making, critical thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Divide students into groups and ask them to prepare a healthy canteen menu. 3. Keep the menu simple and realistic. 4. Give ideas for menu planning, modifying recipes, healthy preparation methods, budgeting, safe food practices, and tips for reducing waste. 5. Ask the groups to present the menu plan in the class, giving justification for the selected items. Assessment of the exercise Reward the best menu planner group HD: 7 Assessment of weekly food consumption Participants 11–15 years/Class VII–X Materials required Paper sheets (A4 size) and pen/pencil Mode Individual work Life skill Decision-making Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask students to recall food items consumed in the previous week. 3. Ask students to list out food items consumed in following categories: a. Fruits and vegetables b. Cereals c. Milk products (cheese, yoghurt, butter) d. Meat, fish and eggs e. Packed food items f. Food items cooked outside the home. 4. Ask students to write the approximate amount of food consumed in each category (day-wise). 5. Appraise the pattern and amount of food items consumed by the students. Assessment of the exercise Participation 20 Facilitator’s manual for schoolteachers Suggested videos to be shown: S. no. Name Description Duration Links 1 Healthy eating: an introduction for children aged 5–11 years Food plays a huge part in keeping us healthy and so we need to make sure we’re eating a variety of foods to get all the right vitamins and nutrients. 2.03 min https://www.youtube.com/ watch?v=mMHVEFWNLMc 2 The food pyramid Educational video for kids In this video we are going to know everything about the food pyramid. If we eat healthy and do exercise we will grow strong both mentally and physically. 4.03 min https://www.youtube.com/ watch?v=0KbA8pFW3tg 3 Nutrition, food pyramid, healthy eating, educational Learn about the foods you need to eat every day to be healthy and strong. Food pyramid 12.07 min https://www.youtube.com/ watch?v=O0T3EP4NEpI 4 Good food & healthy food This video explains the importance of food for the growing body 6.08 min https://www.youtube.com/ watch?v=Fjr4FHswKuA 5 The importance of healthy food This video shows that your kids can know the importance of food. 10.21 min https://www.youtube.com/ watch?v=SdM7tbVvz7Y 21Facilitator’s manual for schoolteachers 1.3 Module: Environmental pollution and protection Learning objectives • Elucidate about environmental pollution and protection. • Know about the causes of environmental pollution. • Identify the harmful effects of air pollution on human beings, plants and animals. • Learn about climate change and its impact on health. Background Environmental pollution occurs due to mixing of harmful substances in the environment. Types of environmental pollution include: • water pollution • air pollution • noise pollution • soil pollution • radioactive pollution. Why is air pollution important? • Air pollution is due to dust from construction activities, vehicular combustion, industrial emissions, burning household fossil fuels, forest/bush fires, volcanic eruptions, etc. • Air pollution is responsible for diseases and deaths due to heart diseases, lung diseases, cancers. • Air pollution affects children more than adults. • It has long-term effects on human health. This module also touches upon climate change and its impact on health. During implementation of this module, students should be encouraged to know about the environment-friendly and environment- detrimental activities in their day-to-day routine. They should be encouraged to look at media reports and news related to climate change and environmental pollution and actions being taken for the same. Discussions on the ways in which our role and contribution can reduce environmental pollution should be promoted on a regular basis. 22 Facilitator’s manual for schoolteachers Exercises for the Environmental pollution module EP: 1 Drawing competition Participants 5 years/Class I Materials required Paper, colours, pencils Mode Individual work Life skill Creative thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Start class discussions regarding the pollution issue by asking questions. 3. Encourage students to respond and share their views. Open discussion allows the children to state their personal views or experience of the topic. 4. Ask them about what actions can be taken to change the situation. 5. After this discussion, ask students to draw pictures of the causes of pollution in the environment around them and the harmful effects of pollution. Assessment of the exercise Reward students for the best perspectives and drawing. 23Facilitator’s manual for schoolteachers EP: 2 Tree plantation Participants 6 years/Class II Materials required Seeds/saplings, gardening tools, water sprayer, water Mode Group work Life skill Self-awareness Time required 1 hour How to perform the exercise 1. The teacher will brief students about the exercise. 2. This activity should be performed outside the classroom in the school grounds or garden. 3. Start the activity with a discussion on the benefits of growing trees and planting and encourage them to plant. 4. Give children their own garden space. (This does not have to be big. You can start with a large container, a few pots, empty bottles, jars, etc.) 5. Use lightweight, easy-to-handle, correct-sized tools and garden equipment. 6. Encourage children to dig in the dirt (younger children love making mud pies). 7. Ask students to sow seeds/saplings in the soil and grow interesting local plants (may be sunflower, corn, pumpkin, tomato or strawberry). 8. Repeat this activity by engaging in group discussion once in three months. 9. Encourage students to care for the plantation on a regular basis with help from the school gardener. 10. Discuss the steps taken to ensure proper growth and survival of the plants. Assessment of the exercise Student participation, teacher observation, reward those whose plants survive after a period of three months. 24 Facilitator’s manual for schoolteachers EP: 3 Water conservation Participants 7 years/Class III Materials required Bucket of water, spoon and mug Mode Group work Life skill Self-awareness Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask the children to stand in a line. A bucket full of water, representing all the water on the earth, is kept at one end of the line. 3. A mug of water is taken out. This represents the world’s fresh water. 4. A spoonful of water is then taken out of the mug and handed over to the first student. 5. Each child is asked to quickly pass it on to the student standing next to him/her till the spoon reaches the end of the line. 6. All the water from the spoon is usually spilled and wasted. The last few participants thus get no water. 7. After this activity, initiate a discussion by asking students to narrate various methods they are familiar with for conserving water. 8. Explain to them the importance of water, the limited fresh water available for the world’s population, hardships faced by populations who don’t have a regular water supply and the stress on water conservation. 9. Explain how each one of us can help at the personal and community levels to conserve water, which should be discussed regularly. 10. The teacher can repeat this activity by engaging in group discussion on rain water harvesting and water conservation, etc. once in three months. Assessment of the exercise Student participation, teacher observation 25Facilitator’s manual for schoolteachers EP: 4 My environment Participants 8 years/Class IV Materials required None Mode Group work Life skills Self-awareness, creative thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Start the activity with a discussion focusing on the various activities that are carried on in the environment and later dividing them into environment-protective and -polluting ones. 3. Take children to the nearby street (if possible), otherwise make them move around in the school itself. 4. After 20 minutes, reassemble and ask each child to present one activity that is protective for the environment and one that is polluting the environment which they have observed. Write the activities on the board or flipchart. 5. Discuss each activity in the class. Ask them how to prevent the polluting activities and what can be done at the personal and community levels. 6. Children can be encouraged to make charts of these activities for display in the classroom and school. Assessment of the exercise Submission on the paper/chart and reward the best ones 26 Facilitator’s manual for schoolteachers EP: 5 My home has…. Participants 9 years/Class V Materials required None Mode Individual work Life skills Self-awareness, problem-solving Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask children to find five objects that can be recycled and five that cannot be recycled. Instruct them to bring that list to school. 3. Further brainstorm with them on the different ways in which non- cycled things can be replaced by recycled ones. 4. The teacher should be prepared to answer questions like: • What are the advantages of using recycled materials at home? • Can I recycle my clothes? Who will help me do so? • Can I recycle my books? How? • How can one adopt methods to make society aware of using recycled materials instead of materials that cannot be recycled? (By campaigning, making posters and organizing a rally, etc.) 5. Children should be encouraged to form a bank of the objects that can be recycled and bring those items to school. Parents and nongovernmental organizations (NGOs) can be involved in this activity. Assessment of the exercise Submission on paper 27Facilitator’s manual for schoolteachers EP: 6 Mobile application for air quality monitoring Participants 10 years/Class VI Materials required Mobile with installed application Mode Individual work Life skill Decision-making Time required 40 minutes How to perform the exercise 1. The teacher will brief the students about the mobile application. 2. Divide students into two groups. 3. The teacher will show the application and explain it to them briefly. 4. Students will monitor air quality index (AQI) for a week and make a chart. 5. Students will identify factors leading to air pollution at their respective cities/towns/villages. 6. Conduct a debate on the steps to curb air pollution. 7. Teachers will help students to prepare a memorandum for the local administration regarding AQI. Assessment of the exercise Student participation, teacher observation Suggested videos to be shown to students: S. no. Name Description Duration Links 1 Air pollution – a short documentary film Explain air pollution in detail. 9.31 min https://www.youtube.com/ watch?v=-3AciDHv4Q0 2 Save me | Short film on environment | Six Sigma Films What happens when children come together to save the tree from being cut 22.50 min https://www.youtube.com/ watch?v=m4POtracLSE&t=178s 3 Air pollution – causes & effects, air quality index, educational videos & lessons for children, kids This video tells the difference between fresh air and polluted air. Lesson includes practical exercises. 10.01 min https://www.youtube.com/ watch?v=e35xZ2C4x3w 4 Street play on “save the environment” It describes different types of pollution. 4.25 min https://www.youtube.com/ watch?v=MUowh4QSoOY 5 Air pollution in India Explains the concept, causes, effects, prevention and control measures 8.08 min https://www.youtube.com/ watch?v=3sC5u8GyZe 28 Facilitator’s manual for schoolteachers 1.4 Module: Injury prevention Learning objectives • Gain knowledge and understanding of road traffic. • Develop an understanding of their own responsibility for keeping themselves safe. • Raise awareness about the risk factors for and impacts of child injuries. • Develop a responsible attitude toward their own safety and the safety of others. Background Children all around the world have a right to a safe environment and protection from injury and all forms of violence. The institutions, services and facilities responsible for the care or protection of children should conform to established standards, particularly in the areas of safety and health. Safeguarding these rights everywhere is not easy, but it can be achieved by concerted action. Children are exposed to hazards and risks in their daily lives and are vulnerable everywhere to the same types of injuries. Exercises for the Injury prevention module IP: 1 Brainstorm: identifying behaviour that can prevent injuries Participants 5 years/Class I Materials required Chalkboard and chalk or flipchart and marker; pictures of unsafe and safe behaviours related to injury prevention (to be made in class) Mode Individual work Life skill Critical thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief children about the exercise. 2. In the large group, ask learners to brainstorm behaviours that can help prevent or lessen the harm from injuries on roads. Write the responses on a chalkboard or flipchart. Examples may include the following: • Wear a seat belt in the car. • Do not distract the driver in a car. • Before crossing a road, stop, carefully look both ways and then cross. • Walk across roads. Do not run across. • When walking on roads after dark, wear bright-coloured clothes so that drivers can see you. • Wear a helmet when riding a bicycle/motorcycle. • Never jump a red traffic light. • Don’t cycle on roads with high-speed vehicles. 29Facilitator’s manual for schoolteachers IP: 1 Brainstorm: identifying behaviour that can prevent injuries 3. Show pictures of some of the unsafe and safe behaviours. 4. Ask learners to brainstorm behaviours that can help prevent or lessen harm from injuries at school. Write the responses on a chalkboard or flipchart. Examples might include the following: • Inside school buildings: ◊ Walk. Do not run. ◊ Do not play rough, especially near furniture. • Do not play with school furniture. • Do not run on the stairs, don’t push others on the stairs. • On the playground: ◊ Watch out for broken objects such as glass. ◊ Play carefully with playground equipment. Do not jump off from high walls. ◊ Do not push others around. • Do not hit anyone with any sports object or material while playing. • Do not jump over the fence or school boundary. 5. Show pictures of unsafe and safe behaviours. Assessment of the exercise Student participation, teacher observation IP: 2 Recognizing the signs and signals of safety Participants 6 years/Class II Materials required None Mode Individual work Life skill Critical thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Teacher discusses with students – how do we know if something is dangerous if there is no adult around? Is there something that might help to tell us what to do? • Brainstorm a list of safety signs and signals (as a class). • Each student will make a safety sign. • Discuss about safety signs on the road, swimming pool, school building, lift, etc. • Ideally, the constructed signs would be used in a follow-up activity to assess a student’s comprehension of the sign’s meaning (such as a more complicated version of red light, green light). Assessment of the exercise Student participation, teacher observation 30 Facilitator’s manual for schoolteachers IP: 3 Personal assessment: “my dangerous behaviour on the roads” Participants 7 years/Class III Materials required Copy of worksheet, pencils or pens Mode Individual work Life skills Decision-making, critical thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Hand out a copy of “My dangerous behaviour on the road” worksheet to each student. 3. Ask students to write on their copy of the worksheet each risky thing they do that is related to safety on the roads and safety at school. Also ask them to write how often they do each of these things, for example, several times a day, once a day, once a week, once a month, or never. 4. Next, ask students to write each risky thing they do that is related to safety on the roads and safety at school that they want to stop doing. 5. Reconvene the large group and ask students to share what they wrote. Then ask students to discuss any challenges they might face in making these changes and how they will deal with them. Examples of challenges might include the following: • Peer pressure to not wear a seat belt or to run around in the school building • Forgetting to wear bright-coloured clothes when walking on a road in the dark or at night • Not wearing helmets while cycling • Non-functional traffic lights or absence of safety signages on the road, in the school. Assessment of the exercise Student participation, teacher observation 31Facilitator’s manual for schoolteachers IP: 4 Safety games Participants 8 years/Class IV Materials required Green and red circles, wooden spatulas, glue or pasting material Mode Individual work Life skills Self-awareness, decision-making Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Give out one red circle and one green circle to each child. Glue circles at one end of the wooden spatulas, one circle on each side, allowing room for the child’s hand to grip the spatula. 3. Tell students “boys and girls, we will now play a safety game. This is the way to play the game. If I tell you a safety story that is safe, show me the green sign for GO to say it is OK. If I tell you a safety story that is not safe, show me the red sign for STOP to say it is not OK.” 4. “Do you understand how to play? Let’s begin.” “A child came running into the classroom and ran into a desk. Is this being safe?” (Children hold up their signs after each story. You will know who does/does not understand.) “A child is holding an adult’s hand while crossing the street. Is this being safe?” “A child is playing ball outside and the ball rolls into the street. The child goes after it. Is this safe?” “It is after school and a child’s mom is waiting in the car. The child sees the car and runs in between the parked cars towards his/her mom. Is this safe?” “The traffic signal just turned green, the child runs to cross the road, is it safe?” “An announcement has been made to gather in the playground for an event. Your classroom is on the second floor. Everyone rushes downstairs as a crowd pushing each other. Is it safe?” “Can anyone share a safety story?” (encourage children to share stories…) Assessment of the exercise Students participation, teacher observation, completing the story, award for best story or best response 32 Facilitator’s manual for schoolteachers IP: 5 Dangerous behaviour exercise Participants 9 years/Class V Materials required Copy of the “dangerous behaviour exercise”, flipchart or chalkboard, pencils/pen Mode Individual work Time required 40 minutes How to perform the exercise 1. Divide students into small groups of 3 or 4 each. Hand out a copy of the worksheet “risky behaviour exercise” to each student (teachers can modify or add the examples of risky behaviour as per the need and situation). 2. Ask students to connect the appropriate risky behaviour in the left- hand column with the negative result it can cause in the right-hand column by drawing a line between them. 3. Reconvene the large group and discuss the exercise. Have a large copy of the “risky behaviour exercise” written on a flipchart or chalk board so that you can draw lines between the behaviour and the results as the students say them one by one. 4. Ask students to discuss why people indulge in such risky behaviour. Examples include the following: • Peer pressure • To impress others • To have fun or feel good • Curiosity • Do not know the negative results • To defy authorities. 5. Ask students to discuss what might make it easier to change their behaviour so that they do not indulge in risky behaviours. Examples include the following: • Learn how to resist peer pressure or how to say no to the challenges thrown by the peer group. • Understand the negative results of dangerous behaviour and that such results are more important than following your peers, having fun or defying authority. You will face the consequences and suffer and not those who pressurize you. Suggested dangerous behaviours exercise Instructions: Draw a line from the risky behaviour in the left-hand column to the possible negative result of doing the behaviour listed in right-hand column. 33Facilitator’s manual for schoolteachers IP: 5 Dangerous behaviour exercise How to perform the exercise Types of dangerous behaviour Possible negative results Riding in a car without a seat belt Get injured after a fall or pierced shoes Running in and out of the classroom Get injured seriously Wearing dark clothes when walking on a road after dark Get hurt in case of sudden brakes or an accident Jumping around in a car Get hurt by banging against the furniture or fall Running across the road without looking first Get hurt or injured seriously in a road traffic accident Playing with broken glass on the playground Distracting the driver, can get involved in an accident Playing rough in the classroom Get hit by a vehicle Jumping off playground equipment from a height Get hurt by banging against the furniture or door Assessment of the exercise Student participation, teacher observation 34 Facilitator’s manual for schoolteachers IP: 6 Quiz Participants 10 years/Class VI Materials required Worksheets Mode Group Life skill Creative thinking Time required 40 minutes How to perform the exercise The teacher will brief students about the exercise. Instruction: make the correct statement bold 1. Where should you stand before crossing the road? a) On the road b) Behind a car c) On the pavement, just behind the curb d) On the pavement where the drivers can’t see 2. When should you wear a helmet? a) While cycling b) While driving a two-wheeler (motorbike, scooter) c) Never d) While cycling and driving a two-wheeler 3. You should wear a seatbelt because a) It is cool to wear one. b) It protects you in case of a sudden brake applied or an accident. c) You can be fined for not wearing it. d) So that the cops don’t catch you 4. At a crossing, what does a flashing yellow light mean? (please check with the national traffic laws and modify accordingly) a) Cross with care. b) Quickly cross while you have time. c) Wait and do not start crossing. d) Walk slowly across the road. 5. Where is the safest place to cross a road? a) Bus stop b) Corner c) Zebra crossing d) Behind parked cars 6. What three things should you always do before crossing the road? a) Stop, look, listen. b) Stop, blink, jog. c) Stop, jog, listen. d) Stop, look, run. 35Facilitator’s manual for schoolteachers IP: 6 Quiz 7. What is the colour or cross code that you should follow? a) Red b) Yellow c) Green d) Blue 8. What does a yellow (amber) traffic light really mean? a) Slow down. b) Stop if it’s safe to do so. c) Caution d) Speed up because the red light’s coming. 9. What should you do as a passenger in a car? a) Sing loudly and play. b) Talk nonstop to the driver. c) Sit quietly and let the driver concentrate on the road. d) Encourage the driver to use their mobile phone to call someone for you. 10. Why isn’t it a good idea to text message while you are walking somewhere? a) You might accidently type the wrong thing. b) It is difficult to type while walking. c) You might send the message to the wrong person. d) You might walk into the road or a rail track without noticing and get hit by a vehicle/train. Assessment of the exercise Student participation, teacher observation Suggested videos to be shown: S. no. Name Description Duration Links 1 Road safety lessons for children This video explains the rules of the road and traffic guidelines to kids. 6.56 min https://www.youtube.com/ watch?v=r7ht0d6pIfs 2 Child safety campaign: electric shock injuries tips This video shows injury prevention. 1.16 min https://www.youtube.com/ watch?v=SmG1qSR2qaM 3 Preventing poisoning in children This video explains prevention of poisoning. 3.04 min https://www.youtube.com/ watch?v=JQob-pwLZJ8 4 Preventing burns and scalds in children This video explains the precautions to be taken to avoid burns and scalds. 2.17 min https://www.youtube.com/ watch?v=82npFu8ue-Q 5. Preventing falls in children This video explains the preventive measures to prevent children from falling. 1.32 min https://www.youtube.com/ watch?v=9kHhTus2Vdg 36 Facilitator’s manual for schoolteachers 1.5 Module: Mental well-being and suicide prevention Learning objectives • Encourage the application of mental health knowledge in overall health and social development. • Identify the physical effects of stress on the body. • Understand suicide, including prevention of risk factors and warning signs. Background Mental health problems are one of the most neglected issues globally. Mental disorders and resulting deaths and disability have increased manifold in recent years. A considerable proportion of children and adolescents have mental health problems ranging from anxiety, depression to severe mental illness. Children with mental health disorders face major challenges with stigma, isolation and discrimination, fears, as well as lack of access to health care and education facilities. This is a clear violation of their fundamental human rights. Poor mental health can have effects on the wider health and development of children and adolescents. It is important to recognize and address persons with mental illness. They constitute a vulnerable section of the society and are subject to discrimination. Families bear disproportionate financial, physical, mental, emotional and social burdens in providing treatment and care to those suffering from mental illness/disorders. Mental illness results in the following: • Stress • Anxiety disorders • Depression • Suicidal tendency/suicide. This module also talks about identification of the early signs of suicidal tendencies and how to deal with suicide-prone behaviour. Use anecdotes, motivational stories and guest lectures of both successful alumni of the school during module exercises. In a nutshell, this module intends to support the foundation of a happy and worry-free lifestyle among school students. Teachers, particularly those teaching higher classes, can consider introduction of common mental disorders such as depression and anxiety. Introduction of mind relaxation techniques such as deep breathing exercises, mediation and yoga, etc. can be considered. 37Facilitator’s manual for schoolteachers Exercises for the Mental well-being module MW: 1 Celebrate mental well-being week Participants 9–10 years/Classes V, VI Materials required None Mode Group work Life skill Team-building Time required 40 minutes per day all seven days of the week (one) How to perform the exercise 1. The teacher will brief students about the exercise. 2. Assign one week with at least 40 minutes in a day for the exercise. 3. Activities to be carried out in a group are as follows: Week day Activities to be done Monday – Connect – Reach out to classmates and students in the school bus. – Connect with friends in the school canteen or playground. – Be proactive during the school assembly. – Be more conscious of the people around you in school and at home. – Make a list of all the people you interacted with during the day. Tuesday – Get active Sports-related activities – children should be given more time to play outdoor games. Wednesday – Be mindful Yoga, meditation, breathing exercises to be conducted in the classroom and playground Thursday – Keep learning Quiz, podcast – for mental alertness and group learning Friday – Share Community-based social activities – can contact local NGOs. Children should be encouraged to donate their extra books, clothes, toys to the lesser privileged. Assessment of the exercise Student participation, teacher observation 38 Facilitator’s manual for schoolteachers MW: 2 Your hobbies Participants 11–12 years/Classes VII, VIII Materials required Paper sheets (A4 size) and pen/pencils Mode Individual work Life skill Creative thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask students about their hobbies and perform some activities in the classroom like dancing, singing, art, reading story books, etc. Gardening, etc. can be undertaken in the school garden. 3. Explain how the hobbies are beneficial for overcoming stress. 4. Hobbies help with mental health and well-being as given below: a) Direct benefits: • Focusing on the task at hand • Physical exercise (in the case of sports, dancing, gardening, etc.) • Creative freedom • Control over how you spend your time (time management). b) Indirect benefits: • Involvement with communities (sharing, participation and engagement) • Accomplishing goals • New experiences (like going somewhere new, learning, making new friends, acquiring knowledge) • Sense of purpose. Assessment of the exercise Submission of the paper, award best participants 39Facilitator’s manual for schoolteachers MW: 3 What causes stress? Participants 13–14 years/Class IX, X Materials required Paper sheets (A4 size) and pen/pencil Mode Individual work Life skill Managing emotions Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. • The teacher will explain the common causes of stress faced by the students and how to overcome them. • Fear of failure • More responsibilities • Social/peer pressure • Fear about the future • Competition. What you can do: • Ask students to build capacity to recover from a difficult situation and see failure as an opportunity to develop strengths. • Tell students that a feeling of uncertainty or worrying about the future is normal and everyone faces this at this stage of life. • Ongoing stress can lead to anxiety and depression, so it’s good to know the warning signs. • It is important to seek help; don’t keep the feelings to yourself. Reach out to friends, family and schoolteachers/counsellor. • Encourage students to speak out if they encounter such emotions. Ask students to make a list of their various emotions, the stressful situations they encounter in their day-to-day life and what they do to manage such situations. Assessment of the exercise Student participation, teacher observation 40 Facilitator’s manual for schoolteachers MW: 4 Practise pranayama and yoga Participants 10–15 years/Classes VI–X Materials required Videos Mode Group work Life skills Self-awareness, coping with stress Time required 1 hour How to perform the exercise 1. The teacher will brief students about the exercise. 2. Arrange for a physical trainer or a yoga instructor in the PT class (one period in a month). Students should also be taught to perform deep breathing exercises and relaxation techniques to remain calm and stress free. 3. Students can perform these exercises and share their experiences (in getting rid of stressful situations and remaining calm) in the class. They may also be encouraged to share their individual ways of dealing with stressful situations at school, home or in the community. What worked for them? Assessment of the exercise Student participation, teacher observation Suggested videos to be shown: S.no. Name of the video Description Duration Links 1. One step closer (mental illness short film) Person attempted suicide because of depression 13.17 min https://www.youtube.com/ watch?v=OwXWUt9xSWk 2 WHO: Providing “quality rights” in mental health services (Gujarat, India) Schizophrenic patient (human rights, quality rights) 12.34 min https://www.youtube.com/ watch?v=phd_PoHuL9c 3 Why improve mental health in schools? This animation explains how building protective factors in the classroom can help students with risk factors in and outside of the school grounds. 2.05 min https://www.youtube.com/ watch?v=s_w6VcOIO8A 4 Talking mental health Animation movie on why different people have different feelings (children) 5.27 min https://www.youtube.com/ watch?v=nCrjevx3-Js 41Facilitator’s manual for schoolteachers S.no. Name of the video Description Duration Links 5 Reach out: a film about mental health awareness This video is about mental illness. 2.31 min https://www.youtube.com/ watch?v=JvSryN0buIE 6 How to spot mental illness Mental health conditions and signs of anxiety are highlighted. 5.07 min https://www.youtube.com/ watch?v=FB49AezFJxs 7 School-link: caring for the mental health needs of children and young people Emphasis on improving the mental health, well-being and resilience of children and young people 2.29 min https://www.youtube.com/ watch?v=kmSinPMVU2U 8. Managing stress – brain smart – BBC All about how to tackle stress 2.23 min https://www.youtube.com/ watch?v=hnpQrMqDoqE 9 Stress management Defining stress management 7.06 min https://www.youtube.com/ watch?v=-AC1cNikArw 10 Stress management strategies: ways to unwind Strategies for stress management 5.05 min https://www.youtube.com/ watch?v=0fL-pn80s-c 1.6 Module: Substance abuse (tobacco and alcohol) Learning objectives • Understanding various types of tobacco and alcohol use • Gaining knowledge about the harmful effects of substance abuse • Identifying and accessing the safety net for support to stay away from substance abuse. Background Substance abuse is the harmful use of substances (like drugs, tobacco, alcohol, etc.) for non- medical purposes. Eighty per cent of the world’s smokers live in low- and middle-income countries like India. In the South-East Asian Region, young and middle-aged adults are becoming more affected by tobacco use during the productive phase of their lives. Smoking brings diseases not just to the user but also to their family through exposure to second-hand smoke. The tobacco industry is luring youth through new flavoured products such as sheesha (hukka, gudguda) and ENDS (electronic nicotine delivery devices or e-cigarettes). Many young people try these products for experimentation and get addicted to them. Tobacco use drives families into poverty as the money spent on tobacco products can be better spent on health, education, clothes and meeting other essential needs. Tobacco smoke contains more than 7000 harmful chemicals, including 69 cancer-causing agents. Tobacco contains nicotine, which is one of the most highly addictive substances. Tobacco use affects 42 Facilitator’s manual for schoolteachers all parts of the human body and leads to cancers, diseases of the heart, lungs, diabetes, oral cavity and other organs. According to WHO, alcohol consumption is related to 200 diseases and injury conditions. The diseases include many types of cancers, diabetes, heart diseases and cirrhosis of the liver. Alcohol use also leads to many domestic problems, increased road traffic injuries and addiction. Young people are at the age of discovering themselves and others, and have time for experimenting with adult behaviours. However, they often lack knowledge or understanding of the risks associated with indulging in such behaviour at their age. Parents, peers, TV personalities, sports stars who use substances serve as role models for the young generation to experiment with harmful substances. Negative consequences of substance abuse: • Physical consequences: trauma (falls, road accidents, involvement in a brawl, etc.) • Interpersonal and social consequences: family tensions/violence, parental absence, learning difficulties, absenteeism from school, social withdrawal, etc. • Psychosocial consequences: feelings of anxiety, depression, memory and concentration problems, and suicide. Why do young people drink alcohol? Alcohol abuse is a long-drawn process. It needs to be emphasized to the students that alcohol abuse starts with experimentation mostly and ultimately becomes habit-forming and an addiction. Hence, experimenting with alcohol should be discouraged. The pressure from peers can be handled with the ability to say “no”, which is achieved through appropriate life skills. 43Facilitator’s manual for schoolteachers Process of alcohol abuse Exercises for Substance abuse module SA: 1 Role-play Participants 11 years/Class VI Materials required Script of role-play Mode Group work Life skill Self-awareness Time required 40 minutes How to perform the exercise The teacher will brief students about the exercise. 1. Set the stage. Before class, prepare a list of at least five tobacco- and five alcohol-related scenarios for your students to conduct the role-play. They should be situations that your students could find themselves facing at home/community or school. You only need to write the opening statements, like: Hey, come on, look what I’ve got. A whole pack of cigarettes and my mom’s lighter! I love the smell of this new cigarette. Don’t you? Hey, buddy, I want you to try this new pouch (tobacco). Absolutely new flavour. This will help you relax. You seem nervous. Hi girls! Have you tried the new sheesha/hukka bar on the Park street restaurant (or City Mall)? They allow youngsters and the flavours are absolutely mind-boggling…. Get some fellow teachers to help you create these scenarios and add to the ideas. Run the list by some young people to make sure the wording will vibe with your students. Cut your written sheet into individual slips and place them in a can. 2. You’re the “bad guy”. Select a student to pick a slip of paper and hand it to you. You start off the conversation by reading this sentence on the paper, in a “bad guy” tone of voice. Be sure that you’re not teaching the kids how to be bad. Try and make the “bad guy” sound a little bit stupid, not the kind of person they would want to emulate. The student then – in his or her own words – refuses the offer. If students find it relatively easy to say no, try pressuring them. Make it difficult for them to find a way out. Counter their arguments with counter-arguments to make it just as tough as any situation they might encounter in real life. Before they feel overwhelmed, however, it is important for you as the bad guy to back off. Even acknowledge that their refusals worked. In case a student volunteers, he or she can also play the role of the “bad guy”. 44 Facilitator’s manual for schoolteachers SA: 1 Role-play How to perform the exercise 3. “Just say no” and mean It. There are several keys to teach students about effective refusal. Most important is to say “no” and mean it. The next most important step is to say “no” and mean it again and again and again. Teach the children that they can, but they don’t have to, give a reason always. That stuff makes you an addict. Cigarettes make your breath smell. You don’t want to be known as a smoker. You don’t want to be an embarrassment to the school. Alcohol is full of empty calories and has been shown to make you fat. It ruins your health and reputation. The important thing is for the students to realize that they can say “no” and still be cool. 4. Then what? If the student is with a friend, he or she should suggest some other fun activities to do. Hey, I’m going to ride my bike to the mall. Want to come? How about a table-tennis match this evening? Want to give chess a try? Have you listened to the new track? Let’s all watch the new movie at my place. 5. When “no” is not enough. Teach students what to do if the person continues to heckle them. Have them look the person in the eye, say the name of the person, and say “no” one more time loud and clear. Then leave. Teach them, whenever possible, in every case, to get out of there and alert a trusted adult or peer right away. Report immediately if the person resorts to bullying. 6. Let students take over. After practising several of these scenes, students may ask to take over the role of the bad guy. No problem. Let students play both sides in the temptation/refusal struggle. If a student is having trouble, let him or her call on another student for help. With each practice, you’ll see students’ refusal skills develop and their confidence build up. 7. Finale. Students will want to play the tobacco/alcohol refusal role- playing game again and again, and if you have time, let them. Sometimes, when the class feels very confident in their ability to refuse drugs, let the whole class join in at once. Pretend to be a drug user and start off with a statement like; hey buddy! Are you a game for the new thing? It just arrived and is driving everyone crazy….. Assessment of the exercise Student participation, teacher observation and award the best performers 45Facilitator’s manual for schoolteachers SA: 2 Saying no Participants 12 years/Class VII Materials required Pen/pencil, worksheets Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Start the discussion by asking for possible reasons why students engage in tobacco/alcohol abuse, focusing on peer pressure tactics and discuss how to deal with peer pressure tactics. List the reasons on the blackboard. • Divide the class into four groups and give each group a role-play mentioned below. • Ask them to use the skills they have learnt so far such as communication, refusal, etc. to enact the role-play. Situation 1: A group of kids that you have always wanted to be friends with have started being nice to you. One day they are going to bunk school and want you to come. You don’t really want to bunk school, but you do want to be friends with them and not make them unhappy. Situation 2: A friend from school asks you to accompany him/her to the market. Once there, your friend buys a cigarette from the shop/store and lights it up. Your friend then asks you to try a cigarette. You hate the smell of smoke, but your friend says you should just try it at least once. Situation 3: A senior from school invites you to attend a party at his house. When you reach the party venue, you discover that some of them are drinking alcohol mixed in the soft drinks. One of them offers you a drink and when you refuse, he makes fun of you and calls you a baby. Situation 4: Exams are around the corner and you are very stressed, as you have not finished your revision. You are finding it very difficult to concentrate because of high levels of anxiety. When you mention this in school, one of your classmates tells you that sometimes when she sniffs paint thinner, it calms her nerves. It helps her finish her revision. She asks you to try it sometimes. Debrief • After each role-play do a debriefing session to discuss the situation. • Ask the other groups if they have been or know of anyone who has been in a similar situation as described in the role-play. How did it feel? • Ask them to identify the communication style that was adopted by the different actors in the role-play. • Ask them to list the positive things that were said during the role- play by the different characters. 46 Facilitator’s manual for schoolteachers SA: 2 Saying no How to perform the exercise • Ask them to list the negative things that were said or negative behaviour that was displayed during the role-play by different characters. • Ask if any different/additional strategies could have also been used to avoid peer pressure. Final debriefing We often hear about negative peer pressure, such as friends telling friends to try cigarettes (also products like e-cigarettes/sheesha), drugs or alcohol. It is important that you make these decisions yourself based on your knowledge, character and family values. Don’t be influenced by others to do something that you feel is not right or fair. But peer pressure isn’t always bad. Friends can also encourage and inspire friends to do great things. Give some examples of positive peer pressure and wrap up the session by encouraging them to adopt these. Try to be in the company of those who stay away from harmful substance use. Promote positive aspects and the strengths of this group. Assessment of the exercise Student participation, teacher observation. Award the best-performing group. SA: 3 Poison puzzle Participants 13 years/Class VIII Materials required Pen/pencil, puzzles, worksheets Mode Group work Life skills Decision-making, creative thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask for volunteers from the class. • Distribute the puzzle packets to the volunteers at the beginning of the class. Each volunteer can be designated as a “peer leader” and will get one set each of the “crooked cigarettes” and “sneaky smokeless tobacco” (optional) puzzles for their groups. • Pick two students to read the script (A and B) and ask students to follow the instructions. • Lead a short class discussion on some of the ingredients found in tobacco. Tell students that they will be learning about some of the ingredients found in tobacco, including smokeless tobacco. All forms of tobacco, including smokeless tobacco, cigarettes, bidis (also products like e-cigarettes, sheesha/hookah), contain several chemicals that are harmful to your health – not just after long-term use but even when used for a short period or even once. 47Facilitator’s manual for schoolteachers SA: 3 Poison puzzle How to perform the exercise • First, ask the students what they already know about this topic. Encourage them to come out with all that they know, myths, stories, etc. Ask students if they know what ingredients are present in tobacco. Write these on the blackboard. The right answers can be ticked at the end of the exercise. If the students are unable to name any of the ingredients, introduce them to some (refer to the tables below). Tell the students that many of these ingredients are poisonous and very harmful, and can be found in other common products that are harmful to human health. • Now divide the class into small working groups with the help of the peer leaders to learn more about these harmful and poisonous ingredients by doing some fun puzzles. • Students will work under the guidance of their peer leaders to complete the two puzzles by matching the poisonous ingredients with the common products. Supervise the peer leaders as they facilitate the small group activity by the working groups. • After completing the puzzle, students will complete the worksheet to reinforce the contents of the two puzzles. Bring the small groups back together as a full class. • Wrap up the activity by telling students that tobacco has many harmful ingredients that have negative health consequences. The most obvious effects of these ingredients are lung and heart diseases, stroke, diabetes and cancers. Tobacco affects almost all organs of the human body. These ingredients affect persons of all ages as soon as they begin to use tobacco or get exposed to tobacco smoke (from someone else’s smoke). Tobacco use weakens the overall immunity of the body and makes you vulnerable to many diseases as compared to those who do not use tobacco. Tobacco is also harmful for the family and the national economy. Money wasted on buying tobacco can be used for food, clothes, education and other needs. Tobacco affects the environment. Many trees are cut to grow a tobacco crop. Cigarettes butts pollute the environment, including the oceans, and are non-biodegradable. SCRIPT 1 Student A: Hello friends! You know tobacco kills more than 7 million people each year worldwide. Have you ever thought about the fact that tobacco smoke contains more than 7000 chemicals and many of these are capable of causing cancer? I always think about the ingredients present in tobacco products that make these so dangerous to our health. Student B: Yes A, I too have been thinking about it. I was worried to know that tobacco kills nearly half of its users due to various diseases. So, I decided to ask our family doctor about this. She told me that tobacco contains many poisonous ingredients and all tobacco products such as cigarettes, smokeless tobacco and e-cigarettes/sheesha have many harmful constituents. 48 Facilitator’s manual for schoolteachers SA: 3 Poison puzzle How to perform the exercise Did you know that the harmful and poisonous contents of cigarettes are also present in other products like rat poison, toilet cleaners, sewer gas, insecticides, paint and car batteries? SCRIPT 2 Student A: Till today, I did not realize that what people smoke or chew as tobacco is indeed so harmful! I did not know that the ingredients used in rat poison, insecticides, naphthalene balls, sewer gas and other poisonous substances are also present in tobacco products, which people consume so often. I am sure that the people who smoke or chew tobacco are not aware about these facts, otherwise they would never harm their bodies by consuming these harmful and poisonous substances. Student B: That’s right, A. It’s important to never start using tobacco as these harmful ingredients really do begin to hurt us right away. At the same time, it is important to stay away from other smokers’ tobacco use. Thanks for your help. Assessment of the exercise Student participation, teacher observation SA: 4 Poster competition Participants 14 years/Class IX Materials required A-3 size paper, colours, pencils Mode Individual work Life skill Creative thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. First, the teacher will discuss the harmful effects of substance abuse. 3. Divide the class into groups of three or four students. 4. Instruct the students to create a poster using their imagination. 5. The teacher will give words related to the topic and ask the students to prepare a poster. 6. Each group can be given a subtopic and will need to decide what their poster would focus on. 7. Students in each group will brainstorm and decide the final theme for the poster of their respective group. 8. Students will present the poster in class. 9. Teachers will be able to both test the students’ knowledge and know if they have misunderstood any concept. Assessment of the exercise Rewarding the group that presents the best poster 49Facilitator’s manual for schoolteachers SA: 5 Quiz: harms of tobacco Participants 15 years/Class X Materials required Blackboard, chalk, quiz questions, some pictures/cards of the harmful effects of tobacco, paper Mode Group work Life skills Critical thinking, problem-solving Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. One day before the exercise Ask students to revise their knowledge about the harmful effects of tobacco from what they had learnt in class and to be prepared. The teacher will take prints of some popular tobacco products and their harmful effects and get ready with the quiz questions. Use some pictures from the intervention tool. Suggested quiz questions are given below (green is the right answer): • How many people die because of tobacco use in the world every year? - 1 million - 7 million - 50 million • What are your chances of dying prematurely (before expected) if you are a tobacco user? - 10% - 25% - 50% • Does tobacco use lead to addiction? - yes - no - don’t know • What is the addictive content of tobacco? - lead - benzene - nicotine • How long does it take nicotine to reach the brain after smoking? - 10 minutes - 1 hour - 10 seconds 50 Facilitator’s manual for schoolteachers SA: 5 Quiz: harms of tobacco How to perform the exercise • Is tobacco use harmful for the heart also? - yes - no - don’t know • How many harmful chemicals are present in tobacco smoke? - 100 - 200 - 7000 • Is smokeless tobacco less harmful than smoking? - yes - no - don’t know • Are e-cigarettes and sheesha smoking less harmful than cigarettes? (show picture cards) - yes - no - not sure • Does exposure to second-hand smoke lead to lung diseases? - yes - no - not sure • Does smoking affect the unborn child if the pregnant mother smokes? - yes - no - not sure • Can you get harmed if you are exposed to tobacco smoke from someone else’s smoking? - yes - no - not sure • Does tobacco affect the environment in the following ways? (picture cards can be shown) - deforestation - soil pollution - loss of top soil - all of the above 51Facilitator’s manual for schoolteachers SA: 5 Quiz: harms of tobacco How to perform the exercise • What is the non-biodegradable material present in cigarette butts? - cellulose in the filter - paper - tobacco • What kinds of substances are present in cigarettes? - chemicals used in insecticides - chemicals used in car batteries - chemicals used in rat poison - all of the above • Addiction to nicotine is like addiction to cocaine or heroin. - yes - no - don’t know • Flavoured tobacco products are less harmful (pictures of local products can be shown) - yes - no - not sure • Because there is no smoke, chewing tobacco does not increase the risk of death from heart diseases and death. - true - false - not sure • E-cigarettes are also called vapes, e-hookahs, vape pens and electronic nicotine delivery systems (ENDS). Any of these is a safe way to help you quit smoking. - true - false - don’t know • Which of the following diseases are commonly caused by chewing tobacco? (picture cards can be shown) - liver cancer - brain cancer - mouth cancer - lung cancer 52 Facilitator’s manual for schoolteachers SA: 5 Quiz: harms of tobacco How to perform the exercise • Are bidis less harmful than cigarettes? - true - false - not sure The teacher can frame some more questions based on the local situation and modify them as per need. On the day of the exercise • Ask students if they are ready for the quiz and ask for two volunteers to conduct the quiz. One volunteer will ask the questions and the other will write the responses on the blackboard. • The volunteers will be handed over the quiz questions. The teacher will help by showing the picture cards for the relevant questions. • The first response/answer will be noted and written on the blackboard along with the name of the respondent. • Nearly 20 questions will be asked and their answers recorded. • Student volunteers will match the answers with the quiz questions sheet and mark the correct answers. • Tick the total number of correct answers. This will reflect the overall collective knowledge of the subject. The teacher will discuss the wrong answers and provide the right answers. The discussion can follow after the responses. • Those giving the first three right answers will be awarded. Assessment of the exercise Student participation, teacher observation, rewards for correct answers Suggested videos to be shown: S. no. Name Description Duration Links 1 Substance abuse (short film) This video is about the peer group influence to initiate alcohol or cigarettes use. 4.48 min https://www.youtube.com/ watch?v=7wX1LP1iaRk 2 That’s right. Addiction is a disease This video explains that addiction is a disease that involves changes in the structure and function of the brain. 2.16 min https://www.youtube.com/ watch?v=P--6LEbksds 3 Drug abuse education – It’s a fact This video provides a lesson to every young person who is curious to know about substance addiction. 10.06 min https://www.youtube.com/ watch?v=gP-hx9qPZiU 53Facilitator’s manual for schoolteachers S. no. Name Description Duration Links 4 Harmful effects of tobacco on the human body, educational video for children This video explains the harmful effects of tobacco. 8.10 min https://www.youtube.com/ watch?v=fF7SNcw7kxQ 5 Know the cost: youth tobacco prevention This video illustrates the major influences and pressures on youth to use tobacco. 6.06 min https://www.youtube.com/ watch?v=cazrhS_6u6k 6 Smoking and its effects on health – Stop today! This video describes the health effects and risks of smoking and promotes smoking cessation. 2.46 min https://www.youtube.com/ watch?v=lW6hwmdZbmE 1.7 Module: Internet addiction and bullying Learning objectives • Enhancing knowledge about Internet addiction and cyber bullying • Knowing the harmful effects of Internet addiction • Understanding the extent, seriousness and dynamics of bullying • Preparing children to recognize and respond effectively to early bullying behaviour. Background Excessive use of online communication and digital technologies is leading to dependence and psychological distress. Children with mental health disorders face major challenges with stigma, isolation and discrimination, as well as lack of access to appropriate health care and education facilities, in violation of their fundamental child and human rights. Poor mental health can have detrimental effects on the overall health and development of children and adolescents. Bullying: It is characterized by repeated exposure of a student to the following negative behaviour: 1. Physical and/or emotional aggression 2. Teasing 3. Name-calling 4. Mockery 5. Threats 6. Harassment 7. Taunting 8. Hazing 9. Social exclusion or rumours. 54 Facilitator’s manual for schoolteachers Some of the negative consequences of Internet addiction and bullying are as follows: 1. Stress and anxiety disorders 2. Health effects on the eyes and body 3. Lack of sleep 4. Loss of appetite 5. Social withdrawal 6. Withdrawal from studies. Some of the factors responsible for Internet addiction are as follows: • Excessive use of the Internet for recreation • Heightened access to social network sites • Using cyber relationships to seek relief from unpleasant feelings and soured personal/family relationships • Family issues • Feeling of neglect and loneliness • Social isolation. Some reasons for the increase in cyber bullying are as follows: • Access to unsupervised mobile/Internet use • Rampant use of social media platforms • Increasing trend of sharing personal details on the Internet . For this module, attempts should be made to include real-life examples by sharing news items, personal experiences by school alumni and lectures in the classroom by experts in cyber security. Exercises for the cyber bullying module CB: 1 Banter vs bullying Participants 11 years/Class VII Materials required Worksheets, pens/pencils, picture cards, scenario cards Mode Group Life skills Critical thinking, decision-making Time required 40 minutes 55Facilitator’s manual for schoolteachers CB: 1 Banter vs bullying How to perform the exercise 1. The teacher will brief students about the exercise. 2. Encourage students to define cyber bullying and recognize examples of it. Ask them to differentiate it from banter. Giving examples of the situations faced by them or their friends. 3. Students can identify which actions cross the line between “banter” and cyber bullying. 4. The teacher will explain the meaning of banter. Banter is “playful and friendly exchange of teasing remarks”. How can one know that it is not banter but bullying? It is bullying when it is intentional, hurtful, repetitive and involves a power imbalance. The teacher will explain this with examples. Students need to understand that all offensive, threatening, violent and abusive language and behaviour is always unacceptable. In case you are unsure of the meaning of any language and behaviour, ask what was meant. Use the picture below: 5. Students should share examples of banter. They should be able to differentiate when banter turns into bullying. Discuss examples on the social media, and messages that they get on social media platforms. Example: Banter: Your friend makes a joke about your new haircut to you, and you shoot back that even with a bad haircut you get more sexual attention than them. Bullying: Your friend makes jokes about your new haircut that they know you feel insecure and embarrassed about in front of the class. There’s a power imbalance too, because there’s an audience. You get visibly upset, but the “banter” continues in public all week. 6. Activity: Students should be divided into three groups. Friendly banter There is no intention to hurt and everone knows the limit. Ignorant banter “crosses the line” with no intent to hurt. Will often say “sorry” Malicious banter Done to humiliate a person – often in public 56 Facilitator’s manual for schoolteachers CB: 1 Banter vs bullying 7. Three scenario-based cards should be made as suggested below (teachers can adapt and change these as per the local situation): a. Scenario 1: “A”, a 10-year-old school student, asks her friend “B” about her assessment results all the time and gives her constant advice on improving her scores. She also teases her in the classroom about this. “B” does not tell anyone about it. b. Scenario 2: “Y”, a 9-year-old schoolboy, told his mother that a few students in his class always asked him to do work, such as getting water, cleaning the desk, holding a schoolbag, etc. The mother asked him take is easy and told “Y” that this is part and parcel of school life, c. “X”, an 8-year-old boy, narrated the story to his parents that on his first day of school, he was encircled by a group of senior students and was asked to perform 100 sit-ups. He refused to do so and was abused by them. The parents decided to change the school of “X”. 8. Hand out one scenario card to each group. 9. Each group will discuss the scenario for 10 minutes as given under the following headings: a. Do you think the scenario described is bullying? Why? b. What do you think about the response of the child and parents? c. Could there be any other possible way of dealing with it? d. How would you deal with it if the same had happened to you? 10. Ask each group to describe the discussion points in the class. 11. Ask students for their feedback on each scenario. 12. Discuss the “dos” and “don’ts” of bullying in the school (refer to intervention tool). Discuss examples of cyber bullying, especially messages shared and received on social media platforms. 13. Bottomline discussion: if the banter goes too far and one feels uncomfortable, tell the person how you feel about it and ask him/ her to stop. If they do not stop or continue to upset you, tell your teacher, parent, any adult you trust such as the school counsellor or a relative. Always report incidences of bullying/cyber bullying. Assessment of the exercise Student participation, teacher observation 57Facilitator’s manual for schoolteachers CB: 2 Collection of paper cuttings on bullying/cyber bullying Participants 12 years/Class VII Materials required Magazines, newspapers, pasting boards, pins Mode Individual Life skill Critical thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask students to collect articles related to bullying/cyber bullying from newspapers, magazines, the Internet (take prints). 3. Ask them to paste these articles/news items on the board. 4. Ask students to read the articles in the class. 5. Students can also share personal experiences and those of their friends. 6. Discuss how important it is to report such incidences, their outcomes, support available at the school and outside the school. Discuss helplines and all the types of support available to deal with such cases. Assessment of the exercise Student participation, teacher observation CB: 3 Group discussion on building self-acceptance through positive self- talk Participants 13–14 years/Classes IX and X Materials required Handout with follow-up sentences, papers, writing board, pens/pencils Mode Group work Life skills Self-awareness, critical thinking Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Students will list on paper the messages (positive or negative) that they have received from other people in their lives. 3. Students will determine whether they adopted those messages and still believe them today. 4. As a group, students will read the “Building self-acceptance through positive self-talk” handout. 5. Students will individually complete the follow-up sentences by using the strategy of self-talk. 58 Facilitator’s manual for schoolteachers CB: 3 Group discussion on building self-acceptance through positive self- talk How to perform the exercise Building self-acceptance through positive self-talk What is self-acceptance? Self-acceptance is being able to recognize your value as a person. It is essentially your level of self-worth and feeling of comfort in your own skin, regardless of your faults and weaknesses. Without self-acceptance, one would not be able to reach their full potential in life. What is the difference between self-acceptance and self-esteem? Self-esteem is a belief or feeling about yourself. It is what you believe or feel you can do on your own. Having high self-esteem can help build self- acceptance. High self-esteem = feeling good about yourself Low self-esteem = feeling bad about yourself Self-acceptance is more of an action than an abstract sense of self. It is something you do – you stick up for yourself, you utilize your strengths and take responsibly for your actions, faults, and you practise loving yourself every day. How can I build my self-acceptance? Self-acceptance reflects the beliefs you gained as a child and adolescent. It usually comes from messages you get about yourself. These messages can come from other people (like parents, teachers or friends) or from yourself. The messages you send yourself is called “self-talk”. If you are used to hearing negative messages from other people, the chances are that you will send yourself negative messages too. Things like “I’m so stupid,” “I’m not good enough at this…” or “It’s my fault this happened” are examples of negative self-talk. One way to rebuild your self-acceptance is to re-train yourself to engage in positive self-talk. Positive self-talk happens when you focus on your strengths and positive qualities, reminding yourself that you are a good and valuable person. You must recognize your abilities and strengths. Follow up sentences: I am strong because…. I can deal with my work efficiently because… I am smart…. I manage my time very well…. I am good at sports…. 59Facilitator’s manual for schoolteachers CB: 3 Group discussion on building self-acceptance through positive self- talk How to perform the exercise I am creative….. I can say no to….. I can sing….. I am a good dancer…. I am an artist... I am popular with my friends…. Assessment of the exercise Participation; students will write down five positive self-talk sentences that they will practise throughout the week. CB: 4 Lectures by an expert on cyber security Participants 11–15 years/Classes VII–X Materials required Whiteboard, projector, pens, pointer Mode Group Life skills Effective communication, managing emotions Time required 40 minutes How to perform the exercise 1. The school will arrange a talk by an expert on cyber bullying. 2. The teacher will brief students about the exercise and introduce the expert. 3. A talk is delivered by the expert on cyber bullying, effects and signs of cyber bullying, measures to prevent it and how children who face cyber bullying can seek help. It would be better to have a PowerPoint presentation supported by short video films. • Ignore the bully. • Block the bully. • Limit access to technology. • Collect evidence. • Tell a trusted adult/parents/teacher/school counsellor. • Change email address and phone number. • Avoid self-blame. • Report on the website. • Contact the relevant authority if needed. Follow-up discussion. Encourage students to participate, share views and ask questions. Assessment of the exercise Student participation, teacher observation, encourage those who reported incidences of cyber bullying. 60 Facilitator’s manual for schoolteachers IA: 5 Calculation of your screen time for television, PC, mobile phone Participants 15 years/Class X Materials required Phone, television, blackboard, chalks, pens/pencils, paper slips Mode Individual Life skill Decision-making Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. The teacher will explain that it is important that we learn to limit screen time in a day/week and explain the drawbacks of excessive use of mobiles/tablets/PCs or television. These include the following: • mental issues (problems with school and paying attention to studies and outdoor games) and physical (trouble sleeping, eating disorders and obesity); • developmental effects on children who spend too much time with electronic devices at a young age. 3. Ask students to note down on a paper slip the time they spend watching television or on the mobile/tablet or PC every day/week. 4. The teacher will collect all the paper slips from the students. The teacher will note the timings listed by the students and write on the blackboard without naming anyone. This will give the estimated time students spend on electronic gadgets and digital technology. Discuss the ways in which students can cut down the time spent on electronic and digital gadgets and increase outdoor activities and sports. Assessment of the exercise Submission of paper, teacher observation 61Facilitator’s manual for schoolteachers Suggested videos to be shown: S. no. Name Description Duration Link 1 It’s not just a joke (short film on cyber bullying) This video explains what parents of kids who are victims of cyber bullying should do to help their child and promote cyber kindness. 28.31 min https://www.youtube.com/ watch?v=X94CNShGNpw 2 Stop cyber bullying before the damage is done Trisha Prabhu (INDIA) In this video, Trisha explains the adverse effects of cyber bullying and how to prevent these. 10.01 min https://www.youtube.com/ watch?v=Ps3Cefys0Kc 3 Cyber bullying (UNICEF) This video explains how access to the Internet and mobiles has made children more vulnerable to abuse and exploitation. 1.20 min https://www.youtube.com/ watch?v=asTti6y39xI 4 Ways to stop bullying The video presents a four-step method that shows how to boost confidence and protect from harm and find help. 5.30 min https://www.youtube.com/ watch?v=ynTuA_tlZDE 5 How to beat cyber bullies Looks at the effects of cyber bullying and ways to end it 5.07 min https://www.youtube.com/ watch?v=Jwu_7IqWh8Y 6 Secondary school scenario B – cyber bullying Explanation on what you should do if you are a victim of cyber bullying 2.37 min https://www.youtube.com/ watch?v=nL4TphI4YAA 62 Facilitator’s manual for schoolteachers Learning objectives • Understanding the importance of accurate and scientific knowledge, attitudes and value- enhanced life skills • Helping and supporting young learners to make informed decisions, solve problems, think creatively and critically, build healthy relationships, cope with challenges and manage their lives in a healthy and productive manner. Background Life-skills education, as defined by the United Nations Children’s Fund (UNICEF), is “a behaviour change or behaviour development approach to address a balance of three areas: knowledge, attitude and skills. The World Health Organization (WHO), while initiating “Life-skills education”, conceptualized life skills as psychological competence. Psychological competence is the individual’s ability to maintain a state of mental well-being and demonstrate this in adaptive and positive behaviour while interacting with others, and with her/his culture and environment. Life skills are abilities for adaptive and positive behaviour that enable individuals to deal with the demands and challenges of everyday life. They are abilities that facilitate the physical, mental and emotional well-being of an individual. Essentially, there are two kinds of skills – those related to thinking called “thinking skills”, which relate to reflection at a personal level, and those related to dealing with others called “social skills”, which are interpersonal skills. The ten core (generic) life skills as listed by WHO are – self- awareness, empathy, critical thinking, creative thinking, decision-making, problem-solving, effective communication, interpersonal relationships, coping with stress and managing emotions. According to scientists, early adolescence (10–14 years) is singled out as a critical period of opportunity for building skills and positive habits, since at this age there is a recognition of self, and ability to think and solve problems. The wider social context of early and middle adolescence provides varied situations in which there is motivation to practise new skills with peers and other individuals outside the family. Developing skills and competencies are recognized as critical to a child’s growing sense of identity. In fact, life skills not only help in realization of a person’s potential but also in living life in a contented and meaningful way. Section 2: Life skills educations 63Facilitator’s manual for schoolteachers Exercises for Life skills module SA: Building positive self-esteem: setting goals Life skill Self-awareness Participants 11 years/Class VI Materials required Worksheets, pens/pencils Mode Individual work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Discuss the importance of setting goals in life and talk about the following points: • Without goals, it would be like driving a vehicle with no clear path and destination: • It could mean reaching a place where we do not want to be. • Goals keep us focused, motivated and give a purpose to life. • To begin with, set small goals that can be easily achieved, pertaining to your daily activities and school work. • Setting very big goals and not achieving them could lead to dissatisfaction and frustration. • We can switch to higher goals later. • Be very clear about the goals to be achieved and be realistic. • Be very clear about how to achieve those goals. Start studying to top the class or perform better. Just wishing for it is not good enough. • The best way to start setting goals is to write them down, as writing clarifies our thinking. • Only a clear mental picture can transform a goal into reality. • Always try to be cheerful and optimistic and believe in yourself. • Believe sincerely and confidently that “I CAN” and “I WILL” reach my goal. Ask the students to think and write three goals that they want to achieve in the next one year on a paper sheet. Against each goal, the actions to achieve or reach the goal can be listed. Possible timelines to reach the goal can be defined. Collect the paper sheets. Select and share some of the goals written on the sheets with the entire class. Discuss the practical aspect of these goals, the possibility of achieving these and what all actions can be taken to enhance the possibility. Also discuss how helpful it is to form the goals and then try one’s best to achieve them. Assessment of the exercise Student participation, teacher observation 64 Facilitator’s manual for schoolteachers E: The value of respect Life skill Empathy Participants 12 years/Class VII Materials required White- or blackboard, marker, chalks, worksheets, pens, pencils Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Discuss with students what their ideas of “respect” are. 3. Discuss the meaning of the word “respect”. Tell students that the first step in developing respect for others and other things is to acknowledge that all people and all things have value. Divide the class into groups of four to five students and allow 5–7 minutes for the groups to brainstorm and list various ways by which they can show respect to others in diverse situations – at home, in school, at public places such as bus stops, the local market, railway station. One representative from each group will report her/his group’s findings to the class. Note the similarities and differences between the findings presented by the various groups. This may be noted down on the board and then categorized into the following groups: 1. Respect for self 2. Respect for others 3. Respect for public property 4. Respect for the environment 5. Respect for cleanliness. Discuss with students the ways by which they can improve respectful behaviour towards their surroundings. Assessment of the exercise Student participation, teacher observation 65Facilitator’s manual for schoolteachers EC: Good listening skills Life skill Effective communication Participants 12 years/Class VII Materials required Role-play script, white- or blackboard, chalks, marker and paper slips Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Inform students that the session will involve role-plays to bring out an important aspect of communication skills. 3. Call students to volunteer for the role-play. 4. Take them out and give them the role-play scripts and situations. 5. In a structured role-play, instruct students (two or more) to portray poor listening habits. They can emulate situations at home or in school. 6. Direct other students to observe the actions of the main character in the play. 7. Feed check: immediately after the role-play, ask the volunteer students what they were feeling as the listener and speaker during the role-play. 8. Initiate a discussion about what was happening in the role-play. The idea is to prompt the students to list all the poor listening habits/ behaviours (both verbal and nonverbal) that were exhibited during the role-play. • Write them on the board. • Point out how poor listening affects the speaker and the relationship between the speaker and the listener. • Now ask students how the main character could have acted differently to exhibit good listening skills. • Post these on the board. • Ask students to demonstrate, through role-play, good listening habits (both verbal and nonverbal); for example, attentiveness, asking open-ended questions, maintaining eye contact with the speaker, not fiddling with objects, etc. • Encourage students to discuss the advantages of good listening. • Instruct students to rate themselves as a listener (on a scale of 1 to 10) based on the traits posted on the board and write this on a paper slip. • The teacher will share the selected responses with the entire class without naming the respondents. • Discuss ways in which poor listening behaviour can be changed and improved. Write the suggested ways on the board and ask students to make a note of it. Assessment of the exercise Student participation, teacher observation 66 Facilitator’s manual for schoolteachers IR: Sharing feelings Life skill Interpersonal relationships Participants 12 years/Class VII Materials required White- or blackboard, chalks, marker Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Encourage students to volunteer, one at a time, to come in front and enact an emotion, e.g. happiness, sadness, anger, etc. and ask the others to guess and then imitate the same. 3. Write down a statement: “It is good to share our feelings with friends” on the board (also read it out aloud). 4. Instruct students to write on a sheet of paper “agree” or “disagree”, depending upon whether they agree or disagree with the statement. 5. Ask students to form two groups, one with all those who agreed and the other with those who disagreed. 6. Instruct each group to present their case and try to convince the other group why they agree or disagree. Allow them five minutes to prepare. 7. Let each group make a presentation and allow a brief discussion between the groups (10 minutes). 8. Let students describe the benefits of sharing feelings and list them on the board. The group that disagreed will tell the reasons for disagreeing and what led them to think in that manner. 9. Have an open discussion on the benefits of sharing feelings. Assessment of the exercise Student participation, teacher observation 67Facilitator’s manual for schoolteachers CT: Keep the balloon up in the air Life skill Critical thinking Participants 13 years/Class VIII Materials required Name list of the famous personality, virtual balloon using chairs Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Create a list of people with very different backgrounds. These may be famous individuals, characters, celebrities from the present day or historical figures. Write each name on a chit and put these in a bowl. 3. Let students choose a character by picking a chit with a name from the bowl. 4. Explain that the entire group of different characters is in a make- belief high-flying hot air balloon. Suddenly the balloon starts losing height. Now, for the balloon to stay up in the air, one person must leave the balloon by jumping out. 5. Taking turns, ask each student to explain why their character should be allowed to stay in the balloon. 6. Once everyone has spoken, instruct the group to decide who should be evicted from the balloon. This can be done by taking a vote and the student with the most votes leaves the balloon. 7. Start the process again. As the hot air balloon is still losing height, so another student must be evicted until there is only one student left. 8. At the end of the debate, discuss with students why the students left the balloon in the order that they did, what were the characteristics or skills and attributes of the people who seemed to be the most and least valuable to society. 9. Tell students that even when their character is no longer in the balloon, it is important to listen to the debate so that they can participate fully in the discussion at the end. The teacher can develop any similar and relevant activity for this exercise. Assessment of the exercise Student participation, teacher observation 68 Facilitator’s manual for schoolteachers CRT The creative solution finders Life skill Creative thinking Participants 13 years/Class VIII Materials required Blank paper and pencil, empty box Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Discuss with the students why and what type of problems they generally face in their life and what is the best way to resolve them. How does creativity support them in solving the problem? 3. Explain to the students that they must solve the problems that they consider important. 4. Give each student a pencil and two sheets of paper. 5. Instruct each student to write a problem question on one of his/her sheets of paper. The question may be personal, such as “What can be done about my family’s irritability in the morning?” or it may be more political or social, such as “How can my country India solve its problem of poor people?” 6. Collect the sheets of paper with the questions written on them from the students. Read them one at a time (without naming anyone) and solicit solutions from the students. There should be at least two solutions for every problem. 7. Continue the activity until all students have shared their problem questions and found new solutions. 8. Discuss the other possible ways or solutions for each problem and ask them why they think these would work. Assessment of the exercise Student participation, teacher observation 69Facilitator’s manual for schoolteachers DM: Making informed choices Life skill Decision-making Participants 14 years/Class IX Materials required Collage pictures related to substance abuse, branded clothes and expensive accessories, fast food products, worksheets, handout with the case studies, chart depicting the POWER model Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Divide the students into three groups. 3. Give each group a collage of pictures related to substance abuse, branded clothes and expensive accessories, and fast food products with a case study attached to each. (See the handout.) 4. Allow 20 minutes for each group to solve the issues given in each case study and ask them to focus on the following points: • What is the problem? • How and why does it arise? • What are the possible ways of solving it? 5. Direct each group to make use of P.O.W.E.R. model to arrive at a decision. Paste the chart depicting the model on the board for everyone to see. 6. Direct each student to speak about the problem given to them and how they were able to make informed choices. Encourage students from the audience to support, contradict or suggest new ideas about the possible ways of addressing that issue. 7. Encourage students to analyse different alternatives critically, such as the societal and personal values and norms, while taking decisions. Use their decision-making skills to make mature decisions after identifying a problem, finding options and evaluating all the options. POWER model P = PROBLEM Step 1: Stop and state (or identify) the problem. O = OPTIONS Step 2: Think of the different things you can do and use them. The more options you have, the better. W = WEIGH Step 3: Look at the good things and weigh them against the bad things of every option that you thought of to solve your problem. The things you value should guide you in your decision-making. E = ELECT Step 4: Choose the best option, talk to a person you respect, then take the best action. Elect the option that signifies what is important to you (values). R = REFLECT Step 5: Think or reflect about what happened because of your decision. 70 Facilitator’s manual for schoolteachers DM: Making informed choices Handout with case studies Case study 1. At a friend’s birthday party, your best friend was wearing a branded watch. You really liked it and after coming home demanded the same from your parents, but they felt that they cannot afford the same at that time. You are upset with your parents’ response. Discuss it with your group. Reflect on the situation, analyse your parents’ “point of view” and then arrive at a possible decision by using the POWER model. Case study 2. You are visiting a restaurant with your friends or parents. The menu card has several options of food items. You want to order a pizza with extra cheese. Your mother wants you to order a healthier option from the menu. You are not happy and tell your parents that you don’t want to eat anything. Discuss it with your group. Reflect on the situation, analyse your parents’ “point of view” and then arrive at a possible decision by using the POWER model. Case study 3. You and your friends have passed the final exams with very good marks. A party is arranged to celebrate the occasion in a hotel. You and your friends arrive at the party venue. You observe that alcohol, cigarettes/ sheesha and some products about which you are not sure are served to the invitees. You are not comfortable with being present there and want to leave. Your friends insist that you stay back and try the products being offered. Discuss it with your group. Reflect on the situation, analyse your “point of view” and then arrive at a possible decision by using the POWER model. Assessment of the exercise Student participation, teacher observation 71Facilitator’s manual for schoolteachers PS: Understanding a problem better Life skill Problem-solving Participants 14 years/Class IX Materials required Pencils or pens, paper slips, cardboard (medium-sized) box Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Have your students create and decorate a cardboard (medium-sized) box with a slit in the top. Label the box “the problem-solving box”. Invite students to anonymously write down and submit any problem or issue they might be having at school or at home, ones that they can’t seem to figure out or solve on their own. Ask three students to draw one of the items each from the box and read it out aloud. 3. Then one by one, have the class as a group figure out the ideal way the student can address the issue and hopefully solve it. Agree on the best possible solution. 4. Ask the students if the person to whom that question belonged is willing to reveal their identity. If a student reveals his identity, ask them if they is satisfied with the solution provided or whether they think otherwise. How are the answers different or were they as you expected? 5. The teacher can repeat the exercise with one student every week. After 6 months, make a list of the problems for which solutions were found and discuss how the exercise helped students. Assessment of the exercise Student participation, teacher observation 72 Facilitator’s manual for schoolteachers ME: How do I manage anger? Life skill Managing emotions/anger Participants 15 years/Class X Materials required Paper, pens/pencils, worksheet white-/blackboard, chalks and marker Mode In pairs Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Inform students that people often cope with anger by using the methods they learnt as children. Instruct students to close their eyes and think about how the people around them (at home, in school and the community) coped with anger when they were small children. What were the actions and words of people when they were angry? 3. Instruct students to turn to the student sitting next to each of them and share some of their memories about how people around them expressed anger when they were children. Students should feel comfortable about the information they share. 4. Allow 5 minutes for discussion. 5. Instruct students to think about how those memories from childhood influence them. (Would they like to they express their anger in the manner they remember from their childhood? Why or why not?) 6. Instruct students to turn back to their partners and discuss their current ways of expressing anger and why they follow those techniques. Is it different from the people in their memory? 7. Now involve the entire class in a discussion on the positive ways of managing anger. Uncontrolled anger can take a toll on both your health and your relationships. Discuss “calming down” or “relaxation” techniques. The following can be tried when you are angry with a person or situation: • Deep breathing • Listening to music • Doing some light exercise or yoga poses • Going out for a walk/jogging/running/playing with friends • Calling a friend you trust and discussing • Reading a book • Singing your favorite song • Watching a music programme on TV. 8. Ask students other ways or techniques that they use or can be adapted to deal with anger. 9. Sum up the session with the help of key messages. Assessment of the exercise Student participation, teacher observation 73Facilitator’s manual for schoolteachers CS: Handling stress (role-plays) Life skill Coping with stress Participants 15 years/class X Materials required Role-play situations, whiteboard and markers or blackboard with chalks Mode Group work Time required 40 minutes How to perform the exercise 1. The teacher will brief students about the exercise. 2. Ask students what they understand by the word “stress”. 3. Direct students to identify some common situations in which they feel stressed (at home, in school or in the community). 4. Make a list of such situations and write them on the board. 5. Divide students into three or four groups. 6. Assign one situation to each group or ask the groups to choose from the list on their own. 7. Give each group 10 minutes and instruct them to prepare a role- play of about 5 minutes based on the situation assigned to them. 8. Each role-play is to be followed by a small discussion with the entire class. 9. At the end of the session, the entire class discusses appropriate ways of handling stress. Students can be encouraged to share personal experiences and how helpful the methods adopted were for handling stress. 10. Students can have a loud laugh together to sum up this activity. Assessment of the exercise Student participation, teacher observation 74 Facilitator’s manual for schoolteachers Bibliography 1. A guide for establishing health promoting schools in the South-East Asia Region. New Delhi: WHO Regional Office for South-East Asia; 2003 (http://apps.searo.who.int/PDS_DOCS/B4255. pdf, accessed 20 February 2020). 2. A guide for tobacco users to quit. Geneva: WHO; 2014 (https://apps.who.int/iris/bitstream/ handle/10665/112833/9789241506939_eng.pdf?sequence=1, accessed 20 February 2020). 3. 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Geneva: World Health Organization; 2008 55. WHO/BASICS/UNICEF. Nutrition essentials: a guide for health managers. UNHCHR; 1999 (https://www.unhcr.org/publications/operations/3bc6f3ab4/nutrition-essentials-guide-health- managers-whobasicsunicef.html, accessed 20 February 2020). 56. World Health Organization Regional Office for Europe. Children’s health and environment case studies: summary book. Fourth Ministerial Conference on Environment and Health, Budapest, Hungary, 23–25 June 2004 (http://www.wecf.eu/cms/download/CHECSSBook.pdf, accessed 20 February 2020). 57. WHO Information series on school health (document 9). Skills for Health. Skills-based health education including life skills: an important component of a child-friendly/health-promoting school. Geneva: World Health Organization; 2003 58. (https://www.who.int/school_youth_health/media/en/sch_skills4health_03.pdf, accessed 26 March 2020). 59. World Health Organization.Towards health promoting schools. 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This intervention tool is to be used along with the Facilitator’s manual for schoolteachers GenNext – Exit NCDs Intervention Tool for prevention of NCD risk factors among schoolchildren ISBN: 978-92-9022-751-9 © World Health Organization 2020 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. 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How to use the intervention tool ............................................................................................. vi 3. Section-I: Promotion of healthy life style ................................................................................. 1 l Physical activity..................................................................................................................2 l Healthy diet .....................................................................................................................11 l Environment pollution and protection ............................................................................20 l Injury prevention .............................................................................................................35 l Mental well-being and suicide prevention ......................................................................41 l Substance use – tobacco and alcohol .............................................................................54 l Internet addiction and bullying .......................................................................................72 11. Section-II: Life skills ................................................................................................................83 iv Intervention Tool for prevention of NCD risk factors among schoolchildren Acronyms HFSS high-fat sugar salt HPN healthier populations and noncommunicable diseases  E cigarettes electronic cigarettes E waste electronic waste NCDs noncommunicable diseases PC personal computer PM particulate matter RTA road traffic accidents RTI road traffic injury WHO world health organization vIntervention Tool for prevention of NCD risk factors among schoolchildren About the Intervention Tool The Intervention Tool discusses promotion of healthy lifestyle, prevention of NCD risk factors and imparting life skills education to schoolchildren in school-based settings The tool is useful for schoolchildren aged 5 to 15 years The tool is divided into two sections: Section I : Promotion of healthy lifestyle and prevention of NCD risk factors • Physical activity • Healthy diet • Environment pollution and protection • Injury prevention • Mental wellbeing and suicide prevention • Substance use (tobacco and alcohol) • Internet addiction and bullying Section II : Life skills education1 vi Intervention Tool for prevention of NCD risk factors among schoolchildren How to use the Intervention Tool? The tool is used as booklet/flipchart/powerpoint presentation as per convenience in the class The tool is meant to be implemented in the school - based setting The tool is to be implemented by the teachers with the help of Facilitator’s Manual At the end of each module exercises are enlisted for students The videos are provided in the Facilitator’s Manual for teachers 1Intervention Tool for prevention of NCD risk factors among schoolchildren SECTION - I Promotion of healthy lifestyle • Physical activity • Healthy diet • Environment pollution and protection • Injury prevention • Mental well-being and suicide prevention • Substance use (tobacco and alcohol) • Internet addiction and bullying 5 to10 years/ Class I-V 11 to 15 years/ Class V-X 2 Intervention Tool for prevention of NCD risk factors among schoolchildren 3Intervention Tool for prevention of NCD risk factors among schoolchildren Physical activity can make you look SMART Benefits of physical activity Regular physical activity helps to maintain healthy body and weight Improves Health & fitness Enhances cognitive performance Psychological and social well-being Growth and development • Healthy heart • Healthy muscles, bones and joints • Reduced risk of diabetes, heart disease, cancer • High academic performance and achievements • Boosts self esteem, self- perception, self-worth • Enhances Communication • Creates environment of togetherness, acceptance, team spirit and success • Improves mental well-being • Reduces overweight and obesity • Improves neuromuscular awareness (coordination and movement control) 4 Intervention Tool for prevention of NCD risk factors among schoolchildren Inadequate physical activity is bad for you Overweight & obesity Chronic diseases in adulthood Anxiety & depression Lack of confidence & cognition Millions of children and adolescents all over the world are overweight or obese and have health risks Source: Global strategy on diet, physical activity and health (WHO, 2004) 5Intervention Tool for prevention of NCD risk factors among schoolchildren Be more active physically 60 minutes of moderate or vigorous activity daily Reduce sitting time and limit screen time in a day More the duration of activities, more the health benefits Vigorous-intensity activities at least three times per week Indulge in sports, playing and outdoor activities as often as possible 6 Intervention Tool for prevention of NCD risk factors among schoolchildren What are the moderate-intensity physical activities? How often do you do these activities in a week? Cycling Brisk walking Playing badminton Dancing 7Intervention Tool for prevention of NCD risk factors among schoolchildren What are the vigorous intensity physical activities? How often do you do these activities in a week? Intensity of activity matters Football Swimming Running 8 Intervention Tool for prevention of NCD risk factors among schoolchildren Make your own physical activity plan for the week Less screen time, more play and outdoor time is key to good health and well-being Watching TV, videos, computer games, sitting more than 30 min at stretch Sports – Swimming, tumbling, weight exercises Aerobic exercises, e.g. running around, biking, skateboard run, sports such as basketball, volleyball, soccer Play outdoors, walk to the store,help with home chores, take the stairs, play with the pets 9Intervention Tool for prevention of NCD risk factors among schoolchildren Physical activity can be fun too With yourself Outdoor games Do jumping, cartwheel Practice sports skills With family Go for walk together Play at the park Switch off TV for a day With friends Dance with music Join a sports team 10 Intervention Tool for prevention of NCD risk factors among schoolchildren Exercises for students Exercises to be carried out by the teacher with the help of the Facilitator‘s manual S. no. Exercises Participants Type Required Tools required Assessment method Refer to Facilitator’s manual PA1 Participation in PT classes 5 years/class I Individual None Attendance Refer to page no. 8 PA2 Daily physical exercises 6 years/class II Individual A-3 size paper, pen Submission of paper Refer to page no. 9 PA3 Holistic approach 7 years/class III Individual Mats Participation in session Refer to page no. 10 PA4 Well-being 8 years/class IV Group Adventure Participation in session Refer to page no. 10 PA5 BMI calculation 9 years/class V Individual BMI worksheet Submission of the form Refer to page no. 11 PA6 Self assessment 10 years/class VI Individual Self assessment form Participation in session Refer to page no. 12 PA7 Physical activity and self assessment 11 - 15 years/ Class VII - X Individual Self assessment form Participation in session Refer to page no. 12 11Intervention Tool for prevention of NCD risk factors among schoolchildren 12 Intervention Tool for prevention of NCD risk factors among schoolchildren What is healthy diet? l A healthy diet is essential for good health and nutrition l A healthy diet comprises a combination of different foods Healthy diet Carbohydrates & fat Bread, rice, milk, yoghurt, butter, cheese Vitamins & minerals Green leafy vegetables, fruits Protein Pulses, tofu, nuts, eggs, fish, meat, chicken 13Intervention Tool for prevention of NCD risk factors among schoolchildren Unhealthy diet may result in.. Obese children Undernourished children Eat more • Vegetables • Fruits • Cereals • Lentils • Pulses • Tofu/cheese Healthy child Obese child Avoid • High sugar & salt • Tobacco • Alcohol • Excessive fat • Junk food 14 Intervention Tool for prevention of NCD risk factors among schoolchildren Benefits of healthy diet Eating habits, lifestyle and behaviour patterns are established during young age and may persist throughout adulthood Mental wellbeing Looking healthy and attractive Disease–free adulthood Better scholastic performance Prevention of obesity Healthy diet 15Intervention Tool for prevention of NCD risk factors among schoolchildren Healthy diet plan for schoolchildren Food items Servings in a day Bread and cereals 4–5 Fruits and vegetables 4–5 Meat, fish, poultry and alternatives (eggs, cooked dried peas, beans, lentils) 2 Milk and milk products (yogurt, cheese, butter, tofu, cottage cheese) 2–3 (< = 11 year) 3–4 (>11 years) Food items high in fat, sugar and salt Minimum *1 Serving= 80 gms/half cup of liquid items 16 Intervention Tool for prevention of NCD risk factors among schoolchildren Frequent eating of high fat sugar salt (HFSS) items is hazardous to health Do not consume these items frequently 17Intervention Tool for prevention of NCD risk factors among schoolchildren Culturally acceptable home-cooked food items are always healthier choices What are options for healthy food? Healthy food can be yummy too 18 Intervention Tool for prevention of NCD risk factors among schoolchildren Do’s and don’t for healthy diet • Start a day with home-cooked wholesome breakfast • Drink plenty of water (2–3 litres) in a day • Home-cooked meals are the best option • Don’t watch television, videos, or use mobile phone while eating • Minimize packed and processed food • Eat fresh and clean food 19Intervention Tool for prevention of NCD risk factors among schoolchildren Exercises for students Exercises to be carried out by the teacher with the help of the Facilitator‘s manual S. No. Exercises Participants Type Tools Required Assessment Method Refer to Facilitator’s manual HD1 Know healthy & unhealthy food items 5 years/class I Individual Done at home (news papers, empty packages) Participation, compilation of food items Refer to page no. 15 HD2 My menu of the day 6 years/class II Group Magazines/newspapers, glue, scissor, chart papers Rewarding the best Refer to page no. 16 HD3 How much do I eat daily 7 years/ class III Individual Paper (A4) and pen Submission of paper Refer to page nos. 16–17 HD4 Nutritional value 8 years/class IV Individual Ask students in advance to collect food labels and note down information written on them Rewarding for the best Refer to page no. 17 HD5 Consumed food items 9 years/class V Individual Paper (A4) and pen Submission of paper Refer to page no. 18 HD6 Prepare school canteen menu 10 years/class VI Group Paper (A4) and pen Participation and group presentation Refer to page no. 19 HD7 Assessment of weekly food consumption 11–15 years individual Paper (A4) and pen Participation Refer to page no. 19 20 Intervention Tool for prevention of NCD risk factors among schoolchildren 21Intervention Tool for prevention of NCD risk factors among schoolchildren What constitutes the environment? • The environment consists of soil, air, water and built infrastructure (buildings, roads etc.) • Environmental factors have an impact on human health 22 Intervention Tool for prevention of NCD risk factors among schoolchildren What is environmental pollution? Mixing of harmful substances in the environment • Physical: household waste, water bottles, plastic bags • Chemical: pesticides and fertilizers, fossil fuels, drugs, toxins • Biological: animal waste, plant waste, human waste • E-waste: computer, electronic items (phones, home appliances) 23Intervention Tool for prevention of NCD risk factors among schoolchildren What are types of environmental pollution? Air pollution is linked to noncommunicable diseases, e.g. heart disease, chronic lung diseases, mental stress Types of pollution Air pollution Radioactive pollution Water pollution Soil pollution Noise pollution 24 Intervention Tool for prevention of NCD risk factors among schoolchildren What do you mean by single use plastic? Single-use plastics, or disposable plastics, are used only once before they are thrown away or recycled. These items are things such as: • Plastic bags • Straws, plastic cups, plates • Coffee stirrers • Water bottles and most of food packaging 25Intervention Tool for prevention of NCD risk factors among schoolchildren Impact of air pollution • Air pollution affects children most • Air pollution is an important risk factor for hypertension, chronic lung diseases • Dangerous for asthma and heart patients • Effects are long-term 26 Intervention Tool for prevention of NCD risk factors among schoolchildren Causes of Air Pollution Vehicular combustion Household burning of biomass/smoking Industrial emissions Natural causes – forest fires, volcano eruptions, pollen dispersal Dust is the main component 27Intervention Tool for prevention of NCD risk factors among schoolchildren Major air pollutants Major air pollutants Carbon mono-oxide (CO) Produced by the incomplete burning of carbon- containing fuels such as petrol, coal and wood Sulphur dioxide (SO2) Coal, petroleum, and other fuels are often impure and contain Sulphur as well as organic (carbon-based) compounds Ozone (O3) Produced by the reaction of oxygen gas with free atoms of oxygen which are formed from reaction between nitrogen oxides and hydrocarbons in sunlight Particulate matter (PM) Tiny solid particles or liquid droplets in the air, the smallest of whichcan pass in to the bloodstream and are very hazardous to health Hydrocarbons formed from the evaporation of materials such as petrol diesel and solvents when exposed to air Nitrogen oxide (NO) Produced by petrol or diesel burning engines and coal/oil furnaces 28 Intervention Tool for prevention of NCD risk factors among schoolchildren Health effect of environmental pollution 29Intervention Tool for prevention of NCD risk factors among schoolchildren What are the measures to reduce air pollution? • Use of public transport and car pooling • Reduce use of fertilizers and pesticides • Stop outdoor waste burning • Use clean fuel for cooking • Stop smoking • Cover vacant areas with grass to reduce dust • Cover construction sites/use mechanized cleaning • Optimal use of resources 30 Intervention Tool for prevention of NCD risk factors among schoolchildren What can we do to protect the environment? • Avoid single-use plastic • Reduce use of plastic items in day-to-day life, replace with green options • Reduce waste generation • Recycle paper, plastic, metals and organic metals • Segregation of waste • Promote reuse of household items • Practice plantation and tree conservation 31Intervention Tool for prevention of NCD risk factors among schoolchildren What is climate change? Climate change/global warming is long-term change in the climate of the earth, city or region Climate change leads to.. • Rise in temperature • Rise in humidity • Raised sea level • Raised ocean heat content • Species migrating upward and pole ward • Melting glaciers • Melting of sea ice • Melting of snow cover of mountains Why climate change is happening Limited resources • Burning of Fossil Fuel • Deforestation • Urbanization Exploitation of excessive resources 32 Intervention Tool for prevention of NCD risk factors among schoolchildren Impact of climate change on health Climate change Heat waves/intense temperature Contamination of air, soil and water Loss of agricultural produce Natural calamities Heat stroke, lung and heart diseases Asthma, allergies, tuberculosis Malnutrition Loss of habitat, vulnerability to diseases 33Intervention Tool for prevention of NCD risk factors among schoolchildren Green good deeds to reduce the impact of climate change Plant trees Maintain adequate nutrition Reduce, reuse, recycle Car pool, walk, cycle or use public transport • Promote solar energy • Limit use of electronics • Practice judicious consumption of resources 34 Intervention Tool for prevention of NCD risk factors among schoolchildren Exercises for students Exercises to be carried out by the teacher with the help of the Facilitator’s manual S. No. Exercises Participants Type Tools required Assessment method Refer to Facilitator’s manual EP1 Drawing competition 5 years / class I Individual Paper, colours Award for painting Refer to page no. 22 EP2 Tree plantation 6 years / class II Individual Gardening equipment Participation Refer to page no. 23 EP3 Water conservation 7 years / class III Individual Distribute paper with pictures Participation Refer to page no. 24 EP4 My environment 8 years / class IV Individual None Submission onpaper Refer to page no. 25 EP5 My home has 9 years / class V Individual None Submission on paper Refer to page no. 26 EP6 Mobile application for air quality monitoring 10 years / class VI Individual Mobile with installed application Participation Refer to page no. 27 35Intervention Tool for prevention of NCD risk factors among schoolchildren 36 Intervention Tool for prevention of NCD risk factors among schoolchildren What is injury? Injury is an intentional/unintentional damage to body due to exposure to an external agent which can be thermal, mechanical, electrical or chemical energy or agent Intentional injury/ violence • Child abuse and other forms of family violence • Dating violence among teens • Aggressive behaviour among youth include verbal abuse, fighting, hitting • Gang activity/violence 37Intervention Tool for prevention of NCD risk factors among schoolchildren Causes of injury in children • Road traffic accidents (RTA) • Burns • Falls • Drowning • Poisoning • Electric injury • Animal bites • Intentional injuries 38 Intervention Tool for prevention of NCD risk factors among schoolchildren Prevention of road traffic injury (RTI) • Follow traffic rules • Get informed about road safety and measures and traffic rules • Ask parents to wear helmet and seat belts • Do not use mobile phone while driving/walking/ crossing road • Use zebra crossing while crossing the road (look right, look left, then make a move) 39Intervention Tool for prevention of NCD risk factors among schoolchildren Prevention of injury in children Prevention at Home • Keep harmful substances out of reach of the child such as: Ž Drugs Ž Fire Ž Rat poison Ž Phenol Ž Pesticides Ž Sharp items • Strengthen road management skills • Avoid furniture near windows • Avoid travelling in overcrowded vehicles • Follow safety measures in outdoor activities • Be aware about first aid and basic life support 40 Intervention Tool for prevention of NCD risk factors among schoolchildren Exercises for students Exercises to be carried out by the teacher with the help of the Facilitator’s manual S. No. Exercises Partici- pants Type Tools required Assessment method Refer to Facilitator’s manual IP1 Brainstorm; identifying behaviour that can prevent injuries Class I Individual Chalkboard and chalk or flipchart and marker; pictures of unsafe and safe behaviour related to injury prevention (to be made in class) Submission of form Refer to page no. 28–29 IP2 Recognizing signs and signals for safety Class II Individual A-3 size paper, pen Student participation, teacher observation Refer to page no. 29 IP3 Personal assessment: my dangerous behavior on the road Class III Individual Copy of “My dangerous behavior on roads” worksheet for each learner, pencils or pens Submission of paper Refer to page no. 30 IP4 Safety games Class IV Group Worksheets, Pen, paper Participation in session, teacher observation Refer to page no. 31 IP5 Dangerous behaviour exercise Class V Group Copy of “Dangerous behaviour exercise” for every learner, flipchart or chalkboard, pencils or pens Observation, participation Refer to page nos. 32–33 IP6 Quiz Class VI Individual Worksheet, pen, pencil Participation in session, teacher observation Refer to page nos. 34–35 41Intervention Tool for prevention of NCD risk factors among schoolchildren 42 Intervention Tool for prevention of NCD risk factors among schoolchildren Think positive: “Life is precious” Mingle with family, friends, teachers Control emotions, such as fear, anger, love, jealousy, guilt, or anxiety Take care of oneself in all situations How to be happy and mentally healthy? 43Intervention Tool for prevention of NCD risk factors among schoolchildren There is a problem in mental health if . . . Depression and anxiety disorder are the most common mental health conditions Noticeable drop in functioning at school, home Withdrawal from social activities in school Problem in logical thinking, lack of concentration, poor memory Fear or suspicious feeling towards others or a strong nervous feeling most of the day Dramatic changes in eating and sleeping habits Rapid or dramatic shifts in feelings/emotions 44 Intervention Tool for prevention of NCD risk factors among schoolchildren What to do? Support and encouragement is key to deal with mental health conditions Get educated about it Inform family, friends, school counsellor Speak up Inform yourteacher 45Intervention Tool for prevention of NCD risk factors among schoolchildren How to reduce stress in daily life? Stress management is key to mental well-being Avoid academic study related excessive stress Do not compare with others, ‘stay positive’ Develop and nurture a hobby Positive attitude towards own body image Get involved in the sport of your liking 46 Intervention Tool for prevention of NCD risk factors among schoolchildren What is suicide or self harm? Suicide is the act of intentionally causing self harm or act leading to death Life is precious Every problem has a solution I love my family and my family loves me No problem is bigger then life 47Intervention Tool for prevention of NCD risk factors among schoolchildren Why do people commit suicide? All causes are preventable Mental illness - depression, conduct disorders, substance abuse Aggressive personality, emotional behaviour Family stress/dysfunction Situational crises (e.g. traumatic death of a loved one, physical or sexual abuse, family violence, conflicts) 48 Intervention Tool for prevention of NCD risk factors among schoolchildren What are warning signs of suicides? A sudden or dramatic change in academic performance Suicide notes and plans (including online postings) Expressing hopelessness about the future Changes in behaviour, appearance, thoughts and or feelings Self hatred, feeling guilty, worthless or ashamed Extreme stress due to death, relationship failures, exam failure, public humiliation Recent change in eating or sleeping habits Sudden increase in substance use- alcoholism, other drug use 49Intervention Tool for prevention of NCD risk factors among schoolchildren Can suicide be prevented? Early Identification and intervention Discussion with experts about the problem Sharing problems with parents, friends and teachers Positive environment in school Treating underlying medical conditions Expressing oneself Showing empathy 50 Intervention Tool for prevention of NCD risk factors among schoolchildren How to deal with negative thoughts? Tell your family Take help of teacher or school counsellor Seek professional help Emotional support from friends Get busy in hobbies 51Intervention Tool for prevention of NCD risk factors among schoolchildren Promotion of mental well-being at school • Regular interaction with teachers, students and parents • Creating peer groups in school • Encouragement to report stress • Early identification of altered behaviour • Helpline for distress situations • Putting mental well being at the core of school policies • Celebrating “mental well-being week” in the schools 52 Intervention Tool for prevention of NCD risk factors among schoolchildren Exercises for students Exercises to be carried out by the teacher with the help of the Facilitator’s manual S. No. Exercises Participants Type Tools required Assessment method Refer to Facilitator’s Manual MW1* Celebrate mental well-being week 11–12 years Group None Participation and observation Refer to page no. 37 MW2 Your hobbies 11–12 years Individual Paper (A4) and pen Submission of paper Refer to page no. 38 MW3 What causes stress? 13–14 years Individual Paper (A4) and pen Participation Refer to page no. 39 MW4 Practice breathing exercises and Yoga 11–15 years Group Videos Participation and group presentation Refer to page no. 40 *More details on next page 53Intervention Tool for prevention of NCD risk factors among schoolchildren Exercise MW1: celebration of mental well-being week Participants : Class I–V (5–10 years) (Refer to facilitator manual page nos: 37–38) Week day Activities to be done One: Connect Reaching out to people in your surroundings, school assembly Two: Get active Sports-related activities Three: Be mindful Yoga, meditation, breathing exercises Four: Keep learning Quiz, podcast Five: Share Community-based social activities 54 Intervention Tool for prevention of NCD risk factors among schoolchildren 55Intervention Tool for prevention of NCD risk factors among schoolchildren Why talk about tobacco? Nicotine is highly addictive Youth are most affected > 8 million deaths in a year globally Most commonly used substance 56 Intervention Tool for prevention of NCD risk factors among schoolchildren What about newer addictive nicotine products? E-cigarettes Do not get attracted by fancy shapes and colours; these are also hazardous to health 57Intervention Tool for prevention of NCD risk factors among schoolchildren Tobacco in smoke form is hazardous All products are extremely addictive and harmful 58 Intervention Tool for prevention of NCD risk factors among schoolchildren Tobacco in smokeless form is hazardous All products are hazardous Khaini Zarda Gutkha Gudaku Snus Tobacco leaves 59Intervention Tool for prevention of NCD risk factors among schoolchildren All are the same…flavoured betel nut products Don’t get attracted by fancy packaging and advertisement by film celebrities and actors Betel nut is addictive and can also lead to cancer and other diseases Using these products will NOT make you FAMOUS BUT it will certainly make you SICK 60 Intervention Tool for prevention of NCD risk factors among schoolchildren Harmful effect of tobacco on health Disfigurement of mouth, oral cancer Impotency/infertility Bad breath, asthma, lung diseases, cancer 61Intervention Tool for prevention of NCD risk factors among schoolchildren Harmful effect of tobacco on the environment Tobacco pollutes the air, water and soil, and affects the ecosystems 62 Intervention Tool for prevention of NCD risk factors among schoolchildren Harmful effect of tobacco on economy Money spent on tobacco by parents can be utilized for your education, better food, clothes There are better options for spending pocket money, such as buying books, hobbies Stop tobacco - Save money 63Intervention Tool for prevention of NCD risk factors among schoolchildren Why stop tobacco? • Tobacco contains NICOTINE • NICOTINE is one of the most addictive substances • It gives pleasure for the MOMENT but makes YOU an addict for LIFE If you smoke, nicotine reaches your brain within 10 seconds 64 Intervention Tool for prevention of NCD risk factors among schoolchildren Quitting tobacco is possible? Quitting can take multiple attempts • Most smokers want to quit but only a few succeed • Always possible to quit even if you failed; try again Every passing day after quitting will take you towards a disease and risk free life It is better not to start tobacco use. It is not COOL to use tobacco, rather it is very ‘UNCOOL’ 65Intervention Tool for prevention of NCD risk factors among schoolchildren Quitting tobacco is possible • Be positive and determined • Avoid situations which urge you to smoke or use tobacco • Don’t have ‘just one’ • Indulge in physical activity, walking and listening to music • Practice relaxation techniques (deep breathing techniques, yoga, meditation) • Handling withdrawal (headaches or stomach-aches, depression, lack of energy, dry mouth, desire to eat) 66 Intervention Tool for prevention of NCD risk factors among schoolchildren Second-hand smoke is hazardous YES, second-hand smoke is harmful When a person smokes in closed spaces such as home, public transport, office, schools etc. second- hand smoke is inhaled by other persons in the vicinity Tobacco smoke contains more than 7000 harmful chemicals and toxins, some of which can cause cancer (nearly 70) One million persons die every year from exposure to second-hand smoke Are you exposed to second-hand smoke? Where? 67Intervention Tool for prevention of NCD risk factors among schoolchildren Why talk about alcohol use? Alcohol removes all inhibitions Youth are most affected > 3 million deaths in year Commonly used substance 68 Intervention Tool for prevention of NCD risk factors among schoolchildren Alcohol is available in various forms Alcohol in all forms is HAZARDOUS to health There is NO SAFE LIMIT of alcohol consumption Beer Spirits 69Intervention Tool for prevention of NCD risk factors among schoolchildren Harmful effects of alcohol use NCDs: Hypertension, depression, diabetes, obesity, cancer Conflicts, domestic violence, suicidal thoughts Road traffic accidents 70 Intervention Tool for prevention of NCD risk factors among schoolchildren How to prevent tobacco and alcohol use? Better not to start • STOP using it NOW (if you are using it). It’s better late than never • Tell your friends, peers about harmful effects of tobacco and alcohol • Support and help your friends to quit tobacco and alcohol use • Discourage tobacco and alcohol use at home, in family, at school • Get informed about help available for tobacco and alcohol quitting There is no safe limit You can enjoy and have fun without tobacco and alcohol 71Intervention Tool for prevention of NCD risk factors among schoolchildren Exercises for students Exercises to be carried out by the teacher with the help of the Facilitator’s manual S. No. Exercises Participants Type Tools required Assessment method Refer to Facilitator’s Manual SA1 Roleplay 11 years Group Script of role play Participation (holding competition) Refer to page nos. 43–44 SA2 Saying No 12 years Group Pencil, worksheet Observation and reward Refer to page nos. 45–46 SA3 Poison puzzle 13 years Group Pencil, puzzles worksheet Observation and reward Refer to page nos. 46–48 SA4 Poster competition 14 years Individual A-3 size paper, colors Participation and reward Refer to page no. 48 SA5 Quiz- harms of tobacco 15 years Group Quiz questions Participation and reward Refer to page nos. 49–52 72 Intervention Tool for prevention of NCD risk factors among schoolchildren 73Intervention Tool for prevention of NCD risk factors among schoolchildren What is Internet addiction? Daily screen time should be less than 2 hours for children from 5 to 15 years Excessive use of online communication technologies leads to dependence and psychological distress 74 Intervention Tool for prevention of NCD risk factors among schoolchildren Internet addiction is a disease Spending maximum time on the Internet Violent behaviour after restricting use Less interaction with family and friends Loss of sleep and appetite Withdrawal from studies, school absenteeism 75Intervention Tool for prevention of NCD risk factors among schoolchildren How does Internet addiction affect schoolchildren Lack of concentration with short attention span Poor social skills and social exclusion Extreme behaviour–aggression or passive Obesity Frequent mood changes 76 Intervention Tool for prevention of NCD risk factors among schoolchildren Internet addiction is preventable Get aware of signs of internet addiction and identify them early Never open sites which offer money, dating, challenges, or any reward Don’t sympathize with anyone blurting their woes and troubles Spend more time in outdoor activities with your family and friends Observe gadget- free days/weekend Be alert about withdrawal from studies, school absenteeism Seek help of teachers, family members, school counsellor, friends 77Intervention Tool for prevention of NCD risk factors among schoolchildren How to prevent Internet addiction? Supervised Internet use Engage more in outdoor activities Reduce and guard screen time 78 Intervention Tool for prevention of NCD risk factors among schoolchildren Bullying is hazardous What is bullying? • Physical and/or emotional aggression • Teasing • Name calling • Mockery • Threats • Harassment • Taunting • Social exclusion or rumours Cyber bullying: Use of technology to harass, threaten, embarrass or target young persons 79Intervention Tool for prevention of NCD risk factors among schoolchildren Bullying is hazardous • Linked to psychological distress • Higher risk of suicides • Development of depression, anxiety disorders • Poor scholastic performance • Social exclusion Every third child suffers from bullying during school time Girls suffer more than boys 80 Intervention Tool for prevention of NCD risk factors among schoolchildren How to prevent bullying ? Ask for help from teachers, family, friends and school counsellor • Do not share personal information on social network • Do not broadcast whereabouts of self and family on Internet • Use secure sites (https://) for money transaction • Seek help immediately • Young children are the usual target • Social network are commonly used • Personal data privacy is important Say “NO” to bullying 81Intervention Tool for prevention of NCD risk factors among schoolchildren Exercises for students Exercises to be carried out by the teacher with the help of the Facilitator’s manual S. No. Exercises Participants Type Tools required Assessment method Refer to Facilitator’s Manual CB1 Banter-vs-bullying 11 years Group Worksheets, scenario and picture cards Observation and participation Refer to page nos. 54–56 CB2 Collection of paper cuttings 12 years Individual Magazines, newspaper Participation Refer to page no. 57 CB3 Group Discussion (building self- acceptance through positive self-talk) 13–14 years Group Handout with follow up sentences, papers, writing board, pen/ pencils Participation and observation Refer to page nos. 57–59 CB4 Lectures by experts on cyber security 10–15 years Group White/black board, projector, pen, pointer Participation Refer to page no. 59 IA 5 Calculation of your screen time for television, PC, mobile 15 years Individual Phone, television Observation Refer to page no. 60 82 Intervention Tool for prevention of NCD risk factors among schoolchildren 83Intervention Tool for prevention of NCD risk factors among schoolchildren SECTION - II Life Skills (This section is applicable for students aged 11–15 years) • Self awareness • Empathy • Effective communication • Interpersonal relationship • Critical thinking • Creative thinking • Problem-solving • Decision-making • Managing emotions • Coping with stress 84 Intervention Tool for prevention of NCD risk factors among schoolchildren Categories of life skills This module should be implemented as per existing school programmes in the respective countries 85Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - self awareness Meaning : Self analysis of our character, our strengths and weaknesses, our likes and dislikes. Benefits of the skill • Deeper understanding of oneself • Proactive rather than reactive • Use mistakes as tools for growth • Purpose of things (what you do) • Pursue your goals and dreams How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual SA Building positive self-esteem: setting goals 11 years Individual Worksheets, pen, pencils Participation Refer to page no. 63 86 Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - empathy Meaning : Obligatory to build successful relations with society and the ability to accept others. Benefits of the skill • Fosters good and positive environment • Way of “being in life and the world” • Heals painful psychological problems • Active constituent in conflict resolution How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual E The value of respect 11 years Individual White/black board, marker, chalks and worksheet Participation Refer to page no. 64 87Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - effective communication Meaning : Self expression, both verbally and non-verbally and being able to express opinions, desires and needs. Benefits of the skill • Leads to greater confidence and satisfaction • Sharpens your ability to reason and think critically • Increases social networking • Enhancement in team work and collaborative attitude How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual EC Good listening skills 12 years Group Roleplay scripts, white/black board, chalks, marker pens and paper slips Participation and observation Refer to page no. 65 88 Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - interpersonal relationship Meaning : Have positive interaction with people and build healthy relationships for mental peace and social well-being. Benefits of the skill • Able to communicate effectively with others • Interpersonal skills vital in all areas of life: at work, in education, and socially How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual IR Sharing feelings 12 years Group White/black board, chalks, marker Participation Refer to page no. 66 89Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - critical thinking Meaning : Ability to analyse information in an objective way in challenging situations. Benefits of the skill • Formulating problems clearly and precisely • Draw reasonable conclusions and make a decision • Identify inconsistencies and errors in reasoning • Figure out solutions to complex problems How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual CT Keep the balloon up in the air 13 years Group Name list (for facilitator), virtual balloon using chairs Participation Refer to page no. 67 90 Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - Creative thinking Meaning : Novel way of doing things with fluency, flexibility, originality and elaboration. Benefits of the skill • Connecting experiences with communication helps in reaching creative solutions • Exploring new ideas and strategies to face challenges • Risk-taking ability to explore innovative ways of solving problems • Able to come up with “out-of-the-box” thinking How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual CRT The creative solution finders 13 years Group Blank paper and pencil, empty box Participation Refer to page no. 68 91Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - Decision-making Meaning : Defining the problems, gathering information and executing solutions. Benefits of the skill • Using facts and figures available to make decisions • Selecting the logical choice from available solutions • Reviewing your decisions and their consequences How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual DM Making informed choices 14 years Group Collage pictures of substance abuse, branded clothes and accessories, fast food products, worksheets, handout with case study, chart depicting the POWER model Participation Refer to page no. 69–70 92 Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - problem solving Meaning : Deal constructively with problems in our lives. Systematic and logical approach in solving problems. Benefits of the skill • Define problem, generate new ideas • Evaluate and select solutions • Implement and follow up on the solutions How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual PS Understanding a problem better 14 years Group Pencils or pens Participation Refer to page no. 71 93Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - managing emotions Meaning : Recognizing and managing emotions and the ability to realize, accept and control feelings. Benefits of the skill • Gives a space to talk about mental health • Helps students set and meet goals • Reduces behaviour problems • Increases student motivation • Improves school environment How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual ME How do I manage anger 15 years In pairs Paper, pen worksheet white board and marker Participation Refer to page no. 72 94 Intervention Tool for prevention of NCD risk factors among schoolchildren Life skill - coping with stress Meaning : Recognizing the source of stress and its effects on your life. Benefits of the skill • Focus on positivity and strengths • Adopting to various stress-releasing activities • Learning to manage your time • Anticipating stressful moments How to practice the skill Life skill Exercises Age Type Tools required Assessment method Refer to Facilitator’s Manual CS Handling stress (Roleplay) 15 years Group Roleplay situations, white/black board, chalks, markers Participation Refer to page no. 73