Sustaining and enhancing healthy lifestyle behavior in students with special needs and their teachers in unexpected crisis events

In unexpected situations, access to health services may be interrupted. In such a situation, the sustainability of health depends on the healthy lifestyle behaviors (HLBD) of the individual. The knowledge and behaviors of disabled individuals towards a healthy lifestyle are not at the desired level. It affects the musculoskeletal and cardiopulmonary system functions as a result of the decrease in the physical activity, especially due to the duration of staying at home and the time spent in front of the screen in distance education, and psychologically, it causes an increase in the incidence of anxiety, stress, and depression. In addition, the teachers also faced various physical and mental health problems due to their prolonged immobility in front of the screen while teaching. It is possible to minimize the short and long-term, direct and indirect effects of the unexpected crisis events on SSN and their teachers, and therefore to keep social participation and quality of life at the highest level both during and after the unexpected crisis events with health promotion strategies. For this reason, countries to improve health need studies focusing on 'Development and Sustainability of HLB'.

Within the scope of the project, it was aimed to improve the HLB knowledge, skills and competence of the SSN and their teachers, and to create a guide and interactive book that enables the development and sustainability of HLB in crisis situations for SSN and their teachers. In this project, HLB was discussed under the heading of physical activity, nutrition and psychological well being. With the guide that developed the HLB to be created in order to enable the target population to overcome the unexpected crisis events with the least impact and to reduce the longterm effects of the crisis; Primary; * Participants' physical activity level was increased by at least 30% * Participants were made aware of healthy nutrition * Participants' psychological well-being was increased * Teachers' knowledge and proficiency on HLB increased Secondary; * Language skills of project partners improved, intercultural interaction increased * Raised awareness about the needs of children with special needs in unexpected crisis situations and contributed to transnational audiences * European culture was made felt by producing solutions to the problems experienced by individuals with special needs on the basis of equal opportunity.

The learning, teaching, training (LTT) activities were implemented to the teachers and SSN for their HLB knowledge, skills, and competence. Before all activities, the participants were assessed via questionnaires (Semistructured Assessment Form, Healthy Lifestyle Behavior Scale-II, International Physical Activity Questionnaire Short Form, Beck Depression Scale, Visual Analogue Scale for anxiety, Healthy Nutrition Attitude Scale) to determine the impact of the activities in this project. The questionnaires were performed 3 times at the beginning, mid-term, and end of the project. LTTs included the activities that were consist of adapted motor activities, psychological intervention, evaluation, elaboration of the intervention plan, stress management, and healthy nutrition. Academicians (physiotherapists and sports trainers) provided knowledge and practice about physical activity to the learners. The SSN were involved in the training about HLB, the session of physical activities, the handicraft workshop, STEAM workshop, healthy snacks workshops, and the stress management workshop. The handicraft workshops and STEAM workshop were used to maintain psychological well-being and were carried out by the teachers in the schools. The physical activities in LTTs had differed via the exercise selection such as strengthening the upper extremities, strengthening the lower extremities, stretching/relaxing exercises, posture exercises, strengthening the core and back muscles, balance and coordination exercises, and aerobic exercises (brisk walking, jogging, dance therapy for cardiovascular endurance). After each LLT, the partners made a pilot implementation to practice what they had learned. During the pilot implementation (local activities), the learners also benefitted from innovative methods. Within the scope of this project, local training given for the development and maintenance of HLB was given online via telecommunication and computer systems. The exercise videos, healthy nutrition videos, and stress management videos were created by specialists. The accessibility of the videos planned in the project was important in terms of being accessible by everyone with equal opportunities. For this reason, communication was provided via WhatsApp application and ZOOM due to having it mobile phone in every home, and training/videos was distributed via mobile phone. In addition, training materials to be used to improve HLB went beyond brochures and posters and were provided with an interactive book. Exercises (strengthening, stretching, posture exercises, cardiovascular endurance, balance and coordination, core stabilization) benefits of physical activity, healthy nutrition, stress management, and activities to maintain mental health were the main topics of the interactive book. Additionally, all videos used within the scope of the project were uploaded to the project web page and the target population benefitted from these outputs asynchronously. It was planned to establish WhatsApp groups by the partners within the scope of local activities. A key-person experienced in physical activity and a key person experienced in nutrition who was a member of the teams of University partner provided mentorship to these groups. End of the pilot implementations, the consortium partners gave feedback for the good practice. The partnership created the guide and interactive book according to the feedback from the pilot implementation as well as scientific knowledge. You can find detailed photos about this on the project website: https://sahhim.eu/gallery/

After the LTT activities, the partners created a guide, an interactive book, and training videos regarding physical activity, exercises, stress management, and healthy nutrition. After the completion of the project, the consortium partners achieved the following results: 1) Created a guide to develop and maintain healthy lifestyle behavior in crisis situations 2) An interactive book was created that enables the adoption and reinforcement of healthy lifestyle behavior 3) Participants' physical activity level increased by at least 30% 4) Participants were made aware of healthy eating habits 5) Participants' psychological well-being improved 6) The anxiety level of the participants decreased 7) Teachers' knowledge and proficiency on HLB increased 8) Experiences gained were shared 9) Language skills of the partners participating in the project were improved, intercultural interaction was increased 10) Contribution was made to transnational audiences by raising awareness about the needs of children with special needs in unexpected crisis situations 11) It was ensured that all partners felt the European culture in solving the problems of disabled people and their close circle. 12) European citizenship awareness was improved 13) Transnational cooperation was encouraged