Main Content
Session Information
08 SES 07, Factors influencing school health promotion interventions and programs
Paper Session
Contribution
Background: Implementing complex and multi-level public health programmes is challenging in school settings. Discrepancies between expected and actual programme outcomes are often reported. Such discrepancies are due to complex interactions between contextual factors. Contextual factors relate to the setting, the community, in which implementation occurs, the stakeholders involved, and the characteristics of the programme itself. This work uses realist evaluation to understand how contextual factors influence the implementation process, to result in variable programme outcomes. This study focuses on identifying contextual factors, pinpointing combinations of contextual factors, and understanding interactions and effects of such factors and combinations on programme outcomes on different levels of the implementation process.
Method
Methods: Schools which had participated in a school-based health promotion programme between 2012 and 2015 were included. Two sets of qualitative data were collected: semi-structured interviews with school staff and programme coordinators; and written documents about the actions implemented in a selection of four schools. Quantitative data included 1553 questionnaires targeting pupils aged 8 to 11 in 14 schools to describe the different school contexts.
Expected Outcomes
Results: The comparison between what was expected from the programme (programme theory) and the outcomes identified in the field data, showed that some of the mechanisms expected to support the implementation of the programme, did not operate as anticipated (e.g. inclusion of training, initiation by decision-maker). Key factors which influenced the implementation process included, amongst other factors, the mode of introduction of the programme, home/school relationship, leadership of the management team, and the level of delegated power. Five types of interactions between contextual factors were put forward: enabling, hindering, neutral, counterbalancing and moderating effects. Recurrent combinations of factors were identified. Implementation was more challenging in vulnerable schools where school climate was poor. Conclusion: A single programme cannot be suited or introduced in the same manner in every context. However, key recurrent combinations of contextual factors could contribute to the design of implementation patterns, which could provide guidelines and recommendation for grass-root programme implementation.
References
WHO. Ottawa Charter for Health Promotion. 1986. http://www.who.int/ healthpromotion/conferences/previous/ottawa/en/index1.html. Accessed 29 Nov 2014. Rowling L, Jeffreys V. Capturing complexity: Integrating health and education research to inform health-promoting schools policy and practice. Health Educ Res. 2006. https://doi.org/10.1093/her/cyl089. St Leger L. The opportunities and effectiveness of the health promoting primary school in improving child health–a review of the claims and evidence. Health Educ Res. 1999;14:1.51–69. Stewart-Brown S. What is the evidence on school health promotion in improving health or preventing disease and, specifically, what is the effectiveness of the health promoting schools approach? Copenhagen: WHO Regional Office for Europe; 2006. In WHO Regional Office for Europe: Health Evidence Network report. http://www.euro.who.int/document/ e88185.pdf. Accessed 18 Nov 2015. Nutbeam D. Evaluating Health Promotion–Progress, Problems and solutions. Health Promot Int. 1998. https://doi.org/10.1093/heapro/13.1.27. Wimbush E, Watson J. An Evaluation Framework for Health Promotion: Theory, Quality and Effectiveness. Evaluation. 2000. https://doi.org/10. 1177/135638900000600302. Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F. Implementation Research: A Synthesis of the Literature. 2005. Samdal O, Rowling L. Implementation Strategies to Promote and Sustain Health and Learning in School. In: Simovska V, Mannix McNamara P, eds. Schools for Health and Sustainability: Theory, Research and Practice. Dordrecht: Springer Netherlands; 2015. Rowling L, Samdal O. Filling the black box of implementation for health- promoting schools. Health Educ. 2011. https://doi.org/10.1108/ 09654281111161202. Durlak JA, Du Pre EP. Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008. https://doi.org/ 10.1007/s10464-008-9165-0. Meyers DC, Durlak JA, Wandersman A. The Quality Implementation Framework: A Synthesis of Critical Steps in the Implementation Process. Am J Community Psychol. 2012. https://doi.org/10.1007/s10464-012-9522-x. Pearson M, Chilton R, Woods HB, et al. Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK). Syst Rev. 2015. Pawson R, Tilley N. Realist Evaluation. In: An Evidence-Based Approach To Public Health and Tackling Health Inequalities: Practical Steps And Methodological Challenges. Dordrecht: Sage; 2004. Mcisaac JD, Mumtaz Z, Veugelers PJ, Kirk SFL. Providing context to the implementation of health promoting schools : A case study. Eval. Program Plann. 2015. https://doi.org/10.1016/j.evalprogplan.2015.08.003.
Programme by Network 2019
00. Central Events (Keynotes, EERA-Panel, EERJ Round Table, Invited Sessions)
Network 1. Continuing Professional Development: Learning for Individuals, Leaders, and Organisations
Network 2. Vocational Education and Training (VETNET)
Network 3. Curriculum Innovation
Network 4. Inclusive Education
Network 5. Children and Youth at Risk and Urban Education
Network 6. Open Learning: Media, Environments and Cultures
Network 7. Social Justice and Intercultural Education
Network 8. Research on Health Education
Network 9. Assessment, Evaluation, Testing and Measurement
Network 10. Teacher Education Research
Network 11. Educational Effectiveness and Quality Assurance
Network 12. LISnet - Library and Information Science Network
Network 13. Philosophy of Education
Network 14. Communities, Families and Schooling in Educational Research
Network 15. Research Partnerships in Education
Network 16. ICT in Education and Training
Network 17. Histories of Education
Network 18. Research in Sport Pedagogy
Network 19. Ethnography
Network 20. Research in Innovative Intercultural Learning Environments
Network 22. Research in Higher Education
Network 23. Policy Studies and Politics of Education
Network 24. Mathematics Education Research
Network 25. Research on Children's Rights in Education
Network 26. Educational Leadership
Network 27. Didactics – Learning and Teaching
Network 28. Sociologies of Education
Network 29. Reserach on Arts Education
Network 30. Research on Environmental und Sustainability Education
Network 31. Research on Language and Education (LEd)
Network 32. Organizational Education
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