Over the past 10 years, 'settings' based health promotion has become a central feature of efforts to promote health that recognize the significance of context. Emerging in part from a perception of an over-reliance on individualistic methods, the approach was built on a profound belief in its value and deployed a range of novel theoretical resources, mainly from organizational sociology and psychology. This initial enthusiasm has been maintained within policy directives, in the published literature and, from our own experience, amongst health promotion practitioners. At the same time, with the maturing of the approach, has come a healthy element of critical review. Drawing upon the literature and based upon our experiences within the Health Education Board for Scotland, this paper seeks to bring together a range of perspectives, casting a critical yet constructive eye on current settings theory and practice. The paper first reviews the nature of settings based work, highlighting the varied bases and expectations that underpin it. Similarly, the many factors that influence the ability of health promoters to deliver such activities are considered. In relation to the construction and delivery of such activity, the paper suggests that there needs to be an explicit and detailed assessment of the nature of the setting, the skills of the health promoter and the associated expectations.

The peer-assisted mock OSCE improved tutee confidence and reduced the anxieties associated with OSCEs. Tutors gain valuable teaching skills. This PAL model is an acceptable, feasible and beneficial method of preparing students for this challenging style of health care examination.

Schools across the world have been involved in health promotion and health education for nearly a century. Do school based initiatives make any difference to the education and health outcomes of young people? This article describes the process in developing the document Promoting health in schools: from evidence to action. The document was produced primarily for the Education sector. It develops an argument about why schools should be undertaking health related initiatives. It also highlights major findings from the literature about what is possible to achieve in school health and the circumstances under which the gains will occur. Attention is focused both on the evidence from the education sector, e.g. effective schools, learning and teaching approaches, and from the health sector, e.g. a whole of school or Health Promoting School (HPS) approach, as well as identifying outcomes from topic areas such as mental and emotional health, healthy eating and nutrition, physical activity, hygiene, sexual health and relationships, substance use and misuse.

THE effect of a healthy eating health promotion in itiative on the knowledge, actitudes and behaviour of secondary-school pupils was investigated in this study in Lothian Region in 1992. This was under taken by comparing pupils in a case study school, which had introduced a healthy eating policy, with pupils in two control schools. The investigation dem onstrated that the levels of knowledge of healthy eating were similar in the three schools, but there were significant differences in eating behaviour be tween the schools. Pupils in the case study school demonstrated healthier snack selection at school and a greater uptake of school meals. There was evidence that wider factors, not within the domain of the school, counteracted the case study school's achievement and the policy implications of this are discussed.

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The health promoting school concept is now a well‐established framework for the development of health promotion initiatives in schools. Increasingly, attention has focused on the evaluation of school‐based health promotion and debate continues over appropriate evaluation designs for the school setting. The authors argue that the case study design provides a useful approach because of its ability to explore the real‐life complexities of social contexts using a combination of quantitative and qualitative methods, with a strong emphasis on process as well as outcome measures. The current ENHPS project in Scotland uses a multiple‐case study design to evaluate healthy eating initiatives in four schools, based on the principles of the health promoting school. Provides a description of the project and highlights the advantages of case study methodology in addressing key issues around effectiveness of school‐based health promotion based on the health promoting school concept.

Changes in the eating habits of young people in Europe and the resulting growth in obesity and overweight are giving cause for concern. The Council of Europe in 2001 decided to establish an ad hoc group consisting of national experts to review the issues. Since then the group has studied current school food practices in Europe in order to be able to issue guidelines targeted at international, national, local and institutional levels. A survey was undertaken on behalf of the Council of Europe and World Health Organization (WHO, European Office) as a starting point. The study was an update of a previous survey carried out in the process of developing the ENHPS healthy eating in school manual and the results were presented at a forum held by the Council of Europe in collaboration with the WHO entitled The European Forum on Eating at School – Making Healthy Choices on the 20th and 21st November 2003. In addition, a number of experts from a range of professional backgrounds, all with a common interest in healthy eating in schools, were invited to present research results and discuss the way forward. The results from the forum have since been compiled into a forum report. The aim of this paper is to present and discuss the findings of the European Network of Health Promoting Schools group and its implications for school food service in the future; to discuss, in general, how schools can become a more active arena for the promotion of healthy eating, and how food service can contribute in this respect. The results present an overview of how food provision is organized in primary and secondary schools, at home, outside the school, lunch boxes, kiosk type outlets, vending machines, cash cafeterias and canteens as well as ‘special food promotions’. Data on how school food is financed and operated are presented together with the findings on future consumer demand. The findings and their implications for school food service operators are discussed. Barriers include improving logistics, reviewing the healthiness of food provision, the use of vending machines, involving stakeholders, complying with standards, integrating food and nutrition issues in the curriculum and giving due attention to future consumer demands. In conclusion, the paper presents guidelines on healthy eating at school issued by the Council of Europe on the basis of the forum and the work done in the ad hoc group.