BackgroundSchools are key settings for health promotion (HP) but the development of suitable approaches for evaluating HP in schools is still a major topic of discussion. This article presents a research protocol of a program developed to evaluate HP. After reviewing HP evaluation issues, the various possible approaches are analyzed and the importance of a realistic evaluation framework and a mixed methods (MM) design are demonstrated.Methods/DesignThe design is based on a systemic approach to evaluation, taking into account the mechanisms, context and outcomes, as defined in realistic evaluation, adjusted to our own French context using an MM approach. The characteristics of the design are illustrated through the evaluation of a nationwide HP program in French primary schools designed to enhance children's social, emotional and physical health by improving teachers' HP practices and promoting a healthy school environment. An embedded MM design is used in which a qualitative data set plays a supportive, secondary role in a study based primarily on a different quantitative data set. The way the qualitative and quantitative approaches are combined through the entire evaluation framework is detailed.DiscussionThis study is a contribution towards the development of suitable approaches for evaluating HP programs in schools. The systemic approach of the evaluation carried out in this research is appropriate since it takes account of the limitations of traditional evaluation approaches and considers suggestions made by the HP research community.

Understanding the contribution of the whole-school staff to health education (HE) is an important goal in HE research. This study aimed to identify the views of staff (principals; teachers; school nurses and doctors; counsellors and administrative, maintenance, canteen and cleaning staff) regarding the nature of their contribution to HE. The research is based on 207 semi-structured interviews of staff in a sample of five French middle schools (grade 6-9). Content analysis was performed using Bardin's method. The results showed that staff members have different views of their role, three main roles were identified: (i) as an educator in everyday life issues (72%); (ii) individual support, listening (14%) and (iii) taking part in collective projects and facilitation (14%). Professional status has a significant influence on the view they have of their contribution to HE. These results show that in order to facilitate consistent implementation of HE, schools need to be supported to build HE policy (need analysis, definition of priorities and partnerships) and also to develop the means by which an inclusive and real sharing of common culture among all staff can happen; this is not limited to teaching staff but includes non-teaching staff also.