Since the 1980s, schools have been recognized as an ideal setting to promote students' and teachers' health. Three decades after the development of the Health Promoting Schools (HPS) approach, however, there is still only limited knowledge about the implementation of health promotion (HP) activities in this setting. Some studies indicate that schools change original concepts significantly when adapting them to local context in the course of implementation. In this paper, we pursue the question how HP is practiced in schools that have agreed to implement HPS concepts from regional service providers (SPs), using data from a multiple-case study conducted in an Austrian province. Furthermore, we explored the HP activities chosen for implementation and the decision-making leading to their implementation. We draw on 22 interviews with members of the school community and provincial HP SPs, 9 group discussions, and 10 observations we have carried out within three schools between November 2010 and January 2012, supplemented by a variety of documents. We have identified 40 different HP activities, of which most targeted students, while mostly focusing on physical activity and/or psychosocial health. Planning, coordination and cooperation at the school level were minimal. Decisions for or against activities were seldom taken together, but taken individually due to personal knowledge, interests and experiences, perceived needs and problems, already existing activities and external influences. The findings suggest that schools rather remain with a traditional topic-based approach instead of realizing an integrated whole-school approach and indicate a need for more support especially during the early phases of implementation.
Schools have been identified as ideal settings for health promotion (HP) among children, adolescents and school staff. Most European countries have established strategies to implement HP into their school system, however, little is known about these national strategies and how effective they have been. School HP implementation concerns processes of adoption, adaptation and operation of a complex intervention into a complex setting. This study analyses the processes that have led to school HP implementation in Scotland from the 1980s until now to identify key factors which facilitated and supported effective implementation. In the tradition of case-study research, 14 interviews with representatives of national and local organizations involved in school health, as well as with school staff were conducted. Furthermore, policy documents, reports and guidelines were collected. The data were analysed following a Grounded Theory approach. Four phases of school HP implementation into the Scottish school system were identified: (i) getting started (1980s-1998), (ii) political will and strategic vision (1999-2001), (iii) national leadership (2002-2008), and (iv) integration and embedding into education system (2008-ongoing). Throughout the phases political will and committed actors, the strategy/tradition to give power to the local authorities and individual schools, and the establishment of partnerships and ownership have supported implementation. Scotland is an interesting case giving important insights into the ways and possibilities of negotiating an interdisciplinary and cross-sectoral theme such as HP in schools. Further research concerning different political systems and national implementation processes is important to widen the understanding of national implementation strategies of school HP.
Schools that want to implement health promotion (HP) are often confronted with obstacles that they cannot overcome by themselves and therefore need support from their environment. However, the issue of which kind of support is needed for HP implementation is complex. A systems approach suggests that the individual logic of each school be considered and that supporting strategies be flexible to specific needs. This article pursues the question which types of support for health promoting schools are offered on a provincial level in Austria. Using a grounded theory approach, 18 in-depth interviews with representatives of provincial organizations and 26 documents relevant for school HP were analysed. As a result, five different strategies of supporting health promoting schools have been identified in Austria: (i) organize exchange among schools, (ii) establish certification and quality control of school health efforts, (iii) offer consultation and information, (iv) carry out a specific HP programme and (v) coordinate HP actors and information. These strategies are usually combined and rarely occur in their pure form. It was also determined that the coordination of the different strategies and human resources for HP are missing for schools in Austria. It is argued that each of these supporting strategies has benefits and limitations for schools and the providers, and that they all have the potential to respond to the school as a complex social system.
Focus groups have become an important method in qualitative psychological research and are also used widely in evaluation studies. However, there has been a surprising lack of attention in the literature in terms of exploring the entire process of conducting focus groups with young people on potentially psychologically sensitive issues such as sexual health. This article draws on our experiences of using focus groups during a specific piece of qualitative research that involved three discrete but inter-related evaluations of sexual health services for young people in the South of England. We focus particularly on the process of using focus groups as an important and useful empirical method to generate primary qualitative data. In doing so, we consider a number of both practical and ethical considerations when planning, facilitating, and following up focus groups with young people that aim to investigate psychologically sensitive issues, in this case, sexual health. As a result, we propose a heuristic framework for conducting focus groups 'from start to finish' including preparing focus groups, facilitating focus groups and following up participants, that offers a contribution to the advancement of qualitative inquiry in psychology. Key recommendations are elicited both for the teaching of qualitative psychological research methods and for the training of qualitative researchers interested in psychological phenomena.Keywords: focus groups, qualitative methods, young people, ethics. 'From Start to Finish': Practical and Ethical Considerations in the Use of Focus Groups to Evaluate Sexual Health Service Interventions for Young PeopleFocus groups are a well-established technique within qualitative research and evaluation and are commonly used within the health and social sciences, particularly psychology, sociology, health promotion, education, public health, and other related fields (e.g.
To change a school into a health-promoting organization, organizational learning is required. The evaluation of an Austrian regional health-promoting schools network provides qualitative data on the views of the different stakeholders on learning in this network (steering group, network coordinator and representatives of the network schools; n = 26). Through thematic analysis and deep-structure analyses, the following three forms of learning in the network were identified: (A) individual learning through input offered by the network coordination, (B) individual learning between the network schools, i.e. through exchange between the representatives of different schools and (C) learning within the participating schools, i.e. organizational learning. Learning between (B) or within the participating schools (C) seems to be rare in the network; concepts of individual teacher learning are prevalent. Difficulties detected relating to the transfer of information from the network to the member schools included barriers to organizational learning such as the lack of collaboration, coordination and communication in the network schools, which might be effects of the school system in which the observed network is located. To ensure connectivity of the information offered by the network, more emphasis should be put on linking health promotion to school development and the core processes of schools.
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