Development and implementation of a tailored health promoting school in The Netherlands: Lessons learned

Abstract

This paper presents the lessons learned from the design and implementation of a whole school Health Promoting School (HPS) pilot on a high school in The Netherlands. This pilot aims to improve a range of health behaviours in adolescents via the Whole School Approach of Health Promoting Schools framework of the WHO-supported Schools for Health in Europe initiative (SHE). Eleven semi-structured interviews were held with key stakeholders in the intervention's design and implementation. Results showed that becoming a HPS should be considered a comprehensive curriculum change that requires significant organizational investments. By integrating the intervention instead of implementing it "as is" into school's existing infrastructure the additional burden to the curriculum was minimized; this was important for intervention relevance and it strengthens feelings of intervention ownership and motivation among teachers. Also, implementation should be led by a steering group of professionals from health sciences and education as well as parents, students and teachers from the school to combine knowledge on practical feasibility and evidence based practices. Teachers should be further educated to increase competence in their new role. Lastly, a central coordinator with proper personal competencies and power to get things done is necessary to steer these developments. Since not all schools are able to make the necessary investments, successfully becoming a HPS is not feasible for just any school at any point in time; it has to be considered a well-planned comprehensive system change. Schools with competing problems such as school violence or organizational struggles should postpone HPS developments.