Exploring the implementation dynamics of the Health Promoting School approach in Europe: a qualitative study among school health representatives

Driessen-Willems, Marion; Severens, Floor; Darlington, Emily; Bartelink, Nina; Kremers, Stef; Assema, Patricia van; Bessems, Kathelijne

doi:10.1108/he-12-2021-0149

Cited by 4 publications

(2 citation statements)

References 30 publications

(83 reference statements)

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“…Research on the participation and involvement of parents also suggests that schools struggle to engage families in general, not just on the topic of health ( DeSpain et al ., 2018 ; Kelty and Wakabayashi, 2020 ). A possible solution to achieving a stronger pupil and parent participation is by focusing on how participatory tools can best be ‘added-in’ to the curriculum and school structure instead of ‘added-on’ as additional (separate) activities ( Driessen-Willems et al ., 2022 ). For example, photovoice could become a recurring project in the curriculum and design thinking sessions as part of parent–teacher conferences.…”

Section: Discussionmentioning

confidence: 99%

Increasing community capacity to improve the implementation of Health Promoting Schools: barriers and facilitators from the FLASH intervention

van Dongen,

Ridder,

Wolters

et al. 2023

Health Promotion International

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Building community capacity is important for the successful implementation of a Health Promoting School. To identify how capacity building can be encouraged in secondary schools, four schools engaged in the Fit Lifestyle at School and at Home (FLASH) intervention for 3 years. This study explores barriers and facilitators that school personnel, parents and pupils experienced in the capacity-building process. Thirty-one stakeholders were interviewed. Transcripts were analysed thematically based on the five actions of the intervention: (i) appoint a Healthy School coordinator and build a team, (ii) determine ambitions, (iii) design and (iv) implement the action plan and (v) evaluate and improve. The time and support allocated to coordinators helped them evolve their role from executors of health-promotion activities to coordinators, instigators and gatekeepers of the implementation process. Participatory tools helped identify shared values among stakeholders to determine context-specific ambitions and leverage points for interventions. Coordinators indicated that they lacked the skills and authority to engage pupils and parents and to reach the broader community. Coordinators struggled with translating promising ideas into action plans of coherent and mutually supportive activities and embedding them into policy. Strong leadership of Healthy School coordinators, who focus on the capacity-building process and foster collaborative relationships, is essential to build community capacity. In this process, more guidance is needed on how to involve the broader community in various phases. Furthermore, coordinators can benefit from professional development to align jointly designed activities into a comprehensive action plan embedded into Healthy School policies.

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Section: Discussionmentioning

confidence: 99%

Increasing community capacity to improve the implementation of Health Promoting Schools: barriers and facilitators from the FLASH intervention

van Dongen,

Ridder,

Wolters

et al. 2023

Health Promotion International

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show abstract

“…Research on participation and involvement of parents also suggests that schools struggle to engage families in general, not just on the topic of health [182,183]. A possible solution to achieving a stronger pupil and parent participation is by focusing on how participatory tools can best be 'added-in' to the curriculum and school structure instead of 'added-on' as additional (separate) activities [184]. For example, Photovoice could become a recurring project in the curriculum and design thinking sessions part of parent-teacher conferences.…”

mentioning

confidence: 99%

Creating a Healthy School together

Dongen¹

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Dutch schools increasingly work towards stimulating healthy choices among adolescents through the Dutch Healthy School-approach. However, interventions and programs are difficult to sustainably embed and maintain in every day practice, and long term effects remain limited. In order to achieve (sustainable) implementation of Healthy School initiatives, it is advocated that the dynamic nature and the complexity of real-life practice needs to be embraced rather than avoided. Two central themes seem to arise when looking at indicators for successful implementation: a) contextualization is key to ensure that local initiatives are tailored to the dynamic and unique context of the school, and b) stakeholders in a school need to feel ownership and need to be empowered by means of leadership, collaboration and community involvement. In order for stakeholders to address these themes, a focus on the concept of ‘building community capacity’ can be an interesting strategy. This pertains ‘the development of knowledge, skills, ownership, leadership, structures and systems to enable effective health promotion’. Despite the fact that community capacity has long been recognized as an important indicator of program success, there is no simple, clear approach available to translate this into a strategy for practice, and to measure the development and impact of such a strategy. This dissertation aims to explore whether and how building community capacity can work as a strategy to (sustainably) implement a context-specific a broadly supported Healthy School-initiative in Dutch secondary schools. In the Fit Lifestyle at School and at Home (FLASH) intervention four prevocational schools in the Netherlands were encouraged to create a Healthy School community that specifically stimulated physical activity and healthy dietary behavior among pupils. The theoretical principles of FLASH are based on the Community Readiness to Change-method, resulting in four capacity-building strategies: 1) identifying and motivating leaders; 2) promoting a participatory school culture; 3) designing and implementing tailored health-promotion activities; and 4) creating a local network of collaborations and resources. Findings illustrated that these strategies, as explored in FLASH, can provide a reference to translate the concept of building community capacity to the real-life practice of Dutch secondary schools. By focusing on capacity-building, schools put more emphasis on the process of becoming a Healthy School that suits their unique and dynamic context. Engaging in continuous conversations about where to go and who and what is needed to get there, enabled stakeholders to move beyond organizing health-topic-specific activities and realize change is also needed on an organizational level. As a result, schools particularly increased their use of strategies concerning leadership and participatory school culture. At the same time, these efforts did not (yet) lead to improved health and health behavior among adolescents, and we observed a stagnation on the "initiation" stage of readiness in all capacity-building strategies. A contributing factor to this observation is that experiences of stakeholders in FLASH show that building community capacity is a long-term process and new focus for stakeholders, and therefore requires time to understand and grow. Because community capacity-building activities initially focus on organizational processes rather than directly stimulating healthy behavior through health promotion activities, delays in the system of a Healthy School community on health-related outcomes can occur. Nevertheless, it is worth engaging in a continued capacity-building process of a "Plan-Do-Check-Act" cycle that can potentially be sustained. By building on the expertise of professionals, the opportunities in and around the school system, and the needs and wants of community members, continuous improvement can be evoked so that schools get into an upward spiral. This can help stakeholders build a strong and professional Healthy School based on an integral approach that is embedded in the school's DNA.

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Promoting wellbeing within the Health Promoting Schools framework: Could life skills be a means rather than an end?

Masson,

Darlington-Bernard,

Darlington

2024

Journal of Epidemiology and Population Health

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Exploring the implementation dynamics of the Health Promoting School approach in Europe: a qualitative study among school health representatives

Cited by 4 publications

References 30 publications

Increasing community capacity to improve the implementation of Health Promoting Schools: barriers and facilitators from the FLASH intervention

Increasing community capacity to improve the implementation of Health Promoting Schools: barriers and facilitators from the FLASH intervention

Creating a Healthy School together

Promoting wellbeing within the Health Promoting Schools framework: Could life skills be a means rather than an end?

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