Facilitating the implementation and efficacy of health-promoting schools via an action-research approach in Taiwan

Abstract

Taiwan launched its evidence-based health-promoting school (HPS) program via an action-research approach in 2010. The program featured a collaborative partnership between schools, local education authorities and university support networks. This study was focused on examining whether an HPS action-research approach was effective in advancing HPS implementation, perceived HPS impact and perceived HPS efficacy in Taiwan. In 2011, questionnaires were sent to 900 sample schools in Taiwan. A total of 621 schools returned the questionnaire, including 488 primary schools and 133 middle schools. The response rate was 69%. This study compared the difference in HPS implementation status, perceived HPS impact and perceived HPS efficacy between those schools that had implemented action-research HPS (138 schools) and those that had not (483 schools). The univariate analysis results indicated that the HPS implementation levels for components that included school health policies, physical environment, social environment, teaching activities and school-community relations were significantly higher in action-research schools than in non-action-research schools. Teachers in action-research schools reported significantly higher levels of HPS impact and HPS efficacy than non-action-research schools. The multivariate analysis results indicated that after controlling for school level and HPS funding, the HPS action-research approach was significantly positively related to greater levels of HPS implementation, perceived HPS impact and perceived HPS efficacy.

Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review

“…Experts from universities participated in support network by providing technical support and local school action research training workshops to build teacher capacity and support implementation [ 74 ]. One study examined the support of the partnership program on continuous improvement for HP [ 74 ] and another assessed if the action research approach was effective in advancing HP implementation [ 75 ] ( micro-, meso- and exosystem ). In Hong Kong, HPS was first launched in 1998, and further developed as a Healthy Schools Award Scheme in 2001 with an aim to promote educational achievements, and to enhance the well-being of school students and staff [ 76 ].…”

“…Forms of legislation and regulation were only identified in a few countries. Scotland had a legislative requirement for HPS to be integration in all schools (which was also accompanied by regular health and well-being inspections) [ 42 ], the United States has a legislative responsibility for all schools to have a wellness policy if they are participating in the national school lunch program [ 59 ] and Taiwan requires all schools to implement HPS [ 75 ]. Communication/marketing and fiscal policies were not explicitly described.…”

“…Another study corroborated this finding by suggesting there was more of an emphasis on establishing partnerships rather than external support that may address the issue of time [ 40 ]. Collaboration and teamwork were also identified as being critical to facilitate the translation and integration of HP policy and practice [ 32 , 34 , 43 , 48 , 52 , 57 , 61 , 62 , 65 , 68 , 70 , 75 , 79 ]. Barnes and colleagues (2013) noted the importance of partnerships in helping to build organizational capacity to sustain the HPS approach [ 65 ].…”

“…Engagement in and success of exchange opportunities in HPS generally may also be influenced by individual factors, such as teacher motivation, professional learning and discretion, or personal interest [ 38 , 41 ]. However, some studies suggest that, HP implementation levels, perceived HP impact and HPS efficacy of teachers are higher when there is increasing participation and system support [ 74 , 75 ].…”

Adaptation of the Scale for Health Promoting Schools to Turkish Society: A Validity and Reliability Study

“…[4][5] Countries such as India, Korea, Taiwan, Austria, the Lao People's Democratic Republic, 9 China, Hong Kong, Australia, and the Netherlands have prepared comprehensive school health checklists for evaluating the health profiles and conditions of HPS, and they have determined criteria according to the countries. [6][7][8][9][10][11][12][13] Mukoma and Flisher (2004) evaluated HPS, reporting that problems could be revealed by determining the appropriate methods in schools and that studies had shown positive advances in HPS. 4 In 1995, WHO provided a series of rules for schools that intended to gain the status of HPS.…”