Student health and well-being in secondary schools: the role of school support staff alongside teaching staff

Moore

Gallagher

et al. 2019

IJERPH

Challenges in changing school system functioning to orient them towards health are commonly underestimated. Understanding the social interactions of school staff from a complex systems perspective may provide valuable insight into how system dynamics may impede or facilitate the promotion of health and wellbeing. Ego social network analysis was employed with wellbeing leads within four diverse case study schools to identify variability in embeddedness of health and wellbeing roles. This variation, as well as the broader context, was then explored through semi-structured qualitative interviews with school staff and a Healthy Schools Coordinator, sampled from the wellbeing leads’ ego-networks. Networks varied in terms of perceived importance and frequency of interactions, centrality, brokerage and cliques. Case study schools that showed higher engagement with health and wellbeing had highly organised, distributed leadership structures, dedicated wellbeing roles, senior leadership support and outside agencies embedded within school systems. Allocation of responsibility for wellbeing to a member of the senior leadership team alongside a distributed leadership approach may facilitate the reorientation of school systems towards health and wellbeing. Ego-network analysis to understand variance in complex school system starting points could be replicated on a larger scale and utilised to design complex interventions.

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

From Complex Interventions to Complex Systems: Using Social Network Analysis to Understand School Engagement with Health and Wellbeing

Moore

Gallagher

et al. 2019

IJERPH

“…The field of implementation has been increasingly concerned with the generalizability of evidence when interventions are scaled-up or scaled-out (34), and there are implications about whether the intervention could be embedded within the system functioning of schools with different socio-economic profiles. For example, study participants felt it would be challenging to deliver the intervention in more socio-economically deprived settings, while extant research suggests that the quality of staff-students relationships is actually more of a priority in schools of a lower socio-economic status (39). Third, while maximum variation in sampling within the case study was pursued, the sample is limited by those who were prepared to participate.…”

Section: Limitationsmentioning

confidence: 99%

Developing whole-school mental health and wellbeing intervention through pragmatic formative process evaluation: A case-study of innovative local practice within the School Health Research Network

Gobat

Williams

et al. 2020

Preprint

Background: The evidence-base for whole school approaches aimed at improving student mental health and wellbeing remains limited. This may be due to a focus on developing and evaluating de-novo, research led interventions, while neglecting the potential of local, contextually-relevant innovation that has demonstrated acceptability and feasibility. This study reports a novel approach to modelling and refining the theory of a whole-school restorative approach, alongside plans to scale up through a national educational infrastructure in order to support robust scientific evaluation. Methods: A pragmatic formative process evaluation was conducted of a routinized whole-school restorative approach aimed at improving student mental health and wellbeing in Wales. Results: The study reports seven phases of the pragmatic formative process evaluation that may be undertaken in the development and evaluation of interventions already in routine practice: 1) identification of innovative local practice; 2) scoping review of evidence-base to identify existing intervention programme theory; outcomes; and contextual characteristics that influence programme theory and implementation; 3) establishment of a Transdisciplinary Action Research (TDAR) group; 4) co-production of an initial intervention logic model with stakeholders; 5) confirmation of logic model with stakeholders; 6) planning for intervention refinement; and 7) planning for feasibility and outcome evaluation. The phases of this model may be iterative and not necessarily sequential. Conclusions: Formative, pragmatic process evaluations support researchers, policy-makers and practitioners in developing a robust scientific evidence-base for acceptable and feasible local innovation that does not have a clear evidence base. The case of a whole-school restorative approach provides a case example of how such an evaluation may be undertaken.

“…The eld of implementation has been increasingly concerned with the generalizability of evidence when interventions are scaled-up or scaled-out (32), and there are considerations about whether the intervention could be embedded within schools of different socioeconomic pro les. For example, study participants felt it would be challenging to deliver the intervention in more socio-economically deprived settings, while extant research suggests that the quality of staff-students relationships is actually more of a priority in schools of a lower socio-economic status (37). Third, while maximum variation in sampling within the case study was pursued, the sample is limited by those who were prepared to participate.…”

Section: Limitationsmentioning

confidence: 99%

Developing whole-school mental health and wellbeing intervention through pragmatic formative process evaluation: A case-study of innovative local practice within the School Health Research Network

Gobat

Williams

et al. 2020

Preprint

Background: The evidence-base for whole school approaches aimed at improving student mental health and wellbeing remains limited. This may be due to a focus on developing and evaluating de-novo, research-led interventions, while neglecting the potential of local, contextually-relevant innovation that has demonstrated acceptability and feasibility. This study reports a novel approach to modelling and refining the programme theory of a whole-school restorative approach, alongside plans to scale up through a national educational infrastructure in order to support robust scientific evaluation.Methods: A pragmatic formative process evaluation was conducted of a routinized whole-school restorative approach aimed at improving student mental health and wellbeing in Wales.Results: The study reports the six phases of the pragmatic formative process evaluation. These are: 1) identification of innovative local practice; 2) scoping review of evidence-base to identify potential programme theory; outcomes; and contextual characteristics that influence implementation; 3) establishment of a Transdisciplinary Action Research (TDAR) group; 4) co-production and confirmation of an initial programme theory with stakeholders; 5) planning to optimise intervention delivery in local contexts; and 6) planning for feasibility and outcome evaluation. The phases of this model may be iterative and not necessarily sequential.Conclusions: Formative, pragmatic process evaluations can support researchers, policy-makers and practitioners in developing robust scientific evidence-bases for acceptable and feasible local innovations that do not already have a clear evidence base. The case of a whole-school restorative approach provides a case example of how such an evaluation may be undertaken.