Understanding of Factors that Enable Health Promoters in Implementing Health-Promoting Schools: A Systematic Review and Narrative Synthesis of Qualitative Evidence

Abstract

Health-promoting schools have been regarded as an important initiative in promoting child and adolescent health in school settings using the whole-school approach. Quantitative research has proved its effectiveness in various school-based programmes. However, few qualitative studies have been conducted to investigate the strategies used by health promoters to implement such initiatives. In this study, the researchers conducted a systematic review and narrative synthesis of the qualitative literature to identify important enablers assisting the implementation of health-promoting schools from the perspectives of health promoters. Five enablers have been identified from the review: (a) Following a framework/guideline to implement health-promoting schools; (b) Obtaining committed support and contributions from the school staff, school board management, government authorities, health agencies and other stakeholders; (c) Adopting a multidisciplinary, collaborative approach to implementing HPS; (d) Establishing professional networks and relationships; and (e) Continuing training and education in school health promotion. This highlights the importance of developing school health policies that meet local health needs, and socio-cultural characteristics that can foster mutual understanding between the health and education sectors so as to foster health promotion in children and adolescents.

Obesity prevention and the Health promoting Schools framework: essential components and barriers to success

“…Many of these findings are congruent with conclusions from other studies examining effective elements of school-based interventions. A recent narrative synthesis of qualitative studies adopting the HPS approach [ 60 ] identified the importance of institutional support, assessment of school needs, ownership of programmes, adequate training and tailoring of intervention components to local contexts. This review also noted the low value placed on health versus academic achievement as a barrier to effective implementation.…”

The Role of School Leaders’ Health Literacy for the Implementation of Health Promoting Schools

“…Compared to highly standardized (i.e., prepackaged) intervention programs, that are delivered with high implementation fidelity, the HPS approach is characterized by context sensitivity that requires adaptations to the specific conditions and dynamic processes of a single school [5,14,15]. Due to the complexity of interventions that are rooted in a broader socio-ecological determination of health, a growing need of a "science of delivery" has been demanded that aims to identify elements and dimensions of high-quality implementation [16].…”

Managing Implementation of a Parental Support Programme for Obesity Prevention in the School Context: The Importance of Creating Commitment in an Overburdened Work Situation, a Qualitative Study

“…High quality formal communication and peer collaboration are known to contribute to effective implementation in general (Damschroder et al, 2009). Multidisciplinary collaborative approaches and professional networks have also been highlighted as one of five enablers regarding implementation of the health-promoting school concept (Hung, Chiang, Dawson, & Lee, 2014). Networks and pre-existing teams might form a solid basis for shared decision-making, which is important not only for a successful implementation but also for program sustainability (Durlak & DuPre, 2008).…”

“…To avoid opposition, staff should be actively involved in detailed planning regarding when and how the programme should be implemented. According to a systematic review on implementation of the concept of health-promoting schools, enthusiasm among staff is maintained if they have a sense of ownership, which can be achieved by letting them play an important role in strategic planning and decision-making (Hung et al, 2014).…”