A qualitative study of health promotion in academy schools in England

Patricia E Jessiman,Esther M F Van Sluijs,Rona Campbell,Russ Jago,Dorothy Newbury-Birch

doi:10.1186/s12889-019-7510-x

Patricia E Jessiman, Esther M F Van Sluijs + Show 3 more

Open Access

https://doi.org/10.1186/s12889-019-7510-x

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Abstract

BackgroundSchools are an important setting for health promotion. In England, around one third of publicly funded schools have become independent of local authorities since 2000 and are now academies, run by an academy trust. The aim of this research was to examine attitudes towards health promotion held by academy trust leaders and senior staff. The research questions were: 1. How do academy trusts in England perceive their role in health promotion amongst students? 2. How are decisions around health promotion made in academy trusts? 3. What factors inhibit and encourage health promotion in academy schools? 4. How might public health academics and practitioners best engage with academy schools to facilitate health promotion activity and research?MethodsQualitative study utilising semi-structured interviews. Twenty five academy and school leaders were purposively sampled to achieve variation in trust size and type. In addition, five respondents were recruited from public and third-sector agencies seeking to work with or influence academy trusts around health promotion. Framework analysis was used to determine emergent themes and identify relationships between themes and respondent type. Early findings were triangulated at a stakeholder event with 40 delegates from academia, local authority public health teams, and third sector organisations.ResultsThere is wide variation amongst senior academy and trust leaders in how they perceive the role of academies in promoting health and wellbeing amongst students. There is also variability in whether academy trusts responsible for more than one school adopt a centralised strategy to health promotion or allow individual schools autonomy. This was dependent on the trust leaders’ attitude and interest in health promotion rather than any perceived external accountability. Identified barriers to health promotion include financial constraints, a narrow focus on educational outcomes and school performance, and limited understanding about effective health interventions.ConclusionIn the current absence of national policy or guidance around health promotion in schools, health has variable status in academies in England. There is a need to better engage all academy trusts in health promotion and support them to implement a strategic approach to health promotion.

Highlights

Schools are an important setting for health promotion
Five non-education sector staff were interviewed. These were individuals whose job role included working with schools on health improvement and education, including two staff from local authority public health teams and three from third-sector health organisations
The analysis identified that Multi-academy trust (MAT) with a coordinated approach often approached aspects of health differently; there existed trust-wide strategies that focussed only on student mental health, or only on physical activity, and one that attempted to identify good practice in all aspects of student health and wellbeing and standardise this across all members schools

Summary

Introduction

Schools are an important setting for health promotion. In England, around one third of publicly funded schools have become independent of local authorities since 2000 and are academies, run by an academy trust. 4. How might public health academics and practitioners best engage with academy schools to facilitate health promotion activity and research?. Schools are key settings for health promotion and healthy children and young people obtain better educational outcomes which, in turn, are associated with better life long health [1]. Schools and the concept of a health promoting school are key aspects of education for children and young people that have been supported globally [3]. This holistic approach involves health education via the curriculum and having a school environment and ethos that is conducive to health and wellbeing, and by Jessiman et al BMC Public Health (2019) 19:1186 engaging with families and the wider community, recognising the importance of this wider environment in supporting children and young people’s health. A Cochrane review of the health promoting schools approach, which included 67 randomised controlled trials, concluded that it was effective in improving aspects of student health [4]

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