Delivery of effective teacher training to promote health and wellbeing in schools: a survey of current practice

Abstract

BackgroundTeachers play an increasingly important part in the wider public health workforce. Initial teacher training (ITT) should prepare teachers to be effective in promoting health and wellbeing in schools. However, questions remain about the provision and quality of public health within ITT courses. We aimed to assess how teacher training prepares teachers to promote health and wellbeing in schools, what barriers to and facilitators of effective training exist, and the relation between ITT and the changing policy landscape in public health and education. MethodsWe did a questionnaire survey of the 208 ITT institutions in England to assess how health is addressed in teacher training (eg, health topics covered, time spent on health, external organisations involved). We randomly sampled course leaders (n=220), stratified by region, type of provider (eg, university-based; employment-based), and number of courses offered. Questionnaire data were analysed with standard descriptive statistics. Qualitative follow-up interviews were done with a semistructured interview schedule with a purposive subsample of 19 questionnaire respondents, to investigate issues in more detail. Interview data were analysed with content analysis to create categories, which led to the generation of broader analytical themes. FindingsThe overall questionnaire response rate was 34% (74 of 220). Most respondents were based in universities (n=43; 58%), followed by school-based training providers (n=21; 28%), and employment-based providers (n=10; 14%). Most courses led by the respondents were postgraduate. 54 (89%) of questionnaire respondents thought emphasis of health of pupils or staff in teacher training was important or very important. The extent to which health was covered in courses varied. 49 (77%) respondents used external organisations to address health issues. Commonly used organisations included with local authorities (n=35; 75%), local schools (n=29; 62%), and charities (n=17; 36%), and less commonly health professionals (n=10; 21%). Some respondents anticipated that changes in educational policy might lead to a reduced focus on health in their courses, whereas others aimed to maintain the inclusion of health. In the follow-up interviews respondents described the ways they were adapting their courses to retain the focus on health. These methods included addressing the health-related aspects of special educational needs, disability, and behaviour management. Evidence of competing priorities existed, with lack of time in a busy curriculum a key barrier to addressing health. A supportive staff ethos and previous health-related experience of teacher educators were cited as facilitators. The interviews also showed that course leaders have a broad idea of health, with some taking a whole-child approach. A common view was that good health is essential for effective learning. This holistic view of education was seen to be in conflict with emerging government educational policy, which seems to place less emphasis on the importance of children and young people's health and wellbeing than previous policies. InterpretationVariability exists in the coverage of health in teacher training, and in methods and approaches. Policy and service delivery are undergoing a period of change in both public health and education, with the perception of less overt support for health and wellbeing in schools. Support does remain, but teacher educators, who generally remain committed to fostering the role of health in ITT, are interpreting policy changes in different ways in the planning of the content and structure of their curricula. Greater policy links between health and education could enhance the facilitating role of health expertise in teacher education. Our study is limited by reliance on the perspectives of college-based ITT providers; future studies should include placement schools. FundingNational Institute for Health Research Public Health Research Programme.