Abstract
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.
Highlights
Youth is a period where many protective and risk behaviours are formed, and there is growing evidence that the school environment can affect health and wellbeing [1]
The wellbeing leads for each case study school were female
These results demonstrate that case study schools’ network structures vary according to the allocation of responsibility for leading health and wellbeing, the extent to which SLT members play brokerage roles, the perceived importance and frequency of interactions with other key agents with regards to health and wellbeing, the number of roles relating to health, and the embeddedness of outside agencies into school systems
Summary
Youth is a period where many protective and risk behaviours are formed, and there is growing evidence that the school environment can affect health and wellbeing [1]. This focus on school environments, rather than individuals within the school, is in line the Ottawa Charter principles, which emphasise a need to support health within the settings of people’s everyday lives [2]. Healthy behaviours have been found to track into adulthood Intervening at this early age may increase the likelihood of positive health and wellbeing and decrease the risk of disease development, such as cancer or coronary heart disease [3,4]. While health education dominated much early school health work, recent systematic reviews highlight the greater effectiveness of multi-level “complex interventions”, such as those using the World Health Organisation’s Health
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