Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review.

Jessie-Lee Mcisaac,Sara Kirk,Janet Curran,Kimberley Hernandez

doi:10.3390/ijerph13020200

Abstract

Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students.

Highlights

School health interventions are most effective in supporting chronic disease and cancer prevention when they target multiple environmental and behavioural components and incorporate a complementary community strategy [1,2,3,4]
The included studies targeted all levels of the school system in Austria, Norway, United Kingdom, Canada, United States, Australia (Western Australia and South Australia ), New Zealand and the Western Pacific
The majority focused on the school system across both primary and secondary schools (n = 31, with seven of these including other school types such as vocational and preschool), including some with younger children and others with post-secondary school

Summary

Introduction

School health interventions are most effective in supporting chronic disease and cancer prevention when they target multiple environmental and behavioural components and incorporate a complementary community strategy [1,2,3,4]. Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support prevention behaviours of healthy eating, physical activity and tobacco use by modifying the social and physical environments in schools [5,6]. HPS advocates for health promotion (HP) actions that influence social norms and improve access, resources, and supports for healthy behaviours [5,6]. There are increasing international calls to action that advocate for increased support for HPS [7]. This support may be undermined by persisting challenges that obstruct uptake of HPS across multiple levels [8,9,10,11,12]. A recent review identified factors facilitating a HPS approach at a school-level [13], there is limited synthesized knowledge on the broader elements that facilitate a HPS approach at a school system-level

Methods

Results

Discussion

Conclusion