Policy content and context for health promotion in Swedish schools. An analysis of municipal school plans

Abstract

In international literature policy documents are considered as major strategic tools for health promotion in schools. In Sweden, since 1991, local municipalities are obliged to produce a politically approved school plan for compulsory schools, grades 1–9, i.e. policy instruments which should indicate the aims and objectives, the moral and political values of the municipality. The aim of this study was to describe the content of school plans, focusing on health and environment in 1994 in 62 municipalities in four counties in Sweden, using content analysis. The study was implemented as a total investigation of the 62 municipalities based on the principles of purposeful sampling procedures in order to provide selections of informative cases for in-depth studies. The content analysis was conducted in four steps. Twelve themes were identified in the school plans, representing different issues on health and environment in the first step. Secondly, quotations illustrate and provide a broader meaning of themes. Third, similarities and differences between the counties and municipalities are summarized. Finally, the strategic components of the HELPSAM model (The HEaLth Promotion Strategy Analysis Model) are presented in relation to the 12 themes. As policy documents the school plans seem to be valid instruments to promote the intentions of the municipality concerning health promotion. A supportive environment for health relates to the physical and social aspects of our surroundings, and these aspects are prominent as themes of the school plans. The major part of the municipalities has focused on environmental issues, well in advance of the desired development of a local Agenda 21. The finding points out a rapid diffusion of environmental questions in the Swedish society, at least in the counties of concern. Policy content and context for health promotion in Swedish schools. An analysis of municipal school plans