A randomised trial of an intervention to develop health promoting schools in Australia: the south western Sydney study

Abstract

OBJECTIVE: This paper describes the evaluation of a health promoting schools intervention carried out in the south western region of Sydney, Australia. The evaluation sought to assess the project's impact on structures to support the health promoting school concept and changes in health–related policies and practices within 22 local schools. METHODS: A randomised controlled study was employed. Intervention schools were offered seminars and training in the health promoting schools concept, encouraged to use a resource kit to help them establish their school as health promoting and invited to participate in a support network. Pre– and post measures of awareness, school structures and policies and practices to support the development of a health promoting school were taken and intervention and control schools compared. RESULTS: There was an increased level of awareness of the health promoting school concept among intervention schools. However, there were no significant changes in health–related policies and practices at the school level, among both intervention and control schools. CONCLUSIONS: A longer time frame and more structured support are required to influence school structures to support the development of a health promoting school. IMPLICATIONS: To facilitate organisational change in schools, health promoting school interventions need to provide structured support for schools and recognise that change takes time. A committee to initiate action, a plan to guide work and school support are likely to facilitate the adoption of the health promoting schools approach. Further work to refine the measurement of school–based action and its outcome and the development of indicators for a health promoting school is needed.

A journey into school health promotion: district implementation of the health promoting schools approach

“…It is important to have both 'top-down' and 'bottom-up'. The need for stakeholder involvement also emerged numerous times throughout the case study and in the literature (Mitchell et al, 2000;Mukoma and Flisher, 2004;Franks et al, 2007). The momentum created by such a synergy of partners allows change not only to happen, but also to be properly supported and embedded.…”

“…The HPS approach has endured for over 15 years, and a number of recent related articles have examined issues of efficacy, evaluation and implementation (St. Leger, 1999;Mitchell et al, 2000;Deschesnes et al, 2003;Mukoma and Flisher, 2004;Stewart-Brown, 2006;Franks et al, 2007). Through meta-analysis, research and evaluation, much has been learned about the broad strokes required to be successful: the importance of an extended timeframe for effective change (Mitchell et al, 2000;Mukoma and Flisher, 2004;Stewart-Brown, 2006), the need for political and financial support (Deschesnes et al, 2003), the involvement of critical partners (Mitchell et al, 2000), and the multifactorial nature of effective HPS (St. Leger, 1999;Stewart-Brown, 2006), to name a few.…”

“…Through meta-analysis, research and evaluation, much has been learned about the broad strokes required to be successful: the importance of an extended timeframe for effective change (Mitchell et al, 2000;Mukoma and Flisher, 2004;Stewart-Brown, 2006), the need for political and financial support (Deschesnes et al, 2003), the involvement of critical partners (Mitchell et al, 2000), and the multifactorial nature of effective HPS (St. Leger, 1999;Stewart-Brown, 2006), to name a few. What appears to be lacking are details of local implementation design and practice.…”

“…Stewart-Brown acknowledged that despite the depth of her meta-analysis for the WHO, there was a failure to answer critical questions related to how particular initiatives worked and what might increase local efficacy. It is generally agreed that further research that utilizes multiple methodologies is necessary for the ongoing development of implementation design, evaluation and effectiveness of the HPS approach (St. Leger, 1999;Mitchell et al, 2000;Deschesnes et al, 2003;Mukoma and Flisher, 2004;Inchley et al, 2006;Stewart-Brown, 2006).…”

A Systematic Review of School-Based Interventions to Prevent Bullying

“…Ten studies 22,25,28,[37][38][39][40][41][42][43] evaluated interventions using a multidisciplinary whole-school approach that included some combination of schoolwide rules and sanctions, teacher training, classroom curriculum, conflict resolution training, and individual counseling. Table 1 describes the components of each of these multidisciplinary studies in detail.…”