Correlates of perceived success of health-promoting interventions in elementary schools

Abstract

Introduction School-based health-promoting interventions (HPIs) aim to support youth development and positively influence modifiable lifestyle behaviours. Identifying factors that contribute to or hinder the perceived success of HPIs could facilitate their adaptation, improve implementation and contribute to HPI sustainability. The objective of this study was to identify factors in three domains (school characteristics, characteristics of the HPI and factors related to planning and implementing the HPI) associated with perceived success of HPIs among school principals in elementary schools. Methods Data were drawn from Project PromeSS, a cross-sectional survey of school principals and/or nominated staff members in a convenience sample of 171 public elementary schools in Quebec, Canada. School board and school recruitment spanned three academic school years (2016–2019). Data on school and participant characteristics, HPI characteristics, variables related to HPI planning and implementation and perceived success of the HPI were collected in two-part, structured telephone interviews. Descriptive statistics were used to characterize schools and study participants. Twenty-eight potential correlates of perceived HPI success were investigated separately in multivariable linear regression modelling. Results Participants generally perceived HPIs as highly successful. After controlling for number of students, language of instruction, school neighbourhood and school deprivation, we identified five correlates of perceived success, including lower teacher turnover, higher scores for school physical environment, school/teacher commitment to student health, principal leadership and school being a developer (vs. adopter) of the HPI. Conclusion If replicated, these factors should be considered by HPI developers and school personnel when planning and implementing HPIs in elementary schools.

Health‐Promoting School Culture: How Do We Measure it and Does it Vary by School Neighborhood Deprivation?*

“…We noted that school physical environment and ease of principal leadership, which have been associated with health promotion effectiveness in other studies, 36,46,47 did not vary by school deprivation in PromeSS. If confirmed, this has positive implications for school health promotion across schools.…”

“…There was, however, a gradient by social deprivation in this scale. Although not detectable at the 0.05 level, this finding could be important given that other studies have identified staff commitment and school prioritization of health as key factors for health promotion effectiveness 36,46,47 . Factors that might explain why commitment is lower in more deprived schools include staff facing urgent social and educational needs which take precedence over health needs, and staff having lower confidence that any intervention will make a difference for students.…”

“…If the internal reliability of these measures is replicated, we suggest that they can be integrated into school health promotion research (e.g., to assess whether school culture relates to intervention effectiveness, to identify whether factors such as social inequality relate to school culture, to assess changes in school culture after implementation of interventions). In other studies using the same PromeSS dataset, our measures were associated with success of health‐promoting interventions as perceived by school informants 36 as well as with institutionalization of health‐promoting interventions 37 …”

“…Although not detectable at the 0.05 level, this finding could be important given that other studies have identified staff commitment and school prioritization of health as key factors for health promotion effectiveness. 36,46,47 Factors that might explain why commitment is lower in more deprived schools include staff facing urgent social and educational needs which take precedence over health needs, and staff having lower confidence that any intervention will make a difference for students. In a qualitative study of principals and school health coordinators in elementary schools, although staff held strong beliefs in the synergistic importance of health and learning, many felt that the pressure on schools to deliver health promotion was a challenge, particularly in deprived neighborhoods.…”

School- and intervention-related factors associated with institutionalization of health promotion interventions in elementary schools

“…Data collection procedures are detailed elsewhere. 13 , 16 Briefly, data were collected in a two-part, structured telephone interview (median length = 52 min) administered by trained interviewers in French or English. School principals were solicited; if they had not worked in their current school at least six months or were unavailable, they were asked to nominate another key informant (i.e.…”