Open letters about health dialogues reveal school staff and students' expectations of school health promotion leadership

Abstract

PurposeThis study explores to what extent health promotion policy in practice and leadership engagement is reflected in school actors' experiences of health dialogues (HDs) and their ideas about promoting health and learning in schools.Design/methodology/approachThe 93 participants consisted of 44 school nurses, 37 students in grades 4, 7 or the first year of high school and 12 teachers, who shared their experiences with HDs by writing open letters.FindingsThe qualitative content analysis resulted in four themes: Putting health on the agenda, Finding a common goal, Walking side by side and Pointing out a healthy direction. The participants' expectations of school health promotion leadership are revealed in suggestions on how the HDs can fulfill both the educational assignment and promote student health.Practical implicationsBased on the findings, we argue that for successful school health promotion leaders need to acknowledge the field of tension where leadership has to take place, anchor health promotion policy and administer “a Sandwich approach” – a top-down and bottom-up leadership simultaneously that facilitates school-based health promotion.Originality/valueWhen different school actors (school nurses, teachers and students) are given a voice, a collective picture of HDs can emerge and help develop health promotion practices.

School leadership that supports health promotion in schools: A systematic literature review

“…Several studies have pointed out how collaborative approaches, particularly those working with teachers via a bottom-up rather than top-down process or the use of a combined top-down and bottom-up leadership approach, are important in facilitating school-based health promotion (Cassar et al, 2020; Kostenius and Lundqvist, 2021; Rainer et al, 2012). Other studies have highlighted how shared or distributed leadership is a way to improve the quality and comprehensiveness of health services for students (DeMatthews and Brown, 2019) and enable teachers to take ownership of school health (Roberts et al, 2016).…”

“…These findings highlight the rapidly growing knowledge base in relation to the issue. The steep increase since 2017 may be linked to the growing awareness that school principals are key actors in health-promoting activities as part of their wider responsibility for education (DeMatthews and Brown, 2019; Kostenius and Lundqvist, 2021; Skott, 2021). Our review of the literature revealed that there is no generally accepted framework for leadership and health promotion in schools.…”

“…Several studies have shown that school health promotion has the greatest effect when it is engendered by good-quality school leadership and strong staff support (Dadaczynski et al, 2020b, 2020c; Dimitropoulos et al, 2019; Samdal and Rowling, 2011; Warren et al, 2019). School principals hold the key to embedding health and wellbeing throughout the whole school and creating a healthy school (Bush, 2022; DeMatthews and Brown, 2019; Kostenius and Lundqvist, 2021; Skott, 2021). Nevertheless, efforts to systematically review the effects of school leadership on school health promotion are still lacking.…”