Systems thinking and complexity: considerations for health promoting schools

Abstract

The health promoting schools concept reflects a comprehensive and integrated philosophy to improving student and personnel health and well-being. Conceptualized as a configuration of interacting, interdependent parts connected through a web of relationships that form a whole greater than the sum of its parts, school health promotion initiatives often target several levels (e.g. individual, professional, procedural and policy) simultaneously. Health promoting initiatives, such as those operationalized under the whole school approach, include several interconnected components that are coordinated to improve health outcomes in complex settings. These complex systems interventions are embedded in intricate arrangements of physical, biological, ecological, social, political and organizational relationships. Systems thinking and characteristics of complex adaptive systems are introduced in this article to provide a perspective that emphasizes the patterns of inter-relationships associated with the nonlinear, dynamic and adaptive nature of complex hierarchical systems. Four systems thinking areas: knowledge, networks, models and organizing are explored as a means to further manage the complex nature of the development and sustainability of health promoting schools. Applying systems thinking and insights about complex adaptive systems can illuminate how to address challenges found in settings with both complicated (i.e. multi-level and multisite) and complex aspects (i.e. synergistic processes and emergent outcomes).

The influence of contextual factors on implementation fidelity in a whole school approach to prevention of violence against women

“…Thus, in considering how to replicate RREiS, in some local contexts, it might be the connections between community groups and agencies and schools that can be used for leverage, for other areas, it might be the department, and for other areas, there may be other institutions that can help broker that introduction. Replicating RREiS effectively would thus require an understanding of local contexts and consideration of adaptations to content and process to suit these local contexts which network analysis could illuminate . This implementation science analysis also reveals that programs could be adapted to suit the characteristics of those leading the initiative, in this case the PILs.…”

“…What has not been investigated is whether the concept of implementation fidelity can be equally applied to policy implementation and curriculum implementation. The challenge of quantifying implementation fidelity in terms of adherence to certain policies and strategies is restrictive given the complex and dynamic nature of schools . It is also unclear from this research the degree to which schools can implement policy audit programs in full and how this relates to health outcomes of students .…”

Professional qualification in the School Health Program from the perspective of Complexity Theory

“…Its effects can be observed by optimizing the health, educational and social characteristics. 1 This perspective was initially proposed by the World Health Organization in the 1980s and 1990s from the launch of the Health Promoting Schools Initiative. 2 Several nations have been influenced and currently carry out interventions with different themes in the school environment, such as physical activity and healthy eating, prevention of drug use and attention to chronic and infectious diseases.…”

How can care settings for people with intellectual disabilities embed health promotion?

“…An health promotion approach in which system thinking is adopted is the healthy settings approach, an integrated approach aimed at creating continuous attention on health promotion in the living environment (Rosas, 2015). The approach is underpinned by socio-ecological theory and organizational change theory (McLeroy, Bibeau, Steckler, & Glanz, 1988;Mittelmark et al, 2017).…”