The picture of health: examining school-based health environments through photographs

Abstract

Health-promoting schools (HPS) is an effective approach to enhance the health and well-being of children and youth, but its measurement remains a challenge considering contextual differences across school environments. The purpose of this study was to qualitatively explore the physical features of the school environment through photographs of schools that had implemented an HPS approach compared with schools that had not. This study used a descriptive approach, wherein physical features of the school environment were distilled through visual images and qualitatively analyzed. School environment data were collected from 18 elementary schools (10 HPS, 8 comparison schools) from a school board in rural Nova Scotia (Canada). Evaluation assistants captured photographs of the physical school environment as part of a broader environment audit. Overarching themes included the promotion, access and availability of opportunities for healthy eating and physical activity, healthy school climate and safety and accessibility of the school. The photographs characterized diverse aspects of the school environment and revealed differences between schools that had implemented an HPS approach compared with schools that had not. There were increased visual cues to support healthy eating, physical activity and mental well-being, and indications of a holistic approach to health among schools that implemented an HPS approach. This research adds to understanding the environmental elements of HPS. The use of photographic data to understand school environments provided an innovative method to explore the physical features of schools that had implemented an HPS approach.

Studies evaluating of health interventions at schools: an integrative literature review

“…This last characteristic corroborates with a research carried out in Canada, which refers to the presence of objects and food to encouraging the promotion of healthy eating and physical activities 142 .…”

Critical race theory–social constructivist bricolage: A health-promoting schools research methodology

“…Hence, to study HPS is necessarily to interrogate underlying issues of power and social justice. While the current literature (Kontak et al, 2016;Renwick, 2014;Rosas, 2015) recognises the capacity of diverse methodologies to provide useful understandings of HPS, there is a paucity of examples to show how this research strategy can be used. We address this knowledge gap by examining the significance of a CRT-social constructivist bricolage or hybrid.…”

A translational approach to characterization and measurement of health-promoting school ethos

“…The analysis of these photos provided the means to introduce complex contextual variation within and between schools that may not have been as robustly captured through surveys or auditor checklists (Iwamoto et al, 2004), contributing to enriching qualitative concepts including aesthetics, resources and safe surroundings. This can support detecting subtle differences between HPS and non-HPS school environments or practices that may otherwise go undetected (Kontak et al, 2017). The use of these methods may also create challenges for the on-going validation of measurement tools using traditional methods, and more work to determine the impact of measuring and assessing context is needed.…”