An article in the special September 2016 issue of the Journal for Education for Sustainable Development (ESD) discusses the characteristics of local supporting municipal/school district infrastructure to support school-baszed and school-linked health promotion and sustainable development. "The article aims to explore the following question: ‘How is education for sustainable development and health education in schools approached and contextualized at a municipal level, and what contradictions and tensions might local structures imply for sustainable health promoting school development?’ Based on interviews with key agents at the municipal level in Denmark and drawing on a knowledge exchange network, the article identifies and discusses the following three themes across education for sustainable development and health education: (i) autonomy, engagement and ownership; (ii) open frameworks and invitations to ‘run with the ball’; and (iii) ad hoc professional development. A main conclusion in the article is that local approaches are largely based on plurality and voluntarism, and are formed around enthusiasts. There is a risk that this framework becomes so flexible that it ‘falls apart’ in the balance between rigidity and flexibility. " This finding is typical of the approach often used at the school level, where initial and on-going efforts are almost always dependent on finding and keeping a local "champion" (who usually burns out, move on or gets promoted to another position without any clear plan for succession. Read more>> (This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN)
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An article in Issue #4, 2015 of Journal of School Violence reports on teacher ability and willingness to implement the many different components of the Olweus Bullying Prevention Program . As with many other such multi-component approaches and programs, the evaluation shows that "among 2,022 teachers, 88.5% female, from 88 elementary schools located in Pennsylvania, results indicated that the majority of respondents had attended the school kick-off event, posted the rules in the classroom, and explained the rules to students. Receiving booster sessions and activities involving parental involvement were the least likely elements to have been performed. Logistic regression analyses revealed that teachers with confidence in their ability to implement the OBPP had completed all of the OBPP programmatic activities. Similarly, multiple regression analysis results revealed that teachers with self-efficacy to implement the OBPP implemented more components than respondents without self-efficacy. In addition, teachers with more OBPP experience were more likely to have completed individual-level activities. Our findings reveal that certain OBPP components are easier to perform than others and that implementer characteristics matter." This study examined the eight activities within the program that teachers are expected to implement. We would expect the same or even more challenges in implementing and especially maintaining the community, school and other components. Read more>> (An item from the ISHN Member information service)
(An item from the ISHN Member information service) The implementation, scaling up, maintenance and sustainability of individual programs as well as multi-intervention approaches such as comprehensive school health promotion requires new frameworks and better ways to understand the complex interactions at multiple levels in several systems. An article in Issue #5, 2015 of Prevention Science helps us toward that goal, as it describes the implementation and sustainability of a Social-Emotional Learning program in four schools in Wales. "his paper draws upon Rogers (2003) Diffusion of Innovations Theory to explain the adoption, implementation and discontinuance of a SEL intervention. A pragmatic, formative process evaluation was conducted in alignment with phase 1 of the UK Medical Research Council’s framework for Developing and Evaluating Complex Interventions. Employing case-study methodology, qualitative data were generated with four socio-economically and academically contrasting secondary schools in Wales implementing the Student Assistance Programme. Semi-structured interviews were conducted with 15 programme stakeholders. Data suggested that variation in implementation activity could be largely attributed to four key intervention reinvention points, which contributed to the transformation of the programme as it interacted with contextual features and individual needs. These reinvention points comprise the following: intervention training, which captures the process through which adopters acquire knowledge about a programme and delivery expertise; intervention assessment, which reflects adopters’ evaluation of an intervention in relation to contextual needs; intervention clarification, which comprises the cascading of knowledge through an organisation in order to secure support in delivery; and intervention responsibility, which refers to the process of assigning accountability for sustainable delivery." Read more>>
(An item from the ISHN Member information service) Public health nutritionists were asked to describe the elements of system and organizational capacity in an article in Issue #10, 2015 of Public Health Nutrition. " A Delphi study involving three iterations of email-delivered questionnaires testing a range of capacity determinants derived from the literature. Consensus was set at >50 % of panellists ranking items as ‘very important’ on a five-point Likert scale across three survey rounds. A total of thirty expert panellists (68 % of an initial panel of forty-four participants) completed all three rounds of Delphi questionnaires. Consensus identified determinants of capacity building in practice including partnerships, resourcing, community development, leadership, workforce development, intelligence and quality of project management." Note: This article reflects the definition of capacity and capacity building developed and used by ISHN as part of its Wikipedia style web site. Read more>>
(An item from the ISHN Member information service) An analysis of coordination the Dutch Healthy School Approach (HSA) is reported in the July 2015 Issue of BMC Public Health. "HSA targets demand-driven practices based on the epidemiological data, a prioritization of needs, an assessment of important/modifiable determinants, the drafting and implementation of a multi-year plan, and its evaluation. All this is done jointly with multiple stakeholders. At school level, implementation is assisted by a ‘HPS advisor’, who represents various public services and providers in individual contacts with schools. At local and regional levels, the public health services (PHSs) function as a coordinator between the education, health and other services stakeholders. Their coordinating role derives from a legal responsibility for the implementation of local public health policy and youth health care financed by the municipality". The study "reports on the longitudinal quantitative and qualitative data resulting from a two-year trajectory (2008–2011) based on the DIagnosis of Sustainable Collaboration (DISC) model. This trajectory aimed to support regional coordinators of comprehensive school health promotion (CSHP) in systematically developing change management and project management to establish intersectoral collaboration. Multilevel analyses of quantitative data on the determinants of collaborations according to the DISC model were done, with 90 respondents (response 57 %) at pretest and 69 respondents (52 %) at posttest. Quantitative data showed major improvements in change management and project management. There were also improvements in consensus development, commitment formation, formalization of the CSHP, and alignment of policies, although organizational problems within the collaboration increased. Content analyses of qualitative data identified five main management styles. Read more>>
(An item from the ISHN Member information service) An education ministry funded evaluation of the effectiveness of the Taiwan Health Promoting Schools Network, the mechanism used to implement school health in that country since 2001 was summarized in the July 2015 issue of the Journal of School Health. The survey of 800 randomly selected schools found that "Respondents were most satisfied with consultants and schools' recognition of responsibilities and rules and their interactions with HPSSN administrators. They were least satisfied with the extent of their HPSSN consultant interaction and believed HPSSN provided insufficient resources to establish HPS. Respondents' consultant partnerships and satisfaction with HPSSN administration significantly predicted HPS implementation. Additionally, the predictive values of healthy policies and school-community relationships were greater than the other 6 HPS components." In other words, capacity and relationships were critical. Read more>>
(An item from the ISHN Member information service) A special issue (Issue 2-3, 2015) of Journal of Educational and Psychological Consultation examines the use of school psychologists as systems-level consultants as a strategy to deal with the complexities of the multi-level changes required to introduce and sustain comprehensive approaches to school mental health promotion. An interdisciplinary perspective is used to select the articles which cover topics such as Interdisciplinary Collaboration Supporting Social-Emotional Learning, Ecologically Based Organizational Consultations, the Competencies for Systems-Level Consultants, Multi-Tiered Systems of Support, Collaboration Between School Psychologists and Administrators and Critical Features and Lessons Learned for Implementation. Read more>> Readers may also be interested in a similar ISHN description of a systems-based approach to SMH that is based on capacity and capacity-building at this web page.
(An item from the ISHN Member information service) An article in Volume 36 of the Annual Review of Public Health describes some of the lessons we have collectively learned about complex interventions to improve health, especiually the ways that complex systems thinking is being used in clinical settings. "Complexity—resulting from interactions among many component parts—is a property of both the intervention and the context (or system) into which it is placed. Complexity increases the unpredictability of effects. Complexity invites new approaches to logic modeling, definitions of integrity and means of standardization, and evaluation. New metaphors and terminology are needed to capture the recognition that knowledge generation comes from the hands of practitioners/ implementers as much as it comes from those usually playing the role of intervention researcher. Failure to acknowledge this may blind us to the very mechanisms we seek to understand. Researchers in clinical settings are documenting health improvement gains made as a consequence of complex systems thinking. Improvement science in clinical settings has much to offer researchers in population health." This succinct summary, presented in the abstract, captures many of the lessons that need to be applied. Since ISHN sponsors a Wikipedia style web site that uses the slogan "where (research) evidence meets (professional) experience, and since many of the summaries in that web site attempt to explain these new ideas based on ecological, systems-based thinking, we highly recommend this article. Read more>>
(An item from the ISHN Member information service) ISHN facilitated an international project in 2010-12 on capacity and implementation issues in school mental health (SMH) promotion. One of the activities was to start the development of a capacity-based systems model that focused on ministry, agency, school and professional capacities. An article in Issue #2, 2015 of Health Promotion Practice describes a similar effort. The researchers examined statewide capacity for SMH using a post hoc application of a district capacity-building framework to interpret findings from a statewide coordinated school health needs/resource assessment. "Participants included school personnel (N = 643) from one state. Descriptive statistics were calculated for survey items, with further examination of subgroup differences among school administrators and nurses. Findings across districts revealed statewide strengths and gaps with regard to leadership and management capacities, internal and external supports, and an indicator of global capacity. Findings support the utility of using a common framework across local and state levels to align efforts and embed capacity-building activities within a data-driven, continuous improvement model." Read more>>
(From the ISHN Member information service) ISHN has started two international discussion groups focused on new approaches to school health promotion and development. (www.schools-for-all.org - Select Discussion Groups) Our Implementation/Capacity group has included the concepts of senior leadership and shared vision as part of the capacities need to implement and sustain comprehensive SH approaches. The Integration within Education group has started a global dialogue with global educator organizations to emphasize that health programs need to work within the core mandates, constraints and concerns of school systems. It is heartening to see research that confirms such topics that are included in the knowledge development agendas of these two ISHN initiatives. An article in Issue #2, 2015 of Health Education Journal reports on a small study in Nova Scotia that examined the variance of implementation in nine schools. "The results revealed that schools assembled into three sequential categories based on the functioning of theoretical components. Higher level visioning and school-level leadership were critical in sustaining the adoption and implementation of HPS across schools and appeared to enable and integrate organisational processes, such as distributed leadership and a collaborative school culture, to enhance HPS implementation at school level. This study confirmed other reports that it is imperative to integrate HPS work with educational values so as to enable partnerships in both the health and education sectors, thereby promoting both health and prosperity among students." Read more>>
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