Canadian Council on Learning | Conseil Canadien sur l'Apprentissage

The Health Promoting School: Developing Indicators and an Evaluation Framework

By Hana Saab, Don Klinger and Lyn Shulha
Queen’s University

Background

The Health Promoting School (HPS) has been proposed as a model that advances both the health and learning needs of students. The model recognizes health as a multidimensional construct that is the product of interconnected and interacting physical, social and psychological factors such as emotional health and subjective well-being.

Goal

The goal of this study was to establish indicators of student health and well-being associated with policies and practices in schools, and to further the understanding of health promoting schools by employing quantitative and qualitative methodologies.

Methodology

The quantitative data analyzed for this study are from the Health Behaviour in School-aged Children study (HBSC) conducted in Canada in 2006. The HBSC is an inter-disciplinary, cross-national collaboration that examines the relationship between adolescent health and a wide range of determinants. HBSC collects data every four years from three representative age groups of children: age 11 – the onset of adolescence; age 13 – the challenge of physical and emotional changes; and age 15 – the period life and career decisions are beginning to be made. The survey is distributed to a random selection of schools across Canada (similar procedures are used in the other 41 countries). Principals or vice-principals at the participating schools also complete a short survey addressing issues related to school size and composition, school disciplinary practices, school policies, and teacher morale, satisfaction and relations with the community.

Description

This study proceeds of in three phases. Phases one and two consist of quantitative analyses of the 2006 HBSC data set:

• The first phase established the significance of student health to academic achievement and is presented in a document titled: Relationship between health and achievement: Evidence from the Health Behaviour in School-aged Children Study.

• The second phase examined the relationship between student-level factors, and school-level factors that could reflect elements of a HPS and a set of student indicators that suggest general health and well-being and is presented in a document titled: Student health and wellbeing: An examination of student and school factors.

• The third phase involved qualitative examinations of two schools in Ontario to “zoom in” on the organizational and structural elements within these schools that appear to be essential for achieving a HPS, and the mechanisms by which these elements intervene to support student health and well-being outcomes. These schools were chosen for study because of their specific initiatives to address issues of students’ health and wellbeing. Both schools have been formally recognised as exemplifying healthy active living schools (health promoting schools) by their respective boards and the Ministry of Education. Analysis of the qualitative data is presented in a document titled: The Health Promoting School: Two case studies in Ontario.

Key findings

The study identified variations across schools in the health and well-being of students and was able to reveal factors within schools that were associated with these differences. These factors, while by no means comprehensive, strengthen the need for health-promoting strategies to address not only the structural and organizational factors within schools, but also school variations that can be attributed to the school's neighbourhood.

The case studies confirm the significance of strengthening the school organizational capacity and improving the school culture as a means of promoting the health and well-being of students. The inclusion of the collective perspectives of administrators, students, teachers and health professionals involved in school health initiatives has established a deeper understanding of a health promoting school and identified the supports and challenges experienced by two school boards and schools in the process of becoming health promoting schools.

Key action areas

This document emphasises five key action areas that need to be addressed when implementing HPS initiatives and enhancing the capability of the education system to improve the health of students by:

1. Incorporating HPS initiatives into school improvement plans at the policy level;
2. Aligning and coordinating the HPS strategy with other ministry of education strategies;
3. Establishing well-defined health-education partnerships to achieve a synergy in the implementation of HPS initiatives;
4. Setting up central support mechanisms with the goal of building capacities within communities to support change and establish leadership; and
5. Allocating fiscal and human resources and coordinating funding streams by the health and education sectors to support a long-term HPS strategy.