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Implementing health promotion programmes in schools: A realist systematic review of research and experience in the United Kingdom

Pearson, M.; Chilton, R.; Wyatt, K.; Abraham, C.; Ford, T.; Woods, HB; Anderson, R.

Authors

R. Chilton

K. Wyatt

C. Abraham

T. Ford

HB Woods

R. Anderson



Abstract

Background
Schools have long been viewed as a good setting in which to encourage healthy lifestyles amongst children, and schools in many countries aspire to more comprehensive, integrated approaches to health promotion. Recent reviews have identified evidence of the effects of school health promotion on children’s and young people’s health. However, understanding of how such programmes can be implemented in schools is more limited.

Methods
We conducted a realist review to identify the conditions and actions which lead to the successful implementation of health promotion programmes in schools. We used the international literature to develop programme theories which were then tested using evaluations of school health promotion programmes conducted in the United Kingdom (UK). Iterative searching and screening was conducted to identify sources and clear criteria applied for appraisal of included sources. A review advisory group comprising educational and public health practitioners, commissioners, and academics was established at the outset.

Results
In consultation with the review advisory group, we developed four programme theories (preparing for implementation, initial implementation, embedding into routine practice, adaptation and evolution); these were then refined using the UK evaluations in the review. This enabled us to identify transferable mechanisms and enabling and constraining contexts and investigate how the operation of mechanisms differed in different contexts. We also identified steps that should be taken at a senior level in relation to preparing for implementation (which revolved around negotiation about programme delivery) and initial implementation (which centred on facilitation, support, and reciprocity—the latter for both programme deliverers and pupils). However, the depth and rigour of evidence concerning embedding into routine practice and adaptation and evolution was limited.

Conclusions
Our findings provide guidance for the design, implementation, and evaluation of health promotion in schools and identify the areas where further research is needed.

Journal Article Type Review
Publication Date Oct 28, 2015
Journal Implementation Science
Electronic ISSN 1748-5908
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 10
Issue 1
Article Number 149
APA6 Citation Pearson, M., Chilton, R., Wyatt, K., Abraham, C., Ford, T., Woods, H., & Anderson, R. (2015). Implementing health promotion programmes in schools: A realist systematic review of research and experience in the United Kingdom. Implementation Science, 10(1), doi:10.1186/s13012-015-0338-6
DOI https://doi.org/10.1186/s13012-015-0338-6
Keywords Health promotion in schools; Implementation; Evaluation; Realist review; Public health
Publisher URL https://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0338-6
Copyright Statement © Pearson et al. 2015

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Copyright Statement
© Pearson et al. 2015

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.





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