Fidelity, Adaptation and Integration of Whole-school Health Promotion Within Dutch Schools: a Cross-sectional Survey Study

Overview

Journal Health Promot Int

Publisher Oxford University Press

Specialty Public Health

Date 2023 Dec 21

PMID 38124497

Authors

Gerjanne Vennegoor

Patricia van Assema

Gerard R M Molleman

Pepijn van Empelen

Joyce Dieleman

Maria W J Jansen

Affiliations

Soon will be listed here.

Abstract

Implementing comprehensive health promotion programs in the school setting can be challenging, as schools can be considered complex adaptive systems. As a first step towards understanding what works in improving implementation for which schools and under which conditions, this study aimed to examine the degree of implementation of health promoting school (HPS) programs, in terms of five dimensions of fidelity (adherence, dose, participant responsiveness, quality of delivery and program differentiation), and the dimensions of adaptation and integration. The HPS Implementation Questionnaire was distributed among ± 2400 primary, secondary, secondary vocational and special needs schools in the Netherlands. Employees of 535 schools (22.3%) filled out the questionnaire. Data were analysed by descriptive statistics and ANOVA tests. The average degree of implementation was 2.55 (SD = 0.58, range = 0.68-3.90; scaled 0-4). The lowest scores were achieved for participant responsiveness and adherence, and the highest for integration and adaptation. Schools that identified as HPS reported significantly higher overall degree of implementation, adherence, dose, participant responsiveness, program differentiation and adaptation than schools that didn't. Primary schools achieved a significantly higher degree of implementation, dose, participant responsiveness, quality of delivery and integration than other school types. In conclusion, many schools work on student health and well-being to some extent, but the vast majority have much room for improvement. Higher implementation scores for schools that identified as HPS underline the value of HPS programs. A broader perspective on health and more insight into conditions for effectiveness and implementation in secondary and secondary vocational schools are needed.

Citing Articles

The Role of School Health Promotion in Students' Dietary Intake during School Hours: A Qualitative Comparative Analysis.

Vonk L, van Empelen P, Huijts T, Eekhout I, Jansen M Nutrients. 2024; 16(13).

PMID: 38999729 PMC: 11243015. DOI: 10.3390/nu16131981.

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