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

Implementation Science

R. Anderson¹  HB Woods²  T. Ford¹  C. Abraham¹  K. Wyatt¹  R. Chilton¹  M. Pearson¹ 

[1] Institute of Health Research, University of Exeter Medical School, St Luke’s Campus, Exeter EX1 2LU, UK;School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK

关键词: Public health;    Realist review;    Evaluation;    Implementation;    Health promotion in schools;   

Others  :  1230932
DOI  :  10.1186/s13012-015-0338-6

 received in 2015-04-30, accepted in 2015-10-14,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Pearson et al.

【 图 表 】

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