Over many years, the scientific literature describing effective approaches to improving children’s health and wellbeing in a school setting has demonstrated the need for strategies to move beyond simply teaching children about health in the classroom to a more holistic whole-school approach.

The World Health Organisation (WHO)7 solidified this groundswell of thinking into what is known today as the Health Promoting Schools Model. WHO define a Health Promoting School as one which “constantly strengthens its capacity as a healthy setting for living, learning and working”7.

A Health Promoting School, therefore, considers its entire school context and aligns its policies and practices with the health information taught to children in the classroom. For example, a Health Promoting School would teach children about the need to protect their skin from the sun and support this by introducing policies such as a ‘No Hat, No Play’ policy; review the school’s uniform to ensure it provides adequate sun protection; provide more shaded play areas and communicate the school’s approach to parents.

The Health Promoting Schools Model has been used to guide the implementation of an array of health issues, with mental health and wellbeing approaches demonstrating great success. It is the cornerstone approach of evidence-based mental health programs used by schools across Australia including the Mind Matters/Kids Matters programs and the School Drug Education and Road Aware program in Western Australia.

While the Health Promoting Schools Model is an excellent planning source for schools wishing to address a health problem, the way in which schools implement the whole-school approach has long been disregarded. Recently the WA School Health Promoting Schools Association8 recommended schools follow the steps below when considering a whole-school approach.

• Raise the issue;
• Advocate, create a need for comprehensive health education;
• Talk to interested staff and parents to gain their support;
• Gain the full support and commitment of the Principal and senior management team;
• Have a health committee and nominated focus areas identified on the school development plan;
• Nominate a health committee coordinator;
• Form a health committee to help raise the profile and to enlist help and support. The committee should include teachers, non-teaching staff, students, parents and community members;
• Conduct an audit of current health promoting actions. What is the school currently doing regarding healthy school policies, the school’s physical environment, the school’s social environment, individual health skills, community links and health services? The purpose of the audit is to determine what your school is currently doing well and if there are any gaps or areas of development that need to be addressed in the area you have identified as a need;
• Share the results of the audit with the school community to determine what gaps need to be addressed;
• Plan outcomes and actions. Consider what outcomes you wish to achieve;
• Establish agreed goals and strategies to achieve them;
• Implement change;
• Monitor the progress of the changes;
• Review; and
• Report on outcomes achieved and celebrate milestones.8

More rigorous debate relating to the science of ‘implementation’ has grown in the literature and has taken our understanding of a whole-school approach to a deeper level. While the Health Promoting Schools Model is important for defining the components of a school that should be addressed in a whole-school program, the process by which we implement an intervention is equally important. Fixsen and colleagues10 pioneered this approach through their succinct summary of the literature relating to implementation failure, culminating in some of the first scientific recommendations for how interventions are implemented successfully. Figure 2 below is a summary of Fixsen’s10 core implementation components essential for the successful implementation of any intervention.

In this model, Fixsen10 suggests that a program should consider the successful implementation components of selecting the right staff; training these staff; consulting and coaching the staff; evaluating staff confidence with the program; evaluating the program; and ensuring there are sufficient facilitative administrative supports such as leadership support.

Should you wish to read more, or see the full report from Dr Stacey Walter Please visit section 7 from the menu.