Background
Issues raised by evaluation in the field of health promotion
Evaluation approaches in the field of health promotion
The realistic evaluation framework
Mixed methods designs
Methods/Design
Research questions
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What are the mechanisms and contextual factors that allow the school community to develop an HP approach?
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How do the strategies developed through the program influence the development of teachers' HP practices and the schools' health promoting environment? How do these practices affect well-being in the schools? What is the influence of the program on the children's perceived life skills?
The health promotion program
Objectives of the program
| - to promote children's social, emotional and physical health by contributing to children's well-being at school [44, 45] and enhancing their life skills [28, 36]; - to develop relevant HP teaching practices and the health promoting environment in schools, - to develop sustainable HP projects in schools by the empowerment of local stakeholders. |
Theoretical background
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- taking into account the development of the children, | |
- linking health to educational issues as well as integrating them into ongoing school activities, | |
- communication with parents and communities, | |
- training and support of school professionals and accessibility of resources and other methodological tools. | |
It also takes into account the special features of the French system. The program is a combination of top-down and bottom-up approaches and therefore the characteristics of the actions implemented in each school may vary [47]. | |
Implementation
| The program is being implemented in 115 schools in 6 French regions. The program started in 2008 and will continue until 2011. In each region, a support team is in charge of the implementation of the HP program. These support teams were trained to provide training and support to the teachers and the schools concerning the HP program, its principles, values, resources and evaluation. Pedagogical resources are provided for each school. Prior to this program, a four-year pilot study was carried out in 21 schools [23, 24]. An ethics committee has also been set up. |
Evaluation protocol
Research question | Dependent variables | Independent variables | |||
---|---|---|---|---|---|
Content | Description | Content | Description | ||
What is the influence of the strategies developed through the intervention in the development of HP practices at school and class levels? | - qual: | Perception of HP | - qual | ||
Collective HP practices | yes/no - qual: types | Institutional recommendations/policy | - qual | ||
of practices | Solicitations | - qual | |||
Perception of HP | - qual | ||||
Interest | - qual | ||||
Perceived self-efficacy | - qual | ||||
- qual: | Motivation | - qual | |||
Individual HP practices | yes/no - qual: types | Institutional recommendations/policy | - qual | ||
of practices | Availability of pedagogical tools | - qual | |||
Training | - qual + quan | ||||
Community's solicitations | - qual | ||||
School climate | - quan: score | ||||
School characteristics | - qual | ||||
What is the influence of These practices on well-being in the school setting? On the relationship established with parents? | From teachers' point of view | Perceived school climate (teachers) | - quan: score | Collective HP practices | - qual: yes/no |
From children's point of view | Perceived school climate (children) | - quan: score | Individual HP practices | - qual: types of practices | |
Violence | - quan: score | School characteristics (rural/urban; educational priority status; school size; socio-economical status...) | - qual | ||
From families' point of view | Perceived school climate (families) | - quan: score | |||
Relationship with parents | quan: score | The actors' perceived school climate | - quan: score | ||
As above with the addition of: | |||||
What is the impact of the perception of the life in school on children's perception of their life skills? | Children's perception of their life skills | - quan: score | Violence | - quan: score | |
- qual | Relationship with parents | - quan: score |
Mechanisms | Contextual factors |
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Outcome 1: Development of an HP approach at the school level | |
- Development of collective work skills - Integration of HP in the school's project - Common perception of HP - Presence of a leader | - National institutional will - Local institutional support - Training means and trained resources - Availability of resources - Community involvement |
Outcome 2: Development of teachers' HP practices | |
- Development of personal skills - Perception of HP - Perceived self-efficacy - Capacity to use resources - Capacity to integrate HP considerations in their practices - Motivation and interest - Teachers' empowerment | - Local institutional support - HP integrated in the school's project - Training means and trained resources - Availability of resources - Existence of an HP approach within the school - Perceived needs of children |
Outcome 3: Development of children's school well-being | |
- Health education activities - Involvement of children in HP project - Development of personal life skills | - Development of a global HP school approach integrating parents and wider community - Teachers having HP practices - Development a supportive psychosocial and physical environment |