Context and the mechanisms in intersectoral school-based health promotion interventions: A critical interpretative synthesis

Introduction: School-based health promotion interventions (SHPI) have been introduced extensively over the last decades, but their implementation and evaluation still present challenges. Among these, the complexity of the environments in which SHPI are implemented, and intersectoral collaboration to promote more sustainable change, must be better addressed within evaluation processes. Objectives: The objectives of this study were to (1) identify pertinent scientific literature on the implementation processes for intersectoral SHPI and (2) develop a programme theory that maps potential elements of context and underlying mechanisms that may influence intersectoral SHPI. Method: A critical interpretative synthesis was performed of elements of context and underlying situational and transformational mechanisms. These were identified based on the scientific literature published between 1997 and 2017 addressing intersectoral SHPI. Results: Six potential elements of context, seven potential situational mechanisms and seven potential transformational mechanisms that can explain SHPI outcomes were identified from 28 articles. The results were integrated into a framework to pinpoint elements that facilitate or impede intersectoral SHPI implementation. Conclusion: The results of this synthesis support a more comprehensive approach to evaluating SHPI, and improved consideration of intersectoral collaboration and the complexity associated with this type of intervention.

[1]  Ingrid Hylander,et al.  Shared responsibility: school nurses' experience of collaborating in school‐based interprofessional teams , 2017, Scandinavian journal of caring sciences.

[2]  Eric C. Jones,et al.  Effects of Sectoral Diversity on Community Coalition Processes and Outcomes , 2017, Prevention Science.

[3]  K. Silva,et al.  School and community relationship in the perspective of Health Promotion , 2017 .

[4]  D. Jourdan,et al.  Health Promoting Schools-a complex approach and a major means to health improvement. , 2017, Health promotion international.

[5]  B. Marchal,et al.  Towards an agenda for implementation science in global health: there is nothing more practical than good (social science) theories , 2017, BMJ Global Health.

[6]  Lise R. Talbot,et al.  Realist evaluation of intersectoral oral health promotion interventions for schoolchildren living in rural Andean communities: a research protocol , 2017, BMJ Open.

[7]  N. D. Vries,et al.  Predictors and mediators of sustainable collaboration and implementation in comprehensive school health promotion , 2017 .

[8]  A. Dabrowski,et al.  Evaluating for impact: what type of data can assist a health promoting school approach? , 2016, Health promotion international.

[9]  A. Braunack-Mayer,et al.  Intersectoral collaboration to implement school-based health programmes: Australian perspectives , 2016, Health promotion international.

[10]  Scott R. Rosas,et al.  Systems thinking and complexity: considerations for health promoting schools , 2015, Health promotion international.

[11]  M. Johri,et al.  What is known about school-based interventions for health promotion and their impact in developing countries? A scoping review of the literature. , 2016, Health education research.

[12]  Suvi Saarikallio,et al.  A Critical Interpretive Synthesis of the Literature Linking Music and Adolescent Mental Health , 2016 .

[13]  M. Vasconcelos,et al.  Colaboração interprofissional no Projeto Saúde e Prevenção na Escola , 2016 .

[14]  T. Jones.  Outcome Measurement in Nursing: Imperatives, Ideals, History, and Challenges , 2016, Online journal of issues in nursing.

[15]  Monika Kastner,et al.  Conceptual recommendations for selecting the most appropriate knowledge synthesis method to answer research questions related to complex evidence. , 2016, Journal of clinical epidemiology.

[16]  Jennifer D'Souza,et al.  Knowledge synthesis methods for generating or refining theory: a scoping review reveals that little guidance is available. , 2016, Journal of clinical epidemiology.

[17]  M. I. Vasconcelos,et al.  Inter-professional collaboration in the 'Health and Prevention in Schools' Project. , 2016, Ciencia & saude coletiva.

[18]  G. Cardon,et al.  Capacity building through cross-sector partnerships: a multiple case study of a sport program in disadvantaged communities in Belgium , 2015, BMC Public Health.

[19]  Valéry Ridde,et al.  The concept of mechanism from a realist approach: a scoping review to facilitate its operationalization in public health program evaluation , 2015, Implementation Science.

[20]  P. van Assema,et al.  Factors influencing perceived sustainability of Dutch community health programs. , 2015, Health promotion international.

[21]  A. Krumeich,et al.  Effectiveness of a systematic approach to promote intersectoral collaboration in comprehensive school health promotion-a multiple-case study using quantitative and qualitative data , 2015, BMC Public Health.

[22]  N. D. Vries,et al.  A multiple-case study of intersectoral collaboration in comprehensive school health promotion using the DIagnosis of Sustainable Collaboration (DISC) model , 2015 .

[23]  L. Brennan,et al.  Partnership and community capacity characteristics in 49 sites implementing healthy eating and active living interventions. , 2015, Journal of public health management and practice : JPHMP.

[24]  P. Nilsen.  Making sense of implementation theories, models and frameworks , 2015, Implementation Science.

[25]  S. Porter.  The uncritical realism of realist evaluation , 2016 .

[26]  E. Waters,et al.  The World Health Organization’s Health Promoting Schools framework: a Cochrane systematic review and meta-analysis , 2014, BMC Public Health.

[27]  P. Mattessich,et al.  Cross-sector collaboration to improve community health: a view of the current landscape. , 2014, Health affairs.

[28]  B. B. Jensen,et al.  Revitalizing the setting approach – supersettings for sustainable impact in community health promotion , 2014, International Journal of Behavioral Nutrition and Physical Activity.

[29]  Okje Anna Koudenburg,et al.  Intersectoral action for health: The experience of a Danish municipality , 2014, Scandinavian journal of public health.

[30]  N. Drouin,et al.  Schools' Capacity to Absorb a "Healthy School" Approach into Their Operations: Insights from a Realist Evaluation. , 2014 .

[31]  V. Ridde,et al.  L’approche réaliste pour l’évaluation de programmes et la revue systématique : De la théorie à la pratique , 2014 .

[32]  J. Inchley,et al.  Phases of health promotion implementation into the Scottish school system. , 2014, Health promotion international.

[33]  M. Tully,et al.  Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study , 2014, International Journal of Behavioral Nutrition and Physical Activity.

[34]  Arpaporn Powwattana,et al.  The diamond level health promoting schools (DLHPS) program for reduced child obesity in Thailand: lessons learned from interviews and focus groups. , 2014, Asia Pacific journal of clinical nutrition.

[35]  C. Ferron,et al.  La promotion de la santé, enfin ? L'évolution du champ de l'éducation pour la santé au cours des dix dernières années , 2013 .

[36]  Didier Jourdan,et al.  Evaluation d’un dispositif de formation et d’accompagnement en promotion de la santé dans les écoles primaires françaises : implications pour la pratique , 2013 .

[37]  D. D. De Souza.  Elaborating the Context-Mechanism-Outcome configuration (CMOc) in realist evaluation: A critical realist perspective , 2013 .

[38]  Denise E. De Souza,et al.  Elaborating the Context-Mechanism-Outcome configuration (CMOc) in realist evaluation: A critical realist perspective , 2013 .

[39]  Ray Pawson,et al.  The Science of Evaluation: A Realist Manifesto , 2013 .

[40]  Ruth Harris,et al.  The realist approach to evaluation research: an introduction , 2012 .

[41]  Ray Pawson,et al.  A realist diagnostic workshop , 2012 .

[42]  J. Francis,et al.  Which experiences of health care delivery matter to service users and why? A critical interpretive synthesis and conceptual map , 2012, Journal of health services research & policy.

[43]  O. Samdal,et al.  Theoretical and Empirical Base for Implementation Components of Health-Promoting Schools. , 2011 .

[44]  Louise Rowling,et al.  Filling the Black Box of Implementation for Health-Promoting Schools. , 2011 .

[45]  M. Kegler,et al.  An Initial Attempt at Operationalizing and Testing the Community Coalition Action Theory , 2011, Health education & behavior : the official publication of the Society for Public Health Education.

[46]  Elizabeth A. Mellin,et al.  Strengthening Interprofessional Team Collaboration: Potential Roles for School Mental Health Professionals , 2011 .

[47]  How divergent conceptions among health and education stakeholders influence the dissemination of healthy schools in Quebec. , 2010, Health promotion international.

[48]  C. Leeuwis,et al.  Community health promotion: a framework to facilitate and evaluate supportive social environments for health. , 2010, Evaluation and program planning.

[49]  L. Vaandrager,et al.  Coordinated action checklist: a tool for partnerships to facilitate and evaluate community health promotion , 2010, Global health promotion.

[50]  F. Leeuw,et al.  Unpacking Black Boxes: Mechanisms and Theory Building in Evaluation , 2010 .

[51]  P. Hedström,et al.  Causal Mechanisms in the Social Sciences , 2010 .

[52]  Don Nutbeam,et al.  Social complex adaptive systems: A response to Haggis , 2010 .

[53]  Don Nutbeam,et al.  Schools as social complex adaptive systems: a new way to understand the challenges of introducing the health promoting schools concept. , 2010, Social science & medicine.

[54]  Approaching complexity: a commentary on Keshavarz, Nutbeam, Rowling and Khavarpour. , 2010, Social science & medicine.

[55]  A. Ofili,et al.  Strengthening Intersectoral Collaboration for Primary Health Care in Developing Countries: Can the Health Sector Play Broader Roles? , 2010, Journal of environmental and public health.

[56]  Ray Pawson,et al.  The Today Programme’s Contribution to Evidence-based Policy , 2010 .

[57]  Hui-Chun Chan,et al.  Community based innovation: its antecedents and its impact on innovation success , 2013, Internet Res..

[58]  K. Zulkosky.  Self‐Efficacy: A Concept Analysis , 2009 .

[59]  N. D. de Vries,et al.  Diagnosis of sustainable collaboration in health promotion – a case study , 2008, BMC public health.

[60]  Gerjo Kok,et al.  The Ecological Approach in Health Promotion Programs: A Decade Later , 2008, American journal of health promotion : AJHP.

[61]  J. Ehrenberg,et al.  Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development , 2007, BMC public health.

[62]  M. Dixon-Woods,et al.  Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups , 2006 .

[63]  Jasmine Gideon,et al.  Implementation of promotion and prevention activities in decentralized health systems: comparative case studies from Chile and Brazil. , 2005, Health promotion international.

[64]  L. Leger.  What's the place of schools in promoting health? Are we too optimistic? , 2004 .

[65]  M. Holosko,et al.  The Story Behind the Story of Collaborative Networks–Relationships Do Matter! , 2004, Journal of health & social policy.

[66]  Fadhel Kaboub.  Realistic Evaluation , 2004 .

[67]  Sara Bennett,et al.  Health sector reform and public sector health worker motivation: a conceptual framework. , 2002, Social science & medicine.

[68]  W. El Ansari,et al.  Interprofessional collaboration: a stakeholder approach to evaluation of voluntary participation in community partnerships. , 2001, Journal of interprofessional care.

[69]  L. Leger,et al.  Schools, health literacy and public health: possibilities and challenges. , 2001 .

[70]  Walid El Ansari, Ceri J. Phillips.  Interprofessional collaboration: a stakeholder approach to evaluation of voluntary participation in community partnerships , 2001 .

[71]  Walid El Ansari, Ceri J. Phillips.  Partnerships, community participation and intersectoral collaboration in South Africa , 2001 .

[72]  W. El Ansari,et al.  Partnerships, community participation and intersectoral collaboration in South Africa. , 2001, Journal of interprofessional care.

[73]  The Health Promoting School, general practice and the creative arts: an example of inter‐sectoral collaboration , 2000 .

[74]  A. Killoran,et al.  Tackling health inequalities through partnership working: Learning from a realistic evaluation , 2000 .

[75]  A. Fletcher.  A Concept Analysis of Motivation , 1999 .