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Qualitative research shows detailed processes, interventions, challenges and self-reported changes associated with Health-Promoting Schools in China

Date: Poster sessions
Source: Forum 11
Authors: Carmen Aldinger, Project Director, Global Programs, Health and Human Development Programs, Education Development Center, USA
with Sen-Hai Yu, Xin-Wei Zhang, Li-Qun Liu, Jun-Xiang Guo, Xue-Dong Pan and Jack Jones (as reviewer/advisor)


This presentation seeks to: 1) describe qualitative methods used in the study of implementation of Health-Promoting Schools (HPS); 2) explain major results and challenges of implementing HPS in Zhejiang Province, China, that can guide further research.

A descriptive study was conducted in nine schools with a total population of about 15 200 students, interviewing a sample of 191 school administrators, teachers, students and parents in three schools at three different time intervals (over a period of 18 months). Conceptually, the study falls into the field of institutional ethnography. To our knowledge, this is the first extensive qualitative evaluation of the implementation of Health-Promoting Schools.

Grounded theory analysis revealed detailed pre-implementation, implementation, and monitoring and evaluation processes; classroom-based, school-wide and outreach activities; and modifications to the physical and psychosocial school environment. Schools faced a number of challenges related to understanding and integrating the HPS concept, including a lack of professional development. Yet, participants reported many health-conducive changes in their attitudes, conceptual knowledge, and behaviours associated with this project.

The self-reports pointed to some unique findings: 1) Participants increased their understanding of the broad concept of health and Health-Promoting Schools. 2) Participants gained a deeper understanding of the relationship between study and health. 3) Teachers and administrators utilized a truly comprehensive approach that addressed various health topics, utilized all components of the HPS model, and focused on holistic development of students. 4) Schools prioritized health and treated it as a co-responsibility with families and communities. 5) Children educated their parents and served as change agents. 6) Leaders provided support and encouragement and served as role models.

In contrast to what would be expected from the traditional education system in China, we observed that: 1) Teachers used participatory teaching and learning strategies. 2) Students worked together instead of competing.

In conclusion, schools' evaluation results indicated the effectiveness of the HPS project, reflected a change in evaluation concepts to a more holistic approach to assessment, but also pointed to a need for more training and technical support, and a desire for further expansion of the HPS project in China as well as other parts of the world.