Schools' absorptive capacity to innovate in health promotion

In search of virtuous learning circles: absorptive capacity and its antecedents in the education sector

Purpose

This study aims to identify context-specific antecedents to schools’ absorptive capacity (AC) and to show how those can enact “a virtuous learning circle.”

Design/methodology/approach

The study uses a mixed method: an exploration based on semi-structured interviews with educational experts; the development of a measurement scale and a partial least squares structural equation modelling to test the impact of the antecedents.

Findings

The results yielded four empirically-grounded antecedents and their measurement scales, namely, prior knowledge, employees’ skills, educational projects and interactions with the environment (Studies one and two). All antecedents are significantly and positively related to AC processes (study three). Using the organizational learning theory perspective, the results have been interpreted as an AC “virtuous learning circle.”

Practical implications

With increasing pressures to adapt, a case of which was the COVID-19 pandemic, schools can greatly benefit from absorbing knowledge flows. This suggests the construction a favourable environment for AC. To this end, the individual (employees’ prior knowledge and skills), organizational (educational projects) and institutional level of managerial action (interactions with the environment) can be effective when create a recursive organizational learning circle. In addition, this study offers an expert-validated measurement scale for self-assessment of a school’s specific contingencies, and thus, for planning of punctual interventions to develop AC.

Originality/value

This study advances the existing body of knowledge management in the educational context by rigorously identifying and validating a scale for measuring the antecedents of AC and developing an interpretive approach to the AC “virtuous circle.”

Analysis of whole-school policy changes in Austrian schools

Health Policies with school-wide effects have been shown to improve the health of students and school staff, but in practice, schools struggle with this approach. Ten Austrian schools which had recently adopted new time structure policies were investigated: On the basis of 19 interviews with school staff, we used thematic analysis to identify facilitating and hindering factors for the implementation processes. Furthermore, agency analysis was applied, in which the interviewees’ use of language was interpreted to estimate their perception of their own agency in the context of policy change. We found that in schools where policy changes were perceived as successfully implemented, staff was convinced of the benefits. In these schools, time structures were understood to directly influence learning and teaching processes and staff members showed a strong feeling of agency. On the other hand, schools were confronted with hindering factors similar to those known from the implementation of other health policies. The results are discussed in the light of current implementation practices, and conclusions for practitioners are drawn.

Predictors and mediators of sustainable collaboration and implementation in comprehensive school health promotion

Purpose

The Diagnosis of Sustainable Collaboration (DISC) model (Leurs et al., 2008) specifies five factors (i.e. project management, change management, context, external factors, and stakeholders’ support) which predict whether collaboration becomes strong and stable. The purpose of this paper is to study the dynamics of these factors in a study of multiple partnerships in comprehensive school health promotion (CSHP).

Design/methodology/approach

A Dutch two-year DISC-based intervention to support coordinators of five CSHP partnerships in the systematic development of intersectoral collaboration was studied in a pretest-posttest design. To uncover the determinants of sustainable collaboration and implementation of CSHP and to find possible mediators, the authors carried out multi-level path analyses of data on the DISC factors obtained from 90 respondents (response of approached respondents: 57 percent) at pretest and 69 respondents (52 percent) at posttest. Mediation mechanisms were assessed using joint significance tests.

Findings

The five DISC factors were important predictors of implementation of CSHP (explained variance: 26 percent) and sustainable collaboration (explained variance: 21 percent). For both outcomes, stakeholders’ support proved to be the most important factor. Regarding sustainable collaboration, mediation analysis showed that stakeholders’ support fully mediated the effects of change management, project management, external factors and context. This indicates that the extent of stakeholders’ support (e.g. appreciation of goals and high levels of commitment) determines whether collaboration becomes sustainable. The authors also found that the extent of stakeholders’ support in turn depends upon a well-functioning project management structure, the employment of change management principles (e.g. creation of a common vision and employment of appropriate change strategies), a favorable organizational context (e.g. positive experience with previous collaboration) and external context (e.g. positive attitudes of financing bodies and supporting health and educational policies). For the actual implementation of CSHP, partial mediation by the support factor was found. There was a direct positive effect of change management indicating that organizational knowledge is also necessary to implement CSHP, and a direct negative effect of project management, probably pointing to the negative effects of too much negotiation in the collaboration.

Research limitations/implications

A design lacking a control group, a small sample and a relatively early assessment after implementation support stopped limit the generalizability of the results.

Practical implications

Strategies targeting the DISC factors can enhance stakeholders’ support and thereby promote sustainable intersectoral collaboration and the implementation of CSHP.

Originality/value

The DISC model provides a fruitful conceptual framework for the study of predictors and processes in public health partnerships. The importance of stakeholders’ support and other factors in the model are demonstrated.

Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review

Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students.

A multiple-case study of intersectoral collaboration in comprehensive school health promotion using the DIagnosis of Sustainable Collaboration (DISC) model

Purpose

– Intersectoral collaboration is often a prerequisite for effective interventions in public health. The purpose of this paper is to assess the facilitating and hindering conditions regarding intersectoral collaboration between health authorities, public health services (PHSs), public services stakeholders (PPSs) and the education sector in comprehensive school health promotion (CSHP) in the Netherlands.

Design/methodology/approach

– CSHP collaborations in five Dutch regions were studied using a questionnaire based on the DIagnosis of Sustainable Collaboration (DISC) model, focusing on: change management; perceptions, intentions and actions of collaborating parties; project organization; and factors in the wider context. Univariate and multivariate analyses with bootstrapping were applied to 106 respondents (62 percent response).

Findings

– A similar pattern of facilitating and hindering conditions emerged for the five regions, showing positive perceptions, but fewer positive intentions and actions. An overall favorable internal and external context for collaboration was found, but limited by bureaucratic procedures and prioritizing stakeholders’ own organizational goals. Change management was rarely applied. Some differences between sectors emerged, with greatest support for collaboration found among the coordinating organizations (PHSs) and least support among the financing organization (municipalities).

Research limitations/implications

– The generalization of the findings is limited to the initial formation stage of collaboration, and may be affected by selection bias, small sample size and possible impact of interdepartmental collaboration within organizations.

Practical implications

– The authors recommend establishing stronger change management to facilitate translation of positive perceptions into intentions and actions, and coordination of divergent organizational structures and orientations among collaborating parties.

Originality/value

– The results show that it is valuable for collaborating parties to conduct DISC analyses to improve intersectoral collaboration in CSHP.

Examining statewide capacity for school health and mental health promotion: a post hoc application of a district capacity-building framework

Schools must possess a variety of capacities to effectively support comprehensive and coordinated school health promotion activities, and researchers have developed a district-level capacity-building framework specific to school health promotion. State-level school health coalitions often support such capacity-building efforts and should embed this work within a data-based, decision-making model. However, there is a lack of guidance for state school health coalitions on how they should collect and use data. This article uses a district-level capacity-building framework to interpret findings from a statewide coordinated school health needs/resource assessment in order to examine statewide capacity for school health promotion. Participants included school personnel (N = 643) from one state. Descriptive statistics were calculated for survey items, with further examination of subgroup differences among school administrators and nurses. Results were then interpreted via a post hoc application of a district-level capacity-building framework. Findings across districts revealed statewide strengths and gaps with regard to leadership and management capacities, internal and external supports, and an indicator of global capacity. Findings support the utility of using a common framework across local and state levels to align efforts and embed capacity-building activities within a data-driven, continuous improvement model.

School health promotion providers' roles in practice and theory: results from a case study

BACKGROUND

Implementation is critical to the success of health promotion (HP) in schools, but little is known about how schools can best be assisted during this process. This article focuses on Austrian HP providers and aspects their roles incorporate.

OBJECTIVE

To investigate the providers' role in the practice of HP implementation and how it differs from its official description. On the basis of these findings, implications are suggested.

METHODS

The data were gathered within the framework of an explorative case study of complex HP interventions. We draw on four interviews with HP organisation staff, five documents from the providers' organisations and seven interviews with school staff from three schools.

RESULTS

In practice, providers took up different responsibilities, e.g., acting as emotional support to school staff and supporting the documentation of projects, guided more by the schools' needs than by the programmes they are helping to implement. Providers focused mostly on the implementation of single activities and did little to emphasize the necessity of organisational change.

POLICY IMPLICATIONS

Our findings suggest that providers' background in health should be complemented by a deeper understanding of the importance of organisational change to further support HP implementation.