Lisa Gugglberger

Capacity building in and for health promoting schools: Results from a qualitative study

OBJECTIVES Research has shown that schools have problems reaching the aim of becoming health promoting for many different reasons and that capacity building in and for schools is needed to develop necessary resources. We use the concept of capacity building as an analytical tool to answer the question of how the implementation of health promotion (HP) in schools can be supported. METHODS As part of a wider qualitative study concerning capacity building in the Austrian school system 11 school heads were interviewed about their needs regarding the success of HP in schools. The interviews were analysed with qualitative content analysis. RESULTS Schools can build several capacities themselves and are well informed about the requirements for implementing HP. The most important resource is institutionalisation of HP, which is not easy to reach. Concerning their environment, schools display a need for financial and human resources for HP, as well as knowledge management and quality control of HP service providers. CONCLUSION Schools need support from their environment not only in building resources but also in taking the important step of institutionalising HP into their core and management processes. A concept of implementation, drawing attention to necessary but unforeseen capacities and resources, is needed.

Support for health promoting schools: a typology of supporting strategies in Austrian provinces

Schools that want to implement health promotion (HP) are often confronted with obstacles that they cannot overcome by themselves and therefore need support from their environment. However, the issue of which kind of support is needed for HP implementation is complex. A systems approach suggests that the individual logic of each school be considered and that supporting strategies be flexible to specific needs. This article pursues the question which types of support for health promoting schools are offered on a provincial level in Austria. Using a grounded theory approach, 18 in-depth interviews with representatives of provincial organizations and 26 documents relevant for school HP were analysed. As a result, five different strategies of supporting health promoting schools have been identified in Austria: (i) organize exchange among schools, (ii) establish certification and quality control of school health efforts, (iii) offer consultation and information, (iv) carry out a specific HP programme and (v) coordinate HP actors and information. These strategies are usually combined and rarely occur in their pure form. It was also determined that the coordination of the different strategies and human resources for HP are missing for schools in Austria. It is argued that each of these supporting strategies has benefits and limitations for schools and the providers, and that they all have the potential to respond to the school as a complex social system.

Phases of health promotion implementation into the Scottish school system

Schools have been identified as ideal settings for health promotion (HP) among children, adolescents and school staff. Most European countries have established strategies to implement HP into their school system, however, little is known about these national strategies and how effective they have been. School HP implementation concerns processes of adoption, adaptation and operation of a complex intervention into a complex setting. This study analyses the processes that have led to school HP implementation in Scotland from the 1980s until now to identify key factors which facilitated and supported effective implementation. In the tradition of case-study research, 14 interviews with representatives of national and local organizations involved in school health, as well as with school staff were conducted. Furthermore, policy documents, reports and guidelines were collected. The data were analysed following a Grounded Theory approach. Four phases of school HP implementation into the Scottish school system were identified: (i) getting started (1980s-1998), (ii) political will and strategic vision (1999-2001), (iii) national leadership (2002-2008), and (iv) integration and embedding into education system (2008-ongoing). Throughout the phases political will and committed actors, the strategy/tradition to give power to the local authorities and individual schools, and the establishment of partnerships and ownership have supported implementation. Scotland is an interesting case giving important insights into the ways and possibilities of negotiating an interdisciplinary and cross-sectoral theme such as HP in schools. Further research concerning different political systems and national implementation processes is important to widen the understanding of national implementation strategies of school HP.

The use of group discussions: a case study of learning about organisational characteristics of schools

This paper focuses on the use of group discussions (GD), as a very open and flexible method of data generation, to learn about organisational characteristics of schools. In comparison to the more structured focus group method, the method of GD is less known; however, we demonstrate that it is a useful method to learn about how specific groups are constituted. The paper will draw on the findings and experiences of nine GDs that were organised with teachers, students and parents in three schools in Austria. They were conducted as part of a case study to learn about the influence of schools’ organisational characteristics on the implementation of health promotion interventions. GDs were analysed using hermeneutic system analysis. We will present our findings, discuss benefits and limitations of using GDs, and give recommendations for the future use within school (or organisational) research.

Learning in networks: individual teacher learning versus organizational learning in a regional health-promoting schools network

To change a school into a health-promoting organization, organizational learning is required. The evaluation of an Austrian regional health-promoting schools network provides qualitative data on the views of the different stakeholders on learning in this network (steering group, network coordinator and representatives of the network schools; n = 26). Through thematic analysis and deep-structure analyses, the following three forms of learning in the network were identified: (A) individual learning through input offered by the network coordination, (B) individual learning between the network schools, i.e. through exchange between the representatives of different schools and (C) learning within the participating schools, i.e. organizational learning. Learning between (B) or within the participating schools (C) seems to be rare in the network; concepts of individual teacher learning are prevalent. Difficulties detected relating to the transfer of information from the network to the member schools included barriers to organizational learning such as the lack of collaboration, coordination and communication in the network schools, which might be effects of the school system in which the observed network is located. To ensure connectivity of the information offered by the network, more emphasis should be put on linking health promotion to school development and the core processes of schools.

Health-Promoting Teaching Strategies in Schools – A Review of the Literature and Recommendations for Teacher Education

While comprehensive approaches towards school health promotion appear promising, they often lack adaptability to the schools. Research on school health promotion rarely includes attention to the core processes of schools, namely teaching and learning. The objective of this chapter is to present recommendations for health-promoting teaching strategies, which also incorporate the goals of student achievement.

Shaping the future e-patient: The citizen-patient in public discourse on e-health

Science Studies, Vol. 22 (2009), No. 1, 24-43 This paper investigates how public discourses, as articulated in EU policy and Austrian media documents, take part in the creation and stabilisation of a new patient figure – the e-patient. The documents we analysed act as one material form for enacting, performing and giving meaning to the changes occurring when a new technology enters established networks in the medical realm. Our analysis will show that the public discourses we studied deploy three rather different forms of discursive registers, each of which address and perform a specific relation between currently new information and communication technologies and citizen-patients. From one place, moment or problem-solution package to the next a slightly different hybrid and ‘multiple citizen-patient’ is being shaped, discussed, observed or concealed. The multiplicity we observed reveals crucial tensions and contradicting expectations expressed towards the future citizen-patient, showing the challenges for e-health in the making.