Markham Wolfgang A, Aveyard Paul
School of Education, University of Birmingham, B15 2TT, Birmingham, UK.
Soc Sci Med. 2003 Mar;56(6):1209-20. doi: 10.1016/s0277-9536(02)00120-x.
This paper outlines a novel explanatory frame for understanding how schools may intervene in order to promote pupils' health. The new theory is synthesised from an Aristotelian interpretation of human functioning and a theory of cultural transmission. In keeping with recent influential theoretical developments, it is proposed that health has its roots in human functioning. It follows from this concept that the promotion of pupils' health is facilitated by the promotion of pupil functioning and the primary mechanisms through which schools promote pupil functioning and, hence, health, are through the influences of school organisation, curriculum development and pedagogic practice on pupil development. According to the new theory, good human functioning is dependent on the realisation of a number of identified essential human capacities and the meeting of identified fundamental human needs. Two essential capacities, the capacity for practical reasoning and the capacity for affiliation with other humans, plan and organise the other essential capacities. The realisation of these two capacities should, it is argued, be the primary focus of health promoting schools. Additionally, health promoting schools should ensure that fundamental human needs concerning non-useful pain and information about the body are met. A number of testable hypotheses are generated from the new theory. Comparisons with existing interpretations of health promoting schools indicate there are similarities in the actions schools should take to promote health. However, the new theory can, uniquely, be used to predict which pupils will enjoy the best health at school and in adulthood. Additionally, according to the new theory, schools do not need designated health education classes or teaching staff with specialist health education roles in order to be health promoting. It is concluded that the new theory may have a number of advantages over existing theories at both the policy and intervention levels.
本文概述了一个全新的解释框架，用于理解学校如何进行干预以促进学生健康。这一新理论是由对人类机能的亚里士多德式解读与文化传播理论综合而成。与近期有影响力的理论发展相一致，本文提出健康源于人类机能。由此概念可知，促进学生机能有助于促进学生健康，而学校促进学生机能进而促进健康的主要机制是通过学校组织、课程开发和教学实践对学生发展产生影响。根据这一新理论，良好的人类机能取决于一些已确定的基本人类能力的实现以及一些已确定的基本人类需求的满足。两种基本能力，即实践推理能力和与他人建立联系的能力，规划和组织着其他基本能力。有人认为，实现这两种能力应成为健康促进学校的主要关注点。此外，健康促进学校应确保满足与无害疼痛及身体信息相关的基本人类需求。新理论产生了一些可检验的假设。与现有对健康促进学校的解释进行比较表明，学校在促进健康方面应采取的行动存在相似之处。然而，新理论独特之处在于可用于预测哪些学生在学校和成年后将享有最佳健康状况。此外，根据新理论，学校无需开设专门的健康教育课程或配备具有专业健康教育职责的教职员工即可促进健康。结论是，新理论在政策和干预层面可能比现有理论具有诸多优势。
