Chen Fu-Li, Lee Albert
Department of Public Health, Fu-Jen Catholic University, New Taipei City, Taiwan
School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Glob Health Promot. 2016 Mar;23(1 Suppl):18-25. doi: 10.1177/1757975916638286.
The Taiwan Ministry of Health and Welfare and Ministry of Education launched the Health-Promoting School (HPS) program in 2002. One of the most significant barriers to evaluating HPS is the absence of adequate instruments. The main aim of this study is to develop the Taiwan Health-Promoting School Accreditation System (HPSAS) framework and then evaluate its accreditation effectiveness.
The HPSAS accreditation standards were derived mainly from the World Health Organization (WHO) publication, WHO Health Promoting Schools: A Framework for Action in 2008 and the Taiwan School Health Act. Delphi technique and pilot test were used to confirm the availability and acceptability of the standards and procedures for HPSAS in 2011. After that, two rounds of school evaluations were completed in 2012 (214 participant schools) and 2014 (182 participant schools). The accreditation operation process included documentary reviews, national and international accredited commissioners conducted on-site visits. Descriptive analyses were used to indicate HPS award level distribution.
The study established six key HPSAS standards. Each standard had at least two components; overall, there were 21 components and 47 scoring elements. Of the participating schools evaluated in 2012, four were at the gold, 14 silver, and 120 bronze levels, compared with five, 20, and 31, respectively, of schools evaluated in 2014. The study showed that schools at different award levels had different full-score rates in six standards. The schools at the gold level performed exceptionally well. The worst performance among the six standards at each award level was in the skill-based health curriculum.
The HPSAS is an objective instrument used to evaluate the process and outcomes of the HPS program. In the future, combinations of different types of data (e.g. students' health behaviors, school climate, or teachers' health-teaching innovations) will enable further validation of the HPS effectiveness.
台湾地区卫生福利部和教育部于2002年发起了健康促进学校（HPS）计划。评估健康促进学校最显著的障碍之一是缺乏适当的工具。本研究的主要目的是制定台湾健康促进学校认证系统（HPSAS）框架，然后评估其认证效果。
HPSAS认证标准主要源自世界卫生组织（WHO）2008年发布的《世界卫生组织健康促进学校：行动框架》以及台湾地区《学校卫生法》。2011年采用德尔菲技术和预试验来确认HPSAS标准及程序的可用性和可接受性。之后，在2012年（214所参与学校）和2014年（182所参与学校）完成了两轮学校评估。认证操作过程包括文件审查、国内和国际认证专员进行的实地考察。采用描述性分析来表明健康促进学校奖项等级分布情况。
该研究确立了六项关键的HPSAS标准。每项标准至少有两个组成部分；总体而言，有21个组成部分和47个评分要素。在2012年接受评估的参与学校中，有4所获得金奖，14所获得银奖，120所获得铜奖，而在2014年接受评估的学校中，这一数字分别为5所、20所和31所。研究表明，不同奖项等级的学校在六项标准中的满分率不同。金奖等级的学校表现格外出色。每个奖项等级的六项标准中表现最差的是基于技能的健康课程。
HPSAS是用于评估健康促进学校计划过程和结果的客观工具。未来，不同类型数据（如学生的健康行为、学校氛围或教师的健康教学创新）的结合将能够进一步验证健康促进学校的有效性。
