Penney Tarra L, McIsaac Jessie-Lee D, Storey Kate, Kontak Julia C H, Ata Nicole, Kuhle Stefan, Kirk Sara F L
Applied Research Collaborations for Health (ARCH), Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, Canada.
School of Public Health, University of Alberta, Edmonton, AB, Canada.
Health Promot Int. 2018 Dec 1;33(6):980-989. doi: 10.1093/heapro/dax039.
A health promoting schools (HPS) approach is hypothesized to influence student health and wellbeing by promoting a 'school ethos' that reflects the physical environment, social relations, organisational structure, policies and practices within schools. This complex set of factors makes health promoting school ethos (HPSE) challenging to define and measure. This work sought to theorise, develop and pilot a measure of HPSE as the context for implementation of HPS initiatives. We used a multi-method, iterative process to identify relevant HPSE concepts through triangulation of conceptual literature, existing tools and the tacit knowledge of school stakeholders. The HPSE measurement tool was administered to 18 elementary schools through a principal and teacher survey and an environmental assessment, followed by the development of HPSE scores for each school. Testing for internal consistency of items was used to examine theorized concepts, and scores for each school are summarised. HPSE included eight conceptual dimensions with internal consistency ranging from α = 0.60 to α = 0.87. Total HPSE scores across schools (N = 18) ranged from 1 to 8 (mean = 3.94, SD = 2.1), with 28-65% of schools reporting 'high' on respective HPSE dimensions. Schools included a heterogeneous mixture of HPSE scores, particularly across different dimensions. Our novel approach to tool development allowed us to conceptualize HPSE using a flexible process comprising different types and sources of evidence. The HPSE tool holds potential for identification and measurement of critical components of different school context as it relates to HPS.
健康促进学校（HPS）方法被假定为通过促进一种“学校风气”来影响学生的健康和幸福，这种风气反映了学校内部的物理环境、社会关系、组织结构、政策和实践。这一复杂的因素组合使得健康促进学校风气（HPSE）难以定义和衡量。这项工作旨在对HPSE进行理论化、开发和试点测量，作为实施HPS倡议的背景。我们采用多方法、迭代过程，通过对概念文献、现有工具和学校利益相关者的隐性知识进行三角测量，来确定相关的HPSE概念。通过校长和教师调查以及环境评估，将HPSE测量工具应用于18所小学，随后为每所学校制定HPSE分数。通过测试项目的内部一致性来检验理论化概念，并汇总每所学校的分数。HPSE包括八个概念维度，内部一致性范围从α = 0.60到α = 0.87。各学校（N = 18）的HPSE总分数范围为1至8（平均值 = 3.94，标准差 = 2.1），28%至65%的学校在各自的HPSE维度上报告为“高”。学校的HPSE分数呈现出异质性混合，特别是在不同维度之间。我们新颖的工具开发方法使我们能够使用一个灵活的过程来概念化HPSE，该过程包括不同类型和来源的证据。HPSE工具在识别和测量与HPS相关的不同学校背景的关键组成部分方面具有潜力。
