Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Int J Environ Res Public Health. 2018 Oct 12;15(10):2243. doi: 10.3390/ijerph15102243.
Schools can play an important role in promoting children's health behaviours. A Dutch initiative, 'The Healthy Primary School of the Future', aims to integrate health and well-being into the school system. We use a contextual action-oriented research approach (CARA) to study the implementation process. Properties of CARA are its focus on contextual differences and the use of monitoring and feedback to support and evaluate the process of change. The aim of this article is to describe the use of the approach. Four schools (each with 200⁻300 children, aged 4⁻12 years) were included; all located in low socio-economic status areas in the south of the Netherlands. Data collection methods include interviews, observations, questionnaires, and health and behavioural measurements. Research contributions include giving feedback and providing schools with a range of possibilities for additional changes. The contextual data we examine include schools' health promoting elements, practices of teachers and parents, dominating organisational issues, and characteristics of the student population; process data include the presence of potential barriers to changes. CARA is an adaptive research approach that generates knowledge and experiences on how to deal with health promotion in complex systems. We think this approach can set an example for research efforts in comparable initiatives.
学校可以在促进儿童健康行为方面发挥重要作用。荷兰的一项倡议“未来健康小学”旨在将健康和幸福融入学校系统。我们使用以情境为导向的行动研究方法（CARA）来研究实施过程。CARA 的特点是关注情境差异，并利用监测和反馈来支持和评估变革过程。本文旨在描述该方法的使用情况。
我们选择了四所学校（每所学校有 200-300 名 4-12 岁的儿童），都位于荷兰南部的低社会经济地位地区。数据收集方法包括访谈、观察、问卷调查以及健康和行为测量。研究的贡献包括提供反馈，并为学校提供一系列额外变革的可能性。我们研究的情境数据包括学校的促进健康因素、教师和家长的实践、主导的组织问题以及学生群体的特点；过程数据包括潜在变革障碍的存在。
CARA 是一种适应性研究方法，可以提供有关如何在复杂系统中进行健康促进的知识和经验。我们认为，这种方法可以为类似倡议的研究工作树立榜样。
