Health promotion: integrating organizational change and student learning strategies.

The background and conceptual support for a model for planned change in schools are presented to facilitate the adoption, implementation, and maintenance of health promotion innovations. The model proposes four phases of change: (1) institutional commitment, (2) alterations in policies and practices, (3) alterations in roles and actions of staff, and (4) student learning activities. The model can be applied to influence organizational change in multiple components of the school health program to predispose, enable, and reinforce student health behavior.