Forbes C A, Williams A J, Wyatt K
University of Exeter, Exeter, United Kingdom.
University of Edinburgh, Edinburgh, United Kingdom.
Public Health Pract (Oxf). 2025 Feb 15;9:100591. doi: 10.1016/j.puhip.2025.100591. eCollection 2025 Jun.
Schools are environments that influence adolescent health choices; understanding schools as complex adaptive systems, we have developed a series of processes that are adaptive to the school context, to support schools to create the conditions for health promotion. The aim of this study was to determine the feasibility and acceptability of capturing the impact of implementing the health promoting school (HPS) process.
feasibility study.
A purposefully selected secondary school in England, with high Free School Meal (FSM) allocation, was recruited to implement the HPS processes, which includes an annual school audit. We developed a questionnaire, to capture lifestyle behaviours and school culture, completed before the audit and 9 months after. Descriptive analysis analysed the questionnaire responses to understand whether it captured similar responses to the audit. Post intervention interviews with staff and a focus group with students assessed the acceptability and practicality of the intervention and study design.
The HPS processes were implemented September 2022-September 2023. Students (n = 337), families (n = 49) and staff (n = 22) completed the school audit in November 2022 and November 2023. 237 students completed The Lifestyle and School Questionnaire at baseline (September 2022) and 210 at follow-up (June 2022). Following the initial school audit, the need to improve the school food was identified and became the school focus; results from the second audit reflected a small positive shift in students' opinion of food provision. It was feasible to capture lifestyle and school culture data using the questionnaire and the same food related priority was captured by the initial questionnaire. However, the timing of the implementation of the changes to the school context meant that this was not captured in the follow up questionnaire results.
This study demonstrates that it is possible to administer questionnaires regarding adolescent lifestyle choices in schools. These findings also suggest that it is feasible and acceptable to implement a set of HPS processes. More research is needed to demonstrate an impact on individual health behaviours.
学校是影响青少年健康选择的环境；将学校理解为复杂适应系统，我们开发了一系列适应学校环境的流程，以支持学校创造促进健康的条件。本研究的目的是确定捕捉实施健康促进学校（HPS）流程影响的可行性和可接受性。
可行性研究。
在英格兰有目的地选择了一所中学，该校免费学校餐（FSM）分配率较高，被招募来实施HPS流程，其中包括年度学校审计。我们编制了一份问卷，用于获取生活方式行为和学校文化信息，在审计前和审计后9个月完成。描述性分析对问卷回复进行分析，以了解其是否获取到与审计类似的回复。对工作人员进行干预后访谈，并与学生进行焦点小组讨论，评估干预措施和研究设计的可接受性和实用性。
HPS流程于2022年9月至2023年9月实施。学生（n = 337）、家庭（n = 49）和工作人员（n = 22）于2022年11月和2023年11月完成了学校审计。237名学生在基线（2022年9月）完成了《生活方式与学校问卷》，210名学生在随访（2022年6月）时完成。在首次学校审计后，确定了改善学校食物的必要性，并成为学校的重点；第二次审计结果反映出学生对食物供应的看法有小幅积极转变。使用问卷获取生活方式和学校文化数据是可行的，初始问卷也捕捉到了相同的与食物相关的优先事项。然而，学校环境变化实施的时间安排意味着这在后续问卷结果中未被捕捉到。
本研究表明，在学校中就青少年生活方式选择进行问卷调查是可行的。这些发现还表明，实施一套HPS流程是可行且可接受的。需要更多研究来证明对个人健康行为的影响。
