Online from: 1992
Subject Area: Health Care Management/Healthcare
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|Title:||Implementing a social-ecological model of health in Wales|
|Author(s):||Heather Rothwell, (Cardiff Institute of Society and Health, Cardiff University, Cardiff, UK), Michael Shepherd, (Cardiff Institute of Society and Health, Cardiff University, Cardiff, UK), Simon Murphy, (Cardiff Institute of Society and Health, Cardiff University, Cardiff, UK), Stephen Burgess, (Data and Methods (WISERD), Wales Institute of Social and Economic Research, Cardiff, UK), Nick Townsend, (BHF Health Promotion Research Group, University of Oxford, Oxford, UK), Claire Pimm, (Welsh Centre for Learning Disabilities, Cardiff University, Cardiff, UK)|
|Citation:||Heather Rothwell, Michael Shepherd, Simon Murphy, Stephen Burgess, Nick Townsend, Claire Pimm, (2010) "Implementing a social-ecological model of health in Wales", Health Education, Vol. 110 Iss: 6, pp.471 - 489|
|Keywords:||Health education, Schools, Wales|
|Article type:||Case study|
|DOI:||10.1108/09654281011087279 (Permanent URL)|
|Publisher:||Emerald Group Publishing Limited|
|Acknowledgements:||Members of the Expert Panel were Sharon Doherty, Judy Orme, Malcolm Thomas, Katherine Weare and Ian Young. Interviews in North Wales were conducted by Keith and Margaret Humphreys. The review was funded by the Welsh Assembly Government.|
Purpose – The purpose of this paper is to assess the implementation of the Welsh Network of Healthy School Schemes (WNHSS) at national, local and school levels, using a systems approach drawing on the Ottawa Charter.
Design/methodology/approach – The approach takes the form of a single-case study using data from a documentary analysis, interviews with Healthy Schools Co-ordinators (
Findings – There was almost universal adherence to a national framework based on Ottawa Charter principles. Substantial progress had been made with advocacy and mediation, although the framework provided less specific guidance regarding enablement. All-Wales training for co-ordinators, the commitment of co-ordinators to working across administrative and professional boundaries, and support from local education and health partnerships, were important determinants of healthy school schemes' growth and efficiency. Primary schools were more successful than secondary schools in embedding health-related changes.
Research limitations/implications – Although findings are largely based on indirect evidence, the use of a social-ecological model of evaluation provided valuable insights into implementation processes at multiple levels. Findings suggest that strong national support benefits programme development and dissemination and should include effective monitoring of local performance. The national strategic environment was influential at all levels of programme implementation. Priorities for further research include application of the social-ecological model and organisational theory to investigate indicators of sustainability and influences on inequalities in health in school health promotion programmes.
Originality/value – The review illustrates the importance of evaluating health promotion programmes at multiple levels using a systems approach.
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