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The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future

Author

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  • Nina Bartelink

    (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
    Academic Collaborative Centre for Public Health Limburg, Public Health Services, P.O. Box 33, 6400 AA Heerlen, The Netherlands)

  • Patricia van Assema

    (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)

  • Maria Jansen

    (Academic Collaborative Centre for Public Health Limburg, Public Health Services, P.O. Box 33, 6400 AA Heerlen, The Netherlands
    Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands)

  • Hans Savelberg

    (Department of Nutritional and Movement Sciences, Nutrition and Translational Research Institute Maastricht (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands)

  • Stef Kremers

    (Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands)

Abstract

Background : The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children’s health and health behaviors. Methods : The study used a mixed-methods design. The school context ( n = 4) was assessed by the characteristics of the school population, teacher’s health-promoting (HP) practices, implementers’ perceived barriers, school’s HP elements, and dominating organizational issues. Outcomes included objectively assessed BMI z-scores and physical activity (PA), and parent and child-reported dietary intake. Analyses included linear mixed models (four intervention schools versus four control schools), and qualitative comparisons between intervention schools with similar HP changes. Results : Effects on outcomes varied considerably across schools (e.g., range in effect size on light PA of 0.01–0.26). Potentially moderating contextual aspects were the child’s socioeconomic background and baseline health behaviors; practices and perceived barriers of employees; and organizational issues at a school level. Conclusions : Similar HP changes lead to different outcomes across schools due to differences in the school context. The adoption of a complex adaptive systems perspective contributes to a better understanding of the variation in effects and it can provide insight on which contextual aspects to focus on or intervene in to optimize the effects of HP initiatives.

Suggested Citation

  • Nina Bartelink & Patricia van Assema & Maria Jansen & Hans Savelberg & Stef Kremers, 2019. "The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future," IJERPH, MDPI, vol. 16(13), pages 1-19, July.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:13:p:2432-:d:246708
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    References listed on IDEAS

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    1. Christopher Burton, 2012. "Heavy Tailed Distributions of Effect Sizes in Systematic Reviews of Complex Interventions," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-7, March.
    2. Dorus W. M. Gevers & Stef P. J. Kremers & Nanne K. De Vries & Patricia Van Assema, 2018. "The Comprehensive Snack Parenting Questionnaire (CSPQ): Development and Test-Retest Reliability," IJERPH, MDPI, vol. 15(5), pages 1-10, April.
    3. Sean Snyder, 2013. "The Simple, the Complicated, and the Complex: Educational Reform Through the Lens of Complexity Theory," OECD Education Working Papers 96, OECD Publishing.
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    Cited by:

    1. Lisanne Vonk & Iris Eekhout & Tim Huijts & Mark Levels & Maria Jansen, 2024. "Does School Health Promotion Have Additional Value for Educational Performance? A Repeated Cross-Sectional Multilevel Study," IJERPH, MDPI, vol. 21(6), pages 1-21, June.
    2. Marion D. Driessen-Willems & Nina H. M. Bartelink & Kathelijne M. H. H. Bessems & Stef P. J. Kremers & Conny Kintzen & Patricia van Assema, 2021. "Co-Creation Approach with Action-Oriented Research Methods to Strengthen “Krachtvoer”; A School-Based Programme to Enhance Healthy Nutrition in Adolescents," IJERPH, MDPI, vol. 18(15), pages 1-12, July.
    3. Lisanne Vonk & Iris Eekhout & Tim Huijts & Mark Levels & Maria Jansen, 2024. "School Health Promotion, the Body Mass Index z-Score, and Psychosocial Health in Primary Schools of the Netherlands," IJERPH, MDPI, vol. 21(8), pages 1-14, August.

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