Implementing a social‐ecological model of health in Wales
Bibliographic record
Abstract
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 ( n =23) and stakeholder ( n ∼93) discussion of interim findings at three regional workshops. 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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".