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The Health Promoting Schools Framework: Known Unknowns and an Agenda for Future Research

Research output: Contribution to journalArticle (Academic Journal)

Original languageEnglish
Number of pages13
JournalHealth Education and Behavior
Early online date15 Nov 2016
DateAccepted/In press - 18 Aug 2016
DateE-pub ahead of print (current) - 15 Nov 2016


The World Health Organization’s Health Promoting Schools (HPS) framework is a whole-school approach to promoting health which recognises the intrinsic relationship between health and education. Our recent Cochrane systematic review found HPS interventions produced improvements in a number of student health outcomes. Here we reflect on what this review was not able to tell us: in other words, what evidence is missing with regard to the HPS approach. Few HPS interventions engage with schools’ ‘core business’ by examining impacts on educational outcomes. Current evidence is dominated by obesity interventions, with most studies conducted in children rather than adolescents. Evidence is lacking for outcomes such as mental or sexual health, substance use and violence. Activities to engage families and communities are currently weak and unlikely to effect behavioral change. The HPS approach is largely absent in low-income settings, despite its potential in meeting children’s basic health needs. Intervention theories are insufficiently complex, often ignoring upstream determinants of health. Few studies provide evidence on intervention sustainability or cost-effectiveness, nor in-depth contextual or process data. We set out an agenda for future school health promotion research, considering implications for key stakeholders; namely national governments, research funders, academics and schools.

    Structured keywords

  • DECIPHer

    Research areas

  • adolescents, children, education, Health Promoting Schools, systematic review

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    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Sage at Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 568 KB, PDF document


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