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

Beki Langford, Christopher P Bonell, Kelli A Komro, Simon Murphy, Daniel Magnus, Elizabeth Waters, Lisa F Gibbs, Rona Campbell

Research output: Contribution to journalArticle (Academic Journal)peer-review

27 Citations (Scopus)
506 Downloads (Pure)


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.
Original languageEnglish
Number of pages13
JournalHealth Education and Behavior
Early online date15 Nov 2016
Publication statusE-pub ahead of print - 15 Nov 2016

Structured keywords

  • DECIPHer


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

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