Introduction

In Chapters 6 and 7, we saw how interventions aiming to increase engagement, belonging, and safety and support in schools can benefit students across a range of health and educational outcomes. This chapter explores how school context, country context and the specific health outcomes being addressed affect what schools need to do.

School context

Different schools have different cultures, different capacities for action, different pressures and different priorities. So when embarking on change, they are likely to need to start from different places and do different things.

Factors affecting delivery

Schools will vary in how hard they find it to deliver health interventions. With Lauren Herlitz, Laurence Blanchard and other colleagues, I have undertaken a couple of systematic reviews looking at what factors affect this. We know from these that implementation is much easier if school staff have the confidence to feel that they are able to deliver the intervention and if they believe in its value. Implementation is also more likely when an intervention has the support of committed colleagues and senior leaders and when it aligns with national policy. Implementation is likely to be sustained if staff can see a rapid positive impact on students’ engagement and wellbeing. Sustained delivery is also more likely if interventions can be adapted to existing school systems and routines.

Implementation is harder when there is a norm within a school of prioritising educational outcomes over student health and wellbeing. It is also harder where there are time and resource constraints, a lack of staff training and a high staff turnover.