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Purpose: The aim of this paper is to identify the role of the principal in establishing a whole school approach for health and wellbeing. Two questions are asked: (1) What do successful Swedish principals do when they take on a whole school approach? (2) How do these results relate to previous research on successful school leadership? Design/methodology/approach: This paper focuses on the complexity of organisational processes and considers the role of successful leadership in managing a whole school approach to health promotion. It presents findings from two different but interlinked projects, and draws on document studies and interviews with principals, student health team members and teachers in Sweden. Findings: This paper argues that successful school leaders are crucial in establishing a whole school approach, because of the work they do to synchronise the health-promoting activities in schools. The study identifies four aspects of coordination that need to be enacted simultaneously when leading health-promoting processes. The fifth aspect identified is that a whole school approach is not limited to the school, but the whole local school context, i.e. a synchronisation between different system levels. Originality/value: Although limited in scale, this paper reports key findings that could have practical implications for school leaders. The study suggests that successful school leadership research needs to use a health-promoting lens in order to make leadership practices health-promoting practices. It also proposes extended comparative research from different fields and contexts. [ABSTRACT FROM AUTHOR]

Purpose Breastfeeding education in the school setting offers the opportunity to improve knowledge base and positively influence beliefs and intentions for students. The purpose of this paper is to analyze the effect of short education program among secondary school students on breastfeeding knowledge and intentions.Design/methodology/approach Total of 106 female and 155 male students from four different high schools in Bjelovar were given online questionnaire about intentions to breastfeed and test of knowledge about breastfeeding, both before and shortly after education. The effect of education and school on breastfeeding intentions and knowledge was examined using mixed design ANOVA. Univariate tests were used to examine relation of several independent variables to breastfeeding intention and knowledge scores before and after education.Findings Results showed statistically significant effect of education on both intentions and knowledge, whereas the effect of school was significant only for intentions. Students show more positive intentions and better knowledge about breastfeeding after education than before education.Research limitations/implications This paper does not entail validation of breastfeeding questionnaire and knowledge test. Due to comprehensiveness and report length, study on validity and reliability of measures is the subject of another paper.Practical implications The authors hope that results of the study will influence professional public in Croatia and encourage it to support implementation of breastfeeding education in curriculum.Originality/value This paper offers the first national intervention data in relation to breastfeeding intentions and knowledge among secondary school students. It provides an evidence for necessity of implementation of well-structured education module in regular curriculum of secondary education in Croatia. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to critically examine school health education in the USA and present alternative approaches for more critical and comprehensive health education.Design/methodology/approach An ecological model framework is used to identify the limitations and opportunities for improvement in school health education in the USA. An argument is made for school health education that embraces ecological approaches, political economy theory, and critical pedagogies.Findings US schools have been tasked with providing health education that is primarily rooted in individualistic approaches. Often missing from this education is recognition of the social and structural determinants of health that greatly influence one’s ability to practice the health behaviors promoted in schools. This raises pedagogical and ethical concerns, which can be addressed by teaching health education that is grounded in ecological and political economy understandings of health and in critical pedagogies that allow students to more comprehensively and accurately understand health, how their worlds influence health, and their agency within those worlds.Practical implications This paper offers justification for a critical model of school health education and for the professional preparation of school health educators that is grounded in critical pedagogy and ecological approaches.Originality/value This work complements other research on critical health education by adding explicit integration of the ecological model and the political economy theory within critical pedagogies. [ABSTRACT FROM AUTHOR]

Purpose Equipping pre-service teachers with the skills and knowledge needed to teach health in socially critical ways requires pre-service teachers to examine and critique individualistic understandings of health. The purpose of this paper is to use Bourdieu’s concepts of the bodily hexis (the body as both separate from society (autonomous individuals) and the body as socially mediated (the influence of social forces upon individuals)) and pedagogic work to investigate the challenges of redressing the reproduction of individualistic conceptualizations of health in teacher education.Design/methodology/approach The paper focusses on an analysis of 31 pre-service teachers’ reflective writing in a foundational health education course, which sought to engage students in thinking about health in socially critical ways. A systematic and procedural form of document analysis was employed to examine and interpret data to investigate the ways in which students were engaging with the socially critical health discourses and course content.Findings The findings evidence that while students attempted to engage with and demonstrate their knowledge of a socially critical view of health, contradictions, or places where students unknowingly slipped into individualistic ways of thinking appeared frequently across the data. Findings are presented to elucidate challenges facing pre-service teachers in teaching the AC:HPE curriculum.Practical implications Findings suggest the need for teacher educators to employ pedagogic practices that can disrupt previous pedagogic work, serving to challenge and interrogate current constructions of health, and delve deeply into critical discourses through interchange and reflection.Originality/value This paper extends the current scholarship of Bourdieusian theoretical concepts in relation to critical health discourses and pedagogies. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to test an hypothesis that teachers’ personal orientations toward food preparation, nutrition and environmental issues would be related to their perceived importance of food skills. Design/methodology/approach – Little research has been conducted on home economics teachers’ views on the importance of the food skills they teach in secondary schools in Australia. Therefore, an online survey was conducted among 261 home economics teachers in Australian secondary schools. The research measured respondents’ ratings of the importance of 70 food skills as well as their teaching preferences and use of resources. Findings – Respondents rated the procedural “hands-on” skills required to prepare a healthy meal as most important. Exploratory factor analysis derived five components (procedures for domestic settings, procedures for vocational settings, cookery methods, food economy, using microwave oven appliances) relating to teachers’ perceived importance of food skills. Teachers’ personal orientations were described as food aesthete, consumer-environmentalist and nutritionist. The findings showed that these were better predictors of the perceived importance of food skills than demographic characteristics. The most important perceived skills related to the basic procedures required by young people to be able to prepare meals for themselves when living independently. Teachers’ personal “orientations” were significantly related to the perceived importance of food skills. Demographic and professional characteristics were poor predictors of these perceptions. Originality/value – The findings provide home economics teachers with an understanding of their selection of particular food skills to teach their students in skill-based healthy eating programmes. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the use and applicability of cultural probes – an explorative participatory method to gain insights into a person’s life and thoughts – to achieve person-centeredness and active involvement in self-management education for people with chronic illness. Design/methodology/approach – An education toolkit inspired by the ideas of cultural probes was developed and feasibility tested in 49 education settings in Denmark. Questionnaires, interviews, and observations were used to collect data, which were analysed using descriptive statistics, analysis of variance, and systematic text condensation. Findings – Educators emphasized the applicability of the toolkit, and between 69 and 82 per cent of educators reported that the toolkit supported them in facilitating person-centred education and active involvement to a high or very high degree. Most educators (81 per cent) reported that they would like to apply the toolkit again in future education to a high or very high degree. Five categories of educator experiences were identified: interaction and activity; person-centeredness; group dynamics and synergy; openness; and light and cheerful atmosphere. Educators talked significantly less in situations where the toolkit was applied. This indicates the ability of the toolkit to facilitate talk among participants and thereby let participants become the focal point of education. Applying cultural probes in patient education targeting people with chronic illness seems to be a useful method to achieve patient-centeredness and active involvement in patient education and to support educators in facilitating this process. Originality/value – Introducing fully flexible education toolkits inspired by cultural probes may, in the future, lead to improved self-management patient education among people with chronic illness. [ABSTRACT FROM AUTHOR]

Purpose -- There is a growing need for school-based nutritional educational programs that promote healthy eating attitudes without increasing an unhealthy focus on restrictive eating or promoting a poor body image. Research suggests that intuitive eating (IE) approaches, which encourage individuals to focus on internal body signals as a guide for eating, have had a positive impact on eating-related psychological outcomes in adults. The purpose of this paper is to investigate the effects an IE education program on the eating attitudes of high school students. Design/methodology/approach -- In a quasi-experimental study, 48 high school students (30 females) in a Midwest town in the USA received instruction on IE or a comparison program over seven days during health classes. Repeated measures analyses of covariance were conducted to examine changes in eating attitudes in sexes across conditions. Findings -- Students who received the IE program made significantly greater gains in overall positive eating attitudes on the Intuitive Eating Scale than students in the comparison program ( p = 0.045), as well as on the Unconditional Permission to Eat subscale ( p = 0.02). There were no significant effects of sex on any of the analyses. Research limitations/implications -- Because of the relatively small sample size and short duration of the program, the results should be generalized with caution. Practical implications -- The results suggest that IE instruction may encourage the development of healthy eating attitudes in high school students, and health teachers may wish to consider including IE instruction in the health curriculum. Originality/value -- This is the first study to examine the effectiveness of an IE program in a K-12 population, with instruction provided in the context of the school. The results are promising and suggest that this may be a fruitful area for future research in nutrition education. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explore educator competencies and roles needed to perform participatory patient education, and develop a comprehensive model describing this. Design/methodology/approach -- Data collection in the qualitative study proceeded through two phases. In the first phase, 28 educators were involved in exploring educator competencies needed to perform participatory, group-based patient education. The paper used qualitative methods: dialogue workshops, interviews and observations. In the second phase, 310 educators were involved in saturating and validating the insights from phase one using workshop techniques such as brainstorming, reflection exercises and the story-dialogue method. A grounded theory approach was used to analyse data. Findings -- A model called "The Health Education Juggler" was developed comprising four educator roles necessary to perform participatory patient education: the Embracer, the Facilitator, the Translator and the Initiator. The validity of the model was confirmed in phase two by educators and showed fit, grab, relevance, workability and modifiability. Practical implications -- The model provides a tool that can be used to support the focus on "juggling" skills in educators: the switching between different educator roles when performing participatory, group-based patient education. The model is useful as an analytical tool for reflection and supervision, as well as for observation and evaluation of participatory, group-based patient education. Originality/value -- The study proposes a comprehensive model consisting of four equally important roles for educators performing participatory, group-based patient education. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explore educators' experiences of putting a participatory and patient-centered education model, "The Health Education Juggler," into practice after having attended a one-day seminar. The model consists of four educator roles in participatory group-based patient education in chronic illness: embracer (takes care of the group), facilitator (generates dialogue and participation), translator (communicates professional knowledge) and initiator (motivates action in patients). Design/methodology/approach -- Qualitative analysis of observations of eight group-based patient education sessions and seven in-depth semi-structured interviews with 11 educators. Findings -- Educators find it difficult to include disease-specific knowledge when working with a flexible patient-centered approach. They tend to stay in the role they find most comfortable during education sessions (most often that of embracer), rather than adopting new and more challenging roles in the teaching process. Educators theoretically understand the role of facilitator, but they do not know how to perform in this role in practice. The ability to juggle all educator roles depends on the ability to master each. Practical implications -- The Health Education Juggler model shows promise in promoting participation and patient-centeredness and as a reflection tool for educators and an analytic tool for quality assessment of patient education. These findings support further development of model use. Originality/value -- This model of educator roles in group-based patient education in chronic illness provides a new approach to patient education. It indicates the need for various professional competencies among educators to provide patient-centered education in a flexible way, with a strong focus on patient-identified problems and challenges, social learning processes and generation of internal motivation in patients. [ABSTRACT FROM AUTHOR]