Development of a School Health Policy Implementation Survey: A Delphi Study

Area of Science:

• Public Health
• Health Policy
• Educational Administration

Background:

• Limited data exist on school health policy implementation due to a lack of validated measurement tools.
• Effective implementation of school health policies is crucial for student well-being.
• The gap between written policies and actual practice in schools needs to be addressed.

Purpose of the Study:

• To develop and pilot a survey instrument for assessing school health policy implementation.
• To create a reliable tool for evaluating the practical application of school health policies.
• To provide a resource for school nurses and administrators.

Main Methods:

• A modified four-round Delphi process was employed to establish consensus on survey content and format.
• A 76-item survey was developed and piloted across 655 schools.
• Environmental audits were conducted in seven schools to validate survey responses.

Main Results:

• The survey achieved a 57.1% return rate (n=378).
• Environmental audits indicated that survey responses accurately reflected school practices for 84.2% of items (n=64).
• 15.8% of survey items (n=12) were revised or removed based on audit findings.

Conclusions:

• The developed survey is a validated measurement tool that addresses a critical research gap.
• This tool can accurately assess school health policy implementation.
• The survey aligns with the Framework for 21st Century School Nursing Practice, supporting school nurses in their roles.