Development and validation of an instrument to evaluate school-health implementation: a sequential mixed-methods...

Area of Science:

• Public Health
• Educational Psychology
• Health Promotion

Background:

• Comprehensive School Health (CSH) is an internationally recognized approach to improve school environments and student health.
• CSH effectively promotes health-enhancing behaviors and improves educational outcomes.
• Existing tools lack the ability to measure holistic shifts in school culture and CSH implementation conditions.

Purpose of the Study:

• To develop and pilot a user-friendly evaluative tool for schools and school authorities to plan and assess Comprehensive School Health (CSH) initiatives.
• To utilize the Essential Conditions for CSH Approach framework in tool development and validation.
• To evaluate the tool's face, content, and construct validity, as well as its internal consistency.

Main Methods:

• A sequential mixed-methods approach was employed, combining qualitative and quantitative phases.
• Phase 1 involved a participatory qualitative approach to develop the tool and assess face/content validity.
• Phase 2 involved a quantitative pilot test to examine construct validity and internal consistency.

Main Results:

• Phase 1 confirmed the tool's face and content validity.
• Phase 2 demonstrated high reliability for many survey items, with acceptable internal consistency at the school level for most Essential Conditions.
• Construct validity showed mixed results, potentially due to sample size, but good model fit was indicated by SRMR values for most Essential Conditions at both school and school-authority levels.

Conclusions:

• The study successfully developed a user-friendly evaluative tool for CSH implementation, providing encouraging pilot results.
• This tool facilitates ongoing data collection on healthy school community process indicators.
• The tool has significant practical applications for the broad adoption, scaling, and long-term evaluation of CSH interventions.