# Evaluation of Health Promotion in International Schools Using the Schools for Health in Europe (SHE) Rapid Assessment Tool

## TL;DR

This study used a health assessment tool to evaluate how well international schools promote health, finding that most needs are partially addressed but some areas need improvement.

## Contribution

The study applies the SHE rapid assessment tool in international schools to evaluate health promotion efforts and identify key improvement areas.

## Key findings

- 80% of respondents felt health promotion needs were partially or fully addressed with medium or high priority.
- 30% of respondents noted that health and well-being needs of students and employees had not been fully assessed or promoted.
- The SHE tool effectively identifies key health indicators for future action in becoming a health-promoting school.

## Abstract

Background: Many schools are committed to the “Five Steps to a Health Promoting School guide” created by the Schools for Health in Europe (SHE) network to avoid chronic disease and promote healthy environments. Objectives: The aim of this study was to evaluate schools’ health promotion policies and practices via the SHE rapid assessment tool. Methods: From February 2019 to June 2019, a cross-sectional survey based on this tool was conducted in nine international schools that are part of a private network operating in multiple countries. The entire school community was offered the opportunity to participate. The survey consisted of 37 questions aligned with the whole-school approach to health promotion and addressed orientation, healthy school policy, the physical and social environment, health skills, community links, and staff well-being using a three-point scale. A univariate analysis was subsequently performed. Results: A total of 929 people responded, 59.7% of whom were women, representing 74 different nationalities (82.5% Europeans). The average age was 25.9 years, ranging from 7 to 77 years. The participants included 57.2% students, 21.3% teachers, 15.3% families, 3.2% management teams, 1% counsellors/psychologists, 1% administrative/service staff, 0.5% catering staff, 0.3% nursing/medical staff, and 0.2% maintenance staff. The findings revealed that 80% of the respondents felt that most of these health promotion needs were being partially or fully addressed, predominantly with medium or high priority. However, 30% of the respondents indicated that the school had not yet assessed the students’ and employees’ health and well-being needs or fully promoted a healthy work-life. Conclusions: The SHE rapid assessment tool serves as an effective initial step in identifying key indicators within the school community, offering insights for future action towards becoming a health-promoting school. These results underscore the importance of addressing social and behavioural determinants of health within different international educational settings to promote positive sociorelational well-being and youth development. By fostering the well-being of children, adolescents, and the educational community, schools play a pivotal role in reducing the risk factors for chronic diseases and supporting psychosocial adaptation.