Actions on governance of health-promoting schools: What do actors think about their acceptability and feasibility?

Background: Understanding what school actors think about the implementation of health promotion actions may support Health-Promoting Schools (HPS) at a large scale.
Objective: To compare the perception of different school actors (policymakers/school managers, researchers, teachers, and health professionals) about acceptability and feasibility of health promotion actions based on the World Health Organization’s HPS framework.
Methods: This cross-sectional, online survey was performed from July to September 2023 using the SurveyMonkey® platform. The “snowball” strategy was used, considering an initial list of individual and institutional contacts from all five regions from Brazil. A standardized list with 20 HPS actions was used considering four dimensions: government policies and resources (n=8), school policies and resources (n=5), school governance and leadership (n=3) and school-community partnerships (n=4). An instrument with indicators of acceptability and feasibility was considered and applied to four groups of actors. Generalized Linear Models were used (p<0.05).
Results: A total of 15 policymakers/school managers, 23 researchers, 37 teachers and 46 health professionals answered the survey. In 3 of 4 HPS dimensions, policymakers/ school managers had lower scores of acceptability and feasibility indicators (easiness, time and training needed, and general satisfaction) when compared to their peers from other groups (p<0.05).
Conclusions: Policymakers/school managers had the worst perception of the acceptability and feasibility of HPS actions on government and school policies and resources, as well as partnerships with the community.
Practical implications: Implementing HPS at a large scale should improve resources and skills of governance of health promotion actions in schools. Training policymakers and school managers on governance of HPS may be a strategy on health promotion agenda in countries with diverse territories and high vulnerabilities, such as Brazil.
Funding: Grants from the Fortaleza’s Secretary of Education (Agreement n. 01/2022/FUNECE/SME) and from the Brazilian National Council for Scientific and Technological Development (312091/2021-4).