1. Health Education and Health Promotion in Schools
Key concepts, perspectives and challenges
Venka Simovska, professor

2. Outline
Theory
Key (selected) concepts of the health promoting schools paradigm
Fragments of research
Policy travel towards school practice – example from an European project and from Denmark (check the articles)
Stakeholders’ perspectives – municipality consultants working with schools
Reflections and discussion
Theory, research and practice
Venka Simovska

3. The landscape - health promotion theory relating to HPS -
What does this picture outline?
Contested field:
Socially constructed
Value loaded
Open to diverse, sometimes contradictory, interpretations
Venka Simovska, DPU

4. The nature of: Knowledge and Society Caplan and Holland, 1990
Radical
Change
Social
Regulation
Objective
Subjective
RADICAL
HUMANIST
STRUCTURALIST
TRADITIONAL
This is one model to analytically categorise the field.
Remember: Map is not the territory!
Venka Simovska, DPU

5. The traditional perspective: expert-led; the aim of health education is transmission of knowledge and behaviour change
The humanist perspective: the goal of health education is to assist individuals in developing their capacities and personal resources so that they can develop healthy lifestyles
Venka Simovska, DPU

6. The radical humanist perspective: individual empowerment is seen as the main aim of health education/promotion. Alongside this, individuals are encouraged to form social and economic networks
The radical structuralist perspective: the origin of health problems lies in structural issues; therefore the aim of health promotion/education is to address relationships between health and social (societal) factors
Venka Simovska, DPU

7. Prevention approach Empowerment approach Radical Approach
Behaviour change and an individual life styles
Empowerment approach
Awareness, skills and competence to influence determinants of health (communities and individuals)
Radical Approach
Critical consciousness and structural change (Freire 1974)
Venka Simovska, DPU

8. Social determinants of health
Social inclusion
Social connectedness, networks and supportive environments (social capital)
A valued social position
A variety of social, cultural and physical activities
Freedom from discrimination and violence
Valuing diversity
Safety and security
Opportunities for self-determination and control
Access to resources of participation
Access to education, work, housing…

9. Ideological tensions Health as a means Health as an end
Social, holistic, salutogenic approaches – focused on empowerment and health determinants
Health as a means
Social justice and democracy
Structural change
Medical, preventative, curative approaches – focused on adopting pre-determined healthy lifestyles
Health as an end
Individual and collective health
Behaviour change

10. Health-Promoting School
Why this photo? What does it say about learning?
Individual
Cognitive
Isolated
Venka Simovska, DPU

11. Dimensions of the HPS Initiative
Holistic, positive notion of health
Health-promotion approach (rather than preventative)
A whole-school approach
Students’ empowerment and action competence concerning health matters
Teachers’ (and health professionals’) skills and competence as ‘facilitators’
Partnerships on different levels: school, local community, society, international community
In contrast, the HPS suggests a different view
Venka Simovska, DPU

12. School as a health-promoting setting
curriculum
links with family and community
physical and psychosocial environment
school’s ethos
Venka Simovska, DPU

13. Critical educational approach to health-promoting schools
Aims
Students’ competence concerning health and health determinants at different levels (e.g. Simovska and Carlsson, 2012; Carlsson and Simovska, 2012)
Student participation as a process and outcome (Griebler et al, 2014; Simovska, 2012)
Pedagogy
Participatory and action-oriented teaching and learning strategies; whole school strategies (Simovska, 2013)
Outcomes
Education as well as health outcomes: qualification, socialization and subjectification (e.g. Biesta 2014)
Praxis is action informed and linked to certain values
Venka Simovska, DPU

14. Three perspectives on human agency
Individual actions
Psychological characteristics
Individuals determine the achievement of goals
Direct influence
Indirect influence
The environment shapes the achievement of goals
Reciprocal determinism
Bandura, Giddens…
Dialectic interaction
Venka Simovska, DPU

15. Empowerment Community Individual
Social action process in which individuals and groups act to gain control over their lives in the context of changing the social and political environment
Individual
Empowerment conveys the psychological sense of personal control or influence and a concern with actual social influence, political power and legal rights
Rappaport, 1984

16. Types of empowerment Economic empowerment
Skills and competences, access to secure incomes
Human and social empowerment
Control over one’s life, communities and societies
Political empowerment
Capacity to claim one’s rights
Cultural empowerment
Capacity to redefine norms and recreate cultural and symbolic practices (e.g. minority rights)

17. Different qualities of participation
From token to genuine - continuum (Simovska, 2005, 2007, 2009…2013)
Token Participation
Genuine Participation
health information
consequences
effects
Focus
processes of knowing
personal meanings
social construction
Outcomes
Target of change
convergent
(ready-made lifestyles, healthy behaviour)
divergent
(critical consciousness, responsible freedom)
individuals
individuals-in-context
Venka Simovska, DPU

18. Participation as taking part
Involvement in health promotion interventions
Interactivity of the methods and strategies
Participation is a motivational tool
Venka Simovska, DPU

19. influencing the matters of concern
Participation as
influencing the matters of concern
Participation is active
Participation involves choice
Participation has the possibility to be effective
Participation is a decision-making strategy
Venka Simovska, DPU

20. Participation – in what?
Dialogue
Negotiating meanings, visions and plans for action
Exploring alternative ideas, explanations and [health] problem solutions
Shared frames of reference
Action
Intentional
Focused on influencing the causes of a health problem in question
The participants have a say in identifying the causes and carrying out health-promoting action
Venka Simovska, DPU

21. Participation and empowerment Green and Tones 2010
Venka Simovska, DPU

22. Action competence
Domain knowledge (health matters)
Intrasubjective and interrelational knowledge
Critical reflection
Commitment and Vision
Experience of taking action (skills)
Psychological resilience
Identity: qualified participant and change agent
Simovska, 2005; 2011
Capability – based on critical thinking and incomplete knowledge – to involve oneself as a person with other persons in responsible actions and counter-actions for a more humane world.
Schnack, 1994: 190
Venka Simovska, DPU

23. Bits of research Simovska, Dadaczynski, Woynarowska, 2012
Madsen, Nordin and Simovska, 2015
Simovska, Nordin, Madsen,2015
Venka Simovska, DPU

24. Prioritization of HP in Danish schools (local - municipality level) (Simovska, Nordin, Madsen, 2015)
Venka Simovska, DPU

25. Policy contents and links to national policy
Venka Simovska, DPU

26. Content focus in practice
Venka Simovska, DPU

27. What do the findings tell us?
Venka Simovska, DPU

28. What next?
Research? Practice?
Venka Simovska, DPU