ArticleBMC public health2019
Process evaluation of the healthy primary School of the Future: the key learning points.
Article in BMC public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02800616 (The Healthy Elementary School of the Future), which is not on this map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Healthy Elementary School of the Future
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Randomized controlled trials on physical activity, diet, or both for public health through body weight management in 5- to 10-year-old pupils: a systematic review and meta-analysis.European journal of public health · 2025Pooled it
- Qualitative process evaluation from a complex systems perspective: A systematic review and framework for public health evaluators.PLoS medicine · 2020Pooled it
- Trial
- Trial
- Understanding context in the implementation of school health promotion: a scoping review and conceptual framework.Systematic reviews · 2026Article
- Feeding change: school meal support in the Netherlands and the perspectives of primary school professionals.BMC public health · 2026Article
- Assessment of School Food Policy Influencing Nutritional Behaviour of Adolescents from the Perspective of School Stakeholders in Ibadan, Oyo State.International journal of environmental research and public health · 2025Article
- 'We get to learn as we move': effects and feasibility of lesson-integrated physical activity in a Swedish primary school.BMC public health · 2024Article
- Influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low socioeconomic status: a systematic review.Implementation science communications · 2024Review
- A qualitative study exploring the perceptions of children, parents and school staff towards the development and implementation of school lunch provision within primary schools in the Netherlands.BMC public health · 2023Article
- Increasing community capacity to improve the implementation of Health Promoting Schools: barriers and facilitators from the FLASH intervention.Health promotion international · 2023Article
- Context matters-the phased development of an adaptable food literacy intervention: Up for Cooking.Health promotion international · 2023Article
- Implementing a Digital Depression Prevention Program in Australian Secondary Schools: Cross-Sectional Qualitative Study.JMIR pediatrics and parenting · 2023Article
- Which factors promote and prohibit successful implementation and normalization of a healthy school lunch program at primary schools in the Netherlands?Journal of health, population, and nutrition · 2022Article
- A scoping review of systems approaches for increasing physical activity in populations.Health research policy and systems · 2022Article
- Exploring primary school years interactions around child weight: A qualitative meta-synthesis of school staff, parent, and child views and experiences.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022Review
- Perceived Barriers to Digitising School-Based Obesity Intervention: An Exploratory Study.The Malaysian journal of medical sciences : MJMS · 2022Article
- In It for the Long Haul: RE-AIM Evaluation of a Preschool Programme Implementing and Maintaining Adult-Initiated Motor Skill Development and Physical Activity across a Two-Year Period.International journal of environmental research and public health · 2022Article
- Implementation of a Dutch school-based integrated approach targeting education, health and poverty-a process evaluation.Health promotion international · 2022Article
- Supporting schools during the implementation of the health-promoting school approach: The roles of a healthy school advisor.Frontiers in public health · 2022Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundWhile schools have potential to contribute to children's health and healthy behaviour, embedding health promotion within complex school systems is challenging. The 'Healthy Primary School of the Future' (HPSF) is an initiative that aims to integrate health and well-being into school systems. Central to HPSF are two top-down changes that are hypothesized as being positively disruptive to the Dutch school system: daily free healthy lunches and structured physical activity sessions. These changes are expected to create momentum for bottom-up processes leading to additional health-promoting changes. Using a programme theory, this paper explores the processes through which HPSF and the school context adapt to one another. The aim is to generate and share knowledge and experiences on how to implement changes in the complex school system to integrate school health promotion.
methodsThe current study involved a mixed methods process evaluation with a contextual action-oriented research approach. The processes of change were investigated in four Dutch primary schools during the development year (2014-2015) and the first two years of implementation (2015-2017) of HPSF. The schools (each with 15-26 teachers and 233-389 children) were in low socio-economic status areas. Measurements included interviews, questionnaires, observations, and analysis of minutes of meetings.
resultsTop-down advice, combined with bottom-up involvement and external practical support were key facilitators in embedding HPSF within the schools' contexts. Sufficient coordination and communication at the school level, team cohesion, and feedback loops enhanced implementation of the changes. Implementation of the healthy lunch appeared to be disruptive and create momentum for additional health-promoting changes.
conclusionsInitiating highly visible positive disruptions to improve school health can act as a catalyst for wider school health promotion efforts. Conditions to create a positive disruption are enough time, and sufficient bottom-up involvement, external support, team cohesion and coordination. The focus should be on each specific school, as each school has their own starting point and process of change.
trial registrationThe study was retrospectively registered in the ClinicalTrials.gov database on 14 June 2016 (NCT02800616).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.