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Health Promotion International Advance Access originally published online on July 5, 2006
Health Promotion International 2006 21(3):209-218; doi:10.1093/heapro/dal020
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© The Author (2006). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

System-wide adoption of health promotion practices by schools: evaluation of a telephone and mail-based dissemination strategy in Australia

Elizabeth Johnstone1, Jenny Knight1,2, Karen Gillham1, Elizabeth Campbell1,2, Craig Nicholas1 and John Wiggers1,2

1 Hunter New England Population Health, Hunter New England Area Health Service New South Wales, Australia 2 University of Newcastle New South Wales, Australia

Address for correspondence: Mrs Jenny Knight, Hunter New England Population Health, Locked Bag 10, Wallsend NSW 2287, Australia E-mail: Jenny.Knight{at}hnehealth.nsw.gov.au

Schools can potentially benefit from system-wide approaches to the dissemination of health promotion practices. This intervention study undertaken in the Hunter Region of NSW, Australia, used a pre-post design to assess whether a phone and mail intervention dissemination strategy was associated with an increase in the proportion of 218 primary schools undertaking eight health promotion practices. Health promotion practices addressed the prevention of harm associated with five agreed health issues—smoking, nutrition, playground safety, asthma and infectious diseases. The study also assessed acceptability of the dissemination strategy to schools, cost and whether intervention schools’ characteristics were associated with uptake of health promotion practices. Compared to baseline a significant improvement in prevalence was observed at both 1 and 2 year follow-up for seven of the eight health promotion practices addressed. The greatest improvement occurred in the first year of the project. There was a greater uptake of the practice of providing information regarding passive smoking in urban schools. The dissemination strategy was found to have a cost per adopted practice of $A121, and to be acceptable to the large majority (>90%) of schools. The results suggest that the dissemination strategy may represent a relatively low cost method of enhancing health promotion practices in schools and of monitoring such practices. Further research addressing the methodological issues of this study is needed to confirm these findings.

Key words: computer-assisted telephone interview; health promotion; primary schools


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