A Fourteen Year Follow-Up Study of Health Promoting Schools in Norway: Principals` Perceptions of Conditions Influencing Sustainability

In this study, we examined the sustainability of health-promoting practices in Norwegian schools that were enrolled in the European Network of Health-Promoting Schools from 1993 to 2003. The research questions were: How do the principals perceive that health-promoting practices have been sustained in the schools following the schools' membership of the health-promoting schools network? In what way is school leadership related to the sustainability of health promotion? The study draws on qualitative data consisting of interviews with seven principals in 2008 and school documents. The schools determined their own priorities for action based on assessment of needs in 1994. After 14 years, health promotion practices were sustained in six of the seven schools. Two factors emerged as vital for sustained health promotion practices: the health-promoting school experience and the maintenance and development of practice. The health-promoting school experience relates to staff who internalized the potential link between health promotion practices, school satisfaction, and learning. This also emphasizes the importance of the transfer of experience in sustaining health promotion practices as the staff turned over. The maintenance of vision and practice relates to the principals' commitment to school health promotion, leadership practices that encourage health promotion practices, and external collaboration with the surrounding community in health promotion