Factors influencing teachers’ Views of Health and Health Education: a Study in 15 Countries

International audienceThere is growing recognition that education and health are inextricably linked to the school context. Not only are healthy children and young people are more likely to enhance their learning abilities and achieve better academic outcomes but also when they feel good and healthy at school they are less likely to undertake high risk behaviours. In this perspective the International Union for Health Promotion and Health Education has been strongly involved in encouraging and advocating the implementation of the “whole-school health promoting school” concept, in which both health and education sectors must work together in schools.Health promotion in a school setting has been defined as school activities undertaken to improve the health of all school users, having a broader concept than classroom health education and it includes activities relating to healthy school policies, the school physical and social environment, the curriculum, community links and health services. There are many factors that may either support or impede the implementation and sustainability of health promotion programmes in schools, such as: (i) the institutional context of the school, i.e. the national and local policies concerning health and environmental school issues, (ii) the specific school context regarding the school Head/Principal/Director’s leadership in creating a school climate of trust, respect, collaboration and openness, (iii) pupils’ involvement and compromise with health programmes, and (iv) teachers’ beliefs and teachers’ perception of their role in health education and health promotion, their confidence in their own competencies to be effective in health promotion programmes, which is tightly linked to their specific health training.Teachers play a central role in the implementation and sustainability of school health promotion programmes as they are the ones able to make the bridge between the school curriculum in the classroom and the whole-school health promotion programmes. It has been shown that teachers must undergo adequate health training in order to develop competencies for the implementation and sustainability of health promotion programmes.The aim of health promotion programmes is to increase wellbeing and to reduce health risks, as stated by Downie et al. Their model of health suggests that health is a relative value, running in a continuum between two poles, positive health (PH) and negative health (NH). It is largely documented that self-perceived health may vary among people as a result of their system of values. Such variation may be particularly evident among countries with socioeconomic and cultural differences. The understanding of teachers’ views about health and health education is of paramount importance for the design and planning of adequate teachers’ training courses. Having all this in mind, the present study analysed the health perceptions of teachers and future teachers from 15 countries in Western Europe, Eastern Europe, Middle East, North Africa, Sub-Saharan Africa and South America. Respondents were asked to complete a questionnaire where a specific question, among others, was constructed on the basis of the Downie et al. model about having positive health and negative health perspectivesMethodThe present work was carried out within the large European project “Biology, Health and Environmental Education for better Citizenship” (BIOHEAD-CITIZEN, FP6, STREP CIT2-CT-2004-506015) involving 19 countries. For the present study we used questionnaire which was constructed and validated by all teams of the project. The original English version was translated into each national language and after validation of the translation it was pre-tested, before implementation in each country. For this study, we focused on health education questions as well as on some personal features (age, gender, teaching group, level of education, religion). Data were collected in 15 countries, Northern Europe, South Europe, Northern Africa, Sub-Saharan Africa, Middle East and South America. In each country the questionnaire was applied to a balanced sample of pre-service teachers (Pre) and in-service teachers (In).. Respondents filled in the questionnaire anonymously. Bivariate and multivariate analyses and a cluster were conducted. For this, independent variables (country, religion, age, teaching group, level of training) and Health Education dependent variables were used. A multivariate logistic regression model was used to evaluate the association between each variables and the dependent variable (view of health) while controlling for all the other variables.Expected OutcomesIn this large international study involving six groups of teachers from 15 countries, a general picture of trends in positive and negative health views were obtained. The survey does not lead to a comprehensive view of the factors influencing teachers’ perception of health but results showed that there is a variety of variables associated with health and health education views. Most of the current studies in school health have been carried out in Western countries. The present results may lead to a better understanding of the similarities and differences among 15 countries with high socioeconomic and cultural diversity. However this is not enough to build appropriate teachers’ training courses to put into practice efficient health promoting initiatives in all countries. If there is a willingness to support the development of health promoting schools at a global level, further studies have to be carried out with data from some of these countries, selected by their striking differences, in order to undergo deeper comparative analysis associated to their specific socioeconomic and cultural features