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HELSEVEL-H-Gode og effektive helse-, omsorgs- og velferdstjenester

Guideline evaluation and implementation mechanisms in school health services

Alternative title: Evaluering av implementering og effekt av retningslinjer i skolehelsetjenesten. En optimaliseringsstudie.

Awarded: NOK 16.0 mill.

A national guideline with best practice recommendations for school health services was launched in 2017. The guideline strongly recommended individual consultations with all 8th graders and cooperation with schools to promote healthy life skills and identify students in need of follow-up. Our overall objectives are to help the service implement this guideline, reach its goals, and increase knowledge about effective implementation strategies and service use among adolescents. Together with users and stakeholders we have developed SchoolHealth, a toolbox of three strategies to implement the guideline, including a web-based tool. We will evaluate and optimize SchoolHealth by studying if and how well the strategies help the service implement the guideline. We will also investigate whether following the guideline helps promote students' life skills and identify students in need of follow-up. Schools will be randomly assigned to different combinations of the three strategies. Doing so will help us learn how implementation strategies work and how to optimize SchoolHealth. Students, school nurses, and school personnel will complete interviews and questionnaires before, immediately after and six months after the consultation. We will compare SchoolHealth with a similar Danish tool and explore service use among students by combining SchoolHealth data with existing health surveys and registers. We will prepare for scaling-up the optimized version of SchoolHealth by developing solution designs for national e-infrastructure. Identifying successful strategies for implementing the guideline can support adolescents in a life phase vital for future health and wellbeing. If successful, SchoolHealth will facilitate health promotion in schools, more effective youth services and systematic cooperation with schools The study will yield valuable knowledge about implementation strategies and service use, increase evidence-based practice, and promote cooperation between Nordic countries.

A national guideline with best practice recommendations for school health services was launched in 2017. The guideline strongly recommended individual consultations with all 8th graders and cooperation with schools to promote healthy life skills and identify students in need of follow-up. Our overall objectives are to help the service implement this guideline, reach its goals, and increase knowledge about effective implementation strategies and service use among adolescents. Together with users and stakeholders we have developed SchoolHealth, a toolbox of three different implementation strategies including a web-based tool. We will evaluate and optimize SchoolHealth by studying the three strategies' effectiveness on guideline fidelity and the extent to which guideline fidelity helps reach the guideline goals. We will use a hybrid evaluation design with a factorial experiment where schools will be matched and randomly assigned to different combinations of the three strategies. Qualitative interviews will complement the quantitative data. Students, school nurses, and school personnel will complete interviews and questionnaires at baseline, after consultation, and 6-months post consultation. We will compare and complement SchoolHealth with a Danish equivalent and explore service use and user pathways by combining SchoolHealth data with existing health surveys and registers. We will prepare scale-up of promising SchoolHealth strategies by developing solution designs for national e-infrastructure. Identifying successful strategies for implementing the guideline can support adolescents in a life phase vital for future health and wellbeing. If successful, SchoolHealth will facilitate health promotion in schools and more effective youth services, which may increase school completion and social inclusion. The study will yield valuable knowledge about implementation mechanisms and service use, increase evidence-based practice, and promote cooperation between Nordic countries.

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HELSEVEL-H-Gode og effektive helse-, omsorgs- og velferdstjenester