What are the challenges faced by professionals working within schools when delivering health promotion sessions to children aged 5-18 years in Liverpool in a post-covid world? A qualitative study.

Abstract

Background: Health promotion within schools is an essential tool to challenging poor health and promoting healthy choices across the lifespan. Literature widely acknowledges that early intervention is key to positive long-term health outcomes and school health education is seen an effective tool to support this. However, Covid-19 has created challenges in how health education is delivered. Some studies have suggested Covid-19 has improved multi-agency working and has generated new, effective methods of delivery whereas others have argued that the role of practitioners has changed, and they now face different challenges which hinder efficacy of health promotion. No studies have been documented which compare pre- and post-pandemic delivery of health education simultaneously through the exploration of practitioner perspectives.

Methods: A qualitative study design was used to conduct research; using individual, semi-structured interviews via Microsoft Teams. A sample of six participants were obtained through purposeful sampling; three participants had a background in education and three participants had a background in public health nursing. Interviews were transcribed and analysed using thematic analysis.

Results: Findings showed that participants experienced poor relationships between multi-agencies, with school health and teaching staff working independently to deliver health promotion, often covering the same topic rather than working together to tailor content according to local need. Resources and attitudes towards health promotion were identified as an area of interest. It was reported that there appears to be a disparity of resources across the locality, with school leaders making individualised decisions on which topics to be included within their settings, often informed by their own beliefs or agendas. Parental attitudes towards health promotion were seen as a significant factor in efficacy; providing a comparison of positive parental engagement pre-covid compared to poor engagement post-covid. The visibility of the school health role was also raised, with comparisons drawn between in-person and virtual relationships as a direct impact of the pandemic. Health practitioners felt that they no longer had strong relationships with school staff and teaching staff reported that they did not know how to access school health teams for support.

Conclusion: Work is needed to improve relationships between health and education, with focus given to the local needs of children rather than to personal agendas of school leaders. Engagement with parents requires significant improvement if the long-term consequences of Covid-19 are to be improved.