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The Role of the APPLE School Principal in Knowledge Exchange and in Implementing Comprehensive School Health to Create a Healthy School Culture Open Access


Other title
Knowledge Exchange
Comprehensive School Health
Health Promotion
School Principal
Healthy School Culture
Type of item
Degree grantor
University of Alberta
Author or creator
Roberts, Erica C
Supervisor and department
Storey, Kate (School of Public Health)
Examining committee member and department
Veugelers, Paul (School of Public Health)
Willows, Noreen (Department of Agricultural, Food & Nutritional Science)
Gleddie, Doug (Department of Elementary Education)
Centre for Health Promotion Studies

Date accepted
Graduation date
Master of Science
Degree level
Comprehensive School Health (CSH) is an internationally recognized framework that moves beyond the individual to holistically address school health, and has been shown to be effective in improving health-enhancing behaviours and educational outcomes. Despite its effectiveness, the specific implementation strategies behind CSH are vague and much remains to be determined to help support its optimization. School leadership has been suggested to be important for the successful implementation of CSH. Furthermore, knowledge exchange (KE) practices, including knowledge brokering and data-driven decision-making (DDDM), are essential to ensure that implementation is evidence-informed. The principal seemingly acts as a key player within KE, yet this role remains to be examined within a project guided by CSH. Overall, multiple methods were used to address two specific objectives within this research, which included: 1) To qualitatively examine the role of the school principal in the implementation of a project guided by CSH, geared at creating a healthy school culture; and 2) To quantitatively examine the extent of knowledge sharing and use of evaluation data by principals in both CSH schools and other randomly selected provincial schools throughout Alberta, Canada. The qualitative component of this research was informed by constructivist approaches of focused ethnography and grounded theory, leading to the overall classification of the study as a grounded ethnography. Semi-structured interviews (n=29) with school principals involved in the Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools), a project guided by the CSH framework, were conducted. Data were collected between April and July 2013. Through both latent content analysis and constant comparison analysis, five major themes emerged, leading to the development of a model representing the fluid role of the principal within the CSH implementation process. Principals: 1) primed the cultural change; 2) communicated the project’s importance to others; 3) negotiated concerns and collaboratively planned; 4) held others accountable to the change, while enabling them to take ownership, and; 5) played an underlying supportive role, providing positive recognition and establishing ongoing commitment. The quantitative component of this research represented a cross-sectional design where principals’ perceptions about the use and sharing of School Reports (reports providing school-specific findings of an evaluation of children’s health behaviours) were captured through the examination of secondary survey data, collected in the spring of 2012. Univariable logistic regression analysis was performed with survey questions examining report sharing and use, whereby data from both APPLE School principals (n=30) and a random sample of principals throughout the province of Alberta, Canada (n=73) were compared. Results showed that APPLE School principals had a statistically significant higher odds of: sharing the report overall; sharing the report outside of the school, particularly with parents; using the report for planning purposes; as well as a higher odds of both sharing and using the report in general. Taken together, findings and recommendations from both the qualitative and quantitative research in this thesis will inform effective leadership practices, helping to improve CSH implementation efforts as well as data use and sharing strategies, ultimately leading to improvements in health outcomes for children and youth.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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