Evaluating the Impact of the School Environment on Teachers' Health and Job Commitment: Is the Health Promoting School a Healthier Workplace?

Despite having been endorsed by the World Health Organisation (WHO) almost a decade ago, and its widespread adoption as a model of "best practice" for school health promotion throughout the world, the Health Promoting Schools framework has not been subjected to widespread evaluation in a way that fully recognises its core tenets. Most evaluations have focused on individual targeted interventions addressing students' health behaviours, or implementation issues such as school health policies or access to services. No evaluations of this approach could be found which investigated the impact of the HPS model on teachers, as a critical factor influencing the school climate, or on organisational processes associated with employee wellbeing within the school setting. There is a vast literature pertaining to conditions of the work environment that affect employee health, including work-related stress. Teaching is considered a highly stressful occupation, and as social pressure continues to place teachers and schools in the role of "in loco parentis" for the socialisation of children, it seems timely to identify those characteristics of the school environment that promote positive health and wellbeing for all. In theory, the HPS model provides a set of principles and procedures that aim to promote health and wellbeing for all members of the school community, yet the impact on school staff has yet to be demonstrated. This thesis reports on research investigating the extent to which adoption of the HPS approach creates a positive work environment for teachers, through enhanced organisational and social capital, and whether selected work environment variables impact on teachers' physical and mental wellbeing, health risk behaviours, job stress, and job commitment. After conducting a statewide audit of health promotion activities in Queensland primary schools, two samples of schools that differed significantly in the extent to which they were implementing organisational strategies consistent with the HPS approach were selected, one sample of 20 schools actively implementing HPS strategies, and a comparison sample of 19 schools not implementing the approach. Schools were matched on geographic location (rural/urban), school size (number of student enrolments), and socio-economic rank (IRSED). A cross-sectional design using a mail-out survey to 1,280 teachers was conducted, and statistical comparisons of the two groups were conducted. Apart from providing the samples of schools for the main research, the statewide audit provided a profile of health promotion activity in Queensland primary schools. Urban, rather than rural schools, and those with higher student enrolments, were most frequently implementing HPS strategies. Socio-economic ranking did not have any statistical bearing on adoption of these strategies. Implementation of school health policies was the most common strategy, although the social and physical environments were also addressed to some extent. The instrument designed for the study, the HPS Audit Checklist, proved effective in distinguishing a continuum of HPS "total scores" and demonstrated good psychometric properties. With respect to differences in measures of the school environment, mean scores for all 11 dimensions of school organisational health, and all 4 dimensions of school social capital, were statistically higher in High HPS, although differences between the two groups were not outstanding. Trends in the results did, however, confirm that schools actively adopting a HPS approach provide a more positive work environment than non-health promoting schools. Effect size was most significant for School Morale, Decision Authority, and Co-worker Support. Both organisational and occupational commitment was higher for teachers in High HPS, and Turnover Intention (plans to leave the workforce/workplace) was lower for teachers in High HPS. Teachers in High HPS reported less job strain and higher skill discretion, despite slightly greater job demands (work pressure) in these schools. They also reported significantly less general psychological distress on 5 measures, and significantly better self-rated mental and physical health. Job strain was most strongly associated with co-worker support, appreciation, and school morale in High HPS, but in Low HPS strain was most strongly associated with leadership style, school morale, and role clarity, suggesting more subtle differences between the two sets of schools. No statistically significant differences were found between teachers in High and Low HPS on self-reported weight, daily dietary habits, dental check-ups, preventive health screenings, alcohol consumption, smoking, cholesterol, BP and exercise. Although this research was limited by its dependence on self-report measures, the high response rate suggests that the results provide a valid profile of the health and psychological wellbeing of teachers in Health Promoting Schools in Queensland. These results also suggest that the HPS approach creates a more positive school environment through building social and organisational capital, and this is reflected in better mental health and stronger job commitment of the teaching workforce. Implications of these results for human resource management within the education sector are discussed. In addition, the implications of a healthier "learning environment", including less stressed and more connected teaching staff, for children's psychosocial and educational outcomes are considered in light of potential future directions for this research.