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Cited by 335School Health and Nursing EducationHealth Policy Implementation SciencePublic Health Policies and Education

Schools as social complex adaptive systems: A new way to understand the challenges of introducing the health promoting schools concept

Keshavarz, Nastaran, Nutbeam, Don, Rowling, Louise, Khavarpour, Freidoon·2010·Social Science & Medicine
DOI 10.1016/j.socscimed.2010.01.034
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Abstract

Achieving system-wide implementation of health promotion programs in schools and sustaining both the program and its health related benefits have proved challenging. This paper reports on a qualitative study examining the implementation of health promoting schools programs in primary schools in Sydney, Australia. It draw upon insights from systems science to examine the relevance and usefulness of the concept of "complex adaptive systems" as a framework to better understand ways in which health promoting school interventions could be introduced and sustained. The primary data for the study were collected by semi-structured interviews with 26 school principals and teachers. Additional information was extracted from publicly available school management plans and annual reports. We examined the data from these sources to determine whether schools exhibit characteristics of complex adaptive systems. The results confirmed that schools do exhibit most, but not all of the characteristics of social complex adaptive systems, and exhibit significant differences with artificial and natural systems. Understanding schools as social complex adaptive systems may help to explain some of the challenges of introducing and sustaining change in schools. These insights may, in turn, lead us to adopt more sophisticated approaches to the diffusion of new programs in school systems that account for the diverse, complex and context specific nature of individual school systems.

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Authors
Keshavarz, N., Nutbeam, D., Rowling, L., & Khavarpour, F.
Affiliations
  • Qazvin University of Medical Sciences (IR)
  • University of Southampton (GB)
  • The University of Sydney (AU)
Corresponding author
Keshavarz, Nastaran
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2010-05
Volume
70
Issue
10
Pages
1467-1474
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2010.01.034
OpenAlex
W2154037039
Cited by
335
References
32
Citations by year
2026: 16 · 2025: 29 · 2024: 28 · 2023: 28 · 2022: 30 · 2021: 27 · 2020: 30 · 2019: 24 · 2018: 21 · 2017: 18 · 2016: 15 · 2015: 18 · 2014: 19 · 2013: 8 · 2012: 8
FWCI
24.90
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
Keywords
health promoting schools, complex adaptive systems, school implementation, program sustainability, elementary school, school principals, teachers, systems science, diffusion of innovations, school change, school health promotion
MeSH terms
Health Promotion, Humans, Interinstitutional Relations, New South Wales, Schools, Social Change, Social Conditions, Social Environment, Students

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