The Intervening Factors of Evidence-Based Educational Policy in the Education and Promotion of Students' Health and Their Evaluation from the Point of View of Experts: A Mixed Study

Extended Abstract

Background

Health education, as a central component of health services and health promotion, has gained great importance by increasing awareness of the social determinants of health or by promoting activities that correct these factors. The health of children, adolescents, and young people is completely related to their healthy behaviors in life, which are primarily shaped by schools. Thus, health education is an important issue in schools due to its lasting effect on students. Based on educational policies, schools pursue health education and promotion using different methods. In this regard, schools can achieve their goals in the field of students' health by designing and using appropriate policies. Researchers believe that there is a growing consensus that the existing arrangements for policymaking in education are far from optimal. One of the policy-making approaches that can be said to have a great impact on the health education of students is the use of evidence-based policymaking, which follows the belief and understanding of how evidence may affect the direction of a policy. It can lead to direct and indirect benefits such as access to optimal information, increasing the effectiveness of prevention programs and policies, greater productivity of the workforce, and more systematic use of public and private resources. The knowledge-policy gap in public health is widely known and the importance of using all types of evidence for the development of health promotion has been emphasized. On the other hand, there is limited research focused on planning to enhance health literacy and awareness through school health programs. Considering the failure of educational policies of schools, the neglect of the evidence-based policy approach, and the lack of research related to the barriers to the application of evidence-based policies in promoting the health of students, this study sought to answer the question of which factors in evidence-based policymaking interfere in the education and promotion of students' health, and to what extent is it possible to pay attention to these factors and eliminate them?

Methods

This mixed exploratory research was conducted in 2022 using a sequential qualitative-quantitative approach. The qualitative method employed was thematic analysis, while the quantitative method used was a survey. The qualitative phase of the study included participants who were experts and policymakers in the field of education and health. The quantitative phase aimed to assess the feasibility of paying attention to the intervening factors in the real environment and in practice. The statistical population included principals of primary, lower secondary, and upper secondary schools in the education districts of Tabriz, totaling 2,590 principals. The sampling method at this stage was the relative stratified random method based on the district, and each district had a share in the sample equal to its share in the society. A total of 366 people were selected for the purpose of the study. To collect data, the elements and concepts of the model extracted from the qualitative phase were organized into dimensions and items, which were then included in a questionnaire distributed to the research sample. In quantitative data analysis, first-order and second-order confirmatory factor analyses were conducted using PLS software to evaluate the fit of the data model. Upon confirming the fit of the model, a one-sample t-test was run in SPSS software.

Results

According to the demographic findings of the qualitative phase of the research, 14 of the participants were university faculty members, and four of them were non-academic faculty members. Four participants had previous experience of high management within the health and educational systems at the provincial level. Two participants held high political positions, four were experts in educational sciences, and 14 were health experts. Thirty sub-themes were extracted from the coding of the interview texts using the thematic analysis of five themes. The themes extracted from the thematic analysis included a lack of dynamism of research policy and evidence collection, a lack of political decision, resource limitation, the evidence-policy gap, and a lack of science uptake.

Conclusion

Based on the findings of this study, it can be stated that the common term "evidence-based policymaking" is still vague and incomprehensible for policymakers, managers, and those who directly deal with it. This ambiguity is mostly due to the lack of provision of evidence-based policymaking requirements. It depends on the evidence as well as the obstacles of this type of policy in the field of education and health promotion of students. The lack of specific approaches and relying on long-term plans, as well as the lack of continuous attention to the institutionalization of regular and systematic collection of evidence, along with the lack of stability of managers and the lack of transparency, can significantly hinder the formation of a suitable context for evidence-based policy in education and promotion of the health of students. Based on the findings, it is suggested that in order to improve evidence-based policymaking in education and promotion of the health of students, infrastructure barriers in the areas of financial, material, human, and informational resources should be taken into consideration. Additionally, efforts should be made to reduce the evidence-policy gap by fostering partnerships and mutual trust between policymakers and researchers.