Empowering teachers for health education: a systemic analysis of engagement in school well-being promotion
Abstract
Purpose: This study investigates the factors influencing primary school teachers' engagement in health education and well-being promotion in France. It aims to identify the personal, institutional and contextual determinants that shape teachers' professional practices and perceptions of health education as part of their educational mission. Design/methodology/approach: The study is embedded within the ALLIANCE initiative, a randomized intervention program involving 101 schools across four French departments. Baseline quantitative data from 243 teachers were collected prior to the start of a three-year training program on health education, psychosocial skills and health literacy, designed to support whole-school health promotion. Bivariate and multivariate statistical analyses (logistic and linear regressions) were conducted to identify predictors of engagement, integration and motivation related to health education. Findings: Teacher engagement was significantly associated with perceived relevance of health education in professional practice, intrinsic interest, self-efficacy, participation in school-wide well-being initiatives, and awareness of peer practices. Collective dynamics and institutional support emerged as key facilitators, while working alone and lack of alignment between resources and perceived roles were negatively associated. Teachers only motivated by the inclusion of HE in the demonstrated weaker integration, highlighting a tension between institutional legitimacy and professional ownership. Research limitations/implications: This study presents several threats to internal validity, including voluntary participation, which may introduce self selection, and reliance on self reported questionnaires, which can generate social desirability and recall bias (Lynagh et al., 1997). External validity is limited by the fact that participating schools were already engaged in a health promotion initiative, restricting generalization beyond similar contexts. Moreover, the analysis is based on cross sectional baseline data, which prevents causal inference; longitudinal follow up and mixed methods analyses are needed, in line with recommendations for complex school health promotion evaluations (Inchley et al., 2007). Practical implications: The next phase of this research will analyze, at Year 3 of the Alliance Initiative, the following question: How do the global standards and institutional frameworks promoted by the Alliance for Health-Promoting Schools shape teachers' pedagogical and professional practices in delivering health education and promoting student well-being in school settings? In addition, a separate article will examine the quality of implementation of the Health-Promoting School approach over time, providing insights into fidelity, adaptation, and sustainability of whole-school strategies. These perspectives aim to deepen understanding of systemic factors influencing teacher engagement and to inform evidence-based strategies for embedding health education within whole-school approaches. Social implications: The findings underscore the need for targeted professional development that strengthens teachers' intrinsic motivation and self-efficacy through experiential and collaborative formats. School leaders should foster supportive environments that embed health education into strategic planning and encourage peer collaboration. From a societal perspective, empowering teachers to deliver comprehensive health education enhances pupils' health literacy, psychosocial skills, and overall well-being, which are essential for academic success and lifelong health. By promoting whole-school approaches, this research supports public health goals and advances equity in education. Originality/value: This study offers a systemic and multi-layered analysis of teacher engagement in health education, extending previous research by integrating personal, relational and organizational dimensions. It provides new insights into the differentiated pathways of engagement and supports the development of whole-school approaches that align policy, training and practice to foster sustainable health promotion in schools.
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BibTeX
@article{simar2026empowering,
title = {{Empowering teachers for health education: a systemic analysis of engagement in school well-being promotion}},
author = {Carine Simar and Philippe Cury and Didier Jourdan and Julie Pironom and Marion Monier and Camille Riera-Navarro and Véronique Regnier},
journal = {Health Education},
year = {2026},
month = sep,
doi = {10.1108/he-08-2025-0160},
url = {https://uca.hal.science/hal-05764941v2},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Empowering teachers for health education: a systemic analysis of engagement in school well-being promotion
AU - Carine Simar
AU - Philippe Cury
AU - Didier Jourdan
AU - Julie Pironom
AU - Marion Monier
AU - Camille Riera-Navarro
AU - Véronique Regnier
PY - 2026
DA - 2026/09/29
JO - Health Education
DO - 10.1108/he-08-2025-0160
UR - https://uca.hal.science/hal-05764941v2
AB - Purpose: This study investigates the factors influencing primary school teachers' engagement in health education and well-being promotion in France. It aims to identify the personal, institutional and contextual determinants that shape teachers' professional practices and perceptions of health education as part of their educational mission. Design/methodology/approach: The study is embedded within the ALLIANCE initiative, a randomized intervention program involving 101 schools across four French departments. Baseline quantitative data from 243 teachers were collected prior to the start of a three-year training program on health education, psychosocial skills and health literacy, designed to support whole-school health promotion. Bivariate and multivariate statistical analyses (logistic and linear regressions) were conducted to identify predictors of engagement, integration and motivation related to health education. Findings: Teacher engagement was significantly associated with perceived relevance of health education in professional practice, intrinsic interest, self-efficacy, participation in school-wide well-being initiatives, and awareness of peer practices. Collective dynamics and institutional support emerged as key facilitators, while working alone and lack of alignment between resources and perceived roles were negatively associated. Teachers only motivated by the inclusion of HE in the demonstrated weaker integration, highlighting a tension between institutional legitimacy and professional ownership. Research limitations/implications: This study presents several threats to internal validity, including voluntary participation, which may introduce self selection, and reliance on self reported questionnaires, which can generate social desirability and recall bias (Lynagh et al., 1997). External validity is limited by the fact that participating schools were already engaged in a health promotion initiative, restricting generalization beyond similar contexts. Moreover, the analysis is based on cross sectional baseline data, which prevents causal inference; longitudinal follow up and mixed methods analyses are needed, in line with recommendations for complex school health promotion evaluations (Inchley et al., 2007). Practical implications: The next phase of this research will analyze, at Year 3 of the Alliance Initiative, the following question: How do the global standards and institutional frameworks promoted by the Alliance for Health-Promoting Schools shape teachers' pedagogical and professional practices in delivering health education and promoting student well-being in school settings? In addition, a separate article will examine the quality of implementation of the Health-Promoting School approach over time, providing insights into fidelity, adaptation, and sustainability of whole-school strategies. These perspectives aim to deepen understanding of systemic factors influencing teacher engagement and to inform evidence-based strategies for embedding health education within whole-school approaches. Social implications: The findings underscore the need for targeted professional development that strengthens teachers' intrinsic motivation and self-efficacy through experiential and collaborative formats. School leaders should foster supportive environments that embed health education into strategic planning and encourage peer collaboration. From a societal perspective, empowering teachers to deliver comprehensive health education enhances pupils' health literacy, psychosocial skills, and overall well-being, which are essential for academic success and lifelong health. By promoting whole-school approaches, this research supports public health goals and advances equity in education. Originality/value: This study offers a systemic and multi-layered analysis of teacher engagement in health education, extending previous research by integrating personal, relational and organizational dimensions. It provides new insights into the differentiated pathways of engagement and supports the development of whole-school approaches that align policy, training and practice to foster sustainable health promotion in schools.
SN - 0965-4283
ER -