This page introduces or starts several topics related to the implementation, diffusion, sustainability and capacities required in school health promotion, safety and social development. These topics currently include the list that has been started below.

Please feel free to add additional topics to this page by using the "easy edit" tool found above. If you are interested in being part of the writers and contributors to any of these topics, please contact: dmccall@internationalschoolhealth.org

In the list of topics below we differentiate among these essential aspects:

1. Some Preliminary Considerations
   
2. Implementation of a program in a specified context
3. Taking an effective program to scale through various means (ie diffusion)
4. Capacity-building and continuous improvement
5. Systems change: improvement and reform
6. Achieving sustainability

In the list below, we have grouped several topics under each heading and listed related concepts along side them. However, there linkages among the topics that is not well represented by the groupings in this tabel. As well, this listing is not exhaustive one and other topics could be added or the topics could be grouped or identified in different ways.

Topics related to Implementation and Sustainability	Related Concepts and Topics
1. Some Preliminary Considerations
Implementing programs in complex ecologies's /open systems such as schools	- Complexity theory, - chaos theory, - linear vs non-linear thinking, - systems thinking
Ecological approaches to school health promotion
Quality in Implementation Practices
Comprehensive Approach, Coordinated Agency-School Program or Whole School Strategy	- Comprehensive Approach - Coordinated Programs - Whole School Strategies	- multi-ssue, multi-system, multi-level, multi-intervention - Agencies & School, multi-interventions - Multi-interventions, only school personnel
System, Ministry, Agency, School, Professional and Community Capacities
Program Implementation, Organizational Development, Systems Change
What do we mean by "sustainable programs"
Recognizing the educational mandate and constraints of the school (Contradictions, challenges and opportunities)	Understanding core mandate of schools Integration with basic operations of the school (Physical, social, student learning, testing, tracking students, reporting to parents, school size, etc) Integration with school improvement planning processes, Integration with school/system reporting and accountability procedures Impact of school's role in accrediting student achievement (ie failing some students each year) Impact of school's role in socializing young people in dominant values (explicit& implicit) of their societies	transportation, recess, school grounds & facilities, staffing, reporting to parents, departments in high schools, professional days, etc - adding health status & behaviours to regular student report cards, - adding health and wellness considerations to school, district & ministry annual reports)
2. Implementation of a Program in a Specific Context
Defining Implementation
Stages of Implementation
Evidence-based Implementation Models/Plans	From Education From Health - PRECEDE-PROCEDE - From Social Services From Law Enforcement
Factors that affect implementation
Local mechanisms that are essential for program implementation
Local drivers and barriers to implementation
Critical Appraisal of the Innovation	- Characteristics of the Innovation - Competitors with similar innovations - Non-related competing issues and programs
Measuring Implementation Quality
Reporting Implementation Quality
Continuous Quality Improvement Based on Measured Implementation Quality
Understanding the impact of the local context on school and program capacity	(e.g. rural schools, inner city, multi-ethnic schools, aboriginal schools, minority language schools, religious schools, schools in disadvantaged communities, schools serving affluent communities, schools disrupted by war, famine, natural disasters, epidemics, schools in low income countries)
3. Taking a Successful Program to a Larger Scale
Defining Distribution, Dissemination and Diffusion
Fidelity to a program or to core practices
Who Pays? Who Owns? Who Controls?
4. Capacity-building and Continuous Improvement
Minimum staff, minimum budget, minimum mandate	Studies, documentation of minimum and optimal staffing ratios, program budgets, minimum curriculum time/number of lessons required
Eight Types of Capacity	1. Coordination of policy, 2. Staff assigned to coordination, 3. Formal and informal mechanisms to support cooperation, 4. Monitoring, reporting and evaluation, 5. Regular Workforce development, 6. Ongoing knowledge exchange, 7. Strategic issue management, 8. Explicit plan for sustainability	Inter-ministry policy, inter-agency policy, professional guidelines and standards Role of coordinator/change agent, skills/training of coordinators Joint program planning, joint budgeting, inter-ministry agreements, inter-agency agreements, school protocols with external service providers, inter-ministry committees, inter-agency committees, school-based committees, joint professional development, shared goal statements Indicator selection & development, Indicator relevance and reliability, survey development,data-based decision-making, school recognition programs, school accreditation/award programs, program implementation methods and capacity, integration with school accountability reporting Application of adult learning principles, promoting reflective teaching and health promotion practice,staff development theories and models, role & training of teachers, accessing and using teacher professional days effectively, staff development as social development, evidence-based teacher in-service models and practices, better and current practices in university teacher education programs, role & training of school nurses, role & training of school resource officers, role & training of school psychologists, role & training of addictions workers, role & training of school social workers, role & training of school guidance counsellors, role & training of school principals, accessing and working with native teacher education programs Perceptions/knowledge of health issues among teachers, administrators, nurses, police officers, social workers etc, studies of knowledge needs & preferences among teachers, counsellors, principals, school district staff, school nurses, addictions workers, police officers, school psychologists, school social workers, effective use of consultations with experts/master practitioners as models of staff development, effective use of communities of practice withing districts, across provinces or countries, Aligning with current or emerging organizational priorities, strategic issue management practices, strategic selection and maintenance of partnerships,
Capacities at different levels in the System	- individual professionals - local school & neighbourhood - school board - other local agencies (health, police, social services, housing, employment, etc - education ministry - health ministry - welfare ministry - law enforcement ministries - federal or national agencies - research centres and funding agencies -
5. Systems Change
Impact of the core (normal) aspects of the school	In schools, the physical environment, social environment, school organizational practices, transitions between levels of schooling and between schools affect health, social development
Size and magnitude of the change: innovation or reform	- In education, reform changes the size and slope of participation/ graduation of students - In health, reform shifts attention and resources from treatment to prevention - In law enforcement, reform changes..... In social/welfare services reform changes...
Systems change models	From Education - Fullan (Tri-level change) - Hargreaves - Hall & Hord From Health Promotion From Business - Total Quality Management
Managing change in "open systems"	- System stasis & stability, - system boundaries, - system-environment interactions, - managing changes, trends of cycles in the context surrounding the system
Addressing the characteristics of "loosely-coupled systems"	- Defining loosely coupled systems - Addressing adopter concerns - Effective use of policy levers - Micro-politics of schools - Role/styles/status of senior managers - Role/styles/status of middle managers - Role/styles/status of front-line workers - Roles/styles/status of clients in system
Understanding schools, public health and other "professional bureaucracies"	- Theories/models of professional bureaucracies - Influence of structures - internal/informal communications within bureaucracies - Social networks within organizations - multi-level systems - Non-rational decision-making in organizations - Knowledge as power & influence - Organizational culture - Organizational readiness to innovate - Professional norms/ideologies/acculturation - Sociology of teachers, nurses, social workers, police - Work life and career trajectories for teachers, nurses, police, social workers, others
Promoting aligned change across multiple systems, agencies and profession	- Types of cooperation - Interprofessional cooperation - Inter-agency cooperation - Interministry cooperation	Models of inter-professional education & training
6. Achieving sustainability
Defining sustainability	- Compatible with core functions of the organization (eg schools have five functions; custody, intellectual development, educational accreditation/selection, vocational preparation, and socialization.) -
Factors that Affect Sustainability
Barriers to Achieving Sustainability