Table 5 Themes and sub-themes on the factors affecting the sustainability of health interventions in schools

Schools’ capacity to sustain health intervention—the social norms, roles and resources that affected whether schools could sustain an interventions

Educational outcomes took precedence over health promotion

N/A

[43, 44, 46, 48, 49, 52, 54, 56, 65]

Staff roles in sustainability—how the professional roles of different staff contributed to sustainability processes.

The importance of the principal and school administration

[43, 45,46,47,48, 52,53,54, 59, 63,64,65]

Teachers’ autonomy in the classroom

[43, 44, 48, 65]

Funding and material resources—the availability of funding, materials and space for sustaining an intervention.

N/A

[45,46,47,48,49, 51, 52, 54,55,56,57,58,59, 63, 64, 66]

Cognitive resources—schools’ access to staff with the knowledge and skills to continue to promote, co-ordinate and/or deliver the intervention.

Staff turnover—the need to train new staff and retain experienced and trained staff.

[43, 46,47,48,49, 51,52,53, 55, 56, 58, 59, 63,64,65]

The importance of training

[43, 46,47,48,49, 51,52,53, 56, 59, 64, 65]

Social resources—the resources that came from schools’ connections with other schools and organisations

N/A

[43, 45, 48, 58]

Staff motivation and commitment—factors influencing the intentions of staff to sustain an intervention

Observing and evaluating effectiveness

N/A

[43,44,45,46,47,48,49,50, 52, 55, 59, 63,64,65,66]

Staff confidence in delivering health promotion

N/A

[43, 46,47,48,49,50, 63, 64]

Parent support for the intervention

N/A

[43, 45, 46, 48, 52, 59, 62, 64, 65]

Believing in the importance of the intervention

N/A

[43, 44, 46,47,48,49, 52, 63]

The impact of school climate

N/A

[46, 54, 60, 63]

Intervention adaptation and integration—factors influencing whether it was operationally possible to sustain an intervention

The workability of the intervention—the work carried out to fit the intervention into existing school practices and routines.

Fitting the intervention into the time available

[44,45,46,47,48,49, 52,53,54,55,56, 58, 63,64,65,66]

Matching the intervention to students’ needs

[43, 46, 53, 54, 63,64,65]

The need for up-to-date materials

[48, 49, 53, 54, 64]

The integration of the intervention into school policies and plans.

N/A

[43, 48, 63]

Wider policy context for health promotion—whether policies supported school health promotion

N/A

N/A

[43, 48, 52, 55,56,57, 62]