Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
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Using Digital Platforms in Schools for
Prevention and Health Promotion:
A Scoping Review
Christian Dagenais, PhD
Michelle Proulx, PhD
Esther Mc Sween-Cadieux, PhD
Objective: Digital platforms for prevention and health promotion (PHP) are now, more than ever,
available for use by school professionals, including teachers. However, little is known about what
motivates them to use such platforms. A scoping review (ScR) was conducted to identify conditions
that promote use by school professionals, including teachers, of PHP digital platforms at schools.
Methods: For our ScR, we accessed ERIC, Sociological Abstracts, MEDLINE, PubMed, and
Web of Science databases (period 2000-2018) in 3 sectors: education, health, online technologies.
For each study, we prepared and validated a summary sheet. Contents dealing with conditions
for use were subjected to open coding, grouped into categories, and synthesized. Results: Of the
3639 articles captured, 17 studies were selected. Five conditions emerged: (1) ensuring that the
digital platform becomes a reference for PHP activity in schools; (2) that the resources needed
for its uptake are mobilized; (3) that it is user-friendly; (4) that the digital platform engages the
participation of everyone involved; and (5) that it is linked to existing programs in the school.
Conclusion: These results can guide the activities deployed in schools for optimal implementation
of PHP programs from digital platforms.
Key words: digital platform; health promotion; healthy schools; school health; teachers
Health Behav Policy Rev.™ 2022;9(2):719-737
DOI: https://doi.org/10.14485/HBPR.9.2.1
T
he close link between health and academ- activities, video games, and other educational re-
ic success is now a matter of consensus. sources made available to students, have focused on
Healthy lifestyles are associated with stu- many issues, including the promotion of healthy
dents’ cognitive development, learning capacity, lifestyles, eg, nutrition, physical activity, and social
attention span, and academic performance in core skills, appropriate stress management, and positive
subjects.1-4 A school climate that fosters emotional mental health, to name a few.9-13 The beneficial ef-
security and positive interpersonal relationships fects of these initiatives have been shown, particu-
enables students to make responsible choices in larly when they are aimed at making the school a
prevention and health promotion associated with healthy living environment where educational and
academic success.5-7 pedagogical objectives are based on a set of preven-
Public health and education stakeholders are in- tive and health promotion measures.8
creasingly aware of this issue. They have formed More than ever, information and communica-
alliances to support the development, well-being, tion technologies (ICTs) occupy an important
and academic success of young people through dif- place in schools, contributing to the achievement
ferent prevention and health promotion initiatives.8 of educational and health objectives.14-16 ICTs have
These initiatives, eg, involving teachers in planning become recognized as a means of facilitating and
Christian Dagenais, University of Montreal, Department of Psychology. Montreal, QC, Canada. Michelle Proulx, University of Montreal, Depart-
ment of Psychology. Montreal, QC, Canada. Esther Mc Sween-Cadieux, University of Montreal, Department of Psychology. Montreal, QC, Canada.
Correspondence to Dr Dagenais; Christian.dagenais@umontreal.ca
Health Behav Policy Rev.TM 2022;9(2):719-737 719Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
energizing knowledge transmission and application The aim of this ScR was to identify the extent
in school settings. These technologies enable pro- and nature of, and gaps in current knowledge re-
fessionals, including teachers, to share knowledge garding conditions that promote the use of PHP
among colleagues and to transmit content in in- digital platforms by teachers and other profession-
teractive formats that support independent learn- als at the preschool, primary, and secondary levels
ing among young people. They have rapid access to of public and private school networks.
information at low cost.15,17,18 However, the uptake It was prepared by the principal researcher (CD),
and use of ICTs pose many challenges in school a research professional (MP), and a database man-
settings and require systematic consideration and ager, using a sustained iterative process (PRISMA)
planning.19 Efforts must be made to implement to ensure complete coverage of the literature (Fig-
proven practices using effective change strategies.20 ure 1). The review was conducted in 7 stages: (1)
To learn more about conditions that could fa- identifying the research question; (2) identifying
cilitate the uptake and use by school professionals relevant studies; (3) choosing the criteria for study
of digital platforms for prevention and health pro- selection; (4) applying the criteria for study selec-
motion (PHP) in schools, a systematic review in tion; (5) charting the data; (6) summarizing the re-
the form of a scoping review (ScR) was needed.21,22 sults; and (7) reporting the results.
More specifically, the objective of the ScR was to
identify conditions for the use of PHP digital plat- Identification of Relevant Studies
forms by teachers and other professionals at the The digital searches (Appendix 1) covered the pe-
preschool, primary, and secondary levels of public riod 2000 to 2018 to capture the most recent initia-
and private school networks. tives relating to PHP based on a digital platform.
The results of this ScR will be useful for guid- Reference databases in education and health were
ing the activities to be undertaken by teachers and consulted, including ERIC, Sociological Abstracts,
other professionals for optimal implementation of MEDLINE, PubMed, and Web of Science. Searches
school-based PHP programs using ICTs. They will, were based on keywords in 3 broad sectors: educa-
as such, have a positive impact on the health, well- tion, health, and online technologies (for example:
being, and academic success of young people. educational activity, adolescent health, e-Health).
First, general searches were done to find relevant
METHODS articles, from which concepts and keywords were
The ScR method was adopted because it is well- identified. The approach was then progressively re-
suited to the examination of emerging fields of fined following an iterative process, eg, redefinition
study for which the body of knowledge is still lim- of keywords, selection of new descriptors, as trials
ited. The method is generally defined as a mapping were carried out in the chosen databases with the
or exploration of the available evidence around a assistance of the database manager, in close collabo-
broad study object and from various sources such as ration with team members. The digital searches were
empirical studies, secondary data from quantitative, entered in the free and open-source bibliographic
qualitative, or mixed-method primary studies, grey data management software Zotero to be accessible
literature. Mainly exploratory in nature and flex- to members of the research team.
ible in approach, while being rigorous, it involves
discerning the boundaries between diverse bodies Choice of Study Selection Criteria
of evidence, by describing their nature, character- The articles selected concerned only empirical
istics, volume, and/or depth.21,23,24 An ScR differs studies on PHP projects that documented the con-
from a Cochrane systematic review, for example, ditions for use of digital platforms by teachers and
in that the decision to include or exclude a study other professionals at the preschool, primary, and
is based not on methodological criteria, but rather secondary levels of public and private networks.
on content relevance.21,22 It is conducted in stages, Only studies dealing with use of platforms host-
as set out originally by Arksey and O’Malley21 cor- ing educational content for PHP programs were
responding to a series of operations and systematic eligible. Both unfavorable and favorable conditions
ways of proceeding. for use were examined, to obtain a nuanced picture
720Dagenais et al
of what is likely to favor use. Content that focused researcher to get along well on the way to perform
on the impacts of using PHP digital platforms was the data extraction and the nature of the data that
excluded. Only studies in English or French were had to be recorded in the form. The research pro-
selected to ensure that data were collected from fessional conducted several reviews of the studies to
relatively similar school environments in terms of ensure the rigor of the data collection.
school organization and governance. The low- and
middle-income countries were excluded due to sig- Summarizing and Reporting Results
nificant differences in Internet access and because Contents dealing with conditions for use were
the content of the digital platforms studied was not subjected to open coding and then grouped into
relevant to those students’ situations. The grey lit- categories and synthesized.25,26 The formulation of
erature was not consulted because we wanted to fo- the narrative was supported by comparisons within
cus on what was published internationally, in peer the data and the identification of contradictory evi-
review journals, regardless of the characteristics and dence. The results were presented in a narrative and
specific contexts of the countries where these pub- tabular format. Analysis of the results identified 5
lications emerged. conditions for the use of PHP digital platforms in
schools, which are presented in the following section.
Application of Study Selection Criteria
The research professional (MP) and the principal RESULTS
researcher (CD) first classified the studies in Zotero Description of Studies Selected
as either relevant (YES) or irrelevant (NO) based on
examination of titles and abstracts which consider- The digital searches initially identified 4342 ar-
ably reduced the number of references retained. ticles, from which 703 duplicates were removed,
They then conducted an iterative and independent leaving 3639 articles. Following the first reviewer’s
review of the remaining documents, compare their (MP) screening of these 3639 references for eligi-
selections, and rework or refine their inclusion and bility, a smaller bank of 113 articles was created.
exclusion criteria, which gradually become defined In a second step, these 113 articles were screened
and substantiated.22 As necessary, the entire article independently by 2 reviewers (CD, MP) and dis-
was reviewed. cussed to reach consensus on the articles to be in-
cluded; ultimately 17 studies were selected (Figure
1). These were conducted between 2008 and 2018,
Charting the Data with half between 2015 and 2018. They were
We used a descriptive-analytical method21 for carried out in the United States (7), the United
charting the data. The method consists of apply- Kingdom (3), the Netherlands (2), Finland (2),
ing a common analytical framework to extract key Australia (1), and Portugal (1), and one (1) in sev-
information from all the documents under review, eral countries. The selected studies concerned digi-
from which a data extraction form was gradually tal platforms addressing several health issues: sexual
assembled. The form was developed collabora- health (6); overweight/obesity (2); nutrition/eating
tively between the principal investigator (CD) and (2); mental health (2); alcohol and drug use (2);
research professional (MP) to be able to determine education on appropriate use of medicines (1);
and define as clearly as possible the variables of oral health (1); infection prevention and appropri-
interest and the data to be extracted based on the ate use of antibiotics and vaccines (1). Most of the
research question. It described the targeted prob- data extracted from these studies was intended for
lem, the objective of the study, its methods, and the teachers only (11/17). The others involved teach-
conditions (positive and negative) relating to the ers and other persons from the staff and/or com-
use of digital platforms. The researcher professional munity (eg, administrators, school nurses, catering
tests the form on 5 documents to ensure that the managers, guidance counselors).
data extraction was well aligned with the research The extracted data came from qualitative (8),
objective and questions and that all the variables of quantitative non-randomized (3), quantitative
interest were covered by the extractions.22 Discus- randomized (1), quantitative descriptive (4), and
sions have taken place regularly with the principal mixed (1) study designs identifying conditions for
Health Behav Policy Rev.TM 2022;9(2):719-737 DOI: https://doi.org/10.14485/HBPR.9.2.1 721Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
Figure 1
PRISMA Flow Diagram
the use of digital platforms either already devel- favorable to the use of digital platforms by teach-
oped or under development by teachers and other ers and other school professionals at the preschool,
professionals. The methods for the studies looking primary, and secondary levels of public and private
at development tended to be cursory and aimed at school networks. Extracts taken from studies in the
modifying the processes around technology use. review support these results as well as a summary
The methods for studies where the digital platform table of favorable and unfavorable conditions for
had already been developed presented varying de- use for all the studies retained in the review. Table
grees of rigor. However, all studies in the review 2 summarizes the 17 studies reviewed.
provided relevant content on the conditions for use That the PHP program’s online platform be-
of PHP digital platforms by teachers and other pro- comes a reference in the school. This condition was
fessionals in school settings. No discrepancies were reported in 16 of the 17 studies. It refers to actions
observed in conditions for use according to type of taken in schools to ensure that a PHP program’s
study design. Table 1 summarizes the designs of the digital platform becomes a benchmark and a tool
17 studies reviewed.15,16,18,27-40 of choice for professionals. The studies showed that
opinions about the content, positive or negative,
Conditions for Use of Digital Platforms. determine whether and how it is used. Further-
Five main conditions emerged from the studies more, a platform’s potential to provide up-to-date,
included in the review that were favorable or un- evidence-based content, in language that is appro-
722Dagenais et al
Table 1
Description of Source Studies and Designs of Data
Extracted Regarding Teachers and Other Professionals
Selected Data extracted –
Description of source studies
articles teachers and other professionals
Digital platforms already developed
Action research (sample: teachers, nurses, school Semi-structured interviews (teachers, nurses, school
15
catering managers) catering managers; N = 16)
16 Qualitative study (sample: teachers and students) Semi-structured interviews (teachers; N = 4)
Non-randomized quantitative study (sample: Pre/post questionnaires (teachers; N, Time 1 = 41;
18
teachers) Time 2 = 54)
27 Qualitative study (sample: students and teachers) Semi-structured interviews (teachers; N = 3)
28 Quantitative descriptive study (sample: teachers) Online questionnaires (teachers; N = 695)
Non-randomized quantitative study (sample:
Pre/post questionnaires (nurses, program coordinators,
nurses, program coordinators, library resource
29 library resource specialists, parents, health educators,
specialists, parents, health educators, teachers,
teachers; N, Time 1 = 28, Time 2 = 14)
students)
Non-randomized quantitative study (sample: Pre/post questionnaires (teachers, administrators,
30 teachers, administrators, community organizations community organizations personnel; N, Time 1 = 16;
personnel) Time 2 = 16)
Quantitative descriptive study (sample: teachers Online questionnaires (teachers and guidance
31
and guidance counselors) counselors; N = 44)
Pre/post questionnaires (teachers and guidance
Mixed study (sample: teachers, guidance counselors; N, Time 1 = 48; Time 2 = 39)
32
counselors, students) Semi-structured interviews (teachers and guidance
counselors; N = 15)
33 Randomized trial (sample: nurses) Experimental/control groups (nurses; N = 526)
Semi-structured interviews and focus groups (teachers;
34 Qualitative study (sample: teachers and students)
N = 16)
Qualitative study (multisite case study) (sample:
35 Semi-structured interviews (teachers; N = 36)
project coordinators, teachers, students)
36 Mixed study (sample: teachers and students) Semi-structured interviews (teachers; N = 8)
Digital platforms under development
Description of online platform development;
37 Focus groups (teachers; N = 14)
qualitative study (sample: teachers)
Description of online platform development;
Post-use questionnaires and focus groups (teachers;
38 mixed study (sample: teachers, health
N = 10)
professionals, students)
Description of online platform development; Online questionnaires with open-ended questions
39
quantitative study (sample: teachers and students) (teachers; N = 26)
Description of online platform development;
40 Semi-structured interviews (teachers; N = 15)
qualitative study (sample: teachers)
priate and understandable, as well as beneficial to they received from iCHAMPSS as accurate and
students, appears to encourage its use. trustworthy.29 Apart from up-to-date information,
Most teachers thought the language in the scripts the ICT-based learning environment supported the
was suitable and comprehensible for Year 8 stu- pupils’ independent, spontaneous nutrition health
dents.37 All respondents perceived the information learning process, as told by one teacher.15
Health Behav Policy Rev.TM 2022;9(2):719-737 DOI: https://doi.org/10.14485/HBPR.9.2.1 723Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
To become a reference in PHP programs, a digi- software (64%) and Internet (28%) for health
tal platform also must offer advantages over other lessons.28
tools available in the school. It must add value by Another crucial factor is time spent in use. Time
being useful, requiring little effort and time, and is precious when the number of teaching hours
having a positive impact on both the professional is limited. Considerable effort, and thus, time, is
and the student. In some studies, digital platform needed to adapt to using the platform, as it in-
use appeared to have been motivated by profession- volves changes in practice, including a new role in
als’ need to transmit a PHP program’s content with assisting students. When successful, however, using
greater rigor, or by a need for knowledge. For ex- the resource saved time, as less was required to plan
ample, it appeared that a PHP digital platform was course materials and more was freed up for plan-
appealing to professionals when it provided them ning teaching activities.
with material that was new (and sometimes free), Lack of time and time pressure to work on the
improved, or not yet sufficiently covered in the project while working through the current cur-
school. Some were intrigued by the unfamiliar con- riculum was a major complain among teachers.16
tent of a platform; they wanted to learn about it so Although featured in one project in particular,33
they could share it with their students and answer the time constrains were seen as a general problem.
their questions. A platform’s use also appeared to be The importance of training was raised in more
fostered when it enabled professionals to fill gaps in than one-fourth of the studies, particularly for
their PHP program instruction, provided quick ac- integrating a platform’s content and developing
cess to more sources of information, and promoted professional skills for planning and implementing
effective delivery of educational activities. projects. Some studies described training needs re-
That resources are invested to ensure uptake of lated to using computers or becoming familiar with
a PHP program’s online platform. This condition a platform’s content. Some suggested that attention
was highlighted in 13 studies. It refers to various should be paid to the pedagogical component of a
forms of support provided for using a PHP digital PHP digital platform and that users needed to be
platform. However, in most studies, these supports trained for the new learning environment. Train-
were problematic. The problems had to do with ing was facilitated when delivered in an entertain-
facilities, such as not enough computers in class- ing manner, eg, using comic strips or cartoons, for
rooms, difficulties in reserving computer rooms, instance.
and poor online access, including the blocking of Adoption of the pedagogical principles of an ICT-
content on sexuality and the presence of firewalls. based learning environment required the school
Other difficulties were sometimes related to the staffs to internalize the ICT-based learning envi-
dissemination and promotion of the resource itself. ronment and use.15
Use also appeared to be constrained by difficult
classroom environments, incompatible schedules That the PHP program’s online platform is
between students and teachers, staff turnover, or user-friendly. This condition was identified by
workload. Lack of funding was sometimes men- 13 studies. These studies all demonstrated the im-
tioned. Ultimately, overloaded time-schedules, lack portance of having a technology that is easy to use
of technical and financial resources, and logistical and navigate and has readily accessible content,
issues were identified among the main obstacles.16 eg, enables targeted searches, or simple structure.
The asynchronous nature of a platform, eg, allow-
School staff members described the ICT-based ing access to content not limited to fixed periods
learning environment as suitable, but the facilities of time, was appreciated, as were its functionalities,
themselves as a weakness in the schools. which made it possible to perform simple and per-
The ICT-based learning environment was evalu- sonalized information searches. To this were added
ated as requiring well-functioning classrooms colorful and attractive design, and appropriate and
with enough computers having telecommunica- understandable language.
tions connections.15 Only 21% had adequate Most teachers enjoyed the interactive and novel
computers for students’ health education, which delivery of the program and found it a stimulat-
may have limited current use of health-related ing and exciting way to learn.37
724Table 2
Summary of Studies on Favorable and Unfavorable Conditions for Use by Teachers and Other Professionals in School Settings
References Objectives Themes Favorable conditions Unfavorable conditions
• Flexible resource that supported • Required adoption of new pedagogical principles:
curiosity new learning environment required internalizing
• Facilitated search for up-to-date alternative teaching methods (eg, problem-based
information learning)
• Allowed for personalized and • Importance of paying attention to transmission of
targeted searches the pedagogical component of the project (not just
• Confidence in the accuracy of a matter of sharing information, but also a teaching
information method to be integrated into the platform’s use)
To investigate the views of
• Increased student motivation • Problems related to facilities (access to only one
school staff on a nutrition
Health Behav Policy Rev.TM 2022;9(2):719-737
and interest, as learning was not computer per class; poor telecommunications
health project implemented
15 Healthy nutrition constrained by place or time connections)
via an ICT-based learning
• Parents also able to familiarize • Need for computer training
environment in a secondary
themselves with the content • Different role of teacher; less involvement,
school (7th-9th grades).
• Supportive of students’ assistance role
independent learning • Use required motivation and attitudinal changes
• Flexible use not tied to a physical compared to traditional teaching
space or specific time • Need for training (on role change, computer use)
• Required planning, especially at the beginning,
demanded a lot of effort
• Required more time for planning and collaboration
with colleagues
• Attractive and intriguing resource • Difficulties in mastering and overcoming technical
for students, source of motivation problems
and commitment, facilitated • Difficulties letting go of the authority role as
concentration students became more autonomous
• Allowed use of, and rapid • Workload
access to, a greater number of • Inadequate financial resources
information sources • Lack of time to work on the project
• New perspectives on teaching • Anxiety at the idea of using a technology
To examine teachers’
via cross-settings collaboration • Technical problems
experiences with and opinion
16 Alcohol use (eg, through rapid access to a • Challenges associated with international
on a web-based, cross-cultural
variety of information, different professional collaboration (eg, lack of time,
project.
perspectives on teaching) scheduling conflicts, logistical challenges, lack of
• Increased interaction between financial and technical resources, language barriers)
teachers and students and • Lack of time to work on the project as part of the
DOI: https://doi.org/10.14485/HBPR.9.2.1
colleagues from other settings curriculum
• Positive effects seen in students
(eg, working at their own pace
autonomously; development of
personal skills) cont on next page
725
Dagenais et al726
Table 2 (cont)
Summary of Studies on Favorable and Unfavorable Conditions for Use by Teachers and Other Professionals in School Settings
References Objectives Themes Favorable conditions Unfavorable conditions
To assess which oral health- • Material on the platform considered useful • Questions about their role as educators in
related web-based resources relation to dental care (brushing, flossing);
teachers consider most helpful putting more responsibility on parents to
and how attitudes, knowledge, ensure their children’s oral and dental health
18 and behavioral intentions Oral health • Did not want dental health technicians to do
concerning oral health-related this type of education with students
teaching change between
before and after having access
to a resource website.
• Requires less planning of the material to • Training needed on how to convey
be transmitted in the courses information or content
To assess student and teacher • Decrease in student assessment time • Sense of loss of control in terms of
perception of sexuality • Acquisition of new content (eg, managing the class (difficulties in
27 education delivered online as Sexuality education contraception) and way of transmitting the keeping students engaged in the task) and
a potential solution to address intervention transmission of content
the gap in access. • Need for more content to address students’
needs (eg, influence of drugs, alcohol on
decision-making)
• Relevance of the resource (resource • Need for more in-depth content covering
evaluated as excellent or good) the usual lesson length
• Comprehensive and interesting content • Need for additional content (eg, antibiotic
To evaluate educators’ Prevention • Appreciation of the interactive nature of resistance)
views on the e-Bug teacher of infections, the lesson plans • Need for different content/tools to provide
28 resources and gain insight into appropriate use • Attractive design and structure different options for users (eg, resources for
the current usage of e-Bug of antibiotics, • Catchy and interactive resource for students with special needs)
resources in schools. vaccination students • Need for practical support tools (CD/DVD)
or apps (9%)
• Need for better promotion and
Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
dissemination of the resource
• Excellent pedagogical tool for teachers • Only 21% had computers that were
and students adequate for health education for students
To pilot-test a “train-the- • A fun way for students to learn about the
trainer” model to diffuse an importance of making good choices about
29 interactive health education Nutrition food and exercise
program into Alabama middle • Platform increased students’ interest in
schools during a school year. health education
• Administrative support for delivery of
good quality health education programs
cont on next pageTable 2 (cont)
Summary of Studies on Favorable and Unfavorable Conditions for Use by Teachers and Other Professionals in School Settings
References Objectives Themes Favorable conditions Unfavorable conditions
• Platform that is easy to use, credible, useful • Only 20% of respondents liked the liaison
and sufficiently stimulating system (discussion forum); the vast
• More useful than other district resources majority found it difficult to use
To pilot-test iCHAMPSS for adopting, implementing, and sustaining
30 for usability and short-term Sexual health the use of content related to pregnancy
psychosocial impact. prevention
• Enjoyable and user-friendly features and
decision support tools
• Accurate and trustworthy information
Health Behav Policy Rev.TM 2022;9(2):719-737
• Useful and relevant tool • Ambivalent assessment of task
To explore the role of
• Easy to use effectiveness during use
innovation characteristics,
• Supported the implementation of mental
individual attitudes and skills,
health content
and organizational factors in
• Intention to use the technology was
school providers’ decisions to
31 Mental health significantly and positively associated
continue use of Centervention,
with positive experience with the tool and
a technology-based tool that
successes experienced (ease of use, utility,
supports implementation of
satisfaction)
evidence-based mental health
• Intention to use the tool was associated with
interventions (EBIs).
level of preparedness and available resources
• Relevant resource • Preference for using printed material that
• Curiosity, desire to go deeper was already available
• Ease of access and navigation • No need to use the training tab: looking
• Useful platform (eg, for printing additional at other tabs to answer questions
To explore provider use of an
materials, downloading videos, accessing • Lack of time, good familiarity with
online system, Centervention,
more resources: reading lists) mental health education, uncertainty
to support the delivery
• Reasons for using the training tab: desire about the added value of using the
of empirically supported
to learn, curiosity, convenience, obtaining program
school-based mental health
32 Mental health training credits, increased confidence level,
interventions, and association
deepening of content, transmission of content
between components of this
in the recommended manner
system, implementation
• Frequency of use of the training tab (to get
indicators, and student
more information, to complete the training in
outcomes.
several sessions)
• Use of the Progress Reports tab (eg, to
DOI: https://doi.org/10.14485/HBPR.9.2.1
help prioritize activities, monitor students’
progress, and report to parents)
cont on next page
727
Dagenais et al728
Table 2 (cont)
Summary of Studies on Favorable and Unfavorable Conditions for Use by Teachers and Other Professionals in School Settings
References Objectives Themes Favorable conditions Unfavorable conditions
To assess the efficacy and • Response to needs (91.5%)
acceptability of a web- • Development of skills to address the issue
based tutorial (Child Health of obesity
Matters, CHM) designed Obesity prevention • Adequate duration and amount of training
33 • Provided immediate access to a resource to
to improve school nurses’ and treatment
communications with families support the intervention
about pediatric weight-related
health issues.
• Curiosity about new teaching materials • Need for more attention to other sexuality
• Linking content with new curricular content; lack of depth in content provided
requirements that emphasized interactivity by the platform.
• Diversity and interactivity of the exercises • Habit of discussing sexuality with their
appreciated students using traditional methods
• Exercises motivated students to find their • Time constraints (limited teaching hours)
own information and answers • Not seeing the added value of certain topics
To perform a process
• Usefulness of the accompanying manual • Limited availability of computers
evaluation among teachers and
• Appeal of content that received little • Problems reserving computer rooms
students to measure the levels
attention in the teaching material • Computer rooms that did not facilitate
of completeness and fidelity, Sexuality and
34 • Useful, clear, and sufficiently supportive group discussions
identify factors influencing relationships
manual • Dissatisfaction with the fact that the
teachers’ implementation,
• Interactive nature of the exercises teachers’ section was accessible to students
and to evaluate the students’
appreciated • Problems accessing the site (eg, blocking
response.
• Attractive, fun, and easy-to-navigate of websites related to sexuality)
platform • Inability to access online exercises
• Materials available free of charge • Negative class atmosphere
• Teachers’ positive attitudes towards LLL+ • Cancellation of classes, changes in group
program composition, schedule changes
Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
• Implementation favoured by students’ • Other curriculum priorities
positive responses
cont on next pageTable 2 (cont)
Summary of Studies on Favorable and Unfavorable Conditions for Use by Teachers and Other Professionals in School Settings
References Objectives Themes Favorable conditions Unfavorable conditions
• Positive assessment of content and • Password requirements and technical
To evaluate the reach, functionality challenges (eg, firewalls, need for assistance
adoption, and implementation • Students demonstrated the ability to to obtain the program URL)
of HEALTH[e]TEEN, a complete the online program at their own • Lessons too long, extensive reading (difficult
school-based Internet obesity pace; able to interact among themselves for students to maintain attention)
36 prevention program, and Obesity • Very instructive program, constructed in • More instruction needed for teachers and
examine differences in student such a way that children could identify students
participation and satisfaction with it
by school, sex, age, and race/ • Attractive website
ethnicity.
Health Behav Policy Rev.TM 2022;9(2):719-737
• Material more useful to secondary school • Need for additional content (eg,
teachers, who recognized that the resource contraception) for teaching at the secondary
enabled them to be well informed and to school level
teach on this unfamiliar subject • Content too dense and complicated for the
• Turnkey materials available for primary primary school level
To describe the process school teachers (who have to teach many • Content that appeared to overly encourage
of developing a medicine more subjects than secondary school drug use (importance of promoting
education program for teachers) to facilitate transmission of the alternative ways of treating illnesses;
elementary and middle content new section created on different types of
schools in Finland and the Medicine • Simple platform structure childhood illnesses)
37 lessons learned during the education program • Questioning how relevant the content on
process. Further described is for students drugs would be to different age groups, for
how teachers evaluated the example, younger children (this content
usefulness of the medicine would be better directed to parents)
education materials created • Need for lesson plans or programs specific to
during the process. age groups (eg, instructions given that would
be ready for immediate use)
• Having readily available turnkey content
(not just suggested activities)
• Negative attitudes among some teachers
towards drugs
DOI: https://doi.org/10.14485/HBPR.9.2.1
cont on next page
729
Dagenais et al730
Table 2 (cont)
Summary of Studies on Favorable and Unfavorable Conditions for Use by Teachers and Other Professionals in School Settings
References Objectives Themes Favorable conditions Unfavorable conditions
• Positive attitude towards the proposed • Some felt the program would be more
approach – harm reduction appropriate for Stage 5 of the syllabus
• Program suitably responsive (eg, in • Some lessons needed to be longer to allow
terms of educational content, student students to better assimilate the content
learning, lesson length) • Certain images presented to young children
• Appropriate program for stage 4 of the (eg, cannabis use) were considered
syllabus unacceptable
• Lessons long enough to cover the • Some terminology and factual information
To describe the formative research concepts taught were deemed difficult for students to
and process of planning that formed • Language used was adapted and understand
Alcohol and
38 the development of a program and understandable to Grade 8 students • Too much information, taught in too much
cannabis use
the evidence base underpinning the • Interactive and new features depth
approach. appreciated (eg, stimulating for the • Insufficient availability of computers
student) • Lack of focus on negative aspects of
• Allowed access to the most recent consumption (eg, long-term effects)
versions • Easier for students to watch the animated
• Basic content held students’ interest cartoons using a projector or DVD
• Required very little training to be used,
while maintaining students’ interest
• Confidence in the content of the • Need to offer training and additional
To describe the development of
resource information to parents
new interactive, bi-lingual Sex and
• Utility and improved teaching
Relationships Education (SRE)
• Easy to use, colourful, attractive
resources called Tyfu i Fyny/
• Good quality ready-to-use resource
Growing Up, suitable for students
Sexuality and • Suitable and interesting for children;
39 aged between 5 and 12 years. It
relationships children loved using it
also discusses the evidence used
Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
• Excellent animations
to support the development of the
• Comprehensive, new, and exciting
resources, the support provided for
resource
teachers and parents and an initial
• Easy to follow
evaluation following their use.
• Interactive nature appreciated
cont on next pageTable 2 (cont)
Summary of Studies on Favorable and Unfavorable Conditions for Use by Teachers and Other Professionals in School Settings
References Objectives Themes Favorable conditions Unfavorable conditions
• Importance of having good quality • Not perceiving the importance of transmitting the
materials and information for classroom content of the platform in its entirety and with
use fidelity
• Help provided by colleagues in the use • Feelings of shame or closed attitudes about
of the system sexuality; difficulty dealing with questions posed
To provide insight into by students or problems encountered by students
the process of systematic with respect to sexuality
development of a Web- • Usual teaching method preferred over online
Sexuality
40 based coaching intervention teaching
education
Health Behav Policy Rev.TM 2022;9(2):719-737
to support teachers in their • E-coaching was desirable as long as the
implementation of a school- intervention was easy to use and accessible and did
based sexual health program. not require too much time or effort
• Lack of time for use
• Adequately supported by the accompanying hard-
copy manual or by colleagues
• Preference for communicating with colleagues
from different schools to share ideas and methods
DOI: https://doi.org/10.14485/HBPR.9.2.1
731
Dagenais et alUsing Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review Teachers were positive about the website describ- terms of use. In particular, it helped avoid overlaps ing it as attractive, cheerful, and mostly easy to in content transmission and introduced new ideas navigate.33 through feedback from all sides. In these studies, In general, the studies we reviewed made positive collaboration or cooperation among colleagues was assessments of the user-friendliness of the various considered crucial, as was the number of colleagues platforms positively. Only a few issues were raised, involved in collaboration. Diversity also appeared concerning technical problems, eg, problematic essential, eg, the involvement of different profes- downloads, or access. For example, some com- sionals in the same school and for different subjects plained about third-party access to conversations in different schools. However, challenges related to between users in discussion forums, and others, collaboration were sometimes noted, including lack eg, students’ ease of access to sections reserved for of time, scheduling conflicts, logistical challenges, teachers. Additionally, teachers expressed a sense and lack of financial and technical resources. Prac- of loss of control, anxiety, or a lack of interest in tical commitment to using ICT-Based learning the tool – teachers preferring to call upon a dedi- environment required the school staff members to cated staff member rather than performing online have more time for planning and cooperation be- research themselves, thereby hindering use. tween colleagues. A few teachers disliked that the teacher environ- The teacher in “School B” who worked alone and ment was accessible for students, or had difficulties only with a class of students initiated less interac- shifting between students versus teacher environ- tion between students and with adults than other ment or online versus offline implementation of schools.34 The involvement of several teachers from program elements. 33 the same school in the project and from different Suggestions were made that could support or fa- subjects in “Schools A and F” appeared to be a cilitate use, such as offering features that would be facilitating factor.34 of practical use, such as an introductory video to That a PHP program’s digital platform is present the platform. For example, in one study, linked to existing programs in the school. This 27 turnkey PHP program tools, ie, ready-to-print condition was raised in 4 studies. They highlighted teaching materials, were developed at the users’ re- the importance of including the technology project quest. The idea of providing information on the in the school’s pedagogical activities. This involves new pedagogical approach resulting from the use ensuring that the project is integrated into course of a digital platform was also raised. For example, syllabi and academic course requirements, includ- respondents noted that their role was being trans- ing activities in PHP integrated into the school’s formed with this use, taking the form of assistance annual course planning, or the teacher’s core cur- to students. Interviewees also appreciated having riculum or even requesting administrative support access to a user manual, in hard copy or download- for these types of activities. able format, offering clear guidelines and providing Two main reasons for incomplete implementation sufficient support for use. Others would have liked were limited time, such as limited teaching hours to have a CD, DVD, or mobile application to sup- per week, and competing curriculum priorities, port use. eg, students needing to work towards the nation- All teachers indicated that the manual was help- al biology exams.33 Only about one-half of par- ful, clear, sufficient and supportive, particularly ticipants reported that their principal supported for certain modules.33 quality health education.28 That a PHP program’s online platform engages all stakeholders. This condition was underscored DISCUSSION in 4 studies. These studies showed the extent to Two main observations can be drawn from the which collaboration among professionals, both data in this review. First, the studies showed a pre- within and outside the institutions, was a favorable ponderant participation of teachers, sometimes or unfavorable condition for implementing a PHP exclusively, sometimes with students and/or other digital platform. The greater this collaboration, school professionals. As such, they raise several issues the more positive impacts it appeared to have in of concern to teachers, many of which are reported 732
Dagenais et al in the scientific literature in the field of education. cifically concerns teachers’ reality. The first has Second, only a limited number of empirical studies to do with the value and credibility that teachers could be identified for this review, indicating that attribute to content hosted on a digital platform this is an emergent field of study. The use of PHP based on that content’s relevance and quality – a digital platforms by teachers and other profession- condition that, again, is echoed in the education als appears recent, or at least, the scientific commu- literature.40 That literature shows that teachers tend nity’s study of such use appears recent, as evidenced to use ICT when the content is of high quality and by the selected studies’ dates of production. up-to-date, offers benefits, and is aligned with their Even though the studies are diverse in terms of values, pedagogical needs, and previous experienc- methods, particularly with respect to design and es.40,43,45 On the other hand, it shows the potential rigor, they nevertheless reveal a set of conditions for resistance to use when these conditions are not that appear favorable to the use of PHP digital plat- met.40,43 Teachers must be convinced of the benefits forms in school settings. These conditions highlight and added value of use, either for themselves or for the importance of ensuring: (1) that the digital students,45,46 as was highlighted in this review. platform becomes a reference for PHP program ac- The second has to do with the diversity of pro- tivity in the school; (2) that the resources needed fessionals involved in the same school, as well as for its uptake are mobilized; and (3) that it is user- the online interactions, and intra- and inter-insti- friendly. More marginally, but still significantly, tutional collaboration; these aspects appear to drive 2 other conditions concerned the importance of the use of PHP digital platforms in the school set- ensuring: (4) that the digital platform engages the ting. The education literature points to the same participation of everyone involved; and (5) that it observation, eg, that teachers are more likely to is linked to existing programs in the school. use technology when they have the support of col- Repeatedly, the studies in this review underscored leagues as some studies confirm.40,43,45 However, the importance of ensuring that school settings we found mixed results on this point – the data have adequate resources in terms of facilities such showing that the school-based professional collab- as Internet access, enough computers, and work oration was a factor that could be both favorable organization, eg, time freed up, to support the use and unfavorable to the use of PHP digital plat- of PHP digital platforms. Although not specific to forms in schools. Indeed, this review highlighted the implementation of programs in schools, this several challenges related to collaboration among aspect, eg, ensuring the availability of sufficient hu- colleagues, including lack of time, scheduling con- man, material, and temporal resources in schools, flicts, logistical challenges, and lack of financial and is well documented in the education literature.40-43 technical resources.16 The user-friendliness of online platforms is also re- The third has do with the level of integration ported as a key requirement.43 of PHP digital platforms into lesson plans or aca- Although most of our selected studies assessing demic curricula. Although mentioned in isolation, the user-friendliness of the platforms were favorable, this condition warrants attention, because curricu- some issues were raised, having to do with technical lar constraints can present obstacles to the use of problems including problematic downloads, access, PHP digital platforms, despite the best intentions certain apprehensions such as anxiety related to use, of teachers and other school professionals.35,47 The and some professionals’ lack of interest in the idea studies in this review provide a wealth of examples of using a digital platform – all this illustrating a of integration efforts that could guide proponents need for support and guidance in uptake and use. of PHP program technology projects. For example, On these last points, the data showed that teach- one platform documented by the review, e-Bug, ers appreciated when a digital platform provided which is widely distributed in several European turnkey teaching materials, a known facilitator for countries, is integrated into the core curriculum implementing PHP programs in schools or for us- of teachers and supported by both schools and au- ing technology in educational activities.44 thorities. It aims to promote appropriate behaviors The review adds 3 other conditions that appear among students in the areas of hygiene, infection more specific to the school setting and more spe- prevention, and prudent use of antibiotics and vac- Health Behav Policy Rev.TM 2022;9(2):719-737 DOI: https://doi.org/10.14485/HBPR.9.2.1 733
Using Digital Platforms in Schools for Prevention and Health Promotion: A Scoping Review
cines. This platform has been implemented in 26 the school environment also must be maximized
countries and translated into 23 languages.27 How- by mobilizing policymakers, school administrators
ever, the integration strategy for the platform has and professionals. More specifically, special interest
not been evaluated. should be paid in:
• establishing national objectives that put for-
IMPLICATIONS FOR HEALTH BEHAVIOR ward educational systems which, through
OR POLICY planned actions, have the effect of institu-
In a guide produced by the World Health Or- tionalizing the prevention and promotion of
ganization (WHO) and the United Nations Ed- health in schools,48 and
ucational Scientific and Cultural Organization • financially supporting schools so that they
(UNESCO),48 the authors highlight evidence- can free up working time and offer the nec-
based areas of implementation that should be pri- essary resources to carry out PHP activities
oritized to make every school a Healthy School. This eg, enough computers in classrooms, online
requires that schools implement much more than access, training, assignment of resource per-
specific health programs, and instead, take a holis- sons to support the use, knowing that PHP
tic approach to promoting health and well-being, projects often take place alongside teaching
in which the culture, conditions, and program- activities and that it takes time to appropriate
ming of a school all contribute to a Healthy School a PHP content.8,12
system. To achieve this goal, they recommend that Researchers also should be involved, as the results
investments be made in school infrastructure – for of the review show the importance of:
example, facilities and spaces, as well as the devel- • conducting research to improve understand-
opment, revision, and implementation of curricula ing of the success factors in the use of PHP
and their associated resources promoting health digital platforms by teachers and other school
and well-being in school subjects. The training of professionals, as the current knowledge pool
professionals and the involvement of students in is still sparse. Future studies should research
PHP activities or programs are also recommended. collaboration between colleagues as a facilita-
Lack of time and workload are, however, recur- tor and constraint to use, as well as the facili-
ring issues in schools. The context of austerity in tators to integration of digital PHP platforms
education, including staff shortages and the lack of in school curricula. This last aspect appears
financial resources,40-43 undoubtedly has an impact fundamental to support use although men-
on the implementation of PHP programs. Among tioned marginally in the review.
other aspects, the implementation of innovative • conducting systematic reviews, including
educational PHP activities into the school environ- ScR, to offer useful lessons about the use
ment appears essential. of PHP digital platforms by students, as we
The emerging use of digital platforms in educa- identified many studies in this area. To our
tion14-16 represent a promising avenue in this regard. knowledge, there are no systematic reviews
The review shows the value that the tool represents shedding light on the perceptions and uses of
for professionals, including teachers, when it facili- these types of platforms.
tates the circulation, transmission and use of relevant
content or when it is eye-catching for professionals Acknowledgements
and interactive. In fact, schools can derive many This study received joint funding from the
benefits from the use of these platforms, and easily Ministère de l’Éducation et de l’enseignement Su-
and inexpensively15,17,18 facilitate the transmission périeur (MÉES) and the Ministère de la Santé et
and application of PHP content by professionals. des Services Sociaux (MSSS).
In line with the recommendations formulated by
the WHO and UNESCO, these platforms should,
however, be based on a comprehensive approach to Human Subjects Approval Statement
health by hosting, for example, not one, but several Production of this paper did not involve collec-
topics of interest to schools. Their integration into tion of original data from human subjects.
734Dagenais et al
Conflict of Interest Disclosure Statement Le Développement des Enfants et des Adolescents dans une
Perspective de Promotion de la Santé et de Prévention en
All authors of this article declare they have no Contexte Scolaire. Québec: Gouvernement du Qué-
conflicts of interest. bec; 2017. www.inspq.qc.ca/sites/default/files/publica-
tions/2243_developpement_promotion_prevention_
contexte_scolaire.pdf. Published 2017. Accessed October
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Health Behav Policy Rev.TM 2022;9(2):719-737 DOI: https://doi.org/10.14485/HBPR.9.2.1 735You can also read
