(Re)framing school as a setting for promoting health and well-being: a double translation process

Abstract

The aim of this paper is to discuss the ways in which the setting approach to health promotion in schools, as part of knowledge-based international policies and guidelines, is embedded in the Danish policy landscape and enacted at the local governance level. The study draws on the sociology of translation and treats policy implementation as a non-linear process of (re)interpretation involving different actors in plural, mutually interwoven, non-hierarchical networks. Data were generated and analysed using a three-tiered process: the first tier focused on key international guidelines, the second on national policies, and the third on policies in selected municipalities. Through these tiers, we discuss actors and actor networks involved in the translation processes, their interactions and the dynamics of problematisation at the national and local levels. The results point to two different, but entangled, processes of translation. At the national level, despite resistance by a number of actors with differing priorities, the translation resulted in the integration of selected key principles of the setting approach to health promotion in the national curriculum for health education. At the municipal level, however, the principles seem to be ‘lost in translation’, as the treatment of schools as settings for promoting health and well-being remains largely subordinate to the discourses of disease prevention and individual behaviour regulation, dominated by the agenda of actors in the health sector.

Keywords:

• Setting-based health promotion
• health-promoting schools
• translation
• policy
• municipalities