PurposeThe aim of this study was to investigate how teachers are positioned within the narratives of other professional actors with regard to working with student health. This report addresses two main research questions: "How are teachers positioned by other professional actors in the context of working with student health?" and "What roles are teachers assigned in student health work within the narratives of these professionals?"Design/methodology/approachA qualitative design with an interactionist approach was adopted to examine the position and roles assigned to teachers when working with student health. Interviews were conducted with nine principals and members of the student health team at two large Swedish high schools. Responses were transcribed verbatim and analysed using thematic analysis and the theoretical framework.FindingsTeachers are given both a central and a marginalized role. Although they are sometimes described as essential for student health, they are rarely positioned as competent within this work.Practical implicationsThe emphasis on high-quality teaching as a contributor to student health represents a practical pathway for schools. Teachers should be supported in creating inclusive, participatory and structured classrooms that inherently promote well-being.Originality/valueThis paper is the first of its kind to examine roles and positions assigned to high school teachers when working with student health in a Swedish context. The results are also valuable in other contexts. Since promotion of student health requires teamwork, it is essential for the main actors to understand each other's roles and potential contributions, which this study contributes to.

School has been identified as a suitable arena for health promotion and teachers are highlighted as crucial for student health. In Sweden, where the study is set, teachers are tasked with school health promotion in national legislative and policy documents. However, research shows that student health can be perceived as situated outside the teacher professional identity and Swedish teachers are traditionally not educated in health. This paper presents findings from a qualitative study conducted in two Swedish high schools. The aim is to examine the students’ perspective of the role of the teacher in working with student health. Interviews with 34 students aged 16–19 years were carried out. Data were analysed using qualitative content analysis with theoretical underpinnings from pragmatism and symbolic interactionism. This approach identified four dominating roles for teachers: 1) a creator of joyful learning, 2) a creator of a sense of control, 3) a spreader of happiness, and 4) a creator of feeling valued. This study shows that the role of the teacher in working with student health is in acting, not in being, and that this role is constantly (re)created through interaction. The student perspective of the role of the teacher in working with student health has close similarities to the role of the teacher in inclusive teaching, merging relational competence with didactic skill. In conclusion, we argue that developing teachers’ didactic as well as relational competency, along with understanding competence within a pragmatic and symbolic interactionist theoretical framework, could improve student health practices. 

This article aims to contribute a social pedagogical perspective of high school teachers’ descriptions of working with student health in their teaching practice in Sweden. Ten high school teachers were interviewed. The teachers considered their student health work as consisting of two main aspects: creating a good relationship and helping the students to succeed. These aspects are implicitly and explicitly described as comprising the recognition of the actors’ social and pedagogical identities. This study shows that social pedagogical recognition is significant for common success in school practice in relation to student health work. Clarifying the teachers’ responsibility and competence in student health work and strengthening teachers in their identity as health promoters could improve student health practice.

This paper presents findings from a qualitative study conducted in two Swedish high schools. The aim of is to examine the students’ perspective of the role of the teacher in working with student health care. Interviews with 34 students aged 16-19 were carried out. Data was analyzed using qualitative content analysis resulting in four dominating roles: 1) Teachers who create joyful learning, 2) Teachers who create a sense of control, 3) Teachers who spread happiness and 4) Teachers who makes the students feel valued. These finding are largely in line with inclusive teaching. A conclusion is that the student perspective of the role of the teacher in student health care has great similarities with the role of the teacher in inclusive teaching. Viewing teachers’ work with student health care in close connection with inclusive teaching can offer a new, pedagogical perspective on the role of the teacher in student health care, perhaps a role where teachers feel comfortable as opposed to something new or outside of their profession.

This study explores the discourse about health promotion and the role of the teacher in Swedish upper secondary schools. The material consists of student health plans from schools and local authorities that were analysed using discourse analysis. The results show that health promotion is largely an empty or floating signifier. The teacher is mainly in discursive shadow. When the teacher is in discursive light, their role in health promotion is connected to ordinary teacher tasks. Schools can set out what health promotion entails to a greater extent and clarify the role of the teacher.

Introduction

This study explores the role of the teacher in working with student health in high school. Teachers have been identified as crucial in promoting student health and wellbeing but it is traditionally not considered a teacher task. The article presents findings from an empirical study in which the views of the teachers are in focus.

School is considered a suitable and vital arena for working with the health of children and young people. This can be done by implementing various programmes and initiatives lead by teachers or other professionals, or in a more informal way in the everyday school practice.

Student health has been and still is a concern for the Student Health Services (SHS). It is however with the teacher that the students spend most of their time in school. A good relationship with the teacher, support from the teacher in meeting academic demands and classroom participation has proven beneficial to student health. There is also a well-documented reciprocal relationship between health and academic achievement. Overall, the same factors which promote learning, also promote health.

In Sweden, where the study is set, student health work “shall be primarily preventive and promoting” (Education Act, 2010:800). Teachers are not explicitly tasked with health promotion but stipulated to cooperate with the SHS regarding student health. While the teacher is not presented as a central actor in the Education Act, other guiding documents highlight the teacher as important for student health. Teachers thus have a role in working with student health but what this role entails is not clear in the governing documents.

The aim of the article is to contribute knowledge about how Swedish high school teachers describe their role(s) in working with student health.

Brief Previous Research

Student health work has been empirically explored before but the role of the teacher in this work is a field in need of further empirical investigation. Much of the research regarding teachers’ involvement in student health work examines various programmes and initiatives implemented at the respective schools. The focus of this article is how teachers describe their role in the informal, everyday student health work, not in a programme or an initiative.

Teacher involvement in health promotion has been criticized. Student mental health promotion can be regarded as an additional task to the existing abundance of teacher tasks. Expanding the role of the teacher is criticized as it can cause added stress and pressure. Lastly, teachers’ increased awareness of mental health problems among children and adolescents, can result in teachers starting to identify many behaviors and experiences previously deemed ordinary or understandable, as indicative of mental health problems

This study contributes knowledge about how teachers describe their roles in student health promotion. This knowledge can be used to improve student health promotion further and contribute added understanding of the complex professional role of the teacher.

Theoretical Points of Departure

The study is based on theories of social constructivism in which social phenomena are understood and become active deeds by means of human interaction; people interpret, reinterpret, negotiate, and use various strategies to influence which interpretation takes precedence, thereby influencing how a phenomenon is understood.

Methodology, Methods, Research Instruments or Sources Used

The empirical data used in this article was collected in connection with a larger qualitative study conducted in two Swedish high schools. Ten teachers participated in the study, with teaching experience from between four and 22 years.The data was collected using semi-structured individual interviews where six open-ended questions guided the interviews. Follow-up questions were formulated in order to gain a deeper understanding of their answers. The interviews were recorded and transcribed verbatim.The data was analysed using qualitative content analysis. After the interviews were read through several times, sections of the interviews pertaining to the aim of the article were selected. These sections were read again and meaning units, i.e. statements that uncovered something related to the aim, were extracted. The extracted meaning units were condensed and coded, resulting in 102 codes. These codes were then grouped into themes, in an iterative process involving, re-reading of the selected interview sections as well as the whole interviews. The groupings were based on the relationship and underlying meanings regarding differences and similarities.

Conclusions, Expected Outcomes or FindingsThe teachers clearly recognize and describe their work with student health in the everyday teaching.Tentative results show one main theme and four themes describing the different internal roles of the teacher as health promotor. The main theme is Conscious use of relationship to facilitate health and learning. The themes are The role of a caring adult, The role of a coach, The role of a student centred pedagogical leader and The role of security creator. The purpose of all the internal roles mentioned above, is to create a professional relationship with the students which is health promoting.

There are no colclusions yet, but it is clear that the teachers consider health promotion a teacher task, not in conflict with their professional role but rather integrated with it.

References                                                                                                                Burr, V. (2015). Social constructionism. Routledge.                                                Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today, 24(2), 105-112. https://doi.org/10.1016/j.nedt.2003.10.001                Gustafsson, J.-E., Allodi Westling, M., Alin Åkerman, B., Eriksson, C., Eriksson, L., Fischbein, S., Granlund, M., Gustafsson, P., Ljungdahl, S., Ogden, T., & Persson, R. S. (2010). School, Learning and Mental Health: A systematic review.                  Hammerin, Z., Andersson, E., & Maivorsdotter, N. (2018). Exploring student participation in teaching: An aspect of student health in school. International journal of educational research, 92, 63-74. https://doi.org/10.1016/j.ijer.2018.09.007                                Partanen, P. (2019). Health for learning - learning for health. The Swedish National Agency of Education.                                                                                     Phillippo, K. L., & Kelly, M. S. (2014). On the Fault Line: A Qualitative Exploration of High School Teachers’ Involvement with Student Mental Health Issues. School Mental Health, 6(3), 184-200. https://doi.org/10.1007/s12310-013-9113-5                     Pössel, P., Rudasill, K. M., Sawyer, M. G., Spence, S. H., & Bjerg, A. C. (2013). Associations between Teacher Emotional Support and Depressive Symptoms in Australian Adolescents: A 5-Year Longitudinal Study. Developmental Psychology, 49(11), 2135-2146. https://doi.org/http://dx.doi.org/10.1037/a0031767

Ever since the Ottawa charter in 1986, health promotion through schools has been stressed across the globe. Both in global and national discourse, schools are made responsible not only for providing education but also for working with pupil health and well-being. In Sweden, where the study is set, it is emphasized in national directives that promoting pupil health should be part of the school practice. Since the Swedish school system is decentralized, these directives need to be interpreted and recontextualized locally. This study aims to explore how the student comes across in Swedish local health policy documents. The data consists of 37 such documents called student health plans collected from different high schools throughout Sweden. The analysis was inspired by critical discourse analysis and tentative results are divided into two main themes; the invisible actor and the passive recipient. The pupil is largely invisible in the documents and the discourse instead focuses on school health service staff and, to some extent, the teachers. When the pupils are visible, they mainly come across as passive recipients of health promoting actions. Since participation, taking action and feeling empowered are key aspects of health promotion, the findings could impact the pupils’ possibilities for health and well-being.

Health and learning are intrinsically linked and have a reciprocal relationship. Healthy students generate better learning outcomes and good learning outcomes in turn generate healthy students. The health of students is traditionally viewed as the concern of the student health staff and not as a central part of the teacher profession.  It is however stipulated by the Swedish National Agency for Education and The Agency of Health and Welfare that the teaching profession also entails health promotion. 

The teacher and the relationship between the teacher and the student have proven crucial to student mental health. This is also noted by The Swedish Education Agency and The Agency of Health and Welfare which state that “student health work is conducted in all school environments especially the classroom where the teacher plays a key part”. In spite of the fundamental role the teacher plays regarding student health, there are no clear guidelines on a state level regarding teachers’ work with student health and it is a responsibility not traditionally associated with teaching. 

In Sweden, school health work is regulated by the Education Act, which states that the work should focus on health promotion and risk prevention. On a municipal and school level there are Student Health Plans which are local documents that interpret national directives and thus guide the school’s work with student health. This study aims to examine how the role of the teacher is presented in such Student Health Plans.

Thirty-seven student health plans ranging from four to 32 pages were collected from municipalities and high school across Sweden. These texts are analyzed using discourse analysis. Dominant and less dominant ways to depict health promotion and the teacher's role in the work were detected. The initial analysis shows that the role of the teacher is mentioned in different ways; that is, the interpretation and specification of what the health promoting work should imply for the teacher vary depending on the municipality and school. The teacher is rarely mentioned in connection to health promoting work but often in relation to remediating or rectifying actions. When the teacher is mentioned in terms of health promotion it is in general and imprecise terms. Moreover, the role of the teacher is recurrently defined in relation to other, quite new professions in school with indeterminate functions, such as ‘student consultant’ and ‘student assistant’. 

Mental health issues among children and youth have increased the past decades in many Nordic and European countries. The part of the school in the work to promote health and prevent risks has been stressed by international and national organizations, but little is known of how it is interpreted and operationalized in relation to the teachers. This study contributes to widen our understanding of how the global and national discourse comes into play, that is, how it is (re)constructed and negotiated, in local School Health Plans. 

Ever since the Ottawa charter in 1986, health promotion through schools has been stressed across the globe. In Sweden, where the present study is set, school health promotion is stipulated on a national level by the Education Act and the Health And Medical Services Act. It is emphasized in national directives that health promotion should be part of the education. The present study aims to widen our understandings of health promotion by exploring the so-called Student Health Plan (SHP) in upper secondary schools, which is a document conducted to concretize the national directives. The aim of the study is to examine how the teacher comes across in the SHPs regarding health promotion. The data consists of 37 SHPs from high schools. The SHPs were analyzed using thematic analysis and the data was coded and divided into themes. The analysis resulted in two themes: The “invisible” teacher and The visible teacher. Teachers are largely “invisible” in the SHPs and lack tasks and responsibility. When the teacher is visible, student attendance, teaching and relational work are areas of responsibility in health promotion. Standard teacher tasks are considered health promotion, which motivates the question of the necessity of a SHP. The findings also suggest that regular teaching is health promoting, strengthening the key role of the teacher in the health promoting work. 

The aim of the article is to contribute knowledge about student participation in teaching as an aspect of student health in school. Teaching is approached as an everyday democratic process that affects individual health, the health of a democratic society and young people’s experiences and attitudes towards democracy. Interviews conducted with high-achieving girls experiencing school-related stress in a Swedish upper secondary school are analysed using the Student Participation in Teaching Model as a methodological framework. The results indicate that the students mainly experience participation as being informed and suggest other dimensions of participation, such as reciprocal responsibility and communication. It is concluded that the teaching itself is a vital dimension of individual and societal democratic health and that this should be emphasised more in teaching practice.