Co-constructing health-promoting school environments through participatory processes

Background

Schools are key settings to address health inequalities and support children’s well-being. Beyond educational practices, the physical and social environment plays a critical role. Health-promoting school approaches emphasize systemic, participatory, and intersectoral strategies. This study explores how participatory research and intermediation processes support the transformation of a school into a health-promoting, sustainable, and equitable environment.

Methods

A qualitative case study was conducted within a school redevelopment project in a disadvantaged urban area in France. Data were collected through participatory methods including focus groups, brainstorming sessions, walking diagnosis, and questionnaires with teachers, students, families, and stakeholders. Data were analysed using thematic content analysis to identify co-construction and intermediation processes.

Results

Findings highlight that participatory processes enable the emergence of a shared vision of a “school of the future”, structured around well-being, relationships, and educational success. Intermediation facilitated the articulation of experiential and scientific knowledge, supporting co-construction of solutions aligned with health promotion principles. These processes operated across levels and contributed to progressive transformations. However, differences in participation generated inequalities in expression, highlighting challenges for equitable engagement. The process identified key levers for health-promoting environments, including participatory governance, alignment between pedagogical and spatial dimensions, and integration of social, environmental, and health objectives.

Conclusions

Participatory and intermediation processes are key to transform schools into equitable and health-promoting environments. Strengthening inclusive participation and bridging knowledge across stakeholders are essential for sustainable change.

Key messages

• Participatory and intersectoral approaches are essential to develop health-promoting school environments.

• Intermediation processes can reduce fragmentation but must address inequalities in participation.