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Introduction
The school setting has always been important for health education because it provides a location to target large groups of children or young people at the same time, and is considered an important setting for promoting health and learning (Pommier et al. , 2010). The Ottawa Charter (WHO, 1986) acknowledged the influence that surroundings can have on an individual's health, and established a course for the settings approach in health promotion, which informed the development of health promoting school (HPS) programmes in the 1980s. The main goal of the settings approach to health promotion is to transform a setting, such as a school, into a health promoting setting (Noblet, 2003).
Based on extensive research and practice over the last 50 years, school health promotion has developed alongside other health promotion contexts that have applied the settings approach (Stewart-Brown, 2006). Within the settings approach, health promotion in schools is understood to be a social process that seeks to encourage both individual and collective empowerment. People in communities and those working in the health arena see schools as playing a contributory role in improving the health and general wellbeing of the whole society (St. Leger, 2004), as do those in the education sector (Speller et al. , 2010). This highlights the potential importance of not basing learning in schools on teaching alone but also on making the whole school environment, including the physical, social and structural environments, healthy and conducive to learning (Simovska, 2004).
Many primary schools in Ireland are participating in the HPS at different levels (HSE, 2013). HPS in Ireland encourages a whole school approach in its implementation, the involvement of all stakeholders involved, improvements to the physical and social environment, and relationship development. However it is not necessary to have reached a certain threshold in these areas to be labelled a HPS, rather a HPS is seen to be striving to improve.
The school socio-ecological environment
A socio-ecological perspective on the settings approach acknowledges that the environmental system, in which people function, affects and influences their health. The recognition of people's interactions within complex socio-cultural, economic and political environments and the influence of these on people's health, either positively or negatively, form the basis for the settings approach to health promotion (Paton et...