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ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1559954
This article is part of the Research Topic Public Health Strategies to Improve Mental Health in the Education Sector: Perspectives and Applications View all 12 articles
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Introduction: Discontinuing effective school health interventions prevents new practices from reaching wider student populations and wastes investment in implementation. While reviews have consistently identified facilitators and barriers to the sustainment of school health interventions, the social processes underlying sustainment remain unclear. We explored the post-trial sustainment of 'Learning Together', a whole-school intervention, found to be effective in preventing bullying and promoting wellbeing in English secondary schools. We examined how staff and students described its sustainment in the two years post-trial, what factors staff referred to in explaining their motivation to sustain it, and how schools' capacities affected sustainment. Methods and materials: Learning Together involved training staff in restorative practice (RP) and supporting schools to implement a staff-student action group and a social and emotional learning curriculum. Using a case-study design, we collected qualitative data from five schools: staff and student interviews one-year post-trial; staff interviews two years post-trial; and descriptive data from the original trial's process evaluation. The General Theory of Implementation guided our thematic analysis. Results: No school sustained the intervention in its entirety. RP was continued by some individuals in all schools and was sustained at school-level in one school. The curriculum and action groups were discontinued in all schools, although actions initiated by the groups were sustained in two schools. Staff motivation to sustain components was affected by their perceived effectiveness, and individual motivations to sustain RP differed from whole-school commitment to sustaining the approach. Schools' capacities to sustain Learning Together were affected by: the prioritisation of academic learning time; the frequent implementation of new initiatives; the timeliness of interventions with school improvements plans; and leadership engagement. Schools needed support to disseminate RP knowledge and skills school-wide and ensure consistent practice, and turnover adversely impacted on knowledge transfer. Discussion: Sustainment was an intentional, labour-intensive, social process. Intervention developers should consider whether/how interventions are designed to work alongside, replace, or can refine existing practices, and should support schools to mainstream evidence-based interventions to sustain them at school-level.
Keywords: Sustainment, behaviour, Whole-school intervention, Health, wellbeing
Received: 13 Jan 2025; Accepted: 07 Apr 2025.
Copyright: © 2025 Herlitz and Bonell. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lauren Herlitz, University College London, London, United Kingdom
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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