To read the full version of this content please select one of the options below:

Health‐promoting changes with children as agents: findings from a multiple case study research

Venka Simovska (Department of Education, Aarhus University, Copenhagen, Denmark)
Monica Carlsson (Department of Education, Aarhus University, Copenhagen, Denmark)

Health Education

ISSN: 0965-4283

Article publication date: 13 April 2012




With the aim of contributing to the evidence base on school‐based health promotion, the authors discuss the outcomes and processes of a European intervention project aiming to prevent obesity among children (4‐16 years) and promote their health and well‐being, titled Shape Up: a school‐community approach to influencing determinants of healthy and balanced growing up.


Multiple case study research was carried out in five schools in five EU countries. Data sources included project documents, interviews, and observations. Narrative qualitative cross‐case analysis was carried out following the single case analyses.


The study showed that, if given sufficient guidance, pupils can act as agents of health‐promoting changes on both school and local community level; they were involved in actions which improved school policies, provisions and affordances for healthier diet and regular physical activity. The study identified three forms of participation, each with a different level of pupil involvement and agency.

Research limitations/implications

The study is qualitative, based on five single cases and cross‐case analysis; this research design implies caution related to extensive non‐contextualised generalisation of the findings. However, valuable implications for research and practice can be drawn, especially in relation to structural barriers for participatory health promotion.


The paper is of value for researchers as well as practitioners in the field, particularly those interested in eco‐social models of health, whole‐school approaches to health promotion and pupil participation. The study's specific value is in the systematic qualitative cross‐case analysis, which contributes to the research rigour and allows for situated generalisation.



Simovska, V. and Carlsson, M. (2012), "Health‐promoting changes with children as agents: findings from a multiple case study research", Health Education, Vol. 112 No. 3, pp. 292-304.



Emerald Group Publishing Limited

Copyright © 2012, Emerald Group Publishing Limited