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A comprehensive “health promoting schools” (HPS) approach is advocated by the World Health Organization to foster the health of students. To date, few studies have evaluated schools' capacity to implement it in an optimal way. The purpose of this paper is to present a conceptual framework that identifies core features likely to facilitate the incorporation of innovation, such as HPS, into school functioning.

The framework was built by combining dimensions derived from two major strands of literature, i.e. management and HPS. It has taken root in Zahra and George's model of organisation absorptive capacity (AC) for new knowledge but has been adapted to better explore AC in a school context. The contrasting cases of two secondary schools that adopted a HPS approach in Quebec, Canada, for at least three years were used to illustrate the value of the framework.

The framework proposed is a multidimensional model that considers components such as modulators, antecedents, integration mechanisms and strategic levers as potential determinants of AC, i.e. acquisition, assimilation, transformation and exploitation. The conceptual framework helped to qualify and compare AC regarding HPS in the two cases and holds promise to appreciate mechanisms having the greatest influence on it.

The framework can serve as a conceptual guide to facilitate the absorption of innovation in schools and to design future empirical research to better understand the underlying process by which schools strengthen their capacities to become settings conducive to the health of youth.

The purpose of this paper is to understand how a Canadian intervention based on a professional development (PD) model did or did not influence schools’ capacities to absorb a Healthy School (HS) approach into their operations. This study is the second part of a research project: previously published results regarding this research provided a detailed description of the PD model and highlighted the relevance and effectiveness of PD in improving actors’ HS-related knowledge and practices. The present paper focuses on the organizational impact of such PD intervention.

The design was based on a realist evaluation approach, which helps to elicit a theory explaining how an intervention leads to particular outcomes. A multi-site case study of three schools with pre- (T ₀) and post- (T ₁) intervention comparison was adopted. Multiple qualitative methods were used to capture how the changes were achieved by collecting data from various stakeholders involved in the intervention.

The PD model tested reinforced the schools’ capacities to absorb this type of initiative. For one of the capacities examined, “exploitation”, i.e., the ability to incorporate and maintain the initiative into schools operation, the evidence was less apparent. In congruence with the realist evaluation, the results are rendered in the form of a contextualized intervention theory identifying the links between the PD and the mechanisms that were likely necessary to explain what led to the changes in “absorptive” capacities (which refers to the capabilities of schools to acquire and assimilate HS knowledge, and also to transform and exploit them, in the context).

The refined theory, based on empirical findings, can enable facilitators and practitioners to gain a deeper understanding of the action mechanisms shown to be determining in the success of HS implementation.