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. 2023 Jul 4;38(4):661-689.
doi: 10.1080/02671522.2021.1961302. Epub 2021 Aug 25.

Evolution of 'whole institution' approaches to improving health in tertiary education settings: a critical scoping review

Helen Sweeting  1 , Hilary Thomson  1 , Valerie Wells  1 , Paul Flowers  2
Affiliations

Evolution of 'whole institution' approaches to improving health in tertiary education settings: a critical scoping review

Helen Sweeting et al. Res Pap Educ. .

Abstract

In recent decades, 'whole school' approaches to improving health have gained traction, based on settings-based health promotion understandings which view a setting, its actors and processes as an integrated 'whole' system with multiple intervention opportunities. Much less is known about 'whole institution' approaches to improving health in tertiary education settings. We conducted a scoping review to describe both empirical and non-empirical (e.g. websites) publications relating to 'whole settings', 'complex systems' and 'participatory'/'action' approaches to improving the health of students and staff within tertiary education settings. English-language publications were identified by searching five academic and four grey literature databases and via the reference lists of studies read for eligibility. We identified 101 publications with marked UK overrepresentation. Since the 1970s, publications have increased, spanning a gradual shift in focus from 'aspirational' to 'conceptual' to 'evaluative'. Terminology is geographically siloed (e.g., 'healthy university' (UK), 'healthy campus' (USA)). Publications tend to focus on 'health' generally rather than specific health dimensions (e.g. diet). Policies, arguably crucial for cascading systemic change, were not the most frequently implemented intervention elements. We conclude that, despite the field's evolution, key questions (e.g., insights into who needs to do what, with whom, where and when; or efficacy) remain unanswered.

Keywords: University; college; review; settings approach; system.

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Figures

Figure 1
Figure 1. Flow chart of searches and exclusions.
Figure 2
Figure 2. Number of each publication type according to publication decade and country.
See this image and copyright information in PMC

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Publication types