Factors influencing the adoption of a Health Promoting School approach in the province of Quebec, Canada

This study examined a prediction model that integrated three categories of predictors likely to influence adoption of the Quebec Healthy Schools (HS) approach, i.e. attributes of the approach, individual and contextual characteristics. HS receptivity was considered as a potential mediator. For this study, 141 respondents representing 96 schools participated in a postal survey. We used bivariate logistic regression to assess factors associated with HS adoption and Baron and Kenny's method to test the mediation effect of HS receptivity. Four predictors related to school organizational characteristics had more weight in influencing the adoption of HS: the 'presence of leaders within schools', 'perceived school contextual barriers', 'school investment in healthy lifestyles' and 'beliefs in collective efficacy'. The influence of the latter two predictors was not direct but mediated by HS receptivity. Our findings showed that standard attributes generally considered as predictors of the adoption of an innovation are not the strongest determinants to explain HS adoption in the present context. The results shed light on the crucial role of organizational context in the adoption of this type of approach.