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Adapting the Health Promotion School (HPS) approach to context specifics is acknowledged as being essential for implementation and achieving optimal effectiveness. This study aims to explore implementation variations on seven HPS spectra (such as top-down to bottom-up involvement of stakeholders) on which implementation of the HPS approach can vary, and the factors that relate to navigation on these spectra.

In 2020, fourteen HPS researchers and professionals from ten European countries participated in semi-structured interviews.

Navigation variations on the HPS spectra occurred throughout most spectra. Further, a tendency was found towards spectrum extremes of addressing multiple core-components, implementing non-disruptive Health Promotion (HP) programmes, and evaluating the HPS approach through an action-oriented research approach. Important general factors were resources, staff capacity and time available to staff members for implementing the HPS approach. Some spectra required more specific factors like organisational skills, leadership or a certain level of democracy.

The implementation of the HPS approach should be supported by implementation strategies addressing the spectrum-specific factors, but more generic factors such as staff capacity, resources and the level of democracy should also be considered.

This study explores navigation variations throughout HPS spectra rather than the HPS approach in general. It also nuances implementation diversity across and within different European contexts.

This study presents an overview of research literature on health promotion in schools, utilizing metadata extracted from 4,328 publications indexed in the Scopus database over the past 35 years.

A bibliometric approach was used to analyze the development and current state of using publication and citation data. A structured keyword search was conducted in the Scopus database to retrieve relevant publications in the field. Frequency counts, rank-ordered tables and time series charts were used to illustrate the dynamic growth of publication and citation data, the core journals, the leading countries and the most frequently used keywords in research on health promotion in school contexts. A series of social network analyses was conducted to explore and visualize the social, intellectual and conceptual structure of the field.

Findings demonstrate that health promotion in the school context is a growing research field that has gained significant momentum in recent years. The research in this field is widely distributed internationally, but the research output is dominated by the US and other English-speaking countries. The study reveals a trend toward increased collaboration among research groups. The level of international collaboration varies. The research field is highly interdisciplinary, and the main research themes addressed in the literature include mental health, well-being and quality of life; health behaviors; oral health education; sexual and reproductive education and general health promotion and health education in schools.

This is the first study to map the development of a research field with growing recognition. It provides a comprehensive overview of the emerging field of health promotion in the school context and its progress over time, contributing to the organization of the research domain. The study demonstrates the need for a new framework for health promotion research that supports the sustainability of health promotion research in schools.