Schools are an ideal setting to deliver public health interventions, yet there are competing obligations that could limit their implementation. This study aimed to examine the decision making process and explore what evidence informs prioritisation of public health interventions in this setting. Semi-structured interviews were conducted with 14 staff in seven UK schools between November 2017 and March 2018. Participants were recruited from schools participating in The Birmingham Daily Mile trial and comprised leadership staff, teachers, and pastoral staff. Analyses used a constant comparison approach to explore the prioritisation process and schools’ use of economic evidence. Teachers felt that they had little decision making influence in regard to public health interventions, with this falling on leadership staff. Participants perceived tension between delivering academic subjects and public health initiatives and thought proven impact was important to justify the opportunity cost. Evidence did not appear to be routinely used, and participants were unaware of cost-effectiveness analyses, but thought it could be a useful tool. This study shows that schools face challenges in balancing the academic, health, and wellbeing needs of children. There is a need for targeted evidence that includes appropriate costs and outcomes and meets school decision makers’ needs.

中文翻译：

---

在学校优先考虑公共卫生干预时使用经济证据：与学校工作人员进行的定性研究

学校是提供公共卫生干预措施的理想场所，但存在可能限制其实施的相互竞争的义务。本研究旨在检查决策过程，并探索在这种情况下哪些证据有助于确定公共卫生干预措施的优先级。2017 年 11 月至 2018 年 3 月期间，对 7 所英国学校的 14 名员工进行了半结构化访谈。参与者是从参与伯明翰每日一英里试验的学校中招募的，包括领导人员、教师和教牧人员。分析使用不断比较的方法来探索优先排序过程和学校对经济证据的使用。教师们认为他们在公共卫生干预方面几乎没有决策影响力，这落在了领导人员身上。参与者认为提供学术科目和公共卫生计划之间存在紧张关系，并认为经过验证的影响对于证明机会成本的合理性很重要。证据似乎没有被常规使用，参与者不知道成本效益分析，但认为它可能是一个有用的工具。这项研究表明，学校在平衡儿童的学业、健康和福祉需求方面面临挑战。需要有针对性的证据，包括适当的成本和结果，并满足学校决策者的需求。这项研究表明，学校在平衡儿童的学业、健康和福祉需求方面面临挑战。需要有针对性的证据，包括适当的成本和结果，并满足学校决策者的需求。这项研究表明，学校在平衡儿童的学业、健康和福祉需求方面面临挑战。需要有针对性的证据，包括适当的成本和结果，并满足学校决策者的需求。