Frontiers in Psychiatry · 4 authors, 5 centres
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This qualitative case study examined four government-run secondary schools in Bihar, India, following the end of the SEHER effectiveness trial, and found that no school sustained the intervention as originally delivered. Two schools adapted by selecting sustainable components, while two discontinued the intervention entirely.
This exploratory qualitative case study collected data from four government-run secondary schools in Bihar, India, after the SEHER whole-school health promotion intervention trial closed. Thirteen school staff were interviewed and 100 students aged 15–18 years participated in eight focus groups across two schools that continued the intervention and two that discontinued it. Thematic analysis using grounded theory identified four interrelated themes explaining sustainability: understanding of the intervention philosophy among school staff, school capabilities to continue activities, school attitudes and motivation, and the education policy environment and governance structures. No school sustained the intervention as originally delivered; two adapted by selecting components perceived as sustainable, while two ceased the program. Schools defaulted to a programmatic approach, retaining curricula-based and knowledge-focused elements while abandoning structural, pedagogical, and environmental components despite these being the mechanisms through which the trial achieved effectiveness.
