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Abstract

Background:

Full-Service Community Schools seek to integrate health, well-being, and academic services in schools by partnering with local community services. Establishing and maintaining community partnerships represents a significant operational challenge for schools. However, limited literature exists that explores the process of establishing a Full-Service Community School with community partners.

Objectives:

This paper explores the process of engaging with initial community partners to develop of Full-Service Community School through the perspective of the coordinator.

Methods:

Using an autoethnographic approach, the paper documents the learning process of the coordinator as they engaged with key health and education professionals as stakeholders in a Full-Service Community School. Data were analysed using reflexive thematic analysis and interpreted using social learning theory.

Results:

Four themes were developed: principles of Full-Service Community Schools are known and valued; integration in Full-Service Community Schools is challenging but critical; coordinators are needed to develop Full-Service Community Schools; developing a Full-Service Community School is a journey.

Conclusion:

While there may be shared enthusiasm among stakeholders for the potential of a Full-Service Community School, there are logistical matters to consider relating integration and coordination which need to be resolved. By focusing on the learning journey of one Full-Service Community School coordinator, insights can be gained for others wanting to implement this model in their school.

Keywords

Autoethnography community hubs community schools Full-Service Community Schools school partnerships social learning theory

Introduction

Schools have recognised that young people who are physically active and mentally healthy perform better academically (Watson et al., 2017) and have thus been partnering with community services to provide additional academic, health, and well-being services to their students (Sanders et al., 2021). Currently in Australia, an array of terminology is used interchangeably to describe the approaches that schools use to provide this holistic support to young people (e.g. Community Hub, Community school, School-based services, School-community partnerships, Schools as Community Hubs). One approach that originated in the USA that has a history of demonstrating positive student outcomes through improving student attendance, behaviour, and academic achievement (Maier et al., 2017; Meloche et al., 2020; Valli et al., 2016) goes by the term Full-Service Community Schools (FSCS).

Universally, FSCSs seek to improve overall student outcomes by integrating health, well-being, and academic services, provided by local community, on the school grounds (Houser, 2016; Min et al., 2017; Valli et al., 2018). An earlier version of FSCSs explored in Australia (under the term full-service schools) noted the potential benefits of the model (Thomson, 1999) and provided commentary on the challenges of sustaining the model including funding and continuity in managing stakeholders (Kirner et al., 1997; Stokes and Mukherjee, 2000). These challenges stem from a central facet of the model; namely, the integration of health services, achieved through school-based wraparound approaches. Wraparound approaches are designed to facilitate, implement, and coordinate school and community-based interventions to meet individual student needs (Bruns et al., 2008). While wraparound approaches support young people experiencing the highest level of need in schools, only a small percentage of students receive this level of support (Yu et al., 2022). FSCSs recognise that some students’ needs are higher than others and incorporate wraparound or ‘integrated student supports’ within the model’s broader holistic strategy which includes the building of collaborative relationships with families and the community through key stakeholder partnerships to respond to the needs of young people, families, and the community (Houser, 2016; Sanders and Galindo, 2020). To this end, the services provided in a FSCS consist of numerous school-community partnerships that may include primary health, dental care, nutrition, physical activities, mental health, family education, job training, and career counselling (Maier et al., 2017). The number of school-community partnerships within a FSCS has previously varied from three to over 80 (Holme et al., 2022). Establishing and maintaining these partnerships with local services to create a FSCS presents a significant operational challenge for a school (Min et al., 2017). To address this challenge, the model calls for a designated coordinator (Dryfoos, 1994).

To date, limited research has explored a coordinator’s experience of establishing a FSCS, including how they identify and develop partnerships that will support the delivery of services for students and the community. This paper focuses on the learning process experienced by one coordinator at the centre of establishing a FSCS in Australia. More specifically, an autoethnographic approach has been employed to document my (i.e. the first-author) experiences as a FSCS coordinator, including what I have learned in the designing and initial stages of FSCS implementation and the stakeholders I have been learning from in this process. While students, teachers, school leaders, parents, and community partners can all be considered stakeholders in the development of a FSCS for this context, this paper focuses on my interactions with health and educational professionals prior to subsequent work that then engages students and their families. Professionals were selected as the initial stakeholder group to engage with to understand the known challenges of establishing and maintaining school and community partnership within a FSCS (Min et al., 2017).

Methodology

Autoethnography positions the researcher as the primary subject of a study as they examine their own experiences within a cultural or social context (Ellis and Adams, 2020). Combining the two disciplines of autobiography, an author writing about their own life, and ethnography, where cultural beliefs and practices are observed and written about (Adams and Herrmann, 2023), autoethnography recognises personal experience as research and is utilised as an interpretive method in qualitative research (Adams et al., 2022).

As a research method, autoethnography has traditionally been utilised to express personal stories of social and cultural significance such as gender and race (Jones et al., 2016). More recently, however, there have been growing accounts of its application to express the lived experience of health practitioners reflecting on their own practice (Ellis and Adams, 2020; Foster et al., 2006; Silva et al., 2017). Given this approach, it is necessary to provide insight into where this research took place and who I am.

Setting and positionality

The research was situated in a newly established urban secondary school in the State of Queensland, Australia. This culturally, linguistically, and socio-economically diverse school is located near a university with mutual interests to enacting the concept of a FSCS model on the school site. I occupy three distinct roles within this school. I am the school’s guidance officer, a role in Queensland Department of Education Schools that is a leadership position and one that provides case management support for students with complex needs as well as provides leadership of health and well-being approaches across a school (Department of Education, 2024). Owing to the school’s governance structures, I have also taken on the role as FSCS coordinator, tasked with developing the model and identifying and engaging with stakeholders. Finally, I am a researcher completing a PhD thesis, investigating my own learning as a FSCS coordinator.

As a researcher, I align with an idealist (ontological) position, recognising that my experiences of the world are subjective and informed by personal, social, and cultural perceptions (Giacomini, 2010). Furthermore, I take an interpretive (epistemological) orientation, viewing reality and knowledge as socially constructed (Tracy, 2013). Socially constructed knowledge or a constructivist approach views individuals and groups as constructing meaning through their interactions as people build their own understanding and new knowledge in their social environment (Robottom, 2004).

Data generation

Data were generated by documenting who I was learning from, and what I was learning, as I went about the process of developing the FSCS approach within the school. I maintained an activity log and recorded detailed notes of my engagement with potential FSCS stakeholders. This included recording who the stakeholders were and the mode of communication (i.e. email; informal or formal meetings that were either phone calls, in-person, or online; formal school events; or face-to-face discussions). Over a 12-month period, I logged engagement with 16 professionals, consisting of: four health practitioners including general practitioners; a social worker; a community health professional; five university academics in health and education fields; and seven educational professionals.

Following my interaction with these stakeholders, I made reflective journal entries about: 1) what I perceived to be each stakeholders’ interests, expectations and/or needs; 2) what new information I had learned about a FSCS and any new stakeholder I was led towards; 3) any shifts in my thinking about FSCSs and its potential application for the school. This process of reflective journaling is common within autoethnographies, and it allowed for the generation of rich data of my own experiences, perspectives, and opinions of stakeholders that could then be used to examine the intersections between myself and social life (Adams et al., 2022). Weekly critical discussions occurred with my doctoral research advisory team (JL, LS and PL) and assisted me to reflect on my thinking and incorporate theory to make sense of my experiences and direct me towards relevant literature.

Ethical approval for the study was received from The University of Queensland (Reference: 2022/HE001972) and was ratified by the State of Queensland Department of Education through the local school principal. All stakeholders provided written informed consent for their involvement in the study and to have the study’s findings published.

Social learning theory

As my research focused on learning and involved engaging with stakeholders, it was helpful to select a theory that had the notion of building new knowledge through social discourse as a central tenet. Wenger and Wenger-Trayner’s (2020) social learning theory was therefore chosen. This theory sees knowledge as relative and socially constructed – a position that aligns closely with this project’s aims given I am reflecting on my personal experiences and constructing my own knowledge and understanding of designing a FSCS with stakeholders. Social learning theory can be applied as a planning tool to initiate projects, used to drive conversation, and evaluate the quality of the learning occurring with stakeholders (Wenger and Wenger-Trayner, 2020) and has been applied to learning in health care and business organisations as a means to improve performance and address societal challenges within these fields (Bond and Blevins, 2019; Li et al., 2009). Social learning theory sees learning occurring through conversation, where there is mutual engagement of uncertainty between stakeholders, where both parties gain new perspectives and are able to generate new knowledge (Wenger and Wenger-Trayner, 2020). In choosing social learning theory as a framework to guide this study, I gained support in understanding how stakeholders come together to learn new concepts, develop new knowledge and solve real-world problems – all attributes required for a FSCS to be established. Social learning theory was also utilised to understand how multiple stakeholders from diverse backgrounds learn and develop new knowledge to address the known and the unknown challenges of designing and developing a FSCS.

Social learning spaces

Within social learning theory, Wenger and Wenger-Trayner (2020) utilise the term, ‘social learning space’ to refer to the specific process of people engaging in social learning to design or create something new. Wenger and Wenger-Trayner (n.d) define social learning spaces as an event, ‘involving mutual engagement in learning, where a group of people work with each other as learning partners to discover how to create something important to the group’. Further to this, social learning theory can also be used to understand the quality of learning and determine if knowledge is leading to meaningful change and meaningful outcomes for those involved in the social learning space (Wenger and Wenger-Trayner, 2020). To this end, Wenger and Wenger-Trayner (2020) developed a framework to both understand and design effective social learning within social learning spaces – which they called the value-creation framework.

Value-creation framework

The value-creation framework place the focus of learning on the experience of social participation and examines the extent to which stakeholders find value in this process. This value is the extent that stakeholders view their involvement in a social learning space as leading to change and impacting on what they are seeking to achieve (Wenger and Wenger-Trayner, 2020). Through value-creation cycles, the effectiveness of learning can be judged based on how much it enables value to stakeholders (Wenger and Wenger-Trayner, 2020). This value can take different forms including immediate, potential, applied, realised, enabling, strategic, orienting, and transformative (see Table 1). Using the definition of social learning spaces, stakeholders involved in this study can be viewed as engaging in a social learning space with myself and the school. Here, the value creation framework supports an understanding of the learning taking place between the school and stakeholders, and the extent to which this learning is informing the school developing a local FSCS model.

Table 1.

Types of value within the value creation framework (adapted from Wenger and Wenger-Trayner, 2020).

Type of value	Description
Immediate Value	The value participants gain during the social learning process engaging with each other in learning.
Potential value	Learning within a social learning space that has the ‘potential’ to lead to meaningful change. Through sharing of practice participants may gain insights from one another that might later lead to provide utility in practice.
Applied value	Learning that begins to be translated into some form of action (i.e., participants proposing a new collaboration or committing to trying a new idea).
Realised value	Learning that leads to tangible change and demonstrates participants engaged in a social learning space are making a difference and achieving outcomes.
Enabling value	Learning how to enable learning both within and outside the social learning space. Enabling value includes those processes, infrastructure, and leadership that contribute and enables learning, and raises the effectiveness of the social learning.
Strategic value	Strategic value recognises the importance external stakeholders whom have a broader ‘strategic’ influence have and the need for participants to involve them in the social learning space in order to make a difference at wider organisational and societal level.
Orienting value	Orientating value recognises that social learning occurs in the context of broader historical, cultural, and political contexts of other people, practices, and institutions. By taking account of these contexts, the personal networks of participants can be leveraged to access resources, information, and contacts beyond their isolated context to have broader impact.
Transformative value	Transformative value recognises that broader institutional and/or cultural changes may or may not result from learning within a social learning space. This may include participants shift in mindset, developing their own innovation, or changes at policy level.

Data analysis

As ‘no one method or process can be prescribed for autoethnographic data analysis and interpretation’ (Chang, 2021: 58), I chose a method based on how it ‘‘fitted’ the project’s purpose’ (Braun and Clarke, 2021: 38). Data were analysed using Braun and Clarke’s (2022) six phases of reflective thematic analysis as this approach values the subjectivity of the researcher. It involves the researcher being critical of their own role, research practice, and processes, and sees the researcher taking an active role in the thematic analysis process of coding and theme generation (Braun and Clarke, 2022). Reflective thematic analysis allowed me to have an open exploratory process to my engagement with the data, research themes, and findings (Braun and Clarke, 2022).

The six phases of reflective thematic analysis commenced with familiarisation as I reviewed all of the data about my experiences as coordinator collaborating with stakeholders. In the subsequent review of the data, I first applied semantic code labels to explore surface level meanings, and in an additional review of the data I applied latent code labels to identify underlying meanings within the data. My analysis was initially inductive (grounded in the data) but became deductive (applying the abovementioned theory) to deepen my analytical interpretation. Through this process, 260 code labels were developed. These codes were initially clustered into eight potential broad patterns and given theme names. Each of the categories was tested against the code labels and data extracts to ensure it offered an accurate representation of the data. This condensing resulted in the generation of four key themes: principles of FSCSs are known and valued; integration in FSCSs is challenging but critical; coordinators are needed to develop FSCSs; developing a FSCS is a journey.

Findings and discussion

Principles of FSCSs are known and valued

While the term FSCS itself was not widely known among the health and educational professionals I engaged with, the principles that underpin the model were known about and valued.

The term FSCS and its synonyms (e.g. full-service schools, community schools) were unknown to the majority of stakeholders. This was exemplified in the following entry where I describe how my interactions with health and educational professionals followed a familiar pattern:

Each time I met with someone I would eagerly share the school’s vision to develop a FSCS model with integrated health services on the school site. This would typically be met with the same question, to explain what a FSCS was. My response would be to share a version of the FSCS definition and through this unpacking people would resonate with an aspect. (Journal entry #5).

This lack of awareness of the terminology aligns with the larger literature describing the many different approaches schools in Australia take to partner with community to support student health and well-being (Cleveland et al., 2023; McShane et al., 2012), a variation in terminology that is also evident internationally (Richardson, 2009). Despite a lack of understanding of the term FSCS, its principles were known and valued.

The stakeholders I engaged with were enthusiastic about the potential of a school approach that provided holistic and integrated health and well-being services to students through strong school-community partnerships. These are the principles of a FSCS (Min et al., 2017). This enthusiasm was observed in my reflections following the initial meeting between the school and the university to discuss the possibility of an on-site school health clinic as part of the larger FSCS model:

The vision for the school to host a range of allied health services through the provision of university student placements was received with great enthusiasm by both the school and university representatives. This was evident by the many ideas that were shared about potential next steps and the general agreeance that these services would provide holistic support for students as well as preventative health and wellbeing programmes for staff and families. There was a sense of excitement about the initiative from all present and further to this, I would learn that there was strong partnership intent from the university to support and develop these services within the school even prior to the meeting taking place. (Journal entry #1).

When viewing this quote through the lens of social learning theory and value creation, it is evident that ‘immediate value’ (Wenger and Wenger-Trayner, 2020) was created for myself as well as the school and university stakeholders when we engaged in collaboration with one another, connected around a shared interest in supporting the health of young people, and welcomed each other as contributors to the model’s development. These meetings held ‘potential value’ (Wenger and Wenger-Trayner, 2020) for everyone involved as, through the sharing of practice, we gained insights from one another that held the potential to lead to meaningful steps in the establishment of services at the school. While this potential value (Wenger and Wenger-Trayner, 2020) existed, I learned that understanding the way health and educational professionals worked might then support the translating of this learning into action as an ‘applied value’.

Integration in FSCSs is challenging but critical

The second theme focused on learning firsthand about the challenge and criticality of integration. Although I had discovered, after reviewing the literature as part of my research role, that schools have a long history of being challenged in their relations with health services (Kubiszyn, 1999; Weist et al., 2003), the extent to which this challenge continued to exist proved surprising to me.

After sharing what I was learning about integrating health services within the school to develop the FSCS model, [the health practitioner] noted that integrating health services in the same building can be problematic, as there is no way to securely share information with each other and with a school team. Furthermore, they noted that interprofessional practice in health is hard [to achieve]. (Journal entry #3).

This was disconcerting, given that the two disciplines of health and education must come together in a FSCS, in order to produce improved health and educational outcomes for students (Lewallen et al., 2015).

Fortunately, discussion about these obstacles also included advice on how to potentially overcome them. For instance, this previous journal entry ended with my noting the health practitioner’s suggestion ‘that it would be critical for all services to be on the school site the same day to enable collaboration and sharing of information’ (Journal entry #3). This notion of considering the scheduling and proximity of services as a way to overcome integration issues was also present in other stakeholder interactions. When reflecting on a phone conversation I had with another educational professional who was leading a school with an existing integrated health and educational support, I wrote the following:

I was interested to learn that they hold a weekly ‘integrated services’ meeting involving all the support services at the school. Here they would share challenges, engage in peer review practice and approaches. What was most insightful for me to hear was that they all work in the same room on the same day, and each of the disciplines have their own ‘scope document’ outlining how they operate in the school. (Journal entry #6).

This advice aligns with research that has found that the co-location of services is key to enabling support services to integrate effectively with one another (Kaehne and Catherall, 2012) and that co-location in schools removes some of the barriers young people can face when trying to access support (Ferenchak et al., 2021). Importantly, the proximity of health services within a school supports the effective use of resources and encourages health and education services to work collaboratively to achieve their common goal of improving outcomes for young people (Chiang et al., 2015).

In addition to this scheduling and proximity advice, I obtained two other key insights from stakeholders:

[Community health professional] noted that when recruiting the right professionals to work in a collaborative multidisciplinary team there must be consideration to having the right personality, as the wrong person can create cultural problems. The team of professionals should form around a young person, whichever health professional the young person sees first should start them connected with the network of other professionals. (Journal entry #9).

[University academic] made the comment that confidentiality needs to be measured to serve the best interests of the student, and this more often than not means sharing information with colleagues when it is indicated. [University academic] would go on to say that they advocate for a whole-school approach where health services are seen as part of the whole school team, where they share and receive information in exactly the same way that other members of the school team do, and health services are not seen as a private and confidential space, but rather as part of a network. (Journal entry #6).

The two key insights stated above represent ‘potential value’ within the value creation cycle (Wenger and Wenger-Trayner, 2020) as they provide insights into overcoming the challenges to the integration between education and health teams required by the FSCS model. More specifically, I was learning that while effective interprofessional practice is key to addressing the challenge of integrating health services (Lalani and Marshall, 2022; Lawn et al., 2014) within the school as part of the FSCS model, I would need to pay attention to the ‘right’ professionals to do this work and how best to frame how these professionals are part of the school system.

Coordinators are needed to develop FSCSs

Given this complexity in relation to integration, the importance of FSCSs having a dedicated coordinator to champion, manage, and develop the multiple partnerships involved in the model became clear. Since becoming the coordinator, I have learned that the role has significant responsibilities that can be difficult to balance with other role requirements:

As I reflect on the time that I have spent thus far seeking out and collaborating with professionals as potential stakeholders to develop the model, I can see that my role (as guidance officer) in the school is prohibitive. I am unable to dedicate the time needed to both manage my role as school guidance officer at the same time as I develop collaborative partnerships with stakeholders. While these connections are slowly developing, it is difficult to develop opportunities to collaborate with potential stakeholders while maintaining the requirements of my current role in the school. (Journal entry #11).

I shared the challenge of maintaining these dual roles in phone calls with two separate stakeholders who were also working in an integrated school and health model. In my reflections following these phone calls, I noted:

What I found interesting was that they referred to the work as all being part of an action research model, never static, with short-term funding coming and going, people moving all the time, different pilot programmes, and that they were managing this and the people who bring additional challenges due to their dynamics and relationships. This sounded overwhelming and the only solution that was given was that the single reason their model has been continued is that it is being carried by a person, who has championed it, and kept it boiling. (Journal entry #10).

I was astounded that the school had established over 47 partnerships with local community organisations and two universities. After speaking with [name] I learned that the school host an extensive range of services that include counselling, community workers, behaviour science interns, marketing students, sustainability students, audiology, and a sports science clinic. I was completely overwhelmed hearing this and could not comprehend how this all would be managed. (Journal entry #8).

These comments align with the literature which argues FSCSs require a coordinator as an additional full-time role within the school if they are to effectively manage multiple partnerships through collaborating with community, as well as champion the model, and respond to funding and resourcing sustainability challenges (Galindo and Sanders, 2019; Medina et al., 2019; Valli et al., 2013). Harnessing the collective contribution by utilising a range of health services represents a significant shift in how schools meet the health and well-being needs of their students. Yet, for this to be achieved these services require coordination to ensure their effective integration into schools. This integration is best facilitated through a coordinator role and as such requires appropriate funding. The value creation framework recognises funding for the role of the coordinator as an external factor contributing to ‘enabling value’ as resources from outside the social learning space enhance the effectiveness of the social learning (Wenger and Wenger-Trayner, 2020). The FSCS coordinator is therefore central to best facilitating learning between stakeholders and supporting the integration of services with one another and within the school.

Developing a FSCS is a journey

Developed in conjunction with the learning identified in the above themes was my understanding of a FSCS. At the start, I thought a FSCS would be a shared initiative with a definitive endpoint when implemented. I have since recognised that establishing a FSCS is a significant undertaking, and an ongoing process requiring the establishment of multiple partnerships, each of which require significant investment of time to develop:

Today, the school and the university met to discuss the potential for allied health students completing placement at the school. A representative from the university who would be potentially coordinating these students made the comment, ‘this would need to be a growing role as it is much bigger than I initially thought’. Both the school and the university were now beginning to realise the enormity of the project and what the FSCS model entails and that it would be a much larger initiative than was first thought. (Journal entry #2).

My experience of engaging with stakeholders as a coordinator aligns with literature that details the challenges associated with delivering and sustaining holistic and integrated support in schools for young people, acknowledging the extensive time commitment needed for school leaders to balance the coordination of multiple partnerships and services with general school priorities (Holme et al., 2022).

In addition to realising the approach to developing a FSCS in the school was bigger than anticipated, the way in which it has been enacted is also different to my initial expectations:

I was under the impression that collaborating with professionals as stakeholders would lead us to collectively develop a Full-Service Community School. Instead, we are finding that our school team is identifying potential allied health services, and the services that respond first are the ones we start and trial. It then is up to myself as coordinator to determine how to best integrate these services into the school. (Journal entry #13).

This shift from thinking the work of developing a FSCS would be a shared endeavour to realising it is almost solely my responsibility added to the abovementioned challenge of coordination and further reinforced the importance of the need for a coordinator.

Overall, the process of engaging with stakeholders has changed my understanding of how a FSCS might be developed. Reflecting after a regular meeting with my research advisory team, I captured my thinking at the time as follows:

‘For us (the school), the FSCS may not be a destination we will reach or achieve, but rather it will be a journey we continue to strive toward’ (Journal entry #12).

While this thought is perhaps daunting, in that there is likely to be no clear endpoint to the work of establishing a FSCS, it is also perhaps liberating in that there is scope for a FSCS to continually evolve as needed.

Conclusion and future directions

This paper has sought to document my experiences as the coordinator of a FSCS, focusing on the learning processes as I engaged with stakeholders to design and implement the approach the school I work in has chosen.

While I have learned that there is considerable enthusiasm from health and educational professionals about the potential for the FSCS model to support improved integration of health and educational supports for young people, I have also learned about the barriers to achieving integration between these stakeholders in schools. My autoethnographic work has also allowed me to reflect on the importance of my role as a coordinator and the journey involved in developing a FSCS. Focusing on and sharing my personal experiences will hopefully provide insight into the process for others hoping to undertake similar work in their schools in the future.

While it has been generative to focus on my interactions with health and educational professionals in this paper, they are not the only stakeholders that I have learned from in the process of developing a FSCS. I now seek to extend this learning approach as we engage with other stakeholder groups, teachers, school leaders, parents, and students. At the next stage of work, students will be prioritised as they are not only the end-users of the services and supports being developed, but are historically underrepresented in research into the implementation of FSCSs. The inclusion of their voices and experiences should be made central to drive the ongoing and future direction of the model.

Footnotes

Authors’ note

No AI was used in the development of and/or finessing of this paper.

Data availability

Anonymised versions of datasets generated during and/or analysed in the current study may be made available from the corresponding author upon reasonable request.

Declaration of conflicting interests

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The first author is an employee of the State of Queensland Department of Education. They undertook this study as an independent researcher and part of a PhD programme. The article represents the views of the authors alone and not the views of the Queensland Government Department of Education.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Nathaniel Tickle

Jessica Lee

Leigh Sperka

Peter A Lewis

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A coordinator’s learning journey in implementing a Full-Service Community School in Australia

Abstract

Background:

Objectives:

Methods:

Results:

Conclusion:

Keywords

Introduction

Methodology

Setting and positionality

Data generation

Social learning theory

Social learning spaces

Value-creation framework

Data analysis

Findings and discussion

Principles of FSCSs are known and valued

Integration in FSCSs is challenging but critical

Coordinators are needed to develop FSCSs

Developing a FSCS is a journey

Conclusion and future directions

Footnotes

Authors’ note

Data availability

Declaration of conflicting interests

Funding

ORCID iDs

References