Abstract
Background:
School-based health promotion interventions in resource-constrained settings must align with curriculum requirements and the local context to be sustainable and effective. In South Africa, there is a need to integrate support for nutrition, psychosocial well-being, and environmental sustainability within everyday teaching and learning.
Aim:
This study explored the expectations of school communities regarding Wellness in Lifestyle, Intake, Fitness, and Environment (Win-LIFE), a school-based health promotion intervention designed for use in resource-constrained South African contexts.
Methods:
A qualitative, multiple-case design was employed using Participatory Reflection and Action (PRA) methodology to co-develop and adapt the intervention with teachers, parents, learners, and institutional stakeholders. Data were generated through document reviews, semi-structured interviews, focus groups, workshops, and observations conducted in three primary schools. Reflexive thematic analysis was used to identify patterns in stakeholder expectations.
Results:
Five key expectations were evident across stakeholders: namely, that the intervention should be educational and practical; that it should be aligned with the South African Curriculum and Assessment Policy Statement for Grades 4–6; that it should be grounded in cooperative learning; that it should be engaging and enjoyable for learners; and that it should be inclusive of parental involvement.
Conclusion:
The findings from this study highlight the importance of contextual alignment, meaningful stakeholder participation, and curriculum integration in the design of sustainable school-based health promotion interventions. The study demonstrates how schools can function as inclusive hubs for promoting health and well-being in marginalised communities.
Keywords
Introduction
South Africa’s socio-economic landscape is characterised by structural inequalities, with poverty and food insecurity continuing to undermine health and learning outcomes for children (Vorster, 2010). In resource-constrained communities, limited access to nutritious food and essential services reduces learners’ capacity to thrive academically and physically (Goetjes et al., 2021; Naicker et al., 2015). This dual burden highlights the urgency of interventions targeting the interconnected challenges of education, health, and well-being (Department of Health, 2014; Perez et al., 2013).
Schools have increasingly been recognised as key platforms for improving collective health and catalysing social change (Jourdan et al., 2021). As institutions that reach both children and families, they hold significant potential to integrate health promotion into learning processes and support community development (Department of Basic Education, 2014; World Health Organization [WHO], 1997). Against this backdrop, the Wellness in Lifestyle, Intake, Fitness, and Environment (Win-LIFE) intervention was designed to address food and nutrition insecurity, psychosocial vulnerability, and environmental challenges in South Africa (Faber et al., 2011). By engaging with the national Curriculum and Assessment Policy Statement (CAPS) for Grades 4–6, Win-LIFE aimed to position schools as hubs of learning, care, and support (Department of Basic Education, 2012).
Aligned with key Sustainable Development Goals, Win-LIFE sought to address SDG 2 (Zero Hunger) through nutrition-focused activities; SDG 3 (Good Health and Well-Being) through psychosocial support and lifestyle education; and SDG 4 (Quality Education) through curriculum integration. Practical gardening and environmental learning included in the intervention engaged with SDG 12 (Responsible Consumption and Production), while its coalition-based design responded to SDG 17 (Partnerships for the Goals). Development was informed by a systematic analysis of national policy documents—including the National School Nutrition Programme (NSNP), the Care and Support for Teaching and Learning Programme, Action Plan to 2014, the CAPS, the Integrated School Health Policy (ISHP), and the Fetsa Tlala Integrated Food Production Initiative—together with international frameworks such as the WHO Health Promoting Schools initiative, the Millennium Development Goals, and the SDGs. Baseline insights from two masters level studies in educational psychology ensured contextual relevance and responsiveness to school and community needs (Department of Basic Education, 2014).
The urgency of this work was underscored by findings from the South African National Health and Nutrition Examination Survey (SANHANES-1), which found that almost 55% of South Africans face hunger or are at risk of it (Shisana et al., 2014), with Black communities being disproportionately affected (Statistics South Africa, 2016). Win-LIFE therefore sought not only to build age-appropriate nutrition knowledge, skills, and attitudes (Nguyen et al., 2015; Hill et al., 2015), but also to strengthen collective action and social responsibility. By involving parents, teachers, and local partners, the intervention aimed to extend the programme’s influence beyond classrooms so as to promote more sustainable community practices (Pallan et al., 2012).
Despite growing recognition of the value of school-based health promotion, there is limited research examining how such initiatives have been developed and implemented in sub-Saharan African contexts (Mukamana and Johri, 2016). Moreover, much of the existing literature focuses on outcomes, offering little insight into the processes, contextual factors, and relational dynamics that determine programme success (Durlak and DuPre, 2008; Warwick et al., 2009). This study addresses this gap by documenting the development and early implementation of Win-LIFE in a resource-constrained community near Bronkhorstspruit, South Africa.
The research took place in a series of phases, in line with the logic of Participatory Reflection and Action (PRA) research. Initial document analysis and co-analysis of the masters’ level datasets surfaced contextually relevant priorities and the needs of the community, after which PRA workshops with teachers and parents shaped locally relevant curriculum content. Focus groups and engagements with university researchers refined emerging components, and semi-structured interviews with national Department of Basic Education (DBE) representatives identified policy and institutional feasibility considerations. Observation, field notes, and reflective journalling during piloting of the Win-Life intervention captured implementation dynamics and stakeholder responses. Accordingly, while parents and teachers shaped content in the early stages, institutional actors contributed feasibility insights mid-development, and observational data illuminated how programme priorities translated in practice.
Importantly, the baseline phase was not approached as a neutral diagnostic exercise, but as the first step in a process of change: community expectations actively functioned as design drivers that informed curriculum choices, activity sequencing, parental engagement strategies, and contextual adaptations adopted in later phases. By foregrounding teachers’, parents’, and learners’ voices, the study demonstrates how learner data generated through PRA-informed activities in the form of participatory classroom tasks, visual artefacts, and researcher observations of learner engagement and sense-making were used to guide what should be taught, how it should be delivered, and who should be involved, showing that baseline inquiry was integral to initiating change rather than separate from it.
This paper illustrates how school-based interventions can act as catalysts to address entrenched educational and health disparities (Aggleton et al., 2010). By embedding health promotion in curriculum processes and strengthening school–community partnerships, the Win-LIFE intervention demonstrated the transformative potential of interdisciplinary collaboration in fostering resilience and empowerment among vulnerable populations (De Lange et al., 2007).
Literature review
South Africa faces persistent food insecurity, particularly in resource-constrained communities characterised by poverty, unemployment, and limited access to nutritious food and basic services (Govender et al., 2016). Children are disproportionately affected by stunting and malnutrition, and reliance on school feeding schemes remains common in rural and peri-urban settings, with life in schools frequently mirroring broader community challenges (Larson and Story, 2009; May et al., 2020). Adults in these environments often experience the parallel burden of diet-related disease, with overnutrition being linked to energy-dense, nutrient-poor diets (Otang-Mbeng et al., 2017). These patterns illustrate how affordability, cultural eating habits, and limited food accessibility reinforce cycles of poor health and diminished learning outcomes. Vendors selling inexpensive, unhealthy foods near schools further exacerbate these problems (Napier and Oldewage-Theron, 2015).
Food insecurity in South Africa is shaped by structural, rather than individual, determinants. Poverty remains a key driver, rooted in socio-political history and reflected in ongoing unemployment and insufficient household income (Govender et al., 2016; Lephakga, 2017). Such vulnerabilities compromise children’s development, academic engagement, and long-term socio-economic prospects (UNESCO, 2016). Addressing these challenges requires programmes and interventions that recognise the broader ecological determinants of health rather than focusing solely on individual behaviours.
Accordingly, ecological and systems-based approaches have become increasingly prominent. The socio-ecological model (Stokols et al., 1996) provides a useful conceptual lens to show how health practices are shaped by interdependent economic, household, community, school, and policy influences. Within this model, schools emerge as strategic leverage points where determinants of health intersect. This aligns with school-based activities such as vegetable gardening and community-driven nutrition education, which seek to integrate food production, dietary knowledge, and household engagement (Faber et al., 2011).
National policies also reinforce the value of schools as sites for health promotion. The ISHP (Departments of Health and Basic Education, 2012), the Care and Support for Teaching and Learning (CSTL) framework (Department of Basic Education and MIET Africa, 2010), and the NSNP (Department of Basic Education, 2011) frame schools as platforms for psychosocial support, nutrition education, and intersectoral collaboration. UNICEF (2016) advocates for school-based interventions that establish lifelong habits, while WHO (1997) recognises the influence of education on well-being. International research similarly demonstrates that school-based initiatives can influence households and communities beyond the classroom (Turunen et al., 2017).
However, evidence also suggests that top-down programme models often fail when they neglect community knowledge and local feasibility constraints. This draws attention to the value of participatory approaches to health education as a complementary approach. Participatory Reflection and Action (PRA) as a way of working that emphasises community ownership, collaborative problem-solving, and feedback-driven adaptation (Ebersöhn and Ferreira, 2012). The use of this kind of approach is consistent with constructivist assumptions about learning which suggest that change is best achieved when stakeholders contribute to intervention design and implementation. Such approaches are particularly relevant in low-resource settings, where sustainability depends on programmes, actions and interventions being contextually attuned and recognised as legitimate by the community.
Together, the socio-ecological model and participatory action principles provided the conceptual foundation for examining school communities’ expectations in this study. These frameworks explain not only why school-based health promotion is necessary, but also why community voice matters for feasibility, ownership, and behavioural uptake. By integrating curriculum-linked delivery with collaborative design, school-health programmes interventions can function as locally embedded systems of care with influence extending from classrooms into homes (Wenhold et al., 2016).
Background to the Win-LIFE intervention
The Win-LIFE (Wellness in Lifestyle, Intake, Fitness, and Environment) intervention sought to address food and nutrition challenges in low-resource South African communities by integrating curriculum-aligned learning with school–community collaboration. Its aim was to strengthen learners’ knowledge, skills and attitudes related to healthy eating, food production, and consumption, while supporting well-being through partnerships with parents and local stakeholders. In this study, the term “school communities” refers not only to the school as an institution but to interconnected actors including learners, teachers, principals, parents, caregivers, and local partners whose decisions and practices influence both learning and health. Teachers’ positioning within everyday school life affords them intimate knowledge of barriers and opportunities, making them essential role-players in shaping feasible, acceptable, and valued interventions.
Win-LIFE is part of a larger, multi-year school health promotion initiative that sought to build interdisciplinary, curriculum-linked, and community-driven responses to nutrition insecurity. Developed alongside the introduction of CAPS 1 (2011–2014), the intervention aimed to enrich Intermediate Phase Life Skills, Natural Sciences, and Technology through context-responsive health promotion (Departments of Health and Basic Education, 2012). The Win-LIFE programme further aligned with the Integrated School Health Policy (ISHP) (Department of Health & Department of Basic Education, 2012, p. 2) which positions schools as hubs of preventive services and psychosocial support, by fostering intersectoral collaboration and enabling schools to function as centres of care and learning. This alignment with CAPS and the ISHP ensured curricular legitimacy and policy coherence, while engagement with school communities strengthened continuity and potential for sustained change.
To integrate developmental and implementation logic, the intervention programme unfolded in five interlinked phases: (1) baseline information gathering to understand community needs, expectations, and contextual constraints; (2) intervention development and revision incorporating multi-stakeholder feedback and expert input; (3) teacher education and training and implementation across three schools for Grades 4 to 6; (4) monitoring and evaluation to assess outcomes and refine components; and (5) reporting and expansion to explore scalability within similar settings.
This article reports on Phase 1 (baseline work), which sought to generate formative insights to shape programme design, delivery mechanisms, and feasibility. For example, teachers suggested activity formats, parents requested take-home materials, and school principals negotiated implementation timelines, illustrating how expectations can become functional design criteria rather than abstract preferences.
Although initial data generation began in 2012, the analysis was conducted subsequently and used formatively to inform the development, piloting, and refinement of later components of the Win-LIFE initiative. The core issues highlighted by participants—nutrition insecurity, psychosocial vulnerability, and the need for school-based support—remain pressing in South Africa and were further amplified during the COVID-19 pandemic. As CAPS and the ISHP remain in effect, the curriculum-linked and partnership-oriented insights generated during the baseline phase continue to hold both conceptual and practical relevance. Accordingly, although the data reflect an earlier developmental stage of the broader Win-LIFE project, the findings provide enduring, policy-relevant insights for the design and implementation of future school-based health promotion interventions and programmes in resource-constrained contexts.
Participatory Reflection and Action (PRA) guided the baseline work, fostering community involvement and interdisciplinary collaboration. This ensured the intervention addressed context-specific challenges while fostering ownership and engagement among stakeholders. Ongoing reflection, planning, and adaptation were integral to the process, allowing the broader Win-LIFE project to remain responsive to emerging needs over time. Critically, school community voice was not symbolic—teachers redesigned workbooks for linguistic accessibility, parents suggested household-level gardening tasks, and school principals coordinated implementation logistics. Such actions illustrate how community voice can enhance usability and strengthen adoption, as a prerequisite for intervention sustainability.
Methods
Design
A multiple case study design was chosen to illuminate how school context shapes priorities, participation, and programme design (Yin, 2012). Three primary schools near Bronkhorstspruit in Gauteng were treated as bounded cases, enabling the identification of common issues—such as nutrition insecurity, psychosocial support needs, and curriculum-linked learning demands—while also attending to contextual variation.
Differences between schools became evident in resourcing levels, school leadership responsiveness, and existing support structures, shaping variation in how different programmes elements came to be emphasised in different schools. These convergent and divergent patterns were explored through cross-case comparison as part of reflexive thematic analysis. The inclusion of school-level and institutional stakeholders enabled the study to capture shared priorities while also surfacing feasibility constraints relevant to the design and implementation of Win-LIFE across contexts.
Context and participants
Data collection occurred throughout the Win-LIFE programme’s development cycle. All participating schools were Quintile 1–3 public schools 2 serving peri-urban communities characterised by high unemployment, reliance on school feeding schemes, and limited service access, justifying their classification as low-resource environments.
Teacher participants varied in experience and roles, and parents represented households with differing levels of vulnerability. Learner participants were intermediate phase learners (Grades 4–6) who engaged with Win-LIFE curriculum-linked classroom activities; their participation took the form of visual and artefact-based PRA outputs, which informed design decisions but did not generate verbatim quotations, and their perspectives are therefore reflected through analytic interpretation rather than direct citation. School principals and deputy principals contributed school-level management perspectives on implementation practicality, while DBE representatives provided clarity on curriculum and policy feasibility, and Agricultural Research Council (ARC) representatives advised on agricultural and environmental components. Their contributions were not limited to validation; in several instances, they qualified or challenged assumptions raised by other participants—for example, school principals agreed with teachers that parental involvement was desirable but questioned its feasibility, and ARC specialists affirmed the importance of including gardening activities but stressed seasonal constraints and material needs.
International stakeholders comprised research collaborators linked to global school health promotion networks, who contributed conceptual guidance via consultancy agreements. Table 1 presents participant categories, sampling strategies, roles, and data generation contributions, along with a coding key clarifying abbreviations used in analysis.
Participant groups, sampling strategies, selection criteria, and contribution to study.
Data collection
Multiple methods were used to elicit data and triangulate insights. Document analysis included the review of key national and international policies—such as the Department of Health and Basic Education (2012), and the Sustainable Development Goals (United Nations, 2013)—to position Win-LIFE within educational and health promotion frameworks and identify best practices (Bowen, 2009). These documents also shaped intervention design, ensuring alignment with Curriculum and Assessment Policy Statement (CAPS) implementation priorities.
Data collection was conducted across three schools through PRA-guided workshops with teachers (n = 45) and parents (n = 23), enabling locally driven content development and the identification of school-specific concerns. For consistency and clarity, all PRA outputs (e.g. focus groups, field notes, artefacts) were coded using a standard notation capturing both data type and site (e.g. School A – FG, School B – FN). Purposive and criterion sampling ensured participants were directly engaged in school nutrition and learner support activities. Learner participation consisted mainly of visual and artefact-based PRA outputs (e.g. drawings, worksheets, and classroom posters), which informed intervention design rather than generating verbatim textual data. (Ebersöhn and Ferreira, 2012). Focus groups served as iterative reflection platforms (Kamberelis and Dimitriadis, 2011). Teacher participation was broadly similar across schools (School A = 15; School B = 14; School C = 16), with parent participation similarly spread across sites (School A = 8; School B = 7; School C = 8).
Semi-structured interviews with DBE and ARC representatives, school principals, and deputy principals generated perspectives on feasibility and implementation (Fontana and Frey, 2005). These interviews also illuminated areas of convergence and disagreement with school community expectations (e.g. DBE endorsement of CAPS alignment but concern about timelines; school principals’ support for experiential learning but concerns regarding teacher workload; ARC queries regarding crop selection and seasonality). Researcher observation captured non-verbal interaction, classroom dynamics, and school culture; field notes and a reflexive journal kept by the lead researcher provided contextual depth (McMillan and Schumacher, 2014), while visual methods, including photographs and artefacts, enriched interpretation (Walsh, 2007).
Cross-case comparison was conducted during analysis to identify convergent and divergent patterns across the three school sites. Themes were examined within each case and then compared across cases to surface shared expectations, context-specific constraints, and variations in feasibility and implementation conditions. This analytic step enabled the identification of patterns that were robust across settings, as well as differences linked to school context (e.g. leadership support, resourcing levels, and existing practices).
Sampling
Purposive sampling selected participants directly involved in Intermediate Phase learning and/or nutrition-related activities (Creswell, 2014). Criterion sampling required affiliation with participating schools and relevance to intervention design. Maximum variation sampling ensured heterogeneity—via the inclusion of teachers with different experience levels, parents with varied socio-economic contexts, and learners from multiple classes (Patton, 2002). Reputational sampling was used for selecting school principals, district officials, DBE representatives, and ARC specialists who were recognised as knowledgeable, influential, or strategically positioned in school health promotion. This approach ensured the sample included those who could articulate both endorsement and critique of emerging ideas, and these voices helped validate feasibility and implementation logic.
Data analysis
Data were analysed using reflexive thematic analysis (Braun and Clarke, 2013), in which themes are constructed through active interpretation by the research team. The analysis drew on multiple data sources, including PRA artefacts (posters and photographs), focus group transcripts, field notes, and reflexive journals. Reflexive memos were used to critically reflect on how researchers’ perspectives and assumptions influenced interpretation, and themes were refined through repeated movement between the data, relevant theory, and reflective discussion. Areas of agreement and disagreement between stakeholders were examined analytically, with convergence strengthening confidence in the themes and divergence highlighting contextual constraints and feasibility limits. Analytic rigour was strengthened through collaborative analysis with postgraduate researchers, team-based reflection, and member checking with teachers and parents to verify the credibility and contextual accuracy of interpretations (Creswell, 2014).
Trustworthiness and ethics
Trustworthiness was enhanced through prolonged engagement, participant validation, peer debriefing, and maintaining an audit trail comprising transcripts, visual artefacts, and field notes. Thick description enabled an assessment of the applicability of findings to comparable settings (Patton, 2002). Ethical approval for the study was granted by the University of Pretoria Faculty of Education’s Ethics Committee (UP12/09/02), as well as by Gauteng Department of Basic Education. Informed consent and assent were obtained from participants as relevant, and confidentiality assurances were provided. Participants approved the use of photographs as part of the PRA data collection where appropriate (Bless et al., 2013).
Results
The findings from this study are structured around five overarching themes developed during date analysis from teachers, parents, learners, and other stakeholders. These themes provide insights into the school community’s expectations and experiences regarding the development and implementation of the Win-LIFE health promotion intervention.
Educational and informative value
Participants consistently highlighted the importance of the Win-LIFE intervention being both educational and informative, with a strong focus on equipping learners and their families with actionable knowledge about health and nutrition. Teachers across the three participating schools expressed the expectation that learners should gain accurate information that they could share with their families and communities. As one teacher explained, Learners must actually learn the correct facts in order for them to tell their parents and other siblings about health and healthy food. (School A, FG, 7 April 2014)
Parents echoed this sentiment, emphasising their need for accessible resources and practical guidance on topics such as balanced diets and vegetable gardening. These contributions underscored a shared belief in the programme’s potential to extend its impact beyond the classroom and foster broader community engagement. One teacher from School B added, The programme must be educative and very informative to everyone. Not only to learners but also their parents. Both must learn from this programme and must actually be able to use what they have learnt. (FG, 7 April 2014)
Teachers envisioned the intervention as a resource to fill critical gaps in nutritional knowledge within resource-constrained communities. For instance, one participant from School C remarked, What I envision for this programme, is that everyone who is involved must acquire knowledge on how to eat a balanced meal and other facts about healthy food at their homes. (FG, 7 April 2014)
Informal discussions highlighted the broader community’s hunger for information. One teacher shared an anecdote about a parent who sought advice on healthy eating and vegetable gardening, demonstrating the value of providing simple, easy-to-understand materials that cater to diverse audiences. As the teacher explained, A school-based health promotion programme must be very simple to understand . . . the language must be simple and the content must be easy to understand by both learners and parents. (FN, 7 April 2014)
Teachers reported that learners could identify food groups, explain why vegetables are “good for your blood,” and recount planting steps at home, with some learners reportedly attempting simple planting activities with caregivers, suggesting early knowledge uptake and initial practical application of learning beyond the classroom. These examples align with evidence that experiential nutrition education supports not only recall but also the translation of knowledge into everyday practices in home contexts (Wenhold et al., 2016).
Integration with CAPS
Participants provided examples of alignment with CAPS in action: seed-germination lessons linked to Natural Sciences content on plant life cycles; balanced meal worksheets aligned to Life Skills topics on food groups; and school garden planning supported Technology themes on design and environmental care.
Teachers from Schools A and C consistently highlighted how linking the intervention to subjects such as Life Skills, Natural Sciences, and Technology would simplify its implementation. As one teacher from School A noted, It must integrate a lot of our Natural Sciences and Technology Grade 4 curriculum and content. That will make it so much easier for me as an educator to teach them. (FG, 7 April 2014, School A, TP 12)
Participants from School C felt that such an alignment would leverage their existing familiarity with CAPS, enhancing both teaching efficacy and learner outcomes. One teacher explained, The programme must integrate the Life Skills and Natural Sciences curriculum we are using currently in our classes . . . this will make it so much easier, because we are already knowledgeable about CAPS curriculum and the content . . . the intervention can be something extra that teaches the CAPS in another way, using colourful books and nice activities that the learners enjoy. (FN, 7 April 2014)
While CAPS alignment was planned, participants experienced difficulties aligning the intervention with curriculum sequencing and timing, highlighting the need for further refinement.
Group work and cooperative learning
Field notes captured instances of learners referring to “our garden” and “our beans,” suggesting emerging ownership through collaborative activities. Teachers believed that group-based activities would enhance learner engagement, foster peer-to-peer interaction, and facilitate deeper learning. As one participant from School B noted, I think learners might learn more when they participate in group activities. In class, there is not enough time to always do group work when we teach the learners new concepts. (PRA-W, 7 April 2014, School B, TP 2)
Participants also emphasised the potential of group work to create a positive and inclusive learning environment. Suggestions included including games and competitions as part of the activities, as these were seen as highly engaging for learners. A teacher from School C proposed, As part of the intervention, group-based games and competitions can be included as part of the activities, because learners always enjoy games. (PRA-W, 7 April 2014, School C, TP 3)
In addition, group work was viewed as a means to strengthen learners’ social interaction skills and foster a sense of belonging. A teacher from School B remarked, I think the social interaction during group activities will assist with this feeling of belonging. (PRA-W, 7 April 2014, School A, TP 5)
Engaging and enjoyable features
Participants highlighted the importance of making the Win-LIFE intervention engaging and enjoyable for learners. Teachers from School B stressed that learners were more likely to participate and retain information when they found the activities fun. As one teacher put it, “The kids must love it and must look forward to participating in the programme” (FN, 7 April 2014).
Practical, hands-on activities, such as seed-germination tasks, were highlighted as memorable ways to help learners grasp and retain concepts. As one teacher noted, “if learners plant seeds in cotton wool . . . they will really enjoy it” (FG, 7 April 2014, School B, TP 9). Visually appealing materials, including colourful workbooks, were also seen as important for sustaining interest. Participants believed that enjoyable features not only enhanced learning but encouraged children to “remember the steps better” and share what they learned with peers and family members, thereby extending the programme’s influence beyond the classroom.
Parental involvement
Parental involvement was seen as a crucial aspect of the Win-LIFE intervention. Teachers viewed parents as key in reinforcing the knowledge and practices taught to learners, creating a ripple effect within the broader community. A teacher participant from School A stated, Health promotion programmes must teach learners and their family members about healthy living and different food groups and the importance of having a vegetable garden . . . if all the parents can be involved and just learn one thing from a health promotion programme and implement it at their homes . . . imagine the effect we will see here at school and in this poor community. (FN, 7 April 2014)
Participants believed that involving parents would empower them to make healthier food choices for their families. A teacher from School B elaborated, If parents are included and involved they will have the necessary knowledge and information to tell their children that if they eat healthy, they will be able to think better, feel better, and look better. (FN, 7 April 2014)
Participants envisioned parent involvement as fostering stronger school-community connections and promoting self-reliance among families. A teacher from School C noted, This health promotion intervention may possibly bring parents, teachers, and learners together. It can teach parents to rely on themselves and would definitely affect our community in a positive way. (FN, 7 April 2014).
Despite practical challenges in involving parents, participants felt that parent participation would meaningfully strengthen the intervention’s impact. They believed that when parents were included in simple, practical activities (such as receiving take-home gardening guides, or attending short school-based demonstrations on planting vegetables), learning is more likely to be reinforced at home. Teachers noted that some parents began asking for gardening advice and seed packets, indicating early signs of engagement and ownership, which is consistent with evidence that parental reinforcement strengthens the impact of school-based health interventions (Du Plessis and Subramanien, 2014).
Discussion
The findings from this study identity five key themes that reflect the school community’s expectations for Win-LIFE. These themes point to the importance of a programme of intervention that is educational, curriculum-aligned, interactive, enjoyable, and inclusive of parental participation. Importantly, rather than assuming universal benefit, stakeholder narratives illustrate how specific design features might generate observable learning shifts. For example, teachers reported that learners “remembered the steps better” after planting seeds, demonstrating how experiential activities supported knowledge retention. Such localised examples align with wider school-health literature showing that contextually grounded pedagogy can foster deeper and potentially long-term improvements in health and nutrition in resource-constrained settings (Vorster, 2010; Wenhold et al., 2016).
The context within which the intervention was developed is marked by entrenched poverty, food insecurity, and developmental risk. Findings show that parents explicitly requested skills relating to balanced diets and vegetable gardening, underscoring the degree to which schools are positioned as sites of health knowledge acquisition. This resonates with literature identifying schools as systems of care capable of influencing families and communities beyond the classroom (Department of Basic Education, 2011). In this study, these expectations were not abstract: teachers shared examples of parents asking for gardening advice and requesting simplified materials they could reuse at home.
A key contribution of the study lay in how it demonstrated ownership emerging through participatory involvement rather than researcher intention alone. Evidence of this was visible in teachers’ voluntary uptake of activities (“I will do this planting lesson with my class”), parents’ requests for take-home content, and teacher adaptations of activity sequencing to fit their schedules. These behaviours show that stakeholders did not merely receive content, they actively shaped and claimed responsibility for its delivery. This reflexive uptake mirrors evidence in the collaborative intervention literature suggesting that participation builds commitment and contextual relevance (Butterfoss and Kegler, 2012).
Engaging methods, particularly cooperative learning and hands-on tasks—were consistently identified as likely to be effective. Teachers noted that seed-germination exercises in cotton wool made concepts “stick” and linked these concepts to Life Skills outcomes. This supports evidence that experiential learning enhances memory and learner agency and reflects observations in the wider Win-LIFE project that school gardens offered an applied learning platform for nutrition education.
Finally, sustainability was not discussed abstractly but observed in design processes driven by PRA. For instance, after teachers recommended simplifying language in the learner workbook so families could use it independently, a change that was subsequently incorporated into the materials. This illustrates how feedback loops can contribute to adaptation and responsiveness, echoing international guidance on sustainable school-based health programming (UNESCO, 2016). It also aligns with reflections from the wider Win-LIFE research effort, which argue that locally attuned adaptation is central to feasibility and uptake in low-resource school settings.
Limitations
This study has several limitations related to data reliability, internal validity, and the generalisability of findings. First, implementation fidelity varied across the three schools, with one site demonstrating limited teacher and learner engagement during early implementation. This uneven participation may have constrained the depth and consistency of insights across cases, although cross-site comparison and triangulation through multiple data sources and co-researcher dialogue helped to strengthen the credibility of interpretations. Second, as with all qualitative, participatory research, findings are shaped by researcher interpretation and positionality. Cultural differences between the researcher and participants may have influenced meaning-making, and the researcher’s presence may have shaped participant responses during PRA activities. These risks were mitigated through reflexive journalling, supervisory debriefing, and member checking with teachers and parents to support interpretive validity. Finally, given the context-specific nature of the study and the focus on a single intervention within three schools in one resource-constrained community, the findings are not statistically generalisable. Rather, transferability is supported through thick description of context, methods, and analytic decisions, enabling readers to assess potential relevance to comparable school-based health promotion settings.
Conclusion
This study of school communities’ expectations of a school-based health promotion intervention shows that these expectations were active forces shaping Win-LIFE’s design and implementation. Teachers, parents, and learners called for curriculum alignment, practical learning, and parent involvement, and these priorities translated into observable actions such as teacher-led seed-germination lessons, parental requests for take-home information, and adjustments to workbook content based on feedback. These findings highlight the value of participatory, context-responsive approaches that are perceived as relevant and which encourage ownership. Going forwards in this context and beyond, school-based health education and promotion efforts should strengthen co-design structures, support parent engagement, and build educator capacity in the use of experiential methods. A key contribution of this study lies in demonstrating that when community expectations are surfaced and incorporated into programme development, they can provide the foundation that enables an intervention or programme to take root, grow, and endure. They can also contribute to improved learning and well-being in poverty-affected and resource-constrained settings.
Footnotes
Acknowledgements
The authors thank the management and staff of the Faculty of Education at the University of Pretoria for institutional support, in particular the Dean of the Faculty, Chika Sehoole. The authors thank the participating schools, teachers, parents, learners, and institutional partners for their time, engagement, and contributions to the study.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this work was supported by the Institute for Food, Nutrition and Well-being (IFNuW) at the University of Pretoria and by Multotec. The funders had no role in the design of the study; the collection, analysis, or interpretation of data; the writing of the manuscript; or the decision to submit the article for publication.
AI statement
No generative AI tools were used to design the study, analyse the data, interpret the findings, or shape the scholarly arguments. ChatGPT was used for light language editing, minor formatting, improving sentence clarity, and checking the structure of reference entries.
Data availability
The datasets generated and/or analysed during this study are not publicly available due to ethical and consent constraints relating to participant confidentiality, but anonymised data may be made available by the corresponding author upon reasonable request, subject to institutional ethics approval.