Reconciling concept and context: The dilemma of implementation in school-based health promotion

The researchers used grounded theory methodology to study the implementatio n of a school-based alcohol and drug prevention project in secondary school s in British Columbia, Canada. Prevention workers (PWs) were responsible fo r working with school and community personnel in a collaborative process to develop, implement, and evaluate prevention strategies in the school using an adaptation of the Precede-Proceed Model for health promotion planning. Before they could begin to do this, PWs had to establish their credibility in the school. Once accepted, the focus of the PWs' work was to reconcile t he goals, values, and philosophy of the project with those of the school. I n doing so, PWs encountered many practical dilemmas. The challenges in reso lving these dilemmas are presented, and the implications for policy and pra ctice are discussed.