School health care teams’ experiences implementing the Strengthening Adolescent Wellbeing Programme in Sweden

Objective: The Strengthening Adolescent Wellbeing (SAW) programme is a universal school-based health education programme led by school health care (SHC) teams aiming to promote wellbeing and mental health in pupils aged 11–14 years. The objective of this study was to describe SHC teams’ experiences in implementing the SAW programme for the first time, focusing its potential for relationship-building between pupils and SHC team members and in health promotion and prevention. Design: Qualitative, descriptive study. Setting: Middle schools in central Sweden. Method: Three mini-focus group interviews were conducted with three SHC teams comprising social workers (n = 6), school nurses (n = 3), and special education teachers (n = 2). Data were analysed using qualitative manifest content analysis. Results: Four categories were identified: (1) opportunities to share experiences and get to know each other; (2) opportunities to demonstrate reliability and give and receive support; (3) the creation of an enjoyable, non-judgemental context in which pupils want to remain; and (4) the provision of a forum for cross-professional work reaching all pupils. Based on this, an overarching theme was developed: the SAW programme provided a likeable non-judgemental forum for pupils where trust thrives, sheltering relationships deepen, and proactive health-promoting work can take place. Conclusion: The study provides a deepened understanding of how and why the manual-driven SAW programme delivered by trained and skilled facilitators in a supportive and non-judgmental context may facilitate relationship-building and health promotion and prevention. Implementing the intervention, with fidelity to the method, in other schools, grades 5 and 6, is likely to have similar outcomes.