title: Developing and implementing an accreditation system for health promoting schools in Northern India: a cross-sectional study.
abstract: BACKGROUND
  The "Health Promoting School" (HPS) is a holistic and comprehensive approach to integrating health promotion within the community. At the time of conducting this study, there was no organized accreditation system for HPS in India. We therefore developed an accreditation system for HPSs using support from key stakeholders and implemented this system in HPS in Chandigarh territory, India.
  
  
  METHODS
  A desk review was undertaken to review HPS accreditation processes used in other countries. An HPS accreditation manual was drafted after discussions with key stakeholders. Seventeen schools (eight government and nine private) were included in the study. A workshop was held with school principals and teachers and other key stakeholders, during which parameters, domains and an accreditation checklist were discussed and finalized. The process of accreditation of these 17 schools was initiated in 2011 according to the accreditation manual. HPSs were encouraged to undertake activities to increase their accreditation grade and were reassessed in 2013 to monitor progress. Each school was graded on the basis of the accreditation scores obtained.
  
  
  RESULTS
  The accreditation manual featured an accreditation checklist, with parameters, scores and domains. It categorized accreditation into four levels: bronze, silver, gold and platinum (each level having its own specific criteria and mandate). In 2011, more than half (52.9%) of the schools belonged to the bronze level and only 23.5% were at the gold level. Improvements were observed upon reassessment after 2 years (2013), with 76.4% of schools at the gold level and only 11.8% at bronze.
  
  
  CONCLUSIONS
  The HPS accreditation system is feasible in school settings and was well implemented in the schools of Chandigarh. Improvements in accreditation scores between 2011 and 2013 suggest that the system may be effective in increasing levels of health promotion in communities.
authors.affiliation: School of Public Health, RN Dogra Block, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India. jsthakur64@gmail.com.
authors.forename: Jarnail Singh
authors.initials: JS
authors.lastname: Thakur
authors.affiliation: School of Public Health, RN Dogra Block, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India. drdeepakpgimer@gmail.com.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
authors.affiliation: School of Public Health, RN Dogra Block, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India. nidhi.jaswal@gmail.com.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Jaswal
authors.affiliation: Advanced Paediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India. bhavneetb@yahoo.com.
authors.forename: Bhavneet
authors.initials: B
authors.lastname: Bharti
authors.affiliation: Indian Council of Medical Research (ICMR), New Delhi, India. ashoogrover@gmail.com.
authors.forename: Ashoo
authors.initials: A
authors.lastname: Grover
authors.affiliation: School Health Programme, Chandigarh Administration, Chandigarh, India. dr.paramjyoti@gmail.com.
authors.forename: Paramjyoti
authors.initials: P
authors.lastname: Thind
mesh_terms: D000068:Accreditation; D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D007194:India; D016730:Program Development; D012572:School Health Services / Q000458:organization & administration*