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Aims: This study aims to explore how a local mainstream secondary school can adapt their current self-referral peer support service in order to increase its use by vulnerable Year 7 pupils, including those that experience bullying. Method: An action research methodology incorporating multiple methods of data collection was employed as a framework to support the division and implementation of an electronic peer support scheme. Qualitative methods were employed to investigate the barriers to reporting bullying and using the peer support schemes in this school. This data was used to plan adaptations to the school's current peer support schemes. Results: The study evolved over three action research cycles, with the results from each cycle informing the general action plan for the next. Reflective discussions with participants supported the development of this research study. The division and subsequent implementation of an electronic peer support scheme was accessed by pupils during a four-month period and evaluated positively by a group of Year 7 pupils. However, no pupils out of the Year 7 cohort (N = 257) accessed either the new electronic scheme or the existing face-to-face peer support scheme when they were available over the autumn term of 2010. Despite this, the levels of bullying being experienced by pupils remained the same. Focus group discussions revealed a number of barriers to reporting bullying and increasing the anonymity of the victim, when reporting was the most important way of overcoming the problem of under-reporting. The barriers to accessing peer support, as well as ways of overcoming them, were identified. Suggestions were made to inform an action plan that would contribute to overcoming problems with the scheme. The results are discussed in relation to existing literature and reflections are made in relation to the action research methodology. The study concludes with a discussion of the implications for future research and practice.

Eight schools, located in Scotland were involved in this study. Four different types of data were collected in the following order: first, 183 semi-structured interviews with a range of staff and pupils across the schools, the interviews covering questions relating to health education, promotion and ethos including quality of relationships; second, a school audit of health education and health promotion in all schools; third, Researcher observations for all schools; and, fourth, questionnaire data collected from 446 pupils across the schools. The Health Promoting School (HPS) concept is based on the belief that schools have the potential to influence their students' health and health behaviour through the school's social organisation, culture and physical environment, as well as through the formal curriculum. To date, there is little empirical evidence to test the effectiveness of the HPS, at least evidence that adjusts for known predictors of the behaviours, a standard set by the more advanced area of 'school effects' research on educational outcomes. This thesis will add to that evidence base. The aims of this study have three main components: first, to quantify 'school effects' on a range of pupils' health behaviours comprising current smoking, weekly alcohol drinking, ever tried drugs and physical activity: second, to assess the extent to which the health behaviour profile of schools are related to health promotion activity as evidenced by an audit: third, to select and analyse qualitative data from three case study schools. The purpose of the second and third aims is to investigate the extent to which school processes are associated with 'school effects' on pupils' health behaviours, triangulating data from different methodologies. The questionnaire data indicated that a strong school effect existed for smoking and drinking to a lesser degree, but not for drugs or physical activity. This addressed the first aim of this study and, in addition, provided the means by which three case study schools were selected. These were the two schools with the lowest (added value) and highest odds (lost value) for smoking after adjustment for known predictors of the health behaviours. Plus, a third school which was significantly different from the school with lowest smoking and located in the same town, as this eased interpretation of the results. Relating to the second aim, the pattern of the 'school effects' on smoking were triangulated with data from three different data sources. First, in the audit, higher levels of action on health education and health promotion were associated with lower (adjusted) rates of smoking. Second, the three case study schools were used to explore the Researcher's observations; the school with added value for smoking was rated more highly than the two with lost value. Regarding the third aim, based on qualitative data from a range of staff and pupils, the analysis showed that the school with added value had progressed furthest towards functioning as a whole school, performing best across all the areas explored. These findings theoretically triangulated with the schools low smoking rates according to the HPS concept. These results confirm the importance of school processes on students' health behaviour, particularly smoking, and support a school-wide or "Health Promoting School" approach to improving health behaviours.