Background: Schools are important avenues for promoting health and wellbeing. They enable a broad reach of children with opportunities to set healthy behaviours early in the life-course and address health inequalities. Despite the growing evidence base available to inform school health improvement, its low contribution to decision making and practice is a well-documented problem. Knowledge translation (KT) in educational settings is under-researched. Urgent design of new KT strategies should be informed by a rich understanding of the causal mechanisms sustaining the low use of evidence for either schools' core business of education or their wider health and wellbeing practices.

Research questions:
What are school practitioners’ views and experiences concerning external research evidence and its use in decision-making? What new insights can these accounts offer to guide the development of KT interventions for schools?

Methods: A systematic review and meta-ethnography was performed according to the seven phases outlined by Noblit & Hare (1988). Fourteen qualitative studies were included, reported between January 2000 and December 2015. They were identified following a rigorous search for published and unpublished literature in seven bibliographic databases and additional snowball techniques. A conceptual model and storyline was produced following re-reading of papers, reciprocal translation and line of argument synthesis.

Results: Five overarching conceptual themes emerged: i) the power of epistemologies orientated in practice; ii) symbolic meaning research-evidence holds for teachers iii) practitioners' role-identity; iv) social processes underlying the diffusion of knowledge; and v) underpinning organisational and socio-political contexts.

Conclusions: Drawing on theories of symbolic interactionism, the line of argument foregrounds the social shaping of the meaning of research and its place within the practitioner identity. Insights for the design of KT interventions in school will be discussed.