Relevant academic links

Here you can find publications written by or related to the work of the SHE Research Group to stimulate and contribute to evidence on school-based health promotion & education.


 A Comparative Study on Adolescents’ Health Literacy in Europe: Findings from the HBSC Study

Cross-sectional data from the newest Health Behavior in School-Aged Children (HBSC) study (collected in 2017–2018) were used for this study. A paper made be Leena Paakari from the SHE research group and colleagues reports the findings from ten countries (Austria, Belgium (Fl), Czechia, England, Estonia, Finland, Germany, Macedonia, Poland, and Slovakia) in total, 14,590 15-year-old pupils, and focuses on health literacy and its  associations with gender, family affluence (FAS), and self-rated health. The findings confirm that there are differences in health literacy levels within and between European countries, and that health literacy does contribute to differences in self-rated health.
Read the article.


The Creating Active Schools Framework (CAS) - a whole-school physical activity framework

Practitioners, policymakers and researchers have codesigned a whole-school Physical Activity (PA) framework, called CAS (Creating Active Schools Framework). The whole-school approach helps to expose the complexity required to create systems change. The framework can be used to shape future policy, research and practice to embed sustainable PA interventions within schools. Initial and in-service teacher training helped foster teachers’ capability, opportunity and motivation to deliver the whole-school approach and national policy supported it. Read the article 'Using a multi-stakeholder experience-based design process to co-develop the Creating Active Schools Framework' by Andy Daly-Smith et al.


COVID-19: health literacy is an underestimated problem

"Health literacy might help people to grasp the reasons behind the recommendations and reflect on outcomes of their various possible actions. However, taking social responsibility, thinking beyond personal interests, and understanding how people make choices—aspects such as ethical viewpoints and behavioural insights—should also be considered within the toolbox of health literacy". This paper by Leena Paakkari and Orkan Okan from 14th April 2020 highlights the importance of health literacy in the time of the COVID-19 pendemic. Read the article.


Health, well-being and education: Building a sustainable future. The Moscow statement on Health Promoting Schools

The purpose of this paper is to introduce the official statement of the Fifth European Conference on Health-Promoting Schools. The conference was held on 20–22 November 2019 in Moscow, Russian Federation, with over 450 participants from 40 countries. SHE has a short version of the Moscow statement on our website, but this paper presents the final statement with six thematic categories (values and principles; environment, climate and health; schools as part of the wider community; non-communicable diseases (NCDs); evidence base; and digital media), with a total of 23 recommendations and calls for action. The writing group consists of Kevin Dadaczynski, Bjarne Bruun Jensen, Nina Grieg Viig, Marjorita Sormunen, Jesper von Seelen, Vladislav Kuchma, Teresa Vilaça, all of them SHE members. Read the article.


The Role of School Leaders’ Health Literacy for the Implementation of Health Promoting Schools

Untill now, only limited empirical studies have addressed health literacy of school staff. But new research shows that the promotion of health literacy would not only result in positive effects on an individual level but also could contribute to a stronger implementation of activities on school health promotion. Read about the cross-sectional study with n = 680 school principals and members of the school management board.
See the article written by Kevin Dadaczynski, Katharina Rathmann, Thomas Hering and Orkan Okan.


Children's Views of 'The Daily Mile' - New Research

Researchers from Swansea University, Wales have published the first mixed-methods study on The Daily Mile, the school-based running programme that is delivered in over 10,000 schools worldwide. Emily Marchant from the SHE research group led the project which explored pupils, teachers and headteachers’ experiences and examined the effect on children’s fitness. Their findings provide a set of recommendations for schools for the effective implementation and sustainability of The Daily Mile. This is the first study to incorporate pupils’ views and highlights the importance of involving children in the design and delivery of programmes like The Daily Mile. See article and news article.


Effective classroom-based Preventive Intervention from Estonia

The PAX Good Behaviour Game (PAX GBG) is a behaviour management strategy that has demonstrated positive effects on children’s and teachers’ wellbeing. The intervention was adapted to Estonia in 2014 and has been implemented in 108 elementary schools. The effectiveness of PAX GBG was evaluated with a two-year, cluster-randomized controlled trial conducted during 2016-2018. This study determined that the intervention had positive and lasting effects on children’s mental health. Read about the effectiveness study.


Addressing Health Literacy in Schools in the WHO European Region

In school, all  children  have  the  right  to  receive  quality  education  on  health  literacy. Any improvement in health literacy skills may benefit the health, growth and development of children, as well as their health in later life and the health of the broader society. In a newly published article,  some  of  the  prerequisites  for  schools  to  become  key  settings  for  health  literacy development in school-aged children, is presented. The  current  state  of  school  health  literacy  policies  within  the  WHO European Region is also  being  discussed.  The article is written by Leena Paakkari, Jo Inchley, Anette Schulz, Martin Weber and Orkan Okan. Read the article.


A systematic review and quality assessment of the evidence of immersive nature-experience for children and adolescents

In this systematic review, the evidence for benefits of direct and deliberate use of public natural environments, e.g. short-termed walking or education outside the classroom, is summarised and assessed. Across heterogeneous types of nature-experience, there was shown conditional support for benefits on self-esteem, self-efficacy, resilience and academic and cognitive performance. Correlational research evidenced higher levels of physical activity in natural environments than comparison conditions. Benefits for outcomes such as self-concept, problem solving, and mood were more inconclusive. The authors are: Mygind, Bølling, Hartmeyer, Kjeldsted, Mygind, & Bentsen (July 2019). Read the review.


A Whole School Physical Activity and Nutrition Intervention

Project Spraoi is an Irish school-based physical activity (PA) and nutrition intervention that reached 473 primary school children and 43 school staff in Cork, Ireland. For 2 school years, intervention schools were assigned an ‘Energizer’, who promoted PA and healthy eating. The evaluation assessed the impact of the intervention on teachers, parents and children. The intervention was associated with smaller waist, slower resting heart rate and favourable nutritional attitudes among 10-year olds. No significant change across other variables or among 6-year olds was found. Teachers, parents and children reported positive outcomes for PA behaviour and nutritional knowledge/ attitudes. Read the article.


Positive Impact of Education Outside the Classroom on Pupil-Pupil Social Relations

Education outside the classroom (EOtC) is found to have a small but positive impact on informal peer affiliations among pupils, i.e. friendship-like relations. Social network analysis in the Danish TEACHOUT study shows that mid-school pupils establish peer affiliations to more new peers when taught school subjects outside the classroom on a weekly basis for a 38 weeks period. Teaching away from school, e.g. museums, forests, and public institutions may require transportation. Time for informal peer-to-peer interaction during transportation seems to retain existing peer affiliations, but do not contribute to new affiliations. The authors are: Bølling, Pfister, Mygind & Nielsen (2019). Read the article.


Whole school physical activity and nutrition intervention

Project Spraoi in Ireland shows two year outcomes of a whole school physical activity and nutrition intervention using the RE-AIM framework. Teachers, parents and children reported positive outcomes for physical activity behaviour and nutritional knowledge/attitudes. Project Spraoi has shown to improve heart rate and prevent further gains in fat mass amongst older aged children. The positive impact of the intervention supports the need for its continued delivery, particularly as children age. Read the article in Irish Educational Studies, The authors are: O’Leary, Rush, Lacey, Burns & Coppinger (2019).


Regular Education Outside the Classroom and Pupils’ Reading Performance

Pupils become better readers when school curricular teaching activities are relocated to places outside the classroom 2-7 hours a week. This finding is independent of subjects taught outside the classroom. No effect of curricular math teaching outside the classroom on math skills was found. These results from the quasi-experimental interventions study TEACHOUT are most important for evaluation of school-based health promotion initiatives to clarify potential positive impacts on core school agenda outcomes because educated children have a healthier lifestyle.
See research papers on education outside the classroom and children’s reading performance (article) and education outside the classroom and children’s math skills (article).


Implementing Physical Activity into Academic Lessons

A Danish study on implementing physical activity in secondary school has been published. The paper describes an intervention study examining the effect of physically active lessons on students’ educational outcomes and the teachers’ perspective on integrating physical activity into academic lessons. The results of this study are expected to provide schools and policy-makers with new insights into the potential of physical acitivity-integrated teaching in secondary school to improve academic achievement and students’ motivation in school. Authors are Ottesen and von Seelen. Read the paper.


(Re)framing school as a setting for promoting health and well-being: a double translation process.

Nordin, Jourdan & Simovska discusses how the setting approach to health promotion in schools is embedded in the Danish policy landscape and enacted at the local governance level. It shows that key principles of the setting approach to health promotion is integrated in the Danish curriculum for health education at national level. But at the municipal level the discourses of disease prevention and individual behaviour regulation has a higher priority than the treatment of schools as settings for promoting health and well-being. Read the paper.


A Transdisciplinary Complex Adaptive Systems (T-CAS) Approach to Developing a National School-Based Culture of Prevention for Health Improvement

Simon et al. describ the structure and underlying theory and approach of the School Health Research Network (SHRN). The article has been published in Prevention Science. It outlines how SHRN has used complex adaptive systems theory to embed itself into the school health system in Wales and move the system towards evidence informed policy and practice. Read the paper.


Adolescent self‐harm prevention and intervention in secondary schools: a survey of staff in England and Wales

A paper focusing on adolescent self-harm has also been published. Using SHRN questionnaire data it investigates secondary schools’ existing provision of adolescent self‐harm prevention and intervention, barriers to delivery of interventions and future needs. Authors: Evans et al. Read the paper.


Education Outside the Classroom and pupil's Social Well-being

New research shows that relocation of school curricular teaching activities to places outside the classroom is related to primary schoolchildren’s psychosocial well‐being. In a quasi-experimental study, children exposed to 2-7 hours of education outside the classroom (EOtC) in average a week for one school-year scored better on prosocial behaviour (for instance helpfulness), compared to children in controled conditions. The education took dominantly place in nature and green areas. The study was part of the Danish TEACHOUT project aiming to investigate physical activity, school motivation, well-being and learning outcomes of an EOtC school-based ‘add-in’ initiative. Research paper on EOtC and Psychosocial Well‐Being. Research paper on ‘add-in’ initiatives.


Multilevel population-based cross-sectional study examining school substance-misuse policy and the use of cannabis, mephedrone and novel psychoactive substances among students aged 11–16 years in schools in Wales

The study showed no effect on the level of drug use among students if they were involved in policy development at their school. The paper by Luke S Midgley, Simon Murphy, Graham Moore, Gillian Hewitt and James White concludes that there are needs for further contextual understanding around the policy-development process and how schools manage drug misuse. Read the paper


Schools for Health and Sustainability: Theory, Research and Practice

Schools for Health and Sustainability: Theory, Research and Practice, edited by Patricia Mannix McNamara and Venka Simovska. Springer 2015


Health Promotion International

In the journal: Health Promotion International you will find many articles written og edited by memebers of the SHE Research Group


Health Education (Emerald Journal)

Health Education (Emerald Journal) has several special issues about health promotion in schools over the years