The Moscow statement on Health-promoting schools highlighted the importance of the add-in approach1. The add-in approach to health promotion describes integrating health activities into a teacher’s curriculum obligations without taking time away from these obligations. This add-in approach differs from add-on health promotion whereby a particular activity is initiated over and above the day-to-day teaching activities of a teacher. The add-in approach provides a win-win approach to health and education and results in the mobilization of additional resources and greater sustainability. The add-on and add-in approach to school health promotion was described as one of the seven key spectra in best practices for Health-promoting schools2.  This add-in approach should always be considered when schools start up a new health promotion initiative. Bentsen et al. (2018) describe three practical descriptions of this approach from Denmark3. Despite the add-in approach being easy to understand and sustainable it can be complicated in practice and requires visual and verbal support from school management. 

1. Dadaczynski, K., Jensen, B.B. Grieg Viig, N., Sormunen, M., von Seelen, J., Kuchma, V., Vilaça, M.T. on behalf of the conference participants (2019). Health, well-being and education: building a sustainable future. The Moscow Statement on Health Promoting Schools. Online available at:

2. Bartelink, N, and Bessems, K. (2019) Health promoting schools in Europe  - State of the Art. Factsheet no. 5. Online at

3. Bentsen, P.,  Bonde, A.H., Schneller, M.B., Danielsen, D., Bruselius-Jensen, M and Aagaard-Hansen J. (2020) Danish ‘add-in’ school-based health promotion: integrating health in curriculum time, Health Promotion International, Volume 35, Issue 1, Pages e70–e77,


Search the SHE glossary