Editorial: Challenges and Advances in Global School Health Promotion

Rafaela Rosário ^1,2* Kevin Dadaczynski ³

• ¹ University of Minho, Braga, Portugal
• ² The Health Sciences Research Unit, Coimbra Nursing School, Coimbra, Coimbra, Portugal
• ³ Fulda University of Applied Sciences, Fulda, Hesse, Germany

leadership, management, professional development), and environmental factors (e.g., physical infrastructure, neighborhood context) all shape health and well-being outcomes. Moreover, these settings also provide sustained opportunities to develop health-related skills, attitudes, and behaviors from an early age, fostering long-term well-being.Shortly after the adoption of the Ottawa Charter, schools emerged as a key avenue for health promotion, largely because young people spend a significant portion of their waking hours in school (3) and can be easily reached there, regardless of their socioeconomic, cultural, or religious background. For instance, between 2000 and 2023, the number of pupils in primary and secondary schools worldwide increased to around 1.41 billion (4). Within a whole-school approach, this also encompasses teachers, who numbered more than 75.53 million worldwide in 2023 (4), as well as school principals and non-teaching staff, all of whom represent a considerable portion of the global workforce. Against this background, extensive research has been conducted in recent decades, with the following emerging as the most common areas of focus: i) mental health, wellbeing, and quality of life; ii) health behaviors; iii) oral health education; iv) sexual and reproductive health education; and v) principles and practices of health promotion in schools (5).With regard to interventions the landscape can described as very heterogeneous and ranges from single actions over curricular activities focusing on the individual knowledge and behavior of pupils to complex Health Promoting School approaches addressing different target groups, topics and school levels. The multitude of developments have been brought together and continued at national and international level e.g. through networks (e.g. Schools for Health in Europe Network, UNESCO), conferences (e.g. European Conference on Health Promoting Schools) or compilations (6)(7)(8). Regularly collating and discussing the state of development is essential, particularly as new global challenges continue to emerge, requiring school health promotion to adapt and respond effectively. Beyond the long-term impact of the COVID-19 pandemic, these challenges encompass, but are not limited to, escalating political conflicts and wars, the weakening of democracy, climate change, and rapid digital advancements (e.g., artificial intelligence). While these developments drive progress in data-driven public health, they also present complex challenges in navigating and managing health information effectively (9,10). This editorial introduces the research topic, "Challenges and Advances in Global School Health Promotion," which showcases a diverse collection of studies from around the globe. These studies address critical aspects of school health promotion, presenting innovative strategies and interventions aimed at creating healthier, more equitable educational environments. A total of 24 manuscripts were selected for publication after rigorous peer review.The contributions from these 24 manuscripts, authored by 143 researchers and practitioners, exemplify a collective effort to advance understanding in this important area. These works underscore a shared commitment to improving the health and well-being of children, families, and educational communities worldwide. By tackling pressing challenges and exploring innovative solutions, this body of research makes a valuable contribution to the implementation and refinement of effective school health promotion strategies.Several manuscripts focus on the mental health and well-being of students and teachers, reflecting a growing recognition of the importance of psychological determinants of health in the school setting. For instance, the study by Granada-López et al. examines the mental health knowledge and classroom experiences of school teachers in Aragon, Spain, emphasizing the need for better training and resources to support students with mental disorders. Edwards et al. present six evidence-based principles for whole-school well-being promotion, emphasizing the integration of well-being with key school goals, building on virtuous cycles, and evaluating well-being promotion through listening to different voices. Their research provides a comprehensive framework for schools to adopt and adapt existing practices to their own contexts. Finally, two papers focus on the perspective of school staff. Svensson and Warne explore the perspectives of school staff in Sweden to deal with students' mental health issues and highlight the need for more resources and greater organizational support. In their paper, Seibt and Kreuzfeld investigate the relationship between working hours, mental health, and early retirement among part-time teachers in Germany.Their findings suggest that reducing teaching hours alone does not improve mental health, but good mental health significantly increases the likelihood of regular retirement. This underscores the need for comprehensive mental health support for teachers. The growing relevance of the ability to deal with health-related information (health literacy) is also becoming increasingly important in school health promotion. Rangnow et al. provide insights into the digital health literacy of primary and secondary school teachers in Germany, identifying