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Background Evidence shows the importance of promoting awareness towards healthy nutrition; sports and health literacy in childhood, as early-incorporated behaviour often shape life-long behaviour patterns. Despite the legally formulated mission by the Austrian government to promote children's health, the available support for this purpose is still disproportionate and does not meet the expectations and demands of health care experts, insurances, and teaching staff regarding the pace and consistency of implementing necessary measures. Thus, local and regional stakeholders (e.g., insurances or education departments) are indispensable to accelerate implementation in the federal province of Tyrol. One measure is the “Quality Label Healthy School Program” which contains a strict set of requirements (e.g. healthy snacks/drinks; psychosocial health, sports and so forth) to promote the overall health of children. Methods We conducted 11 focus groups with five Participants on average to explore enabling and restricting factors, which may determine the successful implementation of the healthy school program. We recruited schools who joined the quality label and invited directly involved teachers as a source to provide insights into the practices, restricting and enabling factors for various health promotion measures. For processing the data, we used partially content analytical tools and the documentary method. Results Influencing factors include: a) lack of resource provision b) creativity in devising strategies for health promotion c) decision-making sovereignty d) support from local authorities &amp; parents e) collaboration &amp; networks f) school-specific needs &amp; circumstances g) Workload &amp; capacity and h) professional ethics. Conclusions Despite the lack of national support for required efforts, local authorities, health insurances and education departments developed own mechanisms and creative strategies to implement child health promotion. Key messages Local authorities, health insurances and education departments developed own mechanisms to promote child’s health and the teaching staff established creative strategies for its implementation. Despite the existing legally formulated mission to promote children's health in Austria, the national support made available for this purpose is still disproportionate to the required efforts.

Integrating child’s health promotion in schools – local mechanisms and strategies