Potentials of a school-based health education program – a theory based analysis of a good practice

Background The gap between our knowledge about healthy lifestyle and health behaviours is significant especially in regions with lower socioeconomic conditions. Promoting lifestyle change requires multilevel approach as described by the Capability, Opportunity, Motivation - Behaviour (COM-B) model and school-based interventions can combat inequalities. Our innovative school-based health program in Northern Hungary might serve as an example for future initiatives. Objectives Our objective was to develop a sustainable one-year health education program in all five secondary schools of the town of Balassagyarmat including broad spectrum of health related topics. We attempted to find new methods so our classroom setting intervention can target the most factors of COM-B with the integration of best practices and novel tools from the field of education and prior health promotion programs. Results It seems possible to integrate elements influencing all levels of COM-B, but in different extent. C: besides knowledge transfer we also focus on improving health-literacy by small-group based, interactive and experiential education enhanced with gamification and an e-learning module. We believe that adolescents have the physical ability for a healthy lifestyle. O: by targeting all students from each class we shape social norms, nevertheless realizable changes in the physical environment is limited. M: both reflective and automatic mechanisms are reinforced by 30-day challenges and rewarding managed by a shared online educational platform ensuring continuality and peer-educators who serve as role-models. The involvement of earlier participants as educators assures the sustainability of the program as well as the internalization of its main messages. Conclusions Well-designed school-based health education programs may aspire for multilevel effect in promoting healthy behaviours even between the restricted opportunities of classroom settings with weakest potential in environmental change. Key messages Health education in classroom setting might shape social norms, and motivation. Targeting change in physical environment is challenging in school-based health programs.